IXPE Mission System Concept and Development Status

The Goal of the Imaging X-Ray Polarimetry Explorer (IXPE) Mi SMEX), is to expand understanding of high-energy astrophysical processes and sources, in support of NASAs first science objective in Astrophysics: Discover how the universe works. IXPE, an international collaboration, will conduct X-ray imaging polarimetry for multiple categories of cosmic X-ray sources such as neutron stars, stellar-mass black holes, supernova remnants and active galactic nuclei. The Observatory uses a single science operational mode capturing the X-ray data from the targets. The IXPE Observatory consists of spacecraft and payload modules built up in parallel to form the Observatory during system integration and test. The payload includes three X-ray telescopes each consisting of a polarization-sensitive, gas pixel X-ray detector, paired with its corresponding grazing incidence mirror module assembly (MMA). A deployable boom provides the correct separation (focal length) between the detector units (DU) and MMAs. These payload elements are supported by the IXPE spacecraft which is derived from the BCP-small spacecraft architecture. This paper summarizes the IXPE mission science objectives, updates the Observatory implementation concept including the payload and spacecraft ts and summarizes the mission status since last years conference

Imaging X-Ray Polarimeter Explorer Systems Engineering Approach and Implementation

The Imaging X-ray Polarimetry Explorer (IXPE) is a NASA Small Explorer x-ray astrophysics mission being implemented by a geographically dispersed team. Each IXPE partner provides unique capabilities and experience which are utilized to design, build and launch the IXPE observator. A rigorous and iterative systems engineering approach is essential to ensuring the successful realization of reliable and cost effective IXPE mission system. The IXPE collaboration and observatory complexity provide both unique challenges and advantages for project systems engineering. The project uses established and tailored systems engineering (SE) methods and teaming approaches to achieve the IXPE mission goals. The IXPE systems engineering team spans all partner organizations. Currently, the project is in system integration and test working through structural environmental testing–vibration testing is just starting. Systems work is now focused on requirements management and maturity assessments, requirements verification and validation via sell-off packages (SOP) and interface control document (ICD) verification while supporting environmental test planning and execution. IXPE verification, validation and characterization (V&V) starts at the component/unit level and rolls up to appropriate higher levels where V&V compliance is assured by collaborative development by the cross-organizational V&V Team. This paper provides a technical summary of the IXPE concept of operations and mission-system (payload, spacecraft, observatory, ground system, launch vehicle), overviews the IXPE systems engineering approach (communications, project reviews, requirements analysis and management, baseline design and design trade studies, interfaces definition and documentation, resource management), describes the verification, validation and characterization activities (requirements validation, models and simulations validation, systems integration and test (I&T), system validation), discusses risk and opportunities philosophy and implementation, outlines COVID 19 accommodations, itemizes some key challenges and lessons-learned followed by the path to launch and conclusions

An intervention to support stroke survivors and their carers in the longer term (LoTS2Care): study protocol for a cluster randomised controlled feasibility trial

Background Despite the evidence that many stroke survivors report longer term unmet needs, the provision of longer term care is limited. To address this, we are conducting a programme of research to develop an evidence-based and replicable longer term care strategy. The developed complex intervention (named New Start), which includes needs identification, exploration of social networks and components of problem solving and self-management, was designed to improve quality of life by addressing unmet needs and increasing participation. Methods/Design A multicentre, cluster randomised controlled feasibility trial designed to inform the design of a possible future definitive cluster randomised controlled trial (cRCT) and explore the potential clinical and cost-effectiveness of New Start. Ten stroke services across the UK will be randomised on a 1:1 basis either to implement New Start or continue with usual care only. New Start will be delivered by trained facilitators and will be offered to all stroke survivors within the services allocated to the intervention arm. Stroke survivors will be eligible for the trial if they are 4–6 months post-stroke and residing in the community. Carers (if available) will also be invited to take part. Invitation to participate will be initiated by post and outcome measures will be collected via postal questionnaires at 3, 6 and 9 months after recruitment. Outcome data relating to perceived health and disability, wellbeing and quality of life as well as unmet needs will be collected. A ‘study within a trial’ (SWAT) is planned to determine the most acceptable format in which to provide the postal questionnaires. Details of health and social care service usage will also be collected to inform the economic evaluation. The feasibility of recruiting services and stroke survivors to the trial and of collecting postal outcomes will be assessed and the potential for effectiveness will be investigated. An embedded process evaluation (reported separately) will assess implementation fidelity and explore and clarify causal assumptions regarding implementation. Discussion This feasibility trial with embedded process evaluation will allow us to gather important and detailed data regarding methodological and implementation issues to inform the design of a possible future definitive cRCT of this complex intervention. Trial Registration ISRCTN38920246. Registered 22 June 2016

