Prevention is better than cure, but...: Preventive medication as a risk to ordinariness?

Preventive health remains at the forefront of public health concerns; recent initiatives, such as the NHS health check, may lead to recommendations for medication in response to the identification of 'at risk' individuals. Little is known about lay views of preventive medication. This paper uses the case of aspirin as a prophylactic against heart disease to explore views among people invited to screening for a trial investigating the efficacy of such an approach. Qualitative interviews (N=46) and focus groups (N=5, participants 31) revealed dilemmas about preventive medication in the form of clashes between norms: first, in general terms, assumptions about the benefit of prevention were complicated by dislike of medication; second, the individual duty to engage in prevention was complicated by the need not to be over involved with one's own health; third, the potential appeal of this alternative approach to health promotion was complicated by unease about the implications of encouraging irresponsible behaviour among others. Though respondents made different decisions about using the drug, they reported very similar ways of trying to resolve these conflicts, drawing upon concepts of necessity and legitimisation and the special ordinariness of the particular dru

Detours and Paths: BRST Complexes and Worldline Formalism

We construct detour complexes from the BRST quantization of worldline diffeomorphism invariant systems. This yields a method to efficiently extract physical quantum field theories from particle models with first class constraint algebras. As an example, we show how to obtain the Maxwell detour complex by gauging N=2 supersymmetric quantum mechanics in curved space. Then we concentrate on first class algebras belonging to a class of recently introduced orthosymplectic quantum mechanical models and give generating functions for detour complexes describing higher spins of arbitrary symmetry types. The first quantized approach facilitates quantum calculations and we employ it to compute the number of physical degrees of freedom associated to the second quantized, field theoretical actions.Comment: 1+35 pages, 1 figure; typos corrected and references added, published versio

A comparison of errorless and errorful therapies for dysgraphia after stroke.

Despite the increasing significance of written communication, there is limited research into spelling therapy for adults with acquired dysgraphia. Existing studies have typically measured spelling accuracy as an outcome, although speed may also be important for functional writing. As spelling is relatively slow, effortful and prone to errors in people with dysgraphia, minimising errors within therapy could be a factor in therapy success. This within-participant case-series study investigated whether errorless and errorful therapies would differ in their effects on spelling speed and accuracy for four participants with acquired dysgraphia. Matched sets of words were treated with errorless or errorful therapy or left untreated. Results were collated one week and five weeks after therapy. Both therapy approaches were successful in improving spelling accuracy. For three participants, equivalent gains were demonstrated following errorless and errorful therapy. One participant made significantly greater improvements in spelling accuracy following errorless therapy. The effects were maintained five weeks later. There was no significant difference in post-therapy spelling speed between the two therapy conditions. The results of this study suggest that both errorful and errorless therapies can be effective methods with which to treat spelling in adults with acquired dysgraphia

U(N|M) quantum mechanics on Kaehler manifolds

We study the extended supersymmetric quantum mechanics, with supercharges transforming in the fundamental representation of U(N|M), as realized in certain one-dimensional nonlinear sigma models with Kaehler manifolds as target space. We discuss the symmetry algebra characterizing these models and, using operatorial methods, compute the heat kernel in the limit of short propagation time. These models are relevant for studying the quantum properties of a certain class of higher spin field equations in first quantization.Comment: 21 pages, a reference adde

Maxwell-like Lagrangians for higher spins

We show how implementing invariance under divergence-free gauge transformations leads to a remarkably simple Lagrangian description of massless bosons of any spin. Our construction covers both flat and (A)dS backgrounds and extends to tensors of arbitrary mixed-symmetry type. Irreducible and traceless fields produce single-particle actions, while whenever trace constraints can be dispensed with the resulting Lagrangians display the same reducible, multi-particle spectra as those emerging from the tensionless limit of free open-string field theory. For all explored options the corresponding kinetic operators take essentially the same form as in the spin-one, Maxwell case.Comment: 77 pages, revised version. Erroneous interpretation and proof of the gauge-fixing procedure for mixed-symmetry fields corrected. As a consequence, the mixed-symmetry, one-particle Lagrangians are to be complemented with conditions on the divergences of the fields; all other conclusions unchanged. Additional minor changes including references added. To appear in JHE

