Collaborative community care management enhancing homecare for people with advanced HIV disease: care planning between nursing and social care consultants, London, United Kingdom

Establishing, assessing and matching needs with available services and client expectations is the essence of joint community care planning, within the new United Kingdom legislation (1). Continuous audit and case review by two fieldworkers have described common themes and recurrent scenarios in community HIV care management within health and social care structures. This poster describes working scenarios, care management practice and care issues encountered by two HIV service consultants: Community Care Coordinator (CCC) and Clinical Nurse Specialist (CNS) within one inner London borough and the coterminous health district, respectively. The community care coordinator for HIV (CCC) within the Islington Neighbourhood Services department provides access to and advice about, the available social and housing services for people living with HIV-related disease. The postholder offers referral to other agencies, a dedicated casework service and an advisory role to field social workers, homecare organisers, community occupational therapists and various social services personnel. A specialist domiciliary home care team is available and operates within the borough's existing generic structure for domiciliary care. The clinical nurse specialist HIV/AIDS (CNS) within Camden and Islington Community Services NHS Trust, provides a consultant nursing service in association with and complimentary to, the existing generic nursing services. The postholder offers clinical support and advice to clients, health and social care professionals, in order to maximise the involvement of primary health care teams in homecare provision. Furthermore, education and training for health care professionals in clinical manifestations, intravenous therapy, treatments and psychosocial care is available within the CNS-led continuing education programme (2). Access to both postholders by field staff is increased through message pager aircall. CCC and CNS work jointly on casework, liaising with and working alongside their colleagues in health and social services structures to provide client care management (3). The case studies presented from monthly audit and case review are recurrent and typical of the workload together with the difficulties associated with trying to maintain quality care with cost-limited community resources, blending generic and specialist services for clients with HIV disease

Partial Flavor Symmetry Restoration for Chiral Staggered Fermions

We study the leading discretization errors for staggered fermions by first constructing the continuum effective Lagrangian including terms of O(a^2), and then constructing the corresponding effective chiral Lagrangian. The terms of O(a^2) in the continuum effective Lagrangian completely break the SU(4) flavor symmetry down to the discrete subgroup respected by the lattice theory. We find, however, that the O(a^2) terms in the potential of the chiral Lagrangian maintain an SO(4) subgroup of SU(4). It follows that the leading discretization errors in the pion masses are SO(4) symmetric, implying three degeneracies within the seven lattice irreducible representations. These predictions hold also for perturbatively improved versions of the action. These degeneracies are observed, to a surprising degree of accuracy, in existing data. We argue that the SO(4) symmetry does not extend to the masses and interactions of other hadrons (vector mesons, baryons, etc), nor to higher order in a^2. We show how it is possible that, for physical quark masses of O(a^2), the new SO(4) symmetry can be spontaneously broken, leading to a staggered analogue of the Aoki-phase of Wilson fermions. This does not, however, appear to happen for presently studied versions of the staggered action.Comment: 26 pages, 2 figures (using psfig). Version to appear in PRD (clarifications added to introduction and section 6; typos corrected; references updated

The role of the real-time simulation facility, SIMFAC, in the design, development and performance verification of the Shuttle Remote Manipulator System (SRMS) with man-in-the-loop

The SIMFAC has played a vital role in the design, development, and performance verification of the shuttle remote manipulator system (SRMS) to be installed in the space shuttle orbiter. The facility provides for realistic man-in-the-loop operation of the SRMS by an operator in the operator complex, a flightlike crew station patterned after the orbiter aft flight deck with all necessary man machine interface elements, including SRMS displays and controls and simulated out-of-the-window and CCTV scenes. The characteristics of the manipulator system, including arm and joint servo dynamics and control algorithms, are simulated by a comprehensive mathematical model within the simulation subsystem of the facility. Major studies carried out using SIMFAC include: SRMS parameter sensitivity evaluations; the development, evaluation, and verification of operating procedures; and malfunction simulation and analysis of malfunction performance. Among the most important and comprehensive man-in-the-loop simulations carried out to date on SIMFAC are those which support SRMS performance verification and certification when the SRMS is part of the integrated orbiter-manipulator system

