Preoperative Education: A Patient-Centered Care Approach

Abstract This project addresses the need for delivering high quality preoperative education to the Arabic speaking patient population served by Sharp Healthcare’s orthopedic service line. A goal set during the institution’s 2015 The Joint Commission Disease-Specific Care survey is to discharge major joint patients to home in two days or less. Data abstracted from Sharp Healthcare’s orthopedic registry revealed that only 30% of Arabic speaking patients are meeting this goal. The current process for educating Arabic speaking patients preoperatively during a one to one educational session with a third party interpreter takes three hours, costs $402.00 per patient, and education is fragmented, abbreviated, and low in quality. When compared to time and costs associated with educating major joint patients at the weekly 90 minute group educational session, costing$3.75 per patient educated, the need for creating a PowerPoint presentation with voice over in the Arabic language to be viewed on a laptop with earbuds during the group educational session was identified. Following a microsystem assessment and root cause analysis, using Kotter’s 8 Step Change Model, preoperative joint replacement education was translated into the Arabic language and a PowerPoint with voice over presentation is being created. The projected outcome is equitable access to knowledge needed by patients to partner in their healthcare and plan for a safe discharge to home in two days or less

Continental Casualty Co. v. Robsac Industries: Federal Declaratory Judgment Actions and Parallel State Proceedings--A Fifth Branch of Abstention

In order to deter parallel state and federal suits involving the same parties and issues in declaratory judgment actions, the Brillhart doctrine requires a balancing test to determine the propriety of exercising federal jurisdictions to grant relief. In Continental Casualty Co. v. Robsac Industries, decided in 1991, the Ninth Circuit held that federal district courts should generally decline to exercise jurisdiction in insurance coverage and other suits brought under the Federal Declaratory Judgments Act. This replaced the balancing test with a general rule favoring federal court abstention. This Casenote examines the Robsac decision in light of abstention doctrine history and previous Ninth Circuit decisions. The author concludes that it is unclear whether Robsac\u27s new standard will in fact deter federal courts from exercising their congressionally conferred jurisdiction

Photon Mass Bound Destroyed by Vortices

The Particle Data Group gives an upper bound on the photon mass $m < 2 \times 10^{-16}$eV from a laboratory experiment and lists, but does not adopt, an astronomical bound $m < 3 \times 10^{-27}$eV, both of which are based on the plausible assumption of large galactic vector-potential. We argue that the interpretations of these experiments should be changed, which alters significantly the bounds on $m$. If $m$ arises from a Higgs effect, both limits are invalid because the Proca vector-potential of the galactic magnetic field may be neutralized by vortices giving a large-scale magnetic field that is effectively Maxwellian. In this regime, experiments sensitive to the Proca potential do not yield a useful bound on $m$. As a by-product, the non-zero photon mass from Higgs effect predicts generation of a primordial magnetic field in the early universe. If, on the other hand, the galactic magnetic field is in the Proca regime, the very existence of the observed large-scale magnetic field gives $m^{-1}\gtrsim 1$kpc, or $m\lesssim 10^{-26}$eV.Comment: 9 pages, discussion of primordial magnetic field adde

Raman Scattering Signatures of Kitaev Spin Liquids in A2_2 IrO3_3 Iridates

We study theoretically the Raman scattering response $I(\omega)$ in the gapless quantum spin liquid phase of the Kitaev-Heisenberg model. The dominant polarization-independent contribution $I_K (\omega)$ reflects the density of states of the emergent Majorana fermions in the ground-state flux-sector. The integrability-breaking Heisenberg exchange generates a second contribution, whose dominant part $I_H (\omega)$ has the form of a quantum quench corresponding to an abrupt insertion of four $Z_2$ gauge fluxes. This results in a weakly polarization dependent response with a sharp peak at the energy of the flux excitation accompanied by broad features, which can be related to Majorana fermions in the presence of the perturbed gauge field. We discuss the experimental situation and explore more generally the influence of integrability breaking for Kitaev spin liquid response functions.Comment: 9 pages including supp. ma

Hybrid Inflation and Particle Physics

The prototype hybrid SUSY SU(5) inflation models, while well motivated from particle physics, and while allowing an acceptable inflationary phase with little or no fine tuning, are shown to have two fundamental phenomenological problems. (1) They inevitably result in the wrong vacuum after inflation is over; and (2) they do not solve the monopole problem. In order to get around the first problem the level of complexity of these models must be increased. One can also avoid the second problem in this way. We also demonstate another possibility by proposing a new general mechanism to avoid the monopole problem with, or without inflation

Choice experiments to elicit the users preferences for coastal erosion management : the case of Praia da Amorosa

Coastal erosion is a complex and increasingly important problem, largely due to its efects and management strategies. The current context of climate change, together with centuries of human occupation of shorelines, adds pressure for the development of sustainable coastal management policies, the success of which crucially depends on the consideration of all stakeholders? perspectives. This research investigates users? preferences over alternative options of coastal erosion management. Through the implementation of a discrete choice experiment, respondents? preferences regarding management alternatives are elicited, and their willingness to pay for alternatives? attributes is estimated. The results show that respondents prefer some interventions to mitigate the problem rather than no action, and prefer lighter intervention (palisades, gangways) to heavy infrastructures (rockflls, seawalls, groynes). Moreover, the results show the presence of preference heterogeneity and thus the need to use more fexible and complex models. Based on the results obtained, it is possible to drive some policy implications. First, the do-nothing option is not viable from the population?s standpoint; second, although some type of coastal erosion protection is demanded by the general population, the preferred approach is for light forms, contrary to the policy adopted in the last century, and still overwhelmingly present in the territory. Lastly, given the considerable heterogeneity in respondents? preferences, careful consideration of the welfare impact of coastal interventions by population segments is required.221F-EEA6-A7D7 | Susana OliveiraN/

Long-range epidemic spreading with immunization

We study the phase transition between survival and extinction in an epidemic process with long-range interactions and immunization. This model can be viewed as the well-known general epidemic process (GEP) in which nearest-neighbor interactions are replaced by Levy flights over distances r which are distributed as P(r) ~ r^(-d-sigma). By extensive numerical simulations we confirm previous field-theoretical results obtained by Janssen et al. [Eur. Phys. J. B7, 137 (1999)].Comment: LaTeX, 14 pages, 4 eps figure

Dynamics of domain walls in magnetic nanostrips

We express dynamics of domain walls in ferromagnetic nanowires in terms of collective coordinates generalizing Thiele's steady-state results. For weak external perturbations the dynamics is dominated by a few soft modes. The general approach is illustrated on the example of a vortex wall relevant to recent experiments with flat nanowires. A two-mode approximation gives a quantitatively accurate description of both the steady viscous motion of the wall in weak magnetic fields and its oscillatory behavior in moderately high fields above the Walker breakdown.Comment: 4 pages, update to published versio