Benefits and challenges of electronic prescribing for general practitioners and pharmacists in regional Australia

Objective: To explore the benefits and challenges of electronic prescribing (e-prescribing) for general practitioners (GPs) and pharmacists in regional New South Wales (NSW). Methods: This qualitative study utilised semistructured interviews conducted virtually or in-person between July and September 2021. Setting and Participants: General practitioners and pharmacists practising in Bathurst NSW. Main Outcomes: Self-reported perceived and experienced benefits and challenges of e-prescribing. Results: Two GPs and four pharmacists participated in the study. Reported benefits of e-prescribing included improvement in the prescribing and dispensing process, patient adherence, and prescription safety and security. The increased convenience for the patients was appreciated particularly during the COVID-19 pandemic. Challenges discussed were how the system was perceived to be unsafe and insecure, costs of messaging and updating general practice software, utilisation of new systems and patient awareness. Pharmacists reported the need for education to patients and staff to minimise the impact of inexperience with the novel technology on workflow efficacy. Conclusion: This study provided first insight and information on the perspectives of GPs and pharmacists 12 months after the implementation of e-prescribing. Further nationwide studies are required to consolidate these findings; provide comparisons with the system's progress since conception; determine whether metropolitan and rural health care professionals share similar perspectives; and shed light on where additional government support may be required

Preliminary surface charging analysis of Ariel payload dielectrics in early transfer orbit and L2-relevant space environment

Ariel [1] is the M4 mission of the ESA’s Cosmic Vision Program 2015-2025, whose aim is to characterize by lowresolution transit spectroscopy the atmospheres of over one thousand warm and hot exoplanets orbiting nearby stars. The operational orbit of the spacecraft is baselined as a large amplitude halo orbit around the Sun-Earth L2 Lagrangian point, as it offers the possibility of long uninterrupted observations in a fairly stable radiative and thermo-mechanical environment. A direct escape injection with a single passage through the Earth radiation belts and no eclipses is foreseen. The space environment around Earth and L2 presents significant design challenges to all spacecraft, including the effects of interactions with Sun radiation and charged particles owning to the surrounding plasma environment, potentially leading to dielectrics charging and unwanted electrostatic discharge (ESD) phenomena endangering the Payload operations and its data integrity. Here, we present some preliminary simulations and analyses about the Ariel Payload dielectrics and semiconductors charging along the transfer orbit from launch to L2 include

Protected silver coating for Ariel telescope mirrors: study of ageing effects

The Atmospheric Remote-sensing Infrared Exoplanet Large-survey (Ariel), selected as ESA’s fourth mediumclass mission in the Cosmic Vision program, is set to launch in 2029. The objective of the study is to conduct spectroscopic observations of approximately one thousand exoplanetary atmospheres for better understanding the planetary system formation and evolution and identifying a clear link between the characteristics of an exoplanet and those of its parent star. The realization of the Ariel’s telescope is a challenging task that is still ongoing. It is an off-axis Cassegrain telescope (M1 parabola, M2 hyperbola) followed by a re-collimating off-axis parabola (M3) and a plane fold mirror (M4). It is made of Al 6061 and designed to operate at visible and infrared wavelengths. The mirrors of the telescope will be coated with protected silver, qualified to operate at cryogenic temperatures. The qualification of the coating was performed according to the ECSS Q-ST-70-17C standard, on a set of samples that have been stored in ISO 6 cleanroom conditions and are subjected to periodic inspection and reflectance measurements to detect any potential performance degradation. The samples consist of a set of Aluminum alloy Al 6061-T651 disks coated with protected silver. This paper presents the results of the morphological characterization of the samples based on Atomic Force Microscopy (AFM) and the reflectivity measurement in the infrared by Fourier Transform Infrared (FTIR) spectroscopy

