A New Symmetry for QED

We demonstrate that QED exhibits a previously unobserved symmetry. Some consequences are discussed.Comment: 9 pages, MZ-TH/93-02, DIAS-STP-93-0

How do HMOs Achieve Savings? The Effectiveness of One Organization\u27s Strategies.

To examine how a group practice used organizational strategies rather than provider-level incentives to achieve savings for health maintenance organization (HMO) compared to fee-for-service (FFS) patients. A large group practice with a group model HMO also treating FFS patients. Data sources were all patient encounter records, demographic files, and clinic records covering 3.5 years (1986-1989). The clinic\u27s procedures to record services and charges were identical for FFS and HMO patients. All FFS and HMO patients under age 65 who received any outpatient services during approximately 100,000 episodes of the seven study illnesses were eligible

Topological Field Theory and Rational Curves

We analyze the superstring propagating on a Calabi-Yau threefold. This theory naturally leads to the consideration of Witten's topological non-linear sigma-model and the structure of rational curves on the Calabi-Yau manifold. We study in detail the case of the world-sheet of the string being mapped to a multiple cover of an isolated rational curve and we show that a natural compactification of the moduli space of such a multiple cover leads to a formula in agreement with a conjecture by Candelas, de la Ossa, Green and Parkes.Comment: 20 page

Charges and fluxes in Maxwell theory on compact manifolds with boundary

We investigate the charges and fluxes that can occur in higher-order Abelian gauge theories defined on compact space-time manifolds with boundary. The boundary is necessary to supply a destination to the electric lines of force emanating from brane sources, thus allowing non-zero net electric charges, but it also introduces new types of electric and magnetic flux. The resulting structure of currents, charges, and fluxes is studied and expressed in the language of relative homology and de Rham cohomology and the corresponding abelian groups. These can be organised in terms of a pair of exact sequences related by the Poincar\'e-Lefschetz isomorphism and by a weaker flip symmetry exchanging the ends of the sequences. It is shown how all this structure is brought into play by the imposition of the appropriately generalised Maxwell's equations. The requirement that these equations be integrable restricts the world-volume of a permitted brane (assumed closed) to be homologous to a cycle on the boundary of space-time. All electric charges and magnetic fluxes are quantised and satisfy the Dirac quantisation condition. But through some boundary cycles there may be unquantised electric fluxes associated with quantised magnetic fluxes and so dyonic in nature.Comment: 28 pages, plain Te

Entropy of random coverings and 4D quantum gravity

We discuss the counting of minimal geodesic ball coverings of $n$-dimensional riemannian manifolds of bounded geometry, fixed Euler characteristic and Reidemeister torsion in a given representation of the fundamental group. This counting bears relevance to the analysis of the continuum limit of discrete models of quantum gravity. We establish the conditions under which the number of coverings grows exponentially with the volume, thus allowing for the search of a continuum limit of the corresponding discretized models. The resulting entropy estimates depend on representations of the fundamental group of the manifold through the corresponding Reidemeister torsion. We discuss the sum over inequivalent representations both in the two-dimensional and in the four-dimensional case. Explicit entropy functions as well as significant bounds on the associated critical exponents are obtained in both cases.Comment: 54 pages, latex, no figure

BRST Analysis of Physical States for 2D (Super) Gravity Coupled to (Super) Conformal Matter

We summarize some recent results on the BRST analysis of physical states of 2D gravity coupled to c<=1 conformal matter and the supersymmetric generalization.Comment: 11 page

Geometric phases in adiabatic Floquet theory, abelian gerbes and Cheon's anholonomy

We study the geometric phase phenomenon in the context of the adiabatic Floquet theory (the so-called the $(t,t')$ Floquet theory). A double integration appears in the geometric phase formula because of the presence of two time variables within the theory. We show that the geometric phases are then identified with horizontal lifts of surfaces in an abelian gerbe with connection, rather than with horizontal lifts of curves in an abelian principal bundle. This higher degree in the geometric phase gauge theory is related to the appearance of changes in the Floquet blocks at the transitions between two local charts of the parameter manifold. We present the physical example of a kicked two-level system where these changes are involved via a Cheon's anholonomy. In this context, the analogy between the usual geometric phase theory and the classical field theory also provides an analogy with the classical string theory.Comment: This new version presents a more complete geometric structure which is topologically non trivia

