On subspace lattices II. Continuity of Lat

We study the continuity of the map Lat sending an ultraweakly closed operator algebra to its invariant subspace lattice. We provide an example showing that Lat is in general discontinuous and give sufficient conditions for the restricted continuity of this map. As consequences we obtain that Lat is continuous on the classes of von Neumann and Arveson algebras and give a general approximative criterion for reflexivity, which extends Arvesonâ??s theorem on the reflexivity of commutative subspace lattices.

On the continuity of the support of masa-bimodules

We anounce results on the continuity of the map sending a masa-bimodule to its support. The proofs of the results will be published elsewhere.

Are family physician visits and continuity of care associated with acute care use at end-of-life? A population-based cohort study of homecare cancer patients

Background: Previous end-of-life cancer research has shown an association between increased family physician continuity of care and reduced use of acute care services; however, it did not focus on a homecare population or control for homecare nursing.

Aim: Among end-of-life homecare cancer patients, to investigate the association of family physician continuity with location of death and hospital and emergency department visits in the last 2 weeks of life while controlling for nursing hours.

Design: Retrospective population-based cohort study.

Setting/participants: Cancer patients with ≥1 family physician visit in 2006 from Ontario, Canada. Family physician continuity of care was assessed using two measures: Modified Usual Provider of Care score and visits/week. Its association with location of death and hospital and emergency department visits in the last 2 weeks of life was examined using logistic regression.

Results: Of 9467 patients identified, the Modified Usual Provider of Care score demonstrated a dose-response relationship with increasing continuity associated with decreased odds of hospital death and visiting the hospital and emergency department in the last 2 weeks of life. More family physician visits/week were associated with lower odds of an emergency department visit in the last 2 weeks of life and hospital death, except for patients with greater than 4 visits/week, where they had increased odds of hospitalizations and hospital deaths.

Conclusions: These results demonstrate an association between increased family physician continuity of care and decreased odds of several acute care outcomes in late life, controlling for homecare nursing and other covariates.©The Author(s) 2013 Reprints and permissions sagepub.co.uk/journalsPermissions.nav.

Creating continuity out of the disruption of a diagnosis of HIV during pregnancy

AIM: To understand the uniqueness of the experience of testing HIV positive from the perspective of pregnant women.

BACKGROUND: As more people learn of their HIV diagnosis through routine screening processes, it is timely to reflect on the impact of receiving an unexpected positive result.

DESIGN: A prospective qualitative study.

METHODS: This paper draws on the case studies of four women who were participating in a larger prospective qualitative study of reproductive decision-making, pregnancy and childbirth following HIV diagnosis. Multiple interviews were conducted following diagnosis during pregnancy, and, after the birth of their babies. Thematic data analysis was undertaken.

RESULTS: Drawing on Becker's theory of disruption, we document the 'sudden disjuncture' of their antenatal diagnosis and the embodied emotional struggle the women engaged in to create continuity in their lives. A diagnosis of HIV disrupted the women's biographies in terms of their health, relationships and social identity. As pregnant women, the threat of HIV was experienced most significantly in relation to their unborn child. However, their narratives also revealed how a diagnosis of HIV in the context of pregnancy, whilst traumatic, provided a focus for regaining continuity in their lives, as the baby became a metaphor for hope and orientation toward the future.

CONCLUSIONS: As HIV testing becomes more 'routine', the findings of this study serve to remind health professionals that a positive diagnosis continues to constitute a major trauma to individuals and families.

RELEVANCE TO CLINICAL PRACTICE: We propose that appropriately educated nursing and midwifery staff could facilitate the 'meaning making' process that is required for newly diagnosed HIV positive persons to find a subjective sense of well-being in their lives.

Auditory cueing in Parkinson's patients with freezing of gait. What matters most: action-relevance or cue-continuity?

Gait disturbances are a common feature of Parkinson’s disease, one of the most severe being freezing of gait. Sensory cueing is a common method used to facilitate stepping in people with Parkinson’s. Recent work has shown that, compared to walking to a metronome, Parkinson’s patients without freezing of gait (nFOG) showed reduced gait variability when imitating recorded sounds of footsteps made on gravel. However, it is not known if these benefits are realised through the continuity of the acoustic information or the action-relevance. Furthermore, no study has examined if these benefits extend to PD with freezing of gait. We prepared four different auditory cues (varying in action-relevance and acoustic continuity) and asked 19 Parkinson’s patients (10 nFOG, 9 with freezing of gait (FOG)) to step in place to each cue. Results showed a superiority of action-relevant cues (regardless of cue-continuity) for inducing reductions in Step coefficient of variation (CV). Acoustic continuity was associated with a significant reduction in Swing CV. Neither cue-continuity nor action-relevance was independently sufficient to increase the time spent stepping before freezing. However, combining both attributes in the same cue did yield significant improvements. This study demonstrates the potential of using action-sounds as sensory cues for Parkinson’s patients with freezing of gait. We suggest that the improvements shown might be considered audio-motor ‘priming’ (i.e., listening to the sounds of footsteps will engage sensorimotor circuitry relevant to the production of that same action, thus effectively bypassing the defective basal ganglia).

