Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Untangling approaches to management and leadership across systems of medical education

Aims: How future doctors might be educated and trained in order to meet the population and system needs of countries is currently being debated. Incorporation of a broad range of capabilities, encompassed within categories of management and, increasingly, leadership, form part of this discussion. The purpose of this paper is to outline a framework by which countries’ progress in this area might be assessed and compared. Methods: Key databases and journals related to this area were reviewed. From relevant articles potential factors impacting on the incorporation of aspects of management and leadership within medical education and training were identified. These factors were tested via an online survey during 2013 with six members of a European Association of doctors who promote medical involvement in hospital management, including members from countries less represented in the health management literature. Results: A framework for analysing how management and leadership education is being approached within different systems of healthcare is developed and presented. Conclusions: More systematic work across a wider range of countries is needed if we are to have a better understanding of how countries within and beyond Europe are approaching and progressing the education of doctors in management and leadership. Keywords: Medical education, Management, Leadership, Competency framework

Best practice framework for Patient and Public Involvement (PPI) in collaborative data analysis of qualitative mental health research: methodology development and refinement

Background Patient and Public Involvement (PPI) in mental health research is increasing, especially in early (pre-funding) stages. PPI is less consistent in later stages, including in analysing qualitative data. The aims of this study were to develop a methodology for involving PPI co-researchers in collaboratively analysing qualitative mental health research data with academic researchers, to pilot and refine this methodology, and to create a best practice framework for collaborative data analysis (CDA) of qualitative mental health research. Methods In the context of the RECOLLECT Study of Recovery Colleges, a critical literature review of collaborative data analysis studies was conducted, to identify approaches and recommendations for successful CDA. A CDA methodology was developed and then piloted in RECOLLECT, followed by refinement and development of a best practice framework. Results From 10 included publications, four CDA approaches were identified: (1) consultation, (2) development, (3) application and (4) development and application of coding framework. Four characteristics of successful CDA were found: CDA process is co-produced; CDA process is realistic regarding time and resources; demands of the CDA process are manageable for PPI co-researchers; and group expectations and dynamics are effectively managed. A four-meeting CDA process was piloted to o-produce a coding framework based on qualitative data collected in RECOLLECT and to create a mental health service user-defined change model relevant to Recovery Colleges. Formal and informal feedback demonstrated active involvement. The CDA process involved an extra 80 person-days of time (40 from PPI coresearchers, 40 from academic researchers).The process was refined into a best practice framework comprising Preparation, CDA and Application phases. Conclusions This study has developed a typology of approaches to collaborative analysis of qualitative data in mental health research, identified from available evidence the characteristics of successful involvement, and developed, piloted and refined the first best practice framework for collaborative analysis of qualitative data. This framework has the potential to support meaningful PPI in data analysis in the context of qualitative mental health research studies, a previously neglected yet central part of the research cycle

Examining clinical leadership in Kenyan public hospitals through the distributed leadership lens

Clinical leadership is recognized as a crucial element in health system strengthening and health policy globally yet it has received relatively little attention in low and middle income countries (LMICs). Moreover, analyses of clinical leadership tend to focus on senior-level individual leaders, overlooking a wider constellation of middle-level leaders delivering health care in practice in a way affected by their health care context. Using the theoretical lens of ‘distributed leadership’, this article examines how middle-level leadership is practised and affected by context in Kenyan county hospitals, providing insights relevant to health care in other LMICs. The article is based on empirical qualitative case studies of clinical departmental leadership in two Kenyan public hospitals, drawing on data gathered through ethnographic observation, interviews and focus groups. We inductively and iteratively coded, analysed and theorized our findings. We found the distributed leadership lens useful for the purpose of analysing middle-level leadership in Kenyan hospitals, although clinical departmental leadership was understood locally in more individualized terms. Our distributed lens revealed medical and nursing leadership occurring in parallel and how only doctors in leadership roles were able to directly influence behaviour among their medical colleagues, using inter-personal skills, power and professional expertize. Finally, we found that Kenyan hospital contexts were characterized by cultures, norms and structures that constrained the way leadership was practiced. We make a theoretical contribution by demonstrating the utility of using distributed leadership as a lens for analysing leadership in LIMC health care contexts, revealing how context, power and inter-professional relationships moderate individual leaders’ ability to bring about change. Our findings, have important implications for how leadership is conceptualized and the way leadership development and training are provided in LMICs health systems

