Reluctance of general practice staff to register patients without documentation: a qualitative study in North East London.

BACKGROUND: Lack of access to documentation is a key barrier to GP registration, despite NHS England guidance stating that documents are not required. Staff attitudes and practice regarding registration of those without documentation are under- researched. AIM: To understand the processes through which registration might be refused for those without documents, and the factors operating to influence this. DESIGN AND SETTING: Qualitative study conducted in general practice across three clinical commissioning groups in North East London. METHOD: In total, 33 participants (GP staff involved in registering new patients) were recruited through email invitation. Semi-structured interviews and focus groups were conducted. Data were analysed using Braun and Clarke's reflexive thematic analysis. Two social theories informed this analysis: Lipsky's street-level bureaucracy and Bourdieu's theory of practice. RESULTS: Despite good knowledge of guidance, most participants expressed reluctance to register those without documentation, often introducing additional hurdles or requirements in their everyday practice. Two explanatory themes were generated: that those without documents were perceived as burdensome, and/or that moral judgements were made about their deservedness to finite resources. Participants described a context of high workload and insufficient funding. Some felt that GP services should be restricted by immigration status, as is widespread in secondary care. CONCLUSION: Improving inclusive registration practice requires addressing staff concerns, supporting navigation of high workloads, tackling financial disincentives to registering transient groups, and challenging narratives that undocumented migrants represent a 'threat' to NHS resources. Furthermore, it is imperative to acknowledge and address upstream drivers, in this instance the Hostile Environment

Thermo-oxidative Stability and Flammability of Three-dimensional Polymers Based on Olygocarbonate-methacrylates

By the irreversible condensation reaction of the mono-methacrylic ester of ethylene glycol and chlorocarbonic esters of 2,2-dimethylpropandiol- 1,3 and 2,2-dimethylene chloride-propandiol-1,3, two olygocarbonate methacrylate (OCM-I and -II, respectively) containing unsaturated ends were synthesised. The polymerization of OCM-I and OCM-II in the presence of cumene hydro.peroxide and an accelerator gave two cross-liinked polymers Ln a yield of 70-750/o. The thermal and thermo-oxidative decompositions of the prepared polymers were studied by the thermogravimetric method and by characterization of the volatile pyrolysis products and the nonvolatile polymer residue. The influence of the polymer structure on the mechanism of the decomposition reactions in vacuo as well as iin the presence of oxygen was discussed. The temperature dependence of thermostabiLity was compared with some polymer flammability parameters

SO(5) superconductor in a Zeeman magnetic field: Phase diagram and thermodynamic properties

In this paper we present calculations of the SO(5) quantum rotor theory of high-T$_{c}$ superconductivity in Zeeman magnetic field. We use the spherical approach for five-component quantum rotors in three-dimensional lattice to obtain formulas for critical lines, free energy, entropy and specific heat and present temperature dependences of these quantities for different values of magnetic field. Our results are in qualitative agreement with relevant experiments on high-T$_{c}$ cuprates.Comment: 4 pages, 2 figures, to appear in Phys. Rev. B, see http://prb.aps.or

Cognitive performance in healthy women during induced hypogonadism and ovarian steroid addback

Background—Gynecology clinic-based studies have consistently demonstrated that induced hypogonadism is accompanied by a decline in cognitive test performance. However, a recent study in healthy asymptomatic controls observed that neither induced hypogonadism nor estradiol replacement influenced cognitive performance. Thus the effects of induced hypogonadism on cognition might not be uniformly experienced across individual women. Moreover, discrepancies in the effects of hypogonadism on cognition also could suggest the existence of specific risk phenotypes that predict a woman’s symptomatic experience during the menopause. In this study, we examined the effects of induced hypogonadism and ovarian steroid replacement on cognitive performance in healthy premenopausal women. Methods—Ovarian suppression was induced with a GnRH agonist (Lupron) and then physiologic levels of estradiol and progesterone were re-introduced in 23 women. Cognitive tests were administered during each hormone condition. To evaluate possible practice effects arising during repeated testing, an identical battery of tests was administered at the same time intervals in 11 untreated women. Results—With the exception of an improved performance on mental rotation during estradiol, we observed no significant effects of estradiol or progesterone on measures of attention, concentration, or memory compared with hypogonadism. Conclusions—In contrast to studies in which a decline in cognitive performance was observed in women receiving ovarian suppression therapy for an underlying gynecologic condition, we confirm a prior report demonstrating that short term changes in gonadal steroids have a limited effect on cognition in young, healthy, women. Differences in the clinical characteristics of the women receiving GnRH agonists could predict a risk for ovarian steroid-related changes in cognitive performance during induced, and possibly, natural menopause

