Using shared goal setting to improve access and equity: a mixed methods study of the Good Goals intervention

Background: Access and equity in children’s therapy services may be improved by directing clinicians’ use of resources toward specific goals that are important to patients. A practice-change intervention (titled ‘Good Goals’) was designed to achieve this. This study investigated uptake, adoption, and possible effects of that intervention in children’s occupational therapy services. Methods: Mixed methods case studies (n = 3 services, including 46 therapists and 558 children) were conducted. The intervention was delivered over 25 weeks through face-to-face training, team workbooks, and ‘tools for change’. Data were collected before, during, and after the intervention on a range of factors using interviews, a focus group, case note analysis, routine data, document analysis, and researchers’ observations. Results: Factors related to uptake and adoptions were: mode of intervention delivery, competing demands on therapists’ time, and leadership by service manager. Service managers and therapists reported that the intervention: helped therapists establish a shared rationale for clinical decisions; increased clarity in service provision; and improved interactions with families and schools. During the study period, therapists’ behaviours changed: identifying goals, odds ratio 2.4 (95% CI 1.5 to 3.8); agreeing goals, 3.5 (2.4 to 5.1); evaluating progress, 2.0 (1.1 to 3.5). Children’s LoT decreased by two months [95% CI −8 to +4 months] across the services. Cost per therapist trained ranged from £1,003 to £1,277, depending upon service size and therapists’ salary bands. Conclusions: Good Goals is a promising quality improvement intervention that can be delivered and adopted in practice and may have benefits. Further research is required to evaluate its: (i) impact on patient outcomes, effectiveness, cost-effectiveness, and (ii) transferability to other clinical contexts

Drawing bobbin lace graphs, or, Fundamental cycles for a subclass of periodic graphs

In this paper, we study a class of graph drawings that arise from bobbin lace patterns. The drawings are periodic and require a combinatorial embedding with specific properties which we outline and demonstrate can be verified in linear time. In addition, a lace graph drawing has a topological requirement: it contains a set of non-contractible directed cycles which must be homotopic to $(1,0)$, that is, when drawn on a torus, each cycle wraps once around the minor meridian axis and zero times around the major longitude axis. We provide an algorithm for finding the two fundamental cycles of a canonical rectangular schema in a supergraph that enforces this topological constraint. The polygonal schema is then used to produce a straight-line drawing of the lace graph inside a rectangular frame. We argue that such a polygonal schema always exists for combinatorial embeddings satisfying the conditions of bobbin lace patterns, and that we can therefore create a pattern, given a graph with a fixed combinatorial embedding of genus one.Comment: Appears in the Proceedings of the 25th International Symposium on Graph Drawing and Network Visualization (GD 2017

Density-and trait-mediated effects of a parasite and a predator in a tri-trophic food web

1. Despite growing interest in ecological consequences of parasitism in food webs, relatively little is known about effects of parasites on long-term population dynamics of non-host species or about whether such effects are density- or trait- mediated. 2. We studied a tri-trophic food chain comprised of: (i) a bacterial basal resource (Serratia fonticola), (ii) an intermediate consumer (Paramecium caudatum), (iii) a top predator (Didinium nasutum), and (iv) a parasite of the intermediate consumer (Holospora undulata). A fully-factorial experimental manipulation of predator and parasite presence/absence was combined with analyses of population dynamics, modelling, and analyses of host (Paramecium) morphology and behavior. 3. Predation and parasitism each reduced the abundance of the intermediate consumer (Paramecium), and parasitism indirectly reduced the abundance of the basal resource (Serratia). However, in combination, predation and parasitism had non-additive effects on the abundance of the intermediate consumer, as well as on that of the basal resource. In both cases, the negative effect of parasitism seemed to be effaced by predation. 4. Infection of the intermediate consumer reduced predator abundance. Modelling and additional experimentation revealed that this was most likely due to parasite reduction of intermediate host abundance (a density-mediated effect), as opposed to changes in predator functional or numerical response. 5. Parasitism altered morphological and behavioural traits, by reducing host cell length and increasing the swimming speed of cells with moderate parasite loads. Additional tests showed no significant difference in Didinium feeding rate on infected and uninfected hosts, suggesting that the combination of these modifications does not affect host vulnerability to predation. However, estimated rates of encounter with Serratia based on these modifications were higher for infected Paramecium than for uninfected Paramecium. 6. A mixture of density-mediated and trait-mediated indirect effects of parasitism on non- host species creates rich and complex possibilities for effects of parasites in food webs that should be included in assessments of possible impacts of parasite eradication or introduction