A chemical survey of exoplanets with ARIEL

Thousands of exoplanets have now been discovered with a huge range of masses, sizes and orbits: from rocky Earth-like planets to large gas giants grazing the surface of their host star. However, the essential nature of these exoplanets remains largely mysterious: there is no known, discernible pattern linking the presence, size, or orbital parameters of a planet to the nature of its parent star. We have little idea whether the chemistry of a planet is linked to its formation environment, or whether the type of host star drives the physics and chemistry of the planet’s birth, and evolution. ARIEL was conceived to observe a large number (~1000) of transiting planets for statistical understanding, including gas giants, Neptunes, super-Earths and Earth-size planets around a range of host star types using transit spectroscopy in the 1.25–7.8 μm spectral range and multiple narrow-band photometry in the optical. ARIEL will focus on warm and hot planets to take advantage of their well-mixed atmospheres which should show minimal condensation and sequestration of high-Z materials compared to their colder Solar System siblings. Said warm and hot atmospheres are expected to be more representative of the planetary bulk composition. Observations of these warm/hot exoplanets, and in particular of their elemental composition (especially C, O, N, S, Si), will allow the understanding of the early stages of planetary and atmospheric formation during the nebular phase and the following few million years. ARIEL will thus provide a representative picture of the chemical nature of the exoplanets and relate this directly to the type and chemical environment of the host star. ARIEL is designed as a dedicated survey mission for combined-light spectroscopy, capable of observing a large and well-defined planet sample within its 4-year mission lifetime. Transit, eclipse and phase-curve spectroscopy methods, whereby the signal from the star and planet are differentiated using knowledge of the planetary ephemerides, allow us to measure atmospheric signals from the planet at levels of 10–100 part per million (ppm) relative to the star and, given the bright nature of targets, also allows more sophisticated techniques, such as eclipse mapping, to give a deeper insight into the nature of the atmosphere. These types of observations require a stable payload and satellite platform with broad, instantaneous wavelength coverage to detect many molecular species, probe the thermal structure, identify clouds and monitor the stellar activity. The wavelength range proposed covers all the expected major atmospheric gases from e.g. H2O, CO2, CH4 NH3, HCN, H2S through to the more exotic metallic compounds, such as TiO, VO, and condensed species. Simulations of ARIEL performance in conducting exoplanet surveys have been performed – using conservative estimates of mission performance and a full model of all significant noise sources in the measurement – using a list of potential ARIEL targets that incorporates the latest available exoplanet statistics. The conclusion at the end of the Phase A study, is that ARIEL – in line with the stated mission objectives – will be able to observe about 1000 exoplanets depending on the details of the adopted survey strategy, thus confirming the feasibility of the main science objectives.Peer reviewedFinal Published versio

Planning the integration and test of a space telescope with a 1 m aluminum primary mirror: the Ariel mission case

Ariel (Atmospheric Remote-Sensing Infrared Exoplanet Large Survey) is ESA’s M4 mission of the “Cosmic Vision” program, with launch scheduled for 2029. Its purpose is to conduct a survey of the atmospheres of known exoplanets through transit spectroscopy. Ariel is based on a 1 m class telescope optimized for spectroscopy in the waveband between 1.95 and 7.8 µm, operating at cryogenic temperatures in the range 40–50 K. The Ariel Telescope is an off-axis, unobscured Cassegrain design, with a parabolic recollimating tertiary mirror and a flat folding mirror directing the output beam parallel to the optical bench. The secondary mirror is mounted on a roto-translating stage for adjustments during the mission. The mirrors and supporting structures are all realized in an aerospace-grade aluminum alloy T6061 for ease of manufacturing and thermalization. The low stiffness of the material, however, poses unique challenges to integration and alignment. Care must be therefore employed when designing and planning the assembly and alignment procedures, necessarily performed at room temperature and with gravity, and the optical performance tests at cryogenic temperatures. This paper provides a high-level description of the Assembly, Integration and Test (AIT) plan for the Ariel telescope and gives an overview of the analyses and reasoning that led to the specific choices and solutions adopted

Patient participation in nursing bedside handover: a systematic mixed-methods review

Background: Numerous reviews of nursing handover have been undertaken, but none have focused on the patients’ role. Objectives: To explore how patient participation in nursing shift-to-shift bedside handover can be enacted. Design: Systematic mixed-methods review. Data sources: Three search strategies were undertaken in July-August 2016: database searching, backwards citation searching and forward citation searching. To be included, papers had to either be research or quality improvement (QI) projects focusing on the patient role. Fifty-four articles were retrieved, including 21 studies and 25 QI projects. Review methods: Screening, data extraction and quality appraisal was undertaken systematically by two reviewers. Research studies and QI projects were synthesised separately using thematic synthesis, then the results of this synthesis were combined using a mixed-method synthesis table. Results: Segregated synthesis of research of patients’ perceptions revealed two contrasting categories; (1) patient-centred handover and (2) nurse-centred handover. Segregated synthesis of research of nurses’ perceptions included three categories: (1) viewing the patient as an information resource; (2) dealing with confidential and sensitive information; and (3) enabling patient participation. The segregated synthesis of QI projects included two categories: (1) nurse barrier to enacting patient participation in bedside handover; and (2) involving patients in beside handover. Once segregated findings were configured, we discovered that the patients’ role in bedside handover involves contributing clinical information related to their care or progress, which may affect patient safety. Barriers relate to nurses’ concerns for the consequences of encouraging patient participation, worries for sharing confidential and sensitive information and feeling hesitant in changing their handover methods. The way nurses approach patients, and how patient-centred they are, constitute further potential barriers. Strategies to improve patient participation in handover include training nurses, making handovers predictable for patients and involving both patients and nurses throughout the change process. Conclusions: Using research and QI projects allowed diverse findings to expand each other and identify gaps between research and heuristic knowledge. Our review showed the tension between standardising handovers and making them predictable for patient participation, while promoting tailored and flexible handovers. Further investigation of this issue is required, to understand how to train nurses and ensure patients’ viewpoint is captured. Many barriers and strategies identified QI projects were from the nurse perspective, thus caution interpreting results is required. We recommend steps be taken in the future to ensure improved quality of QI projects

