Lagrangian multiform structure for the lattice Gel'fand-Dikii hierarchy

The lattice Gel'fand-Dikii hierarchy was introduced by Nijhoff, Papageorgiou, Capel and Quispel in 1992 as the family of partial difference equations generalizing to higher rank the lattice Korteweg-de Vries systems, and includes in particular the lattice Boussinesq system. We present a Lagrangian for the generic member of the lattice Gel'fand-Dikii hierarchy, and show that it can be considered as a Lagrangian 2-form when embedded in a higher dimensional lattice, obeying a closure relation. Thus the multiform structure proposed in arXiv:0903.4086v2 [nlin.SI] is extended to a multi-component system.Comment: 12 page

Identifying systems barriers that may prevent bereavement service access to bereaved carers: A report from an Australian specialist palliative care service

Background: Bereavement follow up is an integral element of palliative care. However, little is known about the systems that link bereavement services with bereaved carers. Aim: To map how effectively a specialist palliative care service linked bereavement service to bereaved carers. Methodology: A retrospective medical audit, using process mapping was undertaken within one Australian specialist palliative care service to identify the systems that linked bereavement services to a consecutive cohort of palliative care decedents (n=60) next of kin. Results: Bereavement records were located for 80% of decedents. Nearly all (98%) had a nominated next of kin, with just over half (54%) of those nominated contacted by bereavement services. Incomplete or missing contact details was the main reason (75%) that the bereavement service was unable to contact the decedents’ next of kin. Conclusion: Having access to a designated bereavement service can ensure that bereaved next of kin are contract routinely and in a timely way. However the effectiveness of this type of service is dependent upon the bereavement service having access to all relevant contact information. There are numerous opportunities to refine and strengthen the recording of palliative care next of kin details to optimize follow up

The VOICE Study: Valuing Opinions, Individual Communication and Experience: Building the evidence base for undertaking patient-centred family meetings in palliative care - a mixed methods study

Background: Despite family meetings being widely used to facilitate discussion among patients, families, and clinicians in palliative care, there is limited evidence to support their use. This study aims to assess the acceptability and feasibility of Patient-Centred Family Meetings in specialist inpatient palliative care units for patients, families, and clinicians and determine the suitability and feasibility of validated outcome measures from the patient and family perspectives. Methods: The study is a mixed-methods quasi-experimental design with pre-planned Patient-Centred Family Meetings at the intervention site. The patient will set the meeting agenda a priori allowing an opportunity for their issues to be prioritised and addressed. At the control site, usual care will be maintained which may include a family meeting. Each site will recruit 20 dyads comprising a terminally ill inpatient and their nominated family member. Pre- and post-test administration of the Distress Thermometer, QUAL-EC, QUAL-E, and Patient Health Questionnaire-4 will assess patient and family distress and satisfaction with quality of life. Patient, family, and clinician interviews post-meeting will provide insights into the meeting feasibility and outcome measures. Recruitment percentages and outcome measure completion will also inform feasibility. Descriptive statistics will summarise pre- and post-meeting data generated by the outcome measures. SPSS will analyse the quantitative data. Grounded theory will guide the qualitative data analysis. Discussion: This study will determine whether planned Patient-Centred Family Meetings are feasible and acceptable and assess the suitability and feasibility of the outcome measures. It will inform a future phase III randomised controlled trial. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12616001083482 on 11 August 201

Mutual Inductance Route to Paramagnetic Meissner Effect in 2D Josephson Junction Arrays

We simulate two-dimensional Josephson junction arrays, including full mutual- inductance effects, as they are cooled below the transition temperature in a magnetic field. We show numerical simulations of the array magnetization as a function of position, as detected by a scanning SQUID which is placed at a fixed height above the array. The calculated magnetization images show striking agreement with the experimental images obtained by A. Nielsen et al. The average array magnetization is found to be paramagnetic for many values of the applied field, confirming that paramagnetism can arise from magnetic screening in multiply-connected superconductors without the presence of d-wave superconductivity.Comment: REVTeX 3.1, 5 pages, 5 figure

