A multilevel neo-institutional analysis of infection prevention and control in English hospitals: coerced safety culture change?

Despite committed policy, regulative and professional efforts on healthcare safety, little is known about how such macro-interventions permeate organisations and shape culture over time. Informed by neo-institutional theory, we examined how inter-organisational influences shaped safety practices and inter-subjective meanings following efforts for coerced culture change. We traced macro-influences from 2000 to 2015 in infection prevention and control (IPC). Safety perceptions and meanings were inductively analysed from 130 in-depth qualitative interviews with senior- and middle-level managers from 30 English hospitals. A total of 869 institutional interventions were identified; 69% had a regulative component. In this context of forced implementation of safety practices, staff experienced inherent tensions concerning the scope of safety, their ability to be open and prioritisation of external mandates over local need. These tensions stemmed from conflicts among three co-existing institutional logics prevalent in the NHS. In response to requests for change, staff flexibly drew from a repertoire of cognitive, material and symbolic resources within and outside their organisations. They crafted 'strategies of action', guided by a situated assessment of first-hand practice experiences complementing collective evaluations of interventions such as 'pragmatic', 'sensible' and also 'legitimate'. Macro-institutional forces exerted influence either directly on individuals or indirectly by enriching the organisational cultural repertoire

Understanding the Degradation of a Model Si Anode in a Li Ion Battery at the Atomic Scale

To advance the understanding of the degradation of the liquid electrolyte and Si electrode, and their interface, we exploit the latest developments in cryo atom probe tomography. We evidence Si anode corrosion from the decomposition of the Li salt before charge discharge cycles even begin. Volume shrinkage during delithiation leads to the development of nanograins from recrystallization in regions left amorphous by the lithiation. The newly created grain boundaries facilitate pulverization of nanoscale Si fragments, and one is found floating in the electrolyte. P is segregated to these grain boundaries, which confirms the decomposition of the electrolyte. As structural defects are bound to assist the nucleation of Li rich phases in subsequent lithiations and accelerate the electrolyte s decomposition, these insights into the developed nanoscale microstructure interacting with the electrolyte contribute to understanding the self catalyzed accelerated degradation Si anodes and can inform new battery designs unaffected by these life limiting factor

Presenting a simplified assistant tool for breast cancer diagnosis in mammography to radiologists

This paper proposes a method to simplify a computational model from logistic regression for clinical use without computer. The model was built using human interpreted featrues including some BI-RADS standardized features for diagnosing the malignant masses. It was compared with the diagnosis using only assessment categorization from BI-RADS. The research aims at assisting radiologists to diagnose the malignancy of breast cancer in a way without using automated computer aided diagnosis system

Electron Dynamics in Nd1.85_{1.85}Ce.15_{.15}CuO4+δ_{4+\delta}: Evidence for the Pseudogap State and Unconventional c-axis Response

Infrared reflectance measurements were made with light polarized along the a- and c-axis of both superconducting and antiferromagnetic phases of electron doped Nd$_{1.85}$Ce$_{.15}$CuO$_{4+\delta}$. The results are compared to characteristic features of the electromagnetic response in hole doped cuprates. Within the CuO$_2$ planes the frequency dependent scattering rate, 1/$\tau(\omega)$, is depressed below $\sim$ 650 cm$^{-1}$; this behavior is a hallmark of the pseudogap state. While in several hole doped compounds the energy scales associated with the pseudogap and superconducting states are quite close, we are able to show that in Nd$_{1.85}$Ce$_{.15}$CuO$_{4+\delta}$ the two scales differ by more than one order of magnitude. Another feature of the in-plane charge response is a peak in the real part of the conductivity, $\sigma_1(\omega)$, at 50-110 cm$^{-1}$ which is in sharp contrast with the Drude-like response where $\sigma_1(\omega)$ is centered at $\omega=0$. This latter effect is similar to what is found in disordered hole doped cuprates and is discussed in the context of carrier localization. Examination of the c-axis conductivity gives evidence for an anomalously broad frequency range from which the interlayer superfluid is accumulated. Compelling evidence for the pseudogap state as well as other characteristics of the charge dynamics in Nd$_{1.85}$Ce$_{.15}$CuO$_{4+\delta}$ signal global similarities of the cuprate phase diagram with respect to electron and hole doping.Comment: Submitted to PR

Measurement of single pi0 production in neutral current neutrino interactions with water by a 1.3 GeV wide band muon neutrino beam

Neutral current single pi0 production induced by neutrinos with a mean energy of 1.3 GeV is measured at a 1000 ton water Cherenkov detector as a near detector of the K2K long baseline neutrino experiment. The cross section for this process relative to the total charged current cross section is measured to be 0.064 +- 0.001 (stat.) +- 0.007 (sys.). The momentum distribution of produced pi0s is measured and is found to be in good agreement with an expectation from the present knowledge of the neutrino cross sections.Comment: 6 pages, 4 figures, Submitted to Phys. Lett.