Gateaux complex differentiability and continuity

As is known, there are everywhere discontinuous infinitely Frechet differentiable functions on the real locally convex spaces D(R) and V(R) of finitely supported infinitely differentiable functions and, respectively, of generalized functions. In this paper the relationship between the complex differentiability and continuity of a function on a complex locally convex space is considered. We describe a class of complex locally convex spaces, which includes the complex space V(R), such that every Gateaux complex-differentiable function on a space of this class is continuous. We also describe another class of locally convex spaces, which includes the complex space D(R), such that on every space of this class there is an everywhere discontinuous infinitely Frechet complex-differentiable function whose derivatives are continuous.

Optimization of an open-ended microwave oven for microelectronics packaging

A physically open, but electrically shielded, microwave open oven can be produced by virtue of the evanescent fields in a waveguide below cutoff. The below cutoff heating chamber is fed by a transverse magnetic resonance established in a dielectric-filled section of the waveguide exploiting continuity of normal electric flux. In order to optimize the fields and the performance of the oven, a thin layer of a dielectric material with higher permittivity is inserted at the interface. Analysis and synthesis of an optimized open oven predicts field enhancement in the heating chamber up to 9.4 dB. Results from experimental testing on two fabricated prototypes are in agreement with the simulated predictions, and demonstrate an up to tenfold improvement in the heating performance. The open-ended oven allows for simultaneous precision alignment, testing, and efficient curing of microelectronic devices, significantly increasing productivity gains.

A Geostatistical Investigation into Changing Permeability of Sandstones During Weathering Simulations

The ability to predict the behavior of masonry materials is crucial to conserve building stone. Natural stone, such as sandstone, is not immune from the processes of weathering in the built environment and suffers from decay by granular disintegration, contour scaling, and multiple flaking. Spatial variation of rock properties is a major contributing factor to inconsistent responses to weathering. This has implications for moisture movement and salt input and output and storage, and results in unpredictability in the decay dynamics of masonry materials. This article explores the use of variography and kriging to investigate the spatial interactions between the trigger factors of stone decay, in particular, permeability and its effect on salt penetration. Sandstone blocks were used to represent fresh building stones from a weathering perspective and gave baseline characteristics for the interpretation of subsequent deterioration and decay pathways. Simulated weathering trials involved preloading a sandstone block with salt and subjecting a separate block to 20 cycles of a weathering trial designed to simulate a temperate weathering regime. Geostatistical analysis indicated differences in the spatial variation of permeability of the fresh rock and that subjected to the weathering regimes. Spatial prediction and visualization showed differences in the spatial continuity of permeability in a horizontal and vertical direction through the preloaded block after salt weathering. Continual wetting with salt and alternate heating increased permeability in a vertical direction, enabling the ingress and movement of salt and moisture more effectively through the stone.

The impact of specialized oncology nursing on patient supportive care outcomes

Meeting the supportive care needs of cancer patients remains a challenge to cancer care systems around the world. Despite significant improvements in the organization of medical care of patients with cancer, numerous surveys of cancer populations demonstrate that significant proportions of patients fail to have their supportive care needs met. One possible solution is the introduction of a care coordinator role using oncology nursing to help ensure that patients' physical, psychological, and social support needs are addressed. Although having face validity, there is little empirical evidence on the effects of nurse-led supportive care coordinator roles on patient reported supportive care outcomes. In this article the authors present the results of a prospective longitudinal cohort study of 113 patients referred to a community-based specialist oncology nursing program. Using validated instruments they found significant improvements in patient-reported outcomes in key supportive care domains: unmet needs, quality of life, and continuity of care, as well as a shift in patterns of health resource utilization from acute care settings to the community over the course of the intervention. The results of this study are important in supporting the design and development of controlled trials to examine provider roles in the coordination of supportive cancer care. Copyright © Taylor & Francis Group, LLC.

Product standardisation as a tool to control prescribing costs a case study of alginate liquid preparations

Introduction Product standardisation involves promoting the prescribing of pre-selected products within a particular category across a healthcare region and is designed to improve patient safety by promoting continuity of medicine use across the primary/secondary care interface, in addition to cost containment without compromising clinical care (i.e. maintaining safety and efficacy). Objectives To examine the impact of product standardisation on the prescribing of compound alginate preparations within primary care in Northern Ireland. Methods Data were obtained on alginate prescribing from the Northern Ireland Central Services Agency (Prescription Pricing Branch), covering a period of 43 months. Two standardisation promotion interventions were carried out at months 18 and 33. In addition to conventional statistical analyses, a simple interrupted time series analysis approach, using graphical interpretation, was used to facilitate interpretation of the data. Results There was a significant increase in the prescribed share of the preferred alginate product in each of the four health boards in Northern Ireland and a decrease in the cost per Defined Daily Dose for alginate liquid preparations overall. Compliance with the standardisation policy was, however, incomplete and was influenced to a marked degree by the activities of the pharmaceutical industry. The overall economic impact of the prescribing changes during the study was small (3.1%). Conclusion The findings suggested that product standardisation significantly influenced the prescribing pattern for compound alginate liquid preparations within primary care across Northern Ireland. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.