The accessibility of research-based knowledge for nurses in United Kingdom acute care settings

Background. The successful dissemination of the results of the National Health Service (NHS) research and development strategy and the development of evidence based approaches to health care rely on clinicians having access to the best available evidence; evidence fit for the purpose of reducing the uncertainties associated with clinical decisions. Aim. To reveal the accessibility of those sources of information actually used by nurses, as well as those which they say they use. Design. Mixed method case site, using interview, observational, Q sort and documentary audit data in medical, surgical and coronary care units (CCUs) in three acute hospitals. Results. Three perspectives on accessibility were identified: (a) the humanist-in which human sources of information were the most accessible; (b) local information for local needs-in which locally produced resources were seen as the most accessible and (c) moving towards technology-in which information technology begins to be seen as accessible. Nurses' experience in a clinical specialty is positively associated with a perception that human sources such clinical nurse specialists, link nurses, doctors and experienced clinical colleagues are more accessible than text based sources. Clinical specialization is associated with different approaches to accessing research knowledge. Coronary care unit nurses were more likely perceive local guidelines, protocols and on-line databases as more accessible than their counterparts in general medical and surgical wards. Only a third of text-based resources available to nurses oil the wards had any explicit research base. These, and the remainder were Out of date (mean age of textbooks 11 years), and authorship hard to ascertain. Conclusion. A strategy to increase the use of research evidence by nurses should harness the influence of clinical nurse specialists, link nurses and those engaged in practice development. These roles Could act as 'conduits' through which research-based messages for practice, and information for clinical decision making, could flow. This role should be explored and enhanced

Acute care nurses' perceptions of barriers to using research information in clinical decision-making

Aim. To examine the barriers that nurses feel prevent them from using research in the decisions they make. Background. A sizeable research literature focusing on research utilization in nursing has developed over the past 20 years. However, this literature is characterized by a number of weaknesses: self-reported utilization behaviour; poor response rates and small, nonrandom sampling strategies. Design. Cross-case analysis involving anonymised qualitative interviews, observation, documentary audit and Q methodological modelling of shared subjectivities amongst nurses. The case sites were three large acute hospitals in the north of England. One hundred and eight nurses were interviewed, 61 of whom were also observed for a total of 180 h, and 122 nurses were involved in the Q modelling exercise (response rate of 64%). Results. Four perspectives were isolated that encompassed the characteristics associated with barriers to research use. These related to the individual, organization, nature of research information itself and environment. Nurses clustered around four main perspectives on the barriers to research use: (1) Problems in interpreting and using research products, which were seen as too complex, 'academic' and overly statistical; (2) Nurses who felt confident with research-based information perceived a lack of organizational support as a significant block; (3) Many nurses felt that researchers and research products lack clinical credibility and that they fail to offer the desired level of clinical direction; (4) Some nurses lacked the skills and, to a lesser degree, the motivation to use research themselves. These individuals liked research messages passed on to them by a third party and sought to foster others' involvement in research-based practice, rather than becoming directly involved themselves. Conclusions. Rejection of research knowledge is not a barrier to its application. Rather, the presentation and management of research knowledge in the workplace represent significant challenges for clinicians, policy-makers and the research community

SCUBA observations of the Horsehead Nebula - what did the horse swallow?

We present observations taken with SCUBA on the JCMT of the Horsehead Nebula in Orion (B33), at wavelengths of 450 and 850 \mum. We see bright emission from that part of the cloud associated with the photon-dominated region (PDR) at the `top' of the horse's head, which we label B33-SMM1. We characterise the physical parameters of the extended dust responsible for this emission, and find that B33-SMM1 contains a more dense core than was previously suspected. We compare the SCUBA data with data from the Infrared Space Observatory (ISO) and find that the emission at 6.75-\mum is offset towards the west, indicating that the mid-infrared emission is tracing the PDR while the submillimetre emission comes from the molecular cloud core behind the PDR. We calculate the virial balance of this core and find that it is not gravitationally bound but is being confined by the external pressure from the HII region IC434, and that it will either be destroyed by the ionising radiation, or else may undergo triggered star formation. Furthermore we find evidence for a lozenge-shaped clump in the `throat' of the horse, which is not seen in emission at shorter wavelengths. We label this source B33-SMM2 and find that it is brighter at submillimetre wavelengths than B33-SMM1. SMM2 is seen in absorption in the 6.75-\mum ISO data, from which we obtain an independent estimate of the column density in excellent agreement with that calculated from the submillimetre emission. We calculate the stability of this core against collapse and find that it is in approximate gravitational virial equilibrium. This is consistent with it being a pre-existing core in B33, possibly pre-stellar in nature, but that it may also eventually undergo collapse under the effects of the HII region.Comment: 11 pages, 6 figures, accepted by MNRA

