'Oh no, no, no, we haven't got time to be doing that': Challenges encountered introducing a breast-feeding support intervention on a postnatal ward

Objective: to identify elements in the environment of a postnatal ward which impacted on the introduction of a breast-feeding support intervention. Design: a concurrent, realist evaluation including practice observations and semi-structured interviews. Setting: a typical British maternity ward. Participants: five midwives and two maternity support workers were observed. Seven midwives and three maternity support workers were interviewed. Informed consent was obtained from all participants. Ethical approval was granted by the relevant authorities. Findings: a high level of non-compliance with the intervention was driven by a lack of time and staff, and the ward staffs' lack of control of the organisation of their time and space. This was compounded by a propensity towards task orientation, workload reduction and resistance to change - all of which supported the existing medical approach to care. Limited support for the intervention was underpinned by staff willingness to reconsider their views and a widespread frustration with current ways of working. Key conclusions: this small, local study suggests that the environment and working conditions on a typical British postnatal ward present significant barriers to the introduction of breast-feeding support interventions requiring a relational approach to care. Implications for practice: midwives and maternity support workers need to be able to control their time and space, and feel able to provide the relational care they perceive that women need, before breast-feeding support interventions can be successfully implemented in practice. Frustration with current ways of working, and a willingness to consider other approaches, could be harnessed to initiate change that would benefit health professionals and the women and families in their care. However, without appropriate leadership or facilitation for change, this could alternatively encourage learned helplessness and passive resistance

Engineering - young people want to be informed

Young people in developed nations recognise the contribution that science and technology make to society and acknowledge their importance now and in the future, yet few view their study as leading to interesting careers. Some countries are taking action to raise interest in science, technologies, engineering and mathematics and increase the number of students studying these subjects. One of the barriers to young people pursuing engineering is their limited or distorted perception of it - they associate it only with building and fixing things. Young people rarely encounter engineers, unlike other professionals, engineering has little or no advocacy in the media and there are few opportunities to experience engineering. Many of the pupils surveyed at the start of Engineering the Future, a three year EPSRC-funded project, wrote “don’t know what engineering is” and/or “would like more information”. This paper reports on work with researchers, policy makers and practitioners in Scotland to develop a sustainable model of activities and interactions that develops pupils’ understanding of the nature of engineering, embeds experiences of engineering within the school classroom and curriculum and promotes engineering as a career. After learning about engineering through the activities the pupils’ perceptions had improved. Almost all considered it important that young people know about engineering, because it is an essential part of everyday life and, in the words of one pupil - “If we know more about it, our minds wouldn’t stay closed to it. We would maybe take it up.

Using Artificial Intelligence to Identify Perpetrators of Technology Facilitated Coercive Control.

This study investigated the feasibility of using Artificial Intelligence to identify perpetrators of coercive control through digital data held on mobile phones. The research also sought the views of the police and victim/survivors of domestic abuse to using technology in this way

Co- Creating a Blended learning Curriculum in Transition to Higher Education: A Student Viewpoint.

Involving students in the design and development of their curriculum is well established in Higher Education but comes with challenges and concerns for both the staff and students. This is not a simple concept and understanding more about the experiences of the student co-creators supports others in developing this aspect of curriculum design. This small scale project uses the individual and collective voices of five second year students who worked with one programme team to co-create a transition module to support new learners entering university. The study explores the co-creation experience and the student’s response to the feedback their co-created curriculum received when it was run for the first time. The study was designed to consider if co-creation of a module was beneficial to the students involved in its co-creation. The findings explored issues in relation to the experience, the actual design of the materials and how this could be developed. The students enjoyed the co-creation, felt appreciated and listened to and felt that this was a positive learning experience. They realised how difficult it is to please everybody and gained a much better appreciation of building learning experiences for others to use. The research highlights the fact that with regards to curriculum development within universities that students should be involved in co-creation as they have an understanding of the requirements of learning form a student perspective. Whilst student satisfaction cannot be necessarily be measured directly, the anecdotal comments from students involved in this project as they graduate are the values they place on the opportunities afforded to them

Snowmass 2001: Jet Energy Flow Project

Conventional cone jet algorithms arose from heuristic considerations of LO hard scattering coupled to independent showering. These algorithms implicitly assume that the final states of individual events can be mapped onto a unique set of jets that are in turn associated with a unique set of underlying hard scattering partons. Thus each final state hadron is assigned to a unique underlying parton. The Jet Energy Flow (JEF) analysis described here does not make such assumptions. The final states of individual events are instead described in terms of flow distributions of hadronic energy. Quantities of physical interest are constructed from the energy flow distribution summed over all events. The resulting analysis is less sensitive to higher order perturbative corrections and the impact of showering and hadronization than the standard cone algorithms.Comment: REVTeX4, 13 pages, 6 figures; Contribution to the P5 Working Group on QCD and Strong Interactions at Snowmass 200