Using tourism free-choice learning experiences to promote environmentally sustainable behaviour: The role of post-visit ‘action resources’

This paper argues the need for the providers of ecotourism and other free‐choice environmental learning experiences to promote the adoption of environmentally sustainable actions beyond their own sites, when visitors return to their home environments. Previous research indicates that although visitors often leave such experiences with a heightened awareness of conservation issues and intentions to adopt environmentally responsible behaviours, only a minority translate these intentions into real actions. Building on research and theory in relation to visitor experiences in free‐choice learning environments, the paper identifies three different stages in the educational process and proposes a strategy for facilitating the translation of visitors' behavioural intentions into the adoption of sustainable actions through the provision of post‐visit action resources

Measurement of the Charged Multiplicities in b, c and Light Quark Events from Z0 Decays

Average charged multiplicities have been measured separately in $b$, $c$ and light quark ($u,d,s$) events from $Z^0$ decays measured in the SLD experiment. Impact parameters of charged tracks were used to select enriched samples of $b$ and light quark events, and reconstructed charmed mesons were used to select $c$ quark events. We measured the charged multiplicities: $\bar{n}_{uds} = 20.21 \pm 0.10 (\rm{stat.})\pm 0.22(\rm{syst.})$, $\bar{n}_{c} = 21.28 \pm 0.46(\rm{stat.}) ^{+0.41}_{-0.36}(\rm{syst.})$ $\bar{n}_{b} = 23.14 \pm 0.10(\rm{stat.}) ^{+0.38}_{-0.37}(\rm{syst.})$, from which we derived the differences between the total average charged multiplicities of $c$ or $b$ quark events and light quark events: $\Delta \bar{n}_c = 1.07 \pm 0.47(\rm{stat.})^{+0.36}_{-0.30}(\rm{syst.})$ and $\Delta \bar{n}_b = 2.93 \pm 0.14(\rm{stat.})^{+0.30}_{-0.29}(\rm{syst.})$. We compared these measurements with those at lower center-of-mass energies and with perturbative QCD predictions. These combined results are in agreement with the QCD expectations and disfavor the hypothesis of flavor-independent fragmentation.Comment: 19 pages LaTex, 4 EPS figures, to appear in Physics Letters

On the Crustal Matter of Magnetars

We have investigated some of the properties of dense sub-nuclear matter at the crustal region (both the outer crust and the inner crust region) of a magnetar. The relativistic version of Thomas-Fermi (TF) model is used in presence of strong quantizing magnetic field for the outer crust matter. The compressed matter in the outer crust, which is a crystal of metallic iron, is replaced by a regular array of spherically symmetric Wigner-Seitz (WS) cells. In the inner crust region, a mixture of iron and heavier neutron rich nuclei along with electrons and free neutrons has been considered. Conventional Harrison-Wheeler (HW) and Bethe-Baym-Pethick (BBP) equation of states are used for the nuclear mass formula. A lot of significant changes in the characteristic properties of dense crustal matter, both at the outer crust and the inner crust, have been observed.Comment: 29 pages REVTEX manuscript, 15 .eps figures (included

Investigation of previously implicated genetic variants in chronic tic disorders: a transmission disequilibrium test approach

Genetic studies in Tourette syndrome (TS) are characterized by scattered and poorly replicated findings. We aimed to replicate findings from candidate gene and genome-wide association studies (GWAS). Our cohort included 465 probands with chronic tic disorder (93% TS) and both parents from 412 families (some probands were siblings). We assessed 75 single nucleotide polymorphisms (SNPs) in 465 parent–child trios; 117 additional SNPs in 211 trios; and 4 additional SNPs in 254 trios. We performed SNP and gene-based transmission disequilibrium tests and compared nominally significant SNP results with those from a large independent case–control cohort. After quality control 71 SNPs were available in 371 trios; 112 SNPs in 179 trios; and 3 SNPs in 192 trios. 17 were candidate SNPs implicated in TS and 2 were implicated in obsessive–compulsive disorder (OCD) or autism spectrum disorder (ASD); 142 were tagging SNPs from eight monoamine neurotransmitter-related genes (including dopamine and serotonin); 10 were top SNPs from TS GWAS; and 13 top SNPs from attention-deficit/hyperactivity disorder, OCD, or ASD GWAS. None of the SNPs or genes reached significance after adjustment for multiple testing. We observed nominal significance for the candidate SNPs rs3744161 (TBCD) and rs4565946 (TPH2) and for five tagging SNPs; none of these showed significance in the independent cohort. Also, SLC1A1 in our gene-based analysis and two TS GWAS SNPs showed nominal significance, rs11603305 (intergenic) and rs621942 (PICALM). We found no convincing support for previously implicated genetic polymorphisms. Targeted re-sequencing should fully appreciate the relevance of candidate genes

Synaptic processes and immune-related pathways implicated in Tourette syndrome.

Tourette syndrome (TS) is a neuropsychiatric disorder of complex genetic architecture involving multiple interacting genes. Here, we sought to elucidate the pathways that underlie the neurobiology of the disorder through genome-wide analysis. We analyzed genome-wide genotypic data of 3581 individuals with TS and 7682 ancestry-matched controls and investigated associations of TS with sets of genes that are expressed in particular cell types and operate in specific neuronal and glial functions. We employed a self-contained, set-based association method (SBA) as well as a competitive gene set method (MAGMA) using individual-level genotype data to perform a comprehensive investigation of the biological background of TS. Our SBA analysis identified three significant gene sets after Bonferroni correction, implicating ligand-gated ion channel signaling, lymphocytic, and cell adhesion and transsynaptic signaling processes. MAGMA analysis further supported the involvement of the cell adhesion and trans-synaptic signaling gene set. The lymphocytic gene set was driven by variants in FLT3, raising an intriguing hypothesis for the involvement of a neuroinflammatory element in TS pathogenesis. The indications of involvement of ligand-gated ion channel signaling reinforce the role of GABA in TS, while the association of cell adhesion and trans-synaptic signaling gene set provides additional support for the role of adhesion molecules in neuropsychiatric disorders. This study reinforces previous findings but also provides new insights into the neurobiology of TS