An empirical model for protostellar collapse

We propose a new analytic model for the initial conditions of protostellar collapse in relatively isolated regions of star formation. The model is non-magnetic, and is based on a Plummer-like radial density profile as its initial condition. It fits: the observed density profiles of pre-stellar cores and Class 0 protostars; recent observations in pre-stellar cores of roughly constant contraction velocities over a wide range of radii; and the lifetimes and accretion rates derived for Class 0 and Class I protostars. However, the model is very simple, having in effect only 2 free parameters, and so should provide a useful framework for interpreting observations of pre-stellar cores and protostars, and for calculations of radiation transport and time-dependent chemistry. As an example, we model the pre-stellar core L1544.Comment: To appear in Astrophysical Journal, Jan 20th, 2001. 18 pages incl. 3 fig

The excess burden of cancer in men in the UK

In general men are at significantly greater risk than women from nearly all of the common cancers that occur in both sexes (with the exception of breast cancer) (White 2009, Wilkins 2006, DH 2007). This report will consider the current overall burden of cancer among men in the UK, estimated from the latest statistics, and outline the extent of the differences between the sexes. All figures and calculations reported here are based on data extracted from the Cancer Research UK CancerStats web pages extracted in June 2009 (Cancer Research UK, 2009)

Searching for Globally Optimal Functional Forms for Inter-Atomic Potentials Using Parallel Tempering and Genetic Programming

We develop a Genetic Programming-based methodology that enables discovery of novel functional forms for classical inter-atomic force-fields, used in molecular dynamics simulations. Unlike previous efforts in the field, that fit only the parameters to the fixed functional forms, we instead use a novel algorithm to search the space of many possible functional forms. While a follow-on practical procedure will use experimental and {\it ab inito} data to find an optimal functional form for a forcefield, we first validate the approach using a manufactured solution. This validation has the advantage of a well-defined metric of success. We manufactured a training set of atomic coordinate data with an associated set of global energies using the well-known Lennard-Jones inter-atomic potential. We performed an automatic functional form fitting procedure starting with a population of random functions, using a genetic programming functional formulation, and a parallel tempering Metropolis-based optimization algorithm. Our massively-parallel method independently discovered the Lennard-Jones function after searching for several hours on 100 processors and covering a miniscule portion of the configuration space. We find that the method is suitable for unsupervised discovery of functional forms for inter-atomic potentials/force-fields. We also find that our parallel tempering Metropolis-based approach significantly improves the optimization convergence time, and takes good advantage of the parallel cluster architecture

Parameterization of solar cells

The aggregation (sorting) of the individual solar cells into an array is commonly based on a single operating point on the current-voltage (I-V) characteristic curve. An alternative approach for cell performance prediction and cell screening is provided by modeling the cell using an equivalent electrical circuit, in which the parameters involved are related to the physical phenomena in the device. These analytical models may be represented by a double exponential I-V characteristic with seven parameters, by a double exponential model with five parameters, or by a single exponential equation with four or five parameters. In this article we address issues concerning methodologies for the determination of solar cell parameters based on measured data points of the I-V characteristic, and introduce a procedure for screening of solar cells for arrays. We show that common curve fitting techniques, e.g., least squares, may produce many combinations of parameter values while maintaining a good fit between the fitted and measured I-V characteristics of the cell. Therefore, techniques relying on curve fitting criteria alone cannot be directly used for cell parameterization. We propose a consistent procedure which takes into account the entire set of parameter values for a batch of cells. This procedure is based on a definition of a mean cell representing the batch, and takes into account the relative contribution of each parameter to the overall goodness of fit. The procedure is demonstrated on a batch of 50 silicon cells for Space Station Freedom