Factors that influence the sustainability of structured allied health journal clubs: a qualitative study

Background: Structured journal clubs are a widely used tool to promote evidence-based practice in health professionals, however some journal clubs (JC) are more effectively sustained than others. To date, little research has provided insights into factors which may influence sustainability of JCs within health care settings. As part of a larger randomised controlled study, this research aimed to gain understanding of clinicians' experiences of sustaining a structured JC format (TREAT- Tailoring Research Evidence and Theory) within their clinical context. The study also aimed to identify which strategies may assist longer term sustainability and future implementation of the TREAT format. Methods: We employed a qualitative methodology, informed by behaviour change theory. Clinicians (n=19) from five different JCs participated in focus groups to explore their experience in sustaining the JC format six months after the formal trial period had completed. Clinicians were asked to describe factors which they perceived helped or hindered sustaining components of the JC format within their local context. Following a descriptive summary of the data, barriers and enablers were thematically analysed according to behaviour change theory domains: capability, motivation and opportunity and further mapped to targeted implementation strategies. Results: Participants reported perceived benefits of maintaining the TREAT format and described several components that promoted its sustainability. Sustaining factors linked to individuals' capability included building research knowledge and skills and having access to research experts. Sustaining factors that enhanced opportunities for behaviour change included management expectation to attend and a team culture which values evidence based practice, while factors found to enhance individuals' motivation included the JC having close application to practice and clinicians sensing ownership of the JC. Several implementation strategies to enhance these factors are described including graduated support to clinicians in facilitation of JCs and greater engagement with managers. Conclusions: Long-term sustainability of a structured JC is dependent on both individual and service level factors and a balance of implementation strategies that enhance capability, opportunity and motivation. Consideration of how clinicians can be engaged to take ownership and build their own capability from the commencement of the JC is important. Trial registration: ACTRN12616000811404

Testing the impact of direct and indirect flood warnings on population behaviour using an agent-based model

This paper uses a coupled hydrodynamic agent-based model (HABM) to investigate the effect of direct or indirect warnings in flood incident response. This model uses the LISFLOOD-FP hydrodynamic model and the NetLogo agent-based framework and is applied to the 2005 flood event in Carlisle, UK. The hydrodynamic model provides a realistic simulation of detailed flood dynamics through the event, whilst the agent-based model component enables simulation and analysis of the complex, in-event social response. NetLogo enables alternative probabilistic daily routine and agent choice scenarios for the individuals of Carlisle to be simulated in a coupled fashion with the flood inundation. Specifically, experiments are conducted using a novel “enhanced social modelling component” based on the Bass diffusion model. From the analysis of these simulations, management stress points (predictable or otherwise) can be presented to those responsible for hazard management and post-event recovery. The results within this paper suggest that these stress points can be present, or amplified, due to a lack of preparedness or a lack of phased evacuation measures. Furthermore, the methods outlined here have the potential for application elsewhere to reduce the complexity and improve the effectiveness of flood incident management. The paper demonstrates the influence that emergent properties have on systematic vulnerability and risk from natural hazards in coupled socio-environmental systems

The microphysics of clouds over the Antarctic Peninsula – Part 1: Observations

Observations of clouds over the Antarctic Peninsula during summer 2010 and 2011 are presented here. The peninsula is up to 2500 m high and acts as a barrier to weather systems approaching from the Pacific sector of the Southern Ocean. Observations of the number of ice and liquid particles as well as the ice water content and liquid water content in the clouds from both sides of the peninsula and from both years were compared. In 2011 there were significantly more water drops and ice crystals, particularly in the east, where there were approximately twice the number of drops and ice crystals in 2011. Ice crystals observations as compared to ice nuclei parameterizations suggest that secondary ice multiplication at temperatures around −5 °C is important for ice crystal formation on both sides of the peninsula below 2000 m. Also, back trajectories have shown that in 2011 the air masses over the peninsula were more likely to have passed close to the surface over the sea ice in the Weddell Sea. This suggests that the sea-ice-covered Weddell Sea can act as a source of both cloud condensation nuclei and ice-nucleating particles

Multi-neuronal refractory period adapts centrally generated behaviour to reward

Oscillating neuronal circuits, known as central pattern generators (CPGs), are responsible for generating rhythmic behaviours such as walking, breathing and chewing. The CPG model alone however does not account for the ability of animals to adapt their future behaviour to changes in the sensory environment that signal reward. Here, using multi-electrode array (MEA) recording in an established experimental model of centrally generated rhythmic behaviour we show that the feeding CPG of Lymnaea stagnalis is itself associated with another, and hitherto unidentified, oscillating neuronal population. This extra-CPG oscillator is characterised by high population-wide activity alternating with population-wide quiescence. During the quiescent periods the CPG is refractory to activation by food-associated stimuli. Furthermore, the duration of the refractory period predicts the timing of the next activation of the CPG, which may be minutes into the future. Rewarding food stimuli and dopamine accelerate the frequency of the extra-CPG oscillator and reduce the duration of its quiescent periods. These findings indicate that dopamine adapts future feeding behaviour to the availability of food by significantly reducing the refractory period of the brain's feeding circuitry

Perspectives on the Historio-sociological Novel : Frank Norris' The Octopus

As an historio-sociological novel The Octopus is important because it synthesizes several features of late nineteenth century America, especially naturalism and the political preponderance of the Southern Pacific railroad. An analysis of this novel provides a better understanding of its features and adds a dimension to the perspective of history