Healthcare quality improvement and ‘work engagement’; concluding results from a national, longitudinal, cross-sectional study of the ‘Productive Ward-Releasing Time to Care’ programme

Concerns about patient safety and reducing harm have led to a particular focus on initiatives that improve healthcare quality. However Quality Improvement (QI) initiatives have in the past typically faltered because they fail to fully engage healthcare professionals, resulting in apathy and resistance amongst this group of key stakeholders. Productive Ward: Releasing Time to Care (PW) is a ward-based QI programme created to help ward-based teams redesign and streamline the way that they work; leaving more time to care for patients. PW is designed to engage and empower ward-based teams to improve the safety, quality and delivery of care

Qualitative Impact Assessment of Land Management Interventions on Ecosystem Services (“QEIA”). Report-1: Executive Summary: QEIA Evidence Review & Integrated Assessment

The focus of this project was to provide an expert-led, rapid qualitative assessment of land management interventions on Ecosystem Services (ES) proposed for inclusion in Environmental Land Management (ELM) schemes. This involved a review of the current evidence base for 741 land management actions on 33 Ecosystem Services and 53 Ecosystem Service indicators by ten teams involving 45 experts drawn from the independent research community in a consistent series of Evidence Reviews covering the broad topics of: • Air quality • Greenhouse gas emissions • Soils • Water management • Biodiversity: croplands • Biodiversity: improved grassland • Biodiversity: semi-natural habitats • Biodiversity: integrated systems-based actions • Carbon sequestration • Cultural services (including recreation, geodiversity and regulatory services). It should be noted that this piece of work is just one element of the wider underpinning work Defra has commissioned to support the development of the ELM schemes

Qualitative impact assessment of land management interventions on Ecosystem Services (‘QEIA’). Report-2: Integrated Assessment

The focus of this project was to provide an expert-led, rapid qualitative assessment of land management interventions on Ecosystem Services (ES) proposed for inclusion in Environmental Land Management (ELM) schemes. This involved a review of the current evidence base for 741 land management actions on 33 Ecosystem Services and 53 Ecosystem Service indicators by ten expert teams drawn from the independent research community in a consistent series of ten Evidence Reviews covering the broad topics of; • Air quality • Greenhouse gas emissions • Soils • Water management • Biodiversity: croplands • Biodiversity: improved grassland • Biodiversity: semi-natural habitats • Biodiversity: integrated systems-based actions • Carbon sequestration • Cultural services (including recreation, geodiversity and regulatory services) These reviews were undertaken rapidly at Defra’s request by ten teams involving 45 experts who together captured more than 2,400 individual sources of evidence. This was followed by the Integrated Assessment (IA) reported here to provide a more accessible summary of these evidence reviews with a focus on capturing the actions with the greatest potential magnitude of change for the intended ES, and their potential co-benefits and trade-offs for the other ES

The Ethics of Engagement in an Age of Austerity: A Paradox Perspective

Our contribution in this paper is to highlight the ethical implications of workforce engagement strategies in an age of austerity. Hard or instrumentalist approaches to workforce engagement create the potential for situations where engaged employees are expected to work ever longer and harder with negative outcomes for their well-being. Our study explores these issues in an investigation of the enactment of an engagement strategy within a UK Health charity, where managers and workers face paradoxical demands to raise service quality and cut costs. We integrate insights from engagement, paradox, and ethic of care literatures, to explore these paradoxical demands—illustrating ways in which engagement experiences become infused with tensions when the workforce faces competing requirements to do 'more with less' resources. We argue that those targeted by these paradoxical engagement strategies need to be supported and cared for, embedded in an ethic of care that provides explicit workplace resources for helping workers and managers cope with and work through corresponding tensions. Our study points to the critical importance of support from senior and frontline managers for open communications and dialogue practices

Rheological Characterization of Next-Generation Ballistic Witness Materials for Body Armor Testing

Roma Plastilina No. 1 (RP1), an artist modeling clay that has been used as a ballistic clay, is essential for evaluation and certification in standards-based ballistic resistance testing of body armor. It serves as a ballistic witness material (BWM) behind the armor, where the magnitude of the plastic deformation in the clay after a ballistic impact is the figure of merit (known as “backface signature”). RP1 is known to exhibit complex thermomechanical behavior that requires temperature conditioning and frequent performance-based evaluations to verify that its deformation response satisfies requirements. A less complex BWM formulation that allows for room-temperature storage and use as well as a more consistent thermomechanical behavior than RP1 is desired, but a validation based only on ballistic performance would be extensive and expensive to accommodate the different ballistic threats. A framework of lab-scale metrologies for measuring the effects of strain, strain rate, and temperature dependence on mechanical properties are needed to guide BWM development. The current work deals with rheological characterization of a candidate BWM, i.e., silicone composite backing material (SCBM), to understand the fundamental structure–property relationships in comparison to those of RP1. Small-amplitude oscillatory shear frequency sweep experiments were performed at temperatures that ranged from 20 °C to 50 °C to map elastic and damping contributions in the linear elastic regime. Large amplitude oscillatory shear (LAOS) experiments were conducted in the non-linear region and the material response was analyzed in the form of Lissajous curve representations with the values of perfect plastic dissipation ratio reported to identify the degree of plasticity. The results show that the SCBM exhibits dynamic properties that are similar in magnitude to those of temperature-conditioned RP1, but with minimal temperature sensitivity and weaker frequency dependence than RP1. Both SCBM and RP1 are identified as elastoviscoplastic materials, which is particularly important for accurate determination of backface signature in body armor evaluation. The mechanical properties of SCBM show some degree of aging and work history effects. The results from this work demonstrate that the rheological properties of SCBM, at small and large strains, are similar to RP1 with substantial improvements in BWM performance requirements in terms of temperature sensitivity and thixotropy