341 research outputs found

    The evolving role of physician organizations in quality related activities

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    Procedural confidence in hospital based practitioners: implications for the training and practice of doctors at all grades

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    <p>Abstract</p> <p>Background</p> <p>Medical doctors routinely undertake a number of practical procedures and these should be performed competently. The UK Postgraduate Medical Education and Training Board (PMETB) curriculum lists the procedures trainees should be competent in. We aimed to describe medical practitioner's confidence in their procedural skills, and to define which practical procedures are important in current medical practice.</p> <p>Methods</p> <p>A cross sectional observational study was performed measuring procedural confidence in 181 hospital practitioners at all grades from 2 centres in East Anglia, England.</p> <p>Results</p> <p>Both trainees and consultants provide significant service provision. SpR level doctors perform the widest range and the highest median number of procedures per year. Most consultants perform few if any procedures, however some perform a narrow range at high volume. Cumulative confidence for the procedures tested peaks in the SpR grade. Five key procedures (central line insertion, lumbar puncture, pleural aspiration, ascitic aspiration, and intercostal drain insertion) are the most commonly performed, are seen as important generic skills, and correspond to the total number of procedures for which confidence can be maintained. Key determinants of confidence are gender, number of procedures performed in the previous year and total number of procedures performed.</p> <p>Conclusion</p> <p>The highest volume of service requirement is for six procedures. The procedural confidence is dependent upon gender, number of procedures performed in the previous year and total number of procedures performed. This has implications for those designing the training curriculum and with regards the move to shorten the duration of training.</p

    A General Black String and its Microscopics

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    Using G2(2) dualities we construct the most general black string solution of minimal five-dimensional ungauged supergravity. The black string has five independent parameters, namely, the magnetic one-brane charge, smeared electric zero-brane charge, boost along the string direction, energy above the BPS bound, and rotation in the transverse space. In one extremal limit it reduces to the three parameter supersymmetric string of five-dimensional minimal supergravity; in another extremal limit it reduces to the three parameter non-supersymmetric extremal string of five-dimensional minimal supergravity. It also admits an extremal limit when it has maximal rotation in the four-dimensional transverse space. The decoupling limit of our general black string is a BTZ black hole times a two sphere. The macroscopic entropy of the string is reproduced by the Maldacena-Strominger-Witten CFT in appropriate ranges of the parameters. When the pressureless condition is imposed, our string describes the infinite radius limit of the most general class of black rings of minimal supergravity. We discuss implications our solution has for extremal and non-extremal black rings of minimal supergravity.Comment: 35 pages; 3 figures; v2 section 4.1.1 rewritten + minor changes + ref adde

    Cardy and Kerr

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    The Kerr/CFT correspondence employs the Cardy formula to compute the entropy of the left moving CFT states. This computation, which correctly reproduces the Bekenstein--Hawking entropy of the four-dimensional extremal Kerr black hole, is performed in a regime where the temperature is of order unity rather than in a high-temperature regime. We show that the comparison of the entropy of the extreme Kerr black hole and the entropy in the CFT can be understood within the Cardy regime by considering a D0-D6 system with the same entropic properties.Comment: 20 pages; LaTeX; JHEP format; v.2 references added, v.3 Section 4 adde

    State-space Manifold and Rotating Black Holes

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    We study a class of fluctuating higher dimensional black hole configurations obtained in string theory/ MM-theory compactifications. We explore the intrinsic Riemannian geometric nature of Gaussian fluctuations arising from the Hessian of the coarse graining entropy, defined over an ensemble of brane microstates. It has been shown that the state-space geometry spanned by the set of invariant parameters is non-degenerate, regular and has a negative scalar curvature for the rotating Myers-Perry black holes, Kaluza-Klein black holes, supersymmetric AdS5AdS_5 black holes, D1D_1-D5D_5 configurations and the associated BMPV black holes. Interestingly, these solutions demonstrate that the principal components of the state-space metric tensor admit a positive definite form, while the off diagonal components do not. Furthermore, the ratio of diagonal components weakens relatively faster than the off diagonal components, and thus they swiftly come into an equilibrium statistical configuration. Novel aspects of the scaling property suggest that the brane-brane statistical pair correlation functions divulge an asymmetric nature, in comparison with the others. This approach indicates that all above configurations are effectively attractive and stable, on an arbitrary hyper-surface of the state-space manifolds. It is nevertheless noticed that there exists an intriguing relationship between non-ideal inter-brane statistical interactions and phase transitions. The ramifications thus described are consistent with the existing picture of the microscopic CFTs. We conclude with an extended discussion of the implications of this work for the physics of black holes in string theory.Comment: 44 pages, Keywords: Rotating Black Holes; State-space Geometry; Statistical Configurations, String Theory, M-Theory. PACS numbers: 04.70.-s Physics of black holes; 04.70.Bw Classical black holes; 04.70.Dy Quantum aspects of black holes, evaporation, thermodynamics; 04.50.Gh Higher-dimensional black holes, black strings, and related objects. Edited the bibliograph

