Theory-based communication skills training for medicine counter assistants to improve consultations for non-prescription medicines

Context: Medicine counter assistants (MCAs) supply the majority of non-prescription medicines (NPMs) to consumers. Suboptimal communication during consultations between consumers and MCAs has been identified as a major cause of inappropriate supply. Evidence from medical consultations suggests that training in specified communication skills can change professional behaviour. Methods: A feasibility study was conducted to evaluate the effect of theory-based communication skills training for MCAs. Thirty MCAs were recruited from 21 community pharmacies in Grampian, Scotland. The intervention comprised 2 4-hour training sessions, held 1 month apart. The sessions were informed by results from previous studies and the Calgary−Cambridge evidence-based model of communication skills training. Strategies for guiding individuals through change were adopted from cognitive behavioural therapy techniques. The theory of planned behaviour was used to assess potential pathways to behaviour change. Recorded data were collected during covert visits to the pharmacies by simulated patients at baseline and 1 month after each training session. Communication performance was measured as the number and type of questions asked. Results: Compared with baseline measures, the total number of questions asked increased in the intervention group at both timepoints. No change was shown in the control group between baseline and follow-up 1, and a decrease was shown in the total number of questions from follow-up 1 to 2. The intervention appeared to have greater effect on consultations involving advice, compared with those concerning product requests. Discussion: Communication performance improved following training. Increased information exchange is associated with guideline-compliant supply of NPMs. A substantive randomised, controlled trial is now planned to assess the intervention.This study was funded by the Chief Scientist Office, Scottish Executive Health Department

Response of discrete nonlinear systems with many degrees of freedom

We study the response of a large array of coupled nonlinear oscillators to parametric excitation, motivated by the growing interest in the nonlinear dynamics of microelectromechanical and nanoelectromechanical systems (MEMS and NEMS). Using a multiscale analysis, we derive an amplitude equation that captures the slow dynamics of the coupled oscillators just above the onset of parametric oscillations. The amplitude equation that we derive here from first principles exhibits a wavenumber dependent bifurcation similar in character to the behavior known to exist in fluids undergoing the Faraday wave instability. We confirm this behavior numerically and make suggestions for testing it experimentally with MEMS and NEMS resonators.Comment: Version 2 is an expanded version of the article, containing detailed steps of the derivation that were left out in version 1, but no additional result

Nonlinear response of a driven vibrating nanobeam in the quantum regime

We analytically investigate the nonlinear response of a damped doubly clamped nanomechanical beam under static longitudinal compression which is excited to transverse vibrations. Starting from a continuous elasticity model for the beam, we consider the dynamics of the beam close to the Euler buckling instability. There, the fundamental transverse mode dominates and a quantum mechanical time-dependent effective single particle Hamiltonian for its amplitude can be derived. In addition, we include the influence of a dissipative Ohmic or super-Ohmic environment. In the rotating frame, a Markovian master equation is derived which includes also the effect of the time-dependent driving in a non-trivial way. The quasienergies of the pure system show multiple avoided level crossings corresponding to multiphonon transitions in the resonator. Around the resonances, the master equation is solved analytically using Van Vleck perturbation theory. Their lineshapes are calculated resulting in simple expressions. We find the general solution for the multiple multiphonon resonances and, most interestingly, a bath-induced transition from a resonant to an antiresonant behavior of the nonlinear response.Comment: 25 pages, 5 figures, submitted to NJ

Microwave Dielectric Loss at Single Photon Energies and milliKelvin Temperatures

The microwave performance of amorphous dielectric materials at very low temperatures and very low excitation strengths displays significant excess loss. Here, we present the loss tangents of some common amorphous and crystalline dielectrics, measured at low temperatures (T < 100 mK) with near single-photon excitation energies, using both coplanar waveguide (CPW) and lumped LC resonators. The loss can be understood using a two-level state (TLS) defect model. A circuit analysis of the half-wavelength resonators we used is outlined, and the energy dissipation of such a resonator on a multilayered dielectric substrate is considered theoretically.Comment: 4 pages, 3 figures, submitted to Applied Physics Letter