MICROMEGAS chambers for hadronic calorimetry at a future linear collider

Prototypes of MICROMEGAS chambers, using bulk technology and analog readout, with 1x1cm2 readout segmentation have been built and tested. Measurements in Ar/iC4H10 (95/5) and Ar/CO2 (80/20) are reported. The dependency of the prototypes gas gain versus pressure, gas temperature and amplification gap thickness variations has been measured with an 55Fe source and a method for temperature and pressure correction of data is presented. A stack of four chambers has been tested in 200GeV/c and 7GeV/c muon and pion beams respectively. Measurements of response uniformity, detection efficiency and hit multiplicity are reported. A bulk MICROMEGAS prototype with embedded digital readout electronics has been assembled and tested. The chamber layout and first results are presented

Molecular and epidemiologic analysis of dengue virus isolates from Somalia.

Nucleotide sequence analysis was performed on 14 dengue virus isolates (13 dengue-2 viruses and 1 dengue-3 virus) recovered from febrile soldiers in Somalia in 1993. The dengue-2 viruses were most closely related to dengue-2 virus recovered in Somalia in 1984. However, differences in nucleotide sequence (0.35% to 1.35%) were evident among the 1993 isolates. These differences were closely associated with the geographic location of the infection as well as with different times of infection at the same location. Genetic difference between strains was not associated with differences in clinical features. Molecular analysis of dengue viruses is a useful adjunct to epidemiologic investigation of their distribution over distance and time

The association between mentoring and training outcomes in junior doctors in medicine: an observational study.

OBJECTIVE: To determine quantitatively if a positive association exists between the mentoring of junior doctors and better training outcomes in postgraduate medical training within the UK. DESIGN: Observational study. PARTICIPANTS: 117 trainees from the East of England Deanery (non-mentored group) and the recently established Royal College of Physicians (RCP) Mentoring scheme (mentored group) who were core medical trainees (CMTs) between 2015 and 2017 completed an online survey. Trainees who received mentoring at the start of higher specialty training, incomplete responses and trainees who were a part of both the East of England deanery and RCP Mentoring scheme were excluded leaving 85 trainees in the non-mentored arm and 25 trainees in the mentored arm. Responses from a total of 110 trainees were analysed. MAIN OUTCOME MEASURES: Pass rates of the various components of the Membership of the Royal College of Physicians (MRCP) (UK) examination (MRCP Part 1, MRCP Part 2 Written and MRCP Part 2 PACES), pass rates at the Annual Review of Competency Progression (ARCP), trainee involvement in significant events, clinical incidents or complaints and trainee feedback on career progression and confidence. RESULTS: Mentored trainees reported higher pass rates of the MRCP Part 1 exam versus non-mentored trainees (84.0% vs 42.4%, p<0.01). Mentored international medical graduates (IMGs) reported higher pass rates than non-mentored IMGs in the MRCP Part 2 Written exam (71.4% vs 24.0%, p<0.05). ARCP pass rates in mentored trainees were observed to be higher than non-mentored trainees (95.8% vs 69.9%, p<0.05). Rates of involvement in significant events, clinical incidents and complaints in both groups did not show any statistical difference. Mentored trainees reported higher confidence and career progression. CONCLUSIONS: A positive association is observed between the mentoring of CMTs and better training outcomes. Further studies are needed to investigate the causative effects of mentoring in postgraduate medical training within the UK

Predicate Abstraction for Linked Data Structures

We present Alias Refinement Types (ART), a new approach to the verification of correctness properties of linked data structures. While there are many techniques for checking that a heap-manipulating program adheres to its specification, they often require that the programmer annotate the behavior of each procedure, for example, in the form of loop invariants and pre- and post-conditions. Predicate abstraction would be an attractive abstract domain for performing invariant inference, existing techniques are not able to reason about the heap with enough precision to verify functional properties of data structure manipulating programs. In this paper, we propose a technique that lifts predicate abstraction to the heap by factoring the analysis of data structures into two orthogonal components: (1) Alias Types, which reason about the physical shape of heap structures, and (2) Refinement Types, which use simple predicates from an SMT decidable theory to capture the logical or semantic properties of the structures. We prove ART sound by translating types into separation logic assertions, thus translating typing derivations in ART into separation logic proofs. We evaluate ART by implementing a tool that performs type inference for an imperative language, and empirically show, using a suite of data-structure benchmarks, that ART requires only 21% of the annotations needed by other state-of-the-art verification techniques