A Damping of the de Haas-van Alphen Oscillations in the superconducting state

Deploying a recently developed semiclassical theory of quasiparticles in the superconducting state we study the de Haas-van Alphen effect. We find that the oscillations have the same frequency as in the normal state but their amplitude is reduced. We find an analytic formulae for this damping which is due to tunnelling between semiclassical quasiparticle orbits comprising both particle-like and hole-like segments. The quantitative predictions of the theory are consistent with the available data.Comment: 7 pages, 5 figure

The GHZ/W-calculus contains rational arithmetic

Graphical calculi for representing interacting quantum systems serve a number of purposes: compositionally, intuitive graphical reasoning, and a logical underpinning for automation. The power of these calculi stems from the fact that they embody generalized symmetries of the structure of quantum operations, which, for example, stretch well beyond the Choi-Jamiolkowski isomorphism. One such calculus takes the GHZ and W states as its basic generators. Here we show that this language allows one to encode standard rational calculus, with the GHZ state as multiplication, the W state as addition, the Pauli X gate as multiplicative inversion, and the Pauli Z gate as additive inversion.Comment: In Proceedings HPC 2010, arXiv:1103.226

Quantum picturalism for topological cluster-state computing

Topological quantum computing is a way of allowing precise quantum computations to run on noisy and imperfect hardware. One implementation uses surface codes created by forming defects in a highly-entangled cluster state. Such a method of computing is a leading candidate for large-scale quantum computing. However, there has been a lack of sufficiently powerful high-level languages to describe computing in this form without resorting to single-qubit operations, which quickly become prohibitively complex as the system size increases. In this paper we apply the category-theoretic work of Abramsky and Coecke to the topological cluster-state model of quantum computing to give a high-level graphical language that enables direct translation between quantum processes and physical patterns of measurement in a computer - a "compiler language". We give the equivalence between the graphical and topological information flows, and show the applicable rewrite algebra for this computing model. We show that this gives us a native graphical language for the design and analysis of topological quantum algorithms, and finish by discussing the possibilities for automating this process on a large scale.Comment: 18 pages, 21 figures. Published in New J. Phys. special issue on topological quantum computin

A Highly Ordered Faraday-Rotation Structure in the Interstellar Medium

We describe a Faraday-rotation structure in the Interstellar Medium detected through polarimetric imaging at 1420 MHz from the Canadian Galactic Plane Survey (CGPS). The structure, at l=91.8, b=-2.5, has an extent of ~2 degree, within which polarization angle varies smoothly over a range of ~100 degree. Polarized intensity also varies smoothly, showing a central peak within an outer shell. This region is in sharp contrast to its surroundings, where low-level chaotic polarization structure occurs on arcminute scales. The Faraday-rotation structure has no counterpart in radio total intensity, and is unrelated to known objects along the line of sight, which include a Lynds Bright Nebula, LBN 416, and the star cluster M39 (NGC7092). It is interpreted as a smooth enhancement of electron density. The absence of a counterpart, either in optical emission or in total intensity, establishes a lower limit to its distance. An upper limit is determined by the strong beam depolarization in this direction. At a probable distance of 350 +/- 50 pc, the size of the object is 10 pc, the enhancement of electron density is 1.7 cm-3, and the mass of ionized gas is 23 M_sun. It has a very smooth internal magnetic field of strength 3 microG, slightly enhanced above the ambient field. G91.8-2.5 is the second such object to be discovered in the CGPS, and it seems likely that such structures are common in the Magneto-Ionic Medium.Comment: 16 pages, 5 figures, ApJ accepte

Template banks to search for compact binaries with spinning components in gravitational wave data

