Role of the community matron in advance care planning and ‘do not attempt CPR’ decision-making: a qualitative study

The community matron (CM) is often the key worker caring for patients with chronic, life-limiting, long-term conditions, but these patients are not always recognised as palliative cases. This study explored the experiences of CMs with regard to advance care planning (ACP) and ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) decision-making to understand whether or not they felt adequately prepared for this aspect of their role, and why. Qualitative data were generated from six CMs using a broad interpretive phenomenological approach. Face-to-face recorded interviews were analysed using template analysis. The study found that although participants faced complex ethical situations around ACP and DNACPR almost on a daily basis, none had received any formal training despite the emphasis on training in national and local guidelines. Participants often struggled to get their patients accepted on to the Gold Standards Framework. The research found variability and complexity of cases to be the main barriers to clear identification of the palliative phase

Coupled thermomechanical dynamics of phase transitions in shape memory alloys and related hysteresis phenomena

In this paper the nonlinear dynamics of shape memory alloy phase transformations is studied with thermomechanical models based on coupled systems of partial differential equations by using computer algebra tools. The reduction procedures of the original model to a system of differential-algebraic equations and its solution are based on the general methodology developed by the authors for the analysis of phase transformations in shape memory materials with low dimensional approximations derived from center manifold theory. Results of computational experiments revealing the martensitic-austenitic phase transition mechanism in a shape-memory-alloy rod are presented. Several groups of computational experiments are reported. They include results on stress- and temperature-induced phase transformations as well as the analysis of the hysteresis phenomenon. All computational experiments are presented for Cu-based structures

Magnetic phases in the correlated Kondo-lattice model

We study magnetic ordering of an extended Kondo-lattice model including an additional on-site Coulomb interaction between the itinerant states. The model is solved in the dynamical mean-field theory using Wilson's numerical renormalization group approach as impurity solver. For a bipartite lattice we find at half filling the expected antiferromagnetic phase. Upon doping this phase is gradually suppressed and hints towards phase separation are observed. For large doping the model exhibits ferromagnetism, the appearance of which can at first sight be explained by Rudermann-Kittel-Kasuya-Yosida interaction. However, for large values of the Kondo coupling $J$ significant differences to a simple Rudermann-Kittel-Kasuya-Yosida picture can be found. We furthermore observe signs of quantum critical points for antiferromagnetic Kondo coupling between the local spins and band states

Chiral symmetry breaking and stability of quark droplets

We discuss the stability of strangelets -- quark droplets with strangeness -- in the Nambu--Jona-Lasinio model supplemented by a boundary condition for quark confinement. Effects of dynamical chiral symmetry breaking are considered properly inside quark droplets of arbitrary baryon number. We obtain the energy per baryon number of quark droplets with baryon number from one to thousands. It is shown that strangelets are not the ground states as compared with nuclei, though they can be locally stable

Neutrino degeneracy and cosmological nucleosynthesis, revisited

A reexamination of the effects of non-zero degeneracies on Big Bang Nucleosynthesis is made. As previously noted, non-trivial alterations of the standard model conclusions can be induced only if excess lepton numbers L sub i, comparable to photon number densities eta sub tau, are assumed (where eta sub tau is approx. 3 times 10(exp 9) eta sub b). Furthermore, the required lepton number densities (L sub i eta sub tau) must be different for upsilon sub e than for upsilon sub mu and epsilon sub tau. It is shown that this loophole in the standard model of nucleosynthesis is robust and will not vanish as abundance and reaction rate determinations improve. However, it is also argued that theoretically (L sub e) approx. (L sub mu) approx. (L sub tau) approx. eta sub b is much less than eta sub tau which would preclude this loophole in standard unified models