    Probing strongly coupled anisotropic plasma

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    We calculate the static potential, the drag force and the jet quenching parameter in strongly coupled anisotropic N=4 super Yang-Mills plasma. We find that the jet quenching is in general enhanced in presence of anisotropy compared to the isotropic case and that its value depends strongly on the direction of the moving quark and the direction along which the momentum broadening occurs. The jet quenching is strongly enhanced for a quark moving along the anisotropic direction and momentum broadening happens along the transverse one. The parameter gets lower for a quark moving along the transverse direction and the momentum broadening considered along the anisotropic one. Finally, a weaker enhancement is observed when the quark moves in the transverse plane and the broadening occurs on the same plane. The drag force for quark motion parallel to the anisotropy is always enhanced. For motion in the transverse space the drag force is enhanced compared to the isotropic case only for quarks having velocity above a critical value. Below this critical value the force is decreased. Moreover, the drag force along the anisotropic direction is always stronger than the force in the transverse space. The diffusion time follows exactly the inverse relations of the drag forces. The static potential is decreased and stronger decrease observed for quark-antiquark pair aligned along the anisotropic direction than the transverse one. We finally comment on our results and elaborate on their similarities and differences with the weakly coupled plasmas.Comment: 1+44 pages, 18 Figures; Added results on static force; Added references; version published in JHE

    Differences in trait impulsivity indicate diversification of dog breeds into working and show lines

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    Impulsiveness describes the inability to inhibit behaviour in the presence of salient cues. Trait-level impulsivity exists on a continuum and individual differences can be adaptive in different contexts. While breed related differences in behavioural tendency in the domestic dog (Canis familiaris) are well established, the phenomenon within lines of a breed which have been selected more recently is not well studied, although it may challenge the popular notion of breed-typical behaviour. We describe differences in impulsivity between and within two dog breeds with working and show lines selected for different levels of impulsivity: Border Collies (herding work) and Labrador Retrievers (gun work). Recent show line selection might have lessened differences in impulsivity between breeds. We tested this hypothesis on a dataset of 1161 individuals assessed using a validated psychometric tool (Dog Impulsivity Assessment Scale - DIAS). Collies were more impulsive on average, consistent with the original purpose of breed selection. Regarding line, working Collies differed from working Labradors, but show lines from the two breeds were not significantly different. Altered or relaxed artificial selection for behavioural traits when appearance rather than behaviour become the primary focus for breeders may reduce average differences in impulsivity between breeds in show lines

    Supersymmetric Solutions in Six Dimensions: A Linear Structure

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    The equations underlying all supersymmetric solutions of six-dimensional minimal ungauged supergravity coupled to an anti-self-dual tensor multiplet have been known for quite a while, and their complicated non-linear form has hindered all attempts to systematically understand and construct BPS solutions. In this paper we show that, by suitably re-parameterizing these equations, one can find a structure that allows one to construct supersymmetric solutions by solving a sequence of linear equations. We then illustrate this method by constructing a new class of geometries describing several parallel spirals carrying D1, D5 and P charge and parameterized by four arbitrary functions of one variable. A similar linear structure is known to exist in five dimensions, where it underlies the black hole, black ring and corresponding microstate geometries. The unexpected generalization of this to six dimensions will have important applications to the construction of new, more general such geometries.Comment: v2: Eqs. (2.1), (2.39) corrected, references added. v3: minor correction

    Moving forward during major goal blockage: situational goal adjustment in women facing infertility

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    Individuals confronting chronic medical conditions often face profound challenges to cherished life goals. The primary aim of this study was to examine the associations of goal adjustment with psychological adjustment in the context of infertility. At study entry (T1; n = 97) and 6 months later (T2; n = 47), women in fertility treatment completed measures of goal blockage, goal adjustment ability, and psychological adjustment. At T1, greater perceived and actual goal blockage were related to negative psychological adjustment. Ability to disengage from the goal of biological parenthood was associated with less infertility-specific thought intrusion, whereas engagement with other goals was related to fewer depressive symptoms and greater positive states of mind. Greater general goal engagement was protective against the negative relationships between low goal disengagement and the dependent variables. Promoting letting go of the unattainable and investing in the possible may be a useful intervention to foster well-being among individuals experiencing profound goal blockage
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