Electron kinetic effects in the nonlinear evolution of a driven ion-acoustic wave

The electron kinetic effects are shown to play an important role in the nonlinear evolution of a driven ion-acoustic wave. The numerical simulation results obtained (i) with a hybrid code, in which the electrons behave as a fluid and the ions are described along the particle-in-cell (PIC) method, are compared with those obtained (ii) with a full-PIC code, in which the kinetic effects on both species are retained. The electron kinetic effects interplay with the usual fluid-type nonlinearity to give rise to a broadband spectrum of ion-acoustic waves saturated at a low level, even in the case of a strong excitation. This low asymptotic level might solve the long-standing problem of the small stimulated Brillouin scattering reflectivity observed in laser-plasma interaction experiments

Electron and ion kinetic effects in the saturation of a driven ion acoustic wave

The role of ion and electron kinetic effects is investigated in the context of the nonlinear saturation of a driven ion acoustic wave(IAW) and its parametric decay into subharmonics. The simulations are carried out with a full–particle-in-cell (PIC) code, in which both ions and electrons are treated kinetically. The full-PIC results are compared with those obtained from a hybrid-PIC code (kinetic ions and Boltzmann electrons). It is found that the largest differences between the two kinds of simulations take place when the IAW is driven above the ion wave-breaking limit. In such a case of a strong drive, the hybrid-PIC simulations lead to a Berstein-Greene-Kruskal-like nonlinear IAW of a large amplitude, while in the full-PIC the IAW amplitude decays to a small level after a transient stage. The electron velocity distribution function is significantly flattened in the domain of small electron velocities. As a result the nonlinear frequency shift due to the electron kinetic effects compensates partly the nonlinear frequency shift due to the ion kinetic effects, allowing then for the parametric decay of the driven IAW into subharmonics. These observations lead to the conclusion that electron kinetic effects become important whenever the nonlinear effects come into play

Harmonic decomposition to describe the nonlinear evolution of stimulated Brillouin scattering

An efficient method to describe the nonlinear evolution of stimulated Brillouin scattering(SBS) in long scale-length plasmas is presented in the limit of a fluid description. The method is based on the decomposition of the various functions characterizing the plasma into their long- and short-wavelength components. It makes it possible to describe self-consistently the interplay between the plasmahydrodynamics,stimulated Brillouin scattering, and the generation of harmonics of the excited ion acoustic wave(IAW). This description is benchmarked numerically in one and two spatial dimensions [one dimensional (1D), two dimensional (2D)], by comparing the numerical results obtained along this method with those provided by a numerical code in which the decomposition into separate spatial scales is not made. The decomposition method proves to be very efficient in terms of computing time, especially in 2D, and very reliable, even in the extreme case of undamped ion acoustic waves. A novel picture of the SBS nonlinear behavior arises, in which the IAWharmonics generation gives rise to local defects appearing in the density and velocity hydrodynamics profiles. Consequently, SBS develops in various spatial domains which seem to be decorrelated one from each other, so that the backscattered Brillouin light is the sum of various backscatteredwaves generated in several independent spatial domains. It follows that the SBSreflectivity is chaotic in time and the resulting time-averaged value is significantly reduced as compared to the case when the IAWharmonics generation and flow modification are ignored. From the results of extensive numerical simulations carried out in 1D and 2D, we are able to infer the SBSreflectivity scaling law as a function of the plasma parameters and laser intensity, in the limit where the kinetic effects are negligible. It appears that this scaling law can be derived in the limit where the IAWharmonics generation is modeled simply by a nonlinear frequency shift

