Development and Evaluation of an Intervention to Support Family Caregivers of People with Cancer to Provide Home-based Care at the End of Life: a Feasibility Study

Purpose: To design and evaluate an intervention to address carers’ needs for practical information and support skills when caring for a person with cancer at end of life. Method: Phase I 29 carers were interviewed about need for practical information, support skills and their preferences for information delivery. The preferred format was a booklet. Phase 2 evaluated the booklet. 31 carers and 14 district nurses participated. Validated questionnaires: on perceptions of caregiving and carer health before and after the booklet was used and interviews with both carers and nurses were undertaken.24 carers completed both interviews. Quantitative data were coded using scale manuals and analysed using SPSSv20 and interview data was analysed thematically. Results: Carers were aged 31-82 and cared for people aged 50-92; 8 carers were male and 23 female; 20 cared for a partner, 8 for a parent and 1 for a sibling (2 undisclosed). Carers were positive about the booklet, however many carers would have liked the booklet earlier. Carers reported feeling more positive about caregiving, and more reassured and competent in their role. District nurses found the booklet useful and reported receiving fewer phone calls from study carers than others in similar situations. Conclusions: The booklet intervention was a source of reassurance to carers and it has the potential to be incorporated into everyday practice. The challenge is in when and how to distribute the booklet and more work is required on the timing of delivery in order to maximise the usefulness of booklet to carers

Development of the Carers’ Alert Thermometer (CAT) to identify family carers struggling with caring for someone dying at home: a mixed method consensus study

Background: There is an increasing international policy direction to promote home death for dying patients which will impact on the demands placed on family carers. The early identification of carer needs and appropriate intervention can help avoid crisis situations for the carer and avoidable hospital admissions which are reported to be a global concern. The aim of the study was to explore what professionals and carers of patients with cancer and advanced progressive illness, in their last year of life, find burdensome and to develop an alert system for use by non-specialist staff. Methods: A mixed-method, multi-phased, consensus study sequentially utilising qualitative and quantitative data to develop and pilot the Carers’ Alert Thermometer (CAT). 245 people (117 carers and 128 professionals) participated in the study across a range of health and social care settings in the North West of England (2011–2014). Results: A number of key domains were identified and prioritised by consensus for inclusion in the CAT. The 8 domains fit within two overarching themes of the reported carer experience; the support needed by the carer to provide care and the support needed for the carer’s own health and well-being. The resultant CAT is an evidence-based alert thermometer consisting of 10 questions, guidance on the possible actions for each alert and space for an action plan to be jointly agreed by the assessor and carer. Preliminary piloting of the CAT has shown it to be valued, fit for purpose and it can be administered by a range of personnel. Conclusions: The CAT enables the identification of current and potential future needs so a proactive approach can be taken to supporting the carer as their role develops over time, with a view to enhancing their well-being and preventing avoidable hospital admissions; ultimately supporting patient choice to remain in their own home

Quantum computation in optical lattices via global laser addressing

A scheme for globally addressing a quantum computer is presented along with its realisation in an optical lattice setup of one, two or three dimensions. The required resources are mainly those necessary for performing quantum simulations of spin systems with optical lattices, circumventing the necessity for single qubit addressing. We present the control procedures, in terms of laser manipulations, required to realise universal quantum computation. Error avoidance with the help of the quantum Zeno effect is presented and a scheme for globally addressed error correction is given. The latter does not require measurements during the computation, facilitating its experimental implementation. As an illustrative example, the pulse sequence for the factorisation of the number fifteen is given.Comment: 11 pages, 10 figures, REVTEX. Initialisation and measurement procedures are adde

The separated electric and magnetic field responses of luminescent bacteria exposed to pulsed microwave irradiation

