Quantum computation in optical lattices via global laser addressing

A scheme for globally addressing a quantum computer is presented along with its realisation in an optical lattice setup of one, two or three dimensions. The required resources are mainly those necessary for performing quantum simulations of spin systems with optical lattices, circumventing the necessity for single qubit addressing. We present the control procedures, in terms of laser manipulations, required to realise universal quantum computation. Error avoidance with the help of the quantum Zeno effect is presented and a scheme for globally addressed error correction is given. The latter does not require measurements during the computation, facilitating its experimental implementation. As an illustrative example, the pulse sequence for the factorisation of the number fifteen is given.Comment: 11 pages, 10 figures, REVTEX. Initialisation and measurement procedures are adde

Implementing a 48 h EWTD-compliant rota for junior doctors in the UK does not compromise patients’ safety : assessor-blind pilot comparison

Background: There are currently no field data about the effect of implementing European Working Time Directive (EWTD)-compliant rotas in a medical setting. Surveys of doctors’ subjective opinions on shift work have not provided reliable objective data with which to evaluate its efficacy. Aim: We therefore studied the effects on patient's safety and doctors’ work-sleep patterns of implementing an EWTD-compliant 48 h work week in a single-blind intervention study carried out over a 12-week period at the University Hospitals Coventry & Warwickshire NHS Trust. We hypothesized that medical error rates would be reduced following the new rota. Methods: Nineteen junior doctors, nine studied while working an intervention schedule of <48 h per week and 10 studied while working traditional weeks of <56 h scheduled hours in medical wards. Work hours and sleep duration were recorded daily. Rate of medical errors (per 1000 patient-days), identified using an established active surveillance methodology, were compared for the Intervention and Traditional wards. Two senior physicians blinded to rota independently rated all suspected errors. Results: Average scheduled work hours were significantly lower on the intervention schedule [43.2 (SD 7.7) (range 26.0–60.0) vs. 52.4 (11.2) (30.0–77.0) h/week; P < 0.001], and there was a non-significant trend for increased total sleep time per day [7.26 (0.36) vs. 6.75 (0.40) h; P = 0.095]. During a total of 4782 patient-days involving 481 admissions, 32.7% fewer total medical errors occurred during the intervention than during the traditional rota (27.6 vs. 41.0 per 1000 patient-days, P = 0.006), including 82.6% fewer intercepted potential adverse events (1.2 vs. 6.9 per 1000 patient-days, P = 0.002) and 31.4% fewer non-intercepted potential adverse events (16.6 vs. 24.2 per 1000 patient-days, P = 0.067). Doctors reported worse educational opportunities on the intervention rota. Conclusions: Whilst concerns remain regarding reduced educational opportunities, our study supports the hypothesis that a 48 h work week coupled with targeted efforts to improve sleep hygiene improves patient safety

Practice Inquiry: Clinical Uncertainty as a Focus for Small-Group Learning and Practice Improvement

PROBLEM: Many primary care physicians in nonacademic settings lack a collegial forum for engaging the clinical uncertainties inherent in their work. PROGRAM DESCRIPTION: “Practice Inquiry” is proposed as a set of small-group, practice-based learning and improvement (PBLI) methods designed to help clinicians better manage case-based clinical uncertainty. Clinicians meet regularly at their offices/clinics to present dilemma cases, share clinical experience, review evidence for blending with experience, and draw implications for practice improvement. From 2001 through 2005, Practice Inquiry was introduced to sites in the San Francisco Bay Area as a demonstration effort. Meeting rosters, case logs, a feedback survey, and meeting field notes documented implementation and provided data for a formative, qualitative evaluation. PROGRAM EVALUATION: Of the 30 sites approached, 14 held introductory meetings. As of summer 2006, 98 clinicians in 11 sites continue to hold regularly scheduled group meetings. Of the 118 patient cases presented in the seven oldest groups, clinician–patient relationship and treatment dilemmas were most common. Clinician feedback and meeting transcript data provided insights into how busy practitioners shared cases, developed trust, and learned new knowledge/skills for moving forward with patients. DISCUSSION: Ongoing clinician involvement suggests that Practice Inquiry is a feasible, acceptable, and potentially useful set of PBLI methods. Two of the Practice Inquiry’s group learning tasks received comparatively less focus: integrating research evidence with clinical experience and tracking dilemma case outcomes. Future work should focus on reducing the methodological limitations of a demonstration effort and examining factors affecting clinician participation. Set-aside work time for clinicians, or other equally potent incentives, will be necessary for the further elaboration of these PBLI methods aimed at managing uncertainty

