CF healthcare workers feel unprepared in providing suitable end of life care and desire more education: Results of a nationwide survey

INTRODUCTION: Little is known about the depth of knowledge and preparedness of CF caregivers in delivering end of life and palliative care to CF patients and families. METHOD: Nationwide survey questionnaires for CF care providers using the CF Foundation Listserv electronic web-based tool. RESULTS: The majority of non-physician CF care providers (55%) had more than 15years of experience in their discipline and 84% of physician had greater than 15years of experience. The majority reported that they felt somewhat or very involved in palliative or end of life care in their current role. Yet, when asked whether they felt adequately prepared to deliver palliative and end of life care, only 18% reported that they were fully prepared and 45% felt that they were only minimally or not prepared. Further, only one third of respondents received more than 10h of education in general palliative or end-of-life care, while only 10% had received more than 10h of education specific to CF end of life care. The majority (73%) of CF healthcare providers preferred more education specific to CF end of life care. CONCLUSION: CF healthcare providers are involved in CF end of life issues but a fair number did not understand their role and felt inadequately prepared in delivering suitable end of life and palliative care. Many desired more education in the provision of such care

Advance care planning in cystic fibrosis: Current practices, challenges, and opportunities

AbstractBackgroundStudies in cystic fibrosis (CF) report late attention to advance care planning (ACP). The purpose of this study was to examine ACP with patients receiving care at US adult CF care programs.MethodsChart abstraction was used to examine ACP with adults with CF dying from respiratory failure between 2011 and 2013.ResultsWe reviewed 210 deaths among 67 CF care programs. Median age at death was 29years (range 18–73). Median FEV1 in the year preceding death was 33% predicted (range 13–100%); 68% had severe lung disease with FEV1p=pp=0.55). The frequency of ACP varied significantly among the 29 programs contributing data from four or more deaths.ConclusionsACP in CF often occurs late in the disease course. Important decisions default to surrogates when opportunities for ACP are missed. Provision of ACP varies significantly among adult CF care programs. Careful evaluation of opportunities to enhance ACP and implementation of recommended approaches may lead to better practices in this important aspect of CF care

A burst search for gravitational waves from binary black holes

Compact binary coalescence (CBC) is one of the most promising sources of gravitational waves. These sources are usually searched for with matched filters which require accurate calculation of the GW waveforms and generation of large template banks. We present a complementary search technique based on algorithms used in un-modeled searches. Initially designed for detection of un-modeled bursts, which can span a very large set of waveform morphologies, the search algorithm presented here is constrained for targeted detection of the smaller subset of CBC signals. The constraint is based on the assumption of elliptical polarisation for signals received at the detector. We expect that the algorithm is sensitive to CBC signals in a wide range of masses, mass ratios, and spin parameters. In preparation for the analysis of data from the fifth LIGO-Virgo science run (S5), we performed preliminary studies of the algorithm on test data. We present the sensitivity of the search to different types of simulated CBC waveforms. Also, we discuss how to extend the results of the test run into a search over all of the current LIGO-Virgo data set.Comment: 12 pages, 4 figures, 2 tables, submitted for publication in CQG in the special issue for the conference proceedings of GWDAW13; corrected some typos, addressed some minor reviewer comments one section restructured and references updated and correcte

Facebook's Mobile Career

At the end of its first decade, Facebook’s identity, popularity, and characteristics are shaped in important ways by its becoming a form of mobile media, as much as it as platform associated with Internet and social media. This paper seeks to explore and understand Facebook as the important force in mobile media and communication it now is. It draws upon and combines perspectives from technology production, design, and economy, as well as user adoption, consumption, practices, affect, emotion, and resistance. The paper discusses the beginnings of mobile Facebook, and the early adoption of mobile Facebook associated with the rise of smartphones. The second part of the paper explores Facebook’s integration with photography (with Instagram) and social games (such as Zynga’s Farmville). The paper argues that Facebook’s mobile career is an accomplishment that has distinctively melded evolving affordances, everyday use across a wide range of settings, as well as political economies, corporate strategy, and design.Australian Research Counci

Phenomenological template family for black-hole coalescence waveforms

Recent progress in numerical relativity has enabled us to model the non-perturbative merger phase of the binary black-hole coalescence problem. Based on these results, we propose a phenomenological family of waveforms which can model the inspiral, merger, and ring-down stages of black hole coalescence. We also construct a template bank using this family of waveforms and discuss its implementation in the search for signatures of gravitational waves produced by black-hole coalescences in the data of ground-based interferometers. This template bank might enable us to extend the present inspiral searches to higher-mass binary black-hole systems, i.e., systems with total mass greater than about 80 solar masses, thereby increasing the reach of the current generation of ground-based detectors.Comment: Minor changes, Submitted to Class. Quantum Grav. (Proc. GWDAW11

Status of NINJA: the Numerical INJection Analysis project

The 2008 NRDA conference introduced the Numerical INJection Analysis project (NINJA), a new collaborative effort between the numerical relativity community and the data analysis community. NINJA focuses on modeling and searching for gravitational wave signatures from the coalescence of binary system of compact objects. We review the scope of this collaboration and the components of the first NINJA project, where numerical relativity groups shared waveforms and data analysis teams applied various techniques to detect them when embedded in colored Gaussian noise

A scattering quantum circuit for measuring Bell's time inequality: a nuclear magnetic resonance demonstration using maximally mixed states

In 1985, Leggett and Garg (1985 Phys. Rev. Lett. 54 857) proposed a Bell-like inequality to test (in)compatibility between two fundamental concepts of quantum mechanics. The first concept is 'macroscopic realism', which is the quality of a physical property of a quantum system being independent of observation at the macroscopic level. The second concept is 'noninvasive measurability', which is the possibility of performing a measurement without disturbing the subsequent evolution of a system. One of the key requirement for testing the violation of the Leggett-Garg inequality, or Bell's time inequality, is the ability to perform noninvasive measurements over a qubit state. In this paper, we present a quantum scattering circuit that implements such a measurement for maximally mixed states. The operation of the circuit is demonstrated using liquid-state nuclear magnetic resonance (NMR) in chloroform, in which the time correlations of a qubit are measured on a probe (ancillary) qubit state. The results clearly show a violation region and are in excellent agreement with the predictions of quantum mechanics

Association Between Use of Specific Drugs and Antiretroviral Adherence: Findings from MACH 14

To determine the association between individual substances of abuse and antiretroviral adherence, analyses require a large sample assessed using electronic data monitoring (EDM). In this analysis, EDM data from 1636 participants in 12 U.S. adherence-focused studies were analyzed to determine the associations between recent use of various substances and adherence during the preceding four weeks. In bivariate analyses comparing adherence among patients who had used a specific substance to those who had not, adherence was significantly lower among those who had recently used cocaine, other stimulants or heroin but not among those who had used cannabis or alcohol. In multivariate analyses controlling for sociodemographics, amount of alcohol use and recent use of any alcohol, cocaine, other stimulants and heroin each was significantly negatively associated with adherence. The significant associations of cocaine, other stimulants, heroin, and alcohol use with adherence suggest that these are important substances to target with adherence-focused interventions