The barriers to and enablers of providing reasonably adjusted health services to people with intellectual disabilities in acute hospitals: evidence from a mixed-methods study.

OBJECTIVE: To identify the factors that promote and compromise the implementation of reasonably adjusted healthcare services for patients with intellectual disabilities in acute National Health Service (NHS) hospitals. DESIGN: A mixed-methods study involving interviews, questionnaires and participant observation (July 2011-March 2013). SETTING: Six acute NHS hospital trusts in England. METHODS: Reasonable adjustments for people with intellectual disabilities were identified through the literature. Data were collected on implementation and staff understanding of these adjustments. RESULTS: Data collected included staff questionnaires (n=990), staff interviews (n=68), interviews with adults with intellectual disabilities (n=33), questionnaires (n=88) and interviews (n=37) with carers of patients with intellectual disabilities, and expert panel discussions (n=42). Hospital strategies that supported implementation of reasonable adjustments did not reliably translate into consistent provision of such adjustments. Good practice often depended on the knowledge, understanding and flexibility of individual staff and teams, leading to the delivery of reasonable adjustments being haphazard throughout the organisation. Major barriers included: lack of effective systems for identifying and flagging patients with intellectual disabilities, lack of staff understanding of the reasonable adjustments that may be needed, lack of clear lines of responsibility and accountability for implementing reasonable adjustments, and lack of allocation of additional funding and resources. Key enablers were the Intellectual Disability Liaison Nurse and the ward manager. CONCLUSIONS: The evidence suggests that ward culture, staff attitudes and staff knowledge are crucial in ensuring that hospital services are accessible to vulnerable patients. The authors suggest that flagging the need for specific reasonable adjustments, rather than the vulnerable condition itself, may address some of the barriers. Further research is recommended that describes and quantifies the most frequently needed reasonable adjustments within the hospital pathways of vulnerable patient groups, and the most effective organisational infrastructure required to guarantee their use, together with resource implications

Scaling function for the noisy Burgers equation in the soliton approximation

We derive the scaling function for the one dimensional noisy Burgers equation in the two-soliton approximation within the weak noise canonical phase space approach. The result is in agreement with an earlier heuristic expression and exhibits the correct scaling properties. The calculation presents the first step in a many body treatment of the correlations in the Burgers equation.Comment: Replacement: Several corrections, 4 pages, Revtex file, 3 figures. To appear in Europhysics Letter

Tracing Slow Winds from T Tauri Stars via Low Velocity Forbidden Line Emission

Using Keck/HIRES spectra {\Delta}v ~ 7 km/s, we analyze forbidden lines of [O I] 6300 {\AA}, [O I] 5577 {\AA} and [S II] 6731 {\AA} from 33 T Tauri stars covering a range of disk evolutionary stages. After removing a high velocity component (HVC) associated with microjets, we study the properties of the low velocity component (LVC). The LVC can be attributed to slow disk winds that could be magnetically (MHD) or thermally (photoevaporative) driven. Both of these winds play an important role in the evolution and dispersal of protoplanetary material. LVC emission is seen in all 30 stars with detected [O I] but only in 2 out of eight with detected [S II] , so our analysis is largely based on the properties of the [O I] LVC. The LVC itself is resolved into broad (BC) and narrow (NC) kinematic components. Both components are found over a wide range of accretion rates and their luminosity is correlated with the accretion luminosity, but the NC is proportionately stronger than the BC in transition disks. The FWHM of both the BC and NC correlates with disk inclination, consistent with Keplerian broadening from radii of 0.05 to 0.5 AU and 0.5 to 5 AU, respectively. The velocity centroids of the BC suggest formation in an MHD disk wind, with the largest blueshifts found in sources with closer to face-on orientations. The velocity centroids of the NC however, show no dependence on disk inclination. The origin of this component is less clear and the evidence for photoevaporation is not conclusive

Definitive spectroscopic determination of the transverse interactions responsible for the magnetic quantum tunneling in Mn12-acetate

We present detailed angle-dependent single crystal electron paramagnetic resonance (EPR) data for field rotations in the hard plane of the S=10 single molecule magnet Mn12-acetate. A clear four-fold variation in the resonance positions may be attributed to an intrinsic fourth order transverse anisotropy (O44). Meanwhile, a four-fold variation of the EPR lineshapes confirms a recently proposed model wherein disorder associated with the acetic acid of crystallization induces a locally varying quadratic (rhombic) transverse anisotropy (O22). These findings explain most aspects of the magnetic quantum tunneling observed in Mn12-acetate.Comment: 7 pages, including figures, accepted for publication in Phys. Rev. Let

Challenges in Bridging Social Semantics and Formal Semantics on the Web

This paper describes several results of Wimmics, a research lab which names stands for: web-instrumented man-machine interactions, communities, and semantics. The approaches introduced here rely on graph-oriented knowledge representation, reasoning and operationalization to model and support actors, actions and interactions in web-based epistemic communities. The re-search results are applied to support and foster interactions in online communities and manage their resources

