Spin dynamics from Majorana fermions

Using the Majorana fermion representation of spin-1/2 local moments, we show how it is possible to directly read off the dynamic spin correlation and susceptibility from the one-particle propagator of the Majorana fermion. We illustrate our method by applying it to the spin dynamics of a non-equilibrium quantum dot, computing the voltage-dependent spin relaxation rate and showing that, at weak coupling, the fluctuation-dissipation relation for the spin of a quantum dot is voltage-dependent. We confirm the voltage-dependent Curie susceptibility recently found by Parcollet and Hooley [Phys. Rev. B {\bf 66}, 085315 (2002)].Comment: Small modifications added to figure and tex

‘ … and now it’s over to you’: recognising and supporting the role of careers leaders in schools in England

There is a long history of teachers and schools being involved in the delivery of career education and guidance. As the breadth of career education and guidance activity in English schools grew throughout the twentieth century it became increasingly necessary to have an individual within the school responsible for leading and managing this activity (the careers leader). The transfer of responsibility for career guidance from local authorities to schools following the Education Act 2011 has intensified the need for this role. There have been various attempts to conceptualise and professionalise the role of careers leader and to develop appropriate training and support. This article defines the role and the rationale for the role, sets out its history and makes recommendations for the future professionalisation of the role. It is argued that this will include recognition of the role by policy, professionalisation and the development of a career structure and the development of appropriate training and CPD.N/

Health insurance coverage in low-income and middle-income countries: progress made to date and related changes in private and public health expenditure

INTRODUCTION: Several low-income and middle-income countries (LMICs) have implemented health insurance programmes to foster accessibility to healthcare and reduce catastrophic household health expenditure. However, there is little information regarding the population coverage of health insurance schemes in LMICs and on the relationship between coverage and health expenditure. This study used open-access data to assess the level of health insurance coverage in LMICs and its relationship with health expenditure. METHODS: We searched for health insurance data for all LMICs and combined this with health expenditure data. We used descriptive statistics to explore levels of and trends in health insurance coverage over time. We then used linear regression models to investigate the relationship between health insurance coverage and sources of health expenditure and catastrophic household health expenditure. RESULTS: We found health insurance data for 100 LMICs and combined this with overall health expenditure data for 99 countries and household health expenditure data for 89 countries. Mean health insurance coverage was 31.1% (range: 0%-98.7%), with wide variations across country-income groups. Average health insurance coverage was 7.9% in low-income countries, 27.3% in lower middle-income countries and 52.5% in upper middle-income countries. We did not find any association between health insurance coverage and health expenditure overall, though coverage was positively associated with public health spending. Additionally, health insurance coverage was not associated with levels of or reductions in catastrophic household health expenditure or impoverishment due to health expenditure. CONCLUSION: These findings indicate that LMICs continue to have low levels of health insurance coverage and that health insurance may not necessarily reduce household health expenditure. However, the lack of regular estimates of health insurance coverage in LMICs does not allow us to draw solid conclusions on the relationship between health insurance coverage and health expenditure

Site selective reading of epigenetic markers by a dual-mode synthetic receptor array.

Variably functionalized self-folding deep cavitands form an arrayed, fluorescent indicator displacement assay system for the detection of post-translationally modified (PTM) histone peptides. The hosts bind trimethyllysine (KMe3) groups, and use secondary upper rim interactions to provide more sensitive discrimination between targets with identical KMe3 binding handles. The sensor array uses multiple different recognition modes to distinguish between miniscule differences in target, such as identical lysine modifications at different sites of histone peptides. In addition, the sensor is affected by global changes in structure, so it is capable of discriminating between identical PTMs, at identical positions on amino acid fragments that vary only in peptide backbone length, and can be applied to detect non-methylation modifications such as acetylation and phosphorylations located multiple residues away from the targeted binding site. The synergistic application of multiple variables allows dual-mode deep cavitands to approach levels of recognition selectivity usually only seen with antibodies

Equity in health insurance schemes enrollment in low and middle-income countries: a systematic review and meta-analysis

BACKGROUND: Ensuring access to essential quality health services and reducing financial hardship for all individuals regardless of their ability to pay are the main goals of universal health coverage. Various health insurance schemes have been recently implemented in low- and middle-income countries (LMICs) to achieve both of these objectives. We systematically reviewed all available literature to assess the extent to which current health insurance schemes truly reach the poor and underserved populations in LMICs. METHODS: In the systematic review, we searched on PubMed, Web of Science, EconLit and Google Scholar to identify eligible studies which captured health insurance enrollment information in LMICs from 2010 up to September 2019. Two authors independently selected studies, extracted data, and appraised included studies. The primary outcome of interest was health insurance enrollment of the most vulnerable populations relative to enrollment of the best-off subgroups. We classified households both with respect to their highest educational attainment and their relative wealth and used random-effects meta-analysis to estimate average enrollment gaps. RESULTS: 48 studies from 17 countries met the inclusion criteria. The average enrollment rate into health insurance schemes for vulnerable populations was 36% with an inter-quartile range of 26%. On average, across countries, households from the wealthiest subgroup had 61% higher odds (95% CI: 1.49 to 1.73) of insurance enrollment than households in the poorest group in the same country. Similarly, the most educated groups had 64% (95% CI: 1.32 to 1.95) higher odds of enrollment than the least educated groups. CONCLUSION: The results of this study show that despite major efforts by governments, health insurance schemes in low-and middle-income countries are generally not reaching the targeted underserved populations and predominantly supporting better-off population groups. Current health insurance designs should be carefully scrutinized, and the extent to which health insurance can be used to support the most vulnerable populations carefully re-assessed by countries, which are aiming to use health insurance schemes as means to reach their UHC goals. Furthermore, studies exploring best practices to include vulnerable groups in health insurance schemes are needed. REGISTRATION: Not available

