Making the Connection: How Provider Dialogue and Network Clusters Can Spur Successful Collaboration

In 2005, the Forbes Funds commissioned a report called Service Clustering: Building Cohesive Public Service Capacity that described collaboration as a way to achieve greater efficiency through shared back-office or non-mission critical functions without reducing consumer choice. The researchers argued that collaboration could best be induced by focusing on providers that are geographically close together and that provide an overlapping set of services. According to the report, "It is easier to share, communicate, and collaborate with your neighbor than with an organization separated by distance." Though this idea is compelling, it has become clear in the years since the 2005 report that the identification of geographic clusters is not sufficient to inspire a host of new collaborations. Formal collaboration, the kind suggested in the past report and the focus of this work, remains a relatively rare phenomenon. Convinced that collaboration continues to promise greater efficiency and effectiveness when successfully implemented, The Forbes Funds revisited the topic this year, hoping to gain further insight into the factors that make collaboration successful and to identify additional clusters of providers that could provide the greatest potential for collaboration

Key success factors when implementing strategic manufacturing initiatives

Purpose – This paper reports the study of key success factors (KSFs) in the project management of the implementation of strategic manufacturing initiatives (SMIs). Design/methodology/approach – In order to gather the experience and knowledge of many industries, from different geographic locations, in a broad range of types and sizes of SMIs, a questionnaire-based survey of practitioners worldwide was selected as the most appropriate research method among those available. Findings – The identification of those tasks and activities that must be done well in order to succeed in the implementation of a SMI in practice. Practical implications – Practitioners focusing their attention on the KSFs identified are more likely to succeed. Once these factors have been identified, the value of benchmarking project management methodologies then comes from drawing attention to those tasks that are key to the success of the implementation of SMIs. Originality/value – The paper presents new thinking by bringing project management into the operations strategy implementation literature as an important mediating factor for success. In this context the factors that are required for successful implementation are identified

Imposed faster and slower walking speeds influence gait stability differently in Parkinson fallers

Objective To evaluate the effect of imposed faster and slower walking speeds on postural stability in people with Parkinson disease (PD). Design Cross-sectional cohort study. Setting General community. Participants Patients with PD (n=84; 51 with a falls history; 33 without) and age-matched controls (n=82) were invited to participate via neurology clinics and preexisting databases. Of those contacted, 99 did not respond (PD=36; controls=63) and 27 were not interested (PD=18; controls=9). After screening, a further 10 patients were excluded; 5 had deep brain stimulation surgery and 5 could not accommodate to the treadmill. The remaining patients (N=30) completed all assessments and were subdivided into PD fallers (n=10), PD nonfallers (n=10), and age-matched controls (n=10) based on falls history. Interventions Not applicable. Main Outcome Measures Three-dimensional accelerometers assessed head and trunk accelerations and allowed calculation of harmonic ratios and root mean square (RMS) accelerations to assess segment control and movement amplitude. Results Symptom severity, balance confidence, and medical history were established before participants walked on a treadmill at 70%, 100%, and 130% of their preferred speed. Head and trunk control was lower for PD fallers than PD nonfallers and older adults. Significant interactions indicated head and trunk control increased with speed for PD nonfallers and older adults, but did not improve at faster speeds for PD fallers. Vertical head and trunk accelerations increased with walking speed for PD nonfallers and older adults, while the PD fallers demonstrated greater anteroposterior RMS accelerations compared with both other groups. Conclusions The results suggest that improved gait dynamics do not necessarily represent improved walking stability, and this must be respected when rehabilitating gait in patients with PD

Randomised controlled trial of the clinical and cost effectiveness of a specialist team for managing refractory unipolar depressive disorder

<p>Abstract</p> <p>Background</p> <p>Around 40 per cent of patients with unipolar depressive disorder who are treated in secondary care mental health services do not respond to first or second line treatments for depression. Such patients have 20 times the suicide rate of the general population and treatment response becomes harder to achieve and sustain the longer they remain depressed. Despite this there are no randomised controlled trials of community based service delivery interventions delivering both algorithm based pharmacotherapy and psychotherapy for patients with chronic depressive disorder in secondary care mental health services who remain moderately or severely depressed after six months treatment. Without such trials evidence based guidelines on services for such patients cannot be derived.</p> <p>Methods/design</p> <p>Single blind individually randomised controlled trial of a specialist depression disorder team (psychiatrist and psychotherapist jointly assessing and providing algorithm based drug and psychological treatment) versus usual secondary care treatment. We will recruit 174 patients with unipolar depressive disorder in secondary mental health services with a Hamilton Depression Rating Scale (HDRS) score ≥ 16 and global assessment of function (GAF) ≤ 60 after ≥ 6 months treatment. The primary outcome measures will be the HDRS and GAF supplemented by economic analysis incuding the EQ5 D and analysis of barriers to care, implementation and the process of care. Audits to benchmark both treatment arms against national standards of care will aid the interpretation of the results of the study.</p> <p>Discussion</p> <p>This trial will be the first to assess the effectiveness and implementation of a community based specialist depression disorder team. The study has been specially designed as part of the CLAHRC Nottinghamshire, Derbyshire and Lincolnshire joint collaboration between university, health and social care organisations to provide information of direct relevance to decisions on commissioning, service provision and implementation.</p> <p>Trial registration</p> <p>Clinical trials.gov identifier NCT01047124</p

