Emergency department communication in persons living with dementia and care partners: A scoping review

OBJECTIVES: To synthesize published research exploring emergency department (ED) communication strategies and decision-making with persons living with dementia (PLWD) and their care partners as the basis for a multistakeholder consensus conference to prioritize future research. DESIGN: Systematic scoping review. SETTINGS AND PARTICIPANTS: PLWD and their care partners in the ED setting. METHODS: Informed by 2 Patient-Intervention-Comparison-Outcome (PICO) questions, we conducted systematic electronic searches of medical research databases for relevant publications following standardized methodological guidelines. The results were presented to interdisciplinary stakeholders, including dementia researchers, clinicians, PLWD, care partners, and advocacy organizations. The PICO questions included: How does communication differ for PLWD compared with persons without dementia? Are there specific communication strategies that improve the outcomes of ED care? Future research areas were prioritized. RESULTS: From 5451 studies identified for PICO-1, 21 were abstracted. From 2687 studies identified for PICO-2, 3 were abstracted. None of the included studies directly evaluated communication differences between PLWD and other populations, nor the effectiveness of specific communication strategies. General themes emerging from the scoping review included perceptions by PLWD/care partners of rushed ED communication, often exacerbated by inconsistent messages between providers. Care partners consistently reported limited engagement in medical decision-making. In order, the research priorities identified included: (1) Barriers/facilitators of effective communication; (2) valid outcome measures of effective communication; (3) best practices for care partner engagement; (4) defining how individual-, provider-, and system-level factors influence communication; and (5) understanding how each member of ED team can ensure high-quality communication. CONCLUSIONS AND IMPLICATIONS: Research exploring ED communication with PLWD is sparse and does not directly evaluate specific communication strategies. Defining barriers and facilitators of effective communication was the highest-ranked research priority, followed by validating outcome measures associated with improved information exchange

Effectively attractive Bose-Einstein condensates in a rotating toroidal trap

We examine an effectively attractive quasi-one-dimensional Bose-Einstein condensate of atoms confined in a rotating toroidal trap, as the magnitude of the coupling constant and the rotational frequency are varied. Using both a variational mean-field approach, as well as a diagonalization technique, we identify the phase diagram between a uniform and a localized state and we describe the system in the two phases.Comment: 4 pages, 4 ps figures, RevTe

Nanotribological properties of nanostructured poly(cysteine methacrylate) brushes

The nanomechanical properties of zwitterionic poly(cysteine methacrylate) (PCysMA) brushes grown from planar surfaces by atom transfer radical polymerisation have been characterised by friction force microscopy (FFM). FFM provides quantitative insights into polymer structure–property relationships and in particular illuminates the dependence of brush swelling on chain packing in nanostructured materials. In ethanol, which is a poor solvent for PCysMA, a linear friction–load relationship is observed, indicating that energy dissipation occurs primarily through ploughing. In contrast, in a good solvent for PCysMA such as water, a non-linear friction–load relationship is observed that can be fitted by Derjaguin–Muller–Toporov (DMT) mechanics, suggesting that the relatively small modulus of the swollen polymer leads to a large contact area and consequently a significant shear contribution to energy dissipation. The brush grafting density was varied by using UV photolysis of C–Br bonds at 244 nm to dehalogenate the surface in a controlled fashion. The surface shear strength increases initially as the brush grafting density is reduced, but then decreases for UV doses greater than 0.5 J cm−2, reaching a limiting value when the brush thickness is ca. 50% that of a brush monolayer. Below this critical grafting density, a collapsed brush layer is obtained. For nm-scale gradient brush structures formed via interferometric lithography, the mean width increases as the period is increased, and the lateral mobility of brushes in these regions is reduced, leading to an increase in brush height as the grafted chains become progressively more extended. For a width of 260 nm, the mean brush height in water and ethanol is close to the thickness of a dense unpatterned brush monolayer synthesised under identical conditions. Both the surface shear stress measured for PCysMA brushes under water and the coefficient of friction measured in ethanol are closely correlated to the feature height, and hence to the chain conformation

Mermin-Ho vortex in ferromagnetic spinor Bose-Einstein condensates

The Mermin-Ho and Anderson-Toulouse coreless non-singular vortices are demonstrated to be thermodynamically stable in ferromagnetic spinor Bose-Einstein condensates with the hyperfine state F=1. The phase diagram is established in a plane of the rotation drive vs the total magnetization by comparing the energies for other competing non-axis-symmetric or singular vortices. Their stability is also checked by evaluating collective modes.Comment: 4 pages, 4 figure

Axisymmetric versus Non-axisymmetric Vortices in Spinor Bose-Einstein Condensates

The structure and stability of various vortices in F=1 spinor Bose-Einstein condensates are investigated by solving the extended Gross-Pitaevskii equation under rotation. We perform an extensive search for stable vortices, considering both axisymmetric and non-axisymmetric vortices and covering a wide range of ferromagnetic and antiferromagnetic interactions. The topological defect called Mermin-Ho (Anderson-Toulouse) vortex is shown to be stable for ferromagnetic case. The phase diagram is established in a plane of external rotation Omega vs total magnetization M by comparing the free energies of possible vortices. It is shown that there are qualitative differences between axisymmetric and non-axisymmetric vortices which are manifested in the Omega- and M-dependences.Comment: 9 pages, 9 figure