Tevatron Run II combination of the effective leptonic electroweak mixing angle

Drell-Yan lepton pairs produced in the process pp→â.,"+â.,"-+X through an intermediate γ∗/Z boson have an asymmetry in their angular distribution related to the spontaneous symmetry breaking of the electroweak force and the associated mixing of its neutral gauge bosons. The CDF and D0 experiments have measured the effective-leptonic electroweak mixing parameter sin2θefflept using electron and muon pairs selected from the full Tevatron proton-antiproton data sets collected in 2001-2011, corresponding to 9-10 fb-1 of integrated luminosity. The combination of these measurements yields the most precise result from hadron colliders, sin2θefflept=0.23148±0.00033. This result is consistent with, and approaches in precision, the best measurements from electron-positron colliders. The standard model inference of the on-shell electroweak mixing parameter sin2θW, or equivalently the W-boson mass MW, using the zfitter software package yields sin2θW=0.22324±0.00033 or equivalently, MW=80.367±0.017 GeV/c2

Search for Sterile Neutrinos Mixing with Muon Neutrinos in MINOS

We report results of a search for oscillations involving a light sterile neutrino over distances of 1.04 and 735 km in a nu(mu)-dominated beam with a peak energy of 3 GeV. The data, from an exposure of 10.56 x 10(20) protons on target, are analyzed using a phenomenological model with one sterile neutrino. We constrain the mixing parameters theta(24) and Delta m(41)(2) and set limits on parameters of the four-dimensional Pontecorvo-Maki-Nakagawa-Sakata matrix, vertical bar U-mu 4 vertical bar(2) and vertical bar U-tau 4 vertical bar(2), under the assumption that mixing between nu(e) and nu(s) is negligible (vertical bar U-e4 vertical bar(2) = 0). No evidence for nu(mu) -> nu(s) transitions is found and we set a world-leading limit on theta(24) for values of Delta m(41)(2) less than or similar to 1 eV(2)

Measurement of single pi(0) production by coherent neutral-current nu Fe interactions in the MINOS Near Detector

Forward single pi(0) production by coherent neutral-current interactions, vA -> vA pi(0), is investigated using a 2.8 x 10(20) protons-on-target exposure of the MINOS Near Detector. For single-shower topologies, the event distribution in production angle exhibits a clear excess above the estimated background at very forward angles for visible energy in the range 1-8 GeV. Cross sections are obtained for the detector medium comprised of 80% iron and 20% carbon nuclei with (A) = 48, the highest-< A > target used to date in the study of this coherent reaction. The total cross section for coherent neutral-current single pi(0) production initiated by the v(mu) flux of the NuMI low-energy beam with mean (mode) E-v of 4.9 GeV (3.0 GeV), is 77.6 +/- 5.0 (stat)(-) (+15.0)(16.8) (syst) x 10(-40) cm(2) pernucleus. The results are in good agreement with predictions of the Berger-Sehgal model

Design, calibration, and performance of the MINERvA detector

The MINERvA(6) experiment is designed to perform precision studies of neutrino-nucleus scattering using nu(mu) and (nu) over bar (mu) neutrinos incident at 1-20 GeV in the NuMI beam at Fermilab. This article presents a detailed description of the MINERvA detector and describes the ex situ and in situ techniques employed to characterize the detector and monitor its performance. The detector is composed of a finely segmented scintillator-based inner tracking region surrounded by electromagnetic and hadronic sampling calorimetry. The upstream portion of the detector includes planes of graphite, iron and lead interleaved between tracking planes to facilitate the study of nuclear effects in neutrino interactions. Observations concerning the detector response over sustained periods of running are reported. The detector design and methods of operation have relevance to future neutrino experiments in which segmented scintillator tracking is utilized. (C) 2014 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/3.0/)