A national survey exploring views and experience of health professionals about transferring patients from critical care home to die.

BACKGROUND: Transferring critically ill patients home to die is poorly explored in the literature to date. This practice is rare, and there is a need to understand health care professionals' (HCP) experience and views. OBJECTIVES: To examine (1) HCPs' experience of transferring patients home to die from critical care, (2) HCPs' views about transfer and (3) characteristics of patients, HCPs would hypothetically consider transferring home to die. DESIGN: A national study developing a web-based survey, which was sent to the lead doctors and nurses in critical care units. SETTING/PARTICIPANTS: Lead doctors and senior nurses (756 individuals) working in 409 critical care units across the United Kingdom were invited to participate in the survey. RESULTS: In total, 180 (23.8%) completed surveys were received. A total of 65 (36.1%) respondents had been actively involved in transferring patients home to die and 28 (15.5%) had been involved in discussions that did not lead to transfer. Respondents were supportive of the idea of transfer home to die (88.8%). Patients identified by respondents as unsuitable for transfer included unstable patients (61.8%), intubated and ventilated patients (68.5%) and patients receiving inotropes (65.7%). There were statistically significant differences in views between those with and without experience and between doctors and nurses. Nurses and those with experience tended to have more positive views. CONCLUSION: While transferring patients home to die is supported in critical care, its frequency in practice remains low. Patient stability and level of intervention are important factors in decision-making in this area. Views held about this practice are influenced by previous experience and the professional role held

Stiffness and energy losses in cylindrically symmetric superconductor levitating systems

Stiffness and hysteretic energy losses are calculated for a magnetically levitating system composed of a type-II superconductor and a permanent magnet when a small vibration is produced in the system. We consider a cylindrically symmetric configuration with only vertical movements and calculate the current profiles under the assumption of the critical state model. The calculations, based on magnetic energy minimization, take into account the demagnetization fields inside the superconductor and the actual shape of the applied field. The dependence of stiffness and hysteretic energy losses upon the different important parameters of the system such as the superconductor aspect ratio, the relative size of the superconductor-permanent magnet, and the critical current of the superconductor are all systematically studied. Finally, in view of the results, we provide some trends on how a system such as the one studied here could be designed in order to optimize both the stiffness and the hysteretic losses.Comment: 8 pages; 8 figure

Remagnetization of bulk high-temperature superconductors subjected to crossed and rotating magnetic fields

Bulk melt-processed Y-Ba-Cu-O (YBCO) has significant potential for a variety of high-field permanent-magnet-like applications, such as the rotor of a brushless motor. When used in rotating devices of this kind, however, the YBCO can be subjected to both transient and alternating magnetic fields that are not parallel to the direction of magnetization and which have a detrimental effect on the trapped field. These effects may lead to long-term decay of the magnetization of the bulk sample. In the present work, we analyze both experimentally and numerically the remagnetization process of a melt-processed YBCO single domain that has been partially demagnetized by a magnetic field applied orthogonal to the initial direction of trapped flux. Magnetic torque measurements are used as a tool to probe changes in the remanent magnetization during various sequences of applied field. The application of a small magnetic field between the transverse cycles parallel to the direction of original magnetization results in partial remagnetization of the sample. Rotating the applied field, however, is found to be much more efficient at remagnetizing the bulk material than applying a magnetizing field pulse of the same amplitude. The principal features of the experimental data can be reproduced qualitatively using a two-dimensional finite-element numerical model based on an E-J power law. Finally, the remagnetization process is shown to result from the complex modification of current distribution within the cross-section of the bulk sample

Behavior of bulk high-temperature superconductors of finite thickness subjected to crossed magnetic fields

Crossed magnetic field effects on bulk high-temperature superconductors have been studied both experimentally and numerically. The sample geometry investigated involves finite-size effects along both (crossed) magnetic field directions. The experiments were carried out on bulk melt-processed Y-Ba-Cu-O (YBCO) single domains that had been pre-magnetized with the applied field parallel to their shortest direction (i.e. the c-axis) and then subjected to several cycles of the application of a transverse magnetic field parallel to the sample ab plane. The magnetic properties were measured using orthogonal pick-up coils, a Hall probe placed against the sample surface and Magneto-Optical Imaging (MOI). We show that all principal features of the experimental data can be reproduced qualitatively using a two-dimensional finite-element numerical model based on an E-J power law and in which the current density flows perpendicularly to the plane within which the two components of magnetic field are varied. The results of this study suggest that the suppression of the magnetic moment under the action of a transverse field can be predicted successfully by ignoring the existence of flux-free configurations or flux-cutting effects. These investigations show that the observed decay in magnetization results from the intricate modification of current distribution within the sample cross-section. It is also shown that the model does not predict any saturation of the magnetic induction, even after a large number (~ 100) of transverse field cycles. These features are shown to be consistent with the experimental data.Comment: 41 pages, 9 figures, accepted in Phys. Rev. B Changes : 8 references added, a few precisions added, some typos correcte