Spin dynamics in InAs-nanowire quantum-dots coupled to a transmission line

We study theoretically electron spins in nanowire quantum dots placed inside a transmission line resonator. Because of the spin-orbit interaction, the spins couple to the electric component of the resonator electromagnetic field and enable coherent manipulation, storage, and read-out of quantum information in an all-electrical fashion. Coupling between distant quantum-dot spins, in one and the same or different nanowires, can be efficiently performed via the resonator mode either in real time or through virtual processes. For the latter case we derive an effective spin-entangling interaction and suggest means to turn it on and off. We consider both transverse and longitudinal types of nanowire quantum-dots and compare their manipulation timescales against the spin relaxation times. For this, we evaluate the rates for spin relaxation induced by the nanowire vibrations (phonons) and show that, as a result of phonon confinement in the nanowire, this rate is a strongly varying function of the spin operation frequency and thus can be drastically reduced compared to lateral quantum dots in GaAs. Our scheme is a step forward to the formation of hybrid structures where qubits of different nature can be integrated in a single device

State tomography of capacitively shunted phase qubits with high fidelity

We introduce a new design concept for superconducting quantum bits (qubits) in which we explicitly separate the capacitive element from the Josephson tunnel junction for improved qubit performance. The number of two-level systems (TLS) that couple to the qubit is thereby reduced by an order of magnitude and the measurement fidelity improves to 90%. This improved design enables the first demonstration of quantum state tomography with superconducting qubits using single shot measurements.Comment: submitted to PR

Sexual behaviour in the face of risk : preliminary results from first AIDS-related surveys

Preliminary results are presented from nationally representative surveys of the adult populations of five African countries, conducted in 1989 and 1990. General awareness of AIDS was high, as was knowledge of sexual transmission. In four of the five surveys, large proportions, from 25 to 64 per cent, of both men and women perceived themselves to have a high or moderate risk of HIV infection. High proportions also reported that they had modified their behaviour typically by more care in selecting partners or greater faithfulness. Greater use of condoms was mentioned rarely. The results, particularly on behavioural change, should not be interpreted literally. But the fact that so many report modification of behaviour at least suggests a willingness to contemplate the need for change. The prognosis would have been much worse, had these surveys indicated widespread denial of risk and unwillingness to consider changes in behaviour

Aseptic fluid transfer system

A method and means is provided, which permits the transfer of fluids between separate detached containers, in a manner which preserves the sterility of the fluids during and after their transfer

Transformed Dissipation in Superconducting Quantum Circuits

Superconducting quantum circuits must be designed carefully to avoid dissipation from coupling to external control circuitry. Here we introduce the concept of current transformation to quantify coupling to the environment. We test this theory with an experimentally-determined impedance transformation of $\sim 10^5$ and find quantitative agreement better than a factor of 2 between this transformation and the reduced lifetime of a phase qubit coupled to a tunable transformer. Higher-order corrections from quantum fluctuations are also calculated with this theory, but found not to limit the qubit lifetime. We also illustrate how this simple connection between current and impedance transformation can be used to rule out dissipation sources in experimental qubit systems.Comment: 4 pages, 4 figure

Strong feedback and current noise in nanoelectromechanical systems

We demonstrate the feasibility of a strong feedback regime for a single-electron tunneling device weakly coupled to an underdamped single-mode oscillator. In this regime, mechanical oscillations are generated and the current is strongly modified whereas the current noise is parametrically big with respect to the Poisson value. This regime requires energy dependence of the tunnel amplitudes. For sufficiently fast tunnel rates the mechanical contribution to current noise can exceed the Poisson value even beyond the strong feedback regime.Comment: 4 pages, 3 figure