What do parents of children with dysphagia think about their MDT? A qualitative study

Objectives: To seek the experiences and perspectives of parents caring for children with dysphagia, with emphasis on their experiences of working within their child’s multidisciplinary team (MDT) Setting: This research was completed in community settings, within families’ homes across the UK. Participants: Fourteen families self-selected to participate in the study. Criteria specified that participants must care for a child under the age of 18 and to decrease ambiguity the term ‘diagnosis of dysphagia’ was defined as the need for modified (thickened) fluids. Exclusion criteria: caring for an adult over the age of 18; diet and fluid modifications for reasons other than dysphagia (e.g. for symptomatic treatment of Gastro-oesophageal reflux disease (GORD). Participants were interviewed within their homes using a semi-structured questionnaire and data was analysed using a descriptive phenomenological approach through use of thematic coding and constant comparison. Themes and relationships were inductively generated from the data. Results: Participants universally expressed a desire to be involved with their child’s multidisciplinary team; this study identified the following facilitators and barriers to collaboration: Accessing Services, Professional Knowledge, and Professional Skillset. Participants described three means of responding to these barriers: Reacting Emotionally, Seeking Solutions, and Making Decisions. Conclusions: This study recorded in-depth reports of participants’ experiences of working with healthcare providers. Despite government-driven efforts towards person-centred health and social care, participants shared accounts of times when this has not occurred, describing a negative impact on the well-being and quality of life of their child and family

Characteristics of chaos evolution in one-dimensional disordered nonlinear lattices

We numerically investigate the characteristics of chaos evolution during wave packet spreading in two typical one-dimensional nonlinear disordered lattices: the Klein-Gordon system and the discrete nonlinear Schr\"{o}dinger equation model. Completing previous investigations \cite{SGF13} we verify that chaotic dynamics is slowing down both for the so-called `weak' and `strong chaos' dynamical regimes encountered in these systems, without showing any signs of a crossover to regular dynamics. The value of the finite-time maximum Lyapunov exponent $\Lambda$ decays in time $t$ as $\Lambda \propto t^{\alpha_{\Lambda}}$, with $\alpha_{\Lambda}$ being different from the $\alpha_{\Lambda}=-1$ value observed in cases of regular motion. In particular, $\alpha_{\Lambda}\approx -0.25$ (weak chaos) and $\alpha_{\Lambda}\approx -0.3$ (strong chaos) for both models, indicating the dynamical differences of the two regimes and the generality of the underlying chaotic mechanisms. The spatiotemporal evolution of the deviation vector associated with $\Lambda$ reveals the meandering of chaotic seeds inside the wave packet, which is needed for obtaining the chaotization of the lattice's excited part.Comment: 11 pages, 10 figure

Complete bond-operator theory of the two-chain spin ladder

The discovery of the almost ideal, two-chain spin-ladder material (C_5H_12N)_2CuBr_4 has once again focused attention on this most fundamental problem in low-dimensional quantum magnetism. Within the bond-operator framework, three qualitative advances are introduced which extend the theory to all finite temperatures and magnetic fields in the gapped regime. This systematic description permits quantitative and parameter-free experimental comparisons, which are presented for the specific heat, and predictions for thermal renormalization of the triplet magnon excitations.Comment: 12 pages, 10 figure