660 research outputs found
Procedural Protections During Medical Peer Review: A Reinterpretation of the Health Care Quality Improvement Act of 1986
High-pressure/high-temperature synthesis of transition metal oxide perovskites
Perovskite and related Ruddlesden-Popper type transition metal oxides synthesised at high pressures and temperatures during the last decade are reviewed. More than 60 such new materials have been reported since 1995. Important developments have included perovskites with complex cation orderings on A and B sites, multiferroic bismuth-based perovskites, and new manganites showing colossal magnetoresistance (CMR) and charge ordering properties
Tests with commercial classical gravimeters in preparation for tests of quantum prototype
Preliminary tests with commercial spring-mass gravimeters have been carried out on the outdoor test field at Ispra in order to establish a test-bed suitable for testing a cold-atom quantum gravimeter. In 2016, the background on a single device was measured. In 2017, a measurements of the field above a buried 5 ton lead mass were carried out, using two gravimeters mounted vertically one above the other. A clear indication of the gravitational field of the test mass with seen, with good signal-to-noise ratio. It was concluded that the general layout is satisfactory, given that the quantum prototype should have sensitivity similar to or better than the conventional instruments. Practical experience gained is helpful for understanding the requirements for mounting and positioning the quantum instrument.JRC.E.2-Technology Innovation in Securit
The cost-effectiveness of smoking cessation support delivered by mobile phone text messaging: Txt2stop.
BACKGROUND: The txt2stop trial has shown that mobile-phone-based smoking cessation support doubles biochemically validated quitting at 6 months. This study examines the cost-effectiveness of smoking cessation support delivered by mobile phone text messaging. METHODS: The lifetime incremental costs and benefits of adding text-based support to current practice are estimated from a UK NHS perspective using a Markov model. The cost-effectiveness was measured in terms of cost per quitter, cost per life year gained and cost per QALY gained. As in previous studies, smokers are assumed to face a higher risk of experiencing the following five diseases: lung cancer, stroke, myocardial infarction, chronic obstructive pulmonary disease, and coronary heart disease (i.e. the main fatal or disabling, but by no means the only, adverse effects of prolonged smoking). The treatment costs and health state values associated with these diseases were identified from the literature. The analysis was based on the age and gender distribution observed in the txt2stop trial. Effectiveness and cost parameters were varied in deterministic sensitivity analyses, and a probabilistic sensitivity analysis was also performed. FINDINGS: The cost of text-based support per 1,000 enrolled smokers is £16,120, which, given an estimated 58 additional quitters at 6 months, equates to £278 per quitter. However, when the future NHS costs saved (as a result of reduced smoking) are included, text-based support would be cost saving. It is estimated that 18 LYs are gained per 1,000 smokers (0.3 LYs per quitter) receiving text-based support, and 29 QALYs are gained (0.5 QALYs per quitter). The deterministic sensitivity analysis indicated that changes in individual model parameters did not alter the conclusion that this is a cost-effective intervention. Similarly, the probabilistic sensitivity analysis indicated a >90 % chance that the intervention will be cost saving. INTERPRETATION: This study shows that under a wide variety of conditions, personalised smoking cessation advice and support by mobile phone message is both beneficial for health and cost saving to a health system
Design Research is Alive and Kicking...
This paper explores the current situation of design research with a particular emphasis on how emerging forms of design research are framing andaddressing contemporaryglobal issues. The paper examines how design research canbe a creative and transformative force in helping to shape our lives in more responsible, sustainable, and meaningful ways. Today, theplurality in design research is clearlyevident given the wide range of conceptual, methodological,technological and theoretical approaches adopted. Moreover, various forms of design research now routinely appear in a vast array of disciplines in and around modern design praxis, including business, engineering, computing, and healthcare. This paper reviews a rich selection of the state-of-the-art design research that exemplify the range of approaches, methods, applications, and collaborations prevalent in emerging forms of design research and presents 10 characteristics of ‘good’ design research that will support design researchers in addressing the complex global issues we face
An A to Z of contemporary design
In 2001, Hal Foster wrote his paper “The ABCs of Contemporary Design*” (Foster, 2002a) as a supplement (part glossary, part guide) to his book Design and Crime (and Other Diatribes) (Foster, 2002b). Foster’s ABCs paper paints design as being a near‐perfect circuit of production and consumption. Foster claims that critical reflection is outdated, which means design is a consumption‐based system and as such design’s role is largely to feed capitalism, let it flourish, and meet the demands of the masses. Over a decade on from Foster’s critical analysis of design, however, it appears that design is in the middle of yet another series of crises (Bremner and Rodgers, 2013) ranging from disciplinary challenges where the profession of design appears to be struggling with its identity, to epistemological and conceptual challenges where the zeitgeist of design thinking and the widespread democratization of the discipline would have us believe that “we are all designers”, and where the remit of design is expanding into ever more far flung areas that cover communications, services, interactions and strategies. It seems timely and fitting, therefore, that we need a new examination of the contemporary world of design. This assessment of contemporary design is apposite given that we currently inhabit a world that we have all combined to create that is seriously unprepared to deal with the mounting crises we face. Collectively, we are destroying some of the most important features of society that we claim to hold most dear (i.e. our planet, our society, and our spirit). Our ecological crisis, wherein we continue to deplete and degrade our natural capital on a massive scale, using up the equivalent of 1.5 planets to meet our current consumption has resulted in one third of our agricultural land disappearing over the last 40 years, which will inevitably lead to food supply crises and an anticipated doubling of food prices by 2030 (Emmott, 2013). Our present social crisis sees nearly 2.5 billion people on our planet living in abject poverty (UNHDR, 2007). There have been many successes at lifting people out of poverty, but this figure has not changed much over the past few decades (Therborn, 2012). Furthermore, the world is currently in a spiritual crisis where, according to World Health Organization (WHO) statistics, 3 times as many people die from suicide as die from homicide or in wars. These global dimensions are collectively creating results that nobody wants and may well constitute the most significant failure of our time. Building on Foster’s ABC template, the authors present a new critical insight from A to Z into the current design situation where issues of professionalism in design, the global financial meltdown, and the rapid adoption of digital technologies have all modified the models of design thought and action. We suggest readers see this paper as a development of Foster’s original supplement
Description and process evaluation of pharmacists' interventions in a pharmacist-led information technology-enabled multicentre cluster randomised controlled trial for reducing medication errors in general practice (PINCER trial)
Objective
To undertake a process evaluation of pharmacists' recommendations arising in the context of a complex IT-enabled pharmacist-delivered randomised controlled trial (PINCER trial) to reduce the risk of hazardous medicines management in general practices.
