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A new type of engine is proposed. The principle of the operation of this engine is as follows. The alternating electric current of high frequency flows from the condenser over the vertical conductor of the cross and branches at its centre in three directions. The vertical current generates a magnetic field. The horizontal currents flow in counter‐directions; therefore their magnetic fields are mutually cancelled, but the side branches of the cross are subjected to the operation of the Ampere force (F) from the magnetic field of the vertical conductor. This force moves the engine forward.

The response of the receiver to a voiced patient safety concern is frequently cited as a barrier to health professionals speaking up. The authors describe a novel Receiver Mindset Framework (RMF) to help health professionals understand the importance of their response when spoken up to.

The framework draws on the broader receiver-focussed literature and integrates innovative findings from a series of empirical studies. These studies examined different receiver behaviour within vignettes, retrospective descriptions of real interactions and behaviour in a simulated interaction.

The authors' findings indicated that speaking up is an intergroup interaction where social identities, context and speaker stance intersect, directly influencing both perceptions of and responses to the message. The authors' studies demonstrated that when spoken up to, health professionals poorly manage their emotions and ineffectively clarify the speaker's concerns. Currently, targeted training for receivers is overwhelmingly absent from speaking-up programmes. The receiver mindset framework provides an evidence-based, healthcare specific, receiver-focussed framework to inform programmes.

Grounded in communication accommodation theory (CAT), the resulting framework shifts speaking up training from being only speaker skill focussed, to training that recognises speaking up as a mutual negotiation between the healthcare speaker and receiver. This framework provides healthcare professionals with a novel approach to use in response to speaking up that enhances their ability to listen, understand and engage in point-of-care negotiations to ensure the physical and psychological safety of patients and staff.

Review of major policy paper in relation to the ambulance service [in England] efficiency and productivity with reference to observed “unacceptable variation”.

Critical review of ambulance service/EMS policy approach in England.

Lord Carter’s review describes failings in performance of UK ambulance service/EMS. However, the identified failings are essentially a repetition of many almost identical similar findings. There is a tendency of policy in respect of the ambulance service in England, as exemplified by Lord Carter’s report to consider analysis of the problem a more significant task that actually addressing the shortcoming defined.

This viewpoint comment piece is produced as a viewpoint with all the attendant limitations implied in this approach. However, it has been produced from an informed position.

Challenge to current UK ambulance policy. Previous repetitious finding need to be addressed definitively.

The efficiency of UK ambulance services/EMS is seriously impaired, and indeed these findings have been acknowledge previously. However, little by way of active remediation has been attempted. The current approach as exemplified in Lord Carter's recent review appears to ensure that analysis of the long- standing problems that exist is sufficient and possible preferable to active remediation and improvement.

No previous critical review of this type has been attempted (as it would be career-limiting).