166 research outputs found
Views of Care at End of Life: A Secondary Analysis of Online Feedback Using Care Opinion
Although there are studies on the use of social media and palliative and end-of-life care (PEOLC), there are no studies specifically investigating the content of online public feedback about PEOLC services. This study sought to understand experiences of end-of-life care provided in hospitals in the West of Scotland by exploring the main themes within the content of stories posted on a nationally endorsed nonprofit feedback online platform, Care Opinion, within a 2-year period. We used âAppreciative Inquiryâ as a theoretical framework for this study to determine what works well in end-of-life care, while also identifying areas for further improvement. Of the 1428 stories published on âCare Opinionâ from March 2019 to 2021 regarding hospitals in the West of Scotland, 48 (3.36%) were related to end-of-life care, of which all were included in data analysis. Using the software package NVivo and thematic analysis, we identified 4 key themes. We found that people overwhelmingly posted positive feedback about their experiences with end-of-life care. People reported positively about staff professionalism in providing compassionate and person-centered care to meet their loved ones needs at end of life. Other experiences of care related to challenges facing healthcare services, particularly during the COVID-19 pandemic. Quality appraisal of staff responses highlighted areas for improving feedback. This study can add to the aim of improving staff response to peopleâs concerns about end-of-life care. This study has provided a novel perspective of patientsâ experiences of end-of-life care in hospitals in the West of Scotland. Novel insights were the appreciation of quality of care, staff professionalism, effective communication, and meeting patientâs needs at end-of-life particularly by nursing staff
The Early Ultraviolet Light-Curves of Type II Supernovae and the Radii of Their Progenitor Stars
We present a sample of 34 normal SNe II detected with the Zwicky Transient
Facility, with multi-band UV light-curves starting at days after
explosion, as well as X-ray detections and upper limits. We characterize the
early UV-optical colors and provide prescriptions for empirical host-extinction
corrections. We show that the days UV-optical colors and the blackbody
evolution of the sample are consistent with the predictions of spherical phase
shock-cooling (SC), independently of the presence of `flash ionization"
features. We present a framework for fitting SC models which can reproduce the
parameters of a set of multi-group simulations without a significant bias up to
20% in radius and velocity. Observations of about half of the SNe II in the
sample are well-fit by models with breakout radii cm. The other
half are typically more luminous, with observations from day 1 onward that are
better fit by a model with a large cm breakout radius. However,
these fits predict an early rise during the first day that is too slow. We
suggest these large-breakout events are explosions of stars with an inflated
envelope or a confined CSM with a steep density profile, at which breakout
occurs. Using the X-ray data, we derive constraints on the extended
( cm) CSM density independent of spectral modeling, and find most
SNe II progenitors lose a few years before
explosion. This provides independent evidence the CSM around many SNe II
progenitors is confined. We show that the overall observed breakout radius
distribution is skewed to higher radii due to a luminosity bias. We argue that
the of red supergiants (RSG) explode as SNe II with breakout
radii consistent with the observed distribution of field RSG, with a tail
extending to large radii, likely due to the presence of CSM.Comment: Submitted to ApJ. Comments are welcome at [email protected] or
[email protected]
Upper limits on the strength of periodic gravitational waves from PSR J1939+2134
The first science run of the LIGO and GEO gravitational wave detectors
presented the opportunity to test methods of searching for gravitational waves
from known pulsars. Here we present new direct upper limits on the strength of
waves from the pulsar PSR J1939+2134 using two independent analysis methods,
one in the frequency domain using frequentist statistics and one in the time
domain using Bayesian inference. Both methods show that the strain amplitude at
Earth from this pulsar is less than a few times .Comment: 7 pages, 1 figure, to appear in the Proceedings of the 5th Edoardo
Amaldi Conference on Gravitational Waves, Tirrenia, Pisa, Italy, 6-11 July
200
Search for gravitational wave bursts in LIGO's third science run
We report on a search for gravitational wave bursts in data from the three
LIGO interferometric detectors during their third science run. The search
targets subsecond bursts in the frequency range 100-1100 Hz for which no
waveform model is assumed, and has a sensitivity in terms of the
root-sum-square (rss) strain amplitude of hrss ~ 10^{-20} / sqrt(Hz). No
gravitational wave signals were detected in the 8 days of analyzed data.Comment: 12 pages, 6 figures. Amaldi-6 conference proceedings to be published
in Classical and Quantum Gravit
Improving the sensitivity to gravitational-wave sources by modifying the input-output optics of advanced interferometers
We study frequency dependent (FD) input-output schemes for signal-recycling
interferometers, the baseline design of Advanced LIGO and the current
configuration of GEO 600. Complementary to a recent proposal by Harms et al. to
use FD input squeezing and ordinary homodyne detection, we explore a scheme
which uses ordinary squeezed vacuum, but FD readout. Both schemes, which are
sub-optimal among all possible input-output schemes, provide a global noise
suppression by the power squeeze factor, while being realizable by using
