Effects of surface condition on Barkhausen emissions from steel

Temperature changes during mechanical processing such as grinding of steel parts can cause phase changes in the microstructure. Thermal shock during the process can give rise to localized surface residual stress. The net result can be reduced wear resistance and fatigue life leading to early failure during service. Effective methods for the detection of such damage are necessary. Barkhausen emissions, which arise from discontinuous motion of domain walls, are sensitive to microstructual changes that affect domain dynamics. Detected Barkhausen signals are predominantly from a surface layer about 200 μm thick, those from deeper being attenuated due to eddy currents. An analysis of the detected signals can provide an indication of the surface condition of the material.Barkhausen signals from parts ground under controlled conditions were found to be dependent on the grinding process conditions. The signal changes were consistent with residual stress measured by x‐ray diffraction and with hardness measurements that are indicative of changes in microstructure

Recruiting general practitioners in England to participate in qualitative research : challenges, strategies, and solutions

In 2012, I conducted my first PhD study exploring general practitioners’ attitudes toward online patient feedback. After designing the research questions and topic guide to conduct the interviews, I reviewed existing literature where authors described recruiting general practitioners to take part in research. I found there was some focus in the literature on the challenges associated with low general practitioner participation in survey-based and intervention studies, but little that described the process, experience, and challenges associated with recruiting general practitioners to take part in qualitative research. Although general practitioners are known to be a difficult group to recruit to take part in research, the recruitment process I experienced was much more challenging than I had anticipated. This case study sheds light on my experience of recruiting 20 general practitioners in England to an interview-based study, and outlines a critical reflection on the eight strategies used for recruitment. I started by using traditional methods such as postal invitations and faxes to recruit general practitioners. Due to the very low success rate, I resorted to using more inexpensive and creative methods, such as sending an invitation letter through email, advertising in general practitioner Email Newsletters, seeking help from existing research networks, recruiting through friends and acquaintances, and using social media. In this case study, I also describe the participants’ (general practitioners’) motivations for taking part in the study, and I conclude with offering suggestions on how to maximize response rates to general practitioner-based qualitative studies in England

Exploring patients’ views toward giving web-based feedback and ratings to general practitioners in England : a qualitative descriptive study

Background: Patient feedback websites or doctor rating websites are increasingly being used by patients to give feedback about their health care experiences. There is little known about why patients in England may give Web-based feedback and what may motivate or dissuade them from giving Web-based feedback. Objective: The aim of this study was to explore patients’ views toward giving Web-based feedback and ratings to general practitioners (GPs), within the context of other feedback methods available in primary care in England, and in particular, paper-based feedback cards. Methods: A descriptive exploratory qualitative approach using face-to-face semistructured interviews was used in this study. Purposive sampling was used to recruit 18 participants from different age groups in London and Coventry. Interviews were transcribed verbatim and analyzed using applied thematic analysis. Results: Half of the participants in this study were not aware of the opportunity to leave feedback for GPs, and there was limited awareness about the methods available to leave feedback for a GP. The majority of participants were not convinced that formal patient feedback was needed by GPs or would be used by GPs for improvement, regardless of whether they gave it via a website or on paper. Some participants said or suggested that they may leave feedback on a website rather than on a paper-based feedback card for several reasons: because of the ability and ease of giving it remotely; because it would be shared with the public; and because it would be taken more seriously by GPs. Others, however, suggested that they would not use a website to leave feedback for the opposite reasons: because of accessibility issues; privacy and security concerns; and because they felt feedback left on a website may be ignored. Conclusions: Patient feedback and rating websites as they currently are will not replace other mechanisms for patients in England to leave feedback for a GP. Rather, they may motivate a small number of patients who have more altruistic motives or wish to place collective pressure on a GP to give Web-based feedback. If the National Health Service or GP practices want more patients to leave Web-based feedback, we suggest they first make patients aware that they can leave anonymous feedback securely on a website for a GP. They can then convince them that their feedback is needed and wanted by GPs for improvement, and that the reviews they leave on the website will be of benefit to other patients to decide which GP to see or which GP practice to join

General practitioners’ concerns about online patient feedback : findings from a descriptive exploratory qualitative study in England

