Advance care planning in 21st century Australia: a systematic review and appraisal of online advance care directive templates against national framework criteria

Objectives A drive to promote advance care planning at a population level has led to a proliferation of online advance care directive (ACD) templates but little information to guide consumer choice. The current study aimed to appraise the quality of online ACD templates promoted for use in Australia. Methods A systematic review of online Australian ACD templates was conducted in February 2014. ACD templates were identified via Google searches, and quality was independently appraised by two reviewers against criteria from the 2011 report A National Framework for Advance Care Directives. Bias either towards or against future medical treatment was assessed using criteria designed to limit subjectivity. Results Fourteen online ACD templates were included, all of which were available only in English. Templates developed by Southern Cross University best met the framework criteria. One ACD template was found to be biased against medical treatment – the Dying with Dignity Victoria Advance Healthcare Directive. Conclusions More research is needed to understand how online resources can optimally elicit and record consumers’ individual preferences for future care. Future iterations of the framework should address online availability and provide a simple rating system to inform choice and drive quality improvement

Spectral imaging of thermal damage induced during microwave ablation in the liver

Induction of thermal damage to tissue through delivery of microwave energy is frequently applied in surgery to destroy diseased tissue such as cancer cells. Minimization of unwanted harm to healthy tissue is still achieved subjectively, and the surgeon has few tools at their disposal to monitor the spread of the induced damage. This work describes the use of optical methods to monitor the time course of changes to the tissue during delivery of microwave energy in the porcine liver. Multispectral imaging and diffuse reflectance spectroscopy are used to monitor temporal changes in optical properties in parallel with thermal imaging. The results demonstrate the ability to monitor the spatial extent of thermal damage on a whole organ, including possible secondary effects due to vascular damage. Future applications of this type of imaging may see the multispectral data used as a feedback mechanism to avoid collateral damage to critical healthy structures and to potentially verify sufficient application of energy to the diseased tissue.Comment: 4pg,6fig. Copyright 2018 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other work

An adult social care compendium of approaches and tools for organisational change

The purpose of this compendium is to support managers working in adult social care to be more knowledgeable about and confident in the application of different approaches and tools relevant to managing change in their organisations. In the compendium an ‘approach to change’ is used to denote an ‘overarching framework that can guide a change process’ and ‘change management tools’ as ‘techniques or templates to understand or support a specific aspect of the change process’. Examples of the latter would be stakeholder mapping exercises, organisational diagnostic methodologies, engagement processes, and direct team based interventions. The compendium does not provide detailed guidance on how to apply each approach and tool, but presents an accessible overview of what each entails, the thinking that lies behind them, and (where available) a reflection on the empirical evidence of their application in practice. Having access to this information will help to demystify the often confusing and intimidating terminology that surrounds change approaches, and in doing so will enable managers to identify the approaches most relevant to a change they are leading and explore in more depth. Understanding the method being followed will also support individuals who access services and their families to engage on a more equal playing field within a change process. This includes people who access services and their families. While potentially relevant to social care managers working at all levels of an organisation, the compendium is specifically designed for those responsible for a single service (e.g. home care team, residential care home) or team (e.g. care management team), and those who directly manage service and team managers

Cation Exchange Capacity of the Clay Fraction of Loess in Southwestern Iowa

The cation exchange capacity of clay-size material extracted from soil with a low organic matter content is largely dependent on the kinds of clay minerals present. If the extracted clay is composed mostly of one kind of clay mineral, the exchange capacity will indicate what that mineral is. This paper reports on cation exchange capacity determinations made on the minus 2 micron clay-size range of selected samples of loess from the southwestern Iowa area

Gauged Dimension Bubbles

Some of the peculiar electrodynamical effects associated with gauged ``dimension bubbles'' are presented. Such bubbles, which effectively enclose a region of 5d spacetime, can arise from a 5d theory with a compact extra dimension. Bubbles with thin domain walls can be stabilized against total collapse by the entrapment of light charged scalar bosons inside the bubble, extending the idea of a neutral dimension bubble to accommodate the case of a gauged U(1) symmetry. Using a dielectric approach to the 4d dilaton-Maxwell theory, it is seen that the bubble wall is almost totally opaque to photons, leading to a new stabilization mechanism due to trapped photons. Photon dominated bubbles very slowly shrink, resulting in a temperature increase inside the bubble. At some critical temperature, however, these bubbles explode, with a release of radiation.Comment: 14 pages, no figures; to appear in Phys.Rev.

Single scalar top production with polarized beams in ep collisions at HERA

From the point of view of the R-parity breaking supersymmetric model, we propose a scalar top (stop) search with longitudinally polarized electron (e-) and positron(e+) beams which will soon be available at the upgraded HERA. Fully polarized e- or e+ beams could produce the stop two times as much as unpolarized beams, while they increase background events due to the process of the standard model by about 30% in comparison with unpolarized ones. We show that right-handed e+ beams at HERA is efficient to produce the stop in the model. With 1 fb**(-1) of integrated luminosity we estimate reach in the coupling constant lambda'(131) for masses of the stop in the range 160-400 GeV. We can set a 95% confidence-level exclusion limit for lambda'(131) > 0.01-0.05 in the stop mass range of 240-280 GeV if no singal of the stop is observed. We also point out that y(=Q**2/sx) distributions of e+ coming from the stop shows the different behavior from those of the standard model.Comment: 12 pages, 6 eps figure

Threshold Photo/Electro Pion Production - Working Group Summary

We summarize the pertinent experimental and theoretical developments in the field of pion photo- and electroproduction in the threshold region. We discuss which experiments and which calculations should be done/performed in the future.Comment: plain TeX (macro included), 6pp, summary talk presented at the workshop on "Chiral Dynamics: Theory and Experiments", MIT, July 25-29, 199

Evolution of emotions on networks leads to the evolution of cooperation in social dilemmas

We show that the resolution of social dilemmas in random graphs and scale-free networks is facilitated by imitating not the strategy of better-performing players but, rather, their emotions. We assume sympathy and envy to be the two emotions that determine the strategy of each player in any given interaction, and we define them as the probabilities of cooperating with players having a lower and a higher payoff, respectively. Starting with a population where all possible combinations of the two emotions are available, the evolutionary process leads to a spontaneous fixation to a single emotional profile that is eventually adopted by all players. However, this emotional profile depends not only on the payoffs but also on the heterogeneity of the interaction network. Homogeneous networks, such as lattices and regular random graphs, lead to fixations that are characterized by high sympathy and high envy, while heterogeneous networks lead to low or modest sympathy but also low envy. Our results thus suggest that public emotions and the propensity to cooperate at large depend, and are in fact determined by, the properties of the interaction network

Use of Phosphates in Soil Stabilization

The use of phosphates for stabilizing soil to be used for road building is a new development. Lyons (1) apparently was one of the first to have appreciated the possibility. He reports that compacted plastic clay soils containing about 2 per cent phosphoric acid have greatly improved resistance to water and weathering, but he gives no explanation of the mechanism of soil-phosphoric acid stabilization. In agriculture it has been known for some time that phosphates are fixed in soil (2). It is also known that sodium phosphates may be used to disperse soils in water for particle size analysis (3). This paper presents a tentative explanation, based on limited experimental evidence, of the mechanism of soil stabilization with phosphates