1,770 research outputs found
The contested and contingent outcomes of Thatcherism in the UK
The death of Margaret Thatcher in April 2013 sparked a range of discussions and debates about the significance of her period in office and the political project to which she gave her name: Thatcherism. This article argues that Thatcherism is best understood as a symbolically important part of the emergence of first-phase neoliberalism. It engages with contemporary debates about Thatcherism among Marxist commentators and suggests that several apparently divergent positions can help us now reach a more useful analysis of Thatcherism’s short- and long-term outcomes for British political economy. The outcomes identified include: an initial crisis in the neoliberal project in the UK; the transformation of the party political system to be reflective of the politics of neoliberalism, rather than its contestation; long-term attempts at the inculcation of the neoliberal individual; de-industrialisation and financial sector dependence; and a fractured and partially unconscious working class. In all long-term outcomes, the contribution of Thatcherism is best understood as partial and largely negative, in that it cleared the way for a longer-term and more constructive attempt to embed neoliberal political economy. The paper concludes by suggesting that this analysis can inform current debates on the left of British politics about how to oppose and challenge the imposition of neoliberal discipline today
Towards high-speed optical quantum memories
Quantum memories, capable of controllably storing and releasing a photon, are
a crucial component for quantum computers and quantum communications. So far,
quantum memories have operated with bandwidths that limit data rates to MHz.
Here we report the coherent storage and retrieval of sub-nanosecond low
intensity light pulses with spectral bandwidths exceeding 1 GHz in cesium
vapor. The novel memory interaction takes place via a far off-resonant
two-photon transition in which the memory bandwidth is dynamically generated by
a strong control field. This allows for an increase in data rates by a factor
of almost 1000 compared to existing quantum memories. The memory works with a
total efficiency of 15% and its coherence is demonstrated by directly
interfering the stored and retrieved pulses. Coherence times in hot atomic
vapors are on the order of microsecond - the expected storage time limit for
this memory.Comment: 13 pages, 5 figure
Addressing challenges in scaling up TB and HIV treatment integration in rural primary healthcare clinics in South Africa (SUTHI): a cluster randomized controlled trial protocol
Background
A large and compelling clinical evidence base has shown that integrated TB and HIV services leads to reduction in human immunodeficiency virus (HIV)- and tuberculosis (TB)-associated mortality and morbidity. Despite official policies and guidelines recommending TB and HIV care integration, its poor implementation has resulted in TB and HIV remaining the commonest causes of death in several countries in sub-Saharan Africa, including South Africa. This study aims to reduce mortality due to TB-HIV co-infection through a quality improvement strategy for scaling up of TB and HIV treatment integration in rural primary healthcare clinics in South Africa.
Methods
The study is designed as an open-label cluster randomized controlled trial. Sixteen clinic supervisors who oversee 40 primary health care (PHC) clinics in two rural districts of KwaZulu-Natal, South Africa will be randomized to either the control group (provision of standard government guidance for TB-HIV integration) or the intervention group (provision of standard government guidance with active enhancement of TB-HIV care integration through a quality improvement approach). The primary outcome is all-cause mortality among TB-HIV patients. Secondary outcomes include time to antiretroviral therapy (ART) initiation among TB-HIV co-infected patients, as well as TB and HIV treatment outcomes at 12 months. In addition, factors that may affect the intervention, such as conditions in the clinic and staff availability, will be closely monitored and documented.
Discussion
This study has the potential to address the gap between the establishment of TB-HIV care integration policies and guidelines and their implementation in the provision of integrated care in PHC clinics. If successful, an evidence-based intervention comprising change ideas, tools, and approaches for quality improvement could inform the future rapid scale up, implementation, and sustainability of improved TB-HIV integration across sub-Sahara Africa and other resource-constrained settings.
Trial registration
Clinicaltrials.gov, NCT02654613. Registered 01 June 2015
ADRIC: Adverse Drug Reactions In Children - a programme of research using mixed methods
Aims
To comprehensively investigate the incidence, nature and risk factors of adverse drug reactions (ADRs) in a hospital-based population of children, with rigorous assessment of causality, severity and avoidability, and to assess the consequent impact on children and families. We aimed to improve the assessment of ADRs by development of new tools to assess causality and avoidability, and to minimise the impact on families by developing better strategies for communication.
Review methods
Two prospective observational studies, each over 1 year, were conducted to assess ADRs in children associated with admission to hospital, and those occurring in children who were in hospital for longer than 48 hours. We conducted a comprehensive systematic review of ADRs in children. We used the findings from these studies to develop and validate tools to assess causality and avoidability of ADRs, and conducted interviews with parents and children who had experienced ADRs, using these findings to develop a leaflet for parents to inform a communication strategy about ADRs.
Results
The estimated incidence of ADRs detected in children on admission to hospital was 2.9% [95% confidence interval (CI) 2.5% to 3.3%]. Of the reactions, 22.1% (95% CI 17% to 28%) were either definitely or possibly avoidable. Prescriptions originating in the community accounted for 44 out of 249 (17.7%) of ADRs, the remainder originating from hospital. A total of 120 out of 249 (48.2%) reactions resulted from treatment for malignancies. Off-label and/or unlicensed (OLUL) medicines were more likely to be implicated in an ADR than authorised medicines [relative risk (RR) 1.67, 95% CI 1.38 to 2.02; p 48 hours, the overall incidence of definite and probable ADRs based on all admissions was 15.9% (95% CI 15.0 to 16.8). Opiate analgesic drugs and drugs used in general anaesthesia (GA) accounted for > 50% of all drugs implicated in ADRs. The odds ratio of an OLUL drug being implicated in an ADR compared with an authorised drug was 2.25 (95% CI 1.95 to 2.59; p < 0.001). Risk factors identified were exposure to a GA, age, oncology treatment and number of medicines. The systematic review estimated that the incidence rates for ADRs causing hospital admission ranged from 0.4% to 10.3% of all children [pooled estimate of 2.9% (95% CI 2.6% to 3.1%)] and from 0.6% to 16.8% of all children exposed to a drug during hospital stay. New tools to assess causality and avoidability of ADRs have been developed and validated. Many parents described being dissatisfied with clinician communication about ADRs, whereas parents of children with cancer emphasised confidence in clinician management of ADRs and the way clinicians communicated about medicines. The accounts of children and young people largely reflected parents’ accounts. Clinicians described using all of the features of communication that parents wanted to see, but made active decisions about when and what to communicate to families about suspected ADRs, which meant that communication may not always match families’ needs and expectations. We developed a leaflet to assist clinicians in communicating ADRs to parents.
