Searching for swept-up hydrogen and helium in the late-time spectra of 11 nearby Type Ia supernovae

The direct detection of a stellar system that explodes as a Type Ia supernova (SN Ia) has not yet been successful. Various indirect methods have been used to investigate SN Ia progenitor systems but none have produced conclusive results. A prediction of single-degenerate models is that H- (or He-) rich material from the envelope of the companion star should be swept up by the SN ejecta in the explosion. Seven SNe Ia have been analysed to date looking for signs of H-rich material in their late-time spectra and none were detected. We present results from new late-time spectra of 11 SNe Ia obtained at the Very Large Telescope using XShooter and FORS2. We present the tentative detection of Hα emission for SN 2013ct, corresponding to ∼0.007 M_⊙ of stripped/ablated companion star material (under the assumptions of the spectral modelling). This mass is significantly lower than expected for single-degenerate scenarios, suggesting that >0.1 M_⊙ of H-rich is present but not observed. We do not detect Hα emission in the other 10 SNe Ia. This brings the total sample of normal SNe Ia with non-detections (<0.001–0.058 M_⊙) of H-rich material to 17 events. The simplest explanation for these non-detections is that these objects did not result from the explosion of a CO white dwarf accreting matter from a H-rich companion star via Roche lobe overflow or symbiotic channels. However, further spectral modelling is needed to confirm this. We also find no evidence of He-emission features, but models with He-rich companion stars are not available to place mass limits.

Using protocols in ICU practice. Engaging the staff.

Aims/Purpose: Protocols are evidenced-based structured guides for directing care to achieve improvements. But translating that evidence into practice is a major challenge. It is not acceptable to simply introduce the protocol and expect it to be adopted and lead to change in practice. Implementation requires effective leadership and management. This presentation describes a strategy for implementation that should promote successful adoption and lead to practice change.
Presentation description: There are many social and behavioural change models to assist and guide practice change. Choosing a model to guide implementation is important for providing a framework for action. The change process requires careful thought, from the protocol itself to the policies and politics within the ICU. In this presentation, I discuss a useful pragmatic guide called the 6SQUID (6 Steps in QUality Intervention Development). This was initially designed for public health interventions, but the model has wider applicability and has similarities with other change process models. Steps requiring consideration include examining the purpose and the need for change; the staff that will be affected and the impact on their workload; and the evidence base supporting the protocol. Subsequent steps in the process that the ICU manager should consider are the change mechanism (widespread multi-disciplinary consultation; adapting the protocol to the local ICU); and identifying how to deliver the change mechanism (educational workshops and preparing staff for the changes are imperative). Recognising the barriers to implementation and change and addressing these locally is also important. Once the protocol has been implemented, there is generally a learning curve before it becomes embedded in practice. Audit and feedback on adherence are useful strategies to monitor and sustain the changes.
Conclusion: Managing change successfully will promote a positive experience for staff. In turn, this will encourage a culture of enthusiasm for translating evidence into practice.