Functional determinants on certain domains

Functional determinants on various domains of the sphere and flat space are presented for scalar and spinor fields.Comment: 14p, plain TeX, talk presented at the 6th Moscow Quantum Gravity Seminar, Moscow, June 12-19, 1995.(Minor errors corrected.

Parents’ and carers’ attitudes to the use of digital technology and its role in the care of children with complex needs.

Abstract Introduction: Parent/carers of disabled children want timely and personalized support. Research suggests that technology may address some limitations associated with traditional methods of communication with therapists (e.g. letter, telephone). This exploratory study examined United Kingdom (UK) parents and carers views on the use of digital technology (i.e. computers/phones) in supporting their child and the potential for its greater use in the care of children with complex needs. Methods: An online survey was distributed via special schools and support forums/networks. Questions explored use of and attitudes to digital technology in the care of children with complex needs. Descriptive statistical analyses and content analyses were undertaken on the data. Results: Respondents were 43 parents/carers whose children used rehabilitation services prior to the COVID-19 pandemic. The majority used digital technology frequently to support their child and saw the potential for greater use in rehabilitation services – provided this was not at the expense of in-person therapist contact. Conclusion: Parents and carers held positive views of digital technology as a tool to support their child and enhance rehabilitation services. Recommendations include regular service consultation on parental/child attitudes to digital service delivery and longitudinal studies to assess related health outcomes

The C_2 heat-kernel coefficient in the presence of boundary discontinuities

We consider the heat-kernel on a manifold whose boundary is piecewise smooth. The set of independent geometrical quantities required to construct an expression for the contribution of the boundary discontinuities to the C_{2} heat-kernel coefficient is derived in the case of a scalar field with Dirichlet and Robin boundary conditions. The coefficient is then determined using conformal symmetry and evaluation on some specific manifolds. For the Robin case a perturbation technique is also developed and employed. The contributions to the smeared heat-kernel coefficient and cocycle function are calculated. Some incomplete results for spinor fields with mixed conditions are also presented.Comment: 25 pages, LaTe

Hyperspherical entanglement entropy

The coefficient of the log term in the entanglement entropy associated with hyperspherical surfaces in flat space-time is shown to equal the conformal anomaly by conformally transforming Euclideanised space--time to a sphere and using already existing formulae for the relevant heat--kernel coefficients after cyclic factoring. The analytical reason for the result is that the conformal anomaly on the lune has an extremum at the ordinary sphere limit. A proof is given. Agreement with a recent evaluation of the coefficient is found.Comment: 7 pages. Final revision. Historical comments amended. Minor remarks adde

A comparison of a structured home-based rehabilitation programme with conventional supervised pulmonary rehabilitation:A randomised non-inferiority trial

Background: Standardised home-based pulmonary rehabilitation (PR) programmes offer an alternative model to centre-based supervised PR for which uptake is currently poor. We determined if a structured home-based unsupervised PR programme was non-inferior to supervised centre-based PR for participants with COPD. Methods: A total of 287 participants with COPD who were referred to PR (187 male, mean (SD) age 68 (8.86) years, FEV1% predicted 48.34 (17.92)) were recruited. They were randomised to either centre-based PR or a structured unsupervised home-based PR programme including a hospital visit with a healthcare professional trained in motivational interviewing, a self-management manual and two telephone calls. Fifty-eight (20%) withdrew from the centre-based group and 51 (18%) from the home group. The primary outcome was dyspnoea domain in the chronic respiratory disease questionnaire (Chronic Respiratory Questionnaire Self-Report; CRQ-SR) at 7 weeks. Measures were taken blinded. We undertook a modified intention-to-treat (mITT) complete case analysis, comparing groups according to original random allocation and with complete data at follow-up. The non-inferiority margin was 0.5 units. Results: There was evidence of significant gains in CRQ-dyspnoea at 7 weeks in both home and centre-based groups. There was inconclusive evidence that home-based PR was non-inferior to PR in dyspnoea (mean group difference, mITT: −0.24, 95% CI −0.61 to 0.12, p=0.18), favouring the centre group at 7 weeks. Conclusions: The standardised home-based programme provides benefits in dyspnoea. Further evidence is needed to definitively determine if the health benefits of the standardised home-based programme are non-inferior or equivalent to supervised centre-based rehabilitation

Further functional determinants

Functional determinants for the scalar Laplacian on spherical caps and slices, flat balls, shells and generalised cylinders are evaluated in two, three and four dimensions using conformal techniques. Both Dirichlet and Robin boundary conditions are allowed for. Some effects of non-smooth boundaries are discussed; in particular the 3-hemiball and the 3-hemishell are considered. The edge and vertex contributions to the $C_{3/2}$ coefficient are examined.Comment: 25 p,JyTex,5 figs. on request

Development of a training program to support health care professionals to deliver the SPACE for COPD self-management program

Open access journalBackground: With the growing burden of COPD and associated morbidity and mortality, a need for self-management has been identified. The Self-management Programme of Activity, Coping and Education for Chronic Obstructive Pulmonary Disease (SPACE for COPD) manual was developed to support self-management in COPD patients. Currently, there is no literature available regarding health care professionals’ training needs when supporting patients with COPD on self-management. Aim: This study sought to identify these needs to inform, design and develop a training program for health care professionals being trained to deliver a self-management program in COPD. Methods: Fourteen health care professionals from both primary and secondary care COPD services participated in face-to-face semistructured interviews. Thematic analysis was used to produce a framework and identify training needs and views on delivery of the SPACE for COPD self-management program. Components of training were web-based knowledge training, with pre- and posttraining knowledge questionnaires, and a 1-day program to introduce the self-management manual. Feedback was given after training to guide the development of the training program. Results: Health care professionals were able to identify areas where they required increased knowledge to support patients. This was overwhelming in aspects of COPD seen to be outside of their current clinical role. Skills in goal setting and behavioral change were not elicited as a training need, suggesting a lack of understanding of components of supporting self-management. An increase in knowledge of COPD was demonstrated following the training program. Conclusion: Both knowledge and skill gaps existed in those who would deliver self-management. Analysis of this has enabled a training program to be designed to address these gaps and enable health care professionals to support patients in self-management. Keywords: self-management, COPD, health care professionals, trainin