Retaining consumer participation in the Fremantle Primary Prevention Study: a general practice team based cardiovascular risk reduction study

Recruitment and retention of participants to lifestyle modification studies can be challenging within a primary care setting. The management of factors such as travel, busy lifestyles and lack of regular follow up of participants can result in considerable attrition rates over the lifecycle of the project. The aim of the study was to understand from a research participant perspective the perceived barriers and facilitators in retaining community participants in primary health care research. This is a qualitative study with data collected from four focus groups facilitated at the end of each of three community forums focusing on sharing the findings of the Fremantle Primary Prevention Study. Overall twelve focus groups were facilitated with participants that had usual care or who were in the intervention arm of the Fremantle Primary Prevention study. Group size ranged from 6 to 10 participants with the interviewer following a semi structured focus group schedule. Thematic analysis extracted common themes from each focus group around contributing factors to participation. The key message was that relationships built over a longer time period with a GP, practice nurses and other practice staff was an important factor in retention of participants. In addition, ease of travel, convenience and regular check ups with the practice were all significant enticement to remain in a study over the course of the research. Being part of their regular GP practice’s involvement in a study was clearly worthwhile as an incentive for participants and offers hope for practice-based research networks undertaking other community-based studies in the future

Early primary care physician contact and health service utilisation in a large sample of recently released ex-prisoners in Australia: Prospective cohort study

Objective: To describe the association between ex-prisoner primary care physician contact within 1 month of prison release and health service utilisation in the 6 months following release. Design: A cohort from the Passports study with a mean follow-up of 219 (±44) days postrelease. Associations were assessed using a multivariate Andersen-Gill model, controlling for a range of other factors. Setting: Face-to-face, baseline interviews were conducted in a sample of prisoners within 6 weeks of expected release from seven prisons in Queensland, Australia, from 2008 to 2010, with telephone follow-up interviews 1, 3 and 6 months postrelease. Participants: From an original population-based sample of 1325 sentenced adult (≥18 years) prisoners, 478 participants were excluded due to not being released from prison during follow-up (n=7, 0.5%), loss to follow-up (n=257, 19.4%), or lacking exposure data (n=214, 16.2%). A total of 847 (63.9%) participants were included in the analyses. Exposure: Primary care physician contact within 1 month of follow-up as a dichotomous measure. Main outcome measures: Adjusted time-to-event hazard rates for hospital, mental health, alcohol and other drug and subsequent primary care physician service utilisations assessed as multiple failure time-interval data. Results: Primary care physician contact prevalence within 1 month of follow-up was 46.5%. One-month primary care physician contact was positively associated with hospital (adjusted HR (AHR)=2.07; 95% CI 1.39 to 3.09), mental health (AHR=1.65; 95% CI 1.24 to 2.19), alcohol and other drug (AHR=1.48; 95% CI 1.15 to 1.90) and subsequent primary care physician service utilisation (AHR=1.47; 95% CI 1.26 to 1.72) over 6 months of follow-up. Conclusions: Engagement with primary care physician services soon after prison release increases health service utilisation during the critical community transition period for ex-prisoners

On the Global Existence of Bohmian Mechanics

We show that the particle motion in Bohmian mechanics, given by the solution of an ordinary differential equation, exists globally: For a large class of potentials the singularities of the velocity field and infinity will not be reached in finite time for typical initial values. A substantial part of the analysis is based on the probabilistic significance of the quantum flux. We elucidate the connection between the conditions necessary for global existence and the self-adjointness of the Schr\"odinger Hamiltonian.Comment: 35 pages, LaTe

Challenges in the care of familial hypercholesterolemia: a community care perspective

Familial hyperchoelsterolaemia (FH) remains under-diagnosed and under-treated in the community setting. Earlier evidence suggested prevalence of 1:500 worldwide but newer evidence suggests it is more common. Less than 15% of FH patients are ever diagnosed with children and young adults rarely tested despite having most to gain given their lifetime exposure. Increasing awareness among primary care teams is critical to improve detection profile for FH. Cascade testing in the community setting needs a sustainable approach to be developed to facilitate family tracing of index cases. The use of the Dutch Lipid Clinic Network Criteria score to facilitate a phenotypic diagnosis is the preferred approach adopted in Australia and eliminates the need to undertake genetic testing for all suspected FH cases

On quantum mean-field models and their quantum annealing

This paper deals with fully-connected mean-field models of quantum spins with p-body ferromagnetic interactions and a transverse field. For p=2 this corresponds to the quantum Curie-Weiss model (a special case of the Lipkin-Meshkov-Glick model) which exhibits a second-order phase transition, while for p>2 the transition is first order. We provide a refined analytical description both of the static and of the dynamic properties of these models. In particular we obtain analytically the exponential rate of decay of the gap at the first-order transition. We also study the slow annealing from the pure transverse field to the pure ferromagnet (and vice versa) and discuss the effect of the first-order transition and of the spinodal limit of metastability on the residual excitation energy, both for finite and exponentially divergent annealing times. In the quantum computation perspective this quantity would assess the efficiency of the quantum adiabatic procedure as an approximation algorithm.Comment: 44 pages, 23 figure