detuned Fabry-Perot cavities as input/output filters. At high frequencies, the
two schemes are shown to be equivalent, while at low frequencies our scheme
gives better performance than that of Harms et al., and is nearly fully
optimal. We then study the sensitivity improvement achievable by these schemes
in Advanced LIGO era (with 30-m filter cavities and current estimates of
filter-mirror losses and thermal noise), for neutron star binary inspirals, and
for narrowband GW sources such as low-mass X-ray binaries and known radio
pulsars. Optical losses are shown to be a major obstacle for the actual
implementation of these techniques in Advanced LIGO. On time scales of
third-generation interferometers, like EURO/LIGO-III (~2012), with
kilometer-scale filter cavities, a signal-recycling interferometer with the FD
readout scheme explored in this paper can have performances comparable to
existing proposals. [abridged]Comment: Figs. 9 and 12 corrected; Appendix added for narrowband data analysi
Recommended from our members
SN 2018fif: The explosion of a large red supergiant discovered in its infancy by the Zwicky transient facility
High-cadence transient surveys are able to capture supernovae closer to their first light than ever before. Applying analytical models to such early emission, we can constrain the progenitor starsâ properties. In this paper, we present observations of SN 2018fif (ZTF 18abokyfk). The supernova was discovered close to first light and monitored by the Zwicky Transient Facility (ZTF) and the Neil Gehrels Swift Observatory. Early spectroscopic observations suggest that the progenitor of SN 2018fif was surrounded by relatively small amounts of circumstellar material compared to all previous cases. This particularity, coupled with the high-cadence multiple-band coverage, makes it a good candidate to investigate using shock-cooling models. We employ the SOPRANOS code, an implementation of the model by Sapir & Waxman and its extension to early times by Morag et al. Compared with previous implementations, SOPRANOS has the advantage of including a careful account of the limited temporal validity domain of the shock-cooling model as well as allowing usage of the entirety of the early UV data. We find that the progenitor of SN 2018fif was a large red supergiant with a radius of R = 744.0-+128.0183.0 Râ and an ejected mass of Mej = 9.3-+5.80.4 Mâ. Our model also gives information on the explosion epoch, the progenitorâs inner structure, the shock velocity, and the extinction. The distribution of radii is double-peaked, with smaller radii corresponding to lower values of the extinction, earlier recombination times, and a better match to the early UV data. If these correlations persist in future objects, denser spectroscopic monitoring constraining the time of recombination, as well as accurate UV observations (e.g., with ULTRASAT), will help break the extinction/radius degeneracy and independently determine both
Palliative care early in the care continuum among patients with serious respiratory illness an official ATS/AAHPM/HPNA/SWHPN policy statement
Background:
Patients with serious respiratory illness and their caregivers suffer considerable burdens, and palliative care is a fundamental right for anyone who needs it. However, the overwhelming majority of patients do not receive timely palliative care before the end of life, despite robust evidence for improved outcomes.
Goals:
This policy statement by the American Thoracic Society (ATS) and partnering societies advocates for improved integration of high-quality palliative care early in the care continuum for patients with serious respiratory illness and their caregivers and provides clinicians and policymakers with a framework to accomplish this.
Methods:
An international and interprofessional expert committee, including patients and caregivers, achieved consensus across a diverse working group representing pulmonaryâcritical care, palliative care, bioethics, health law and policy, geriatrics, nursing, physiotherapy, social work, pharmacy, patient advocacy, psychology, and sociology.
Results:
The committee developed fundamental values, principles, and policy recommendations for integrating palliative care in serious respiratory illness care across seven domains: 1) delivery models, 2) comprehensive symptom assessment and management, 3) advance care planning and goals of care discussions, 4) caregiver support, 5) health disparities, 6) mass casualty events and emergency preparedness, and 7) research priorities. The recommendations encourage timely integration of palliative care, promote innovative primary and secondary or specialist palliative care delivery models, and advocate for research and policy initiatives to improve the availability and quality of palliative care for patients and their caregivers.
Conclusions:
This multisociety policy statement establishes a framework for early palliative care in serious respiratory illness and provides guidance for pulmonaryâcritical care clinicians and policymakers for its proactive integration
Searching for a Stochastic Background of Gravitational Waves with LIGO
The Laser Interferometer Gravitational-wave Observatory (LIGO) has performed
the fourth science run, S4, with significantly improved interferometer
sensitivities with respect to previous runs. Using data acquired during this
science run, we place a limit on the amplitude of a stochastic background of
gravitational waves. For a frequency independent spectrum, the new limit is
. This is currently the most sensitive
result in the frequency range 51-150 Hz, with a factor of 13 improvement over
the previous LIGO result. We discuss complementarity of the new result with
other constraints on a stochastic background of gravitational waves, and we
investigate implications of the new result for different models of this
background.Comment: 37 pages, 16 figure
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