9 research outputs found
Evidence of Andreev bound states as a hallmark of the FFLO phase in -(BEDT-TTF)Cu(NCS)
Superconductivity is a quantum phenomena arising, in its simplest form, from
pairing of fermions with opposite spin into a state with zero net momentum.
Whether superconductivity can occur in fermionic systems with unequal number of
two species distinguished by spin, atomic hyperfine states, flavor, presents an
important open question in condensed matter, cold atoms, and quantum
chromodynamics, physics. In the former case the imbalance between spin-up and
spin-down electrons forming the Cooper pairs is indyced by the magnetic field.
Nearly fifty years ago Fulde, Ferrell, Larkin and Ovchinnikov (FFLO) proposed
that such imbalanced system can lead to exotic superconductivity in which pairs
acquire finite momentum. The finite pair momentum leads to spatially
inhomogeneous state consisting of of a periodic alternation of "normal" and
"superconducting" regions. Here, we report nuclear magnetic resonance (NMR)
measurements providing microscopic evidence for the existence of this new
superconducting state through the observation of spin-polarized quasiparticles
forming so-called Andreev bound states.Comment: 6 pages, 5 fig
Impact of a tailored program on the implementation of evidence-based recommendations for multimorbid patients with polypharmacy in primary care practices — results of a cluster-randomized controlled trial
Background: Multimorbid patients receiving polypharmacy represent a growing population at high risk for negative health outcomes. Tailoring is an approach of systematic intervention development taking account of previously identified determinants of practice. The aim of this study was to assess the effect of a tailored program to improve the implementation of three important processes of care for this patient group: (a) structured medication counseling including brown bag reviews, (b) the use of medication lists, and (c) structured medication reviews to reduce potentially inappropriate medication. Methods: We conducted a cluster-randomized controlled trial with a follow-up time of 9 months. Participants were general practitioners (GPs) organized in quality circles and participating in a GP-centered care contract of a German health insurance. Patients aged >50 years, suffering from at least 3 chronic diseases, receiving more than 4 drugs, and being at high risk for medication-related events according to the assessment of the treating GP were enrolled. The tailored program consisted of a workshop for GPs and health care assistants, educational materials and reminders for patients, and the elaboration of implementation action plans. The primary outcome was the change in the degree of implementation between baseline and follow-up, measured by a summary score of 10 indicators. The indicators were based on structured surveys with patients and GPs. Results: We analyzed the data of 21 GPs (10 - intervention group, 11 - control group) and 273 patients (130 - intervention group, 143 - control group). The increase in the degree of implementation was 4.2 percentage points (95% confidence interval: −0.3, 8.6) higher in the intervention group compared to the control group (p = 0.1). Two of the 10 indicators were significantly improved in the intervention group: medication counseling (p = 0.017) and brown bag review (p = 0.012). Secondary outcomes showed an effect on patients’ self-reported use of medication lists when buying drugs in the pharmacy (p = 0.03). Conclusions: The tailored program may improve implementation of medication counseling and brown bag review whereas the use of medication lists and medication reviews did not improve. No effect of the tailored program on the combined primary outcome could be substantiated. Due to limitations of the study, results have to be interpreted carefully. The factors facilitating and hindering successful implementation will be examined in a comprehensive process evaluation. Trial registration number ISRCTN34664024, assigned 14/08/201