Impact on maternity professionals of novel approaches to clinical audit feedback

We compared three approaches to feedback of clinical audit findings relating to miscarriage in 15 Scottish maternity services (printed report alone; report plus Action Planning Letter; report plus face-to-face Facilitated Action Planning). We surveyed clinicians to measure Theory of Planned Behaviour constructs (in the context of two audit criteria) before and after feedback (n=253) and assessed perceptions of the audit through in-depth interviews (n=17). Pre-feedback, clinicians had positive attitudes and strong subjective norms and intentions to comply, although perceived behavioural control was lower. Generally, positive attitudes, subjective norms and intentions increased after feedback but for one of the two criteria (providing a 7-day miscarriage service), perceived behavioural control decreased. No changes over time reached statistical significance and analysis of covariance (adjusting for pre-feedback scores) showed no consistent relationships between method of feedback and post-feedback construct scores. Interviews revealed positive perceptions of audit but frustration at lack of capacity to implement changes. While interventions which increased intensity of feedback proved feasible and acceptable to clinicians, we were unable to demonstrate that they increased intention to comply with audit criteria.This study was funded by NHS Quality Improvement Scotland

A Framework for Measuring the Performance and Power Consumption of Storage Components under Typical Workload

Although the cost of storage components are reportedaccurately by the vendors, it is not clear whether the performance (IOps,MiBps) and power consumption (W) specifications they provide are accurateunder ‘typical’ workloads. Accurately measuring this informationis a vital step in providing input for optimal storage systems design. Thispaper measures storage disk performance and power consumption using‘typical’ workloads. The workloads are generated using an open sourceversion of the (industry standard) SPC-1 benchmark. This benchmarkcreates a realistic synthetic workload that aggregates multiple usersutilizing data storage simultaneously. A flexible current sensor board hasalso been developed to measure various storage devices simultaneously.This work represents a significant contribution to data storage benchmarkingresources (both performance and power consumption) as wehave embedded the open source SPC-1 benchmark spc1 within an opensource workload generator fio, in addition to our flexible current sensordevelopment. The integration provides an easily available benchmark forresearchers developing new storage technologies. This benchmark shouldgive a reasonable estimation of performance with the official SPC-1benchmark for systems that do not yet fulfill all the requirements for anofficial SPC-1 benchmark. With accurate information, our frameworkshows promise in alleviating much of the complexity in future storagesystems design

Chiropractic & Osteopathy. A new journal

Both chiropractic and osteopathy are over a century old. They are now regarded as complementary health professions. There is an imperative for both professions to research the principles and claims that underpin them, and the new journal Chiropractic & Osteopathy provides a scientific forum for the publication of such research

The paediatric Bohler's angle and crucial angle of Gissane: a case series

<p>Abstract</p> <p>Background</p> <p>Bohler's angle and the crucial angle of Gissane can be used to assess calcaneal fractures. While the normal adult values of these angles are widely known, the normal paediatric values have not yet been established. Our aim is to investigate Bohler's angle and the crucial angle of Gissane in a paediatric population and establish normal paediatric reference values.</p> <p>Method</p> <p>We measured Bohler's angle and the crucial angle of Gissane using normal plain ankle radiographs of 763 patients from birth to 14 years of age completed over a five year period from July 2003 to June 2008.</p> <p>Results</p> <p>In our paediatric study group, the mean Bohler's angle was 35.2 degrees and the mean crucial angle of Gissane was 111.3 degrees. In an adult comparison group, the mean Bohler's angle was 39.2 degrees and the mean crucial angle of Gissane was 113.8 degrees. The differences in Bohler's angle and the crucial angle of Gissane between these two groups were statistically significant.</p> <p>Conclusion</p> <p>We have presented the normal values of Bohler's angle and the crucial angle of Gissane in a paediatric population. These values may provide a useful comparison to assist with the management of the paediatric calcaneal fracture.</p

Effective dose and image quality of CBCT diagnostic imaging scans

To address the important issues surrounding the CBCT imaging modality we have initiated an investigation of CBCT dosimetry and its relation to image quality in pediatric and adult patients. RANDO, ATOM adult and ATOM child phantoms were scanned with the i-CAT Next Generation CBCT machine at the 17x23cm field of view. Each phantom houses 24 optical stimulated luminescent (OSL) dosimeters or thurmolumonescent (TLD) dosimeters. Dosimeter readings were used to calculate equivalent dose, effective dose and patient risk using 2007 ICRP guidelines. OSL calibration and correction was verified using an ion chamber, NanoDot OSL dosimeters and a medical radiography system. Effective dose calculations ranged between 71μSv (TLD) and 65μSv (OSL) for the RANDO phantom and 70 and 71 for the Adult and child phantoms respectively. Our results validate optical stimulated luminescent dosimeters and the ATOM phantoms as efficient and accurate tools to estimate the effective dose of CBCT scans.Master of Scienc

Short-lived spots in solar-like stars as observed by CoRoT

Context. CoRoT light curves have an unprecedented photometric quality, having simultaneously a high signal-to-noise ratio, a long time span and a nearly continuous duty-cycle. Aims. We analyse the light-curves of four bright targets observed in the seismology field and study short-lived small spots in solar-like stars. Methods. We present a simple spot modeling by iterative analysis. Its ability to extract relevant parameters is ensured by implementing relaxation steps to avoid convergence to local minima of the sum of the residuals between observations and modeling. The use of Monte-Carlo simulations allows us to estimate the performance of the fits. Results. Our starspot modeling gives a representation of the spots on these stars in agreement with other well tested methods. Within this framework, parameters such as rigid-body rotation and spot lifetimes seem to be precisely determined. Then, the lifetime/rotation period ratios are in the range 0.5 - 2, and there is clear evidence for differential rotation.Comment: 11 pages Accepted in A&

Constraints on Adaptive Evolution: The functional trade-off between reproduction and fast-start swimming performance in the Trinidadian guppy (Poecilia reticulata)

The empirical study of natural selection reveals that adaptations often involve trade-offs between competing functions. Because natural selection acts on whole organisms rather than isolated traits, adaptive evolution may be constrained by the interaction between traits that are functionally integrated. Yet, few attempts have been made to characterize how and when such constraints are manifested or whether they limit the adaptive divergence of populations. Here we examine the consequences of adaptive life-history evolution on locomotor performance in the live-bearing guppy. In response to increased predation from piscivorous fish, Trinidadian guppies evolve an increased allocation of resources toward reproduction. These populations are also under strong selection for rapid fast-start swimming performance to evade predators. Because embryo development increases a female\u27s wet mass as she approaches parturition, an increased investment in reproductive allocation should impede fast-start performance. We find evidence for adaptive but constrained evolution of fast-start swimming performance in laboratory trials conducted on second-generation lab-reared fish. Female guppies from high-predation localities attain a faster acceleration and velocity and travel a greater distance during fast-start swimming trials. However, velocity and distance traveled decline more rapidly over the course of pregnancy in these same females, thus reducing the magnitude of divergence in swimming performance between high- and low-predation populations. This functional trade-off between reproduction and swimming performance reveals how different aspects of the phenotype are integrated and highlights the complexity of adaptation at the whole-organism level