Bearing witness and being bounded; the experiences of nurses in adult critical care in relation to the survivorship needs of patients and families

Aim: To discern and understand the responses of nurses to the survivorship needs of patients and family members in adult critical care units. Background: The critical care environment is a demanding place of work which may limit nurses to immediacy of care, such is the proximity to death and the pressure of work. Design: A constructivist grounded theory approach with constant comparative analysis. Methods: As part of a wider study and following ethical approval, eleven critical care nurses working within a general adult critical care unit were interviewed with respect to their experiences in meeting the psychosocial needs of patients and family members. Through the process of constant comparative analysis an overarching selective code was constructed. EQUATOR guidelines for qualitative research (COREQ) applied. Results: The data illuminated a path of developing expertise permitting integration of physical, psychological and family care with technology and humanity. Gaining such proficiency is demanding and the data presented reveals the challenges that nurses experience along the way. Conclusion: The study confirms that working within a critical care environment is an emotionally charged challenge and may incur an emotional cost. Nurses can find themselves bounded by the walls of the critical care unit and experience personal and professional conflicts in their role. Nurses bear witness to the early stages of the survivorship trajectory but are limited in their support of ongoing needs. Relevance to Clinical Practice: Critical care nurses can experience personal and professional conflicts when caring for both patients and families. This can lead to moral distress and may contribute to compassion fatigue. Critical care nurses appear bounded to the delivery of physiological and technical care, in the moment, as demanded by the patient's acuity. Consequentially this limits nurses’ ability to support the onward survivorship trajectory. Increased pressure and demands on critical care beds has contributed further to occupational stress in this care setting

A process for selecting ecological indicators for application in monitoring impacts to Air Quality Related Values (AQRVs) from atmospheric pollutants. Final report

Section 160 of the Clean Air Act (CAA) calls for measures be taken {open_quotes}to preserve, protect, and enhance air quality in national parks, national wilderness areas, national monuments, national seashores, and other areas of special national or regional natural, recreational, scenic, or historic value.{close_quotes} Pursuant to this, stringent requirement have been established for {open_quotes}Class I{close_quotes} areas, which include most National Parks and Wilderness Areas. Federal Land Managers (FLMs) are charged with the task of carrying out these requirements through the identification of air quality related values (AQRVs) that are potentially at risk from atmospheric pollutants. This is a complex task, the success of which is dependent on the gathering of information on a wide variety of factors that contribute to the potential for impacting resources in Class I areas. Further complicating the issue is the diversity of ecological systems found in Class I areas. There is a critical need for the development of monitoring programs to assess the status of AQRVs in Class I areas with respect to impacts caused by atmospheric pollutants. These monitoring programs must be based on the measurement of a carefully selected suite of key physical, chemical, and biological parameters that serve as indicators of the status of the ecosystems found in Class I areas. Such programs must be both scientifically-based and cost-effective, and must provide the data necessary for FLMs to make objective, defensible decisions. This document summarizes a method for developing AQRV monitoring programs in Class I areas

Supersymmetry of Rotating Branes

We present a new 1/8 supersymmetric intersecting M-brane solution of D=11 supergravity with two independent rotation parameters. The metric has a non-singular event horizon and the near-horizon geometry is adS_3\times S^3\times S^3\times\bE^2 (just as in the non-rotating case). We also present a method of determining the isometry supergroup of supergravity solutions from the Killing spinors and use it to show that for the near horizon solution it is $D(2|1,\alpha)\times D(2|1,\alpha)$ where $\alpha$ is the ratio of the two 3-sphere radii. We also consider various dimensional reductions of our solution, and the corresponding effect of these reductions on the Killing spinors and the isometry supergroups.Comment: Latex, 29 page

Localized Branes and Black Holes

We address the delocalization of low dimensional D-branes and NS-branes when they are a part of a higher dimensional BPS black brane, and the homogeneity of the resulting horizon. We show that the effective delocalization of such branes is a classical effect that occurs when localized branes are brought together. Thus, the fact that the few known solutions with inhomogeneous horizons are highly singular need not indicate a singularity of generic D- and NS-brane states. Rather, these singular solutions are likely to be unphysical as they cannot be constructed from localized branes which are brought together from a finite separation.Comment: 13 pages, RevTex, no figures, few references and comments adde

