Impact of published clinical outcomes data: case study in NHS hospital trusts

Objective To examine the impact of the publication of clinical outcomes data on NHS Trusts in Scotland to inform the development of similar schemes elsewhere. Design Case studies including semistructured interviews and a review of background statistics. Setting Eight Scottish NHS acute trusts. Participants 48 trust staff comprising chief executives, medical directors, stroke consultants, breast cancer consultants, nurse managers, and junior doctors. Main outcome measures Staff views on the benefits and drawbacks of clinical outcome indicators provided by the clinical resource and audit group (CRAG) and perceptions of the impact of these data on clinical practice and continuous improvement of quality. Results The CRAG indicators had a low profile in the trusts and were rarely cited as informing internal quality improvement or used externally to identify best practice. The indicators were mainly used to support applications for further funding and service development. The poor effect was attributable to a lack of professional belief in the indicators, arising from perceived problems around quality of data and time lag between collection and presentation of data; limited dissemination; weak incentives to take action; a predilection for process rather than outcome indicators; and a belief that informal information is often more useful than quantitative data in the assessment of clinical performance. Conclusions Those responsible for developing clinical indicator programmes should develop robust datasets. They should also encourage a working environment and incentives such that these data are used to improve continuously

On commuting varieties of parabolic subalgebras

Let $G$ be a connected reductive algebraic group over an algebraically closed field $k$, and assume that the characteristic of $k$ is zero or a pretty good prime for $G$. Let $P$ be a parabolic subgroup of $G$ and let $\mathfrak p$ be the Lie algebra of $P$. We consider the commuting variety $\mathcal C(\mathfrak p) = \{(X,Y) \in \mathfrak p \times \mathfrak p \mid [X,Y] = 0\}$. Our main theorem gives a necessary and sufficient condition for irreducibility of $\mathcal C(\mathfrak p)$ in terms of the modality of the adjoint action of $P$ on the nilpotent variety of $\mathfrak p$. As a consequence, for the case $P = B$ a Borel subgroup of $G$, we give a classification of when $\mathcal C(\mathfrak b)$ is irreducible; this builds on a partial classification given by Keeton. Further, in cases where $\mathcal C(\mathfrak p)$ is irreducible, we consider whether $\mathcal C(\mathfrak p)$ is a normal variety. In particular, this leads to a classification of when $\mathcal C(\mathfrak b)$ is normal.Comment: 19 pages; minor update

The So-Called Groups of Militant Insanity Against the Video Police: Anti-Psychiatry and Autonomia in 1970s Italian Audiovisual Media

This talk explored how anti-psychiatry was taken up both in the Radio Alice free radio station and also cinematic culture in Italy in the 1970s, focusing on the work of Marco Bellocchio, Elio Petri, and especially Alberto Grifi. While Grifi's work Anna (Grifi and Sarchielli, 1975) is a relatively well-known anti-psychiatric video experiment, anti-psychiatry runs through his 1970s work in proximity with the creative autonomia movement that also gave rise to Radio Alice. However, these currents were already present in key works of Bellocchio and Petri, especially in Fists in the Pocket (Bellocchio, 1965), Matti da slegare (Fit to be Untied, 1975) and La classe operaia va in paradiso (Petri, 1971). In the latter sound is especially significant to indicate the inter-relations between class struggle, sexuality and psychic and emotional states and this would also form the basis for Radio Alice's reinvention of radio as a delirious machinery for a militant destabilisation of the state, capital and the mass media. If this militant insanity lost out in the end to the video police in the form of both mass arrests and the rise of Berlusconi's media empire, it provides a rich legacy for 21st century reinvention

Audiovision and Gesamtkunstwerk: The Aesthetics of First and Second Generation Industrial Music Video

Michel Chion has famously and provocatively referred to film as a sound art (Chion 2009), developing his earlier reading of cinema in the synaesthetic audiovisual terms of Audio-Vision (Chion 1994). Similarly, it is possible to argue that industrial music from its beginnings with groups like Throbbing Gristle, Cabaret Voltaire, SPK and others was an audiovisual art-form, as much as a musical one, and never simply a generic sonic style. The visual aspects of industrial music were not necessarily limited to film and video and included such things as the development of logos and other design features on record sleeves and as concert backdrops, as well as specific uses of photography and other visual arts. These visual elements were often deployed via strategies of anonymity and ambiguity, generating meanings out of a deliberate and playful constitutive vagueness. However, whenever it was technically feasible to do so, industrial groups made use of both film and video technologies, and in terms of the latter were pioneers in the combination of music and video, before and outside of its commercial codification. This chapter examines this field of audiovisual activity as a form of audiovisuology that goes well beyond the promotion and iillustration of popular music

Telephones, Voice Recorders, Microphones, Phonographs: A Media Archaeology of Sonic Technologies in Twin Peaks

This article argues that sonic technologies, such as telephones, voice recorders and phonographs, alongside more (audio)visual ones such as flickering fluorescent lights, videos, and the television sets are crucial to the world of Twin Peaks, and constitute this world as both a communications network with portals to the unknown, and an accumulation of recordings of ghosted voices and entities, perhaps finding its ultimate expression in the backwards reprocessed speech in the Black Lodge. This lodge can be understood as a space in which there are nothing but recordings, albeit now on a cosmic, spiritual and demonic level. Using a media archaeological approach to these devices in the series, this paper will argue that they were already operating by a media archaeological logic, generating the world of Twin Peaks as a haunted archive of sonic and other mediations

Shapes and Dynamics from the Time-Dependent Mean Field

Explaining observed properties in terms of underlying shape degrees of freedom is a well--established prism with which to understand atomic nuclei. Self--consistent mean--field models provide one tool to understand nuclear shapes, and their link to other nuclear properties and observables. We present examples of how the time--dependent extension of the mean--field approach can be used in particular to shed light on nuclear shape properties, particularly looking at the giant resonances built on deformed nuclear ground states, and at dynamics in highly-deformed fission isomers. Example calculations are shown of $^{28}$Si in the first case, and $^{240}$Pu in the latter case.Comment: 9 pages, 5 figures, to appear in proceedings of International Workshop "Shapes and Dynamics of Atomic Nuclei: Contemporary Aspects" (SDANCA-15), 8-10 October 2015, Sofia, Bulgari

Explicit large nuclear charge limit of electronic ground states for Li, Be, B, C, N, O, F, Ne and basic aspects of the periodic table

This paper is concerned with the Schrödinger equation for atoms and ions with $N=1$ to 10 electrons. In the asymptotic limit of large nuclear charge $Z$, we determine explicitly the low-lying energy levels and eigenstates. The asymptotic energies and wavefunctions are in good quantitative agreement with experimental data for positive ions, and in excellent qualitative agreement even for neutral atoms ($Z=N$). In particular, the predicted ground state spin and angular momentum quantum numbers ($^1S$ for He, Be, Ne, $^2S$ for H and Li, $^4S$ for N, $^2P$ for B and F, and $^3P$ for C and O) agree with experiment in every case. The asymptotic Schrödinger ground states agree, up to small corrections, with the semiempirical hydrogen orbital configurations developed by Bohr, Hund, and Slater to explain the periodic table. In rare cases where our results deviate from this picture, such as the ordering of the lowest $^1D^o$ and $^3S^o$ states of the carbon isoelectronic sequence, experiment confirms our predictions and not Hund's