Co-designing interventions within quality improvement initiatives : notes from the field

Increasingly, quality improvement programmes are developed with an explicit mandate to involve patients, carers, and members of the public. A quality improvement and research programme in Northwest London has nearly a decade of experience in this field. This article provides an overview of how improvement initiatives supported by the programme have involved patients in the co-design of interventions within various clinical settings. Reflections on some of the challenges and facilitators are offered. Extending roles for patients beyond co- designing interventions to involving them in implementation offers new levels of engagement and transparenc

TEMPERATURE-DEPENDENCE OF DOMAIN-WALL COERCIVE FIELD IN MAGNETIC GARNET-FILMS

The coercive properties of magnetically uniaxial liquid-phase epitaxy garnet films were investigated between 10 K and the Neel temperature (T(N) less-than-or-equal-to 500 K). Two independent methods, the results of which are nearly identical (magnetical response of oscillating domain walls and the method of coercive loops measured in a vibrating sample magnetometer), were used. Besides the usual domain-wall coercive field, H(dw), the critical coercive pressure, p(dw), was also introduced as it describes in a direct way the interactions of the domain walls with the wall-pinning traps. Both H(dw) and p(dw) were found to increase exponentially with decreasing temperature. Three different types of wall-pinning traps were identified in the sample and their strength, their rate of change with temperature, and their temperature range of activity were determined

SURVEY OF THE DEPENDENCE ON TEMPERATURE OF THE COERCIVITY OF GARNET-FILMS

The temperature dependence of the domain-wall coercive field of epitaxial magnetic garnets films has been investigated in the entire temperature range of the ferrimagnetic phase, and has been found to be described by a set of parametric exponents. In subsequent temperature regions different slopes were observed, with breaking points whose position was found to be sample dependent. A survey ba.ed on literature Data as well as on a large number of our own samples shows the general existence of this piecewise exponential dependence and the presence of the breaking points. This type of domain-wall coercive field temperature dependence was found in all samples in the large family of the epitaxial garnets (about 30 specimens of more than ten chemical compositionsj and also in another strongly anisotropic material (TbFeCo)

Structural optimization incorporating centrifugal and Coriolis effects

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/76888/1/AIAA-10798-921.pd

Constraint on axial-vector meson mixing angle from nonrelativistic constituent quark model

In a nonrelativistic constituent quark model we find a constraint on the mixing angle of the strange axial-vector mesons, $35^o\stackrel{<}{\sim } \theta _K\stackrel{<}{\sim }55^o,$ determined solely by two parameters: the mass difference of the $a_1$ and $b_1$ mesons and the ratio of the constituent quark masses.Comment: 8 pages, LaTe

Better use of data to improve parent satisfaction (BUDS): protocol for a prospective before-and-after pilot study employing mixed methods to improve parent experience of neonatal care

Introduction Having a baby that requires neonatal care is stressful and traumatic. Parents often report dissatisfaction with communication of clinical information. In the UK neonatal care data are recorded daily using electronic patient record systems (EPR), from which deidentified data form the National Neonatal Research Database (NNRD). We aim to evaluate the impact of sharing neonatal EPR data with parents, on parent-reported satisfaction, parent–staff interactions, staff workload and data completeness. Methods A prospective, before-and-after, mixed-method study. Participants are parents of inpatient babies (maximum 90) and staff in a tertiary neonatal intensive care unit, London, UK. The intervention was developed by former neonatal parents, neonatologists and neonatal nurses: a communication tool for parents comprising individualised, written, daily infant updates for parents, derived from EPR data. The intervention will be provided to parents over 6 weeks. Plan-Do-Study-Act cycles will inform the tool’s iterative development and improvement. The tool’s impact will be measured using a validated parent survey, staff survey, data completeness measures and interviews. Analysis Primary outcome: parent satisfaction ‘with communication of clinical information and involvement in care’. Secondary outcomes: parent–staff interactions, staff workload, data completeness. Baseline survey data will be obtained from clinical service evaluation preceding the intervention. Baseline data completeness will be derived from the NNRD. During the intervention, surveys will be administered biweekly and data completeness assessed daily. We will analyse outcomes using run charts and partially paired statistical tests. Parent and staff interviews will explore information exchange and the communication tool’s impact. Discussion This study will evaluate the impact of a parent co-designed intervention on communication with parents in neonatal care and the completeness of routinely recorded electronic clinical data. Better use of routinely recorded clinical data provides the opportunity to improve parent satisfaction and increase the research utility of such data, benefiting clinical care