Electromagnetic fields (EMFs) are ubiquitous in the digital world we inhabit, with microwave and millimetre wave sources of non-ionizing radiation employed extensively in electronics and communications, e.g., in mobile phones and Wi-Fi. Indeed, the advent of 5G systems and the “internet of things” is likely to lead to massive densification of wireless networks. Whilst the thermal effects of EMFs on biological systems are well characterised, their putative non-thermal effects remain a controversial subject. Here, we use the bioluminescent marine bacterium, Vibrio fischeri, to monitor the effects of pulsed microwave electromagnetic fields, of nominal frequency 2.5 GHz, on light emission. Separated electric and magnetic field effects were investigated using a resonant microwave cavity, within which the maxima of each field are separated. For pulsed electric field exposure, the bacteria gave reproducible responses and recovery in light emission. At the lowest pulsed duty cycle (1.25%) and after short durations (100 ms) of exposure to the electric field at power levels of 4.5 W rms, we observed an initial stimulation of bioluminescence, whereas successive microwave pulses became inhibitory. Much of this behaviour is due to thermal effects, as the bacterial light output is very sensitive to the local temperature. Conversely, magnetic field exposure gave no measurable short-term responses even at the highest power levels of 32 W rms. Thus, we were able to detect, de-convolute, and evaluate independently the effects of separated electric and magnetic fields on exposure of a luminescent biological system to microwave irradiation

Optimising long-term athletic development: An investigation of practitioners’ knowledge, adherence, practices and challenges

Long-term athletic development practices have been recommended for the past two decades. However, limited research exists exploring the knowledge and skills required by practitioners to optimise long-term athletic development. Therefore, this study aimed to evaluate the knowledge, adherence, practices, and challenges of practitioners responsible for delivering long-term athletic development. A mixed methods survey was completed by 236 practitioners (e.g., sport coaches, physical education teachers) consisting of four parts; 1) demographics, 2) knowledge, 3) adherence, and 4) practices and challenges. Quantitative and qualitative data were analysed by Friedman’s analysis of variance and thematic analyses, respectively. Quantitative findings showed practitioners 1) recognised their responsibility for delivering long-term athletic development, 2) have a familiarity with existing developmental models, and 3) had high adherence, focused upon health and wellbeing, to delivering long-term athletic development. However, practices associated with growth and maturity, monitoring and assessment, and the systematic progression and individualisation of training had lower adherence. Qualitative analysis indicated that practitioner’s perceived definitions of athleticism and long-term athletic development were inconsistent, especially according to the psychological components (i.e., confidence). Practitioners’ descriptions of their long-term athletic development practices identified two higher order themes; 1) goals, in which long-term athletic development “is for life” and the importance of “an individual centered journey” highlighted as sub-themes; and 2) realities of delivering long-term athletic development, whereby variety in programme delivery, monitoring development and practical challenges were noted as key priorities. Eight practical challenges were identified including governance and priorities, resources, education, early specialization, high training volumes, staff communication, parents and youth motivation. This mixed method survey highlighted a multitude of knowledge, adherence, practices and challenges towards long-term athletic development. These novel findings can help inform policy to optimise long-term athletic development and to support the complex problem of developing a healthier, fitter and more physically active youth population

Entanglement Dynamics in 1D Quantum Cellular Automata

Several proposed schemes for the physical realization of a quantum computer consist of qubits arranged in a cellular array. In the quantum circuit model of quantum computation, an often complex series of two-qubit gate operations is required between arbitrarily distant pairs of lattice qubits. An alternative model of quantum computation based on quantum cellular automata (QCA) requires only homogeneous local interactions that can be implemented in parallel. This would be a huge simplification in an actual experiment. We find some minimal physical requirements for the construction of unitary QCA in a 1 dimensional Ising spin chain and demonstrate optimal pulse sequences for information transport and entanglement distribution. We also introduce the theory of non-unitary QCA and show by example that non-unitary rules can generate environment assisted entanglement.Comment: 12 pages, 8 figures, submitted to Physical Review