Order of the Chiral and Continuum Limits in Staggered Chiral Perturbation Theory

Durr and Hoelbling recently observed that the continuum and chiral limits do not commute in the two dimensional, one flavor, Schwinger model with staggered fermions. I point out that such lack of commutativity can also be seen in four-dimensional staggered chiral perturbation theory (SChPT) in quenched or partially quenched quantities constructed to be particularly sensitive to the chiral limit. Although the physics involved in the SChPT examples is quite different from that in the Schwinger model, neither singularity seems to be connected to the trick of taking the nth root of the fermion determinant to remove unwanted degrees of freedom ("tastes"). Further, I argue that the singularities in SChPT are absent in most commonly-computed quantities in the unquenched (full) QCD case and do not imply any unexpected systematic errors in recent MILC calculations with staggered fermions.Comment: 14 pages, 1 figure. v3: Spurious symbol, introduced by conflicting tex macros, removed. Clarification of discussion in several place

Simulations with different lattice Dirac operators for valence and sea quarks

We discuss simulations with different lattice Dirac operators for sea and valence quarks. A goal of such a "mixed" action approach is to probe deeper the chiral regime of QCD by enabling simulations with light valence quarks. This is achieved by using chiral fermions as valence quarks while computationally inexpensive fermions are used in the sea sector. Specifically, we consider Wilson sea quarks and Ginsparg-Wilson valence quarks. The local Symanzik action for this mixed theory is derived to O(a), and the appropriate low energy chiral effective Lagrangian is constructed, including the leading O(a) contributions. Using this Lagrangian one can calculate expressions for physical observables and determine the Gasser-Leutwyler coefficients by fitting them to the lattice data.Comment: 17 pages, 1 ps figure (2 clarification paragraphs added

Non-birational twisted derived equivalences in abelian GLSMs

In this paper we discuss some examples of abelian gauged linear sigma models realizing twisted derived equivalences between non-birational spaces, and realizing geometries in novel fashions. Examples of gauged linear sigma models with non-birational Kahler phases are a relatively new phenomenon. Most of our examples involve gauged linear sigma models for complete intersections of quadric hypersurfaces, though we also discuss some more general cases and their interpretation. We also propose a more general understanding of the relationship between Kahler phases of gauged linear sigma models, namely that they are related by (and realize) Kuznetsov's `homological projective duality.' Along the way, we shall see how `noncommutative spaces' (in Kontsevich's sense) are realized physically in gauged linear sigma models, providing examples of new types of conformal field theories. Throughout, the physical realization of stacks plays a key role in interpreting physical structures appearing in GLSMs, and we find that stacks are implicitly much more common in GLSMs than previously realized.Comment: 54 pages, LaTeX; v2: typo fixe

Constraint on the Low Energy Constants of Wilson Chiral Perturbation Theory

Wilson chiral perturbation theory (WChPT) is the effective field theory describing the long- distance properties of lattice QCD with Wilson or twisted-mass fermions. We consider here WChPT for the theory with two light flavors of Wilson fermions or a single light twisted-mass fermion. Discretization errors introduce three low energy constants (LECs) into partially quenched WChPT at O(a^2), conventionally called W'_6, W'_7 and W'_8 . The phase structure of the theory at non-zero a depends on the sign of the combination 2W'_6 + W'_8, while the spectrum of the lattice Hermitian Wilson-Dirac operator depends on all three constants. It has been argued, based on the positivity of partition functions of fixed topological charge, and on the convergence of graded group integrals that arise in the epsilon-regime of ChPT, that there is a constraint on the LECs arising from the underlying lattice theory. In particular, for W'_6 = W'_7 = 0, the constraint found is W'_8 \le 0. Here we provide an alternative line of argument, based on mass inequalities for the underlying partially quenched theory. We find that W'_8 \le 0, irrespective of the values of W'_6 and W'_7. Our constraint implies that 2W'_6 > |W'_8| if the phase diagram is to be described by the first-order scenario, as recent simulations suggest is the case for some choices of action.Comment: 10 pages, no figure

Parallel transport on non-Abelian flux tubes

I propose a way of unambiguously parallel transporting fields on non-Abelian flux tubes, or strings, by means of two gauge fields. One gauge field transports along the tube, while the other transports normal to the tube. Ambiguity is removed by imposing an integrability condition on the pair of fields. The construction leads to a gauge theory of mathematical objects known as Lie 2-groups, which are known to result also from the parallel transport of the flux tubes themselves. The integrability condition is also shown to be equivalent to the assumption that parallel transport along nearby string configurations are equal up to arbitrary gauge transformations. Attempts to implement this condition in a field theory leads to effective actions for two-form fields.Comment: significant portions of text rewritten, references adde