The experiences of patients and carers in the daily management of care at the end of life

Background Home is the preferred location for most people with an advanced disease and at the end of life. A variety of care professionals work in community settings to provide support to this population. Patients and their spouses, who also care for them (spouse-carers), are rarely accompanied by these sources of support at all times, and have to manage independently between their contact with care professionals. Aim To explore how patients and spouse-carers manage their involvement with care professionals in the community setting. Method Interpretive phenomenology informs the design of the research, whereby 16 interviews were conducted with the patients and spouse-carers. Interviews were recorded and transcribed verbatim. Data were analysed using phenomenological techniques including template analysis. Findings Patients and spouse-carers were interdependent and both parties played a role in co-ordinating care and managing relationships with professional care providers. The patients and spouse-carers actively made choices about how to manage their situation, and develop and modify managing strategies based on their experiences. Conclusions When daily management is effective and care professionals acknowledge the dyadic nature of the patient and spouse-carer relationship, people have confidence in living with advanced disease

Phase Diagram of the Attractive Hubbard Model with Inhomogeneous Interactions

The phase diagram of the attractive Hubbard model with spatially inhomogeneous interactions is obtained using a single site dynamical mean field theory like approach. The model is characterized by three parameters: the interaction strength, the active fraction (fraction of sites with the attractive interaction), and electron filling. The calculations indicate that in a parameter regime with intermediate values of interaction strength (compared to the bare bandwidth of the electrons), and intermediate values of the active fraction, "non-BCS" superconductivity is obtained. The results of this work are likely to be relevant to many systems with spatially inhomogeneous superconductivity such as strongly correlated oxides, systems with negative U centers, and, in future, cold atom optical lattices.Comment: 9 pages, 7 figures, to appear in Physical Review

Nontrivial temporal scaling in a Galilean stick-slip dynamics

We examine the stick-slip fluctuating response of a rough massive non-rotating cylinder moving on a rough inclined groove which is submitted to weak external perturbations and which is maintained well below the angle of repose. The experiments presented here, which are reminiscent of the Galileo's works with rolling objects on inclines, have brought in the last years important new insights into the friction between surfaces in relative motion and are of relevance for earthquakes, differing from classical block-spring models by the mechanism of energy input in the system. Robust nontrivial temporal scaling laws appearing in the dynamics of this system are reported, and it is shown that the time-support where dissipation occurs approaches a statistical fractal set with a fixed value of dimension. The distribution of periods of inactivity in the intermittent motion of the cylinder is also studied and found to be closely related to the lacunarity of a random version of the classic triadic Cantor set on the line.Comment: 7 pages including 6 figure

Correlations and Omori law in Spamming

The most costly and annoying characteristic of the e-mail communication system is the large number of unsolicited commercial e-mails, known as spams, that are continuously received. Via the investigation of the statistical properties of the spam delivering intertimes, we show that spams delivered to a given recipient are time correlated: if the intertime between two consecutive spams is small (large), then the next spam will most probably arrive after a small (large) intertime. Spam temporal correlations are reproduced by a numerical model based on the random superposition of spam sequences, each one described by the Omori law. This and other experimental findings suggest that statistical approaches may be used to infer how spammers operate.Comment: Europhysics Letters, to appea

Solubility isotope effects in aqueous solutions of methane

The isotope effect on the Henry's law coefficients of methane in aqueous solution (H/D and C-12/C-13 substitution) are interpreted using the statistical mechanical theory of condensed phase isotope effects. The missing spectroscopic data needed for the implementation of the theory were obtained either experimentally (infrared measurements), by computer simulation (molecular dynamics technique), or estimated using the Wilson's GF matrix method. The order of magnitude and sign of both solute isotope effects can be predicted by the theory. Even a crude estimation based on data from previous vapor pressure isotope effect studies of pure methane at low temperature can explain the inverse effect found for the solubility of deuterated methane in water. (C) 2002 American Institute of Physics

Using the post‐operative quality recovery scale to evaluate recovery with different neuromuscular blocking reversal agentsin the Portuguese population ‐ interim analysis results: 1AP3‐8

