Search results

The purpose of this paper is to report on the use of an innovative peer review approach to identifying and addressing the causes of inappropriate admissions from hospital to nursing homes in South Gloucestershire (SG). It explains the methodology that was developed, the findings of the peer review process and reflects on the effectiveness of the process.

The peer review consisted of two stages. The first stage involved a panel of local stakeholders carrying out an audit of a random selection of cases where people had been assessed as needing permanent nursing or residential care. From this four cases of inappropriate admissions were identified. Stage two involved an externally facilitated process with two peer challenge panels; one of local stakeholders and the other external experts. The two panels analysed the cases of inappropriate admissions, identified the system causes and suggested actions to tackle the issues which were fed back to an audience of local stakeholders.

The combination of case audit and peer review was successful in providing robust challenge to the processes in SG by identifying shortcomings in the system and suggesting actions to improve outcomes.

The approach was taken in one Council area and therefore may not be replicable in another area.

The case study suggests that a peer review approach using both local and external peers, including providers, is an effective way to identify weaknesses in the health and social care processes. The insights offered by external peers and providers is helpful for councils in identifying where to focus resources and suggests that other areas should consider proactive adaptations to the peer review methodology that is offered as part of the LGA’s programme of sector-led improvement.

The case study suggests that a peer review approach could have a positive impact on the quality of care and quality of life for older people who are admitted to hospital.

The case study offers an innovative and original use of the peer review approach in social care that can be shared with other councils and partners. The Southwest Improvement Board have identified it as of particular interest to other areas seeking to work with partners to identify and implement positive change.

The purpose of this study is to investigate how the emotion expressed by a fictitious proposer influences the responder’s decision to accept or reject a severely unfair deal, represented by the splitting of a predetermined sum of money between the two players during an ultimatum game (UG). Rejection leads both parts to dissipate that sum. Critically the authors consider the situation in which both players have the best alternative to negotiation agreement (BATNA), which simulates a backup plan to rely on in case of no agreement.

The participants played a UG and, to foster the ecological validity of the paradigm, the parts could both rely on a more or less generous BATNA. The critical manipulation was the emotion expressed by the proposer while their BATNA was either hidden (Exp. 1) or communicated (Exp. 2).

The proposer’s emotions influenced participants’ own emotions, affected their social evaluations about the proposer, the desire for future interactions with the proposer and were used to infer the proposer’s BATNA when it was unknown. In this latter case, proposers’ emotions and in particular his/her happiness, decreased dramatically the participants’ tendency to reject even severely unfair offers.

Past research on UG has been predominantly aimed to investigate the effect of responders’ emotions or the effects of responders’ emotions on the proposer, devoting little attention to how the critical responder’s acceptance/rejection decision might be affected by the proposer’s emotion. Especially in the ecological situation where the parts have a BATNA in case of non-agreement.

Primary care groups are required to demonstrate that patients and the public are involved in the planning, delivery and evaluation of the services they provide. However, a review of the literature suggests that managers' ability will be greatly tested if they are to achieve meaningful progress in this area. Some suggestions are made to assist managers in this important role. In the next issue of MCC, Part 2 reports findings from a locality case study.

This chapter explores distributed leadership in volunteer multistakeholder groups tackling complex problems, focusing on community organizing practices to bridge the gap between health and health care in Columbia, South Carolina. Columbia faces increasing chronic disease, high rates of uninsured, unequal access to healthcare services, and rising costs. Regional leaders periodically tackled these problems together but faced challenges common to multistakeholder groups. In 2010, leaders from Columbia partnered with the authors in a learning enterprise to find new, more sustainable ways to address these challenges. Together we adapted a community organizing approach to develop distributed leadership skills necessary to overcome the challenges of volunteer multistakeholder groups and transform the health system in a local area. In the first year, teams provided health screenings to over 1,000 residents; over 3,000 residents exercised leadership to improve community health; over 5,000 residents pledged to improve their health. Clinic hours were extended; new health coaches focused on primary care and wellness programs. Providers and payers committed to reinvesting a share of savings in the community, which has a voice in their use. We show that developing distributed leadership via community organizing offers an approach to solving seemingly intractable community problems.

Hexahedral meshing is one of the most important steps in performing an accurate simulation using the finite element analysis (FEA). However, the current hexahedral meshing method in the industry is a nonautomatic and inefficient method, i.e. manually decomposing the model into suitable blocks and obtaining the hexahedral mesh from these blocks by mapping or sweeping algorithms. The purpose of this paper is to propose an almost automatic decomposition algorithm based on the 3D frame field and model features to replace the traditional time-consuming and laborious manual decomposition method.