Higher spin interactions with scalar matter on constant curvature spacetimes: conserved current and cubic coupling generating functions

Cubic couplings between a complex scalar field and a tower of symmetric tensor gauge fields of all ranks are investigated on any constant curvature spacetime of dimension d>2. Following Noether's method, the gauge fields interact with the scalar field via minimal coupling to the conserved currents. A symmetric conserved current, bilinear in the scalar field and containing up to r derivatives, is obtained for any rank r from its flat spacetime counterpart in dimension d+1, via a radial dimensional reduction valid precisely for the mass-square domain of unitarity in (anti) de Sitter spacetime of dimension d. The infinite collection of conserved currents and cubic vertices are summarized in a compact form by making use of generating functions and of the Weyl/Wigner quantization on constant curvature spaces.Comment: 35+1 pages, v2: two references added, typos corrected, enlarged discussions in Subsection 5.2 and in Conclusion, to appear in JHE

Patients’ Perceptions and Experiences of Familial Hypercholesterolemia, Cascade Genetic Screening and Treatment

Background: Familial hypercholesterolemia (FH) is a serious genetic disorder affecting approximately 1 in every 300 to 500 individuals and is characterised by excessively high low-density lipoprotein (LDL) cholesterol levels, substantially increased risk of early-onset coronary heart disease (CHD) and premature mortality. If FH is untreated, it leads to a greater than 50 % risk of CHD in men by the age of 50 and at least 30 % in women by the age of 60. FH can be diagnosed through genetic screening and effectively managed through pharmacological treatment and lifestyle changes. Purpose: Familial hypercholesterolemia (FH) is a genetic health condition that increases the risk of cardiovascular disease. Although FH can be effectively managed with appropriate pharmacological and dietary interventions, FH detection rate through genetic screening remains low. The present study explored perceptions and experiences of FH patients (N = 18) involved in a genetic cascade screening programme. Methods: Face-to-face interviews were conducted to assess patients’ knowledge and understanding of FH, explore factors linked to adherence to health-protective behaviours and examine perceptions of genetic screening. Results: Thematic analysis of interviews revealed four themes: disease knowledge, severity of FH, lifestyle behavioural change and barriers to cascade screening and treatment. Participants recognised FH as a permanent, genetic condition that increased their risk of CHD and premature mortality. Many participants dismissed the seriousness of FH and the importance of lifestyle changes because they perceived it to be effectively managed through medication. Despite positive attitudes toward screening, many participants reported that relatives were reluctant to attend screening due to their relatives’ ‘fatalistic’ outlook or low motivation. Participants believed that they had insufficient authority or control to persuade family members to attend screening and welcomed greater hospital assistance for contact with relatives. Conclusions: Findings support the adoption of direct methods of recruitment to cascade screening led by medical professionals, who were perceived as having greater authority. Other implications included the need for clinicians to provide clear information, particularly to those who are asymptomatic, related to the seriousness of FH and the necessity for adherence to medication and lifestyle changes

Half-integer Higher Spin Fields in (A)dS from Spinning Particle Models

We make use of O(2r+1) spinning particle models to construct linearized higher-spin curvatures in (A)dS spaces for fields of arbitrary half-integer spin propagating in a space of arbitrary (even) dimension: the field potentials, whose curvatures are computed with the present models, are spinor-tensors of mixed symmetry corresponding to Young tableaux with D/2 - 1 rows and r columns, thus reducing to totally symmetric spinor-tensors in four dimensions. The paper generalizes similar results obtained in the context of integer spins in (A)dS.Comment: 1+18 pages; minor changes in the notation, references updated. Published versio