Analytic Behaviour of Competition among Three Species

We analyse the classical model of competition between three species studied by May and Leonard ({\it SIAM J Appl Math} \textbf{29} (1975) 243-256) with the approaches of singularity analysis and symmetry analysis to identify values of the parameters for which the system is integrable. We observe some striking relations between critical values arising from the approach of dynamical systems and the singularity and symmetry analyses.Comment: 14 pages, to appear in Journal of Nonlinear Mathematical Physic

Inductive learning spatial attention

This paper investigates the automatic induction of spatial attention from the visual observation of objects manipulated on a table top. In this work, space is represented in terms of a novel observer-object relative reference system, named Local Cardinal System, defined upon the local neighbourhood of objects on the table. We present results of applying the proposed methodology on five distinct scenarios involving the construction of spatial patterns of coloured blocks

How much do we really lose?—Yield losses in the proximity of natural landscape elements in agricultural landscapes

Natural landscape elements (NLEs) in agricultural landscapes contribute to biodiversity and ecosystem services, but are also regarded as an obstacle for large‐scale agricultural production. However, the effects of NLEs on crop yield have rarely been measured. Here, we investigated how different bordering structures, such as agricultural roads, field‐to‐field borders, forests, hedgerows, and kettle holes, influence agricultural yields. We hypothesized that (a) yield values at field borders differ from mid‐field yields and that (b) the extent of this change in yields depends on the bordering structure. We measured winter wheat yields along transects with log‐scaled distances from the border into the agricultural field within two intensively managed agricultural landscapes in Germany (2014 near Göttingen, and 2015–2017 in the Uckermark). We observed a yield loss adjacent to every investigated bordering structure of 11%–38% in comparison with mid‐field yields. However, depending on the bordering structure, this yield loss disappeared at different distances. While the proximity of kettle holes did not affect yields more than neighboring agricultural fields, woody landscape elements had strong effects on winter wheat yields. Notably, 95% of mid‐field yields could already be reached at a distance of 11.3 m from a kettle hole and at a distance of 17.8 m from hedgerows as well as forest borders. Our findings suggest that yield losses are especially relevant directly adjacent to woody landscape elements, but not adjacent to in‐field water bodies. This highlights the potential to simultaneously counteract yield losses close to the field border and enhance biodiversity by combining different NLEs in agricultural landscapes such as creating strips of extensive grassland vegetation between woody landscape elements and agricultural fields. In conclusion, our results can be used to quantify ecocompensations to find optimal solutions for the delivery of productive and regulative ecosystem services in heterogeneous agricultural landscapes

Arendt and political realism: towards a realist account of political judgement

This article argues that Hannah Arendt’s thought can offer significant insights on political judgement for realism in political theory. We identify a realist position which emphasises the need to account for how humans judge politically, contra moralist tendencies to limit its exercise to rational standards, but which fails to provide a sufficient conception of its structure and potential. Limited appeals to political judgement render the realist defence of the political elusive, and compromise the endeavour to offer a meaningful alternative to the moralist tendency to displace politics. The potential and limitations of realist discussions on judgement are made visible in relation to proto-realists Judith Shklar and Isaiah Berlin. In seeking to enrich the realist conception of the political, the article introduces the displacement critique found in the neglected Arendtian ‘realism’. It also provides the foundations for a distinctly realist account of political judgement which, we argue, requires elaboration along two dimensions: the social coding of political judgement and the political capacities that help judgement build a suitable political sphere

Object knowledge modulates colour appearance

We investigated the memory colour effect for colour diagnostic artificial objects. Since knowledge about these objects and their colours has been learned in everyday life, these stimuli allow the investigation of the influence of acquired object knowledge on colour appearance. These investigations are relevant for questions about how object and colour information in high-level vision interact as well as for research about the influence of learning and experience on perception in general. In order to identify suitable artificial objects, we developed a reaction time paradigm that measures (subjective) colour diagnosticity. In the main experiment, participants adjusted sixteen such objects to their typical colour as well as to grey. If the achromatic object appears in its typical colour, then participants should adjust it to the opponent colour in order to subjectively perceive it as grey. We found that knowledge about the typical colour influences the colour appearance of artificial objects. This effect was particularly strong along the daylight axis

A new perturbative expansion of the time evolution operator associated with a quantum system

A novel expansion of the evolution operator associated with a -- in general, time-dependent -- perturbed quantum Hamiltonian is presented. It is shown that it has a wide range of possible realizations that can be fitted according to computational convenience or to satisfy specific requirements. As a remarkable example, the quantum Hamiltonian describing a laser-driven trapped ion is studied in detail.Comment: 32 pages; modified version with examples of my previous paper quant-ph/0404056; to appear on the J. of Optics B: Quantum and Semiclassical Optics, Special Issue on 'Optics and Squeeze Transformations after Einstein