Alien Registration- Mctague, James L. (Dedham, Hancock County)

https://digitalmaine.com/alien_docs/19942/thumbnail.jp

Barriers and facilitators to palliative care education in nursing and residential homes: a rapid review

Background: There is insufficient high-quality evidence to suggest that palliative care education can impact care home settings. Aims: To identify, appraise and synthesise all available evidence on the barriers and facilitators to providing palliative care education in residential and nursing care homes and to generate recommendations to increase the effectiveness of future palliative care education programmes in care homes. Methods: A rapid review searching CINAHL, Medline and ProQuest. One author screened full-text articles for inclusion. Any uncertainties were discussed with a second author. Findings: Twenty-two articles were included in the full review. Analysis of the included articles revealed the following overlapping themes: structural systems; cultural and personal issues; and knowledge translation issues with interaction. Conclusion: Addressing the barriers and facilitators when designing palliative care education programmes for care homes will lead to more successful outcomes

Evaluating a palliative care education programme for domiciliary care workers

Background: Many domiciliary care workers have reported low confidence and isolation when delivering end of life care in patients’ homes. Project Extension for Community Healthcare Outcomes (ECHO) is an initiative that has demonstrated success in increasing confidence and knowledge of end of life care in UK nursing home and community hospice workers, but it has not been evaluated with domiciliary care workers. Aim: To test the acceptability of Project ECHO to domiciliary care workers as a means of increasing their knowledge of, and confidence in, delivering palliative care, and its effectiveness in reducing their isolation by developing a community of practice. Method: A service evaluation, involving one domiciliary care agency delivering care in the community, was conducted from May 2018 to April 2019. The participants were 25 home care workers who were employed by the agency. Participants were invited to attend an event at which gaps in their knowledge were identified, and a curriculum of learning on the Project ECHO programme was developed. The learning involved 12 educational sessions over 12 months, with each session teaching a different component of palliative care. Questionnaires were completed by the participants before and after the educational sessions to assess their effect. In addition, a focus group was conducted with four of the participants. Results: Comparison of the questionnaires completed before and after participating in the education sessions revealed an increase in self-reported knowledge across all 12 topics of the curriculum and an increase in confidence in seven of the 12 topics. However, attendance across the 12 sessions was variable, with no more than nine being attended by any one participant. Conclusion: Palliative care education for domiciliary care staff using ECHO methodology was well received, relevant and accessible, and may have the potential to improve self-assessed knowledge and confidence. However, finding an ideal time for as many staff to attend as possible may be challenging

Dissipation in ferrofluids: Mesoscopic versus hydrodynamic theory

Part of the field dependent dissipation in ferrofluids occurs due to the rotational motion of the ferromagnetic grains relative to the viscous flow of the carrier fluid. The classical theoretical description due to Shliomis uses a mesoscopic treatment of the particle motion to derive a relaxation equation for the non-equilibrium part of the magnetization. Complementary, the hydrodynamic approach of Liu involves only macroscopic quantities and results in dissipative Maxwell equations for the magnetic fields in the ferrofluid. Different stress tensors and constitutive equations lead to deviating theoretical predictions in those situations, where the magnetic relaxation processes cannot be considered instantaneous on the hydrodynamic time scale. We quantify these differences for two situations of experimental relevance namely a resting fluid in an oscillating oblique field and the damping of parametrically excited surface waves. The possibilities of an experimental differentiation between the two theoretical approaches is discussed.Comment: 14 pages, 2 figures, to appear in PR

RELATIONSHIP BETWEEN LOBLOLLY PINE SMALL CLEAR SPECIMENS AND DIMENSION LUMBER TESTED IN STATIC BENDING

Prior to the 1980s the allowable stresses for lumber in North America were derived from testing of small clear specimens but the procedures changed because these models were found to be inaccurate.  Nevertheless, small clear testing continues to be used around the world for allowable stress determinations and in studies that examine forest management impacts on wood quality.  Using small clears and nondestructive technologies is advantageous because of the ease of obtaining and testing small clear specimens compared to lumber.  The objective of this study was to compare the mechanical properties in bending of small clear specimens with lumber specimens for loblolly pine.  Eight hundred and forty-one pieces of lumber in the No. 1 to No. 3 grades and 2×4 to 2×10 sizes were collected from a forest-thru-mill study and tested in static bending.  A small clear specimen (25 x 25 x 410 mm) was prepared from each piece of lumber and tested in static bending.  The effect of growth ring orientation was explored and overall samples tested on the radial or rift face did a better job of explaining the variation in lumber than samples tested on the tangential face; however, the relationships were generally poor for the modulus of elasticity (MOE) (R2 = 0.22) and modulus of rupture (MOR) (R2 = 0.11) pooled data.  A lumber-based multiple regression model explained 44% and 37% of the variability for MOE and MOR, respectively; whereas a stand-based multiple regression model explained 41% and 29% of the variability for MOE and MOR, respectively

