563 research outputs found
Question design in nurse-led and GP-led telephone triage for same-day appointment requests: a comparative investigation
Objective: To compare doctorsâ and nursesâ communication with patients in primary care telephone triage consultations. Design: Qualitative comparative study of content and form of questions in 51 telephone triage encounters between practitioners (general practitioners (GPs)=29; nurses=22) and patients requesting a same-day appointment in primary care. Audio-recordings of nurse-led calls were synchronised with video recordings of nurse's use of computer decision support software (CDSS) during triage. Setting: 2 GP practices in Devon and Warwickshire, UK. Participants: 4 GPs and 29 patients; and 4 nurses and 22 patients requesting a same-day face-to-face appointment with a GP. Main outcome measure: Form and content of practitioner-initiated questions and patient responses during clinical assessment. Results: A total of 484 questionâresponse sequences were coded (160 GP; 324 N). Despite average call lengths being similar (GP=4â
min, 37â
s, (SD=1â
min, 26â
s); N=4â
min, 39â
s, (SD=2â
min, 22â
s)), GPs and nurses differed in the average number (GP=5.51, (SD=4.66); N=14.72, (SD=6.42)), content and form of questions asked. A higher frequency of questioning in nurse-led triage was found to be due to nursesâ use of CDSS to guide telephone triage. 89% of nurse questions were oriented to asking patients about their reported symptoms or to wider-information gathering, compared to 54% of GP questions. 43% of GP questions involved eliciting patient concerns or expectations, and obtaining details of medical history, compared to 11% of nurse questions. Nurses using CDSS frequently delivered questions designed as declarative statements requesting confirmation and which typically preferred a âno problemâ response. In contrast, GPs asked a higher proportion of interrogative questions designed to request information. Conclusions: Nurses and GPs emphasise different aspects of the clinical assessment process during telephone triage. These different styles of triage have implications for the type of information available following nurse-led or doctor-led triage, and for how patients experience triage
Shear-free radiating collapse and conformal flatness
Here we study some general properties of spherical shear-free collapse. Its
general solution when imposing conformal flatness is reobtained [1,2] and
matched to the outgoing Vaidya spacetime. We propose a simple model satisfying
these conditions and study its physical consequences. Special attention
deserve, the role played by relaxational processes and the conspicuous link
betweeen dissipation and density inhomogeneity.Comment: 13 pages Latex. Some misprints in eqs.(17), (30) and (35) have been
correcte
Strange matter in rotating compact stars
We have constructed equations of state involving various exotic forms of
matter with large strangeness fraction such as hyperon matter, Bose-Einstein
condensates of antikaons and strange quark matter. First order phase
transitions from hadronic to antikaon condensed and quark matter are considered
here. The hadronic phase is described by the relativistic field theoretical
model. Later those equations of state are exploited to investigate models of
uniformly rotating compact stars. The effect of rotation on the third family
branch for the equation of state involving only antikaon condensates is
investigated. We also discuss the back bending phenomenon due to a first order
phase transition from condensed to quark matter.Comment: 8 pages, 4 figures; Plenary talk delivered at Strangeness in Quark
Matter (SQM) 2004 held in Cape Town, South Africa from 15-20 September;
Accepted for publication in the proceedings in Journal of Physics
A uniform treatment of the orbital effects due to a violation of the Strong Equivalence Principle in the gravitational Stark-like limit
We analytically work out several effects which a violation of the Strong
Equivalence Principle (SEP) induces on the orbital motion of a binary system
constituted of self-gravitating bodies immersed in a constant and uniform
external field. We do not restrict to the small eccentricity limit. Moreover,
we do not select any specific spatial orientation of the external polarizing
field. We explicitly calculate the SEP-induced mean rates of change of all the
osculating Keplerian orbital elements of the binary, the perturbation of the
projection of the binary orbit onto the line-of-sight, the shift of the radial
velocity, and the range and range-rate signatures and as well. We find that the
ratio of the SEP precessions of the node and the inclination of the binary
depends only on and the pericenter of the binary itself, being independent on
both the magnitude and the orientation of the polarizing field, and on the
semimajor axis, the eccentricity and the node of the binary. Our results, which
do not depend on any particular SEP-violating theoretical scheme, can be
applied to quite general astronomical and astrophysical scenarios. They can be
used to better interpret present and future SEP experiments, especially when
several theoretical SEP mechanisms may be involved, and to suitably design new
dedicated tests.Comment: LaTex2e, 14 pages, no figures, no tables, 42 references. To appear in
Classical and Quantum Gravity (CQG
Improved Models of Stellar Core Collapse and Still no Explosions: What is Missing?
