Brief smoking cessation in acute Welsh hospitals: A realist approach

This implementation study sought to determine what works to support brief smoking cessation (BSC) in acute hospital settings, through exploration of organizational delivery and the role of healthcare professionals (HCPs). We used a realist approach, with embedded stakeholder engagement, within a large health organization. We conducted interviews (n = 27), a survey (n = 279) and organization documentation review (n = 44). The final programme theory suggests HCPs implement BSC when they value it as part of their role in contributing to improved patient outcomes; this is due to personal and professional influences, such as knowledge or experience. Organizational support, training and working in an environment where BSC is visible as standard care, positively influences implementation. However, the context exerts a strong influence on whether BSC is implemented, or not. HCPs make nuanced judgements on whether to implement BSC based on their assessment of the patient's responses, the patient's condition and other acute care demands. HCPs are less likely to implement BSC in dynamic and uncertain environments, as they are concerned about adversely impacting on the clinician-patient relationship and prioritize other acute care requirements. Organizations should actively promote BSC as a core function of the acute hospital setting and improve professional practice through leadership, training, feedback and visible indicators of organizational commitment. HCPs can be persuaded that implementing BSC is an acute care priority and an expectation of standard practice for improving patient outcomes

Dark Solitons in High Velocity Waveguide Polariton Fluids

We study exciton-polariton nonlinear optical fluids in the high momentum waveguide regime for the first time. We demonstrate the formation of dark solitons with the expected dependence of width on fluid density for both main classes of soliton-forming fluid defects. The results are well described by numerical modeling of the fluid propagation. We deduce a continuous wave nonlinearity more than ten times that on picosecond time scales, arising due to interaction with the exciton reservoir

The gas turbulence in planetary nebulae: quantification and multi-D maps from long-slit, wide-spectral range echellogram

This methodological paper is part of a short series dedicated to the long-standing astronomical problem of de-projecting the bi-dimensional, apparent morphology of a three-dimensional distribution of gas. We focus on the quantification and spatial recovery of turbulent motions in planetary nebulae (and other classes of expanding nebulae) by means of long-slit echellograms over a wide spectral range. We introduce some basic theoretical notions, discuss the observational methodology, and develop an accurate procedure disentangling all broadening components of the velocity profile in all spatial positions of each spectral image. This allows us to extract random, non-thermal motions at unprecedented accuracy, and to map them in 1-, 2- and 3-dimensions. We present the solution to practical problems in the multi-dimensional turbulence-analysis of a testing-planetary nebula (NGC 7009), using the three-step procedure (spatio-kinematics, tomography, and 3-D rendering) developed at the Astronomical Observatory of Padua. In addition, we introduce an observational paradigm valid for all spectroscopic parameters in all classes of expanding nebulae. Unsteady, chaotic motions at a local scale constitute a fundamental (although elusive) kinematical parameter of each planetary nebula, providing deep insights on its different shaping agents and mechanisms, and on their mutual interaction. The detailed study of turbulence, its stratification within a target and (possible) systematic variation among different sub-classes of planetary nebulae deserve long-slit, multi-position angle, wide-spectral range echellograms containing emissions at low-, medium-, and high-ionization, to be analyzed pixel-to-pixel with a straightforward and versatile methodology, extracting all the physical information stored in each frame at best.Comment: 11 page, 10 figures, A&A in pres

Recruitment, augmentation and apoptosis of rat osteoclasts in 1,25-(OH)2D3 response to short-term treatment with 1,25-dihydroxyvitamin D3in vivo

