Nurse led care

What's the difference between medical and nursing care? The answer is not straightforward, but shortages in the medical workforce mean that nurses are increasingly called on to undertake work that was previously done by doctors (such as undertaking surgery,1 prescribing drugs, performing triage in emergency departments), whereas shortages in the nursing workforce mean that healthcare assistants now do many tasks that nurses are trained to do. This fluidity in professional roles and competencies enables the health workforce to respond to need, but are outcomes for patients being improved? Do these benefits come at an additional cost, and if so, are they worth paying for

Linear scaling calculation of band edge states and doped semiconductors

Linear scaling methods provide total energy, but no energy levels and canonical wavefuctions. From the density matrix computed through the density matrix purification methods, we propose an order-N (O(N)) method for calculating both the energies and wavefuctions of band edge states, which are important for optical properties and chemical reactions. In addition, we also develop an O(N) algorithm to deal with doped semiconductors based on the O(N) method for band edge states calculation. We illustrate the O(N) behavior of the new method by applying it to boron nitride (BN) nanotubes and BN nanotubes with an adsorbed hydrogen atom. The band gap of various BN nanotubes are investigated systematicly and the acceptor levels of BN nanotubes with an isolated adsorbed H atom are computed. Our methods are simple, robust, and especially suited for the application in self-consistent field electronic structure theory

Imaging and manipulating electrons in a 1D quantum dot with Coulomb blockade microscopy

Motivated by the recent experiments by the Westervelt group using a mobile tip to probe the electronic state of quantum dots formed on a segmented nanowire, we study the shifts in Coulomb blockade peak positions as a function of the spatial variation of the tip potential, which can be termed "Coulomb blockade microscopy". We show that if the tip can be brought sufficiently close to the nanowire, one can distinguish a high density electronic liquid state from a Wigner crystal state by microscopy with a weak tip potential. In the opposite limit of a strongly negative tip potential, the potential depletes the electronic density under it and divides the quantum wire into two partitions. There the tip can push individual electrons from one partition to the other, and the Coulomb blockade micrograph can clearly track such transitions. We show that this phenomenon can be used to qualitatively estimate the relative importance of the electron interaction compared to one particle potential and kinetic energies. Finally, we propose that a weak tip Coulomb blockade micrograph focusing on the transition between electron number N=0 and N=1 states may be used to experimentally map the one-particle potential landscape produced by impurities and inhomogeneities.Comment: 4 pages 7 figure

Ordered and periodic chaos of the bounded one dimensinal multibarrier potential

Numerical analysis indicates that there exists an unexpected new ordered chaos for the bounded one-dimensional multibarrier potential. For certain values of the number of barriers, repeated identical forms (periods) of the wavepackets result upon passing through the multibarrier potential.Comment: 16 pages, 9 figures, 1 Table. Some former text removed and other introduce

Local electronic nematicity in the one-band Hubbard model

Nematicity is a well known property of liquid crystals and has been recently discussed in the context of strongly interacting electrons. An electronic nematic phase has been seen by many experiments in certain strongly correlated materials, in particular, in the pseudogap phase generic to many hole-doped cuprate superconductors. Recent measurements in high $T_c$ superconductors has shown even if the lattice is perfectly rotationally symmetric, the ground state can still have strongly nematic local properties. Our study of the two-dimensional Hubbard model provides strong support of the recent experimental results on local rotational $C_4$ symmetry breaking. The variational cluster approach is used here to show the possibility of an electronic nematic state and the proximity of the underlying symmetry-breaking ground state within the Hubbard model. We identify this nematic phase in the overdoped region and show that the local nematicity decreases with increasing electron filling. Our results also indicate that strong Coulomb interaction may drive the nematic phase into a phase similar to the stripe structure. The calculated spin (magnetic) correlation function in momentum space shows the effects resulting from real-space nematicity

The Optimal Inhomogeneity for Superconductivity: Finite Size Studies

We report the results of exact diagonalization studies of Hubbard models on a $4\times 4$ square lattice with periodic boundary conditions and various degrees and patterns of inhomogeneity, which are represented by inequivalent hopping integrals $t$ and $t^{\prime}$. We focus primarily on two patterns, the checkerboard and the striped cases, for a large range of values of the on-site repulsion $U$ and doped hole concentration, $x$. We present evidence that superconductivity is strongest for $U$ of order the bandwidth, and intermediate inhomogeneity, $0 <t^\prime< t$. The maximum value of the ``pair-binding energy'' we have found with purely repulsive interactions is $\Delta_{pb} = 0.32t$ for the checkerboard Hubbard model with $U=8t$ and $t^\prime = 0.5t$. Moreover, for near optimal values, our results are insensitive to changes in boundary conditions, suggesting that the correlation length is sufficiently short that finite size effects are already unimportant.Comment: 8 pages, 9 figures; minor revisions; more references adde

