The conduct and process of mental capacity assessments in home healthcare settings

The assessment of capacity to consent to treatment is key to shared practitioner–patient decision-making. It is the responsibility of the person closest to the decision being made to carry out the assessment. The aim was to examine the factors that influence mental capacity assessments in home health care settings and identify the facilitators and inhibitors to the conduct and process of assessments as perceived and experienced by non-medical health practitioners providing generalist community services. Semi-structured interviews with a purposive sample of community nurses, community physiotherapists and community occupational therapists in one NHS Trust in London. Data were analysed thematically. The main themes were issues relating to: intrinsic patient factors and behaviours; recognising, managing and utilising the influence of the family; practitioner motivation and competence; working together as a team to optimise shared decision making, and; the importance of place. While some issues appear germane to both hospital and home health care settings, others are unique to – or manifest very differently in – home health care settings. The findings suggest that the influence of family members, long-term practitioner–patient relationships and physical distance from co-workers make the conduct and process of mental capacity assessments in home health care settings an inherently complex endeavour

Integrating social media into routine midwifery services: Maternity Direct+

The use of social media to disseminate and receive health messages has increased over the past ten years, and many women use social media to access pregnancy information. However, the NHS has been slow to integrate consumer facing Internet technologies into routine care services. This article describes an innovative social media project, Maternity Direct+, an Internet midwife employed by Basildon and Thurrock University Hospitals NHS Foundation Trust. The Internet midwife uses Facebook to disseminate health messages and answer non-urgent questions from pregnant women, mothers up to 28 days after birth, and women planning a pregnancy. Findings from the project evaluation demonstrated a high level of demand for a responsive, evidence-based, non-urgent information and advice service for pregnant women and new mothers, and high levels of user satisfaction. The authors conclude that social media can be integrated into routine midwifery services and used to complement existing communication channels

Quasar outflow energetics from broad absorption line variability

Quasar outflows have long been recognized as potential contributors to the co-evolution between supermassive black holes (SMBHs) and their host galaxies. The role of outflows in AGN feedback processes can be better understood by placing observational constraints on wind locations and kinetic energies. We utilize broad absorption line (BAL) variability to investigate the properties of a sample of 71 BAL quasars with P$\thinspace$V broad absorption. The presence of P$\thinspace$V BALs indicates that other BALs like C$\thinspace$IV are saturated, such that variability in those lines favours clouds crossing the line of sight. We use these constraints with measurements of BAL variability to estimate outflow locations and energetics. Our data set consists of multiple-epoch spectra from the Sloan Digital Sky Survey and MDM Observatory. We detect significant (4$\sigma$) BAL variations from 10 quasars in our sample over rest frame time-scales between < 0.2-3.8 yr. Our derived distances for the 10 variable outflows are nominally < 1-10 pc from the SMBH using the transverse-motion scenario, and < 100-1000 pc from the central source using ionization-change considerations. These distances, in combination with the estimated high outflow column densities (i.e. $N_{\textrm{H}}$ > 10$^{22}$ cm$^{-2}$), yield outflow kinetic luminosities between ~ 0.001-1 times the bolometric luminosity of the quasar, indicating that many absorber energies within our sample are viable for AGN feedback.Comment: 19 pages, 3 figures, 4 tables, 1 supplementary figure, accepted to MNRA

Growth and Survival of the Halophyte Salicornia Europaera L. Under Saline Field Conditions

Author Institution: Department of Botany, Ohio UniversityField investigations were carried out to determine growth and survival rates of Salicornia europaea L. in a saline environment at Rittman, Ohio. Collected data indicated that from 62% to 100% of the seedlings within the 'A saline zones investigated did not survive to maturity. Seedling mortality was statistically correlated at P<0.01 to rising soil salinity stress during late spring and summer. Plant growth was minimal between April and June, increasing sharply during late summer and fall

Constraining FeLoBAL outflows from absorption line variability

FeLoBALs are a rare class of quasar outflows with low-ionization broad absorption lines (BALs), large column densities, and potentially large kinetic energies that might be important for `feedback' to galaxy evolution. In order to probe the physical properties of these outflows, we conducted a multiple-epoch, absorption line variability study of 12 FeLoBAL quasars spanning a redshift range between 0.7 and 1.9 over rest frame time-scales of approximately 10 d to 7.6 yr. We detect absorption line variability with greater than 8 sigma confidence in 3 out of the 12 sources in our sample over time-scales of 0.6 to 7.6 yr. Variable wavelength intervals are associated with ground and excited state Fe II multiplets, the Mg II 2796, 2803 doublet, Mg I 2852, and excited state Ni II multiplets. The observed variability along with evidence of saturation in the absorption lines favors transverse motions of gas across the line of sight (LOS) as the preferred scenario, and allows us to constrain the outflow distance from the supermassive black hole (SMBH) to be less than 69, 7, and 60 pc for our three variable sources. In combination with other studies, these results suggest that the outflowing gas in FeLoBAL quasars resides on a range of scales and includes matter within tens of parsecs of the central source.Comment: 21 pages, 6 figures, 2 supplementary figures (attached at the end of the manuscript), accepted to Monthly Notices of the Royal Astronomical Societ

Clustering and Synchronization of Oscillator Networks

Using a recently described technique for manipulating the clustering coefficient of a network without changing its degree distribution, we examine the effect of clustering on the synchronization of phase oscillators on networks with Poisson and scale-free degree distributions. For both types of network, increased clustering hinders global synchronization as the network splits into dynamical clusters that oscillate at different frequencies. Surprisingly, in scale-free networks, clustering promotes the synchronization of the most connected nodes (hubs) even though it inhibits global synchronization. As a result, scale-free networks show an additional, advanced transition instead of a single synchronization threshold. This cluster-enhanced synchronization of hubs may be relevant to the brain with its scale-free and highly clustered structure.Comment: Submitted to Phys. Rev.

Collaborative multidisciplinary learning : quantity surveying students’ perspectives

The construction industry is highly fragmented and is known for its adversarial culture, culminating in poor quality projects not completed on time or within budget. The aim of this study is thus to guide the design of QS programme curricula in order to help students develop the requisite knowledge and skills to work more collaboratively in their multi-disciplinary future workplaces. A qualitative approach was considered appropriate as the authors were concerned with gathering an initial understanding of what students think of multi-disciplinary learning. The data collection method used was a questionnaire which was developed by the Behaviours4Collaboration (B4C) team. Knowledge gaps were still found across all the key areas where a future QS practitioner needs to be collaborative (either as a project contributor or as a project leader) despite the need for change instigated by the multi-disciplinary (BIM) education revolution. The study concludes that universities will need to be selective in teaching, and innovative in reorienting, QS education so that a collaborative BIM education can be effected in stages, increasing in complexity as the students’ technical knowledge grows. This will help students to build the competencies needed to make them future leaders. It will also support programme currency and delivery