Cavity optomechanics with Si3N4 membranes at cryogenic temperatures

We describe a cryogenic cavity-optomechanical system that combines Si3N4 membranes with a mechanically-rigid Fabry-Perot cavity. The extremely high quality-factor frequency products of the membranes allow us to cool a MHz mechanical mode to a phonon occupation of less than 10, starting at a bath temperature of 5 kelvin. We show that even at cold temperatures thermally-occupied mechanical modes of the cavity elements can be a limitation, and we discuss methods to reduce these effects sufficiently to achieve ground state cooling. This promising new platform should have versatile uses for hybrid devices and searches for radiation pressure shot noise.Comment: 19 pages, 5 figures, submitted to New Journal of Physic

One-loop divergences in the two-dimensional non-anticommutative supersymmetric sigma-model

We discuss the structure of the non-anticommutative N=2 non-linear sigma-model in two dimensions, constructing differential operators which implement the deformed supersymmetry generators and using them to reproduce the classical action. We then compute the one-loop quantum corrections and express them in a more compact form using the differential operators.Comment: 20pp, 8 figures, uses LaTeX. Title expanded to clarify conten

Managing Patients With Heart Failure: A Qualitative Study of Multidisciplinary Teams With Specialist Heart Failure Nurses

PURPOSE The purpose of this study was to explore the perceptions and experiences of health care clinicians working in multidisciplinary teams that include specialist heart failure nurses when caring for the management of heart failure patients. METHODS We used a qualitative in-depth interview study nested in a broader ethnographic study of unplanned admissions in heart failure patients (HoldFAST). We interviewed 24 health care clinicians across primary, secondary, and community care in 3 locations in the Midlands, South Central, and South West of England. RESULTS Within a framework of the role and contribution of the heart failure specialist nurse, our study identified 2 thematic areas that the clinicians agreed still represent particular challenges when working with heart failure patients. The first was communication with patients, in particular explaining the diagnosis and helping patients to understand the condition. The participants recognized that such communication was most effective when they had a long-term relationship with patients and families and that the specialist nurse played an important part in achieving this relationship. The second was communication within the team. Multidisciplinary input was especially needed because of the complexity of many patients and issues around medications, and the participants believed the specialist nurse may facilitate team communication. CONCLUSIONS The study highlights the role of specialist heart failure nurses in delivering education tailored to patients and facilitating better liaison among all clinicians, particularly when dealing with the management of comorbidities and drug regimens. The way in which specialist nurses were able to be caseworkers for their patients was perceived as a method of ensuring coordination and continuity of care

Characterization of discriminative stimulus effects of the neuroactive steroid pregnanolone

ABSTRACT Reduced pregnane neurosteroids such as allopregnanolone and pregnanolone are potent neuromodulators able to affect a number of membrane receptors, including ␥-aminobutyric acid (GABA) A , N-methyl-D-aspartate (NMDA), 5-hydroxytryptamine (5-HT) 3 , and 1 receptors. The present study used a drug discrimination procedure to assess further the receptor effects of pregnanolone in vivo. Rats were trained to discriminate 5 mg/kg pregnanolone from saline in a two-lever operant task maintained by food reinforcement. The opiate agonist morphine and the negative GABA A modulator dehydroepiandrosterone sulfate did not substitute for pregnanolone. All of the GABA A positive modulators tested (allopregnanolone, epipregnanolone, androsterone, pentobarbital, midazolam, and zolpidem) dose dependently substituted for pregnanolone. The direct GABA-site agonists 4,5,6,7-tetrahydroisoxazolo[4,5-c]pyridin-3-ol and muscimol failed to substitute for pregnanolone. Ethanol and the 1 receptor agonist SKF 10047 fully substituted for pregnanolone, and the NMDA antagonist MK-801 partially substituted for pregnanolone. The 5-HT 3 antagonist tropisetron did not substitute at any dose tested. The 5-HT 3 agonist SR 57227A reached full substitution, whereas the other 5-HT 3 agonist tested, m-chlorophenylbiguanide, produced partial substitution. These results suggest that positive GABA A modulation, but not direct agonism, confers a discriminative stimulus effect similar to pregnanolone. Additionally, antagonism of NMDA receptors and activation of 5-HT 3 and 1 receptors modulate stimulus effects similar to the pregnanolone cue. Overall, the data suggest that pregnanolone produces discriminative stimulus effects representative of a wide-spectrum sedative hypnotic

Isotropic-nematic phase transition in suspensions of filamentous virus and the neutral polymer Dextran

We present an experimental study of the isotropic-nematic phase transition in an aqueous mixture of charged semi-flexible rods (fd virus) and neutral polymer (Dextran). A complete phase diagram is measured as a function of ionic strength and polymer molecular weight. At high ionic strength we find that adding polymer widens the isotropic-nematic coexistence region with polymers preferentially partitioning into the isotropic phase, while at low ionic strength the added polymer has no effect on the phase transition. The nematic order parameter is determined from birefringence measurements and is found to be independent of polymer concentration (or equivalently the strength of attraction). The experimental results are compared with the existing theoretical predictions for the isotropic-nematic transition in rods with attractive interactions.Comment: 8 Figures. To be published in Phys. Rev. E. For more information see http://www.elsie.brandeis.ed

