Developing international evidence suggests that cultural norms and ethical principles of a family, population or healthcare environment influence attitudes towards CAH, particularly where CAH has symbolic meaning; representing care, hope and trust. However, there is surprisingly little robust evidence regarding dying patients, or the wider general public's views, on the perceived value of CAH in the last days and hours of life. Accordingly, a need for greater understanding of the perceptions regarding CAH, and their effects, is required.
Bose-Einstein condensates (BECs) are in many ways similar to laser light. In Fox-Li-type simulations, which involve free evolution of a two-dimensional BEC in combination with periodic focusing and localized loss, we model here numerically the BEC equivalent of transverse aspects of laser resonators. We discuss possible experimental realizations in the form of periodic series of light pulses interacting with the BEC. We show that such experiments can result in trapped, structurally stable, modes analogous to Hermite-Gaussian laser modes. This outlines a new way of trapping BECs and illustrates further the analogy between BECs and laser light
IntroductionProvision of 24/7 palliative care is a national priority. Hospices endeavour to respond to the palliative care needs of patients and families timeously, though resources are limited.AimThis study aimed to evaluate urgent admission requests to the hospice, via the on-call doctor.MethodsData on time of call; reason for and source of referral (GPs, community nurses, patients and families); whether the patient was known to the hospice; and details about the decision to admit were collected prospectively over three months.ResultsThere were 131 admissions to the hospice. Fifty-seven requests for urgent admission were recorded, the majority for symptom control (n = 34). Thirty-eight (67%) were considered appropriate requests - defined as patients with specialist palliative care needs that could not be met elsewhere. Twenty (53%) appropriate requests were admitted the same day, and 10 (26%) the following. Eight patients (21%) were not admitted because of bed or staff shortages; four were directed to the acute sector as an alternative place of care.Nineteen (33%) requests were not accepted, mostly because they were considered clinically inappropriate. However, six (11%) were provided with support and advice which enabled patients to remain in their current setting.ConclusionsThere is a need for direct access to a specialist palliative care doctor as this service is frequently used. Most appropriate requests for urgent admission were admitted within one day, suggesting a responsive service. Education for healthcare professionals is needed to ensure appropriate hospice referral, enabling patients to achieve their preferred place of care.ReferencesPalliative and end of life care Priority Setting Partnership. Putting patients, carers and clinicians at the heart of palliative and end of life care research: The James Lind Alliance; 2015Ritchie L. Pulling together: transforming urgent care for the people of Scotland. Edinburgh, UK: Scottish Government; 2015
Competing interests EAF is a founder and share holder of VIDA Diagnostics, a company that is commercialising pulmonary image analysis software developed, in part, at the University of Iowa.Provenance and peer review Not commissioned; internally peer reviewed.
Results There were 30 TTA prescriptions between AugustDecember 2016. 11 were handwritten and 19 were electronic. The average time to complete the process of a TTA was 20 (19-21) minutes for handwritten and 14 (12-16) minutes for a typed electronic version. The average number of items prescribed was equivocal between the groups. There were 8 enquires raised by the pharmacy team, equating to an additional 4 min average of extra processing time per TTA. For the first two months there were 5 enquiries raised, 4 were related to legibility. A further 3 enquiries were raised up to December and these were related to prescribing practices. Conclusion The time taken to process TTAs has been reduced with the introduction of an electronic printed version. By learning from this cycle, we hope to continue our improvement in the discharge process by preventing delays. By using the model for improvement, small changes can help improve patient care.
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