Contact visits for looked after children: the views of children, parents and professionals

Section A This review explored the views and experiences of children, birth parents, foster carers, social workers, and contact supervisors to provide an understanding of contact from all perspectives. A systematic search yielded 10 studies. The papers presented findings showed that establishing clear boundaries and defining roles and expectations within contact was important to promote good working relationships. Practical issues such as timing and location of contact were discussed, with good communication and information sharing between all seen as conductive to positive contact. Section B A three-round Delphi methodology was used to explore the views and experiences of care leavers, parents and professionals facilitating visits, to understand which factors define good quality contact and gain consensus across roles to understand the most important factors influencing this. Overall, 8 care leavers, 10 parents, 20 foster carers, 16 supervisors, and 15 social workers participated. Results found that all groups reached strong agreement around the importance of increased parent support and collaboration between all parties involved in contact. Clear and transparent communication was key to developing positive relationships ensuring good quality contact. The need for increased support and training for professionals was also discussed

The significance of periventricular leukomalacia on ophthalmic outcome

Aim: Periventricular leukomalacia (PVL) is a type of cerebral white matter damage commonly arising within neonates born prematurely. This review aims to evaluate the literature relating to the long-term ophthalmic outcomes following PVL, focussing on the relationship between neuro-imaging and visual out- come. Methods: A literature review was undertaken between October 2013 and January 2015. Articles were sourced using PubMed, ResearchGate and forward citation searches. Results: PVL is shown to increase an individual’s chance of developing ocular defects, namely cerebral visual impairment, strabismus, visual field defects and visuoperceptual anomalies. The severity and extent of PVL is directly proportional to both the chance of developing an ocular defect, and the severity of said ocular defect; however, there is not a perfect correlation and ophthalmic outcome is specific to each individual. There have also been reports of strabismus being the presenting factor, leading to an investigation which revealed the presence of PVL that had been missed during the neonatal period. Neuro-imaging has been shown to have some predictive ability, varying depending on the area of the visual pathway examined, and the aspect of visual outcome predicted. Conclusions: While predictive results gathered via neuro-imaging can offer insight into visual outcome, these must be consolidated through non-radiological clinical testing. Strabismus has been documented as a presenting factor in patients with PVL. Therefore the initial presentation of a patient with PVL, where the diagnosis has been missed during the neonatal period, may be through the orthoptic department

Facilitating LOS Debriefings: A Training Manual

This manual is a practical guide to help airline instructors effectively facilitate debriefings of Line Oriented Simulations (LOS). It is based on a recently completed study of Line Oriented Flight Training (LOFT) debriefings at several U.S. airlines. This manual presents specific facilitation tools instructors can use to achieve debriefing objectives. The approach of the manual is to be flexible so it can be tailored to the individual needs of each airline. Part One clarifies the purpose and objectives of facilitation in the LOS setting. Part Two provides recommendations for clarifying roles and expectations and presents a model for organizing discussion. Part Tree suggests techniques for eliciting active crew participation and in-depth analysis and evaluation. Finally, in Part Four, these techniques are organized according to the facilitation model. Examples of how to effectively use the techniques are provided throughout, including strategies to try when the debriefing objectives are not being fully achieved

LOFT Debriefings: An Analysis of Instructor Techniques and Crew Participation

This study analyzes techniques instructors use to facilitate crew analysis and evaluation of their Line-Oriented Flight Training (LOFT) performance. A rating instrument called the Debriefing Assessment Battery (DAB) was developed which enables raters to reliably assess instructor facilitation techniques and characterize crew participation. Thirty-six debriefing sessions conducted at five U.S. airlines were analyzed to determine the nature of instructor facilitation and crew participation. Ratings obtained using the DAB corresponded closely with descriptive measures of instructor and crew performance. The data provide empirical evidence that facilitation can be an effective tool for increasing the depth of crew participation and self-analysis of CRM performance. Instructor facilitation skill varied dramatically, suggesting a need for more concrete hands-on training in facilitation techniques. Crews were responsive but fell short of actively leading their own debriefings. Ways to improve debriefing effectiveness are suggested

An evaluation of the implementation of Advanced Nurse Practitioner (ANP) roles in an acute hospital setting.