Using the quality circle approach to empower disadvantaged youth in addressing cyberbullying: an exploration across five European countries

Digital communication technologies play an important role in the social development of young people, but can create vulnerabilities to cyberbullying and other negative online experiences. The Blurred Lives project aimed to tackle cyberbullying innovatively using a co-participatory approach, collaborating with 14–16-year olds living in areas of socio-economic disadvantage in five European countries. In phase one, 2,658 teenagers were surveyed on their internet use and any unpleasant online experiences. This data informed the second phase where the participating countries worked together with 237 adolescents across 10 schools with adult facilitators to create original anti-cyberbullying resources for teachers, parents/carers, peers, and social media providers using the Quality Circle approach. This methodology adopts an ethos of working together to solve a problem in small, peer-led groups. Each group was tasked with creating a resource for one of the target audience groups. The final resources comprise a rich variety of different formats including videos, comic strips, a board game, leaflets, posters, and newsletters. The pupil feedback highlights, for most but not all participants, an increased knowledge of cyberbullying and e-safety skills, as well as enhanced problem-solving skills, levels of confidence, and group work skills. Several operational challenges are also discussed, including the importance of school-level support, planning, staffing, and finding an appropriate balance between facilitator support and pupil agency

How can frontline expertise and new models of care best contribute to safely reducing avoidable acute admissions? A mixed-methods study of four acute hospitals

Background: Hospital emergency admissions have risen annually, exacerbating pressures on emergency departments (EDs) and acute medical units. These pressures have an adverse impact on patient experience and potentially lead to suboptimal clinical decision-making. In response, a variety of innovations have been developed, but whether or not these reduce inappropriate admissions or improve patient and clinician experience is largely unknown. Aims: To investigate the interplay of service factors influencing decision-making about emergency admissions, and to understand how the medical assessment process is experienced by patients, carers and practitioners. Methods: The project used a multiple case study design for a mixed-methods analysis of decision-making about admissions in four acute hospitals. The primary research comprised two parts: value stream mapping to measure time spent by practitioners on key activities in 108 patient pathways, including an embedded study of cost; and an ethnographic study incorporating data from 65 patients, 30 carers and 282 practitioners of different specialties and levels. Additional data were collected through a clinical panel, learning sets, stakeholder workshops, reading groups and review of site data and documentation. We used a realist synthesis approach to integrate findings from all sources. Findings: Patients’ experiences of emergency care were positive and they often did not raise concerns, whereas carers were more vocal. Staff’s focus on patient flow sometimes limited time for basic care, optimal communication and shared decision-making. Practitioners admitted or discharged few patients during the first hour, but decision-making increased rapidly towards the 4-hour target. Overall, patients’ journey times were similar, although waiting before being seen, for tests or after admission decisions, varied considerably. The meaning of what constituted an ‘admission’ varied across sites and sometimes within a site. Medical and social complexity, targets and ‘bed pressure’, patient safety and risk, each influenced admission/discharge decision-making. Each site responded to these pressures with different initiatives designed to expedite appropriate decision-making. New ways of using hospital ‘space’ were identified. Clinical decision units and observation wards allow potentially dischargeable patients with medical and/or social complexity to be ‘off the clock’, allowing time for tests, observation or safe discharge. New teams supported admission avoidance: an acute general practitioner service filtered patients prior to arrival; discharge teams linked with community services; specialist teams for the elderly facilitated outpatient treatment. Senior doctors had a range of roles: evaluating complex patients, advising and training juniors, and overseeing ED activity. Conclusions: This research shows how hospitals under pressure manage complexity, safety and risk in emergency care by developing ‘ground-up’ initiatives that facilitate timely, appropriate and safe decision-making, and alternative care pathways for lower-risk, ambulatory patients. New teams and ‘off the clock’ spaces contribute to safely reducing avoidable admissions; frontline expertise brings value not only by placing senior experienced practitioners at the front door of EDs, but also by using seniors in advisory roles. Although the principal limitation of this research is its observational design, so that causation cannot be inferred, its strength is hypothesis generation. Further research should test whether or not the service and care innovations identified here can improve patient experience of acute care and safely reduce avoidable admissions. Funding: The National Institute for Health Research (NIHR) Health Services and Delivery Research programme (project number 10/1010/06). This research was supported by the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula

The non-anticommutative supersymmetric Wess-Zumino model

We discuss the non-anticommutative (N=1/2) supersymmetric Wess-Zumino model in four dimensions. Firstly we introduce differential operators which implement the non-anticommutative supersymmetry algebra acting on the component fields and action. Then we perform the renormalisation of the model up to two-loop order, including the complete set of terms necessary for renormalisability. We show that (at least up to this order) the results obtained when we eliminate the auxiliary field after renormalisation are equivalent to those obtained when we eliminate the auxiliary fields before quantisation.Comment: 28 pages, 7 figures, uses LaTe