Conclusion
The Adverse Drug Reactions In Children (ADRIC) programme has provided the most comprehensive assessment, to date, of the size and nature of ADRs in children presenting to, and cared for in, hospital, and the outputs that have resulted will improve the management and understanding of ADRs in children and adults within the NHS. Recommendations for future research: assess the values that parents and children place on the use of different medicines and the risks that they will find acceptable within these contexts; focusing on high-risk drugs identified in ADRIC, determine the optimum drug dose for children through the development of a gold standard practice for the extrapolation of adult drug doses, alongside targeted pharmacokinetic/pharmacodynamic studies; assess the research and clinical applications of the Liverpool Causality Assessment Tool and the Liverpool Avoidability Assessment Tool; evaluate, in more detail, morbidities associated with anaesthesia and surgery in children, including follow-up in the community and in the home setting and an assessment of the most appropriate treatment regimens to prevent pain, vomiting and other postoperative complications; further evaluate strategies for communication with families, children and young people about ADRs; and quantify ADRs in other settings, for example critical care and neonatology
Interfacing GHz-bandwidth heralded single photons with a room-temperature Raman quantum memory
Photonics is a promising platform for quantum technologies. However, photon
sources and two-photon gates currently only operate probabilistically.
Large-scale photonic processing will therefore be impossible without a
multiplexing strategy to actively select successful events. High
time-bandwidth-product quantum memories - devices that store and retrieve
single photons on-demand - provide an efficient remedy via active
synchronisation. Here we interface a GHz-bandwidth heralded single-photon
source and a room-temperature Raman memory with a time-bandwidth product
exceeding 1000. We store heralded single photons and observe a clear influence
of the input photon statistics on the retrieved light, which agrees with our
theoretical model. The preservation of the stored field's statistics is limited
by four-wave-mixing noise, which we identify as the key remaining challenge in
the development of practical memories for scalable photonic information
processing
High-speed noise-free optical quantum memory
Quantum networks promise to revolutionise computing, simulation, and
communication. Light is the ideal information carrier for quantum networks, as
its properties are not degraded by noise in ambient conditions, and it can
support large bandwidths enabling fast operations and a large information
capacity. Quantum memories, devices that store, manipulate, and release on
demand quantum light, have been identified as critical components of photonic
quantum networks, because they facilitate scalability. However, any noise
introduced by the memory can render the device classical by destroying the
quantum character of the light. Here we introduce an intrinsically noise-free
memory protocol based on two-photon off-resonant cascaded absorption (ORCA). We
consequently demonstrate for the first time successful storage of GHz-bandwidth
heralded single photons in a warm atomic vapour with no added noise; confirmed
by the unaltered photon statistics upon recall. Our ORCA memory platform meets
the stringent noise-requirements for quantum memories whilst offering technical
simplicity and high-speed operation, and therefore is immediately applicable to
low-latency quantum networks
Theory of noise suppression in {\Lambda}-type quantum memories by means of a cavity
Quantum memories, capable of storing single photons or other quantum states
of light, to be retrieved on-demand, offer a route to large-scale quantum
information processing with light. A promising class of memories is based on
far-off-resonant Raman absorption in ensembles of -type atoms. However
at room temperature these systems exhibit unwanted four-wave mixing, which is
prohibitive for applications at the single-photon level. Here we show how this
noise can be suppressed by placing the storage medium inside a moderate-finesse
optical cavity, thereby removing the main roadblock hindering this approach to
quantum memory.Comment: 10 pages, 3 figures. This paper provides the theoretical background
to our recent experimental demonstration of noise suppression in a
cavity-enhanced Raman-type memory ( arXiv:1510.04625 ). See also the related
paper arXiv:1511.05448, which describes numerical modelling of an atom-filled
cavity. Comments welcom
Relationship Between Villous Shape and Mural Structure in Neutron Irradiated Small Intestine
Previous work on irradiation of mouse small intestine has assessed the changes produced by counting crypts/microcolonies, scoring villous shape or examining morphological changes in specific parts of the wall.
This paper used scanning and transmission electron microscopy to study the effects of whole body irradiation with 5 Gy neutrons on the surface and internal features of the intestinal wall of CFLP mice, 1 day, 3 days and 7 days after treatment.
Empirical scores from the ultrastructural findings were inserted into a Morphological Index display calculated from analytical data based on cell counts and area measurements obtained from resin histology sections. The final data display showed that the neutron irradiation produced marked structural changes in different cells and tissues by 1 day. These changes were maximal at 3 days with substantial improvement by 7 days.
When this data display was compared with scores taken from scanning electron microscopy of the mucosal surface, the change in villous shape from erect fingerlike projections to lower profiles less suited to absorption was seen to correlate more with changes in the smooth muscle than with the epithelial cryptal compartment
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