Improving professional practice in the disclosure of a diagnosis of dementia : a modeling experiment to evaluate a theory-based intervention

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Spatially resolved investigation of the optical and structural properties of CuCl thin films on Si

CuCl thin films grown on (100) Si by thermal evaporation are studied by means of low temperature photoluminescence (PL) and reflectance spectroscopies. Spatially and wavelength resolved room temperature cathodoluminescence (CL) imaging of the surface of the CuCl samples in a scanning electron microscope (SEM) has also been performed. The reflectance spectra are modeled using a dielectric response function with various models involving dead layers and reflected waves in the thin film and the exciton-polariton structure obtained is compared to other studies of CuCl. The modeling is shown to match the experimental data quite well when a dead layer is included at the air/CuCl and CuCl/Si interfaces. Some inconsistencies between the CL spectra and those measured by PL and reflectance have been observed. The effects of changing the accelerating voltage of the probe from 10 keV to the range 1-5 keV to allow depth analysis of the CL are reported, in order to pinpoint the spatial origin of the CL emission within the thin film

The development of a theory-based intervention to promote appropriate disclosure of a diagnosis of dementia

Background: The development and description of interventions to change professional practice are often limited by the lack of an explicit theoretical and empirical basis. We set out to develop an intervention to promote appropriate disclosure of a diagnosis of dementia based on theoretical and empirical work. Methods: We identified three key disclosure behaviours: finding out what the patient already knows or suspects about their diagnosis; using the actual words 'dementia' or 'Alzheimer's disease' when talking to the patient; and exploring what the diagnosis means to the patient. We conducted a questionnaire survey of older peoples' mental health teams (MHTs) based upon theoretical constructs from the Theory of Planned Behaviour (TPB) and Social Cognitive Theory (SCT) and used the findings to identify factors that predicted mental health professionals' intentions to perform each behaviour. We selected behaviour change techniques likely to alter these factors. Results: The change techniques selected were: persuasive communication to target subjective norm; behavioural modelling and graded tasks to target self-efficacy; persuasive communication to target attitude towards the use of explicit terminology when talking to the patient; and behavioural modelling by MHTs to target perceived behavioural control for finding out what the patient already knows or suspects and exploring what the diagnosis means to the patient. We operationalised these behaviour change techniques using an interactive 'pen and paper' intervention designed to increase intentions to perform the three target behaviours. Conclusion : It is feasible to develop an intervention to change professional behaviour based upon theoretical models, empirical data and evidence based behaviour change techniques. The next step is to evaluate the effect of such an intervention on behavioural intention. We argue that this approach to development and reporting of interventions will contribute to the science of implementation by providing replicable interventions that illuminate the principles and processes underlying change.This project is funded by UK Medical Research Council, Grant reference number G0300999. Jeremy Grimshaw holds a Canada Research Chair in Health Knowledge Transfer and Uptake. Jill Francis is funded by the Chief Scientist Office of the Scottish Government Health Directorate. The views expressed in this study are those of the authors

Laser Guide Stars for Extremely Large Telescopes: Efficient Shack-Hartmann Wavefront Sensor Design using Weighted center-of-gravity algorithm

Over the last few years increasing consideration has been given to the study of Laser Guide Stars (LGS) for the measurement of the disturbance introduced by the atmosphere in optical and near-infrared astronomical observations from the ground. A possible method for the generation of a LGS is the excitation of the Sodium layer in the upper atmosphere at approximately 90 km of altitude. Since the Sodium layer is approximately 10 km thick, the artificial reference source looks elongated, especially when observed from the edge of a large aperture. The spot elongation strongly limits the performance of the most common wavefront sensors. The centroiding accuracy in a Shack-Hartmann wavefront sensor, for instance, decreases proportionally to the elongation (in a photon noise dominated regime). To compensate for this effect a straightforward solution is to increase the laser power, i.e. to increase the number of detected photons per subaperture. The scope of the work presented in this paper is twofold: an analysis of the performance of the Weighted Center of Gravity algorithm for centroiding with elongated spots and the determination of the required number of photons to achieve a certain average wavefront error over the telescope aperture.Comment: 10 pages, 14 figure

Evidence-based selection of theories for designing behaviour change interventions : using methods based on theoretical construct domains to understand clinicians' blood transfusion behaviour

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Applying Network Theory to Epidemics: Control Measures for Mycoplasma pneumoniae Outbreaks

We introduce a novel mathematical approach to investigating the spread and control of communicable infections in closed communities. Mycoplasma pneumoniae is a major cause of bacterial pneumonia in the United States. Outbreaks of illness attributable to mycoplasma commonly occur in closed or semi-closed communities. These outbreaks are difficult to contain because of delays in outbreak detection, the long incubation period of the bacterium, and an incomplete understanding of the effectiveness of infection control strategies. Our model explicitly captures the patterns of interactions among patients and caregivers in an institution with multiple wards. Analysis of this contact network predicts that, despite the relatively low prevalence of mycoplasma pneumonia found among caregivers, the patterns of caregiver activity and the extent to which they are protected against infection may be fundamental to the control and prevention of mycoplasma outbreaks. In particular, the most effective interventions are those that reduce the diversity of interactions between caregivers and patients

A New Strategy for Deep Wide-Field High Resolution Optical Imaging

We propose a new strategy for obtaining enhanced resolution (FWHM = 0.12 arcsec) deep optical images over a wide field of view. As is well known, this type of image quality can be obtained in principle simply by fast guiding on a small (D = 1.5m) telescope at a good site, but only for target objects which lie within a limited angular distance of a suitably bright guide star. For high altitude turbulence this 'isokinetic angle' is approximately 1 arcminute. With a 1 degree field say one would need to track and correct the motions of thousands of isokinetic patches, yet there are typically too few sufficiently bright guide stars to provide the necessary guiding information. Our proposed solution to these problems has two novel features. The first is to use orthogonal transfer charge-coupled device (OTCCD) technology to effectively implement a wide field 'rubber focal plane' detector composed of an array of cells which can be guided independently. The second is to combine measured motions of a set of guide stars made with an array of telescopes to provide the extra information needed to fully determine the deflection field. We discuss the performance, feasibility and design constraints on a system which would provide the collecting area equivalent to a single 9m telescope, a 1 degree square field and 0.12 arcsec FWHM image quality.Comment: 46 pages, 22 figures, submitted to PASP, a version with higher resolution images and other supplementary material can be found at http://www.ifa.hawaii.edu/~kaiser/wfhr

Performances zootechniques de la poule Ardennaise, une race ancienne pour le futur ?

Nowadays, Belgian poultry breeding is characterized by a strong biodiversity that is nevertheless greatly endangered. The present work aims at evaluating the zootechnical potential of an ancient poultry breed originating from the Franco-Belgian Ardennes region, the Ardennaise. This breed shows an important phenotypic variation, with 10 different varieties being recognized. This study evaluates the Ardennaise production performances and is divided into three parts: (1) the analysis of the growth and the consumption indices over a twelve weeks period, (2) the comparison of the growth over seventeen weeks in four varieties, (3) the study of eggs number and eggs weight over 70 weeks laying. The results indicate that the Ardennaise breed constitutes a good dual purpose breed that could be interestingly submitted to selection. Its use in industrial crosses for egg composition amelioration is also proposed. Lastly, this works shows the importance of extending the here developed evaluation protocol to other Belgian endangered poultry breeds to motivate the necessary conservation programs

Using psychological theory to understand the clinical management of type 2 diabetes in Primary Care : a comparison across two European countries

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