Exponential Divergence and Long Time Relaxation in Chaotic Quantum Dynamics

Phase space representations of the dynamics of the quantal and classical cat map are used to explore quantum--classical correspondence in a K-system: as $\hbar \to 0$, the classical chaotic behavior is shown to emerge smoothly and exactly. The quantum dynamics near the classical limit displays both exponential separation of adjacent distributions and long time relaxation, two characteristic features of classical chaotic motion.Comment: 10 pages, ReVTeX, to appear in Phys. Rev. Lett. 13 figures NOT included. Available either as LARGE (uuencoded gzipped) postscript files or hard-copies from [email protected]

Who is in the transition gap? Transition from CAMHS to AMHS in the Republic of Ireland

Objective: The ITRACK study explored the process and predictors of transition between Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) in the Republic of Ireland. Method: Following ethical approval, clinicians in each of Ireland's four Health Service Executive (HSE) areas were contacted, informed about the study and invited to participate. Clinicians identified all cases who had reached the transition boundary (i.e. upper age limit for that CAMHS team ) between January and December 2010. Data were collected on clinical and socio-demographic details and factors that informed the decision to refer or not refer to AMHS and case notes were scrutinised to ascertain the extent of information exchanged between services during transition

Childhood membranoproliferative glomerulonephritis type I: Limited steroid therapy

Childhood membranoproliferative glomerulonephritis type I: Limited steroid therapy. Nineteen patients with biopsy proven membranopro liferative glomerulonephritis type I (MPGN I) and a minimum of three years of follow-up (mean 6.5 ± 0.7 years) have been treated with an uncontrolled regimen of limited corticosteroids . Initial therapy ranged from 20 mg per os (po) every other day to 30 mg/kg/day i.v. for three consecutive days, depending on clinical disease severity. Therapy was then decreased based on each patient's improving clinical status. At diagnosis creatinine clearance (Ccr) was < 80 ml/min/l .73 m2 in 12 patients and < 50 in 2. All patients had hematuria and proteinuria, with 15 in the nephrotic range. Hypertension, present at diagnosis in 13, developed in five others following institution of prednisone, and was controlled medically. Renal biopsy was repeated after two years of therapy prior to cessation of treatment (mean total treatment duration 38 ± 3 months). Follow-up biopsy revealed decreased glomerular inflamn activity in 88% of patients. All patients have now been off prednisone for 40 ± 9 months. The mean CCr is 126 ± 5 ml/min/l.73 m2. Eight patients have normal urinalyses. These data suggest that early therapy with a limited course of corticosteroids, and control of associ ated hypertension, may forestall progressive renal insufficiency in children with MPGN type I

Transitioning from child and adolescent mental health services with attention-deficit hyperactivity disorder in Ireland: case note review

Aim: In a context of international concern about early adult mental health service provision, this study identifies characteristics and service outcomes of young people with attention-deficit hyperactivity disorder (ADHD) reaching the child and adolescent mental health service (CAMHS) transition boundary in Ireland. Methods: The iTRACK study invited all 60 CAMHS teams in Ireland to participate; 8 teams retrospectively identified clinical case files for 62 eligible young people reaching the CAMHS transition boundary in all four Health Service Executive Regions. A secondary case note analysis identified characteristics, co-morbidities, referral and service outcomes for iTRACK cases with ADHD (n = 20). Results: Two-thirds of young people with ADHD were on psychotropic medication and half had mental health co-morbidities, yet none was directly transferred to public adult mental health services (AMHS) at the transition boundary. Nearly half were retained in CAMHS, for an average of over a year; most either disengaged from services (40%) and/or actively refused transfer to AMHS (35%) at or after the transition boundary. There was a perception by CAMHS clinicians that adult services did not accept ADHD cases or lacked relevant service/expertise. Conclusions: Despite high rates of medication use and comorbid mental health difficulties, there appears to be a complete absence of referral to publically available adult mental health services for ADHD youth transitioning from CAMHS in Ireland. More understanding of obstacles and optimum service configuration is essential to ensure that care is both available and accessible to young people with ADHD

Transit Timing Observations from Kepler: VII. Confirmation of 27 planets in 13 multiplanet systems via Transit Timing Variations and orbital stability

We confirm 27 planets in 13 planetary systems by showing the existence of statistically significant anti-correlated transit timing variations (TTVs), which demonstrates that the planet candidates are in the same system, and long-term dynamical stability, which places limits on the masses of the candidates---showing that they are planetary. %This overall method of planet confirmation was first applied to \kepler systems 23 through 32. All of these newly confirmed planetary systems have orbital periods that place them near first-order mean motion resonances (MMRs), including 6 systems near the 2:1 MMR, 5 near 3:2, and one each near 4:3, 5:4, and 6:5. In addition, several unconfirmed planet candidates exist in some systems (that cannot be confirmed with this method at this time). A few of these candidates would also be near first order MMRs with either the confirmed planets or with other candidates. One system of particular interest, Kepler-56 (KOI-1241), is a pair of planets orbiting a 12th magnitude, giant star with radius over three times that of the Sun and effective temperature of 4900 K---among the largest stars known to host a transiting exoplanetary system.Comment: 12 pages, 13 figures, 5 tables. Submitted to MNRA

