Mark Andrew Ashworth and Barrie Dunn
This paper aims to present the results of a 32-year-old laboratory study of whisker growth from tin electrodeposits that was originally undertaken to gain an increased…
Abstract
Purpose
This paper aims to present the results of a 32-year-old laboratory study of whisker growth from tin electrodeposits that was originally undertaken to gain an increased understanding of the phenomenon of tin whisker growth.
Design/methodology/approach
Whisker growth was evaluated using electroplated C-rings (both stressed and un-stressed) that were stored throughout in a desiccator at room temperature. Analysis has recently been undertaken to evaluate whisker growth and intermetallic growth after 32 years of storage. Scanning electron microscopy analysis has been performed to investigate whisker length and, using polished cross-sections, the morphology, thickness and type of intermetallic formation.
Findings
Normal tin-plated deposits on brass and steel with a copper barrier layer nucleated whiskers within five months, and in each case, these grew to lengths between 1 and 4.5 mm. For normal tin electroplated onto brass, a one- or two-month nucleation period was needed before whiskers developed. They reached a maximum length of about 1.5 mm after six months, and little or no further growth occurred during the subsequent 32 years. Very few whiskers grew on the tin-plated steel samples and no intermetallic formation was observed. None of the fused tin plating samples nucleated whiskers during the 32-year period.
Practical implications
Knowledge about vintage whiskers is important to take steps to increase the resiliency of space missions. Similarly, such knowledge is important to engineers engaged in products reaching their nominal end-of-life, but where, for reasons of economy, these products cannot be replaced.
Originality/value
This study represents a unique insight into whisker growth and intermetallic formation over an extremely long time period.
Details
Keywords
Thomas Round, Mark Ashworth, Tessa Crilly, Ewan Ferlie and Charles Wolfe
A well-funded, four-year integrated care programme was implemented in south London. The programme attempted to integrate care across primary, acute, community, mental health and…
Abstract
Purpose
A well-funded, four-year integrated care programme was implemented in south London. The programme attempted to integrate care across primary, acute, community, mental health and social care. The purpose of this paper is to reduce hospital admissions and nursing home placements. Programme evaluation aimed to identify what worked well and what did not; lessons learnt; the value of integrated care investment.
Design/methodology/approach
Qualitative data were obtained from documentary analysis, stakeholder interviews, focus groups and observational data from programme meetings. Framework analysis was applied to stakeholder interview and focus group data in order to generate themes.
Findings
The integrated care project had not delivered expected radical reductions in hospital or nursing home utilisation. In response, the scheme was reformulated to focus on feasible service integration. Other benefits emerged, particularly system transformation. Nine themes emerged: shared vision/case for change; interventions; leadership; relationships; organisational structures and governance; citizens and patients; evaluation and monitoring; macro level. Each theme was interpreted in terms of “successes”, “challenges” and “lessons learnt”.
Research limitations/implications
Evaluation was hampered by lack of a clear evaluation strategy from programme inception to conclusion, and of the evidence required to corroborate claims of benefit.
Practical implications
Key lessons learnt included: importance of strong clinical leadership, shared ownership and inbuilt evaluation.
Originality/value
Primary care was a key player in the integrated care programme. Initial resistance delayed implementation and related to concerns about vertical integration and scepticism about unrealistic goals. A focus on clinical care and shared ownership contributed to eventual system transformation.
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Eloise Radcliffe, Maria Kordowicz, Caroline Mak, Guy Shefer, David Armstrong, Patrick White and Mark Ashworth
The purpose of this paper is to understand the barriers and enablers to lean implementation as part of an imaging quality improvement programme from a socio-cultural perspective.
Abstract
Purpose
The purpose of this paper is to understand the barriers and enablers to lean implementation as part of an imaging quality improvement programme from a socio-cultural perspective.
Design/methodology/approach
An in-depth 33 month ethnographic study, using observation and qualitative interviews, examined the process of lean implementation as part of an improvement programme.
