General Practice after the Introduction of the QOF

While the Quality and Outcomes Framework (QOF) is reported to improve performance, its impact on some aspects of organisations need to be explored given the increased reliance on such schemes. Organisational culture can be seen as providing a sense of common values, belief, and norms, which may act as guidelines for behaviour in organisational settings. This research employs a competing value framework depictures different types of culture based on specific focuses and processes. The study is based on interviews with 2 GP practices in the north of England involving 19 participants. Healthcare professionals were aware that there is a dominant value held and shared strongly among members of the organisations-to provide high quality patient-centred services. This study found that while clan culture is still strong in both practices, changes occured in respondents' culture after the implementation of the QOF.

AUDIT OF ANTIBIOTIC USAGE IN A MEDIUM-SIZED GENERAL-HOSPITAL OVER AN 11-YEAR PERIOD - THE IMPACT OF ANTIBIOTIC POLICIES

The objective of the present study was to evaluate trends in antibiotic expenditure over an 11-year period (1982-1992) in a 370-bed district general hospital in Northern Ireland and to examine the impact of two separate antibiotic policies on antibiotic usage. A further objective was to examine the attitudes of prescribers to the second policy. Drug utilization review was used to collect information on antibiotic expenditure and usage before and after introduction of separate antibiotic policies in 1985 (not intensively monitored) and 1989 (intensively monitored). A mail questionnaire was used to determine the attitudes of prescribers. The first policy (1985) showed no benefits with regard to the number of antibiotic entities stocked (45 before, 45 after), number of dosage units issued (9.35 increase) or expenditure (33.35 increase). The 1989 policy led to significant reductions in the number of antibiotic entities stocked (28.9%), number of antibiotics issued (11.9%) and expenditure (6.1%). Expenditure began to spiral upwards when active monitoring of the second policy was suspended. The majority of prescribers (87.2%) who responded to the questionnaire (56.5% response rate) felt that the 1989 policy made a positive contribution to antibiotic usage in the hospital.

Optical and near-infrared coverage of SN 2004et: physical parameters and comparison with other Type IIP supernovae

We present new optical and near-infrared (NIR) photometry and spectroscopy of the Type IIP supernova (SN), SN 2004et. In combination with already published data, this provides one of the most complete studies of optical and NIR data for any Type IIP SN from just after explosion to +500 d. The contribution of the NIR flux to the bolometric light curve is estimated to increase from 15 per cent at explosion to around 50 per cent at the end of the plateau and then declines to 40 per cent at 300 d. SN 2004et is one of the most luminous IIP SNe which has been well studied and characterized, and with a luminosity of log L = 42.3 erg s-1 and a 56Ni mass of 0.06 +/- 0.04 M-circle dot, it is two times brighter than SN 1999em. We provide parametrized bolometric corrections as a function of time since explosion for SN 2004et and three other IIP SNe that have extensive optical and NIR data. These can be used as templates for future events in optical and NIR surveys without full wavelength coverage. We compare the physical parameters of SN 2004et with those of other well-studied IIP SNe and find that the kinetic energies span a range of 1050-1051 erg. We compare the ejected masses calculated from hydrodynamic models with the progenitor masses and limits derived from pre-discovery images. Some of the ejected mass estimates are significantly higher than the progenitor mass estimates, with SN 2004et showing perhaps the most serious mass discrepancy. With the current models, it appears difficult to reconcile 100 d plateau lengths and high expansion velocities with the low ejected masses of 5-6 M-circle dot implied from 7-8 M-circle dot progenitors. The nebular phase is studied using very late-time Hubble Space Telescope photometry, along with optical and NIR spectroscopy. The light curve shows a clear flattening at 600 d in the optical and the NIR, which is likely due to the ejecta impacting on circumstellar material. We further show that the [O i] 6300, 6364 A line strengths in the nebular spectra of four Type IIP SNe imply ejected oxygen masses of 0.5-1.5 M-circle dot.

Massive stars exploding in a He-rich circumstellar medium - I. Type Ibn (SN 2006jc-like) events

We present new spectroscopic and photometric data of the Type Ibn supernovae 2006jc, 2000er and 2002ao. We discuss the general properties of this recently proposed supernova family, which also includes SN 1999cq. The early-time monitoring of SN 2000er traces the evolution of this class of objects during the first few days after the shock breakout. An overall similarity in the photometric and spectroscopic evolution is found among the members of this group, which would be unexpected if the energy in these core-collapse events was dominated by the interaction between supernova ejecta and circumstellar medium. Type Ibn supernovae appear to be rather normal Type Ib/c supernova explosions which occur within a He-rich circumstellar environment. SNe Ibn are therefore likely produced by the explosion of Wolf-Rayet progenitors still embedded in the He-rich material lost by the star in recent mass-loss episodes, which resemble known luminous blue variable eruptions. The evolved Wolf-Rayet star could either result from the evolution of a very massive star or be the more evolved member of a massive binary system. We also suggest that there are a number of arguments in favour of a Type Ibn classification for the historical SN 1885A (S-Andromedae), previously considered as an anomalous Type la event with some resemblance to SN 1991bg.

Core-collapse supernovae in low-metallicity environments and future all-sky transient surveys

Aims. Massive stars in low-metallicity environments may produce exotic explosions such as long-duration gamma-ray bursts and pair-instability supernovae when they die as core-collapse supernovae (CCSNe). Such events are predicted to be relatively common in the early Universe during the first episodes of star-formation. To understand these distant explosions it is vital to study nearby CCSNe arising in low-metallicity environments to determine if the explosions have different characteristics to those studied locally in high-metallicity galaxies. Many of the nearby supernova searches concentrate their efforts on high star-formation rate galaxies, hence biasing the discoveries to metal rich regimes. Here we determine the feasibility of searching for these CCSNe in metal-poor dwarf galaxies using various survey strategies.

