Treatment resistant depression in primary care: Co-constructing difficult encounters

Many patients with depression do not recover despite medication or therapy. Individuals with treatment resistant depression often have co-morbid anxiety, personality difficulties and drug or alcohol misuse and have been characterised as difficult, heartsink or problem personalities by general practitioners. Yet critical studies of interaction in medical settings suggest that the context may have a role in constructing the patient. A total of 12 audio-recorded routine consultations were analysed following guidelines for qualitative analysis of medical discourse. The interpretation focused on ways in which the context and structure of primary care consultations in a UK setting construct difficult encounters, which may lead to patients with treatment resistant depression being seen as difficult to manage in various ways. Three overarching observations were that presentation of multiple problems in multiple domains clash with the consultation format; that patients? atypically high level of activity in a time-limited setting prevents patient-centred work; that the question and answer format restricts multifaceted discussions of social and emotional problems, preventing shared understandings emerging. However, although interactions appear uneasy, they are repaired and may be moderately palliative. Suggestions are made for re-orienting general practitioner work with treatment resistant depression towards long-term goal setting outside of the traditional consultation structure in order to develop shared understandings

Feynman graph polynomials

The integrand of any multi-loop integral is characterised after Feynman parametrisation by two polynomials. In this review we summarise the properties of these polynomials. Topics covered in this article include among others: Spanning trees and spanning forests, the all-minors matrix-tree theorem, recursion relations due to contraction and deletion of edges, Dodgson's identity and matroids.Comment: 35 pages, references adde

Micro-cooler Enhancements by Barrier Interface Analysis

Peer reviewedPublisher PD

Impact ionisation electroluminescence in planar GaAs-based heterostructure Gunn diodes:Spatial distribution and impact of doping nonuniformities

When biased in the negative differential resistance regime, electroluminescence (EL) is emitted from planar GaAs heterostructure Gunn diodes. This EL is due to the recombination of electrons in the device channel with holes that are generated by impact ionisation when the Gunn domains reach the anode edge. The EL forms non-uniform patterns whose intensity shows short-range intensity variations in the direction parallel to the contacts and decreases along the device channel towards the cathode. This paper employs Monte Carlo models, in conjunction with the experimental data, to analyse these non-uniform EL patterns and to study the carrier dynamics responsible for them. It is found that the short-range lateral (i.e., parallel to the device contacts) EL patterns are probably due to non-uniformities in the doping of the anode contact, illustrating the usefulness of EL analysis on the detection of such inhomogeneities. The overall decreasing EL intensity towards the anode is also discussed in terms of the interaction of holes with the time-dependent electric field due to the transit of the Gunn domains. Due to their lower relative mobility and the low electric field outside of the Gunn domain, freshly generated holes remain close to the anode until the arrival of a new domain accelerates them towards the cathode. When the average over the transit of several Gunn domains is considered, this results in a higher hole density, and hence a higher EL intensity, next to the anode

Spectroscopic imaging of single atoms within a bulk solid

The ability to localize, identify and measure the electronic environment of individual atoms will provide fundamental insights into many issues in materials science, physics and nanotechnology. We demonstrate, using an aberration-corrected scanning transmission microscope, the spectroscopic imaging of single La atoms inside CaTiO3. Dynamical simulations confirm that the spectroscopic information is spatially confined around the scattering atom. Furthermore we show how the depth of the atom within the crystal may be estimated.Comment: 4 pages and 3 figures. Accepted in Phys.Rev.Let