Molecular Detection of Invasive Species in Heterogeneous Mixtures Using a Microfluidic Carbon Nanotube Platform

Screening methods to prevent introductions of invasive species are critical for the protection of environmental and economic benefits provided by native species and uninvaded ecosystems. Coastal ecosystems worldwide remain vulnerable to damage from aquatic species introductions, particularly via ballast water discharge from ships. Because current ballast management practices are not completely effective, rapid and sensitive screening methods are needed for on-site testing of ships in transit. Here, we describe a detection technology based on a microfluidic chip containing DNA oligonucleotide functionalized carbon nanotubes. We demonstrate the efficacy of the chip using three ballast-transported species either established (Dreissena bugensis) or of potential threat (Eriocheir sinensis and Limnoperna fortuneii) to the Laurentian Great Lakes. With further refinement for on-board application, the technology could lead to real-time ballast water screening to improve ship-specific management and control decisions

Why less may be more: a mixed methods study of the work and relatedness of 'weak ties' in supporting long-term condition self-management

Background: The distribution of the roles and responsibilities of long-term condition management (LTCM) outside of formal health services implicates a wide set of relationships and activities of involvement. Yet, compared to studies of professional implementation, patient systems of implementation remain under-investigated. The aim of this paper is to explore the work, meaning and function attributed to ‘weaker’ ties relative to other more bonding relationships in order to identify the place of these within a context of systems of support for long-term conditions. Methods: This is a mixed methods survey with nested qualitative study. A total of 300 people from deprived areas in the North West of England with chronic illnesses took part in a survey conducted in 2010 to 2011. A concentric circles diagram was used as a research tool with which participants identified 2,544 network members who contributed to illness management. Notions of ‘work’ were used to describe activities associated with chronic illness and to identify how weaker ties are included and perceived to be involved through social network members (SNM) contributions. Results: The results provide an articulation of how SNMs are substantially involved in weak tie illness management. Weaker ties constituted 16.1% of network membership involved in illness work. The amount of work undertaken was similar but less than that of stronger ties. Weaker ties appeared more durable and less liable to loss over time than stronger ties. The qualitative accounts suggested that weak ties enabled the moral positioning of the self-managing ‘self’ and acted on the basis of a strong sense of reciprocity. Conclusions: Weak ties act as an acceptable bridge between a sense of personal agency and control and the need for external support because it is possible to construct a sense of moral acceptability through reciprocal exchange. Access to weak tie resources needs to be taken into account when considering the ways in which systems of health implementation for chronic illness are designed and delivered

Supporting self-management after attending a structured education programme: a qualitative longitudinal investigation of type 1 diabetes patients’ experiences and views

Background: Structured education programmes for patients with diabetes and other chronic conditions are being widely adopted. However, follow-up studies suggest that course graduates may struggle to sustain the self-care practices taught on their courses over time. This study explored the support needs of patients with type 1 diabetes after attending a structured education programme promoting an empowerment approach and training in use of flexible intensive insulin therapy, a regimen now widely advocated and used to manage this condition. The objective was to inform future support offered to course graduates. Methods: Repeat, in-depth interviews with 30 type 1 diabetes patients after attending Dose Adjustment for Normal Eating (DAFNE) courses in the UK, and six and 12 months later. Data were analysed using an inductive, thematic approach. Results: While the flexible intensive insulin treatment approach taught on DAFNE courses was seen as a logical and effective way of managing one’s diabetes, it was also considered more technically complex than other insulin regimens. To sustain effective disease self-management using flexible intensive insulin treatment over time, patients often expected, and needed, on-going input and support from health care professionals trained in the approach. This included: help determining insulin dose adjustments; reassurance; and, opportunities to trouble-shoot issues of concern. While some benefits were identified to receiving follow-up support in a group setting, most patients stated a preference or need for tailored and individualised support from appropriately-trained clinicians, accessible on an ‘as and when needed’ basis. Conclusions: Our findings highlight potential limitations to group-based forms of follow-up support for sustaining diabetes self-management. To maintain the clinical benefits of structured education for patients with type 1 diabetes over time, course graduates may benefit from and prefer ongoing, one-to-one support from health care professionals trained in the programme’s practices and principles. This support should be tailored and personalised to reflect patients’ specific and unique experiences of applying their education and training in the context of their everyday lives, and could be the subject of future research