Further evidence of the absence of Replica Symmetry Breaking in Random Bond Potts Models

In this short note, we present supporting evidence for the replica symmetric approach to the random bond q-state Potts models. The evidence is statistically strong enough to reject the applicability of the Parisi replica symmetry breaking scheme to this class of models. The test we use is a generalization of one formerly proposed by Dotsenko et al. and consists in measuring scaling laws of disordered-averaged moments of the spin-spin correlation functions. Numerical results, obtained via Monte Carlo simulations for several values of q, are shown to be in fair agreement with the replica symmetric values computed by using perturbative CFT for the second and third moments of the q=3 model. RSB effects, which should increase in strength with moment, are unobserved.Comment: 7 pages, some minor modifications (mainly misprints). To Appear in Europhysics Letter

Global health security: where is the data to inform health system strengthening?

[Extract] The Ebola outbreak in West Africa (2013–2016) triggered a renewed interest and sense of urgency about global health security. A surge of reports and publications ensued, examining various aspects of emerging infectious disease outbreaks. In 2016, Olivero and colleagues published a biogeographical approach mapping favourable conditions that facilitated the Ebola outbreak, in terms of environmental factors and the presence of potential host animals.1 Constructing biological vulnerability maps has value to guide preparations for future emerging infectious disease outbreaks, especially in low-income and middle-income countries. But perhaps more important is the need to develop similar ‘vulnerability maps’ to capture the ability of health systems to prevent or respond to major infectious disease challenges. Without a health system vulnerability map, or the public availability of the data to generate it, efforts to achieve global health security in relation to emerging infectious disease outbreaks will likely be limited and post hoc, rather than pre-emptive and strategic. Unfortunately, the revived interest in global health security has not been matched with commensurate action. In 2014, the G7 (Group of Seven) endorsed the Global Health Security Agenda (GHSA), a partnership of governments and international organisations with the goal of accelerating the achievement of the core disease outbreak preparedness and response capacities as required by the International Health Regulations, but progress has been limited

Performance-based incentives and community health workers’ outputs, a systematic review

Objective To review the evidence on the impact on measurable outcomes of performance-based incentives for community health workers (CHWs) in low-and middle-income countries. Methods We conducted a systematic review of intervention studies published before November 2020 that evaluated the impact of financial and non-financial performance-based incentives for CHWs. Outcomes included patient health indicators; quality, utilization or delivery of health-care services; and CHW motivation or satisfaction. We assessed risk of bias for all included studies using the Cochrane tool. We based our narrative synthesis on a framework for measuring the performance of CHW programmes, comprising inputs, processes, performance outputs and health outcomes. Findings Two reviewers screened 2811 records; we included 12 studies, 11 of which were randomized controlled trials and one a non-randomized trial. We found that non-financial, publicly displayed recognition of CHWs’ efforts was effective in improved service delivery outcomes. While large financial incentives were more effective than small ones in bringing about improved performance, they often resulted in the reallocation of effort away from other, non-incentivized tasks. We found no studies that tested a combined package of financial and non-financial incentives. The rationale for the design of performance-based incentives or explanation of how incentives interacted with contextual factors were rarely reported. Conclusion Financial performance-based incentives alone can improve CHW service delivery outcomes, but at the risk of unincentivized tasks being neglected. As calls to professionalize CHW programmes gain momentum, research that explores the interactions among different forms of incentives, context and sustainability is needed

Performance-based incentives and community health workers' outputs, a systematic review.

ObjectiveTo review the evidence on the impact on measurable outcomes of performance-based incentives for community health workers (CHWs) in low- and middle-income countries.MethodsWe conducted a systematic review of intervention studies published before November 2020 that evaluated the impact of financial and non-financial performance-based incentives for CHWs. Outcomes included patient health indicators; quality, utilization or delivery of health-care services; and CHW motivation or satisfaction. We assessed risk of bias for all included studies using the Cochrane tool. We based our narrative synthesis on a framework for measuring the performance of CHW programmes, comprising inputs, processes, performance outputs and health outcomes.FindingsTwo reviewers screened 2811 records; we included 12 studies, 11 of which were randomized controlled trials and one a non-randomized trial. We found that non-financial, publicly displayed recognition of CHWs' efforts was effective in improved service delivery outcomes. While large financial incentives were more effective than small ones in bringing about improved performance, they often resulted in the reallocation of effort away from other, non-incentivized tasks. We found no studies that tested a combined package of financial and non-financial incentives. The rationale for the design of performance-based incentives or explanation of how incentives interacted with contextual factors were rarely reported.ConclusionFinancial performance-based incentives alone can improve CHW service delivery outcomes, but at the risk of unincentivized tasks being neglected. As calls to professionalize CHW programmes gain momentum, research that explores the interactions among different forms of incentives, context and sustainability is needed

