Higher-Order Corrections to Instantons

The energy levels of the double-well potential receive, beyond perturbation theory, contributions which are non-analytic in the coupling strength; these are related to instanton effects. For example, the separation between the energies of odd- and even-parity states is given at leading order by the one-instanton contribution. However to determine the energies more accurately multi-instanton configurations have also to be taken into account. We investigate here the two-instanton contributions. First we calculate analytically higher-order corrections to multi-instanton effects. We then verify that the difference betweeen numerically determined energy eigenvalues, and the generalized Borel sum of the perturbation series can be described to very high accuracy by two-instanton contributions. We also calculate higher-order corrections to the leading factorial growth of the perturbative coefficients and show that these are consistent with analytic results for the two-instanton effect and with exact data for the first 200 perturbative coefficients.Comment: 7 pages, LaTe

Can processes make relationships work? The Triple Helix between structure and action

This contribution seeks to explore how complex adaptive theory can be applied at the conceptual level to unpack Triple Helix models. We use two cases to examine this issue – the Finnish Strategic Centres for Science, Technology & Innovation (SHOKs) and the Canadian Business-led Networks of Centres of Excellence (BL-NCE). Both types of centres are organisational structures that aspire to be business-led, with a considerable portion of their activities driven by (industrial) users’ interests and requirements. Reflecting on the centres’ activities along three dimensions – knowledge generation, consensus building and innovation – we contend that conceptualising the Triple Helix from a process perspective will improve the dialogue between stakeholders and shareholders

Monitoring and evaluation of human resources for health: an international perspective

BACKGROUND: Despite the undoubted importance of human resources to the functions of health systems, there is little consistency between countries in how human resource strategies are monitored and evaluated. This paper presents an integrated approach for developing an evidence base on human resources for health (HRH) to support decision-making, drawing on a framework for health systems performance assessment. METHODS: Conceptual and methodological issues for selecting indicators for HRH monitoring and evaluation are discussed, and a range of primary and secondary data sources that might be used to generate indicators are reviewed. Descriptive analyses are conducted drawing primarily on one type of source, namely routinely reported data on the numbers of health personnel and medical schools as covered by national reporting systems and compiled by the World Health Organization. Regression techniques are used to triangulate a given HRH indicator calculated from different data sources across multiple countries. RESULTS: Major variations in the supply of health personnel and training opportunities are found to occur by region. However, certain discrepancies are also observed in measuring the same indicator from different sources, possibly related to the occupational classification or to the sources' representation. CONCLUSION: Evidence-based information is needed to better understand trends in HRH. Although a range of sources exist that can potentially be used for HRH assessment, the information that can be derived from many of these individual sources precludes refined analysis. A variety of data sources and analytical approaches, each with its own strengths and limitations, is required to reflect the complexity of HRH issues. In order to enhance cross-national comparability, data collection efforts should be processed through the use of internationally standardized classifications (in particular, for occupation, industry and education) at the greatest level of detail possible

Fibres for Sportswear

This book describes the differences between woven and knitted structures, provides an understanding of fabric behavior and the characteristics of a functional garment, and outlines the importance of garment fit and consumer perception of ..

A written self-help intervention for depressed adults comparing behavioural activation combined with physical activity promotion with a self-help intervention based upon behavioural activation alone: study protocol for a parallel group pilot randomised controlled trial (BAcPAc)

notes: PMCID: PMC4061537types: Journal Article© 2014 Farrand et al.; licensee BioMed Central Ltd.Challenges remain to find ways to support patients with depression who have low levels of physical activity (PA) to overcome perceived barriers and enhance the perceived value of PA for preventing future relapse. There is an evidence-base for behavioural activation (BA) for depression, which focuses on supporting patients to restore activities that have been avoided, but practitioners have no specific training in promoting PA. We aimed to design and evaluate an integrated BA and PA (BAcPAc) practitioner-led, written, self-help intervention to enhance both physical and mental health.NPRI-

Implementation fidelity of a nurse-led falls prevention program in acute hospitals during the 6-PACK trial