Gaps in detailed knowledge of human papillomavirus (HPV) and the HPV vaccine among medical students in Scotland

<p>Background: A vaccination programme targeted against human papillomavirus (HPV) types16 and 18 was introduced in the UK in 2008, with the aim of decreasing incidence of cervical disease. Vaccine roll out to 12–13 year old girls with a catch-up programme for girls aged up to 17 years and 364 days was accompanied by a very comprehensive public health information (PHI) campaign which described the role of HPV in the development of cervical cancer.</p> <p>Methods: A brief questionnaire, designed to assess acquisition of knowledge of HPV infection and its association to cervical cancer, was administered to two different cohorts of male and female 1st year medical students (school leavers: 83% in age range 17–20) at a UK university. The study was timed so that the first survey in 2008 immediately followed a summer's intensive PHI campaign and very shortly after vaccine roll-out (150 students). The second survey was exactly one year later over which time there was a sustained PHI campaign (213 students).</p> <p>Results: We addressed three research questions: knowledge about three specific details of HPV infection that could be acquired from PHI, whether length of the PHI campaign and/or vaccination of females had any bearing on HPV knowledge, and knowledge differences between men and women regarding HPV. No female student in the 2008 cohort had completed the three-dose vaccine schedule compared to 58.4% of female students in 2009. Overall, participants’ knowledge regarding the sexually transmitted nature of HPV and its association with cervical cancer was high in both year groups. However, in both years, less than 50% of students correctly identified that HPV causes over 90% of cases of cervical cancer. Males gave fewer correct answers for these two details in 2009. In 2008 only around 50% of students recognised that the current vaccine protects against a limited subset of cervical cancer-causing HPV sub-types, although there was a significant increase in correct response among female students in the 2009 cohort compared to the 2008 cohort.</p> <p>onclusions: This study highlights a lack of understanding regarding the extent of protection against cervical cancer conferred by the HPV vaccine, even among an educated population in the UK who could have a vested interest in acquiring such knowledge. The intensive PHI campaign accompanying the first year of HPV vaccination seemed to have little effect on knowledge over time. This is one of the first studies to assess detailed knowledge of HPV in both males and females. There is scope for continued improvements to PHI regarding the link between HPV infection and cervical cancer.</p&gt

The Influence of Superpositional Wave Function Oscillations on Shor's Quantum Algorithm

We investigate the influence of superpositional wave function oscillations on the performance of Shor's quantum algorithm for factorization of integers. It is shown that the wave function oscillations can destroy the required quantum interference. This undesirable effect can be routinely eliminated using a resonant pulse implementation of quantum computation, but requires special analysis for non-resonant implementations.Comment: 4 pages, NO figures, revte

Neo-Aristotelian Naturalism and the Evolutionary Objection: Rethinking the Relevance of Empirical Science

Neo-Aristotelian metaethical naturalism is a modern attempt at naturalizing ethics using ideas from Aristotle’s teleological metaphysics. Proponents of this view argue that moral virtue in human beings is an instance of natural goodness, a kind of goodness supposedly also found in the realm of non-human living things. Many critics question whether neo-Aristotelian naturalism is tenable in light of modern evolutionary biology. Two influential lines of objection have appealed to an evolutionary understanding of human nature and natural teleology to argue against this view. In this paper, I offer a reconstruction of these two seemingly different lines of objection as raising instances of the same dilemma, giving neo-Aristotelians a choice between contradicting our considered moral judgment and abandoning metaethical naturalism. I argue that resolving the dilemma requires showing a particular kind of continuity between the norms of moral virtue and norms that are necessary for understanding non-human living things. I also argue that in order to show such a continuity, neo-Aristotelians need to revise the relationship they adopt with empirical science and acknowledge that the latter is relevant to assessing their central commitments regarding living things. Finally, I argue that to move this debate forward, both neo-Aristotelians and their critics should pay attention to recent work on the concept of organism in evolutionary and developmental biology