Investment case for two-year post university speciality training in family medicine in Tajikistan: how much is needed for continuing and scaling up the improved education of family doctors?

Background: A new two-year Post University Specialty Training (PUST) programme in family medicine was introduced to improve the quality of postgraduate speciality medical education in Tajikistan. Postgraduate education of family doctors (FDs) needs to be urgently scaled up, as 38% of FD positions in Tajikistan remained unfilled in 2018. Moreover, the international financial support for the PUST programme is ending. This investment case assesses the minimum funding needed for the continuation and scale-up of PUST and establishes the rationale for the investment in the light of a recent evaluation. Methods: The costs of the programme were calculated for 2018 and a scale-up forecast made for the period 2019-2023. The impact of the scale-up on the shortage of FDs was assessed. An evaluation using a Multiple Choice Questionnaire and Objective Structured Clinical Examination (OSCE) assessed and compared theoretical knowledge, clinical skills and competencies of PUST trained and conventionally trained FDs. Results: The annual costs of the programme were US$228,000 in 2018. The total investment needed for scaling up PUST from 31 new FDs in 2018 to 100 FD graduates each year by 2023 was US$ 802,000.However, when the retirement of FDs and population growth are considered, the scale-up will result only in maintaining the current level of FDs working and not solve the country's FD shortage. The PUST FDs demonstrated significantly better clinical skills than the conventionally trained interns, scoring 60 and 45% of OSCE points, respectively. Theoretical knowledge showed a similar trend; PUST FDs answered 44% and interns 38% of the questions correctly. Conclusions: The two-year PUST programme has clearly demonstrated it produces better skilled family doctors than the conventional one-year internship, albeit some enduring quality concerns do still prevail. The discontinuation of international support for PUST would be a major setback and risks potentially losing the benefits of the programme for family medicine and also other specialities. To guarantee the supply of adequately trained FDs and address the FD shortage, the PUST should be continued and scaled up. Therefore, it is essential that international support is extended and a gradual transition to sustainable national financing gets underway

Conformal maps from a 2-torus to the 4-sphere

We study the space of conformal immersions of a 2-torus into the 4-sphere. The moduli space of generalized Darboux transforms of such an immersed torus has the structure of a Riemann surface, the spectral curve. This Riemann surface arises as the zero locus of the determinant of a holomorphic family of Dirac type operators parameterized over the complexified dual torus. The kernel line bundle of this family over the spectral curve describes the generalized Darboux transforms of the conformally immersed torus. If the spectral curve has finite genus the kernel bundle can be extended to the compactification of the spectral curve and we obtain a linear 2-torus worth of algebraic curves in projective 3-space. The original conformal immersion of the 2-torus is recovered as the orbit under this family of the point at infinity on the spectral curve projected to the 4-sphere via the twistor fibration.Comment: 27 pages, 5 figure

Universality of Symmetry and Mixed-symmetry Collective Nuclear States

The global correlation in the observed variation with mass number of the $E2$ and summed $M1$ transition strengths is examined for rare earth nuclei. It is shown that a theory of correlated $S$ and $D$ fermion pairs with a simple pairing plus quadrupole interaction leads naturally to this universality. Thus a unified and quantitative description emerges for low-lying quadrupole and dipole strengths.Comment: In press, Phys. Rev. Lett. 199

Switchable Coupling of Vibrations to Two-Electron Carbon-Nanotube Quantum Dot States

We report transport measurements on a quantum dot in a partly suspended carbon nanotube. Electrostatic tuning allows us to modify and even switch 'on' and 'off' the coupling to the quantized stretching vibration across several charge states. The magnetic-field dependence indicates that only the two-electron spin-triplet excited state couples to the mechanical motion, indicating mechanical coupling to both the valley degree of freedom and the exchange interaction, in contrast to standard models

Thermal and electromagnetic properties of 166-Er and 167-Er

The primary gamma-ray spectra of 166-Er and 167-Er are deduced from the (3-He,alpha gamma) and (3-He,3-He' gamma) reaction, respectively, enabling a simultaneous extraction of the level density and the gamma-ray strength function. Entropy, temperature and heat capacity are deduced from the level density within the micro-canonical and the canonical ensemble, displaying signals of a phase-like transition from the pair-correlated ground state to an uncorrelated state at Tc=0.5 MeV. The gamma-ray strength function displays a bump around E-gamma=3 MeV, interpreted as the pygmy resonance.Comment: 21 pages including 2 tables and 11 figure