Barriers and facilitators to HPV vaccination in primary care practices: A mixed methods study using the Consolidated Framework for Implementation Research

Abstract Background In the United States, the effective, safe huma papilloma virus (HPV) vaccine is underused and opportunities to prevent cancer continue to be missed. National guidelines recommend completing the 2–3 dose HPV vaccine series by age 13, well before exposure to the sexually transmitted virus. Accurate characterization of the facilitators and barriers to full implementation of HPV vaccine recommendations in the primary care setting could inform effective implementation strategies. Methods We used the Consolidated Framework for Implementation Research (CFIR) to systematically investigate and characterize factors that influence HPV vaccine use in 10 primary care practices (16 providers) using a concurrent mixed methods design. The CFIR was used to guide collection and analysis of qualitative data collected through in-person semi-structured interviews with the primary care providers. We analyzed HPV vaccine use with data abstracted from medical charts. Constructs that most strongly influenced vaccine use were identified by integrating the qualitative and quantitative data. Results Of the 72 CFIR constructs assessed, seven strongly distinguished and seven weakly distinguished between providers with higher versus lower HPV vaccine coverage. The majority of strongly distinguishing constructs were facilitators and were related to characteristics of the providers (knowledge and beliefs; self-efficacy; readiness for change), their perception of the intervention (relative advantage of vaccinating younger vs. older adolescents), and their process to deliver the vaccine (executing). Additional weakly distinguishing constructs that were facilitators were from outer setting (peer pressure; financial incentives), inner setting (networks and communications and readiness for implementation) and process (planning; engaging, and reflecting and evaluating). Two strongly distinguishing constructs were barriers to use, one from the intervention (adaptability of the age of initiation) and the other from outer setting (patient needs and resources). Conclusions Using CFIR to systematically examine the use of this vaccine in independent primary care practices enabled us to identify facilitators and barriers at the provider, interpersonal and practice level that need to be addressed in future efforts to increase vaccine use in such settings. Our findings suggest that implementation strategies that target the provider and help them to address multi-level barriers to HPV vaccine use merit further investigation

Practicing What We Teach: Adherence to Healthy Meeting Guidelines at Extension Meetings and Events

Cooperative Extension promotes healthy behaviors, including nutritious eating and physical activity. Research-based healthy meeting guidelines pertaining to foods and beverages served at Extension-sponsored events have been adopted in some states. The extent of adherence to Healthy Eating at Meetings guidelines was assessed by observing foods and beverages served at Extension-sponsored events across one state. Over a four-month period, 69 events involving foods and/or beverages were observed, including 33 events on a state university’s campus and 46 events across 36 counties. Observed events included meetings, workshops and conferences for faculty and staff, agricultural trainings and field days for the public, 4-H camps and special activities for youth and their families, and county and state fair events. Photos and menus of the foods and beverages served were assessed using a seven-item scorecard based on the Healthy Eating at Meetings guidelines. The average score for adherence to the guidelines was 57%, with a range of 10%-93%. Results suggest that adopting healthy meeting guidelines may not be enough to ensure that nutritious foods are served and that healthy eating is modeled at Extension-sponsored events. This study indicates that further research to explore Extension professionals’ knowledge of and attitudes toward healthy meeting guidelines is needed

Mobilizing Rural Communities to Prevent Childhood Obesity: A Tool Kit

The tool kit Mobilizing Rural Communities to Prevent Childhood Obesity is the product of a seven-state multidisciplinary research project focused on enhancing obesity prevention efforts by integrating community coaching into the work of rural community coalitions. The interactive tool kit is available at no cost both in print form and online, and it consists of five tutorials that present best practices and lessons learned throughout the research project. Extension professionals working within health promotion coalitions may wish to use or promote the tool kit. Coalition members can complete the activities contained in the tool kit individually or as a group