Kinetic effects in stimulated Brillouin scattering

The role of ion and electron kinetic effects in the nonlinear evolution of stimulated Brillouin scattering (SBS) is investigated by means of particle-in-cell numerical simulations. The simulations were carried out in one and two spatial dimensions (1D and 2D), with a full PIC code, in which both ions and electrons are kinetic. The full PIC simulations are compared with those obtained from a hybrid PIC code (kinetic ions and Boltzmann electrons), making it possible to determine in which limit the electron kinetic effects are important. The simulation geometry corresponds to a coherent laser beam interacting with an expanding plasma slab. In the 1D simulations, the interaction becomes incoherent, as time goes on, in a domain that spatially begins in the plasma region close to the laser light entrance, and that ends within the plasma at a frontier which moves faster than the ion acoustic wave (IAW) velocity. The higher the laser intensity, the faster moves the frontier of this spatial domain. The SBS reflectivity drops at the very moment when this domain fills entirely the plasma. Two regimes have to be distinguished. In the regimes of low laser intensity, strong sub-harmonic generation of the excited IAW is observed to take place in this moving spatial domain, so that the SBS reflectivity drop is interpreted as being due to sub-harmonic generation. In the opposite regime of high laser intensity, there is no evidence of strong sub-harmonic generation, whereas a strong ion heating is observed, so that the reflectivity drop is interpreted as being due to enhanced ion damping. In the 1D simulations the electron kinetic effects are found to be able to smooth temporally the SBS reflectivity, although the overall picture remains the same when the electrons are taken as a Boltzmann fluid. In the 2D simulations, the SBS reflectivity is observed to drop rapidly in time because of the efficient nonlinear Landau damping on the ions, as previously reported by Cohen et al. [1]. In these 2D simulations, the electron kinetic effects are found to play a negligible role as compared with the ion kinetic effects

Advance care planning in patients with incurable cancer: Study protocol for a randomised controlled trial

Introduction: There is limited evidence documenting the effectiveness of Advance Care Planning (ACP) in cancer care. The present randomised trial is designed to evaluate whether the administration of formal ACP improves compliance with patients' end-of-life (EOL) wishes and patient and family satisfaction with care. Methods and analysis: A randomised control trial in eight oncology centres across New South Wales and Victoria, Australia, is designed to assess the efficacy of a formal ACP intervention for patients with cancer. Patients with incurable cancer and an expected survival of 3-12 months, plus a nominated family member or friend will be randomised to receive either standard care or standard care plus a formal ACP intervention. The project sample size is 210 patient-family/friend dyads. The primary outcome measure is family/friendreported: (1) discussion with the patient about their EOL wishes and (2) perception that the patient's EOL wishes were met. Secondary outcome measures include: documentation of and compliance with patient preferences for medical intervention at the EOL; the family/friend's perception of the quality of the patient's EOL care; the impact of death on surviving family; patient-family and patient-healthcare provider communication about EOL care; patient and family/ friend satisfaction with care; quality of life of patient and family/friend subsequent to trial entry, the patient's strength of preferences for quality of life and length of life; the costs of care subsequent to trial entry and place of death. Ethics and dissemination: Ethical approval was received from the Sydney Local Health District (RPA Zone) Human Research Ethical Committee, Australia (Protocol number X13-0064). Study results will be submitted for publication in peer-reviewed journals and presented at national and international conferences. Trial registration number: Pre-results; ACTRN12613001288718

Does implementation matter if comprehension is lacking? A qualitative investigation into perceptions of advance care planning in people with cancer

Purpose: While advance care planning holds promise, uptake is variable and it is unclear how well people engage with or comprehend advance care planning. The objective of this study was to explore how people with cancer comprehended Advance Care Plans and examine how accurately advance care planning documentation represented patient wishes. Methods: This study used a qualitative descriptive design. Data collection comprised interviews and an examination of participants’ existing advance care planning documentation. Participants included those who had any diagnosis of cancer with an advance care plan recorded: Refusal of Treatment Certificate; Statement of Choices; and/or Enduring Power of Attorney (Medical Treatment) at one cancer treatment centre. Results: Fourteen participants were involved in the study. Twelve participants were female (86%). The mean age was 77 (range: 61-91) and participants had completed their advance care planning documentation between 8 and 72 weeks prior to the interview (mean 33 weeks). Three themes were evident from the data: Incomplete advance care planning understanding and confidence; Limited congruence for attitude and documentation; Advance care planning can enable peace of mind. Complete advance care planning understanding was unusual; most participants demonstrated partial comprehension of their own advance care plan, and some indicated very limited understanding. Participants’ attitudes and their written document congruence was limited, but advance care planning was seen as helpful. Conclusions: This study highlighted advance care planning was not a completely accurate representation of patient wishes. There is opportunity to improve how patients comprehend their own advance care planning documentation