Three Gravitational Lenses for the Price of One: Enhanced Strong Lensing through Galaxy Clustering

We report the serendipitous discovery of two strong gravitational lens candidates (ACS J160919+6532 and ACS J160910+6532) in deep images obtained with the Advanced Camera for Surveys on the Hubble Space Telescope, each less than 40 arcsec from the previously known gravitational lens system CLASS B1608+656. The redshifts of both lens galaxies have been measured with Keck and Gemini: one is a member of a small galaxy group at z~0.63, which also includes the lensing galaxy in the B1608+656 system, and the second is a member of a foreground group at z~0.43. By measuring the effective radii and surface brightnesses of the two lens galaxies, we infer their velocity dispersions based on the passively evolving Fundamental Plane (FP) relation. Elliptical isothermal lens mass models are able to explain their image configurations within the lens hypothesis, with a velocity dispersion compatible with that estimated from the FP for a reasonable source-redshift range. Based on the large number of massive early-type galaxies in the field and the number-density of faint blue galaxies, the presence of two additional lens systems around CLASS B1608+656 is not unlikely in hindsight. Gravitational lens galaxies are predominantly early-type galaxies, which are clustered, and the lensed quasar host galaxies are also clustered. Therefore, obtaining deep high-resolution images of the fields around known strong lens systems is an excellent method of enhancing the probability of finding additional strong gravitational lens systems.Comment: Submitted to ApJ. 8 pages, 6 figure

Managing marine disease emergencies in an era of rapid change

Infectious marine diseases can decimate populations and are increasing among some taxa due to global change and our increasing reliance on marine environments. Marine diseases become emergencies when significant ecological, economic or social impacts occur. We can prepare for and manage these emergencies through improved surveillance, and the development and iterative refinement of approaches to mitigate disease and its impacts. Improving surveillance requires fast, accurate diagnoses, forecasting disease risk and real-time monitoring of disease-promoting environmental conditions. Diversifying impact mitigation involves increasing host resilience to disease, reducing pathogen abundance and managing environmental factors that facilitate disease. Disease surveillance and mitigation can be adaptive if informed by research advances and catalysed by communication among observers, researchers and decision-makers using information-sharing platforms. Recent increases in the awareness of the threats posed by marine diseases may lead to policy frameworks that facilitate the responses and management that marine disease emergencies require

Properties of the Strange Axial Mesons in the Relativized Quark Model

We studied properties of the strange axial mesons in the relativized quark model. We calculated the $K_1$ decay constant in the quark model and showed how it can be used to extract the $K_1 (^3P_1) - K_1 (^1P_1)$ mixing angle ($\theta_K$) from the weak decay $\tau \to K_1 \nu_\tau$. The ratio $BR(\tau \to \nu_\tau K_1 (1270))/BR(\tau\to \nu_\tau K_1(1400))$ is the most sensitive measurement and also the most reliable since the largest of the theoretical uncertainties factor out. However the current bounds extracted from the TPC/Two-Gamma collaboration measurements are rather weak: we typically obtain $-30^o \lesssim \theta_K \lesssim 50^o$ at 68\% C.L. We also calculated the strong OZI-allowed decays in the pseudoscalar emission model and the flux-tube breaking model and extracted a $^3P_1 - ^1P_1$ mixing angle of $\theta_K \simeq 45^o$. Our analysis also indicates that the heavy quark limit does not give a good description of the strange mesons.Comment: Revised version to be published in Phys. Rev. D. Minor changes. Latex file uses revtex version 3 and epsfig, 4 postcript figures are attached. The full postcript version with embedded figures is available at ftp://ftp.physics.carleton.ca/pub/theory/godfrey/ocipc9512.ps.

Academic Functioning and Mental Health in Adolescence

The current study examines patterns of academic functioning and mental health in 184 middle school children and the relation of such patterns to their prior and subsequent functioning. Data were collected from children during their second, third, fourth, eighth, and ninth grade school years. Cluster analyses were used to delineate patterns of academic functioning and mental health during eighth grade. The authors examined the relation of these patterns to academic functioning and mental health 1 year later the transition to high school, and then examined the long-term developmental roots of the eighth grade patterns using data collected during elementary school years. Results indicated variegated patterns of academic and emotional functioning at eighth grade and stability in these patterns across the high school transition. Some long-term continuity was found among children showing uniformly positive or negative functioning at eighth grade. Studying child functioning across multiple domains and time periods is discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68127/2/10.1177_0743558499142002.pd