Transitions to palliative care in acute hospitals in England: qualitative study

Objective To explore how transitions to a palliative care approach are perceived to be managed in acute hospital settings in England

Experiment towards continuous-variable entanglement swapping: Highly correlated four-partite quantum state

We present a protocol for performing entanglement swapping with intense pulsed beams. In a first step, the generation of amplitude correlations between two systems that have never interacted directly is demonstrated. This is verified in direct detection with electronic modulation of the detected photocurrents. The measured correlations are better than expected from a classical reconstruction scheme. In the entanglement swapping process, a four--partite entangled state is generated. We prove experimentally that the amplitudes of the four optical modes are quantum correlated 3 dB below shot noise, which is due to the potential four--party entanglement.Comment: 9 pages, 10 figures, update of references 9 and 10; minor inconsistency in notation removed; format for units in the figures change

Pedagogy: the silent partner in early years learning

This paper sets out to look critically at the influences on pedagogy in early years education, at the ways in which it is enacted in practice and the pedagogical perspectives held by practitioners. The aim of the paper is to explore the current state of understanding and suggest areas to be included in an agenda for future research. The factors that influence practitioners’ actions are reviewed and the consensus around child-centredness and play is challenged. Findings from two studies of pedagogy in action in the early years are presented and examined in terms of socio-cultural theory and its implications for practice. The first of these studies draws attention to the varied nature of pedagogical interactions that support learning while the second looks at the experience of pedagogical innovation. The need for researchers and practitioners to find effective ways of communicating and working together is stressed throughout the paper

Strengthening field-based training in low and middle-income countries to build public health capacity: Lessons from Australia's Master of Applied Epidemiology program

BACKGROUND: The International Health Regulations (2005) and the emergence and global spread of infectious diseases have triggered a re-assessment of how rich countries should support capacity development for communicable disease control in low and medium income countries (LMIC). In LMIC, three types of public health training have been tried: the university-based model; streamed training for specialised workers; and field-based programs. The first has low rates of production and teaching may not always be based on the needs and priorities of the host country. The second model is efficient, but does not accord the workers sufficient status to enable them to impact on policy. The third has the most potential as a capacity development measure for LMIC, but in practice faces challenges which may limit its ability to promote capacity development. DISCUSSION: We describe Australia's first Master of Applied Epidemiology (MAE) model (established in 1991), which uses field-based training to strengthen the control of communicable diseases. A central attribute of this model is the way it partners and complements health department initiatives to enhance workforce skills, health system performance and the evidence-base for policies, programs and practice. SUMMARY: The MAE experience throws light on ways Australia could collaborate in regional capacity development initiatives. Key needs are a shared vision for a regional approach to integrate training with initiatives that strengthen service and research, and the pooling of human, financial and technical resources. We focus on communicable diseases, but our findings and recommendations are generalisable to other areas of public health

Leadership and the Australian Greens

This paper examines the inherent tension between a Green political party’s genesis and official ideology and the conventional forms and practices of party leadership enacted in the vast bulk of other parties, regardless of their place on the ideological spectrum. A rich picture is painted of this ongoing struggle through a case study of the Australian Greens with vivid descriptions presented on organisational leadership issues by Australian state and federal Green members of parliaments. What emerges from the data is the Australian Green MPs’ conundrum in retaining an egalitarian and participatory democracy ethos while seeking to expand their existing frame of leadership to being both more pragmatic and oriented towards active involvement in government

A High Statistics Search for Ultra-High Energy Gamma-Ray Emission from Cygnus X-3 and Hercules X-1

We have carried out a high statistics (2 Billion events) search for ultra-high energy gamma-ray emission from the X-ray binary sources Cygnus X-3 and Hercules X-1. Using data taken with the CASA-MIA detector over a five year period (1990-1995), we find no evidence for steady emission from either source at energies above 115 TeV. The derived upper limits on such emission are more than two orders of magnitude lower than earlier claimed detections. We also find no evidence for neutral particle or gamma-ray emission from either source on time scales of one day and 0.5 hr. For Cygnus X-3, there is no evidence for emission correlated with the 4.8 hr X-ray periodicity or with the occurrence of large radio flares. Unless one postulates that these sources were very active earlier and are now dormant, the limits presented here put into question the earlier results, and highlight the difficulties that possible future experiments will have in detecting gamma-ray signals at ultra-high energies.Comment: 26 LaTeX pages, 16 PostScript figures, uses psfig.sty to be published in Physical Review

New genetic loci implicated in fasting glucose homeostasis and their impact on type 2 diabetes risk.

Levels of circulating glucose are tightly regulated. To identify new loci influencing glycemic traits, we performed meta-analyses of 21 genome-wide association studies informative for fasting glucose, fasting insulin and indices of beta-cell function (HOMA-B) and insulin resistance (HOMA-IR) in up to 46,186 nondiabetic participants. Follow-up of 25 loci in up to 76,558 additional subjects identified 16 loci associated with fasting glucose and HOMA-B and two loci associated with fasting insulin and HOMA-IR. These include nine loci newly associated with fasting glucose (in or near ADCY5, MADD, ADRA2A, CRY2, FADS1, GLIS3, SLC2A2, PROX1 and C2CD4B) and one influencing fasting insulin and HOMA-IR (near IGF1). We also demonstrated association of ADCY5, PROX1, GCK, GCKR and DGKB-TMEM195 with type 2 diabetes. Within these loci, likely biological candidate genes influence signal transduction, cell proliferation, development, glucose-sensing and circadian regulation. Our results demonstrate that genetic studies of glycemic traits can identify type 2 diabetes risk loci, as well as loci containing gene variants that are associated with a modest elevation in glucose levels but are not associated with overt diabetes

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin