An exploratory study of medical outpatients’ use of mobiles and internet in Malta

Introduction: Medical services face inexorably rising demand, due to ageing populations, who tend to suffer from chronic diseases. Self-management is advocated to better chronic disease outcomes; mobile technology and Internet are potential channels for improving patient self- care models. It enables targeted patient information and feedback, as well the potential to improve effectiveness via better adherence. The evidence base to date looks promising, but is limited and needs further assessment. Malta has a mobile subscription rate of 117%, with 64.3% of the population being Internet users;70% of households have internet access, rising to 96% of households with children; older persons are least likely to have internet access. Objectives: To assess mobile phone ownership, SMS (short messaging service) and Internet access by patients attending Medical Outpatients in two Health Centres. Methods: Consecutive medical outpatients attending between Oct 2011-Jan 2012 were asked about their mobile phone ownership, SMS usage and Internet access; demographic data including age decile and gender were also noted. Data was completely anonymised. Results: 205 patients were included in this pilot sample, comprising 44.7% men, 55.3% women. The mean ages were 63 years for men and 65 years for women. 77% use a mobile phone, over half use SMSs and just over a third have Internet access at home. There was no gender difference for mobile and SMS usage; Internet usage was somewhat commoner in men, but the numbers were too small to achieve significance. Conclusions: Mobile phone usage is common in this group of medical outpatients, especially in the deciles most likely to suffer from chronic disease. SMS usage is common. Home Internet usage reflects the older patient population - but compares favourably with the national rate of 31.7% to 12.7% quoted for individuals ranging from 55-74 years. Use of these channels is feasible-although this will require a ‘blended’ approach so as to target patients appropriately.peer-reviewe

Several types of types in programming languages

Types are an important part of any modern programming language, but we often forget that the concept of type we understand nowadays is not the same it was perceived in the sixties. Moreover, we conflate the concept of "type" in programming languages with the concept of the same name in mathematical logic, an identification that is only the result of the convergence of two different paths, which started apart with different aims. The paper will present several remarks (some historical, some of more conceptual character) on the subject, as a basis for a further investigation. The thesis we will argue is that there are three different characters at play in programming languages, all of them now called types: the technical concept used in language design to guide implementation; the general abstraction mechanism used as a modelling tool; the classifying tool inherited from mathematical logic. We will suggest three possible dates ad quem for their presence in the programming language literature, suggesting that the emergence of the concept of type in computer science is relatively independent from the logical tradition, until the Curry-Howard isomorphism will make an explicit bridge between them.Comment: History and Philosophy of Computing, HAPOC 2015. To appear in LNC

First-Principles Semiclassical Initial Value Representation Molecular Dynamics

A method for carrying out semiclassical initial value representation calculations using first-principles molecular dynamics (FP-SC-IVR) is presented. This method can extract the full vibrational power spectrum of carbon dioxide from a single trajectory providing numerical results that agree with experiment even for Fermi resonant states. The computational demands of the method are comparable to those of classical single-trajectory calculations, while describing uniquely quantum features such as the zero-point energy and Fermi resonances. By propagating the nuclear degrees of freedom using first-principles Born-Oppenheimer molecular dynamics, the stability of the method presented is improved considerably when compared to dynamics carried out using fitted potential energy surfaces and numerical derivatives.Comment: 5 pages, 2 figures, made stylistic and clarity change

What do Cardiovascular patients think about their referrals?

Introduction: The referral process from primary to secondary care establishes the basis for subsequent care in chronic conditions. The aim of the study was to describe patient perceptions of the information in the Ticket of Referral (TOR) using cardiovascular referrals as an exemplar. Methods: Consecutive cardiovascular referrals to MCC and Cardiology Outpatients were invited to participate anonymously in a brief semi-structured audio-recorded interview (Aug-Sep 2014). They ranked fields in the TOR on a scale of1(essential) to 4 (should not be included), and identified the three most/least important fields. They indicated whether other information was required, and whether the inclusion of a checklist of cardiovascular risk factors would be helpful. Data was entered into Excel and analysed with descriptive statistics, ranking and content analysis. Results: 53 patients were invited, three declined; most participants were over 50 years, 50% male, 50% female. Fields scored highly included 'Current treatment and allergies' and 'Clinical examination findings'; low scores were awarded to 'Next of kin,' 'telephone' and 'mobile' numbers'. The most important fields identified were 'Identity card number' and 'Reasons for referral'. Patient contact details including 'telephone number' and 'address' were identified as least important. Most patients did not consider other information was required; however, 96% considered it would be helpful to include cardiovascular risk factors. Conclusion: 'ID number', and 'Reasons for referral' were identified as most important, with 'Current treatment and allergies' and 'clinical findings' highly scored. Patients considered the inclusion of relevant risk factors could be useful which may be helpful for self-care.peer-reviewe

Stationary Black Holes: Uniqueness and Beyond

The spectrum of known black-hole solutions to the stationary Einstein equations has been steadily increasing, sometimes in unexpected ways. In particular, it has turned out that not all black-hole-equilibrium configurations are characterized by their mass, angular momentum and global charges. Moreover, the high degree of symmetry displayed by vacuum and electro-vacuum black-hole spacetimes ceases to exist in self-gravitating non-linear field theories. This text aims to review some developments in the subject and to discuss them in light of the uniqueness theorem for the Einstein-Maxwell system.Comment: Major update of the original version by Markus Heusler from 1998. Piotr T. Chru\'sciel and Jo\~ao Lopes Costa succeeded to this review's authorship. Significantly restructured and updated all sections; changes are too numerous to be usefully described here. The number of references increased from 186 to 32