The Ariel payload design post-PDR

The Ariel space mission will characterize spectroscopically the atmospheres of a large and diverse sample of hundreds of exoplanets. Through the study of targets with a wide range of planetary parameters (mass, density, equilibrium temperature) and host star types the origin for the diversity observed in known exoplanets will be better understood. Ariel is an ESA Medium class science mission (M4) with a spacecraft bus developed by industry under contract to ESA, and a Payload provided by a consortium of national funding agencies in ESA member states, plus contributions from NASA, the CSA and JAXA. The payload is based on a 1-meter class telescope operated at below 60K, built all in Aluminium, which feeds two science instruments. A multi-channel photometer and low-resolution spectrometer instrument (the FGS, Fine Guidance System instrument) operating from 0.5 – 1.95 microns in wavelength provides both guidance information for stabilizing the spacecraft pointing as well as vital scientific information from spectroscopy in the near-infrared and photometry in the visible channels. The Ariel InfraRed Spectrometer (AIRS) instrument provides medium resolution spectroscopy from 1.95 – 7.8 microns wavelength coverage over two instrument channels. Supporting subsystems provide the necessary mechanical, thermal and electronics support to the cryogenic payload. This paper presents the overall picture of the payload for the Ariel mission. The payload tightly integrates the design and analysis of the various payload elements (including for example the integrated STOP analysis of the Telescope and Common Optics) in order to allow the exacting photometric stability requirements for the mission to be met. The Ariel payload has passed through the Preliminary Design Review (completed in Q2 2023) and is now developing and building prototype models of the Telescope, Instruments and Subsystems (details of which will be provided in other contributions to this conference). This paper will present the current status of the development work and outline the future plans to complete the build and verification of the integrated payload

The Ariel payload electrical and electronic architecture: a summary of the current design and implementation status

Ariel is the M4 mission of the ESA’s Cosmic Vision Program 2015-2025, whose aim is to characterize by lowresolution transit spectroscopy the atmospheres of over one thousand warm and hot exoplanets orbiting nearby stars. It has been selected by ESA in March 2018 and adopted in November 2020 to be flown, then, in 2029. It is the first survey mission dedicated to measuring the chemical composition and thermal structures of the atmospheres of hundreds of transiting exoplanets, in order to enable planetary science far beyond the boundaries of the Solar System. The Payload (P/L) is based on a cold section (PLM – Payload Module) working at cryogenic temperatures and a warm section, located within the Spacecraft (S/C) Service Vehicle Module (SVM) and hosting five warm units operated at ambient temperature (253-313 K). The P/L and its electrical, electronic and data handling architecture has been designed and optimized to perform transit spectroscopy from space during primary and secondary planetary eclipses in order to achieve a large set of unbiased observations to shed light and fully understand the nature of exoplanets atmospheres, retrieving information about planets interior and determining the key factors affecting the formation and evolution of planetary systems

Enabling planetary science across light-years. Ariel Definition Study Report

Ariel, the Atmospheric Remote-sensing Infrared Exoplanet Large-survey, was adopted as the fourth medium-class mission in ESA's Cosmic Vision programme to be launched in 2029. During its 4-year mission, Ariel will study what exoplanets are made of, how they formed and how they evolve, by surveying a diverse sample of about 1000 extrasolar planets, simultaneously in visible and infrared wavelengths. It is the first mission dedicated to measuring the chemical composition and thermal structures of hundreds of transiting exoplanets, enabling planetary science far beyond the boundaries of the Solar System. The payload consists of an off-axis Cassegrain telescope (primary mirror 1100 mm x 730 mm ellipse) and two separate instruments (FGS and AIRS) covering simultaneously 0.5-7.8 micron spectral range. The satellite is best placed into an L2 orbit to maximise the thermal stability and the field of regard. The payload module is passively cooled via a series of V-Groove radiators; the detectors for the AIRS are the only items that require active cooling via an active Ne JT cooler. The Ariel payload is developed by a consortium of more than 50 institutes from 16 ESA countries, which include the UK, France, Italy, Belgium, Poland, Spain, Austria, Denmark, Ireland, Portugal, Czech Republic, Hungary, the Netherlands, Sweden, Norway, Estonia, and a NASA contribution