Chronic kidney disease care delivered by US family medicine and internal medicine trainees: results from an online survey

BACKGROUND: Complications of chronic kidney disease (CKD) contribute to morbidity and mortality. Consequently, treatment guidelines have been developed to facilitate early detection and treatment. However, given the high prevalence of CKD, many patients with early CKD are seen by non-nephrologists, who need to be aware of CKD complications, screening methods and treatment goals in order to initiate timely therapy and referral. METHODS: We performed a web-based survey to assess perceptions and practice patterns in CKD care among 376 family medicine and internal medicine trainees in the United States. Questions were focused on the identification of CKD risk factors, screening for CKD and associated co-morbidities, as well as management of anemia and secondary hyperparathyroidism in patients with CKD. RESULTS: Our data show that CKD risk factors are not universally recognized, screening for CKD complications is not generally taken into consideration, and that the management of anemia and secondary hyperparathyroidism poses major diagnostic and therapeutic difficulties for trainees. CONCLUSION: Educational efforts are needed to raise awareness of clinical practice guidelines and recommendations for patients with CKD among future practitioners

Theory, practice, research: Casual acquaintances or a seamless whole?

This paper challenges the positivist conception of the relationship between theory, practice and research which implicitly separates theory, practice and research even where there have been explicit attempts to achieve their integration. It will be argued that the theory, research and practice processes are inseparable and that a failure to recognise this leads to missing important elements of the inquiry process which limits and distorts the process. The more sophisticated post-positivist position which has emerged recently also fails to avoid these problems. Rather than critique the positivist position from another paradigmatic vantage point, an immanent critique is developed which reformulates the positivist approach from within its own principles. The reformulated positivism involves an explicit action and participatory orientation to the practice-theory-research process

The rise of relativism: The future of theory and knowledge development in social work

This paper explores a range of paradigms evident in recent debates about social work theory and epistemology, including the positivist, post-positivist, interpretivist, critical, ecological, feminist, poststructural and creative position. While applauding the openness generated by these competing approaches, concerns are raised about the emergence of a meta-paradigm of relativism. After identifying the evidence of this move towards relativism in various paradigms, the potential problems and limitations of this trend for social work are explored. Relativism has, however, played an important role in undermining dogmatic attachments to certain positions and the paper attempts to rescue this useful quality of relativism while combining it with a constructive commitment to creative action

A validity study of the national UK colposcopy objective structured clinical examination-is it a test fit for purpose?

This study examines the validity and reliability of the British Society for Colposcopy and Cytopathology (BSCCP) objective structured clinical examination (OSCE). The BSCCP OSCE results obtained over eight OSCE circuits were analysed using SPSS 15. Face validity and content validity were established from expert opinion and blueprinting. Statistically significant difference was not shown in construct validity through level of experience (P = 0.867, P = 0.822, P = 0.59, P = 0.74, P = 0.12, P = 0.01; these are the P values for each of the patient interaction stations) however, concurrent validity was established against the gynaecology mini-CEX (sensitivity = 1, specificity = 0.8, positive predictive value = 0.947, negative predicitive value = 1). The reliability of the OSCE's range from Cronbach's alpha of 0.617 to 0.775. The OSCE has face, content and concurrent validity