Nonlinear effects in the excited states of many-fermion Einstein-Dirac solitons

Funding: P. E. D. L. acknowledges funding from a St Leonards scholarship from the University of St Andrews and from UKRI under EPSRC Grant No. EP/R513337/1.We present an analysis of excited-state solutions for a gravitationally localized system consisting of a filled shell of high-angular-momentum fermions, using the Einstein-Dirac formalism introduced by Finster, Smoller, and Yau [Phys. Rev. D 59, 104020 (1999)]. We show that, even when the particle number is relatively low (Nf ≥ 6), the increased nonlinearity in the system causes a significant deviation in behavior from the two-fermion case. Excited-state solutions can no longer be uniquely identified by the value of their central redshift, with this multiplicity producing distortions in the characteristic spiraling forms of the mass-radius relations. We discuss the connection between this effect and the internal structure of solutions in the relativistic regime.Publisher PDFPeer reviewe

Fermion self-trapping in the optical geometry of Einstein-Dirac solitons

Funding: St Leonards scholarship from the University of St Andrews and from UKRI under EPSRC Grant No. EP/R513337/1 (P.E.D.L).We analyze gravitationally localized states of multiple fermions with high angular momenta, in the formalism introduced by Finster, Smoller, and Yau [Phys Rev. D 59, 104020 (1999)]. We show that the resulting solitonlike wave functions can be naturally interpreted in terms of a form of self-trapping, where the fermions become localized on shells the locations of which correspond to those of “bulges” in the optical geometry created by their own energy density.Publisher PDFPeer reviewe

Governance factors that affect the implementation of health financing reforms in Tanzania: an exploratory study of stakeholders' perspectives

The development of effective and inclusive health financing reforms is crucial for the progressive realisation of universal health coverage in low-income and middle-income countries. Tanzania has been reforming health financing policies to expand health insurance coverage and achieve better access to quality healthcare for all. Recent reforms have included improved community health funds (iCHFs), and others are underway to implement a mandatory national health insurance scheme in order to expand access to services and improve financial risk protection. Governance is a crucial structural determinant for the successful implementation of health financing reforms, however there is little understanding of the governance elements that hinder the implementation of health financing reforms such as the iCHF in Tanzania. Therefore, this study used the perspectives of health sector stakeholders to explore governance factors that influence the implementation of health financing reforms in Tanzania. We interviewed 36 stakeholders including implementers of health financing reforms, policymakers and health insurance beneficiaries in the regions of Dodoma, Dar es Salaam and Kilimanjaro. Normalisation process theory and governance elements guided the structure of the in-depth interviews and analysis. Governance factors that emerged from participants as facilitators included a shared strategic vision for a single mandatory health insurance, community engagement and collaboration with diverse stakeholders in the implementation of health financing policies and enhanced monitoring of iCHF enrolment due to digitisation of registration process. Governance factors that emerged as barriers to the implementation were a lack of transparency, limited involvement of the private sector in service delivery, weak accountability for revenues generated from community level and limited resources due to iCHF design. If stakeholders do not address the governance factors that hinder the implementation of health financing reforms, then current efforts to expand health insurance coverage are unlikely to succeed on their own

Effectiveness of guided self-help in decreasing expressed emotion in family caregivers of people diagnosed with depression in Thailand: a randomised controlled trial

Background: High expressed emotion (EE) can extend the duration of illness and precipitate relapse; however, little evidence-based information is available to assist family caregivers of individuals with depression. In the present exploratory study, we examined the effectiveness of a cognitive behaviour therapy (CBT) based guided self-help (GSH) manual in decreasing EE in caregivers of people with depression, in Thailand. Method: A parallel group randomised controlled trial was conducted, following CONSORT guidelines, with 54 caregivers who were allocated equally to GSH or control group (standard outpatient department support). In addition, both groups were contacted weekly by telephone. EE was assessed, using the Family Questionnaire (FQ), at baseline, post-test (Week 8) and follow-up (Week 12). Results: FQ scores at baseline indicated that both groups had similar, though moderately high level of EE. However, between baseline and post-test EE scores decreased markedly in the intervention group, but in contrast, they increased slightly in the control group. Between post-test and follow-up, little change took place in the EE scores of either group. Overall, the intervention group recipients of GSH showed a significant decrease in EE whereas the control group recipients of standard outpatient department support reported a slight increase in EE. Conclusion: These findings provide preliminary evidence that GSH is beneficial in reducing EE in caregivers, which is advantageous to family members with depression and caregivers. The approach may be used as an adjunct to the limited outpatient department support given to caregivers by mental health professionals and, perhaps, to caregivers who do not attend these departments