Economic evaluation of a nursing-led intermediate care unit

Objectives: The aim of this paper is to examine the costs of introducing a nursing-led ward program together with examining the impact this may have on patients' outcomes. Methods; The study had a sample size of 177 patients with a mean age of 77, and randomized to either a treatment group (care on a nursing-led ward, n = 97) or a control group (standard care usually on a consultant-led acute ward, n = 80). Resource use data including length of stay, tests and investigations performed, and multidisciplinary involvement in care were collected. Results: There were no significant differences in outcome between the two groups. The inpatient costs for the treatment group were significantly higher, due to the longer length of stay in this group. However, the postdischarge costs were significantly lower for the treatment group. Conclusions: The provision of nursing-led intermediate care units has been proposed as a solution to inappropriate use of acute medical wards by patients who require additional nursing rather than medical care. Whether the treatment group is ultimately cost-additive is dependent on how long reductions in postdischarge resource use are maintained

Solving the characteristic initial value problem for colliding plane gravitational and electromagnetic waves

A method is presented for solving the characteristic initial value problem for the collision and subsequent nonlinear interaction of plane gravitational or gravitational and electromagnetic waves in a Minkowski background. This method generalizes the monodromy transform approach to fields with nonanalytic behaviour on the characteristics inherent to waves with distinct wave fronts. The crux of the method is in a reformulation of the main nonlinear symmetry reduced field equations as linear integral equations whose solutions are determined by generalized (``dynamical'') monodromy data which evolve from data specified on the initial characteristics (the wavefronts).Comment: 4 pages, RevTe

Consistent Resolution of Some Relativistic Quantum Paradoxes

A relativistic version of the (consistent or decoherent) histories approach to quantum theory is developed on the basis of earlier work by Hartle, and used to discuss relativistic forms of the paradoxes of spherical wave packet collapse, Bohm's formulation of Einstein-Podolsky-Rosen, and Hardy's paradox. It is argued that wave function collapse is not needed for introducing probabilities into relativistic quantum mechanics, and in any case should never be thought of as a physical process. Alternative approaches to stochastic time dependence can be used to construct a physical picture of the measurement process that is less misleading than collapse models. In particular, one can employ a coarse-grained but fully quantum mechanical description in which particles move along trajectories, with behavior under Lorentz transformations the same as in classical relativistic physics, and detectors are triggered by particles reaching them along such trajectories. States entangled between spacelike separate regions are also legitimate quantum descriptions, and can be consistently handled by the formalism presented here. The paradoxes in question arise because of using modes of reasoning which, while correct for classical physics, are inconsistent with the mathematical structure of quantum theory, and are resolved (or tamed) by using a proper quantum analysis. In particular, there is no need to invoke, nor any evidence for, mysterious long-range superluminal influences, and thus no incompatibility, at least from this source, between relativity theory and quantum mechanics.Comment: Latex 42 pages, 7 figures in text using PSTrick

Arithmetically Cohen-Macaulay Bundles on complete intersection varieties of sufficiently high multidegree

Recently it has been proved that any arithmetically Cohen-Macaulay (ACM) bundle of rank two on a general, smooth hypersurface of degree at least three and dimension at least four is a sum of line bundles. When the dimension of the hypersurface is three, a similar result is true provided the degree of the hypersurface is at least six. We extend these results to complete intersection subvarieties by proving that any ACM bundle of rank two on a general, smooth complete intersection subvariety of sufficiently high multi-degree and dimension at least four splits. We also obtain partial results in the case of threefolds.Comment: 15 page

P,T-Violating Nuclear Matrix Elements in the One-Meson Exchange Approximation

Expressions for the P,T-violating NN potentials are derived for $\pi$, $\rho$ and $\omega$ exchange. The nuclear matrix elements for $\rho$ and $\omega$ exchange are shown to be greatly suppressed, so that, under the assumption of comparable coupling constants, $\pi$ exchange would dominate by two orders of magnitude. The ratio of P,T-violating to P-violating matrix elements is found to remain approximately constant across the nuclear mass table, thus establishing the proportionality between time-reversal-violation and parity-violation matrix elements. The calculated values of this ratio suggest a need to obtain an accuracy of order $5 \times 10^{-4}$ for the ratio of the PT-violating to P-violating asymmetries in neutron transmission experiments in order to improve on the present limits on the isovector pion coupling constant.Comment: 17 pages, LaTeX, no figure

