15 research outputs found
Generalised time functions and finiteness of the Lorentzian distance
We show that finiteness of the Lorentzian distance is equivalent to the
existence of generalised time functions with gradient uniformly bounded away
from light cones. To derive this result we introduce new techniques to
construct and manipulate achronal sets. As a consequence of these techniques we
obtain a functional description of the Lorentzian distance extending the work
of Franco and Moretti.Comment: 22 pages. Some imprecisions clarified compared to first versio
A Correspondence Between Distances and Embeddings for Manifolds: New Techniques for Applications of the Abstract Boundary
We present a one-to-one correspondence between equivalence classes of
embeddings of a manifold (into a larger manifold of the same dimension) and
equivalence classes of certain distances on the manifold. This correspondence
allows us to use the Abstract Boundary to describe the structure of the `edge'
of our manifold without resorting to structures external to the manifold
itself. This is particularly important in the study of singularities within
General Relativity where singularities lie on this `edge'. The ability to talk
about the same objects, e.g., singularities, via different structures provides
alternative routes for investigation which can be invaluable in the pursuit of
physically motivated problems where certain types of information are
unavailable or difficult to use.Comment: 23 page
Generalizations of the Abstract Boundary singularity theorem
The Abstract Boundary singularity theorem was first proven by Ashley and
Scott. It links the existence of incomplete causal geodesics in strongly
causal, maximally extended spacetimes to the existence of Abstract Boundary
essential singularities, i.e., non-removable singular boundary points. We give
two generalizations of this theorem: the first to continuous causal curves and
the distinguishing condition, the second to locally Lipschitz curves in
manifolds such that no inextendible locally Lipschitz curve is totally
imprisoned. To do this we extend generalized affine parameters from
curves to locally Lipschitz curves.Comment: 24 page
Multiple hospital organisational factors are associated with adverse patient outcomes post hip fracture in England and Wales:the REDUCE record-linkage cohort study
Multiple Organisational Factors Improve Multi-Disciplinary Care Delivery to Patients with Hip Fractures:A Qualitative Study of Service Delivery
Multiple Organisational Factors are Associated with Adverse Patient Outcomes Post Hip Fracture in Hospitals in England & Wales
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Reducing unwarranted variation in the delivery of high quality hip fracture services in England and Wales (REDUCE): protocol for a mixed-methods study
Introduction Substantial variation in the delivery of hip fracture care, and patient outcomes persists between hospitals, despite established UK national standards and guidelines. Patientsâ outcomes are partly explained by patient-level risk factors, but it is hypothesised that organisational-level factors account for the persistence of unwarranted variation in outcomes. The mixed-methods REducing unwarranted variation in the Delivery of high qUality hip fraCture services in England and Wales (REDUCE) study, aims to determine key organisational factors to target to improve patient care.
Methods and analysis Quantitative analysis will assess the outcomes of patients treated at 172 hospitals in England and Wales (2016â2019) using National Hip Fracture Database data combined with English Hospital Episodes Statistics; Patient Episode Database for Wales; Civil Registration (deaths) and multiple organisational-level audits to characterise each service provider. Statistical analyses will identify which organisational factors explain variation in patient outcomes, and typify care pathways with high-quality consistent patient outcomes. Documentary analysis of 20 anonymised British Orthopaedic Association hospital-initiated peer-review reports, and qualitative interviews with staff from four diverse UK hospitals providing hip fracture care, will identify barriers and facilitators to care delivery. The COVID-19 pandemic has posed a major challenge to the resilience of services and interviews will explore strategies used to adapt and innovate. This system-wide understanding will inform the development, in partnership with key national stakeholders, of an âImplementation Toolkitâ to inform and improve commissioning and delivery of hip fracture services.
Ethics and dissemination This study was approved: quantitative study by London, City and East Research Ethics Committee (20/LO/0101); and qualitative study by Faculty of Health Sciences University of Bristol Research Ethics Committee (Ref: 108284), National Health Service (NHS) Health Research Authority (20/HRA/71) and each NHS Trust provided Research and Development approval. Findings will be disseminated through scientific conferences, peer-reviewed journals and online workshops