Mechanism of Thermal Reversal of the (Fulvalene)tetracarbonyldiruthenium Photoisomerization: Toward Molecular Solar-Thermal Energy Storage

In the currently intensifying quest to harness solar energy for the powering of our planet, most efforts are centered around photoinduced generic charge separation, such as in photovoltaics, water splitting, other small molecule activation, and biologically inspired photosynthetic systems. In contrast, direct collection of heat from sunlight has received much less diversified attention, its bulk devoted to the development of concentrating solar thermal power plants, in which mirrors are used to focus the sun beam on an appropriate heat transfer material. An attractive alternative strategy would be to trap solar energy in the form of chemical bonds, ideally through the photoconversion of a suitable molecule to a higher energy isomer, which, in turn, would release the stored energy by thermal reversal. Such a system would encompass the essential elements of a rechargeable heat battery, with its inherent advantages of storage, transportability, and use on demand. The underlying concept has been explored extensively with organic molecules (such as the norbornadiene-quadricyclane cycle), often in the context of developing photoswitches. On the other hand, organometallic complexes have remained relatively obscure in this capacity, despite a number of advantages, including expanded structural tunability and generally favorable electronic absorption regimes. A highly promising organometallic system is the previously reported, robust photo-thermal fulvalene (Fv) diruthenium couple 1 {l_reversible} 2 (Scheme 1). However, although reversible and moderately efficient, lack of a full, detailed atom-scale understanding of its key conversion and storage mechanisms have limited our ability to improve on its performance or identify optimal variants, such as substituents on the Fv, ligands other than CO, and alternative metals. Here we present a theoretical investigation, in conjunction with corroborating experiments, of the mechanism for the heat releasing step of 2 {yields} 1 and its Fe (4) and Os (6) relatives. The results of the combined study has enabled a rigorous interpretation of earlier and new experimental measurements and paint a surprising picture. First-principles calculations were employed based on spin unrestricted density functional theory (DFT) with a non-empirical gradient corrected exchange-correlation functional. Ultrasoft pseudopotentials were used to describe the valence-core interactions of electrons, including scalar relativistic effects of the core. Wavefunctions and charge densities were expanded in plane waves with kinetic energies up to 25 and 200 Rydberg, respectively. Reaction pathways were delineated with the string method, as implemented within the Car-Parrinello approach. This method allows for the efficient determination of the minimum energy path (MEP) of atomistic transitions and thus also saddle points (transition states, TSs), which are the energy maxima along the MEP. All geometries were optimized until all forces on the atoms were less than 0.02 eV/{angstrom}. The calculated structures of 1 and 2 were in good agreement with their experimental counterparts

Pooling and expanding registries of familial hypercholesterolaemia to assess gaps in care and improve disease management and outcomes : Rationale and design of the global EAS Familial Hypercholesterolaemia Studies Collaboration

Background: The potential for global collaborations to better inform public health policy regarding major non-hypercholesterolaemia (FH), a common genetic disorder associated with premature cardiovascular disease, is yet to be reliably ascertained using similar approaches. The European Atherosclerosis Society FH Studies Collaboration (EAS FHSC) is a new initiative of international stakeholders which will help establish a global FH registry to generate large-scale, robust data on the burden of FH worldwide. Methods: The EAS FHSC will maximise the potential exploitation of currently available and future FH data (retrospective and prospective) by bringing together regional/national/international data sources with access to individuals with a clinical and/or genetic diagnosis of heterozygous or homozygous FH. A novel bespoke electronic platform and FH Data Warehouse will be developed to allow secure data sharing, validation, cleaning, pooling, harmonisation and analysis irrespective of the source or format. Standard statistical procedures will allow us to investigate cross-sectional associations, patterns of real-world practice, trends over time, and analyse risk and outcomes (e.g. cardiovascular outcomes, all-cause death), accounting for potential confounders and subgroup effects. Conclusions: The EAS FHSC represents an excellent opportunity to integrate individual efforts across the world to tackle the global burden of FH. The information garnered from the registry will help reduce gaps in knowledge, inform best practices, assist in clinical trials design, support clinical guidelines and policies development, and ultimately improve the care of FH patients. (C) 2016 Elsevier Ireland Ltd.Peer reviewe

Mechanism of Macroscopic Motion of Oleate Helical Assemblies : Cooperative Deprotonation of Carboxyl Groups Triggered by Photoisomerization of Azobenzene Derivatives

Macroscopic and spatially ordered motions of self-assemblies composed of oleic acid and a small amount of an azobenzene derivative, induced by azobenzene photoisomerization, was previously reported. However, the mechanism of the generation of submillimeter-scale motions by the nanosized structural transition of azobenzene was not clarified. Herein, an underlying mechanism of the motions is proposed in which deprotonation of carboxyl groups in co-operation with azobenzene photoisomerization causes a morphological transition of the self-assembly, which in turn results in macroscopic forceful dynamics. The photoinduced deprotonation was investigated by potentiometric pH titration and FTIR spectroscopy. The concept of hierarchical molecular interaction generating macroscale function is expected to promote the next stage of supramolecular chemistry