The conversation: developing confidence to provide end of life care in Salford nursing homes

The study was funded by the Burdett Trust for Nursing and partly by Salford Primary Care Trust. A realistic evaluation design was used to collect data using a range of approaches, from before and after surveys of confidence in delivering end of life care, to participant observation and interviews. A total of 43 people were interviewed involving both staff, residents and relatives. Key Messages a) Significant resources are needed to engage staff, residents and relatives/carers with the idea of advance care planning b) Care home staff are optimistic about involving residents and relatives in planning care at the end of life and some relatives become very involved in care c) Clearly registered nurses and other care home workers such as care assistants have different roles, but the overlap between these and the appropriate boundaries would benefit from further work d) Talking to residents and relatives about their feelings and wishes for care at the end of life remains especially difficult, but education and training in key skills and knowledge can engender both ability and motivation e) Care homes need strong and well-informed leadership in order to implement the Gold Standards Framework f) Placing a relative in a care home involves strain and an ability to compromise ‘there’s no perfect place’ g) Advance care planning can reduce the distress and the number of inappropriate hospital admissions, but is challenging in the face of staff rotation and out of hours medical staff being unpredictable h) The principles of the Gold Standards Framework are widely seen as sensible, but clinical challenges include diagnosing and predicting dying trajectories, especially in heart failure, chronic pulmonary disease and dementia i) A particular concern of staff is how to approach nutrition and hydration as frailty and death approach j) Communicating about diagnosis and especially prognosis with residents who lack capacity is an increasing problem k) Natural justice suggests that resources should be allocated to the general standardisation of a good quality of care at the end of life in ALL care homes whatever their Care Quality Commission ratin

Structural Properties and Relative Stability of (Meta)Stable Ordered, Partially-ordered and Disordered Al-Li Alloy Phases

We resolve issues that have plagued reliable prediction of relative phase stability for solid-solutions and compounds. Due to its commercially important phase diagram, we showcase Al-Li system because historically density-functional theory (DFT) results show large scatter and limited success in predicting the structural properties and stability of solid-solutions relative to ordered compounds. Using recent advances in an optimal basis-set representation of the topology of electronic charge density (and, hence, atomic size), we present DFT results that agree reasonably well with all known experimental data for the structural properties and formation energies of ordered, off-stoichiometric partially-ordered and disordered alloys, opening the way for reliable study in complex alloys.Comment: 7 pages, 2 figures, 2 Table

Hypersonic test facility Patent

Hypersonic test facility for studying ablation in models under high pressure and high temperatur

Vertex Operators and Soliton Time Delays in Affine Toda Field Theory

In a space-time of two dimensions the overall effect of the collision of two solitons is a time delay (or advance) of their final trajectories relative to their initial trajectories. For the solitons of affine Toda field theories, the space-time displacement of the trajectories is proportional to the logarithm of a number $X$ depending only on the species of the colliding solitons and their rapidity difference. $X$ is the factor arising in the normal ordering of the product of the two vertex operators associated with the solitons. $X$ is shown to take real values between $0$ and $1$. This means that, whenever the solitons are distinguishable, so that transmission rather than reflection is the only possible interpretation of the classical scattering process, the time delay is negative and so an indication of attractive forces between the solitons.Comment: p. 24 Latex, Swansea-SWAT/93-94/3

Ensemble Density Functional Theory for Inhomogeneous Fractional Quantum Hall Systems

The fractional quantum Hall effect (FQHE) occurs at certain magnetic field strengths B*(n) in a two-dimensional electron gas of density n at strong magnetic fields perpendicular to the plane of the electron gas. At these magnetic fields strengths, the system is incompressible, i.e., there is a finite cost in energy for creating charge density fluctuations in the bulk, while the boundary of the electron gas has gapless modes of density waves. The bulk energy gap arises because of the strong electron-electron interactions. While there are very good models for infinite homogeneous systems and for the gapless excitations of the boundary of the electron gas, computational methods to accurately model finite, inhomogeneous systems with more then about ten electrons have not been available until very recently. We will here review an ensemble density functional approach to studying the ground state of large inhomogeneous spin polarized FQHE systems.Comment: 23 pages (revtex), 6 Postscript figures. To be published in Int. J. Quant. Chem. (invited talk at the 1996 Sanibel Symposium

General heatbath algorithm for pure lattice gauge theory

A heatbath algorithm is proposed for pure SU(N) lattice gauge theory based on the Manton action of the plaquette element for general gauge group N. Comparison is made to the Metropolis thermalization algorithm using both the Wilson and Manton actions. The heatbath algorithm is found to outperform the Metropolis algorithm in both execution speed and decorrelation rate. Results, mostly in D=3, for N=2 through 5 at several values for the inverse coupling are presented.Comment: 9 pages, 10 figures, 1 table, major revision, final version, to appear in PR

High-Fidelity Readout in Circuit Quantum Electrodynamics Using the Jaynes-Cummings Nonlinearity

We demonstrate a qubit readout scheme that exploits the Jaynes-Cummings nonlinearity of a superconducting cavity coupled to transmon qubits. We find that in the strongly-driven dispersive regime of this system, there is the unexpected onset of a high-transmission "bright" state at a critical power which depends sensitively on the initial qubit state. A simple and robust measurement protocol exploiting this effect achieves a single-shot fidelity of 87% using a conventional sample design and experimental setup, and at least 61% fidelity to joint correlations of three qubits.Comment: 5 pages, 4 figure

Radiative corrections and parity nonconservation in heavy atoms

The self-energy and the vertex radiative corrections to the effect of parity nonconservation in heavy atoms are calculated analytically in orders Z alpha^2 and Z^2 alpha^3 ln(lambda_C/r_0), where lambda_C and r_0 being the Compton wavelength and the nuclear radius, respectively. The value of the radiative correction is -0.85% for Cs and -1.41% for Tl. Using these results we have performed analysis of the experimental data on atomic parity nonconservation. The obtained values of the nuclear weak charge, Q_W=-72.90(28)_{exp}(35)_{theor} for Cs, and Q_W=-116.7(1.2)_{exp}(3.4)_{theor} for Tl, agree with predictions of the standard model. As an application of our approach we have also calculated analytically dependence of the Lamb shift on the finite nuclear size.Comment: 4 pages, 4 figure