Coupled-mode equations and gap solitons in a two-dimensional nonlinear elliptic problem with a separable periodic potential

We address a two-dimensional nonlinear elliptic problem with a finite-amplitude periodic potential. For a class of separable symmetric potentials, we study the bifurcation of the first band gap in the spectrum of the linear Schr\"{o}dinger operator and the relevant coupled-mode equations to describe this bifurcation. The coupled-mode equations are derived by the rigorous analysis based on the Fourier--Bloch decomposition and the Implicit Function Theorem in the space of bounded continuous functions vanishing at infinity. Persistence of reversible localized solutions, called gap solitons, beyond the coupled-mode equations is proved under a non-degeneracy assumption on the kernel of the linearization operator. Various branches of reversible localized solutions are classified numerically in the framework of the coupled-mode equations and convergence of the approximation error is verified. Error estimates on the time-dependent solutions of the Gross--Pitaevskii equation and the coupled-mode equations are obtained for a finite-time interval.Comment: 32 pages, 16 figure

Failing boys and moral panics: perspectives on the underachievement debate

The paper re-examines the underachievement debate from the perspective of the ‘discourse of derision’ that surrounds much writing in this area. It considers the contradictions and inconsistencies which underpin much of the discourse – from a reinterpretation of examination scores, to the conflation of the concepts of ‘under’ and ‘low’ achievement and finally to the lack of consensus on a means of defining and measuring the term underachievement. In doing so, this paper suggests a more innovative approach for understanding, re-evaluating and perhaps rejecting the notion of underachievement

\u3ci\u3eStaphylococcus aureus\u3c/i\u3e Metabolic Adaptations during the Transition from a Daptomycin Susceptibility Phenotype to a Daptomycin Nonsusceptibility Phenotype

Staphylococcus aureus is a major cause of nosocomial and community-acquired infections. The success of S. aureus as a pathogen is due in part to its many virulence determinants and resistance to antimicrobials. In particular, methicillin-resistant S. aureus has emerged as a major cause of infections and led to increased use of the antibiotics vancomycin and daptomycin, which has increased the isolation of vancomycin-intermediate S. aureus and daptomycin-nonsusceptible S. aureus strains. The most common mechanism by which S. aureus acquires intermediate resistance to antibiotics is by adapting its physiology and metabolism to permit growth in the presence of these antibiotics, a process known as adaptive resistance. To better understand the physiological and metabolic changes associated with adaptive resistance, six daptomycin-susceptible and -nonsusceptible isogenic strain pairs were examined for changes in growth, competitive fitness, and metabolic alterations. Interestingly, daptomycin nonsusceptibility coincides with a slightly delayed transition to the postexponential growth phase and alterations in metabolism. Specifically, daptomycin-nonsusceptible strains have decreased tricarboxylic acid cycle activity, which correlates with increased synthesis of pyrimidines and purines and increased carbon flow to pathways associated with wall teichoic acid and peptidoglycan biosynthesis. Importantly, these data provided an opportunity to alter the daptomycin nonsusceptibility phenotype by manipulating bacterial metabolism, a first step in developing compounds that target metabolic pathways that can be used in combination with daptomycin to reduce treatment failures

Crystal properties of eigenstates for quantum cat maps

Using the Bargmann-Husimi representation of quantum mechanics on a torus phase space, we study analytically eigenstates of quantized cat maps. The linearity of these maps implies a close relationship between classically invariant sublattices on the one hand, and the patterns (or `constellations') of Husimi zeros of certain quantum eigenstates on the other hand. For these states, the zero patterns are crystals on the torus. As a consequence, we can compute explicit families of eigenstates for which the zero patterns become uniformly distributed on the torus phase space in the limit $\hbar\to 0$. This result constitutes a first rigorous example of semi-classical equidistribution for Husimi zeros of eigenstates in quantized one-dimensional chaotic systems.Comment: 43 pages, LaTeX, including 7 eps figures Some amendments were made in order to clarify the text, mainly in the 4 first sections. Figures are unchanged. To be published in: Nonlinearit

Quantum Mechanics on the cylinder

A new approach to deformation quantization on the cylinder considered as phase space is presented. The method is based on the standard Moyal formalism for R^2 adapted to (S^1 x R) by the Weil--Brezin--Zak transformation. The results are compared with other solutions of this problem presented by Kasperkovitz and Peev (Ann. Phys. vol. 230, 21 (1994)0 and by Plebanski and collaborators (Acta Phys. Pol. vol. B 31}, 561 (2000)). The equivalence of these three methods is proved.Comment: 21 pages, LaTe