Are older people at risk of sexually transmitted infections? A new look at the evidence

Two policy documents were published by the UK Department of Health in 2001 which established the service development agendas for their respective areas over the coming years. The National Service Framework (NSF) for Older People sets out national standards for ‘better, fairer and more integrated health and social care services for older people’ and ‘addresses conditions significant to older ages’ to promote ‘active and healthy aging’. The National Sexual Health Strategy identifies ways to ensure that that the sexual health of the UK population is maximized, predicated on the grounds that ‘our sexual health affects our physical and psychological well-being and is central to some of the most important and lasting relationships in our lives’. What is striking, if perhaps ultimately unsurprising, is that there is no overlap between the documents. The NSF for Older People makes no reference to sexuality or sexual health issues, and the National Sexual Health Strategy makes no reference to older people and, indeed, explicitly focuses on younger people, particularly through linking the prevention of sexually transmitted infections (STIs) with the reduction in teenage pregnancies

Static Einstein-Maxwell Solutions in 2+1 dimensions

We obtain the Einstein-Maxwell equations for (2+1)-dimensional static space-time, which are invariant under the transformation $q_0=i\,q_2,q_2=i\,q_0,\alpha \rightleftharpoons \gamma$. It is shown that the magnetic solution obtained with the help of the procedure used in Ref.~\cite{Cataldo}, can be obtained from the static BTZ solution using an appropriate transformation. Superpositions of a perfect fluid and an electric or a magnetic field are separately studied and their corresponding solutions found.Comment: 8 pages, LaTeX, no figures, to appear in Physical Review

Barriers to providing palliative care for older people in acute hospitals

Background: the need for access to high-quality palliative care at the end of life is becoming of increasing public health concern. The majority of deaths in the UK occur in acute hospitals, and older people are particularly likely to die in this setting. However, little is known about the barriers to palliative care provision for older people within acute hospitals. Objective: to explore the perspectives of health professionals regarding barriers to optimal palliative care for older people in acute hospitals. Methods: fifty-eight health professionals participated in eight focus groups and four semi-structured interviews. Results: participants identified various barriers to palliative care provision for older people, including attitudinal differences to the care of older people, a focus on curative treatments within hospitals and a lack of resources. Participants also reported differing understandings of whose responsibility it was to provide palliative care for older people, and uncertainly over the roles of specialist and generalist palliative care providers in acute hospitals. Conclusions: numerous barriers exist to the provision of high-quality palliative care for older people within acute hospital settings. Additional research is now required to further explore age-related issues contributing to poor access to palliative care

Statistical properties of classical gravitating particles in (2+1) dimensions

We report the statistical properties of classical particles in (2+1) gravity as resulting from numerical simulations. Only particle momenta have been taken into account. In the range of total momentum where thermal equilibrium is reached, the distribution function and the corresponding Boltzmann entropy are computed. In the presence of large gravity effects, different extensions of the temperature turn out to be inequivalent, the distribution function has a power law high-energy tail and the entropy as a function of the internal energy presents a flex. When the energy approaches the open universe limit, the entropy and the mean value of the particle kinetic energy seem to diverge.Comment: Latex2e (amssymb) file, 17 page

Unbound Universe

Astronom

Non-Perturbative Particle Dynamics

We construct a non-perturbative, single-valued solution for the metric and the motion of two interacting particles in ($2+1$)-Gravity, by using a Coulomb gauge of conformal type. The method provides the mapping from multivalued ( minkowskian ) coordinates to single-valued ones, which solves the non-abelian monodromies due to particles's momenta and can be applied also to the general N-body case.Comment: 11 pages, LaTeX, no figure

What is the cost of palliative care in the UK? A systematic review

OBJECTIVES: Little is known about the cost of a palliative care approach in the UK, and there is an absence of robust activity and unit cost data. The aim of this study was to review evidence on the costs of specialist and generalist palliative care in the UK, and to explore different approaches used for capturing activity and unit cost data. METHODS: A systematic review with narrative synthesis. Four electronic databases were searched for empirical literature on the costs of a palliative care approach in the UK, and a narrative method was used to synthesise the data. RESULTS: Ten papers met our inclusion criteria. The studies displayed significant variation in their estimates of the cost of palliative care, therefore it was not possible to present an accurate aggregate cost of palliative care in the UK. The majority of studies explored costs from a National Health Service perspective and only two studies included informal care costs. Approaches to estimating activity and costs varied. Particular challenges were noted with capturing activity and cost data for hospice and informal care. CONCLUSION: The data are limited, and the heterogeneity is such that it is not possible to provide an aggregate cost of palliative care in the UK. It is notable that the costs of hospice care and informal care are often neglected in economic studies. Further work is needed to address methodological and practical challenges in order to gain a more complete understanding of the costs of palliative care

(2+1)-Gravity with Moving Particles in an Instantaneous Gauge

By defining a regular gauge which is conformal-like and provides instantaneous field propagation, we investigate classical solutions of (2+1)-Gravity coupled to arbitrarily moving point-like particles. We show how to separate field equations from self-consistent motion and we provide a solution for the metric and the motion in the two-body case with arbitrary speed, up to second order in the mass parameters.Comment: 16 pages, LaTeX, no figure

Quantum Stability of (2+1)-Spacetimes with Non-Trivial Topology

Quantum fields are investigated in the (2+1)-open-universes with non-trivial topologies by the method of images. The universes are locally de Sitter spacetime and anti-de Sitter spacetime. In the present article we study spacetimes whose spatial topologies are a torus with a cusp and a sphere with three cusps as a step toward the more general case. A quantum energy momentum tensor is obtained by the point stripping method. Though the cusps are no singularities, the latter cusps cause the divergence of the quantum field. This suggests that only the latter cusps are quantum mechanically unstable. Of course at the singularity of the background spacetime the quantum field diverges. Also the possibility of the divergence of topological effect by a negative spatial curvature is discussed. Since the volume of the negatively curved space is larger than that of the flat space, one see so many images of a single source by the non-trivial topology. It is confirmed that this divergence does not appear in our models of topologies. The results will be applicable to the case of three dimensional multi black hole\cite{BR}.Comment: 17 pages, revtex, 3 uuencoded figures containe

Self-Gravitating Strings In 2+1 Dimensions

We present a family of classical spacetimes in 2+1 dimensions. Such a spacetime is produced by a Nambu-Goto self-gravitating string. Due to the special properties of three-dimensional gravity, the metric is completely described as a Minkowski space with two identified worldsheets. In the flat limit, the standard string is recovered. The formalism is developed for an open string with massive endpoints, but applies to other boundary conditions as well. We consider another limit, where the string tension vanishes in geometrical units but the end-masses produce finite deficit angles. In this limit, our open string reduces to the free-masses solution of Gott, which possesses closed timelike curves when the relative motion of the two masses is sufficiently rapid. We discuss the possible causal structures of our spacetimes in other regimes. It is shown that the induced worldsheet Liouville mode obeys ({\it classically}) a differential equation, similar to the Liouville equation and reducing to it in the flat limit. A quadratic action formulation of this system is presented. The possibility and significance of quantizing the self-gravitating string, is discussed.Comment: 55 page