An efficient numerical algorithm for the transient analysis of high-frequency non-linear circuits

The paper proposes a new approach for the discrete-time integration of non-linear differential equations that describe the behaviour of high-frequency circuits, in particular those containing complex equivalent-circuit models of microwave transistor devices. The proposed approach reformulates a conventional predictor-corrector method in terms of Pad�© approximates about each function sample. The method is especially suited to the kind of non-linear stiff differential equations that arise frequently in high-frequency analysis

CAD identification and validation of a non-linear dynamic model for performance analysis of large-signal amplifiers

We describe the CAD identification and software implementation of a Volterra-like integral series expansion for the behavioral-level simulation of communication amplifiers. The model represents an improvement with respect to the classical AM-AM AM-PM memoryless approach. The performance of the model is compared with both the AM-AM AM-PM approach and circuit-level CAD simulatio

Initiating advance care planning on end-of-life issues in dementia: Ambiguity among UK and Dutch physicians

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Providing Optimal Palliative Care for Persons Living with Dementia: A Comparison of Physician Perceptions in the Netherlands and the United Kingdom

BACKGROUND: The European Association for Palliative Care (EAPC) recently issued a framework that defines optimal palliative care in dementia. However, implementation of the guidelines may pose challenges for physicians working with dementia patients in practice. OBJECTIVE: To measure and compare the perceptions of physicians in two European regions regarding the importance and challenges of implementing recommendations for optimal palliative care in dementia patients. DESIGN: Cross-sectional observational study. SETTING: The Netherlands and the United Kingdom. SUBJECTS: Physicians (n = 317) providing palliative care to patients with dementia. MEASUREMENTS: Postal survey. RESULTS: Physicians in the Netherlands and Northern Ireland (NI), United Kingdom, prioritized the same domains of optimal palliative care for dementia and these match the priorities in the EAPC-endorsed guidelines. Respondents in both countries rated lack of education of professional teams and lack of awareness of the general public among the most important barriers to providing palliative care in dementia. NI respondents also identified access to specialist support as a barrier. The results indicate that there is a strong consensus among experts, elderly care physicians, and general practitioners across a variety of settings in Europe that person-centered care involving optimal communication and shared decision making is the top priority for delivering optimal palliative care in dementia. CONCLUSIONS: The current findings both support and enhance the new recommendations ratified by the EAPC. To take forward the implementation of EAPC guidelines for palliative care for dementia, it will be necessary to assess the challenges more thoroughly at a country-specific level and to design and test interventions that may include systemic changes to help physicians overcome such challenges

Minimal Steiner Trees for 2k×2kSquare Lattices

AbstractWe prove a conjecture of Chung, Graham, and Gardner (Math. Mag.62(1989), 83–96), giving the form of the minimal Steiner trees for the set of points comprising the vertices of a 2k×2ksquare lattice. Each full component of these minimal trees is the minimal Steiner tree for the four vertices of a square

Family care conferences in long-term care: Exploring content and processes in end-of-life communication

© Cambridge University Press 2017. Objective: End-of-life (EoL) communication in long-term care (LTC) homes is often inadequate and delayed, leaving residents dying with unknown preferences or goals of care. Poor communication with staff contributes to families feeling unprepared, distressed, and dissatisfied with care. Family care conferences (FCCs) aim to increase structured systematic communication around goals and plans for the end of life. As part of the Strengthening a Palliative Approach to Care (SPA-LTC) project, FCCs were implemented in four LTC sites in Ontario, Canada. The purpose of this substudy was to examine FCC content and such guiding processes as documentation and multidisciplinary staff participation.Method: A total of 24 FCCs were held for residents with a Palliative Performance Scale score of 40% (nearing death). Data were collected from conference forms (i.e., Family Questionnaires, Care Plan Conference Summaries), site-specific electronic chart documents, and fieldnotes. Directed content analysis of data was informed by the Canadian Hospice Palliative Care Association's Square of Care Model, which describes eight domains of care: disease management, physical, psychological, social, practical, spiritual, EoL, and loss/bereavement.Results: The FCCs addressed an average of 71% of the content domains, with physical and EoL care addressed most frequently and loss/bereavement addressed the least. Two goals and five interventions were documented and planned on average per FCC. Examination of the processes supporting EoL communication found: (1) advantages to using FCC forms versus electronic charts; and (2) high levels of multidisciplinary participation overall but limited participation of personal support workers (PSWs) and physicians.Significance of Results: Communication around the end of life in LTC can be supported through the use of FCCs. Description of content and FCC processes provides guidance to persons implementing FCCs. Recommendations for tailoring conferences to optimize communication include use of specific conference forms, increased bereavement discussion, and further engagement of PSWs and physicians