Impact of introducing practical obstetric multi-professional training (PROMPT) into maternity units in Victoria, Australia

Objective: To assess the introduction of Practical Obstetric Multi-professional Training (PROMPT) into maternity units and evaluate effects on organisational culture and perinatal outcomes. Design: A retrospective cohort study. Setting: Maternity units in eight public hospitals in metropolitan and regional Victoria, Australia. Population: Staff in eight maternity units and a total of 43 408 babies born between July 2008 and December 2011. Methods: Representatives from eight Victorian hospitals underwent a single day of training (Train the Trainer), to conduct PROMPT. Organisational culture was compared before and after PROMPT. Clinical outcomes were evaluated before, during and after PROMPT. Main outcome measures: The number of courses run and the proportion of staff trained were determined. Organisational culture was measured using the Safety Attitude Questionnaire. Clinical measures included Apgar scores at 1 and 5 minutes (Apgar 1 and Apgar 5), cord lactate, blood loss and length of baby's stay in hospital. Results: Seven of the eight hospitals conducted PROMPT. Overall about 50% of staff were trained in each year of the study. Significant increases were found in Safety Attitude Questionnaire scores representing domains of teamwork (Hedges' g 0.27, 95% confidence interval [95% CI] 0.13-0.41), safety (Hedges' g 0.28, 95% CI 0.15-0.42) and perception of management (Hedges' g 0.17, 95% CI 0.04-0.31). There were significant improvements in Apgar 1 (OR 0.84, 95% CI 0.77-0.91), cord lactates (odds ratio 0.92, 95% CI 0.85-0.99) and average length of baby's stay in hospital (Hedges' g 0.03, 95% CI 0.01-0.05) during or after training, but no change in Apgar 5 scores or proportion of cases with high blood loss. Conclusion: PROMPT can be introduced using the Train the Trainer model. Improvements in organisational culture and some clinical measures were observed following PROMPT

Investigation and modelling of traffic issues in immersive audio environments

Copyright © 2004 IEEEA growing area of technical importance is that of distributed virtual environments for work and play. For the audio component of such environments to be useful, great emphasis must be placed on the delivery of high quality audio scenes in which participants may change their relative positions. In this paper we describe and analyze an algorithm focused on maintaining relative synchronization between multiple users of such an environment and examine the subjective quality of service achieved

Perils of quantitative easing

Quantitative easing compromises the control of the central bank over the stochastic path of inflation

Perils of unconventional monetary policy

Unconventional monetary policy, by relaxing restrictions on the composition of the balance sheet of the central bank, compromises control over the stochastic path of inflation; or, in open economies, over the stochastic path of exchange rates. If the composition of the balance sheet is unrestricted then the path of inflation is indeterminate. This is the case under pure quantitative easing, where the target is the size of real money balances. In contrast, credit easing policies restrict the composition of the portfolio by targeting a specific expansion in the maturity profile of bonds bought, and thus can implement a determinate path of inflation. The composition of the portfolios traded by monetary-fiscal authorities also determines premia in asset and currency markets

Calculating Nonlocal Optical Properties of Structures with Arbitrary Shape

In a recent Letter [Phys. Rev. Lett. 103, 097403 (2009)], we outlined a computational method to calculate the optical properties of structures with a spatially nonlocal dielectric function. In this Article, we detail the full method, and verify it against analytical results for cylindrical nanowires. Then, as examples of our method, we calculate the optical properties of Au nanostructures in one, two, and three dimensions. We first calculate the transmission, reflection, and absorption spectra of thin films. Because of their simplicity, these systems demonstrate clearly the longitudinal (or volume) plasmons characteristic of nonlocal effects, which result in anomalous absorption and plasmon blueshifting. We then study the optical properties of spherical nanoparticles, which also exhibit such nonlocal effects. Finally, we compare the maximum and average electric field enhancements around nanowires of various shapes to local theory predictions. We demonstrate that when nonlocal effects are included, significant decreases in such properties can occur.Comment: 30 pages, 12 figures, 1 tabl

Total energy calculation of high pressure selenium: The origin of incommensurate modulations in Se-IV and the instability of proposed Se-II

We present calculation of the high pressure crystal structures in selenium, including rational approximants to the recently reported incommensurate phases. We show how the incommensurate phases can be intuitively explained in terms of imaginary phonon frequencies arising from Kohn anomalies in the putative undistorted phase. We also find inconsistencies between the calculated and experimental Se-II phase - the calculations show it to be a metastable metal while the experiment finds a stable semiconductor. We propose that the experimentally reported structure is probably in error.Comment: 4 pages 4 figure