Investigating Alaskan Methane and Carbon Dioxide Fluxes Using Measurements from the CARVE Tower

Northern high-latitude carbon sources and sinks, including those resulting from degrading permafrost, are thought to be sensitive to the rapidly warming climate. Because the near-surface atmosphere integrates surface fluxes over large ( ∼ 500–1000 km) scales, atmospheric monitoring of carbon dioxide (CO2) and methane (CH4) mole fractions in the daytime mixed layer is a promising method for detecting change in the carbon cycle throughout boreal Alaska. Here we use CO2 and CH4 measurements from a NOAA tower 17 km north of Fairbanks, AK, established as part of NASA\u27s Carbon in Arctic Reservoirs Vulnerability Experiment (CARVE), to investigate regional fluxes of CO2 and CH4 for 2012–2014. CARVE was designed to use aircraft and surface observations to better understand and quantify the sensitivity of Alaskan carbon fluxes to climate variability. We use high-resolution meteorological fields from the Polar Weather Research and Forecasting (WRF) model coupled with the Stochastic Time-Inverted Lagrangian Transport model (hereafter, WRF-STILT), along with the Polar Vegetation Photosynthesis and Respiration Model (PolarVPRM), to investigate fluxes of CO2 in boreal Alaska using the tower observations, which are sensitive to large areas of central Alaska. We show that simulated PolarVPRM–WRF-STILT CO2 mole fractions show remarkably good agreement with tower observations, suggesting that the WRF-STILT model represents the meteorology of the region quite well, and that the PolarVPRM flux magnitudes and spatial distribution are generally consistent with CO2 mole fractions observed at the CARVE tower. One exception to this good agreement is that during the fall of all 3 years, PolarVPRM cannot reproduce the observed CO2 respiration. Using the WRF-STILT model, we find that average CH4 fluxes in boreal Alaska are somewhat lower than flux estimates by Chang et al. (2014) over all of Alaska for May–September 2012; we also find that enhancements appear to persist during some wintertime periods, augmenting those observed during the summer and fall. The possibility of significant fall and winter CO2 and CH4 fluxes underscores the need for year-round in situ observations to quantify changes in boreal Alaskan annual carbon balance

The Pan-STARRS Moving Object Processing System

We describe the Pan-STARRS Moving Object Processing System (MOPS), a modern software package that produces automatic asteroid discoveries and identifications from catalogs of transient detections from next-generation astronomical survey telescopes. MOPS achieves > 99.5% efficiency in producing orbits from a synthetic but realistic population of asteroids whose measurements were simulated for a Pan-STARRS4-class telescope. Additionally, using a non-physical grid population, we demonstrate that MOPS can detect populations of currently unknown objects such as interstellar asteroids. MOPS has been adapted successfully to the prototype Pan-STARRS1 telescope despite differences in expected false detection rates, fill-factor loss and relatively sparse observing cadence compared to a hypothetical Pan-STARRS4 telescope and survey. MOPS remains >99.5% efficient at detecting objects on a single night but drops to 80% efficiency at producing orbits for objects detected on multiple nights. This loss is primarily due to configurable MOPS processing limits that are not yet tuned for the Pan-STARRS1 mission. The core MOPS software package is the product of more than 15 person-years of software development and incorporates countless additional years of effort in third-party software to perform lower-level functions such as spatial searching or orbit determination. We describe the high-level design of MOPS and essential subcomponents, the suitability of MOPS for other survey programs, and suggest a road map for future MOPS development.Comment: 57 Pages, 26 Figures, 13 Table

Spin-photon interface and spin-controlled photon switching in a nanobeam waveguide

Access to the electron spin is at the heart of many protocols for integrated and distributed quantum-information processing [1-4]. For instance, interfacing the spin-state of an electron and a photon can be utilized to perform quantum gates between photons [2,5] or to entangle remote spin states [6-9]. Ultimately, a quantum network of entangled spins constitutes a new paradigm in quantum optics [1]. Towards this goal, an integrated spin-photon interface would be a major leap forward. Here we demonstrate an efficient and optically programmable interface between the spin of an electron in a quantum dot and photons in a nanophotonic waveguide. The spin can be deterministically prepared with a fidelity of 96\%. Subsequently the system is used to implement a "single-spin photonic switch", where the spin state of the electron directs the flow of photons through the waveguide. The spin-photon interface may enable on-chip photon-photon gates [2], single-photon transistors [10], and efficient photonic cluster state generation [11]

The Truth, the Whole Truth, and Nothing but the Truth: A Pragmatic Guide to Assessing Empirical Evaluations

An unsound claim can misdirect a field, encouraging the pursuit of unworthy ideas and the abandonment of promising ideas. An inadequate description of a claim can make it difficult to reason about the claim, for example to determine whether the claim is sound. Many practitioners will acknowledge the threat of un- sound claims or inadequate descriptions of claims to their field. We believe that this situation is exacerbated and even encouraged by the lack of a systematic approach to exploring, exposing, and addressing the source of unsound claims and poor exposition. This paper proposes a framework that identifies three sins of reasoning that lead to unsound claims and two sins of exposition that lead to poorly described claims. Sins of exposition obfuscate the objective of determining whether or not a claim is sound, while sins of reasoning lead directly to unsound claims. Our framework provides practitioners with a principled way of critiquing the integrity of their own work and the work of others. We hope that this will help individuals conduct better science and encourage a cultural shift in our research community to identify and promulgate sound claims