Functionality and feedback: a realist synthesis of the collation, interpretation and utilisation of patient-reported outcome measures data to improve patient care

Background: The feedback of patient-reported outcome measures (PROMs) data is intended to support the care of individual patients and to act as a quality improvement (QI) strategy. Objectives: To (1) identify the ideas and assumptions underlying how individual and aggregated PROMs data are intended to improve patient care, and (2) review the evidence to examine the circumstances in which and processes through which PROMs feedback improves patient care. Design: Two separate but related realist syntheses: (1) feedback of aggregate PROMs and performance data to improve patient care, and (2) feedback of individual PROMs data to improve patient care. Interventions: Aggregate – feedback and public reporting of PROMs, patient experience data and performance data to hospital providers and primary care organisations. Individual – feedback of PROMs in oncology, palliative care and the care of people with mental health problems in primary and secondary care settings. Main outcome measures: Aggregate – providers’ responses, attitudes and experiences of using PROMs and performance data to improve patient care. Individual – providers’ and patients’ experiences of using PROMs data to raise issues with clinicians, change clinicians’ communication practices, change patient management and improve patient well-being. Data sources: Searches of electronic databases and forwards and backwards citation tracking. Review methods: Realist synthesis to identify, test and refine programme theories about when, how and why PROMs feedback leads to improvements in patient care. Results: Providers were more likely to take steps to improve patient care in response to the feedback and public reporting of aggregate PROMs and performance data if they perceived that these data were credible, were aimed at improving patient care, and were timely and provided a clear indication of the source of the problem. However, implementing substantial and sustainable improvement to patient care required system-wide approaches. In the care of individual patients, PROMs function more as a tool to support patients in raising issues with clinicians than they do in substantially changing clinicians’ communication practices with patients. Patients valued both standardised and individualised PROMs as a tool to raise issues, but thought is required as to which patients may benefit and which may not. In settings such as palliative care and psychotherapy, clinicians viewed individualised PROMs as useful to build rapport and support the therapeutic process. PROMs feedback did not substantially shift clinicians’ communication practices or focus discussion on psychosocial issues; this required a shift in clinicians’ perceptions of their remit. Strengths and limitations: There was a paucity of research examining the feedback of aggregate PROMs data to providers, and we drew on evidence from interventions with similar programme theories (other forms of performance data) to test our theories. Conclusions: PROMs data act as ‘tin openers’ rather than ‘dials’. Providers need more support and guidance on how to collect their own internal data, how to rule out alternative explanations for their outlier status and how to explore the possible causes of their outlier status. There is also tension between PROMs as a QI strategy versus their use in the care of individual patients; PROMs that clinicians find useful in assessing patients, such as individualised measures, are not useful as indicators of service quality. Future work: Future research should (1) explore how differently performing providers have responded to aggregate PROMs feedback, and how organisations have collected PROMs data both for individual patient care and to improve service quality; and (2) explore whether or not and how incorporating PROMs into patients’ electronic records allows multiple different clinicians to receive PROMs feedback, discuss it with patients and act on the data to improve patient care

A chronic care ostomy self-management program for cancer survivors

Individuals with ostomies experience extensive changes in health-related quality of life (HRQOL) and daily routine. Patients and families are typically forced to use trial and error to improve self-management.This work was supported by grants from the National Cancer Insti-tute at the National Institutes of Health (grant number R21CA133337) and Arizona Cancer Center Support (grant numberCA023074). The funders had no role in the design and conduct of the study, collection, management, analysis and interpretation ofthe data, and preparation, review or approval of the manuscript.Published online 25 January 2016. 12 month embargo.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

A chronic care ostomy self-management program for cancer survivors.

Individuals with ostomies experience extensive changes in health-related quality of life (HRQOL) and daily routine. Patients and families are typically forced to use trial and error to improve self-management.This work was supported by grants from the National Cancer Insti-tute at the National Institutes of Health (grant number R21CA133337) and Arizona Cancer Center Support (grant numberCA023074). The funders had no role in the design and conduct of the study, collection, management, analysis and interpretation ofthe data, and preparation, review or approval of the manuscript.Published online 25 January 2016. 12 month embargo.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]