Findings
Implementation of lean was more successful compared with other reports of lean in healthcare settings. Key enablers of lean were high levels of multidisciplinary staff involvement and engagement; the professional credibility of facilitators and clinicians as early adopters, all within a wider culture of relatively strong inter-professional relationships in the imaging department. These enablers combined with the more routinised and standardised nature of imaging pathways compared to some other acute specialties suggest that imaging is fertile ground for lean, linked to the manufacturing origins of lean.
Practical implications
When introducing lean within healthcare settings, special attention needs to be paid to the specific healthcare context and the existing cultures of inter-professional relationships. Fostering an improvement culture and engagement with training, together with adequate financial resource, are a key to contributing to the level of acceptability of an improvement tool such as lean.
Originality/value
This ethnographic study, bringing together rich multi-source data, has provided a detailed insight into the cultural workings of the process of lean implementation within a complex healthcare system.
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Special hospitals are notorious for their social isolation. In this sense they are not unlike tribal societies. These hospitals, like their tribal counterparts, are ripe for local…
Abstract
Special hospitals are notorious for their social isolation. In this sense they are not unlike tribal societies. These hospitals, like their tribal counterparts, are ripe for local time reckoning to emerge. A previous study that focussed on tribal societies is used here to illustrate socio‐temporal issues ‐ primarily because of their social isolation, which is comparable with the isolation from wider society of the special hospital, a factor that is essential for local time reckoning to emerge at any significant level.
This article describes the practical steps needed to establish and maintain patients on clozapine within secure psychiatric services, particularly where patients have a history of…
Abstract
This article describes the practical steps needed to establish and maintain patients on clozapine within secure psychiatric services, particularly where patients have a history of non‐adherence to treatment. The role of psychiatric nurses in creating a climate of therapeutic optimism is stressed. A number of techniques which optimise adherence are described.
Online developments ‐ Two new online services show the continuing onward march of this method of access to certain types of information for traders and investors.
Mark Chandley, Maxine Cromar-Hayes, Dave Mercer, Bridget Clancy, Iain Wilkie and Gary Thorpe
The purpose of this paper is to derive from an on-going, innovative, project to explore the concept, and application, of “recovery” in the care and clinical management of patients…
Abstract
Purpose
The purpose of this paper is to derive from an on-going, innovative, project to explore the concept, and application, of “recovery” in the care and clinical management of patients detained in one UK high-security hospital.
Design/methodology/approach
Utilising a qualitative, action research, methodology the aim was to involve forensic mental health nurses in a collaborative, client-centred approach to identification and resolution of dilemmas in the process of planning care for offender-patients.
Findings
In this context the authors identify constraints and contradictions involved in employing recovery principles in institutions critics refer to as part of the disciplinary apparatus of psychiatric and social control; where the taken for granted lives, and relations, of an incarcerated population are measured by the calendar, not the clock.
Research limitations/implications
Protective practices remain highly relevant in high-secure practice. Safety, an important value for all can by and large be achieved through recovery approaches. The humanistic elements of recovery can offer up safe and useful methods of deploying the mental health nurse on the ward. Many nurses have the prerequisite approach but there remains a wide scope to enhance those skills. Many see the approach as axiomatic though nurse education often prepares nurses with a biomedical view of the ward.
Practical implications
Currently, philosophical tenets of recovery are enshrined in contemporary health policy and professional directives but, as yet, have not been translated into high-secure settings. Drawing on preliminary findings, attention is given to the value of socially situated approaches in challenging historic dominance of a medical model.
Social implications
It is concluded that recovery could be a forerunner of reforms necessary for the continued relevance of high-secure care into the twenty-first century.
Originality/value
This research is located in high-secure setting. The social situation is marked by the extent of the isolation involved. A value is in this situation. First it is akin to the isolation of the tribe utilised by many anthropologists for their ability to adopt the “social laboratory” status to test out theories of behaviour in industrial society. The authors urge others to utilise this research in this way. Second, the situation represents the locus of so many of societies dilemmas, paradoxes and fears that moral issues morph from what is the mundane in wider society. In this way humanistic approaches are tested via action research with nurses in some rigouous ways.