The next phase of healthcare improvement: what can we learn from social movements?

To date, improvement in health care has relied mainly on a "top down" programme by programme approach to service change and development. This has spawned a multitude of different and often impressive improvement schemes and activities. We question whether what has been happening will be sufficient to achieve the desired scale of change within the time scales set. Is it a case of "more of the same" or are there new and different approaches that might now be usefully implemented? Evidence from the social sciences suggests that other perspectives may help to recast large scale organisational change efforts in a new light and offer a different, though complementary, approach to improvement thinking and practice. Particularly prominent is the recognition that such large scale change in organisations relies not only on the "external drivers" but on the ability to connect with and mobilise people?s own "internal" energies and drivers for change, thus creating a "bottom up" locally led "grass roots" movement for improvement and change

Exchange Rate Regimes and Revenue Performance in Sub-Saharan Africa

It has been argued that the institutions of the CFA Franc zone may have reduced inflation but that they also induced misalignment of the real exchange rate and that this is the explanation for their dismal revenue performance. This paper uses a panel of 22 countries in sub-Saharan Africa to estimate revenue performance over the period from 1980 to 1996. It finds that the poor cumulative relative revenue performance of the franc zone countries is mainly attributable to differences in environmental and structural factors, and to their different responses to changes in the equilibrium real exchange rate, but that the misalignment of the real exchange rate also played a part.

Towards a million change agents. A review of the social movements literature: implications for large scale change in the NHS.

This review explores 'social movements' as a new way of thinking about large-scale systems change and assesses the potential contribution of applying this new perspective to NHS improvement

Real space first-principles derived semiempirical pseudopotentials applied to tunneling magnetoresistance

In this letter we present a real space density functional theory (DFT) localized basis set semi-empirical pseudopotential (SEP) approach. The method is applied to iron and magnesium oxide, where bulk SEP and local spin density approximation (LSDA) band structure calculations are shown to agree within approximately 0.1 eV. Subsequently we investigate the qualitative transferability of bulk derived SEPs to Fe/MgO/Fe tunnel junctions. We find that the SEP method is particularly well suited to address the tight binding transferability problem because the transferability error at the interface can be characterized not only in orbital space (via the interface local density of states) but also in real space (via the system potential). To achieve a quantitative parameterization, we introduce the notion of ghost semi-empirical pseudopotentials extracted from the first-principles calculated Fe/MgO bonding interface. Such interface corrections are shown to be particularly necessary for barrier widths in the range of 1 nm, where interface states on opposite sides of the barrier couple effectively and play a important role in the transmission characteristics. In general the results underscore the need for separate tight binding interface and bulk parameter sets when modeling conduction through thin heterojunctions on the nanoscale.Comment: Submitted to Journal of Applied Physic

Trajectory generation for road vehicle obstacle avoidance using convex optimization

This paper presents a method for trajectory generation using convex optimization to find a feasible, obstacle-free path for a road vehicle. Consideration of vehicle rotation is shown to be necessary if the trajectory is to avoid obstacles specified in a fixed Earth axis system. The paper establishes that, despite the presence of significant non-linearities, it is possible to articulate the obstacle avoidance problem in a tractable convex form using multiple optimization passes. Finally, it is shown by simulation that an optimal trajectory that accounts for the vehicle’s changing velocity throughout the manoeuvre is superior to a previous analytical method that assumes constant speed

Vortex Mass in BCS systems: Kopnin and Baym-Chandler contributions

The Kopnin mass and the Baym-Chandler mass of the vortex have the same origin. Both represent the mass of the normal component trapped by the vortex. The Kopnin mass of the vortex is formed by quasiparticles localized in the vicinity of the vortex. In the superclean limit it is calculated as linear response exactly in the same way as the density of the normal component is calculated in homogeneous superfluid. The Baym-Chandler mass is the hydrodynamical (associated) mass trapped by vortex. It is analogous to the normal component formed by inhomogeneities, such as pores and impurities. Both contributions are calculated for the generic model of the continuous vortex core.Comment: revtex file, 3 pages, 1 figure. Initially appeared as Comment to the paper by E.B. Sonin et al "Vortex motion in charged and neutral superfluids: A hydrodynamic approach" (Phys. Rev. B 57, 575 (1998)). The calculation of the backflow mass is adde

A decade of ejecta dust formation in the Type IIn SN 2005ip

In order to understand the contribution of core-collapse supernovae to the dust budget of the early universe, it is important to understand not only the mass of dust that can form in core-collapse supernovae but also the location and rate of dust formation. SN 2005ip is of particular interest since dust has been inferred to have formed in both the ejecta and the post-shock region behind the radiative reverse shock. We have collated eight optical archival spectra that span the lifetime of SN 2005ip and we additionally present a new X-shooter optical-near-IR spectrum of SN 2005ip at 4075d post-discovery. Using the Monte Carlo line transfer code DAMOCLES, we have modelled the blueshifted broad and intermediate width H$\alpha$, H$\beta$ and He I lines from 48d to 4075d post-discovery using an ejecta dust model. We find that dust in the ejecta can account for the asymmetries observed in the broad and intermediate width H$\alpha$, H$\beta$ and He I line profiles at all epochs and that it is not necessary to invoke post-shock dust formation to explain the blueshifting observed in the intermediate width post-shock lines. Using a Bayesian approach, we have determined the evolution of the ejecta dust mass in SN 2005ip over 10 years presuming an ejecta dust model, with an increasing dust mass from ~10$^{-8}$ M$_{\odot}$ at 48d to a current dust mass of $\sim$0.1 M$_{\odot}$.Comment: Accepted by MNRAS, 17 pages, 11 figures. Author accepted manuscript. Accepted on 04/03/19. Deposited on 07/03/1

Comet and Meteorite Traditions of Aboriginal Australians

Of the hundreds of distinct Aboriginal cultures of Australia, many have oral traditions rich in descriptions and explanations of comets, meteors, meteorites, airbursts, impact events, and impact craters. These views generally attribute these phenomena to spirits, death, and bad omens. There are also many traditions that describe the formation of meteorite craters as well as impact events that are not known to Western science.Comment: Encyclopaedia of the History of Science, Technology, and Medicine in Non-Western Cultures, 2014. Edited by Helaine Selin. Springer Netherland