Theory Support for the Excited Baryon Program at the Jlab 12 GeV Upgrade

This document outlines major directions in theoretical support for the measurement of nucleon resonance transition form factors at the JLab 12 GeV upgrade with the CLAS12 detector. Using single and double meson production, prominent resonances in the mass range up to 2 GeV will be studied in the range of photon virtuality $Q^2$ up to 12 GeV$^2$ where quark degrees of freedom are expected to dominate. High level theoretical analysis of these data will open up opportunities to understand how the interactions of dressed quarks create the ground and excited nucleon states and how these interactions emerge from QCD. The paper reviews the current status and the prospects of QCD based model approaches that relate phenomenological information on transition form factors to the non-perturbative strong interaction mechanisms, that are responsible for resonance formation.Comment: 52 pages, 19 figures, White Paper of the Electromagnetic N-N* Transition Form Factor Workshop at Jefferson Lab, October 13-15, 2008, Newport News, VA, US

Generation of angular-momentum-dominated electron beams from a photoinjector

Various projects under study require an angular-momentum-dominated electron beam generated by a photoinjector. Some of the proposals directly use the angular-momentum-dominated beams (e.g. electron cooling of heavy ions), while others require the beam to be transformed into a flat beam (e.g. possible electron injectors for light sources and linear colliders). In this paper, we report our experimental study of an angular-momentum-dominated beam produced in a photoinjector, addressing the dependencies of angular momentum on initial conditions. We also briefly discuss the removal of angular momentum. The results of the experiment, carried out at the Fermilab/NICADD Photoinjector Laboratory, are found to be in good agreement with theoretical and numerical models.Comment: 8 pages, 7 figures, submitted to Phys. Rev. ST Accel. Beam

Novel Features Arising in the Maximally Random Jammed Packings of Superballs

Dense random packings of hard particles are useful models of granular media and are closely related to the structure of nonequilibrium low-temperature amorphous phases of matter. Most work has been done for random jammed packings of spheres, and it is only recently that corresponding packings of nonspherical particles (e.g., ellipsoids) have received attention. Here we report a study of the maximally random jammed (MRJ) packings of binary superdisks and monodispersed superballs whose shapes are defined by |x_1|^2p+...+|x_2|^2p<=1 with d = 2 and 3, respectively, where p is the deformation parameter with values in the interval (0, infinity). We find that the MRJ densities of such packings increase dramatically and nonanalytically as one moves away from the circular-disk and sphere point. Moreover, the disordered packings are hypostatic and the local arrangements of particles are necessarily nontrivially correlated to achieve jamming. We term such correlated structures "nongeneric". The degree of "nongenericity" of the packings is quantitatively characterized by determining the fraction of local coordination structures in which the central particles have fewer contacting neighbors than average. We also show that such seemingly special packing configurations are counterintuitively not rare. As the anisotropy of the particles increases, the fraction of rattlers decreases while the minimal orientational order increases. These novel characteristics result from the unique rotational symmetry breaking manner of the particles.Comment: 20 pages, 8 figure

Ionization dynamics in intense pulsed laser radiation. Effects of frequency chirping

Via a non-perturbative method we study the population dynamics and photoelectron spectra of Cs atoms subject to intense chirped laser pulses, with gaussian beams. We include above threshold ionization spectral peaks. The frequency of the laser is near resonance with the 6s-7p transition. Dominant couplings are included exactly, weaker ones accounted for perturbatively. We calculate the relevant transition matrix elements, including spin-orbit coupling. The pulse is taken to be a hyperbolic secant in time and the chirping a hyperbolic tangent. This choice allows the equations of motions for the probability amplitudes to be solved analytically as a series expansion in the variable u=(tanh(pi t/tau)+1)/2, where tau is a measure of the pulse length. We find that the chirping changes the ionization dynamics and the photoelectron spectra noticeably, especially for longer pulses of the order of 10^4 a.u. The peaks shift and change in height, and interference effects between the 7p levels are enhanced or diminished according to the amount of chirping and its sign. The integrated ionization probability is not strongly affected.Comment: Accepted by J. Phys. B; 18 pages, 17 figures. Latex, uses ioplppt.sty, iopl10.sty and psfig.st

Maximum Likelihood Estimation in Gaussian Chain Graph Models under the Alternative Markov Property

The AMP Markov property is a recently proposed alternative Markov property for chain graphs. In the case of continuous variables with a joint multivariate Gaussian distribution, it is the AMP rather than the earlier introduced LWF Markov property that is coherent with data-generation by natural block-recursive regressions. In this paper, we show that maximum likelihood estimates in Gaussian AMP chain graph models can be obtained by combining generalized least squares and iterative proportional fitting to an iterative algorithm. In an appendix, we give useful convergence results for iterative partial maximization algorithms that apply in particular to the described algorithm.Comment: 15 pages, article will appear in Scandinavian Journal of Statistic