Faint supernovae and supernova impostors: case studies of SN 2002kg/NGC 2403-V37 and SN 2003gm

Photometric and spectroscopic observations of the faint Supernovae (SNe) 2002kg and 2003gm, and their precursors, in NGC 2403 and NGC 5334, respectively, are presented. The properties of these SNe are discussed in the context of previously proposed scenarios for faint SNe: low-mass progenitors producing underenergetic SNe; SNe with ejecta constrained by a circumstellar medium; and outbursts of massive Luminous Blue Variables (LBVs). The last scenario has been referred to as 'Type V SNe', 'SN impostors' or 'fake SNe'.

Hubble Space Telescope imaging of the progenitor sites of six nearby core-collapse supernovae

The search for the progenitors of six core-collapse supernovae (CCSNe) in archival Hubble Space Telescope (HST) WFPC2 pre-explosion imaging is presented. These SNe are 1999an, 1999br, 1999ev, 2000ds, 2000ew and 2001B. Post-explosion imaging of the SNe, with the HST ACS/WFC, has been utilized with the technique of differential astrometry to identify the progenitor locations on the pre-explosion imaging. SNe 1999br, 1999ev, 2000ew and 2001B are recovered in late-time imaging, and estimates of the progenitor locations on the pre-explosion imaging, with subpixel accuracy, have been made. Only the progenitor of the Type II-P SN 1999ev has been recovered, on pre-explosion F555W imaging, at a 4.8 sigma significance level. Assuming a red supergiant progenitor, the pre-explosion observation is consistent with M-ZAMS = 15-18 M-circle dot. The progenitors of the other five SNe were below the 3 sigma detection threshold of the pre-explosion observations. The detection thresholds were translated to mass limits for the progenitors by comparison with stellar evolution models. Pre-explosion observations of the peculiarly faint SN 1999br limit the mass of a red supergiant progenitor to M-ZAMS

The binary progenitor of Tycho Brahe's 1572 supernova

The brightness of type Ia supernovae, and their homogeneity as a class, makes them powerful tools in cosmology, yet little is known about the progenitor systems of these explosions. They are thought to arise when a white dwarf accretes matter from a companion star, is compressed and undergoes a thermonuclear explosion(1-3). Unless the companion star is another white dwarf ( in which case it should be destroyed by the mass-transfer process itself), it should survive and show distinguishing properties. Tycho's supernova(4,5) is one of only two type Ia supernovae observed in our Galaxy, and so provides an opportunity to address observationally the identification of the surviving companion. Here we report a survey of the central region of its remnant, around the position of the explosion, which excludes red giants as the mass donor of the exploding white dwarf. We found a type G0 - G2 star, similar to our Sun in surface temperature and luminosity ( but lower surface gravity), moving at more than three times the mean velocity of the stars at that distance, which appears to be the surviving companion of the supernova.

Mass limits for the progenitor star of supernova 2001du and other Type II-P supernovae

The supernova SN 2001du was discovered in the galaxy NGC 1365 at a distance of 19 +/- 2 Mpc, and is a core-collapse event of Type II-P. Images of this galaxy, of moderate depth, have been taken with the Hubble Space Telescope approximately 6.6 yr before discovery and include the supernova position on the WFPC2 field of view. We have observed the supernova with the WFPC2 to allow accurate differential astrometry of SN 2001du on the pre-explosion frames. As a core-collapse event it is expected that the progenitor was a massive, luminous star. There is a marginal detection (3sigma) of a source close to the supernova position on the pre-discovery V -band frame, but it is not precisely coincident and we do not believe it to be a robust detection of a point source. We conclude that there is no stellar progenitor at the supernova position and derive sensitivity limits of the pre-discovery images that provide an upper mass limit for the progenitor star. We estimate that the progenitor had a mass of less than 15 M-circle dot . We revisit two other nearby Type II-P supernovae that have high-quality pre-explosion images, and refine the upper mass limits for the progenitor stars. Using a new distance determination for SN 1999gi from the expanding photosphere method, we revise the upper mass limit to 12 M-circle dot . We present new HST images of the site of SN 1999em, which validate the use of lower spatial resolution ground-based images in the progenitor studies and use a new Cepheid distance to the galaxy to measure an upper mass limit of 15 M-circle dot for that progenitor. Finally we compile all the direct information available for the progenitors of eight nearby core-collapse supernovae and compare their mass estimates. These are compared with the latest stellar evolutionary models of pre-supernova evolution which have attempted to relate metallicity and mass to the supernovae type. Although this is statistically limited at present, reasonable agreement is already found for the lower-mass events (generally the II-P), but some discrepancies appear at higher masses.

A comparison between star formation rate diagnostics and rate of core collapse supernovae within 11 Mpc

Aims. The core collapse supernova rate provides a strong lower limit for the star formation rate (SFR). Progress in using it as a cosmic SFR tracer requires some confidence that it is consistent with more conventional SFR diagnostics in the nearby Universe. This paper compares standard SFR measurements based on H alpha, far ultraviolet (FUV) and total infrared (TIR) galaxy luminosities with the observed core collapse supernova rate in the same galaxy sample. The comparison can be viewed from two perspectives. Firstly, by adopting an estimate of the minimum stellar mass to produce a core collapse supernova one can determine a SFR from supernova numbers. Secondly, the radiative SFR can be assumed to be robust and then the supernova statistics provide a constrain on the minimum stellar mass for core collapse supernova progenitors.