Preferences for Prenatal Tests for Cystic Fibrosis: A Discrete Choice Experiment to Compare the Views of Adult Patients, Carriers of Cystic Fibrosis and Health Professionals

As new technologies enable the development of non-invasive prenatal diagnosis (NIPD) for cystic fibrosis (CF), research examining stakeholder views is essential for the preparation of implementation strategies. Here, we compare the views of potential service users with those of health professionals who provide counselling for prenatal tests. A questionnaire incorporating a discrete choice experiment examined preferences for key attributes of NIPD and explored views on NIPD for CF. Adult patients (n = 92) and carriers of CF (n = 50) were recruited from one children’s and one adult NHS specialist CF centre. Health professionals (n = 70) were recruited via an e-mail invitation to relevant professional bodies. The key attribute affecting service user testing preferences was no miscarriage risk, while for health professionals, accuracy and early testing were important. The uptake of NIPD by service users was predicted to be high and includes couples that would currently decline invasive testing. Many service users (47%) and health professionals (55.2%) thought the availability of NIPD for CF would increase the pressure to undergo prenatal testing. Most service users (68.5%) thought NIPD for CF should be offered to all pregnant women, whereas more health professionals (68.2%) thought NIPD should be reserved for known carrier couples. The implications for clinical practice are discussed

Distributed lag models for hydrological data

The distributed lag model (DLM), used most prominently in air pollution studies, finds application wherever the effect of a covariate is delayed and distributed through time. We explore the use of modified formulations of DLMs to provide flexible varying-coeficient models with smoothness constraints, applicable in any setting in which lagged covariates are regressed on a time-dependent response. The models are applied to simulated flow and rainfall data and to flow data from a Scottish mountain river, with particular emphasis on approximating the relationship between environmental covariates and flow regimes in order to detect the influence of unobserved processes. It was found that under certain rainfall conditions some of the variability in the influence of rainfall on flow arises through a complex interaction between antecedent ground wetness and the time-delay in rainfall. The models are able to identify subtle changes in rainfall response, particularly in the location of peak influence in the lag structure and offer a computationally attractive approach for fitting DLMs

Multi-particle Correlations in Quaternionic Quantum Systems

We investigate the outcomes of measurements on correlated, few-body quantum systems described by a quaternionic quantum mechanics that allows for regions of quaternionic curvature. We find that a multi-particle interferometry experiment using a correlated system of four nonrelativistic, spin-half particles has the potential to detect the presence of quaternionic curvature. Two-body systems, however, are shown to give predictions identical to those of standard quantum mechanics when relative angles are used in the construction of the operators corresponding to measurements of particle spin components.Comment: REVTeX 3.0, 16 pages, no figures, UM-P-94/54, RCHEP-94/1

Assessment of methods of acquiring analyzing, and reporting crop production statistics, volume 4

There are no author-identified significant results in this report

Social work education, training and standards in the Asia-Pacific region

This article discusses the joint project between the International Association of Schools of Social Work (IASSW) and the International Federation of Social Workers (IFSW) to establish guidelines for the training and standard setting that elucidates what social work represents on a global level. While it is impossible to address all the issues that might be significant in such a large scope, attention is given to the challenges establishing global standards might encounter in a region as diverse as the Asia-Pacific

Spectroscopy of drums and quantum billiards: perturbative and non-perturbative results

We develop powerful numerical and analytical techniques for the solution of the Helmholtz equation on general domains. We prove two theorems: the first theorem provides an exact formula for the ground state of an arbirtrary membrane, while the second theorem generalizes this result to any excited state of the membrane. We also develop a systematic perturbative scheme which can be used to study the small deformations of a membrane of circular or square shapes. We discuss several applications, obtaining numerical and analytical results.Comment: 29 pages, 12 figures, 7 tabl

Topological Constraints on the Charge Distributions for the Thomson Problem

The method of Morse theory is used to analyze the distributions of unit charges interacting through a repulsive force and constrained to move on the surface of a sphere -- the Thomson problem. We find that, due to topological reasons, the system may organize itself in the form of pentagonal structures. This gives a qualitative account for the interesting ``pentagonal buttons'' discovered in recent numerical work.Comment: 10 pages; dedicated to Rafael Sorkin on his 60th birthda

The Standard Model Fermion Spectrum From Complex Projective spaces

It is shown that the quarks and leptons of the standard model, including a right-handed neutrino, can be obtained by gauging the holonomy groups of complex projective spaces of complex dimensions two and three. The spectrum emerges as chiral zero modes of the Dirac operator coupled to gauge fields and the demonstration involves an index theorem analysis on a general complex projective space in the presence of topologically non-trivial SU(n)xU(1) gauge fields. The construction may have applications in type IIA string theory and non-commutative geometry.Comment: 13 pages. Typset using LaTeX and JHEP3 style files. Minor typos correcte

Health practitioner and student attitudes to caring for transgender patients in Tasmania

Background and objective Healthcare practitioners struggle to vprovide inclusive and affirming care= to transgender (trans) people. This study examined Tasmanian healthcare practitioners’ and students’ understandings and approaches to trans health. Methods The study comprised qualitative semistructured interviews with 17 healthcare practitioners (doctors, psychologists, nurses and other allied health workers) and students (of medicine, nursing and pharmacy) across Tasmania, Australia. Data were analysed using a reflexive thematic analysis. Results The authors identified three key themes: lack of training in trans healthcare, limited resources to support trans patients, and the importance and challenges of trans-inclusive language. Discussion Healthcare practitioners faced challenges providing inclusive and affirming healthcare for trans people due to limited experience with trans patients, and few educational opportunities and referral pathways to support patients. Healthcare practitioners need better support an

Tasmanian healthcare professionals' & students' capacity for LGBTI + inclusive care: A qualitative inquiry

The health disparities and care needs of lesbian, gay, bisexual, transgender and intersex (LGBTI+) patients are becoming well known. However, healthcare practitioners (HCPs) and medical students across the Global North report limited understanding of this population and express concern about their capacity to meet the needs of LGBTI + patients. To address these gaps in literature and practice, this study draws on qualitative interviews with 12 clinicians and five health professional students exploring their understandings and approaches to LGBTI + inclusive practice in Tasmania, Australia. Through a reflexive thematic analysis, we identified that both practicing clinicians and students did not believe that their training adequately prepared them to treat LGBTI + patients. Other key barriers included reduced awareness of LGBTI + community needs due to the lack of exposure to LGBTI + patients and unfamiliarity with appropriate referral pathways in the regional Tasmanian context. Conversely, factors enabling provision of LGBTI + inclusive care included prior experience working with LGBTI + patients and establishing a network of supportive colleagues and local services. Participants who identified as LGBTI + themselves saw their personal experiences as a strength in supporting LGBTI + patients. While awareness of LGBTI + inclusive health practice is increasing, Tasmanian practitioners report insufficient training and practical difficulties with referral as key challenges