Background: When tested in a randomized controlled trial (RCT) of 31,411 patients, the nurse-led 6-PACK falls prevention program did not reduce falls. Poor implementation fidelity (i.e., program not implemented as intended) may explain this result. Despite repeated calls for the examination of implementation fidelity as an essential component of evaluating interventions designed to improve the delivery of care, it has been neglected in prior falls prevention studies. This study examined implementation fidelity of the 6-PACK program during a large multi-site RCT. Methods: Based on the 6-PACK implementation framework and intervention description, implementation fidelity was examined by quantifying adherence to program components and organizational support. Adherence indicators were: 1) falls-risk tool completion; and for patients classified as high-risk, provision of 2) a ‘Falls alert’ sign; and 3) at least one additional 6-PACK intervention. Organizational support indicators were: 1) provision of resources (executive sponsorship, site clinical leaders and equipment); 2) implementation activities (modification of patient care plans; training; implementation tailoring; audits, reminders and feedback; and provision of data); and 3) program acceptability. Data were collected from daily bedside observation, medical records, resource utilization diaries and nurse surveys. Results: All seven intervention components were delivered on the 12 intervention wards. Program adherence data were collected from 103,398 observations and medical record audits. The falls-risk tool was completed each day for 75% of patients. Of the 38% of patients classified as high-risk, 79% had a ‘Falls alert’ sign and 63% were provided with at least one additional 6-PACK intervention, as recommended. All hospitals provided the recommended resources and undertook the nine outlined program implementation activities. Most of the nurses surveyed considered program components important for falls prevention. Conclusions: While implementation fidelity was variable across wards, overall it was found to be acceptable during the RCT. Implementation failure is unlikely to be a key factor for the observed lack of program effectiveness in the 6-PACK trial. Trial registration: The 6-PACK cluster RCT is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12611000332921 (29 March 2011)

Enhancing off-site manufacturing through early contractor involvement (ECI) in New Zealand

Procurement strategies that enable early contractor involvement (ECI) in design may enhance off-site manufacturing (OSM) by overcoming previously identified barriers to its uptake. Involving constructors during the design stage can reduce the risk of design buildability issues, and standardising traditionally bespoke ECI processes may help overcome cultural resistance to unfamiliar OSM technology. Following literature review and using case studies, document analysis and legal doctrine, a two-stage ECI conceptual process model for New Zealand is proposed. This was tested and refined following feedback at a conference. The model comprises a first-stage pre-construction contract and a second-stage standard-form construction contract. Key process variables are considered with solutions to provide collaboration and transparency while maintaining competitive fixed pricing across the supply chain. Legal doctrine analysis is used to distinguish between design buildability obligations and design codes compliance. The model contributes towards the development of a standard form for pre-construction contracts

Cultural value and cultural policy:Some evidence from the world of live music

This article considers live music policy in relation to wider debates on the cultural (as opposed to instrumental) value of the arts. The findings are based on research into amateur/enthusiast, state-funded and commercial concerts across a range of genres – classical, traditional folk, jazz, singer–songwriter and indie – using the Edinburgh Queen’s Hall venue as a case study. We argue that (1) articulations of the cultural or intrinsic value of live music across genres tend to lapse back into descriptions of instrumental value; (2) although explanations vary from audiences, artists and promoters as to why they participate in live music, they also share certain characteristics across genres and sometimes challenge stereotypes about genre-specific behaviours; and (3) there are lessons to be learned for live music policy from examining a venue that plays host to a range of genres and promotional practices

Fundamental Reform of Payment for Adult Primary Care: Comprehensive Payment for Comprehensive Care

Primary care is essential to the effective and efficient functioning of health care delivery systems, yet there is an impending crisis in the field due in part to a dysfunctional payment system. We present a fundamentally new model of payment for primary care, replacing encounter-based imbursement with comprehensive payment for comprehensive care. Unlike former iterations of primary care capitation (which simply bundled inadequate fee-for-service payments), our comprehensive payment model represents new investment in adult primary care, with substantial increases in payment over current levels. The comprehensive payment is directed to practices to include support for the modern systems and teams essential to the delivery of comprehensive, coordinated care. Income to primary physicians is increased commensurate with the high level of responsibility expected. To ensure optimal allocation of resources and the rewarding of desired outcomes, the comprehensive payment is needs/risk-adjusted and performance-based. Our model establishes a new social contract with the primary care community, substantially increasing payment in return for achieving important societal health system goals, including improved accessibility, quality, safety, and efficiency. Attainment of these goals should help offset and justify the costs of the investment. Field tests of this and other new models of payment for primary care are urgently needed