Background Although much is known about the regulation of osteoclast (OC) formation and activity, little is known about OC senescence. In particular, the fate of of OC seen after 1,25-(OH)2D3 administration in vivo is unclear. There is evidence that the normal fate of OC is to undergo apoptosis (programmed cell death). We have investigated the effect of short-term application of high dose 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3) on OC apoptosis in an experimental rat model. Methods OC recruitment, augmentation and apoptosis was visualised and quantitated by staining histochemically for tartrate resistant acid phosphatase (TRAP), double staining for TRAP/ED1 or TRAP/DAPI, in situ DNA fragmentation end labelling and histomorphometric analysis. Results Short-term treatment with high-dose 1,25-(OH)2D3 increased the recruitment of OC precursors in the bone marrow resulting in a short-lived increase in OC numbers. This was rapidly followed by an increase in the number of apoptotic OC and their subsequent removal. The response of OC to 1,25-(OH)2D3 treatment was dose and site dependent; higher doses producing stronger, more rapid responses and the response in the tibiae being consistently stronger and more rapid than in the vertebrae. Conclusions This study demonstrates that (1) after recruitment, OC are removed from the resorption site by apoptosis (2) the combined use of TRAP and ED1 can be used to identify OC and their precursors in vivo (3) double staining for TRAP and DAPI or in situ DNA fragmentation end labelling can be used to identify apoptotic OC in vivo

Sexuality, Intimacy and Older Care Home Residents.

YESOver half a million people aged 65+ live in care homes (ONS 2011). Yet, sex, sexuality and intimacy and old people remain overlooked in social policy and professional practice (Hafford-Letchfield 2008). We explore narratives from a feasibility study based in Northwest England that consulted on the significance of researching sexuality and intimacy. We draw on narratives generated with two focus groups of professional carers (n = 16) and interviews with three residents, (two male and one female) and four female spouses (n = 7). All three types of stakeholders expressed concern about privacy and environmental impediments to intimacy (e.g. shortage of double rooms). However, distinct concerns were expressed by each group. Residents’ expressed scepticism that the topic was ‘too personal’, that old people were post-sexual or that sex/intimacy were part of range of needs and could be eclipsed by those relating to grand-parenting, avoiding isolation and personalization of care. Spouses emphasized the importance of intimacy over sex/sexuality as an indicator of the depth and longevity of a relationship but were concerned about unmet needs and loss of influence over their partners’ care. Obliged to meet a complex of legal, professional, ethical and interpersonal obligations, care staff articulated a need for guidance to help them support residents and their significant others. We conclude with practical recommendations that address barriers to enabling intimacy

Constructing Memories of Holmfirth through 'Last of the Summer Wine'

Last of the Summer Wine (BBC, 1973-2010) was filmed in Holmfirth, West Yorkshire, UK for 37 years. Its presence in the town has affected collective memories of the space and place of the region. In examining Summer Wine’s continued presence in Holmfirth even after it has ceased production, we investigate how the series as a text, institution and brand serves to spatially inform Holmfirth and construct, embed and inform cultural memory

Postpartum consultation: Occurrence, requirements and expectations

<p>Abstract</p> <p>Background</p> <p>As a matter of routine, midwives in Sweden have spoken with women about their experiences of labour in a so-called 'postpartum consultation'. However, the possibility of offering women this kind of consultation today is reduced due to shortage of both time and resources. The aim of this study was to explore the occurrence, women's requirements of, and experiences of a postpartum consultation, and to identify expectations from women who wanted but did not have a consultation with the midwife assisting during labour.</p> <p>Methods</p> <p>All Swedish speaking women who gave birth to a live born child at a University Hospital in western Sweden were consecutively included for a phone interview over a three-week period. An additional phone interview was conducted with the women who did not have a postpartum consultation, but who wanted to talk with the midwife assisting during labour. Data from the interviews were analysed using qualitative content analysis.</p> <p>Results</p> <p>Of the 150 interviewed women, 56% (n = 84) had a postpartum consultation of which 61.9% (n = 52) had this with the midwife assisting during labour. Twenty of the 28 women who did not have a consultation with anyone still desired to talk with the midwife assisting during labour. Of these, 19 were interviewed. The content the women wanted to talk about was summarized in four categories: to understand the course of events during labour; to put into words, feelings about undignified management; to describe own behaviour and feelings, and to describe own fear.</p> <p>Conclusion</p> <p>The survey shows that the frequency of postpartum consultation is decreasing, that the majority of women who give birth today still require it, but only about half of them receive it. It is crucial to develop a plan for these consultations that meets both the women's needs and the organization within current maternity care.</p