Using Loose Coupling Theory to Understand Interprofessional Collaborative Practice on a Transplantation Team

Background: A central paradox dwells at the heart of interprofessional care: the tension between autonomy and interdependence. This report uses an ethnographic study to understand how this tension shapes collaborative practice on a distributed, interprofessional transplant team in a Canadian teaching hospital.Methods & Findings: Over four months, two trained observers conducted an ethnography through 162 observation hours, 30 field interviews and 17 formal interviews with 39 consented participants. Data collection and inductive analysis proceeded iteratively. Loose coupling theory was used as a resource to make sense of key themes. We describe the transplant team as a constellation made up of core, inter-service, and outside hospital dimensions. Next, we trace the nature of coupling activities within and across these dimensions of the team constellation, focusing on recurring communication challenges which can signal the relationship between autonomy and interdependence in collaborative acts.Conclusions: We conclude that coupling is fluid and subject to human agency, and that the tension between autonomy and interdependence can be highly productive. Team members, including patients, may negotiate and construct their relations on an autonomy/interdependence axis for strategic purposes. Far from being trapped in a paradox, team members use autonomy and interdependence as resources to achieve complex goals in collaborative settings.&nbsp

Callan-Symanzik-Lifshitz approach to generic competing systems

We present the Callan-Symanzik-Lifshitz method to approaching the critical behaviors of systems with arbitrary competing interactions. Every distinct competition subspace in the anisotropic cases define an independent set of renormalized vertex parts via normalization conditions with nonvanishing distinct masses at zero external momenta. Otherwise, only one mass scale is required in the isotropic behaviors. At the critical dimension, we prove: i) the existence of the Callan-Symanzik-Lifshitz equations and ii) the multiplicative renormalizability of the vertex functions using the inductive method. Away from the critical dimension, we utilize the orthogonal approximation to compute higher loop Feynman integrals, anisotropic as well as isotropic, necessary to get the exponents $\eta_{n}$ and $\nu_{n}$ at least up to two-loop level. Moreover, we calculate the latter exactly for isotropic behaviors at the same perturbative order. Similarly to the computation in the massless formalism, the orthogonal approximation is found to be exact at one-loop order. The outcome for all critical exponents matches exactly with those computed using the zero mass field-theoretic description renormalized at nonvanishing external momenta.Comment: 58 pages, RevTex4, no figure

Tricritical Points in the Sherrington-Kirkpatrick Model in the Presence of Discrete Random Fields

The infinite-range-interaction Ising spin glass is considered in the presence of an external random magnetic field following a trimodal (three-peak) distribution. The model is studied through the replica method and phase diagrams are obtained within the replica-symmetry approximation. It is shown that the border of the ferromagnetic phase may present first-order phase transitions, as well as tricritical points at finite temperatures. Analogous to what happens for the Ising ferromagnet under a trimodal random field, it is verified that the first-order phase transitions are directly related to the dilution in the fields (represented by $p_{0}$). The ferromagnetic boundary at zero temperature also exhibits an interesting behavior: for $0<p_{0}<p_{0}^{*} \approx 0.30856$, a single tricritical point occurs, whereas if $p_{0}>p_{0}^{*}$ the critical frontier is completely continuous; however, for $p_{0}=p_{0}^{*}$, a fourth-order critical point appears. The stability analysis of the replica-symmetric solution is performed and the regions of validity of such a solution are identified; in particular, the Almeida-Thouless line in the plane field versus temperature is shown to depend on the weight $p_{0}$.Comment: 23pages, 7 ps figure

Fanny Copeland and the geographical imagination

Raised in Scotland, married and divorced in the English south, an adopted Slovene, Fanny Copeland (1872 – 1970) occupied the intersection of a number of complex spatial and temporal conjunctures. A Slavophile, she played a part in the formation of what subsequently became the Kingdom of Yugoslavia that emerged from the First World War. Living in Ljubljana, she facilitated the first ‘foreign visit’ (in 1932) of the newly formed Le Play Society (a precursor of the Institute of British Geographers) and guided its studies of Solčava (a then ‘remote’ Alpine valley system) which, led by Dudley Stamp and commended by Halford Mackinder, were subsequently hailed as a model for regional studies elsewhere. Arrested by the Gestapo and interned in Italy during the Second World War, she eventually returned to a socialist Yugoslavia, a celebrated figure. An accomplished musician, linguist, and mountaineer, she became an authority on (and populist for) the Julian Alps and was instrumental in the establishment of the Triglav National Park. Copeland’s role as participant observer (and protagonist) enriches our understanding of the particularities of her time and place and illuminates some inter-war relationships within G/geography, inside and outside the academy, suggesting their relative autonomy in the production of geographical knowledge

Eligibility and Exclusion of Hemochromatosis Patients as Voluntary Blood Donors

BACKGROUND: Hereditary hemochromatosis patients are excluded in many countries as voluntary blood donors. In 1991, changes in the Canadian Red Cross policy allowed healthy hemochromatosis patients to become voluntary donors

CRITICAL PROPERTIES OF T. G. S. AND R. S. AS DETERMINED BY a d. c. ELECTRIC FIELD METHOD

La dépendance de la polarisation sur la température en présence d'un champ électrique statique, a été mesurée pour les diélectriques ferroélectriques de sulfate de triglycine T.G.S. et de sel de Rochelle R. S. De même le coefficient critique β a été mesuré. Les résultats sont en accord avec ceux fournis par la théorie des champs moyens, ceci pour ε = (Tc - T)/Tc ≥ 1,2 x 10-4 pour T. G. S. et ≥ 2,4 x 10-3 pour R. S. Des écarts à la théorie ont été observés pour des valeurs de ε inférieures à celles données ci-dessus.The dependence of the polarization on the temperature under the influence of a constant electric field has been measured for ferroelectric triglycine sulfate (T. G. S.) and Rochelle salt (R. S.), and the critical exponent β has been determined. The results are consistent with the prediction of the mean field theory for ε = (Tc - T)/Tc ≥ 1.2 x 10-4 in T. G. S. and ε ≥ 2.4 x 10-3 in R. S. Below these values of ε deviations from the mean field theory were observed

The role of hepatitis B immunoglobulin in hepatitis B related liver transplantation: Canadian Transplant Centre Position Paper

Introduction. Hepatitis B virus (HBV) related liver transplant (LT) recipients face a high risk of HBV reinfection in the absence of continuous post-operative HBV prophylaxis. Combination HBV prophylaxis with hepa-titis B immune globulin (HBIg) and nucleos(t)ide anti-viral agents prevents HBV recurrence in 90 to 100% of patients who undergo transplantation for hepatitis B and is considered the standard of care in Canada. Post liver transplant HBV prophylaxis protocols vary with regard to the dosing, duration and routes of HBIg administration. All Canadian transplant centres managing liver transplant patients were surveyed as to their HBV transplant protocols.Results. Results of the survey showed that the majority of the Canadian transplant centres use an oral antiviral in combination with long term or indefinite HBIg for prevention of HBV recurrence post liver transplantation. Studies were done to test new protocols using lower HBIg doses given intramuscularly or subcutaneously alone or in combination with antiviral agents.Conclusion. Long term HBIg administration post transplantation in combination with antiviral agents is an integral part of Canadian HBV related liver transplant protocol