Weak Lensing Determination of the Mass in Galaxy Halos

We detect the weak gravitational lensing distortion of 450,000 background galaxies (20<R<23) by 790 foreground galaxies (R<18) selected from the Las Campanas Redshift Survey (LCRS). This is the first detection of weak lensing by field galaxies of known redshift, and as such permits us to reconstruct the shear profile of the typical field galaxy halo in absolute physical units (modulo H_0), and to investigate the dependence of halo mass upon galaxy luminosity. This is also the first galaxy-galaxy lensing study for which the calibration errors are negligible. Within a projected radius of 200 \hkpc, the shear profile is consistent with an isothermal profile with circular velocity 164+-20 km/s for an L* galaxy, consistent with typical disk rotation at this luminosity. This halo mass normalization, combined with the halo profile derived by Fischer et al (2000) from lensing analysis SDSS data, places a lower limit of (2.7+-0.6) x 10^{12}h^{-1} solar masses on the mass of an L* galaxy halo, in good agreement with satellite galaxy studies. Given the known luminosity function of LCRS galaxies, and the assumption that $M\propto L^\beta$ for galaxies, we determine that the mass within 260\hkpc of normal galaxies contributes $\Omega=0.16\pm0.03$ to the density of the Universe (for $\beta=1$) or $\Omega=0.24\pm0.06$ for $\beta=0.5$. These lensing data suggest that $0.6<\beta<2.4$ (95% CL), only marginally in agreement with the usual $\beta\approx0.5$ Faber-Jackson or Tully-Fisher scaling. This is the most complete direct inventory of the matter content of the Universe to date.Comment: 18 pages, incl. 3 figures. Submitted to ApJ 6/7/00, still no response from the referee after four months

Entanglement requirements for implementing bipartite unitary operations

We prove, using a new method based on map-state duality, lower bounds on entanglement resources needed to deterministically implement a bipartite unitary using separable (SEP) operations, which include LOCC (local operations and classical communication) as a particular case. It is known that the Schmidt rank of an entangled pure state resource cannot be less than the Schmidt rank of the unitary. We prove that if these ranks are equal the resource must be uniformly (maximally) entangled: equal nonzero Schmidt coefficients. Higher rank resources can have less entanglement: we have found numerical examples of Schmidt rank 2 unitaries which can be deterministically implemented, by either SEP or LOCC, using an entangled resource of two qutrits with less than one ebit of entanglement.Comment: 7 pages Revte

GSH23.0-0.7+117, a neutral hydrogen shell in the inner Galaxy

GSH23.0-0.7+117 is a well-defined neutral hydrogen shell discovered in the VLA Galactic Plane Survey (VGPS). Only the blueshifted side of the shell was detected. The expansion velocity and systemic velocity were determined through the systematic behavior of the HI emission with velocity. The center of the shell is at (l,b,v)=(23.05,-0.77,+117 km/s). The angular radius of the shell is 6.8', or 15 pc at a distance of 7.8 kpc. The HI mass divided by the volume of the half-shell implies an average density n_H = 11 +/- 4 cm^{-3} for the medium in which the shell expanded. The estimated age of GSH23.0-0.7+117 is 1 Myr, with an upper limit of 2 Myr. The modest expansion energy of 2 * 10^{48} erg can be provided by the stellar wind of a single O4 to O8 star over the age of the shell. The 3 sigma upper limit to the 1.4 GHz continuum flux density (S_{1.4} < 248 mJy) is used to derive an upper limit to the Lyman continuum luminosity generated inside the shell. This upper limit implies a maximum of one O9 star (O8 to O9.5 taking into account the error in the distance) inside the HI shell, unless most of the incident ionizing flux leaks through the HI shell. To allow this, the shell should be fragmented on scales smaller than the beam (2.3 pc). If the stellar wind bubble is not adiabatic, or the bubble has burst (as suggested by the HI channel maps), agreement between the energy and ionization requirements is even less likely. The limit set by the non-detection in the continuum provides a significant challenge for the interpretation of GSH23.0-0.7+117 as a stellar wind bubble. A similar analysis may be applicable to other Galactic HI shells that have not been detected in the continuum.Comment: 18 pages, 6 figures. Figures 1 and 4 separately in GIF format. Accepted for publication in Astrophysical Journa