Background and Goal of Study: Post-operative Quality Recovery Scale (PQRS), is the first scale evaluating several domains of postoperative recovery. The objectives of this study were to compare overal and physiologic, cognitive, and functional domains of post-operative recovery af ter elective surgical procedures using neostigmine or sugammadex as neuromuscular blocking (NMB) reversal agents, to validate the use of PQRS in the Portuguese population and to objectively assess muscular strength recovery. Materials and Methods: Prospective multicenter observational study comparing postoperative recovery between 2 cohorts of 50 adult patients submitted to elective surgical procedures with general anesthesia using Nondepolarizing Muscle Relaxants and NMB reversal with neostigmine or sugammadex. Measurements obtained using Portuguese version of PQRS at dif ferent timepoint: baseline,15 minutes (T15), 40 minutes (T40), one and three days af ter surgery. Full recovery defined as return to values identical or higher than those measured at baseline, prior to surgery. Muscular strength measured with KERN- MAP® Dynamometer. Ethics Committees approval was obtained. Statistics used linear T-Test, Qui Square and Fisher exact test, data presented as mean±SD for continuous variables. Interim analysis results presented Results and Discussion: Thirty patients received neostigmine and 21 sugammadex. Age and BMI 50.4±11.8 and 28.6±5.6 in the neostigmine group and 38.2±12.7 and 24.7± 4.5 in the sugammadex group (p< 0,001). Overall response rate at T15 was 86% for neostigmine and 95% for sugammadex (p= 0.22). Dif ferences in favor of sugammadex group noted in nociceptive and emotional domains, 80 vs 100% respectively (p=0.04). Overall response rate at T40 was 80% for neostigmine and 65% for sugammadex (p=0.33), primarily reflecting constraints on activities of daily life. Muscular strength did not dif fer. Improvements in recovery scores from T15 to T40 were observed in both groups, without significant dif ferences . Postoperative assessments were feasible using PQRS at T15 and T40 and seem appropriate for comparisons between postoperative recovery domains and overall recovery . These preliminary results suggest nociceptive and emotional domains recovery at T15 may be faster with sugammadex. Conclusion: The results support the adopted PQRS validation process and the potential of this scale as a tool for the evaluation of post operative recovery evaluation in the Portuguese populatio

Parameter limits for neutrino oscillation with decoherence in KamLAND

FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESCONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQIn the framework of open quantum systems, we analyze data from KamLAND by using a model that considers neutrino oscillation in a three-family approximation with the inclusion of the decoherence effect. Using chi(2) test, we find new limits for the decoherence parameter, which we call gamma, considering the most recent data by KamLAND. Assuming an energy dependence of the type gamma=gamma(0) (E/E-0)(n), at a 95% C.L., the limits found are 3.7 x 10(-24) GeV for n=-1, 6.8 x 10(-22) GeV for n=0, and 1.5 x 10(-19) GeV for n=1 on the energy dependence.951117FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESCONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESCONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQSem informaçãoSem informaçãoSem informaçã

Einstein gravity as a 3D conformally invariant theory

We give an alternative description of the physical content of general relativity that does not require a Lorentz invariant spacetime. Instead, we find that gravity admits a dual description in terms of a theory where local size is irrelevant. The dual theory is invariant under foliation preserving 3-diffeomorphisms and 3D conformal transformations that preserve the 3-volume (for the spatially compact case). Locally, this symmetry is identical to that of Horava-Lifshitz gravity in the high energy limit but our theory is equivalent to Einstein gravity. Specifically, we find that the solutions of general relativity, in a gauge where the spatial hypersurfaces have constant mean extrinsic curvature, can be mapped to solutions of a particular gauge fixing of the dual theory. Moreover, this duality is not accidental. We provide a general geometric picture for our procedure that allows us to trade foliation invariance for conformal invariance. The dual theory provides a new proposal for the theory space of quantum gravity.Comment: 27 pages. Published version (minor changes and corrections