Methods
PINCER pharmacists manually recorded patients' demographics, details of interventions recommended, actions undertaken by practice staff and time taken to manage individual cases of hazardous medicines management. Data were coded, double-entered into SPSS version 15 and then summarised using percentages for categorical data (with 95% confidence interval (CI)) and, as appropriate, means (± standard deviation) or medians (interquartile range) for continuous data.
Key findings
Pharmacists spent a median of 20 min (interquartile range 10, 30) reviewing medical records, recommending interventions and completing actions in each case of hazardous medicines management. Pharmacists judged 72% (95% CI 70, 74; 1463/2026) of cases of hazardous medicines management to be clinically relevant. Pharmacists recommended 2105 interventions in 74% (95% CI 73, 76; 1516/2038) of cases and 1685 actions were taken in 61% (95% CI 59, 63; 1246/2038) of cases; 66% (95% CI 64, 68; 1383/2105) of interventions recommended by pharmacists were completed and 5% (95% CI 4, 6; 104/2105) of recommendations were accepted by general practitioners (GPs), but not completed at the end of the pharmacists' placement; the remaining recommendations were rejected or considered not relevant by GPs.
Conclusions
The outcome measures were used to target pharmacist activity in general practice towards patients at risk from hazardous medicines management. Recommendations from trained PINCER pharmacists were found to be broadly acceptable to GPs and led to ameliorative action in the majority of cases. It seems likely that the approach used by the PINCER pharmacists could be employed by other practice pharmacists following appropriate training
Bayesian inference from terrestrial gravimetry measurements of near-surface anomalies using a bespoke reversible-jump Markov chain Monte Carlo algorithm
This work describes a Bayesian algorithm developed to tackle the problem of inference from two-dimensional grids of terrestrial gravity measurements. Near-surface voids such as pipelines and tunnels were the motivating application. The forward models used to approximate the gravity signal due to these potentially complex underground anomalies were sums of simple geometrical shapes: the sphere, finite horizontal cylinder and cuboid. The model parameters of these shapes are related non-linearly to the gravity signal. The reversible-jump Markov chain Monte Carlo algorithm was used, allowing changes to the number of objects comprising the forward model. The natural parsimony of the algorithm was shown to be key for obtaining depth information without the need for arbitrary regularisation. Exploring the Bayesian posterior distribution in this way, spatial, geometrical and anomaly mass information can be obtained as outputs from the inference process, given prior information regarding the soil-anomaly density contrast. This was demonstrated both with synthetic noisy gravity and gravity gradient data and with field gravity data obtained using the Scintrex CG-5 commercial gravimeter. The methodology used to obtain field survey data using the CG-5 over multiple days is described, with discussion of the assignment of measurement uncertainty. A 134 point measurement grid was taken above two spatially separate concrete anomalies, for which volume and density information were known. The data was input into the Bayesian inference algorithm, the forward model parameters were successfully inferred within the total uncertainty
Co-designing with people living with dementia
This paper presents research that illustrates how design thought and action has contributed to the co-design and development of a mass-produced product with people living with dementia. The research, undertaken in collaboration with Alzheimer Scotland, has adopted a range of disruptive design interventions for breaking the cycle of well-formed opinions, strategies, mindsets, and ways-of-doing, that tend to remain unchallenged in the health and social care of people living with dementia. The research has resulted in a number of co-designed interventions that will help change the perception of dementia by showing that people living with dementia can offer much to UK society after diagnosis. It is envisaged that the co-designed activities and interventions will help reconnect people recently diagnosed with dementia to help build their self-esteem, identity and dignity and help keep the person with dementia connected to their community, thus delaying the need for formal support and avoid the need for crisis responses. The paper reports on an initial intervention where the author worked collaboratively with over 130 people diagnosed with dementia across Scotland in the co-design and development of a new tartan. The paper concludes with a number of recommendations for researchers when co-designing with people living with dementia
- …