BPS-Saturated Bound States of Tilted P-Branes in Type II String Theory

We found BPS-saturated solutions of M-theory and Type II string theory which correspond to (non-marginally) bound states of p-branes intersecting at angles different from pi/2. These solutions are obtained by starting with a BPS marginally bound (orthogonally) intersecting configurations of two p-branes (e.g, two four-branes of Type II string theory), performing a boost transformation at an angle with respect to the world-volume of the configuration, performing T-duality transformation along the boost-direction, S-duality transformation, and T- transformations along the direction perpendicular to the boost transformation. The resulting configuration is non-marginally bound BPS-saturated solution whose static metric possesses the off-diagonal term which cannot be removed by a coordinate transformation, and thus signifies an angle (different from pi/2) between the resulting intersecting p-branes. Additional new p-branes are bound to this configuration, in order to ensure the stability of such a static, tilted configuration.Comment: 11 pages, Latex with two postscript figures, minor corrections, version to appear in Phys. Rev.

Supertubes

It is shown that a IIA superstring carrying D0-brane charge can be `blown-up', in a {\it Minkowski vacuum} background, to a (1/4)-supersymmetric tubular D2-brane, supported against collapse by the angular momentum generated by crossed electric and magnetic Born-Infeld fields. This `supertube' can be viewed as a worldvolume realization of the sigma-model Q-lump.Comment: Revision includes mention of some configurations dual to the supertub

Classification of Higher Dimensional Spacetimes

We algebraically classify some higher dimensional spacetimes, including a number of vacuum solutions of the Einstein field equations which can represent higher dimensional black holes. We discuss some consequences of this work.Comment: 16 pages, 1 Tabl

Supergravity Duals to the Noncommutative N=4 SYM theory in the Infinite Momentum Frame

In this work the construction of supergravity duals to the noncommutative ${\cal N}=4$ SYM theory in the infinite momentum frame but with constant momentum density is attempted. In the absence of the content of noncommutativity, it has been known for some time that the previous $AdS_{5}/CFT_{4}$ correspondence should be replaced by the $K_{5}/CFT_{4}$ (with $K_{(p+2)}$ denoting the generalized Kaigorodov spacetime) correspondence with the pp-wave propagating on the BPS brane worldvolume. Interestingly enough, putting together the two contents, i.e., the introduction of noncommutativity and at the same time that of the pp-wave along the brane worldvolume, leads to quite nontrivial consequences such as the emergence of ``time-space'' noncommutativity in addition to the ``space-space'' noncommutativity in the manifold on which the dual gauge theory is defined. Taking the gravity decoupling limit, it has been realized that for small $u$, the solutions all reduce to $K_{5}\times S^5$ geometry confirming our expectation that the IR dynamics of the dual gauge theory should be unaffected by the noncommutativity while as $u\to \infty$, the solutions start to deviate significantly from $K_{5}\times S^5$ limit indicating that the UV dynamics of the dual gauge theory would be heavily distorted by the effect of noncommutativity.Comment: 21 pages, Latex, One expression changed, a reference added, to appear in Phys. Rev.

G-Structures, Fluxes and Calibrations in M-Theory

We study the most general supersymmetric warped M-theory backgrounds with non-trivial G-flux of the type R^{1,2} x M_8 and AdS_3 x M_8. We give a set of necessary and sufficient conditions for preservation of supersymmetry which are phrased in terms of G-structures and their intrinsic torsion. These equations may be interpreted as calibration conditions for a static ``dyonic'' M-brane, that is, an M5-brane with self-dual three-form turned on. When the electric flux is turned off we obtain the supersymmetry conditions and non-linear PDEs describing M5-branes wrapped on associative and special Lagrangian three-cycles in manifolds with G_2 and SU(3) structures, respectively. As an illustration of our formalism, we recover the 1/2-BPS dyonic M-brane, and also construct some new examples.Comment: 40 pages; v2: one reference added, typos correcte