Coherence Transition of Small Josephson Junctions Coupled to a Single-Mode Resonant Cavity: Connection to the Dicke Model

We calculate the thermodynamic properties of a collection of $N$ small Josephson junctions coupled to a single-mode resonant electromagnetic cavity, at finite temperature $T$, using several approaches. In the first approach, we include all the quantum-mechanical levels of the junction, but treat the junction-cavity interaction using a mean-field approximation developed previously for $T = 0$. In the other approaches, the junctions are treated including only the two lowest energy levels per junction, but with two different Hamiltonians. The first of these maps onto the Dicke model of quantum optics. The second is a modified Dicke model which contains an additional XY-like coupling between the junctions. The modified Dicke model can be treated using a mean-field theory, which in the limit of zero XY coupling gives the solution of the Dicke model in the thermodynamic limit using Glauber coherent states to represent the cavity. In all cases, for an $N$-independent junction-cavity coupling, there is a critical junction number $N$ above which there is a continuous transition from incoherence to coherence with decreasing $T$. If the coupling scales with $N$ so as to give a well-behaved thermodynamic limit, there is a critical minimum coupling strength for the onset of coherence. In all three models, the cavity photon occupation numbers have a non-Bose distribution when the system is coherent.Comment: 26 page

A unified framework for the Kondo problem and for an impurity in a Luttinger liquid

We develop a unified theoretical framework for the anisotropic Kondo model and the boundary sine-Gordon model. They are both boundary integrable quantum field theories with a quantum-group spin at the boundary which takes values, respectively, in standard or cyclic representations of the quantum group $SU(2)_q$. This unification is powerful, and allows us to find new results for both models. For the anisotropic Kondo problem, we find exact expressions (in the presence of a magnetic field) for all the coefficients in the ``Anderson-Yuval'' perturbative expansion. Our expressions hold initially in the very anisotropic regime, but we show how to continue them beyond the Toulouse point all the way to the isotropic point using an analog of dimensional regularization. For the boundary sine-Gordon model, which describes an impurity in a Luttinger liquid, we find the non-equilibrium conductance for all values of the Luttinger coupling.Comment: 36 pages (22 in double-page format), 7 figures in uuencoded file, uses harvmac and epsf macro

Isolation of a wide range of minerals from a thermally treated plant: Equisetum arvense, a Mare’s tale

Silica is the second most abundant biomineral being exceeded in nature only by biogenic CaCO3. Many land plants (such as rice, cereals, cucumber, etc.) deposit silica in significant amounts to reinforce their tissues and as a systematic response to pathogen attack. One of the most ancient species of living vascular plants, Equisetum arvense is also able to take up and accumulate silica in all parts of the plant. Numerous methods have been developed for elimination of the organic material and/or metal ions present in plant material to isolate biogenic silica. However, depending on the chemical and/or physical treatment applied to branch or stem from Equisetum arvense; other mineral forms such glass-type materials (i.e. CaSiO3), salts (i.e. KCl) or luminescent materials can also be isolated from the plant material. In the current contribution, we show the chemical and/or thermal routes that lead to the formation of a number of different mineral types in addition to biogenic silica

The A-B transition in superfluid helium-3 under confinement in a thin slab geometry

The influence of confinement on the topological phases of superfluid 3He is studied using the torsional pendulum method. We focus on the phase transition between the chiral A-phase and the time-reversal-invariant B-phase, motivated by the prediction of a spatiallymodulated (stripe) phase at the A-B phase boundary. We confine superfluid 3He to a single 1.08 {\mu}m thick nanofluidic cavity incorporated into a high-precision torsion pendulum, and map the phase diagram between 0.1 and 5.6 bar. We observe only small supercooling of the A-phase, in comparison to bulk or when confined in aerogel. This has a non-monotonic pressure dependence, suggesting that a new intrinsic B-phase nucleation mechanism operates under confinement, mediated by the putative stripe phase. Both the phase diagram and the relative superfluid fraction of the A and B phases, show that strong coupling is present at all pressures, with implications for the stability of the stripe phase.Comment: 6 figures, 1 table + supplemental informatio

Quantum superpositions of clockwise and counterclockwise supercurrent states in the dynamics of a rf-SQUID exposed to a quantized electromagnetic field

The dynamical behavior of a superconducting quantum interference device (a rf-SQUID) irradiated by a single mode quantized electromagnetic field is theoretically investigated. Treating the SQUID as a flux qubit, we analyze the dynamics of the combined system within the low lying energy Hilbert subspace both in the asymmetric and in the symmetric SQUID potential configurations. We show that the temporal evolution of the system is dominated by an oscillatory behavior characterized by more than one, generally speaking, incommensurable Rabi frequencies whose expressions are explicitly given. We find that the external parameters may fixed in such a way to realize a control on the dynamical replay of the total system which, for instance, may be forced to exhibit a periodic evolution accompanied by the occurrence of an oscillatory disappearance of entanglement between the two subsystems. We demonstrate the possibility of generating quantum maximally entangled superpositions of the two macroscopically distinguishable states describing clockwise and counterclockwise supercurrents in the loop. The experimental feasibility of our proposal is briefly discussed.Comment: 16 pages, 7 figures, submitted to PR