Differences Between US and UK Adults in Stroke Preparedness: Evidence From Parallel Population-Based Community Surveys

Background and Purpose&mdash;Although time-dependent treatment is available, most people delay contacting emergency medical services for stroke. Given differences in the healthcare system and public health campaigns, exploring between-country differences in stroke preparedness may identify novel ways to increase acute stroke treatment.&nbsp; Methods&mdash;A survey was mailed to population-based samples in Ingham County, Michigan, US (n=2500), and Newcastle upon Tyne, UK (n=2500). Surveys included stroke perceptions and stroke/nonstroke scenarios to assess recognition and response to stroke. Between-country differences and associations with stroke preparedness were examined usingttests and linear mixed models.&nbsp; Results&mdash;Overall response rate was 27.4%. The mean age of participants was 55 years, and 58% were female. US participants were better in recognizing stroke (70% versus 63%, d=0.27) and were more likely to call emergency medical services (55% versus 52%, d=0.11). After controlling for demographics and comorbidities, US participants remained more likely to recognize stroke but were not more likely to respond appropriately. A greater belief that medical treatment can help with stroke and understanding of stroke was associated with improved stroke recognition and response.&nbsp; Conclusions&mdash;Overall, stroke recognition and response were moderate. US participants were modestly better at recognising stroke, although there was little difference in response to stroke. Future stroke awareness interventions could focus more on stroke outcome expectations and developing a greater understanding of stroke among the public

Antibiotic resistant Shigella is a major cause of diarrhoea in the Highlands of Papua New Guinea

Introduction: Diarrhoea remains a major cause of illness in Papua New Guinea (PNG); however, little is known about its aetiology. As a result of the cholera outbreak that spread throughout PNG in 2009-2011, we conducted diarrhoeal surveillance in Eastern Highlands Province. Methodology: Following informed consent and a brief questionnaire, participants provided a stool sample or duplicate rectal swabs. Samples were tested for common bacterial pathogens Salmonella spp., Shigella spp., Vibrio spp., Campylobacter spp. and Yersinia enterocolitica using established culture methods. Enteric parasites were detected using microscopy. Results: A total of 216 participants were enrolled; where age was recorded, 42% were under 5 years of age, 6.7% were 5 to 17 years of age and 51.3% ≥18 years of age. One or more pathogens were detected in 68 (31.5%) participants, with Shigella (primarily S. flexneri) being the most commonly isolated (47 of 216 participants). Enteric parasites were detected in 23 of the 216 participants, occurring as a co-infection with another pathogen in 12 of 23 cases. No Vibrio cholerae was detected. Shigella isolates were commonly resistant to ampicillin, tetracycline, co-trimoxazole and chloramphenicol. Conclusions: Shigellae, specifically S. flexneri, are important pathogens in the highlands of PNG. While most studies in low-income settings focus on childhood aetiology, we have demonstrated the importance of Shigella in both children and adults. Enteric parasites remain present and presumably contribute to the burden of gastrointestinal illness. While improvements in sanitation and hygiene would help lower the burden of all aetiologies of infectious diarrhoea, additional control strategies targeting Shigella may also be warranted

Exploring social identity change during mental healthcare transition

Adolescents attending Child & Adolescent Mental Health Services (CAMHS) requiring ongoing care are transferred to adult services (AMHS) at eighteen. Many young people with service needs are not being referred, or are refusing referral to AMHS. This study explored these issues from a social identity change perspective. Transcripts of interviews conducted with young people (n=11), their parents (n=5) and child (n=11) and adult (n=8) psychiatrists were thematically analysed. Transition to AMHS confirmed an ill ness identity. Young people adopting this identity saw continued service engagement as identity-congruent. Disengagement was attributed to failure to adopt an illness identity or to an emerging adult identity associated with greater independence. Fractious professional relationships hindered transition and delayed the formation of a therapeutic alliance with AMHS staff. Disengagement post-transfer was linked to incompatibility between the AMHS service remit and specific illness identities. This study demonstrates how an intersection between identities shapes service engagement and disengagement

Theology, News and Notes - Vol. 40, No. 02

Theology News & Notes was a theological journal published by Fuller Theological Seminary from 1954 through 2014.https://digitalcommons.fuller.edu/tnn/1116/thumbnail.jp