Contemporary splinting practice in the UK for adults with neurological dysfunction: A cross-sectional survey

This article is made available through the Brunel Open Access Publishing Fund.Aim: To explore the contemporary splinting practice of UK occupational therapists and physiotherapists for adults with neurological dysfunction. Method: Cross-sectional online survey of members of the Association of Chartered Physiotherapists in Neurology and College of Occupational Therapists Specialist Section Neurological Practice. Results: Four hundred and twenty therapists completed the survey. Contracture management is the most common rationale for therapists splinting adults with neurological dysfunction. Other shared therapeutic goals of splinting include maintaining muscle and joint alignment, spasticity management, function, pain management and control of oedema. Considerable clinical uncertainty was uncovered in practice particularly around wearing regimens of splints. Most therapists have access to locally-derived splinting guidelines, which may contribute to this diversity of practice. Conclusions: This study provides a unique insight into aspects of contemporary splinting practice among UK therapists, who belong to a specialist neurological professional network and work in a number of different health-care settings with adults who have a neurological condition. Study findings show a wide variation in splinting practice, thereby indicating a potential need for national guidance to assist therapists in this area of clinical uncertainty. Further research is required to establish best practice parameters for splinting in neurological rehabilitation

Comparing proxy rated quality of life of people living with dementia in care homes

Background: Improving quality of life (QOL) for people with dementia is a priority. In care homes, we often rely on proxy ratings from staff and family but we do not know if, or how, they differ in care homes. Methods: We compared 1056 pairs of staff and family DEMQOL-Proxy ratings from 86 care homes across England. We explored factors associated with ratings quantitatively using multilevel modelling and, qualitatively, through thematic analysis of 12 staff and 12 relative interviews. Results: Staff and family ratings were weakly correlated (ρs = 0.35). Median staff scores were higher than family's (104 v. 101; p < 0.001). Family were more likely than staff to rate resident QOL as ‘Poor’ (χ2 = 55.91, p < 0.001). Staff and family rated QOL higher when residents had fewer neuropsychiatric symptoms and severe dementia. Staff rated QOL higher in homes with lower staff:resident ratios and when staff were native English speakers. Family rated QOL higher when the resident had spent longer living in the care home and was a native English. Spouses rated residents’ QOL higher than other relatives. Qualitative results suggest differences arise because staff felt good care provided high QOL but families compared the present to the past. Family judgements centre on loss and are complicated by decisions about care home placement and their understandings of dementia. Conclusion: Proxy reports differ systematically between staff and family. Reports are influenced by the rater:staff and family may conceptualise QOL differently

BCS pairing in Fermi systems with several flavors

Motivated by the prospect of Bardeen-Cooper-Schrieffer (BCS) pairing in cold fermionic gases we analyze the superfluid phase of 3 fermionic flavors in the attractive Hubbard model. We show that there are several low--lying collective pairing modes and investigate their damping due to the partially gapless nature of the single-particle spectrum. Furthermore we analyze how these modes show up in the density response of the system. Apart from the Anderson-Bogoliubov phase mode of the pairing between two flavors, the dynamical structure factor contains signatures of the gapless third flavor. This picture is found to be robust against perturbations that break the global SU(3)-symmetry of the Hamiltonian.Comment: 13 pages, 6 figure

Polarisation Observations of H2_{2}O JK−1K1=532−441J_{K_{-1}K_{1}} = 5_{32} - 4_{41} 620.701 GHz Maser Emission with Herschel/HIFI in Orion KL

Context. The high intensities and narrow bandwidths exhibited by some astronomical masers make them ideal tools for studying star-forming giant molecular clouds. The water maser transition $J_{K_{-1}K_{1}}=5_{32}-4_{41}$ at 620.701 GHz can only be observed from above Earth's strongly absorbing atmosphere; its emission has recently been detected from space. Aims. We sought to further characterize the star-forming environment of Orion KL by investigating the linear polarisation of a source emitting a narrow 620.701 GHz maser feature with the heterodyne spectrometer HIFI on board the Herschel Space Observatory. Methods. High-resolution spectral datasets were collected over a thirteen month period beginning in 2011 March, to establish not only the linear polarisation but also the temporal variability of the source. Results. Within a $3\sigma$ uncertainty, no polarisation was detected to an upper limit of approximately 2%. These results are compared with coeval linear polarisation measurements of the 22.235 GHz $J_{K_{-1}K_{1}}=6_{16}-5_{23}$ maser line from the Effelsberg 100-m radio telescope, typically a much stronger maser transition. Although strongly polarised emission is observed for one component of the 22.235 GHz maser at 7.2 km s$^{-1}$, a weaker component at the same velocity as the 620.701 GHz maser at 11.7 km s$^{-1}$ is much less polarised.Comment: Accepted for publication in A&