The proposed algorithm is based on the 3D frame field and features, where features are used to construct feature-cutting surfaces and the 3D frame field is used to construct singular-cutting surfaces. The feature-cutting surfaces constructed from concave features first reduce the complexity of the model and decompose it into some coarse blocks. Then, an improved 3D frame field algorithm is performed on these coarse blocks to extract the singular structure and construct singular-cutting surfaces to further decompose the coarse blocks. In most modeling examples, the proposed algorithm uses both types of cutting surfaces to decompose models fully automatically. In a few examples with special requirements for hexahedral meshes, the algorithm requires manual input of some user-defined cutting surfaces and constructs different singular-cutting surfaces to ensure the effectiveness of the decomposition.

Benefiting from the feature decomposition and the 3D frame field algorithm, the output blocks of the proposed algorithm have no inner singular structure and are suitable for the mapping or sweeping algorithm. The introduction of internal constraints makes 3D frame field generation more robust in this paper, and it can automatically correct some invalid 3–5 singular structures. In a few examples with special requirements, the proposed algorithm successfully generates valid blocks even though the singular structure of the model is modified by user-defined cutting surfaces.

The proposed algorithm takes the advantage of feature decomposition and the 3D frame field to generate suitable blocks for a mapping or sweeping algorithm, which saves a lot of simulation time and requires less experience. The user-defined cutting surfaces enable the creation of special hexahedral meshes, which was difficult with previous algorithms. An improved 3D frame field generation method is proposed to correct some invalid singular structures and improve the robustness of the previous methods.

This paper aims to investigate the feasibility of adding macro-textures to triangle meshes for additive manufacturing (AM) focusing on possible time and quality issues in both software processing and part fabrication.

A demonstrative software tool was developed to apply user-selected textures to existing meshes. The computational procedure is a three-dimensional extension of the solid texturing method used in computer graphics. The tool was tested for speed and quality of results, considering also the pre- and post-processing operations required. Some textured meshes were printed by different processes to test build speed and quality.

The tool can handle models with realistic complexity in acceptable computation times. Parts are built without difficulties or extra-costs achieving a good aesthetic yield of the texture.

The tool cannot reproduce sample patterns but requires the development of a generation algorithm for different type of textures. Mesh processing operations may take a long time when very fine textures are added to large parts.

Direct texturing can help obtain parts with aesthetic or functional textures without the need for surface post-treatments, which can be especially difficult and expensive for plastic parts.

The proposed method improves the uniformity and consistency of textures compared to existing approaches, and can support future systematic studies on the detail resolution of AM processes.

This study aims to develop a random polygon garment pattern generator and a drape simulation system to automate the garment design process.

Garments were categorized into four groups based on the geometric features of the human body. Garment patterns in each group consisted of basic points, and the patterns were automatically placed, sewn and simulated around the body in three-dimensional space. Additional pattern manipulation functions were developed to modify the shapes of patterns by adding darts and cuts, either manually or randomly.

Users can produce new designs they had not considered before using the random manipulation functions. Since the three-dimensional simulation process is automated, users can focus solely on the design process.

Garments composed of multiple layers were not considered.

This system differs from existing clothing computer-aided design systems in that even users lacking prior knowledge of garment design can generate various examples. It can help users understand the relationship between 2D patterns and 3D garments without the need for a pattern drafting process.

The purpose of this paper is to apply current understanding of service user involvement (SUI) to forensic practice with reference to the benefits and drawbacks. Specifically, it discusses models of SUI and their application to a psychologically informed planned environment (PIPE) located in a Category C male prison.

Drawing upon residents’ experiences, the evaluation reflects on the contribution of cultural, environmental and political factors to the success or failure of SUI within the PIPE service.

The evaluation will review current systems and explore ways of improving and strengthening strategies by referring to the “whole systems approach” to SUI (Wright, 2006).

The evaluation makes recommendations for local and national SUI within PIPE services.

Ancient Chinese architecture is famous for its wooden frame structure and unique position in world architecture history. As numerous types of components and complex combinations exist, the overall structural system and how they are interlocked have always been crucial but challenging parts of the study. Students find it hard to understand and remember the concepts using traditional 2D paper media, making such knowledge unattractive to pass on to the new generation. To overcome the challenges, this research aims to examine the effect of combining Virtual Reality (VR) with digital interaction games in learning structural characteristics (dougong) of ancient Chinese architecture.

This research develops an interactive cognitive system in the VR environment based on constructivist theory to improve the learning approach of ancient Chinese architecture. Applying an experimental procedure, the feedback of an experimental group using the VR cognition system and a control group using traditional learning 2D media are collected to examine the differences in learning effectiveness and user experience.

This study develops an interactive cognitive system to aid in learning the structural system of ancient Chinese architecture. The results indicate that integrating VR and interactive learning games can increase students' positive attitudes and learning effectiveness towards ancient Chinese architecture.

This study integrates VR technology and interactive games to improve the learning approach. It examines the effect of applying the concept of human–computer interaction in learning ancient Chinese buildings. The concept of designing the interactive cognitive system is expected to guide students gradually to be the main body of learning and stimulate their learning enthusiasm and motivation.