Theory of momentum resolved tunneling into a short quantum wire

Motivated by recent tunneling experiments in the parallel wire geometry, we calculate results for momentum resolved tunneling into a short one-dimensional wire, containing a small number of electrons. We derive some general theorems about the momentum dependence, and we carry out exact calculations for up to N=4 electrons in the final state, for a system with screened Coulomb interactions that models the situation of the experiments. We also investigate the limit of large $N$ using a Luttinger-liquid type analysis. We consider the low-density regime, where the system is close to the Wigner crystal limit, and where the energy scale for spin excitations can be much lower than for charge excitations, and we consider temperatures intermediate between the relevant spin energies and charge excitations, as well as temperatures below both energy scales.Comment: 19 pages, 13 figures, clarified text in a few points, added 1 figure, updated reference

What's the evidence that NICE guidance has been implemented? Results from a national evaluation using time series analysis, audit of patients' notes, and interviews

OBJECTIVES: To assess the extent and pattern of implementation of guidance issued by the National Institute for Clinical Excellence (NICE). DESIGN: Interrupted time series analysis, review of case notes, survey, and interviews. SETTING: Acute and primary care trusts in England and Wales. PARTICIPANTS: All primary care prescribing, hospital pharmacies; a random sample of 20 acute trusts, 17 mental health trusts, and 21 primary care trusts; and senior clinicians and managers from five acute trusts. MAIN OUTCOME MEASURES: Rates of prescribing and use of procedures and medical devices relative to evidence based guidance. RESULTS: 6308 usable patient audit forms were returned. Implementation of NICE guidance varied by trust and by topic. Prescribing of some taxanes for cancer (P <0.002) and orlistat for obesity (P <0.001) significantly increased in line with guidance. Prescribing of drugs for Alzheimer’s disease and prophylactic extraction of wisdom teeth showed trends consistent with, but not obviously a consequence of, the guidance. Prescribing practice often did not accord with the details of the guidance. No change was apparent in the use of hearing aids, hip prostheses, implantable cardioverter defibrillators, laparoscopic hernia repair, and laparoscopic colorectal cancer surgery after NICE guidance had been issued. CONCLUSIONS: Implementation of NICE guidance has been variable. Guidance seems more likely to be adopted when there is strong professional support, a stable and convincing evidence base, and no increased or unfunded costs, in organisations that have established good systems for tracking guidance implementation and where the professionals involved are not isolated. Guidance needs to be clear and reflect the clinical context

Fluctuations of the correlation dimension at metal-insulator transitions

We investigate numerically the inverse participation ratio, $P_2$, of the 3D Anderson model and of the power-law random banded matrix (PRBM) model at criticality. We found that the variance of $\ln P_2$ scales with system size $L$ as $\sigma^2(L)=\sigma^2(\infty)-A L^{-D_2/2d}$, being $D_2$ the correlation dimension and $d$ the system dimension. Therefore the concept of a correlation dimension is well defined in the two models considered. The 3D Anderson transition and the PRBM transition for $b=0.3$ (see the text for the definition of $b$) are fairly similar with respect to all critical magnitudes studied.Comment: RevTex, 5 pages, 4 eps figures, to be published in Phys. Rev. Let

Iterative methods for solving Ax = b GMRES/FOM versus QMR/BiCG

We study the convergence of GMRES/FOM and QMR/BiCG methods for solving nonsymmetric Az = b. We prove that given the results of a BiCG computation on Az = b, we can obtain a matrix B with the same eigenvalues as A and a vector c such that the residual norms generated by a FOM computation on Bz = c are identical to those generated by the BiCG computations. Using a unitary equivalence for each of these methods, we obtain test problems where we can easily vary certain spectral properties of the matrices. We use these test problems to study the effects of nonnormality on the convergence of GMRES and QMR, to study the effects of eigenvalue outliers on the convergence of QMR, and to compare the convergence of restarted GMRES and QMR across a family of normal and nonnormal problems. Our GMRES tests on nonnormal test matrices indicate that nonnormality can have unexpected effects upon the residual norm convergence, giving misleading indications of superior convergence when the error norms for GMRES are not significantly different from those for QMR. Our QMR tests indicate that the convergence of the QMR residual and error norms is infLuenced predominantly by small and large eigenvalue outliers and by the character, real, complex, or nearly real, of the outliers and the other eigenvalues. In our comparison tests QMR outperformed GMRES(10) and GMRES(20) on both the normal and nonnormal test matrices. If you have difficulty viewing the second part of the linked postscript file, open the file: http://www.cs.umd.edu/fs/ftp/pub/papers/papers/3587.figures.ps. This is the second part of the paper in a separate file. (Also cross-referenced as UMIACS-TR-96-2