Defining the gap between research and practice in public relations programme evaluation - towards a new research agenda

The current situation in public relations programme evaluation is neatly summarized by McCoy who commented that 'probably the most common buzzwords in public relations in the last ten years have been evaluation and accountability' (McCoy 2005, 3). This paper examines the academic and practitioner-based literature and research on programme evaluation and it detects different priorities and approaches that may partly explain why the debate on acceptable and agreed evaluation methods continues. It analyses those differences and proposes a research agenda to bridge the gap and move the debate forward

Sceptical Employees as CSR Ambassadors in Times of Financial Uncertainty

This chapter offers new insights into the understanding of internal (employee) perceptions of organizational corporate social responsibility (CSR) policies and strategies. This study explores the significance of employees’ involvement and scepticism upon CSR initiatives and focuses on the effects it may have upon word of mouth (WOM) and the development of employee–organisation relationships. Desk research introduces the research questions. Data for the research questions were gathered through a self-completion questionnaire distributed in a hardcopy form to the sample. An individual’s level of scepticism and involvement appears to affect the development of a positive effect on employees’ WOM. Involvement with the domain of the investment may be a central factor affecting relationship building within the organization, and upon generation of positive WOM. The chapter offers a conceptual framework to public relations (PR) and corporate communications practitioners, which may enrich their views and understanding of the use and value of CSR for communication strategies and practices. For-profit organisations are major institutions in today’s society. CSR is proffered as presenting advantages for (at macro level) society and (micro level) the organization and its employees. Concepts, such as involvement and scepticism, which have not been rigorously examined in PR and corporate communication literature, are addressed. By examining employee perceptions, managers and academic researchers gain insights into the acceptance, appreciation and effectiveness of CSR policies and activities upon the employee stakeholder group. This will affect current and future CSR communication strategies. The knowledge acquired from this chapter may be transferable outside the for-profit sector

The Affective Impact of Financial Skewness on Neural Activity and Choice

Few finance theories consider the influence of “skewness” (or large and asymmetric but unlikely outcomes) on financial choice. We investigated the impact of skewed gambles on subjects' neural activity, self-reported affective responses, and subsequent preferences using functional magnetic resonance imaging (FMRI). Neurally, skewed gambles elicited more anterior insula activation than symmetric gambles equated for expected value and variance, and positively skewed gambles also specifically elicited more nucleus accumbens (NAcc) activation than negatively skewed gambles. Affectively, positively skewed gambles elicited more positive arousal and negatively skewed gambles elicited more negative arousal than symmetric gambles equated for expected value and variance. Subjects also preferred positively skewed gambles more, but negatively skewed gambles less than symmetric gambles of equal expected value. Individual differences in both NAcc activity and positive arousal predicted preferences for positively skewed gambles. These findings support an anticipatory affect account in which statistical properties of gambles—including skewness—can influence neural activity, affective responses, and ultimately, choice

Bulk high-Tc superconductors with drilled holes: how to arrange the holes to maximize the trapped magnetic flux ?

Drilling holes in a bulk high-Tc superconductor enhances the oxygen annealing and the heat exchange with the cooling liquid. However, drilling holes also reduces the amount of magnetic flux that can be trapped in the sample. In this paper, we use the Bean model to study the magnetization and the current line distribution in drilled samples, as a function of the hole positions. A single hole perturbs the critical current flow over an extended region that is bounded by a discontinuity line, where the direction of the current density changes abruptly. We demonstrate that the trapped magnetic flux is maximized if the center of each hole is positioned on one of the discontinuity lines produced by the neighbouring holes. For a cylindrical sample, we construct a polar triangular hole pattern that exploits this principle; in such a lattice, the trapped field is ~20% higher than in a squared lattice, for which the holes do not lie on discontinuity lines. This result indicates that one can simultaneously enhance the oxygen annealing, the heat transfer, and maximize the trapped field