Developing priorities for quality improvement in acute medicine using a modified Delphi method A consensus process hosted by the Society for Acute Medicine Quality Improvement Committee (SAM-QI).

INTRODUCTION: The SAM Quality Improvement Committee (SAM-QI), set up in 2016, has worked over the last year to determine the priority Acute Medicine QI topics. They have also discussed and put forward proposals to improve QI training for Acute Medicine professionals. METHODS: A modified Delphi process was completed over four rounds to determine priority QI topics. Online meetings were also used to develop proposals for QI training. RESULTS: Same Day Emergency Care (SDEC) was chosen as the priority topic for QI work within Acute Medicine. CONCLUSION: The SAM-QI group settled on SDEC being the priority topic for Acute Medicine QI development. Throughout the Delphi process SAM-QI has also developed proposals for QI training that will help Acute Medicine professionals deliver coordinated meaningful improvements in care.

Cherenkov radiation-based optical fibre diagnostics of fast electrons generated in intense laser-plasma interactions.

Diagnosing fast electrons is important to understand the physics underpinning intense laser-produced plasmas. Here, we demonstrate experimentally that a Cherenkov radiation-based optical fibre can serve as a reliable diagnostic to characterize the fast electrons escaping from solid targets irradiated by ultra-intense laser pulses. Using optical fibre loops, the number and angular distributions of the escaping electrons are obtained. The data agree well with measurements made using image plate stacks. The optical fibre can be operated at high-repetition rates and is insensitive to x-rays and ion beams, which makes it advantageous over other routinely used fast electron diagnostics in some aspects.

Dual Ion Species Plasma Expansion from Isotopically Layered Cryogenic Targets.

A dual ion species plasma expansion scheme from a novel target structure is introduced, in which a nanometer-thick layer of pure deuterium exists as a buffer species at the target-vacuum interface of a hydrogen plasma. Modeling shows that by controlling the deuterium layer thickness, a composite H^{+}/D^{+} ion beam can be produced by target normal sheath acceleration (TNSA), with an adjustable ratio of ion densities, as high energy proton acceleration is suppressed by the acceleration of a spectrally peaked deuteron beam. Particle in cell modeling shows that a (4.3±0.7) MeV per nucleon deuteron beam is accelerated, in a directional cone of half angle 9°. Experimentally, this was investigated using state of the art cryogenic targetry and a spectrally peaked deuteron beam of (3.4±0.7) MeV per nucleon was measured in a cone of half angle 7°-9°, while maintaining a significant TNSA proton component.

High resolution Thomson Parabola Spectrometer for full spectral capture of multi-species ion beams.

We report on the experimental characterisation of laser-driven ion beams using a Thomson Parabola Spectrometer (TPS) equipped with trapezoidally shaped electric plates, proposed by Gwynne et al. [Rev. Sci. Instrum. 85, 033304 (2014)]. While a pair of extended (30 cm long) electric plates was able to produce a significant increase in the separation between neighbouring ion species at high energies, deploying a trapezoidal design circumvented the spectral clipping at the low energy end of the ion spectra. The shape of the electric plate was chosen carefully considering, for the given spectrometer configuration, the range of detectable ion energies and species. Analytical tracing of the ion parabolas matches closely with the experimental data, which suggests a minimal effect of fringe fields on the escaping ions close to the wedged edge of the electrode. The analytical formulae were derived considering the relativistic correction required for the high energy ions to be characterised using such spectrometer.