A complex regional intervention to implement advance care planning in one town's nursing homes: Protocol of a controlled inter-regional study

<p>Abstract</p> <p>Background</p> <p>Advance Care Planning (ACP) is an emerging strategy to ensure that well-reflected, meaningful and clearly documented treatment preferences are available and respected when critical decisions about life-sustaining treatment need to be made for patients unable to consent. In Germany, recent legislation confirms that advance directives (AD) have to be followed if they apply to the medical situation, but implementation of ACP has not yet been described.</p> <p>Methods/Design</p> <p>In a longitudinal controlled study, we compare 1 intervention region (4 nursing homes [n/hs], altogether 421 residents) with 2 control regions (10 n/hs, altogether 985 residents). Inclusion went from 01.02.09 to 30.06.09, observation lasted until 30.06.10. Primary endpoint is the prevalence of ADs at follow-up, 17 (12) months after the first (last) possible inclusion. Secondary endpoints compare relevance and validity of ADs, process quality, the rate of life-sustaining interventions and, in deceased residents, location of death and intensity of treatment before death. The regional multifaceted intervention on the basis of the US program Respecting Choices^®comprises training of n/h staff as facilitators, training of General Practitioners, education of hospital and ambulance staff, and development of eligible tools, including Physician Orders for Life-Sustaining Treatment in case of Emergency (POLST-E).</p> <p><it>Participation data: </it>Of 1406 residents reported to live in the 14 n/hs plus an estimated turnover of 176 residents until the last possible inclusion date, 645 (41%) were willing to participate. Response rates were 38% in the intervention region and 42% in the control region. Non-responder analysis shows an equal distribution of sex and age but a bias towards dependency on nursing care in the responder group. <it>Outcome analysis </it>of this study will become available in the course of 2011.</p> <p>Discussion</p> <p>Implementing an ACP program for the n/hs and related health care providers of a region requires a complex community intervention with the effect of nothing less than a cultural shift in this health care sector. This study is to our knowledge the first to develop a strategy for regional implementation of ACP, and to evaluate its feasibility in a controlled design.</p> <p>Trial Registration</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN99887420">ISRCTN99887420</a></p

A reference linkage map for Eucalyptus

Background: Genetic linkage maps are invaluable resources in plant research. They provide a key tool for many genetic applications including: mapping quantitative trait loci (QTL); comparative mapping; identifying unlinked (i.e. independent) DNA markers for fingerprinting, population genetics and phylogenetics; assisting genome sequence assembly; relating physical and recombination distances along the genome and map-based cloning of genes. Eucalypts are the dominant tree species in most Australian ecosystems and of economic importance globally as plantation trees. The genome sequence of E. grandis has recently been released providing unprecedented opportunities for genetic and genomic research in the genus. A robust reference linkage map containing sequence-based molecular markers is needed to capitalise on this resource. Several high density linkage maps have recently been constructed for the main commercial forestry species in the genus (E. grandis, E. urophylla and E. globulus) using sequenced Diversity Arrays Technology (DArT) and microsatellite markers. To provide a single reference linkage map for eucalypts a composite map was produced through the integration of data from seven independent mapping experiments (1950 individuals) using a marker-merging method. Results: The composite map totalled 1107 cM and contained 4101 markers; comprising 3880 DArT, 213 microsatellite and eight candidate genes. Eighty-one DArT markers were mapped to two or more linkage groups, resulting in the 4101 markers being mapped to 4191 map positions. Approximately 13% of DArT markers mapped to identical map positions, thus the composite map contained 3634 unique loci at an average interval of 0.31 cM. Conclusion: The composite map represents the most saturated linkage map yet produced in Eucalyptus. As the majority of DArT markers contained on the map have been sequenced, the map provides a direct link to the E. grandis genome sequence and will serve as an important reference for progressing eucalypt research