Gravitational waves from coalescing compact binaries are one of the most promising sources for detectors such as LIGO, Virgo and GEO600. If the components of the binary posess significant angular momentum (spin), as is likely to be the case if one component is a black hole, spin-induced precession of a binary's orbital plane causes modulation of the gravitational-wave amplitude and phase. If the templates used in a matched-filter search do not accurately model these effects then the sensitivity, and hence the detection rate, will be reduced. We investigate the ability of several search pipelines to detect gravitational waves from compact binaries with spin. We use the post-Newtonian approximation to model the inspiral phase of the signal and construct two new template banks using the phenomenological waveforms of Buonanno, Chen and Vallisneri. We compare the performance of these template banks to that of banks constructed using the stationary phase approximation to the non-spinning post-Newtonian inspiral waveform currently used by LIGO and Virgo in the search for compact binary coalescence. We find that, at the same false alarm rate, a search pipeline using phenomenological templates is no more effective than a pipeline which uses non-spinning templates. We recommend the continued use of the non-spinning stationary phase template bank until the false alarm rate associated with templates which include spin effects can be substantially reduced.Comment: 11 pages, 3 figure

A pilot study of the Mistletoe and Breast Cancer (MAB) trial:a protocol for a randomised double-blind controlled trial

BACKGROUND: A Cochrane review of mistletoe therapy concludes that there is some evidence that mistletoe extracts may offer benefits on measures of quality of life during chemotherapy for breast cancer, but these results need replication. Our aim is to add to this evidence base by initially testing the feasibility of a UK pilot placebo-controlled, double-blind randomised controlled trial of mistletoe therapy in patients with breast cancer undergoing chemotherapy with or without radiotherapy. METHODS/DESIGN: A mixed phase pilot placebo-controlled, double-blind randomised controlled trial of mistletoe therapy in patients with breast cancer (EudraCT number: 2018-000279-34). There will be three arms (groups) in the trial: Iscador M, Iscador P, with physiological saline as the placebo. The aim is to recruit 45 adult patients with a new diagnosis of early or locally advanced breast cancer, up to 12 weeks following definitive breast surgery whose standard treatment plan includes chemotherapy with or without radiotherapy. They will be taught to administer the mistletoe and breast cancer (MAB) therapies subcutaneously. MAB therapy will continue throughout their standard chemotherapy and radiotherapy and 1 month beyond. The main outcome of the MAB study is the feasibility of conducting such a trial within the NHS in order to inform a future fully powered investigative trial. Feasibility will be measured through recruitment, retention and patient experience using clinical research forms, patient diaries, cancer-related questionnaires and qualitative interviews conducted with both patients and oncology staff. DISCUSSION: This trial is the first of its kind in the UK. Currently, mistletoe therapy is mostly available through private practice in the UK. Completion of this feasibility study will support applications for further funding for a fully powered randomised controlled trial which will measure effectiveness and cost-effectiveness of this herbal therapy

Effects of the 2006 El Nino on Tropospheric Ozone and Carbon Monoxide: Implications for Dynamics and Biomass Burning

We have studied the effects of the 2006 El Nino on tropospheric O3 and CO at tropical and sub-tropical latitudes measured from the OMI and MLS instruments on the Aura satellite. The 2006 El Nino-induced drought allowed forest fires set to clear land to burn out of control during October and November in the Indonesian region. The effects of these fires are clearly seen in the enhancement of GO concentration measured from the MLS instrument. We have used a global model of atmospheric chemistry and transport (GMI CTM) to quantify the relative irrrportance of biomass burning and large scale transport: in producing observed changes in tropospheric O3 and CO . The model results show that during October and November both biomass burning and meteorological changes contributed almost equally to the observed increase in tropospheric O3 in the Indonesian region. The biomass component was 4-6 DU but it was limited to the Indonesian region where the fires were most intense, The dynamical component was 4-8 DU but it covered a much larger area in the Indian Ocean extending from South East Asia in the north to western Australia in the south. By December 2006, the effect of biomass taming was reduced to zero and the obsemed changes in tropospheric O3 were mostly due to dynamical effects. The model results show an increase of 2-3% in the global burden of tropospheric ozone. In comparison, the global burdean of CO increased by 8-12%