Observational constraints on Cosmic Reionization

Recent observations have set the first constraints on the epoch of reionization (EoR), corresponding to the formation epoch of the first luminous objects. Studies of Gunn-Peterson (GP) absorption, and related phenomena, suggest a qualitative change in the state of the intergalactic medium (IGM) at $z \sim 6$, indicating a rapid increase in the neutral fraction of the IGM, from $x_{HI} 10^{-3}$, perhaps up to 0.1, at $z \ge 6$. Conversely, transmission spikes in the GP trough, and the evolution of the \lya galaxy luminosity function indicate $x_{HI} < 0.5$ at $z\sim 6.5$, while the large scale polarization of the cosmic microwave background (CMB) implies a significant ionization fraction extending to higher redshifts, $z \sim 11 \pm 3$. The results suggest that reionization is less an event than a process, with the process beginning as early as $z \sim 14$, and with the 'percolation', or 'overlap' phase ending at $z \sim 6$. The data are consistent with low luminosity star forming galaxies as being the dominant sources of reionizing photons. Low frequency radio telescopes currently under construction should be able to make the first direct measurements of HI 21cm emission from the neutral IGM during the EoR, and upcoming measurements of secondary CMB temperature anisotropy will provide fine details of the dynamics of the reionized IGM.Comment: to appear in ARAA 2006, vol 44, page 415-462; latex. 84 pages. 15 fi

Self-avoiding walks crossing a square

We study a restricted class of self-avoiding walks (SAW) which start at the origin (0, 0), end at $(L, L)$, and are entirely contained in the square $[0, L] \times [0, L]$ on the square lattice ${\mathbb Z}^2$. The number of distinct walks is known to grow as $\lambda^{L^2+o(L^2)}$. We estimate $\lambda = 1.744550 \pm 0.000005$ as well as obtaining strict upper and lower bounds, $1.628 < \lambda < 1.782.$ We give exact results for the number of SAW of length $2L + 2K$ for $K = 0, 1, 2$ and asymptotic results for $K = o(L^{1/3})$. We also consider the model in which a weight or {\em fugacity} $x$ is associated with each step of the walk. This gives rise to a canonical model of a phase transition. For $x < 1/\mu$ the average length of a SAW grows as $L$, while for $x > 1/\mu$ it grows as $L^2$. Here $\mu$ is the growth constant of unconstrained SAW in ${\mathbb Z}^2$. For $x = 1/\mu$ we provide numerical evidence, but no proof, that the average walk length grows as $L^{4/3}$. We also consider Hamiltonian walks under the same restriction. They are known to grow as $\tau^{L^2+o(L^2)}$ on the same $L \times L$ lattice. We give precise estimates for $\tau$ as well as upper and lower bounds, and prove that $\tau < \lambda.$Comment: 27 pages, 9 figures. Paper updated and reorganised following refereein

Suppression of Octahedral Tilts and Associated Changes of Electronic Properties at Epitaxial Oxide Heterostructure Interfaces

Epitaxial oxide interfaces with broken translational symmetry have emerged as a central paradigm behind the novel behaviors of oxide superlattices. Here, we use scanning transmission electron microscopy to demonstrate a direct, quantitative unit-cell-by-unit-cell mapping of lattice parameters and oxygen octahedral rotations across the BiFeO3-La0.7Sr0.3MnO3 interface to elucidate how the change of crystal symmetry is accommodated. Combined with low-loss electron energy loss spectroscopy imaging, we demonstrate a mesoscopic antiferrodistortive phase transition and elucidate associated changes in electronic properties in a thin layer directly adjacent to the interface

Terahertz oscillations in an In_0.53Ga_0.47As submicron planar gunn diode

The length of the transit region of a Gunn diode determines the natural frequency at which it operates in fundamental mode – the shorter the device, the higher the frequency of operation. The long-held view on Gunn diode design is that for a functioning device the minimum length of the transit region is about 1.5μm, limiting the devices to fundamental mode operation at frequencies of roughly 60 GHz. Study of these devices by more advanced Monte Carlo techniques that simulate the ballistic transport and electron-phonon interactions that govern device behaviour, offers a new lower bound of 0.5μm, which is already being approached by the experimental evidence that has shown planar and vertical devices exhibiting Gunn operation at 600nm and 700nm, respectively. The paper presents results of the first ever THz submicron planar Gunn diode fabricated in In&lt;sub&gt;0.53&lt;/sub&gt;Ga&lt;sub&gt;0.47&lt;/sub&gt;A on an InP substrate, operating at a fundamental frequency above 300 GHz. Experimentally measured rf power of 28 µW was obtained from a 600 nm long ×120 µm wide device. At this new length, operation in fundamental mode at much higher frequencies becomes possible – the Monte Carlo model used predicts power output at frequencies over 300 GHz