Dispersity-Driven Melting Transition in Two Dimensional Solids

We perform extensive simulations of $10^4$ Lennard-Jones particles to study the effect of particle size dispersity on the thermodynamic stability of two-dimensional solids. We find a novel phase diagram in the dispersity-density parameter space. We observe that for large values of the density there is a threshold value of the size dispersity above which the solid melts to a liquid along a line of first order phase transitions. For smaller values of density, our results are consistent with the presence of an intermediate hexatic phase. Further, these findings support the possibility of a multicritical point in the dispersity-density parameter space.Comment: In revtex format, 4 pages, 6 postscript figures. Submitted to PR

Improving diagnosis and broadening the phenotypes in early-onset seizure and severe developmental delay disorders through gene panel analysis

BACKGROUND: We sought to investigate the diagnostic yield and mutation spectrum in previously reported genes for early-onset epilepsy and disorders of severe developmental delay. METHODS: In 400 patients with these disorders with no known underlying aetiology and no major structural brain anomaly, we analysed 46 genes using a combination of targeted sequencing on an Illumina MiSeq platform and targeted, exon-level microarray copy number analysis. RESULTS: We identified causative mutations in 71/400 patients (18%). The diagnostic rate was highest among those with seizure onset within the first two months of life (39%), although overall it was similar in those with and without seizures. The most frequently mutated gene was SCN2A (11 patients, 3%). Other recurrently mutated genes included CDKL5, KCNQ2, SCN8A (six patients each), FOXG1, MECP2, SCN1A, STXBP1 (five patients each), KCNT1, PCDH19, TCF4 (three patients each) and ATP1A3, PRRT2 and SLC9A6 (two patients each). Mutations in EHMT1, GABRB3, LGI1, MBD5, PIGA, UBE3A and ZEB2 were each found in single patients. We found mutations in a number of genes in patients where either the electroclinical features or dysmorphic phenotypes were atypical for the identified gene. In only 11 cases (15%) had the clinician sufficient certainty to specify the mutated gene as the likely cause before testing. CONCLUSIONS: Our data demonstrate the considerable utility of a gene panel approach in the diagnosis of patients with early-onset epilepsy and severe developmental delay disorders., They provide further insights into the phenotypic spectrum and genotype-phenotype correlations for a number of the causative genes and emphasise the value of exon-level copy number testing in their analysis

Study of solid 4He in two dimensions. The issue of zero-point defects and study of confined crystal

Defects are believed to play a fundamental role in the supersolid state of 4He. We report on studies by exact Quantum Monte Carlo (QMC) simulations at zero temperature of the properties of solid 4He in presence of many vacancies, up to 30 in two dimensions (2D). In all studied cases the crystalline order is stable at least as long as the concentration of vacancies is below 2.5%. In the 2D system for a small number, n_v, of vacancies such defects can be identified in the crystalline lattice and are strongly correlated with an attractive interaction. On the contrary when n_v~10 vacancies in the relaxed system disappear and in their place one finds dislocations and a revival of the Bose-Einstein condensation. Thus, should zero-point motion defects be present in solid 4He, such defects would be dislocations and not vacancies, at least in 2D. In order to avoid using periodic boundary conditions we have studied the exact ground state of solid 4He confined in a circular region by an external potential. We find that defects tend to be localized in an interfacial region of width of about 15 A. Our computation allows to put as upper bound limit to zero--point defects the concentration 0.003 in the 2D system close to melting density.Comment: 17 pages, accepted for publication in J. Low Temp. Phys., Special Issue on Supersolid

Jamming at Zero Temperature and Zero Applied Stress: the Epitome of Disorder

We have studied how 2- and 3- dimensional systems made up of particles interacting with finite range, repulsive potentials jam (i.e., develop a yield stress in a disordered state) at zero temperature and applied stress. For each configuration, there is a unique jamming threshold, $\phi_c$, at which particles can no longer avoid each other and the bulk and shear moduli simultaneously become non-zero. The distribution of $\phi_c$ values becomes narrower as the system size increases, so that essentially all configurations jam at the same $\phi$ in the thermodynamic limit. This packing fraction corresponds to the previously measured value for random close-packing. In fact, our results provide a well-defined meaning for "random close-packing" in terms of the fraction of all phase space with inherent structures that jam. The jamming threshold, Point J, occurring at zero temperature and applied stress and at the random close-packing density, has properties reminiscent of an ordinary critical point. As Point J is approached from higher packing fractions, power-law scaling is found for many quantities. Moreover, near Point J, certain quantities no longer self-average, suggesting the existence of a length scale that diverges at J. However, Point J also differs from an ordinary critical point: the scaling exponents do not depend on dimension but do depend on the interparticle potential. Finally, as Point J is approached from high packing fractions, the density of vibrational states develops a large excess of low-frequency modes. All of these results suggest that Point J may control behavior in its vicinity-perhaps even at the glass transition.Comment: 21 pages, 20 figure