Local critical behaviour at aperiodic surface extended perturbation in the Ising quantum chain

The surface critical behaviour of the semi--infinite one--dimensional quantum Ising model in a transverse field is studied in the presence of an aperiodic surface extended modulation. The perturbed couplings are distributed according to a generalized Fredholm sequence, leading to a marginal perturbation and varying surface exponents. The surface magnetic exponents are calculated exactly whereas the expression of the surface energy density exponent is conjectured from a finite--size scaling study. The system displays surface order at the bulk critical point, above a critical value of the modulation amplitude. It may be considered as a discrete realization of the Hilhorst--van Leeuwen model.Comment: 13 pages, TeX file + 6 figures, epsf neede

Heterologous Expression of Alteromonas macleodii and Thiocapsa roseopersicina [NiFe] Hydrogenases in Synechococcus elongatus

Oxygen-tolerant [NiFe] hydrogenases may be used in future photobiological hydrogen production systems once the enzymes can be heterologously expressed in host organisms of interest. To achieve heterologous expression of [NiFe] hydrogenases in cyanobacteria, the two hydrogenase structural genes from Alteromonas macleodii Deep ecotype (AltDE), hynS and hynL, along with the surrounding genes in the gene operon of HynSL were cloned in a vector with an IPTG-inducible promoter and introduced into Synechococcus elongatus PCC7942. The hydrogenase protein was expressed at the correct size upon induction with IPTG. The heterologously-expressed HynSL hydrogenase was active when tested by in vitro H2 evolution assay, indicating the correct assembly of the catalytic center in the cyanobacterial host. Using a similar expression system, the hydrogenase structural genes from Thiocapsa roseopersicina (hynSL) and the entire set of known accessory genes were transferred to S. elongatus. A protein of the correct size was expressed but had no activity. However, when the 11 accessory genes from AltDE were co-expressed with hynSL, the T. roseopersicina hydrogenase was found to be active by in vitro assay. This is the first report of active, heterologously-expressed [NiFe] hydrogenases in cyanobacteria

Barricades and brickwalls - a qualitative study exploring perceptions of medication use and deprescribing in long-term care

Background The co-administration of multiple drugs (polypharmacy) is the single most common cause of adverse drug events in the older population, and residents of long-term care facilities (LTCFs) are at particularly high risk of medication harm. \u27Deprescribing\u27 - the withdrawal of an inappropriate medication with goal of managing polypharmacy and improving outcomes - may improve the quality of life of LTCF residents. The RELEASE study sought to explore perceptions of medication use and the concept of deprescribing in LTCFs. Methods Focus groups and interviews were conducted with General Practitioners (GPs), pharmacists, nursing staff, residents and their relatives within three LTCFs in the Illawarra-Shoalhaven region of NSW, Australia. Audiotapes were transcribed verbatim and, using the Integrative Model of Behaviour Prediction as a framework, thematic analysis of transcripts was conducted using QSR NVivo 10. Results Participants acknowledged the burden of too many medications (time to administer, physical discomfort, cost), yet displayed passivity towards medication reduction. Residents and relatives lacked understanding of medicine indications or potential harms. Willingness to initiate and accept medication change was dependent on the GP, who emerged as a central trusted figure. GPs preferred \u27the path of least resistance\u27, signalling systems barriers (poor uniformity of LTCF medical records, limited trained LTCF personnel); time constraints (resident consultations, follow-up with specialists and family); and the organisation of care (collaborating with LTCF staff, pharmacists and prescribing specialists) as obstacles to deprescribing. Conclusions Targeted engagement is required to raise awareness of the risks of polypharmacy in LTCFs and encourage acceptance of deprescribing amongst residents and their relatives. GPs are integral to the success of deprescribing initiatives within this sector