The N = 1 Supersymmetric Wong Equations and the Non-Abelian Landau Problem

A Lagrangian formulation is given extending to N = 1 supersymmetry the motion of a charged point particle with spin in a non-abelian external field. The classical formulation is constructed for any external static non-abelian SU(N) gauge potential. As an illustration, a specific gauge is fixed enabling canonical quantization and the study of the supersymmetric non-abelian Landau problem. The spectrum of the quantum Hamiltonian operator follows in accordance with the supersymmetric structure.Comment: 10 page

Neuronal and psychological underpinnings of pathological gambling

Like in the case of drugs, gambling hijacks reward circuits in a brain which is not prepared to receive such intense stimulation. Dopamine is normally released in response to reward and uncertainty in order to allow animals to stay alive in their environment – where rewards are relatively unpredictable. In this case, behavior is regulated by environmental feedbacks, leading animals to persevere or to give up. In contrast, drugs provide a direct, intense pharmacological stimulation of the dopamine system that operates independently of environmental feedbacks, and hence causes “motivational runaways”. With respect to gambling, the confined environment experienced by gamblers favors the emergence of excitatory conditioned cues, so that positive feedbacks take over negative feedbacks. Although drugs and gambling may act differently, their abnormal activation of reward circuitry generates an underestimation of negative consequences and promotes the development of addictive/compulsive behavior. In Parkinson’s and Huntington’s disease, dopamine-related therapies may disrupt these feedbacks on dopamine signalling, potentially leading to various addictions, including pathological gambling. The goal of this Research Topic is to further our understanding of the neurobiological mechanisms underlying the development of pathological gambling. This eBook contains a cross-disciplinary collection of research and review articles, ranging in scope from animal behavioral models to human imaging studies

Development and validation of the Vietnamese Primary Care Assessment Tool : provider version

Aim: To adapt the provider version of the Primary Care Assessment Tool (PCAT) for Vietnam and determine its internal consistency and validity. Background: There is a growing need to measure and explore the impact of various characteristics of health care systems on the quality of primary care. It would provide the best evidence for policy makers if these evaluations come from both the demand and supply sides of the health care sector. Comparatively more researchers have studied primary care quality from the consumer perspective than from the provider's perspective. This study aims at the latter. Method: Our study translated and adapted the PCAT provider version (PCAT PE) into a Vietnamese version, after which a cross-sectional survey was conducted to examine the feasibility, internal consistency and validity of the Vietnamese PCAT provider version (VN PCAT PE). All general doctors working at 152 commune health centres in Thua Thien Hue province had been selected to participate in the survey. Findings: The VN PCAT PE is an instrument for evaluation of primary care in Vietnam with 116 items comprising six scales representing four core primary care domains, and three additional scales representing three derivative domains. From the translation and cultural adaptation stage, two items were combined, two items were removed and one item was added. Six other items were excluded due to problems in item-total correlations. All items have a low non-response or 'don't know/don't remember' response rate, and there were no floor or ceiling effects. All scales had a Cronbach's alpha above 0.80, except for the Coordination scale, which still was above the minimum level of 0.70. Conclusion: The VN PCAT PE demonstrates adequate internal consistency and validity to be used as an effective tool for measuring the quality of primary care in Vietnam from the provider perspective

Development and validation of the Vietnamese primary care assessment tool

Objective : To adapt the consumer version of the Primary Care Assessment Tool (PCAT) for Vietnam and determine its internal consistency and validity. Design : A quantitative cross sectional study. Setting : 56 communes in 3 representative provinces of central Vietnam. Participants : Total of 3289 people who used health care services at health facility at least once over the past two years. Results : The Vietnamese adult expanded consumer version of the PCAT (VN PCAT-AE) is an instrument for evaluation of primary care in Vietnam with 70 items comprising six scales representing four core primary care domains, and three additional scales representing three derivative domains. Sixteen other items from the original tool were not included in the final instrument, due to problems with missing values, floor or ceiling effects, and item-total correlations. All the retained scales have a Cronbach’s alpha above 0.70 except for the subscale of Family Centeredness. Conclusions : The VN PCAT-AE demonstrates adequate internal consistency and validity to be used as an effective tool for measuring the quality of primary care in Vietnam from the consumer perspective. Additional work in the future to optimize valid measurement in all domains consistent with the original version of the tool may be helpful as the primary care system in Vietnam further develops

Patient experiences of primary care quality amongst different types of health care facilities in central Vietnam

Background: Patient experience with primary health care services can vary markedly between different types of health care facilities, even within the same country setting. Given known benefits of high quality primary health care, the performance of these facilities may significantly impact population health. The aim of this study was to compare the quality of primary care in different types of health facilities as experienced by Vietnamese consumers. Methods:1662 people who utilized primary health care services at least once over the past two years in various types of facilities in central Vietnam were surveyed in a cross-sectional study using the Vietnamese version of the Primary Care Assessment Tool (VN PCAT-AE) to assess overall primary care quality as well as several different domains of high quality primary care services. Results: Commune health centers were associated with the highest overall primary care quality (PCAT expanded score 21.07, p<0.001) as well as high scores in nearly all individual domains of primary care quality experienced by consumers compared with other types of facilities. Conversely, private facilities such as private clinics and pharmacies were rated lowest overall (PCAT expanded score 18.45, p<0.05 and 16.90, p<0.001 respectively). District hospitals and other government hospitals (PCAT expanded score 20.10 and 19.72 respectively) were reported as the best quality in comprehensiveness of available services (p<0.001). Polyclinics performed quite well in comprehensiveness of services available (3.11) and first contact-access (2.79) but less so in other domains, especially in cultural competency (1.87). Conclusions: The high quality of primary care services experienced by consumers in commune health centers compared with other facilities gives Vietnam ample reason to promote greater use of these community-based primary care facilities. Populations may benefit most from building and strengthening grassroots networks of such community-based health centers as an effective solution for overcrowding at hospitals while simultaneously providing better overall health outcomes