SU(N) quantum spin models: A variational wavefunction study

The study of SU(N) quantum spin models is relevant to a variety of physical systems including ultracold atoms in optical lattices, and also leads to insights into novel quantum phases and phase transitions of SU(2) spin models. We use Gutzwiller projected fermionic variational wavefunctions to explore the phase diagram and correlation functions of SU(N) spin models in the self-conjugate representation, with Heisenberg bilinear and biquadratic interactions. In 1D, the variational phase diagram of the SU(4) spin chain is constructed by examining instabilities of the Gutzwiller projected free fermion ground state to various broken symmetries, and it agrees well with exact results.The spin and dimer correlations of the Gutzwiller projected free fermion state with N flavors of fermions are also in good agreement with exact and 1/N calculations for the critical points of SU(N) spin chains. In 2D, the variational phase diagram on the square lattice is obtained by studying instabilities of the Gutzwiller projected pi-flux state. The variational ground state of the pure Heisenberg model is found to exhibit long range Neel order for N=2,4 and spin Peierls order for N > 4. For N=4 and 6, biquadratic interactions lead to a complex phase diagram which includes an extended valence bond crystal in both cases, as well as a stable pi-flux phase for N=6. The spin correlations of the projected pi-flux state at N=4 are in good agreement with 1/N calculations. We find that this state also shows strongly enhanced dimer correlations, in qualitative accord with the large-N results. We compare our results with a recent QMC study of the SU(4) Heisenberg model.Comment: 22 pages, 7 figs, added references to arxiv versio

Serologic response to culture filtrate antigens of Mycobacterium ulcerans during Buruli ulcer disease.

Buruli ulcer (BU) is an emerging necrotic skin disease caused by Mycobacterium ulcerans. To assess the potential for a serodiagnostic test, we measured the humoral immune response of BU patients to M. ulcerans antigens and compared this response with delayed-type hypersensitivity responses to both Burulin and PPD. The delayed-type hypersensitivity response generally supported the diagnosis of BU, with overall reactivity to Burulin in 28 (71.8%) of 39 patients tested, compared with 3 (14%) of 21 healthy controls. However, this positive skin test response was observed primarily in patients with healed or active disease, and rarely in patients with early disease (p=0.009). When tested for a serologic response to M. ulcerans culture filtrate, 43 (70.5%) of 61 BU patients had antibodies to these antigens, compared with 10 (37.0%) of 27 controls and 4 (30. 8%) of 13 tuberculosis patients. There was no correlation between disease stage and the onset of this serum antibody response. Our findings suggest that serologic testing may be useful in the diagnosis and surveillance of BU

Survey of patient and public perceptions of electronic health records for healthcare, policy and research: Study protocol

BACKGROUND: Immediate access to patients’ complete health records via electronic databases could improve healthcare and facilitate health research. However, the possible benefits of a national electronic health records (EHR) system must be balanced against public concerns about data security and personal privacy. Successful development of EHR requires better understanding of the views of the public and those most affected by EHR: users of the National Health Service. This study aims to explore the correlation between personal healthcare experience (including number of healthcare contacts and number and type of longer term conditions) and views relating to development of EHR for healthcare, health services planning and policy and health research. METHODS/DESIGN: A multi-site cross-sectional self-complete questionnaire designed and piloted for use in waiting rooms was administered to patients from randomly selected outpatients’ clinics at a university teaching hospital (431 beds) and general practice surgeries from the four primary care trusts within the catchment area of the hospital. All patients entering the selected outpatients clinics and general practice surgeries were invited to take part in the survey during August-September 2011. Statistical analyses will be conducted using descriptive techniques to present respondents’ overall views about electronic health records and logistic regression to explore associations between these views and participants’ personal circumstances, experiences, sociodemographics and more specific views about electronic health records. DISCUSSION: The study design and implementation were successful, resulting in unusually high response rates and overall recruitment (85.5%, 5336 responses). Rates for face-to-face recruitment in previous work are variable, but typically lower (mean 76.7%, SD 20). We discuss details of how we collected the data to provide insight into how we obtained this unusually high response rate

Low-energy sector of the S=1/2 Kagome antiferromagnet

Starting from a modified version of the the S=1/2 Kagome antiferromagnet to emphasize the role of elementary triangles, an effective Hamiltonian involving spin and chirality variables is derived. A mean-field decoupling that retains the quantum nature of these variables is shown to yield a Hamiltonian that can be solved exactly, leading to the following predictions: i) The number of low lying singlet states increase with the number of sites N like 1.15 to the power N; ii) A singlet-triplet gap remains in the thermodynamic limit; iii) Spinons form boundstates with a small binding energy. By comparing these properties with those of the regular Kagome lattice as revealed by numerical experiments, we argue that this description captures the essential low energy physics of that model.Comment: 4 pages including 3 figure