NEGOTIATING ETHICAL RESIDUE ASSOCIATED WITH BEDSIDE RATIONING: A GROUNDED THEORY STUDY WITH FAMILY PHYSICIANS

In any health care system where funds are limited, priorities must be set. Resource allocation, also called priority setting or rationing, may determine who receives treatment, what treatment they receive, or amount of time spent with professionals. Bedside rationing decisions are those which health care professionals make at the clinical level. Ethical distress and residue theory may inform the investigation of discomfort and conflict identified in physicians who ration care. Ethical distress is experienced when external constraints make it nearly impossible to do “the right thing,” and ethical residue represents the traces which remain following unresolved ethical distress. This study aims to explore how physicians negotiate ethical residue associated with making bedside rationing decisions on an ongoing basis, using a grounded theory methodology. The findings indicate that “doing everything I think patients need” is central to this process. Findings may inform medical ethics education and training interventions for practicing physicians

Analytic Approximations for the Primordial Power Spectrum with Israel Junction Conditions

This work compares cosmological matching conditions used in approximating generic pre-inflationary phases of the universe. We show that the joining conditions for primordial scalar perturbations assumed by Contaldi et al. are inconsistent with the physically motivated Israel junction conditions, however, performing general relativistic matching with the aforementioned constraints results in unrealistic primordial power spectra. Eliminating the need for ambiguous matching, we look at an alternative semi-analytic model for producing the primordial power spectrum allowing for finite duration cosmological phase transitions.Comment: 21 pages, 10 figures. To be submitted to PR

Professional decision-making in medicine: Development of a new measure and preliminary evidence of validity

INTRODUCTION: This study developed a new Professional Decision-Making in Medicine Measure that assesses the use of effective decision-making strategies: seek help, manage emotions, recognize consequences and rules, and test assumptions and motives. The aim was to develop a content valid measure and obtain initial evidence for construct validity so that the measure could be used in future research or educational assessment. METHODS: Clinical scenario-based items were developed based on a review of the literature and interviews with physicians. For each item, respondents are tasked with selecting two responses (out of six plausible options) that they would choose in that situation. Three of the six options reflect a decision-making strategy; these responses are scored as correct. Data were collected from a sample of 318 fourth-year medical students in the United States. They completed a 16-item version of the measure (Form A) and measures of social desirability, moral disengagement, and professionalism attitudes. Professionalism ratings from clerkships were also obtained. A sub-group (n = 63) completed a second 16-item measure (Form B) to pilot test the instrument, as two test forms are useful for pre-posttest designs. RESULTS: Scores on the new measure indicated that, on average, participants answered 75% of items correctly. Evidence for construct validity included the lack of correlation between scores on the measure and socially desirable responding, negative correlation with moral disengagement, and modest to low correlations with professionalism attitudes. A positive correlation was observed with a clerkship rating focused on professionalism in peer interactions. CONCLUSIONS: These findings demonstrate modest proficiency in the use of decision-making strategies among fourth-year medical students. Additional research using the Professional Decision-Making Measure should explore scores among physicians in various career stages, and the causes and correlates of scores. Educators could utilize the measure to assess courses that teach decision-making strategies

Magnetic dipole moments in single and coupled split-ring resonators

We examine the role of magnetic dipoles in single and coupled pairs of metallic split-ring resonators by numerically computing their magnitude and examining their relative contributions to the scattering cross section. We demonstrate that magnetic dipoles can strongly influence the scattering cross section along particular directions. It is also found that the magnetic dipole parallel to the incident magnetic field and/or high-order multipoles may play a significant role in the linear response of coupled split-ring resonators.Comment: 7 pages, 3 figures, 1 tabl

Faraday Rotation as a diagnostic of Galactic foreground contamination of CMB maps

The contribution from the residuals of the foreground can have a significant impact on the temperature maps of the Cosmic Microwave Background (CMB). Mostly, the focus has been on the galactic plane, when foreground cleaning has taken place. However, in this paper, we will investigate the possible foreground contamination, from sources outside the galactic plane in the CMB maps. We will analyze the correlation between the Faraday rotation map and the CMB temperature map. The Faraday rotation map is dependent on the galactic magnetic field, as well as the thermal electron density, and both may contribute to the CMB temperature. We find that the standard deviation for the mean cross correlation deviate from that of simulations at the 99.9% level. Additionally, a comparison between the CMB temperature extrema and the extremum points of the Faraday rotation is also performed, showing a general overlap between the two. Also we find that the CMB Cold Spot is located at an area of strong negative cross correlation, meaning that it may be explained by a galactic origin. Further, we investigate nearby supernova remnants in the galaxy, traced by the galactic radio loops. These super nova remnants are located at high and low galactic latitude, and thus well outside the galactic plane. We find some correlation between the Faraday Rotation and the CMB temperature, at select radio loops. This indicate, that the galactic foregrounds may affect the CMB, at high galactic latitudesComment: 13 pages, 22 figures, 6 table

Strain evolution in GaN Nanowires: from free-surface objects to coalesced templates

Top-down fabricated GaN nanowires, 250 nm in diameter and with various heights, have been used to experimentally determine the evolution of strain along the vertical direction of 1-dimensional objects. X-ray diffraction and photoluminescence techniques have been used to obtain the strain profile inside the nanowires from their base to their top facet for both initial compressive and tensile strains. The relaxation behaviors derived from optical and structural characterizations perfectly match the numerical results of calculations based on a continuous media approach. By monitoring the elastic relaxation enabled by the lateral free-surfaces, the height from which the nanowires can be considered strain-free has been estimated. Based on this result, NWs sufficiently high to be strain-free have been coalesced to form a continuous GaN layer. X-ray diffraction, photoluminescence and cathodoluminescence clearly show that despite the initial strain-free nanowires template, the final GaN layer is strained

Cross-correlation of the CMB and foregrounds phases derived from the WMAP data

We present circular and linear cross-correlation tests and the "friend-of-friend" analysis for phases of the Internal Linear Combination Map (ILC) and the WMAP foregrounds for all K--W frequency bands at the range of multipoles $\ell\le100$. We compare also Tegmark, de Oliveira-Costa and Hamilton (2003) and Naselsky et al. (2003) cleaned maps with corresponding foregrounds. We have found significant deviations from the expected Poissonian statistics for all the cleaned maps and foregrounds. Our analysis shows that, for a low multipole range of the cleaned maps, power spectra contains some of the foregrounds residuals mainly from the W band.Comment: 11 pages, 10 figures. Submitted to MNRA

Spectra of weighted algebras of holomorphic functions

We consider weighted algebras of holomorphic functions on a Banach space. We determine conditions on a family of weights that assure that the corresponding weighted space is an algebra or has polynomial Schauder decompositions. We study the spectra of weighted algebras and endow them with an analytic structure. We also deal with composition operators and algebra homomorphisms, in particular to investigate how their induced mappings act on the analytic structure of the spectrum. Moreover, a Banach-Stone type question is addressed.Comment: 25 pages Corrected typo

Non-Gaussianity detections in the Bianchi VIIh corrected WMAP 1-year data made with directional spherical wavelets

Many of the current anomalies reported in the Wilkinson Microwave Anisotropy Probe (WMAP) 1-year data disappear after `correcting' for the best-fit embedded Bianchi type VII_h component (Jaffe et al. 2005), albeit assuming no dark energy component. We investigate the effect of this Bianchi correction on the detections of non-Gaussianity in the WMAP data that we previously made using directional spherical wavelets (McEwen et al. 2005a). As previously discovered by Jaffe et al. (2005), the deviations from Gaussianity in the kurtosis of spherical Mexican hat wavelet coefficients are eliminated once the data is corrected for the Bianchi component. This is due to the reduction of the cold spot at Galactic coordinates (l,b)=(209^\circ,-57\circ), which Cruz et al. (2005) claim to be the source of non-Gaussianity introduced in the kurtosis. Our previous detections of non-Gaussianity observed in the skewness of spherical wavelet coefficients are not reduced by the Bianchi correction. Indeed, the most significant detection of non-Gaussianity made with the spherical real Morlet wavelet at a significant level of 98.4% remains (using a very conservative method to estimate the significance). We make our code to simulate Bianchi induced temperature fluctuations publicly available.Comment: 11 pages, 8 figures, replaced to match version accepted by MNRA