Waterproofed Photomultiplier Tube Assemblies for the Daya Bay Reactor Neutrino Experiment

In the Daya Bay Reactor Neutrino Experiment 960 20-cm-diameter waterproof photomultiplier tubes are used to instrument three water pools as Cherenkov detectors for detecting cosmic-ray muons. Of these 960 photomultiplier tubes, 341 are recycled from the MACRO experiment. A systematic program was undertaken to refurbish them as waterproof assemblies. In the context of passing the water leakage check, a success rate better than 97% was achieved. Details of the design, fabrication, testing, operation, and performance of these waterproofed photomultiplier-tube assemblies are presented.Comment: 16 pages, 11 figures. Submitted to Nucl. Instr. Met

Care Toward the End of Life in Older Populations and Its Implementation Facilitators and Barriers: A Scoping Review

Purpose To inform health system improvements for care of elderly populations approaching the end of life (EOL) by identifying important elements of care and implementation barriers and facilitators. Design A scoping review was carried out to identify key themes in EOL care. Articles were identified from MEDLINE, the Cochrane Library, organizational websites, and internet searches. Eligible publications included reviews, reports, and policy documents published between 2005 and 2016. Initially, eligible documents included reviews or reports concerning effective or important models or components of EOL care in older populations, and evidence was thematically synthesized. Later, other documents were identified to contextualize implementation issues. Results Thematic synthesis using 35 reports identified key features in EOL care: (1) enabling policies and environments; (2) care pathways and models; (3) assessment and prognostication; (4) advance care planning and advance directives; (5) palliative and hospice care; (6) integrated and multidisciplinary care; (7) effective communication; (8) staff training and experience; (9) emotional and spiritual support; (10) personalized care; and (11) resources. Barriers in implementing EOL care include fragmented services, poor communication, difficult prognostication, difficulty in accepting prognosis, and the curative focus in medical care. Conclusions Quality EOL care for older populations requires many core components but the local context and implementation issues may ultimately determine if these elements can be incorporated into the system to improve care. Changes at the macro-level (system/national), meso-level (organizational), and micro-level (individual) will be required to successfully implement service changes to provide holistic and person-centered EOL care for elderly populations