Two-dimensional hydrodynamic simulations of stellar core-collapse with and
without rotation are presented which for the first time were performed by
solving the Boltzmann equation for the neutrino transport including a
state-of-the-art description of neutrino interactions. Although convection
develops below the neutrinosphere and in the neutrino-heated region behind the
supernova shock, the models do not explode. This suggests missing physics,
possibly with respect to the nuclear equation of state and weak interactions in
the subnuclear regime. However, it might also indicate a fundamental problem of
the neutrino-driven explosion mechanism.Comment: PRL submitted; 3 eps figures, 1 colored, high-quality available upon
reques
Radiating Shear-Free Gravitational Collapse with Charge
We present a new shear free model for the gravitational collapse of a
spherically symmetric charged body. We propose a dissipative contraction with
radiation emitted outwards. The Einstein field equations, using the junction
conditions and an ansatz, are integrated numerically. A check of the energy
conditions is also performed. We obtain that the charge delays the black hole
formation and it can even halt the collapse.Comment: 22 pages, 9 figures. It has been corrected several typos and included
several references. Accepted for publication in GR
Isospin-rich nuclei in neutron star matter
Stability of nuclei beyond the drip lines in the presence of an enveloping
gas of nucleons and electrons, as prevailing in the inner crust of a neutron
star, is studied in the temperature-dependent Thomas-Fermi framework. A
limiting asymmetry in the isospin space beyond which nuclei cannot exist
emerges from the calculations. The ambient conditions like temperature, baryon
density and neutrino concentration under which these exotic nuclear systems can
be formed are studied in some detail.Comment: Submitted to Phy. Rev. C: Revtex version of manuscript 22 pages and
10 PS-files for figure
Isospin-rich nuclei in neutron star matter
Stability of nuclei beyond the drip lines in the presence of an enveloping
gas of nucleons and electrons, as prevailing in the inner crust of a neutron
star, is studied in the temperature-dependent Thomas-Fermi framework. A
limiting asymmetry in the isospin space beyond which nuclei cannot exist
emerges from the calculations. The ambient conditions like temperature, baryon
density and neutrino concentration under which these exotic nuclear systems can
be formed are studied in some detail.Comment: Submitted to Phy. Rev. C: Revtex version of manuscript 22 pages and
10 PS-files for figure
The Tolman VII solution, trapped null orbits and w - modes
The Tolman VII solution is an exact static spherically symmetric perfect
fluid solution of Einstein's equations that exhibits a surprisingly good
approximation to a neutron star. We show that this solution exhibits trapped
null orbits in a causal region even for a tenuity (total radius to mass ratio)
. In this region the dynamical part of the potential for axial w - modes
dominates over the centrifugal part.Comment: 5 pages revtex. 10 figures png. Further information at
http://grtensor.phy.queensu.ca/tolmanvii
New Supernova Constraints on Sterile Neutrino Production
We consider the possibility that a light sterile-neutrino species can
be produced by scattering during the cooling of a proto-neutron star.
If we parameterize the sterile neutrino production cross-section by a parameter
as , where is an electron, neutron or proton, we show that is
constrained by limits to the conversion of to in the region
between the sterile-neutrino trapping region and the electron-neutrino trapping
region. This consideration excludes values of in the range between 10^{-4}
\la A \la 10^{-1}.Comment: 12 pages; Late
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