Vibrational Branching Ratios From The Dissociation Of The NeIBr Van Der Waals Molecule

The degree of vibrational excitation in the IBr fragment from the vibrational predissociation of NeIBr (A (3)PI(1)) has been measured using two-color pump-probe laser-induced fluorescence spectroscopy. We find that for the lowest initial vibrational states examined, DELTA-upsilon = -1 dissociation pathways dominate the dynamics, while this channel is closed for upsilon greater-than-or-equal-to 17. From this result, the A state binding energy (D0) of the complex is determined to be 67 +/- 4 cm-1, while that in the X electronic state is found to be 73 +/- 4 cm-1. The X state binding energy is identical to that for NeI2 and NeBr2, suggesting that the potential energy surface for NeIBr can be constructed from a summation of atom-atom pair potentials; we present such a model potential energy surface. The variations in the vibrational branching ratios, when combined with the trends in the predissociation rates, point to the importance of fragment rotational excitation in the dynamics of the dissociation

Digital Natives, but Not Information Fluent: Assessing Information Literacy

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To cannulate or not to cannulate? Variation, appropriateness and potential for reduction in cannulation rates by ambulance staff

Background: Peripheral intravenous (IV) cannulation is a key intervention in the prehospital setting, but inappropriate use may cause unnecessary pain, distress or risk of infection. The aim of this study was to examine the rate and appropriateness of prehospital cannulation and the relative importance of factors associated with increased likelihood of cannulation. Design and setting: Cross-sectional survey of patients transported in Lincolnshire, East Midlands Ambulance Service. Methods: Retrospective non-identifiable data for September 2006 were extracted. Clinical conditions were classified according to whether they warranted, did not warrant or were uncertain as to the need for cannulation. Other potential indications for cannulation including IV drug administration, reduced consciousness, systolic hypotension, respiratory depression and haemorrhage were combined to determine whether cannulation was indicated. Other variables were investigated as predictors of cannulation. The method of analysis was agreed at the outset. Results: Paramedics cannulated 14.6% (1295/8866) of patients. IV drug administration, clinical indication, reduced conscious level, respiratory depression and hypotension were associated with greater likelihood of cannulation (p,0.001). Cannulation was more likely in older patients but was not associated with gender, haemorrhage or hypoglycaemia. Multivariate logistic regression showed IV drug administration as the strongest predictor of cannulation. Cannulation rates varied threefold by ambulance station (mean 13.4%, 5.8% to 19.0%). It was estimated that 202 (15.6%) of the cannulations performed could potentially have been avoided. Conclusion: Rates of cannulation were higher than previous studies with wide variations between ambulance stations. 15.6% of cannulations performed could have been avoided, thus reducing pain, distress and other potential complications such as thrombophlebitis, extravasation and infection. The generalisability of this study was limited by use of a single site, short duration and dependence on accurate retrospective data. The data demonstrating wide variations suggest that there may be scope for consideration of interventions to reduce cannulation rates

An evaluation of an educational intervention to reduce inappropriate cannulation and improve cannulation technique by paramedics

Background: Intravenous cannulation enables administration of fluids or drugs by paramedics in prehospital settings. Inappropriate use and poor technique carry risks for patients, including pain and infection. We aimed to investigate the effect of an educational intervention designed to reduce the rate of inappropriate cannulation and to improve cannulation technique. Method: We used a non-randomised control group design, comparing two counties in the East Midlands (UK)as intervention and control areas. The educational intervention was based on Joint Royal Colleges Ambulance Liaison Committee guidance and delivered to paramedic team leaders who cascaded it to their teams. We analysed rates of inappropriate cannulation before and after the intervention using routine clinical data. We also assessed overall cannulation rates before and after the intervention. A sample of paramedics was assessed post-intervention on cannulation technique with a ‘‘model’’ arm using a predesigned checklist. Results: There was a non-significant reduction in inappropriate (no intravenous fluids or drugs given) cannulation rates in the intervention area (1.0% to 0%) compared with the control area (2.5% to 2.6%). There was a significant (p,0.001) reduction in cannulation rates in the intervention area (9.1% to 6.5%; OR 0.7, 95% CI 0.48 to 1.03) compared with an increase in the control area (13.8% to 19.1%; OR 1.47, 95% CI 1.15 to 1.90), a significant difference (p,0.001). Paramedics in the intervention area were significantly more likely to use correct hand-washing techniques post-intervention (74.5% vs. 14.9%; p,0.001). Conclusion: The educational intervention was effective in bringing about changes leading to enhanced quality and safety in some aspects of prehospital cannulation

Medical education research remains the poor relation

The requirement that clinical practice should be based on the best available evidence has been paralleled by calls for medical education to become more evidence based.1-3 This has resulted, among other initiatives, in the establishment of the Best Evidence for Medical Education (BEME) Collaboration4 and the Campbell Collaboration, an off-shoot of the Cochrane Collaboration. The BEME initiative includes dissemination of best evidence to support medical education and the encouragement of a culture capable of nurturing more rigorous and better funded research

Integrating Process with Outcome Data in a Randomized Controlled Trial of Sex Education

Integration of process with outcome evaluations has been recommended as a way of addressing some of the criticisms of Randomized Controlled Trials (RCTs) for evaluating social interventions. This is the second of two articles (the first was published in issue 10(4) of this journal) discussing the design, implementation and analysis of a process evaluation as an integral part of the RIPPLE (Randomized Intervention of Pupil Peer-Led sex Education) Study. The methods for integrating process and outcome data are outlined and findings are presented to illustrate how integration of process and outcome data enabled exploration of: 1) variation between schools in the extent and quality of the intervention implemented, and any impact of this on outcomes; 2) the processes by which the intervention might affect outcomes; and 3) the extent to which different subgroups of students or schools may have responded differently to the intervention. The article concludes with a discussion of the methodological issues arising from this attempt at integrating process and outcome evaluations within the design of an RCT

Behind the Scenes: An Ethnographic Study of A Working Kitchen

During the latter half of the 20th century, many towns and cities throughout the UK have faced processes of deindustrialisation. These developments have drastically changed the cultural and social landscapes of many locales and populations. The most notable shift, particularly in the North East of England, has been the transformation from labour markets dominated by coal and other forms of heavy industry to one typified by insecure service sector employment. The hospitality industry is one that now dominates and although aspects of this service industry have received much academic attention of late, very few have focused on what happens behind the scenes. This study seeks to rectify this. Based on the result of an ethnographic study of a working kitchen in a relatively exclusive hotel in the North East of England, it explores a particular overlooked sub-section of the contemporary British workforce, who are part of one of the largest industries in Western society. The study shows what working life is like within a contemporary hotel kitchen by situating the lives of these kitchen workers within the new economy and juxtaposing the harsh realities of backstage kitchen life with the ever-present image of indulgent consumption that frames the front stage location of the hotel. It aims to explore the different pleasures that are included with the purchase of ‘a meal’ and by taking a critical look at the consumerised dining experience, provides a concrete setting on which to compare the backstage environment of the kitchen. Furthermore, it details the intricacies of working in contemporary service employment in the ‘neo-capitalist’ economy, the drudgeries of kitchen life and the realities of cooking as a practical activity, as well as exploring the working relations, identities, status hierarchies and social ties of this environment