Aim: To evaluate the impact of implementing Advanced Nurse Practitioner roles on patients, staff members and organizational outcomes in an acute hospital. Background: The worldwide development of advanced practice roles in nursing has been influenced by increasing demands and costs of health care. A key issue in the UK has been the reduction in hours junior doctors can work. While there is evidence these roles can have a positive impact in a variety of clinical specialties, little is known about the impact advanced nurses substituting for junior doctors can have on patients, staff members and organizational outcomes in general hospital care settings. Design: Collective case study. Methods: A collective case study in a district general hospital in England was undertaken in 2011–2012. Interviews with strategic stakeholders (n = 13) were followed by three individual case studies. Each case study represented the clinical area in which the roles had been introduced: medicine, surgery and orthopaedics and included interviews (n = 32) and non-participant observation of practice. Findings: The ANPs had a positive impact on patient experience, outcomes and safety. They improved staff knowledge, skills and competence and enhanced quality of working life, distribution of workload and team-working. ANPs contributed to the achievement of organizational priorities and targets and development of policy. Conclusion: ANPs undertaking duties traditionally performed by junior doctors in acute hospital settings can have a positive impact on a range of indicators relating to patients, staff members and organizational outcomes which are highly relevant to nursing

Demonstration of a Quantum Gate using Electromagnetically Induced Transparency

We demonstrate a native $\mathrm{CNOT}$ gate between two individually addressed neutral atoms based on electromagnetically induced transparency (EIT). This protocol utilizes the strong long-range interactions of Rydberg states to enable conditional state transfer on the target qubit when operated in the blockade regime. An advantage of this scheme is it enables implementation of multi-qubit CNOT$^k$ gates using a pulse sequence independent of qubit number, and provides an simple gate for efficient implementation of quantum algorithms and error correction. We achieve a loss corrected gate fidelity of $\mathcal{F}_\mathrm{CNOT}^\mathrm{cor} = 0.82(6)$, and prepare an entangled Bell-state with $\mathcal{F}_\mathrm{Bell}^\mathrm{cor} = 0.66(5)$, limited at present by laser power. We present a number of technical improvements to advance this to a level required for fault-tolerant scaling.Comment: 6 pages, 5 figures plus Supplementary Materia

Endothelial progenitor cells control the angiogenic switch in mouse lung metastasis

Angiogenesis-mediated progression of micrometastasis to lethal macrometastasis is the major cause of death in cancer patients. Here, using mouse models of pulmonary metastasis, we identify bone marrow (BM)-derived endothelial progenitor cells (EPCs) as critical regulators of this angiogenic switch. We show that tumors induce expression of the transcription factor Id1 in the EPCs and that suppression of Id1 after metastatic colonization blocked EPC mobilization, caused angiogenesis inhibition, impaired pulmonary macrometastases, and increased survival of tumor-bearing animals. These findings establish the role of EPCs in metastatic progression in preclinical models and suggest that selective targeting of EPCs may merit investigation as a therapy for cancer patients with lung metastases

GEO debris and interplanetary dust: fluxes and charging behavior

In September 1996, a dust/debris detector: GORID was launched into the geostationary (GEO) region as a piggyback instrument on the Russian Express-2 telecommunications spacecraft. The instrument began its normal operation in April 1997 and ended its mission in July 2002. The goal of this work was to use GORID's particle data to identify and separate the space debris to interplanetary dust particles (IDPs) in GEO, to more finely determine the instrument's measurement characteristics and to derive impact fluxes. While the physical characteristics of the GORID impacts alone are insufficient for a reliable distinction between debris and interplanetary dust, the temporal behavior of the impacts are strong enough indicators to separate the populations based on clustering. Non-cluster events are predominantly interplanetary, while cluster events are debris. The GORID mean flux distributions (at mass thresholds which are impact speed dependent) for IDPs, corrected for dead time, are 1.35x10^{-4} m^{-2} s^{-1} using a mean detection rate: 0.54 d^{-1}, and for space debris are 6.1x10^{-4} m^{-2} s^{-1} using a mean detection rate: 2.5 d^{-1}. Beta-meteoroids were not detected. Clusters could be a closely-packed debris cloud or a particle breaking up due to electrostatic fragmentation after high charging.Comment: * Comments: 6 pages, 4 postscript figures, in Dust in Planetary Systems 2005, Krueger, H. and Graps, A. eds., ESA Publications, SP in press (2006). For high resolution version, see: http://www.mpi-hd.mpg.de/dustgroup/~graps/dips2005/GrapsetalDIPS2005.pd