Electron collisions with iron peak elements: a computational grand challenge

This paper discusses the calculation of electron impact collision strengths and effective collision strengths for iron peak elements of importance in the analysis of many astronomical and laboratory spectra. It commences with a brief overview of R-matrix theory which is the basis of computer programs which have been widely used to calculate the relevant atomic data used in this analysis. A summary is then given of calculations carried out over the last 20 y for electron collisions with Fe II. The grand challenge, represented by the calculation of accurate collision strengths and effective collision strengths for this ion, is then discussed. A new parallel R-matrix program PRMAT, which is being developed to meet this challenge, is then described and results of recent calculations, using this program to determine optically forbidden transitions in e- – Ni IV on a Cray T3E-1200 parallel supercomputer, are presented. The implications of this e- – Ni IV calculation for the determination of accurate data from an isoelectronic e- – Fe II calculation are discussed and finally some future directions of research are reviewed.

The challenge of patients’ unmet palliative care needs in the final stages of chronic illness.

Background: There is consensus in the literature that the end of life care for patients with chronic illness is suboptimal, but research on the specific needs of this population is limited. Aim: This study aimed to use a mixed methodology and case study approach to explore the palliative care needs of patients with a non-cancer diagnosis from the perspectives of the patient, their significant other and the clinical team responsible for their care. Patients (n 18) had a diagnosis of either end-stage heart failure, renal failure or respiratory disease. Methods: The Short Form 36 and Hospital and Anxiety and Depression Questionnaire were completed by all patients. Unstructured interviews were (n 35) were conducted separately with each patient and then their significant other. These were followed by a focus group discussion (n 18) with the multiprofessional clinical team. Quantitative data were analysed using simple descriptive statistics and simple descriptive statistics. All qualitative data were taped, transcribed and analysed using Colaizzi’s approach to qualitative analysis. Findings: Deteriorating health status was the central theme derived from this analysis. It led to decreased independence, social isolation and family burden. These problems were mitigated by the limited resources at the individual’s disposal and the availability of support from hospital and community services. Generally resources and support were perceived as lacking. All participants in this study expressed concerns regarding the patients’ future and some patients described feelings of depression or acceptance of the inevitability of imminent death. Conclusion: Patients dying from chronic illness in this study had many concerns and unmet clinical needs. Care teams were frustrated by the lack of resources available to them and admitted they were ill-equipped to provide for the individual’s holistic needs. Some clinicians described difficulty in talking openly with the patient and family regarding the palliative nature of their treatment. An earlier and more effective implementation of the palliative care approach is necessary if the needs of patients in the final stages of chronic illness are to be adequately addressed. Pa