Primary care quality in Vietnam : perceptions and opinions of primary care physicians in commune health centers : a mixed-methods study

Introduction: Measuring the performance of a primary care system is one of the very first steps to find out whether there is room for improvement. To obtain an objective and comprehensive view, this measurement should come from both the supply and demand sides of the system. Patients' experiences of primary care have been studied around the world, but much less energy has been invested in researching providers' perspectives. This research aims to explore how primary care physicians working at commune health centers in Vietnam evaluate their performance and their opinions on how to improve the quality of primary care services. Materials and methods: First, a quantitative study was conducted using the validated Vietnamese PCAT questionnaire-provider expanded version (VN PCAT PE) targeting all primary care physicians (PCPs) working at commune health centers in a province of Central Vietnam. Next, a qualitative study was carried out, consisting of in-depth interviews with PCPs, to better understand the results of the quantitative survey and gain insight on barriers of primary care services and how to overcome them. Results: In the quantitative portion of our study, 150 PCPs rated the quality of ongoing care and first contact in CHCs as the best (3.09 and 3.11 out of 4, respectively), and coordination as the worst performing core domain (2.53). Twenty-two PCPs also participated in our qualitative research. In regards to challenges that primary care physicians face during their daily practice, three central themes emerged: 1) patient factors such as client attitude and knowledge, 2) provider factors such as the burden of administrative work and lack of training opportunities, and 3) contextual factors such as low income and lack of resources including medicines and diagnostics. Participants recommended more health promotion campaigns in the media, increasing the number of services available at CHCs (such as being able to take blood samples), reducing the workload related to administration for CHC leaders, greater government subsidies, and providing more training courses for PCPs. Conclusions: Findings from this study offer a valuable view from the supply-side of the primary care system, specifically those who directly deliver primary care services. Along with the earlier study on consumers' evaluation of the Vietnamese primary care system, and literature from other low and middle-income countries, these findings offer emerging evidence for policymakers to improve the quality of primary care in Vietnam

An overview of commonalities in the mechanisms underlying gambling and substance use disorders

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Managing the complexity of doing it all : an exploratory study on students' experiences when trained stepwise in conducting consultations

Background: At most medical schools the components required to conduct a consultation, medical knowledge, communication, clinical reasoning and physical examination skills, are trained separately. Afterwards, all the knowledge and skills students acquired must be integrated into complete consultations, an art that lies at the heart of the medical profession. Inevitably, students experience conducting consultations as complex and challenging. Literature emphasizes the importance of three didactic course principles: moving from partial tasks to whole task learning, diminishing supervisors' support and gradually increasing students' responsibility. This study explores students' experiences of an integrated consultation course using these three didactic principles to support them in this difficult task. Methods: Six focus groups were conducted with 20 pre-clerkship and 19 clerkship students in total. Discussions were audiotaped, transcribed and analysed by Nvivo using the constant comparative strategy within a thematic analysis. Results: Conducting complete consultations motivated students in their learning process as future physician. Initially, students were very much focused on medical problem solving. Completing the whole task of a consultation obligated them to transfer their theoretical medical knowledge into applicable clinical knowledge on the spot. Furthermore, diminishing the support of a supervisor triggered students to reflect on their own actions but contrasted with their increased appreciation of critical feedback. Increasing students' responsibility stimulated their active learning but made some students feel overloaded. These students were anxious to miss patient information or not being able to take the right decisions or to answer patients' questions, which sometimes resulted in evasive coping techniques, such as talking faster to prevent the patient asking questions. Conclusion: The complex task of conducting complete consultations should be implemented early within medical curricula because students need time to organize their medical knowledge into applicable clinical knowledge. An integrated consultation course should comprise a step-by-step teaching strategy with a variety of supervisors' feedback modi, adapted to students' competence. Finally, students should be guided in formulating achievable standards to prevent them from feeling overloaded in practicing complete consultations with simulated or real patients

Comparative anatomy and angiography of the cardiac coronary venous system in four species: human, ovine, porcine, and canine.

INTRODUCTION: The coronary arterial system has been the subject of greater investigation than its venous system due to the importance of human coronary artery disease. With the advent of new percutaneous treatments, the anatomy of the coronary venous system has increasing relevancy. We compared the organization of the coronary venous circulation in three species commonly used in research and compared these to normal humans using both macroscopic anatomic and angiographic studies. ANIMALS: The anatomy of five explanted hearts from healthy dogs, pigs, and sheep were studied macroscopically, and 10 explanted hearts per animal species and 10 clinically normal human were examined by angiography. METHODS: Animal hearts were injected with latex and dissected macroscopically. The coronary venous system of humans was evaluated from clinical angiographic studies. In the animal hearts, a retrograde angiographic study was performed via a Foley catheter in the coronary sinus. RESULTS: The general organization of the coronary venous circulation was similar among humans, dogs, sheep, and pigs. Despite overall similarities to humans, animal hearts demonstrated the absence of the oblique vein of the left atrium and differences in position and organization of venous valves; venous diameters; number of tributary veins; and presence of an anastomosis between the left and right (human anterior and posterior) venous tree. The left azygos of the pig and sheep joined the coronary sinus. CONCLUSIONS: Anatomical differences must be considered when planning biomedical and veterinary studies incorporating cardiac veins. This study provides baseline data regarding structure and organization of the cardiac venous system