Talking about weight talk : primary care practitioner knowledge, attitudes and practice

Background: Primary care practitioners (PCPs) have a vital role in patient weight management. This study investigates knowledge, attitudes and practice of UK PCPs regarding patient weight management. Methods: A cross-sectional questionnaire assessed PCP perceived knowledge, self-reported practice, attitudes towards overweight/obesity and actual knowledge regarding overweight and obesity management. Practitioners from NE Scotland were invited to participate. Results: Participants comprised 107 PCPs. Most participants viewed management of overweight and obesity as core to their roles and 75% reported discussing weight with overweight/obese patients. Management techniques included discussion and advice provision. Behavioural change techniques (BCTs) were reported infrequently, despite perceptions that patients lacked motivation to lose weight. A quarter of participants reported a lack of training and a third reported inadequate skills to manage overweight/obese patients. Mean percent correct for knowledge questions was approximately 53%. Barriers to patient weight management included lack of specialists for referral and limited time. Conclusions: This study confirmed a primary care role in managing weight in overweight/obese patients. Our finding that most participants reported discussing weight with their overweight or obese patients is unsupported by previously published research, however, a more comprehensive sample of practitioners is required to scrutinize this disparity. Incongruence exists between practitioners’ perceptions of difficulties associated with patient weight loss and the tools they use to address them. Inclusion of training in BCT, the provision of weight care specialists, or referral on to commercial weight loss organizations may provide more effective pathways for PCPs to assist weight loss for overweight/obese patients in primary care.PostprintPeer reviewe

Behaviour of three charged particles on a plane under perpendicular magnetic field

We consider the problem of three identical charged particles on a plane under a perpendicular magnetic field and interacting through Coulomb repulsion. This problem is treated within Taut's framework, in the limit of vanishing center of mass vector $\vec{R} \to \vec{0}$, which corresponds to the strong magnetic field limit, occuring for example in the Fractional Quantum Hall Effect. Using the solutions of the biconfluent Heun equation, we compute the eigenstates and show that there is two sets of solutions. The first one corresponds to a system of three independent anyons which have their angular momenta fixed by the value of the magnetic field and specified by a dimensionless parameter $C \simeq \frac{l_B}{l_0}$, the ratio of $l_B$, the magnetic length, over $l_0$, the Bohr radius. This anyonic character, consistent with quantum mechanics of identical particles in two dimensions, is induced by competing physical forces. The second one corresponds to the case of the Landau problem when $C \to 0$. Finally we compare these states with the quantum Hall states and find that the Laughlin wave functions are special cases of our solutions under certains conditions.Comment: 15 pages, 3 figures, Accepeted in JP

Classical phase space and statistical mechanics of identical particles

Starting from the quantum theory of identical particles, we show how to define a classical mechanics that retains information about the quantum statistics. We consider two examples of relevance for the quantum Hall effect: identical particles in the lowest Landau level, and vortices in the Chern-Simons Ginzburg-Landau model. In both cases the resulting {\em classical} statistical mechanics is shown to be a nontrivial classical limit of Haldane's exclusion statistics.Comment: 40 pages, Late

Fractional Exclusion Statistics and Anyons

Do anyons, dynamically realized by the field theoretic Chern-Simons construction, obey fractional exclusion statistics? We find that they do if the statistical interaction between anyons and anti-anyons is taken into account. For this anyon model, we show perturbatively that the exchange statistical parameter of anyons is equal to the exclusion statistical parameter. We obtain the same result by applying the relation between the exclusion statistical parameter and the second virial coefficient in the non-relativistic limit.Comment: 9 pages, latex, IFT-498-UN

Analytic Representation of Finite Quantum Systems

A transform between functions in R and functions in Zd is used to define the analogue of number and coherent states in the context of finite d-dimensional quantum systems. The coherent states are used to define an analytic representation in terms of theta functions. All states are represented by entire functions with growth of order 2, which have exactly d zeros in each cell. The analytic function of a state is constructed from its zeros. Results about the completeness of finite sets of coherent states within a cell are derived

Remarks on the Configuration Space Approach to Spin-Statistics

The angular momentum operators for a system of two spin-zero indistinguishable particles are constructed, using Isham's Canonical Group Quantization method. This mathematically rigorous method provides a hint at the correct definition of (total) angular momentum operators, for arbitrary spin, in a system of indistinguishable particles. The connection with other configuration space approaches to spin-statistics is discussed, as well as the relevance of the obtained results in view of a possible alternative proof of the spin-statistics theorem.Comment: 18 page

