Billiard in the space with a time machine

We study a system of an elastic ball moving in the non-relativistic spacetime with a nontrivial causal structure produced by a wormhole-based time machine. For such a system it is possible to formulate a simple model of the so-called `grandfather paradox': for certain `paradoxical' initial conditions the standard straight trajectory of the ball would self-collide inconsistently. We analyze globally consistent solutions of local equations of motion, namely, we find all trajectories with one self-collision. It is demonstrated that all standard initial conditions have a consistent evolution, including those `paradoxical' ones, for which the inconsistent collision-free trajectory is superseded by a special consistent self-colliding trajectory. Moreover, it is shown that for a wide class of initial conditions more than one globally consistent evolution exist. The nontrivial causal structure thus breaks the uniqueness of the classical theory even for locally deterministic physical laws.Comment: 13 pages, 16 figure

Shared geriatric mental health care in a rural community

Introduction: A pilot project in shared mental health care was initiated to explore opportunities to increase the capacity of the rural primary care system as a resource for older people with mental health needs. This was done within a framework for the delivery of best practices in geriatric mental health outreach. Methods: Shared-care strategies combining education and clinical consultation between mentor psychiatrists and family physicians were implemented and then evaluated after one year to identify key factors in the success of approaches to shared mental health care for older people in a rural setting. Results: Results provided new insights into shared care between primary care and specialty geriatric mental health services, rural geriatric mental health service delivery, developmental phases in service learning approaches, and building knowledge networks to promote continuing best practices. Conclusion: The results from the project's process evaluation have been integrated into the development of a permanent shared geriatric mental health care service for the rural setting. Preparation for an outcome evaluation that will focus on the impact on patient care has also been initiated

Older adults experiences of rehabilitation in acute health care

Rehabilitation is a key component of nursing and allied healthcare professionals’ roles in most health and social care settings. This paper reports on stage 2 of an action research project to ascertain older adult's experience of rehabilitation. Twenty postdischarge interviews were conducted and the interview transcripts were analysed using thematic content analysis. All older adults discharged from an acute older acute rehabilitation ward to their own homes in the community were eligible to participate. The only exclusion criterion was older adults who were thought to be unable to give consent to participate by the nurse in charge and the researcher. Whilst 92 older adults were eligible to participate in this research study, only 20 were interviewed. The findings from this study suggest that older adults valued communication with health professionals but were aware of their time constraints that hindered communication. This study suggests that both nurses and allied health professionals are not actively providing rehabilitative services to promote health and well-being, which contradicts the focus of active ageing. Furthermore, there was evidence of unmet needs on discharge, and older adults unable to recall the professions that were involved in their interventions and the rationale for therapy input. It is suggested that further research is needed to explore the effectiveness of allied health rehabilitation in the acute setting. This study highlights the need for further research into older adults’ perceptions of the rehabilitation process in the acute setting

Application of information theory to test item weighting.

Thesis (Ed.D.)--Boston University

Communications and Related Projects

Contains reports on six research projects

Drag coefficient of spherical particles in turbulent channel flow

The paper presents results of numerical calculations of drag coefficientsof large sphericalsolidparticles. Several hydraulic cases were tested. The first one -the spheres were fixed at different heights above a roughbed of an open channel, the second one -the spheres moved along the channel bed and the thirdone -the sphere impacted and rebounded from a smooth surface. Finite Volumeand Lattice Boltzmann methodswere used for the simulations. The Particle Image Velocimetry (2D-PIV) was used to determine the velocity field in the open channel

Communications Research

Contains reports on six research projects

An age-friendly health systems implementation: A virtual clinic as an educational technology innovation

Virtual gaming simulation is an innovative pedagogical approach to enhancing experiential learning. Case Western Reserve University and CVS Health\u27s MinuteClinic teams, with funding from The John A. Hartford Foundation, developed a virtual gaming technology to educate advance practice providers about Age-Friendly Health Systems, 4Ms care: What Matters, Medication, Mentation, Mobility

Disease Management in Skilled Nursing Facilities Improves Outcomes for Patients With a Primary Diagnosis of Heart Failure.

OBJECTIVE: Skilled nursing facilities (SNFs) are common destinations after hospitalization for patients with heart failure (HF). Our objective was to determine if patients in SNFs with a primary hospital discharge diagnosis of HF benefit from an HF disease management program (HF-DMP). DESIGN: This is a subgroup analysis of multisite, physician and practice blocked, cluster-randomized controlled trial of HF-DMP vs usual care for patients in SNF with an HF diagnosis. The HF-DMP standardized SNF HF care using HF practice guidelines and performance measures and was delivered by an HF nurse advocate. SETTING AND PARTICIPANTS: Patients with a primary hospital discharge diagnosis of HF discharged to SNF. METHODS: Composite outcome of all-cause hospitalization, emergency department visits, and mortality were evaluated at 30 and 60 days post SNF admission. Linear mixed models accounted for patient clustering at the physician level. RESULTS: Of 671 individuals enrolled in the main study, 125 had a primary hospital discharge diagnosis of HF (50 HF-DMP; 75 usual care). Mean age was 79 ± 10 years, 53% women, and mean ejection fraction 46% ± 15%. At 60 days post SNF admission, the rate of the composite outcome was lower in the HF-DMP group (30%) compared with usual care (52%) (P = .02). The rate of the composite outcome at 30 days for the HF-DMP group was 18% vs 31% in the usual care group (P = .11). CONCLUSIONS AND IMPLICATIONS: Patients with a primary hospital discharge diagnosis of HF who received HF-DMP while cared for in an SNF had lower rates of the composite outcome at 60 days. Standardized HF management during SNF stays may be important for patients with a primary discharge diagnosis of HF

Communications Research

Contains reports on five research projects