Background: The growth in the volume of online patient feedback, including online patient ratings and comments, suggests that patients are embracing the opportunity to review online their experience of receiving health care. Very little is known about health care professionals’ attitudes toward online patient feedback and whether health care professionals are comfortable with the public nature of the feedback. Objective: The aim of the overall study was to explore and describe general practitioners’ attitudes toward online patient feedback. This paper reports on the findings of one of the aims of the study, which was to explore and understand the concerns that general practitioners (GPs) in England have about online patient feedback. This could then be used to improve online patient feedback platforms and help to increase usage of online patient feedback by GPs and, by extension, their patients. Methods: A descriptive qualitative approach using face-to-face semistructured interviews was used in this study. A topic guide was developed following a literature review and discussions with key stakeholders. GPs (N=20) were recruited from Cambridgeshire, London, and Northwest England through probability and snowball sampling. Interviews were transcribed verbatim and analyzed in NVivo using the framework method, a form of thematic analysis. Results: Most participants in this study had concerns about online patient feedback. They questioned the validity of online patient feedback because of data and user biases and lack of representativeness, the usability of online patient feedback due to the feedback being anonymous, the transparency of online patient feedback because of the risk of false allegations and breaching confidentiality, and the resulting impact of all those factors on them, their professional practice, and their relationship with their patients. Conclusions: The majority of GPs interviewed had reservations and concerns about online patient feedback and questioned its validity and usefulness among other things. Based on the findings from the study, recommendations for online patient feedback website providers in England are given. These include suggestions to make some specific changes to the platform and the need to promote online patient feedback more among both GPs and health care users, which may help to reduce some of the concerns raised by GPs about online patient feedback in this study

Public awareness, usage and predictors for the use of doctor rating websites : a cross-sectional study in England

Background: With the advent and popularity of social media and consumer rating websites, as well as the emergence of the digitally engaged patient, there has been an increased interest in doctor rating websites or online patient feedback (OPF) websites, both inside and outside academia. There is however little known about how the public across England view such rating websites as a medium to give patient experience feedback. Objective: The aim was to measure and understand public awareness and usage of doctor rating websites as a mode to give experiential feedback about GPs in general practice in England, within the context of other feedback methods, so that the value of OPF websites from the patients’ perspective could be determined. Methods: A mixed methods population questionnaire was designed, validated and implemented face to face using a cross-sectional design with a representative sample of the public (n=844) in England. The results of the questionnaire were analysed using chi square tests, binomial logistic regressions and content analysis. Results: Public awareness of OPF websites as a channel to leave experiential feedback about GPs was found to be low at 15% (128/844); however, usage and future consideration to use OPF websites was found to be extremely low, with current patient usage at just 0.36% (3/844), and patient intention to use OPF in the future at 18% (150/844). Furthermore, only 4-5% of those who would consider leaving feedback in the future selected doctor rating websites as their most preferred method to leave feedback about a GP, and more than half of patients said they would consider leaving feedback about GPs using another method, but not using an OPF website. Conclusions: The findings appear to suggest that OPF websites may not be an effective channel for collecting feedback on patient experience in general practice, and feedback on OPF websites is not likely to be representative of the patient experience in the near future. This challenges the use of OPF not just as a mode for collecting patient experience data, but for patient choice and monitoring too. We recommend the NHS to channel its investment and resources towards providing more direct and private feedback methods in general practice (such as opportunities for face-to-face feedback, email-based feedback and web-based private feedback forms), as these are much more likely to be used currently by the majority of patients in England. Keywords: online reviews; Physician quality; Primary Care; Internet; Quality patient empowerment; quality transparency; public reporting

An integrated safety measurement model : a new perspective for performance measurement

Performance measurement systems provide an opportunity not only to determine if organisations are effectively delivering their strategy and meeting their vision, but also to enable improvements. In 2009, the NHS implemented the NHS Performance Framework (Department of Health 2009), which has since been altered yearly in line with changing governments and policy alterations. Although originally designed to be applied to Primary Care Trusts (PCTs) from April 2010, the NHS reform, which seeks the replacement of PCTs with GP Consortia, has rendered the framework redundant in primary care (Department of Health 2010a). Since then, the NHS Outcomes Framework (Department of Health 2010b) has been published, and focuses on 5 outcome domains that are expected to show national level performance across the whole of the NHS. This high level system has failed to provide a performance picture of any individual service, of which there are many, in addition to proving reliant on outcome (lagging) indicators which have long been recognised as a poor singular method for measuring performance (Eccles and Pyburn 1992; Kaplan and Norton 1992). This study advocates service specific performance measurement and the engagement of stakeholders during the design process to develop leading and lagging indicators of value to the stakeholders. This is in particular with efforts to shift the onus onto patients to maintain health; as is true of the case management programme, which forms the case study for this research. The case management programme aims to reduce expensive hospital admissions for patients with complex long term conditions (LTCs) (Department of Health 2005). It expects to be able to achieve this by implementing a case management approach to oversee the most at risk patients, to develop an integrated care plan and to empower patients to become actively involved in their care at home. This paper will present the underlying literature that supports the development of a safety measurement model and describes the methodology used to gain validation by a key stakeholder group

Innovation by Degrees

The innovative ability of an individual is only partly inherent. With an appropriate balance of education, training and experience, this ability can be developed. This paper describes a new research degree – the Engineering Doctorate – which can provide this balance. The basic principles of the EngD are described, as are the benefits and industrial relevance of the programme. Its main features are a requirement for innovation in the application of knowledge to industrial business and a high level of flexibility. It is also shown to be suitable for engineers at all career stages from fresh graduate to director level. </jats:p