Fock Representations of Quantum Fields with Generalized Statistic

We develop a rigorous framework for constructing Fock representations of quantum fields obeying generalized statistics associated with certain solutions of the spectral quantum Yang-Baxter equation. The main features of these representations are investigated. Various aspects of the underlying mathematical structure are illustrated by means of explicit examples.Comment: 26 pages, Te

Vortices on Higher Genus Surfaces

We consider the topological interactions of vortices on general surfaces. If the genus of the surface is greater than zero, the handles can carry magnetic flux. The classical state of the vortices and the handles can be described by a mapping from the fundamental group to the unbroken gauge group. The allowed configurations must satisfy a relation induced by the fundamental group. Upon quantization, the handles can carry ``Cheshire charge.'' The motion of the vortices can be described by the braid group of the surface. How the motion of the vortices affects the state is analyzed in detail.Comment: 28 pages with 10 figures; uses phyzzx and psfig; Caltech preprint CALT-68-187

Understanding health-care outcomes of older people with cognitive impairment and/or dementia admitted to hospital: a mixed-methods study

BACKGROUND: Cognitive impairment is common in older people admitted to hospital, but previous research has focused on single conditions. OBJECTIVE: This project sits in phase 0/1 of the Medical Research Council Framework for the Development and Evaluation of Complex Interventions. It aims to develop an understanding of current health-care outcomes. This will be used in the future development of a multidomain intervention for people with confusion (dementia and cognitive impairment) in general hospitals. The research was conducted from January 2015 to June 2018 and used data from people admitted between 2012 and 2013. DESIGN: For the review of outcomes, the systematic review identified peer-reviewed quantitative epidemiology measuring prevalence and associations with outcomes. Screening for duplication and relevance was followed by full-text review, quality assessment and a narrative review (141 papers). A survey sought opinion on the key outcomes for people with dementia and/or confusion and their carers in the acute hospital (n = 78). For the analysis of outcomes including cost, the prospective cohort study was in a medical admissions unit in an acute hospital in one Scottish health board covering 10% of the Scottish population. The participants (n = 6724) were older people (aged ≥ 65 years) with or without a cognitive spectrum disorder who were admitted as medical emergencies between January 2012 and December 2013 and who underwent a structured nurse assessment. ‘Cognitive spectrum disorder’ was defined as any combination of delirium, known dementia or an Abbreviated Mental Test score of < 8 out of 10 points. The main outcome measures were living at home 30 days after discharge, mortality within 2 years of admission, length of stay, re-admission within 2 years of admission and cost. DATA SOURCES: Scottish Morbidity Records 01 was linked to the Older Persons Routine Acute Assessment data set. RESULTS: In the systematic review, methodological heterogeneity, especially concerning diagnostic criteria, means that there is significant overlap in conditions of patients presenting to general hospitals with confusion. Patients and their families expect that patients are discharged in the same or a better condition than they were in on admission or, failing that, that they have a satisfactory experience of their admission. Cognitive spectrum disorders were present in more than one-third of patients aged ≥ 65 years, and in over half of those aged ≥ 85 years. Outcomes were worse in those patients with cognitive spectrum disorders than in those without: length of stay 25.0 vs. 11.8 days, 30-day mortality 13.6% vs. 9.0%, 1-year mortality 40.0% vs. 26.0%, 1-year mortality or re-admission 62.4% vs. 51.5%, respectively (all p < 0.01). There was relatively little difference by cognitive spectrum disorder type; for example, the presence of any cognitive spectrum disorder was associated with an increased mortality over the entire period of follow-up, but with different temporal patterns depending on the type of cognitive spectrum disorder. The cost of admission was higher for those with cognitive spectrum disorders, but the average daily cost was lower. LIMITATIONS: A lack of diagnosis and/or standardisation of diagnosis for dementia and/or delirium was a limitation for the systematic review, the quantitative study and the economic study. The economic study was limited to in-hospital costs as data for social or informal care costs were unavailable. The survey was conducted online, limiting its reach to older carers and those people with cognitive spectrum disorders. CONCLUSIONS: Cognitive spectrum disorders are common in older inpatients and are associated with considerably worse health-care outcomes, with significant overlap between individual cognitive spectrum disorders. This suggests the need for health-care systems to systematically identify and develop care pathways for older people with cognitive spectrum disorders, and avoid focusing on only condition-specific pathways. FUTURE WORKS: Development and evaluation of a multidomain intervention for the management of patients with cognitive spectrum disorders in hospital. STUDY REGISTRATION: This study is registered as PROSPERO CRD42015024492. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 8. See the NIHR Journals Library website for further project information