4,941 research outputs found
The Analytic Bootstrap and AdS Superhorizon Locality
We take an analytic approach to the CFT bootstrap, studying the 4-pt
correlators of d > 2 dimensional CFTs in an Eikonal-type limit, where the
conformal cross ratios satisfy |u| << |v| < 1. We prove that every CFT with a
scalar operator \phi must contain infinite sequences of operators O_{\tau,l}
with twist approaching \tau -> 2\Delta_\phi + 2n for each integer n as l ->
infinity. We show how the rate of approach is controlled by the twist and OPE
coefficient of the leading twist operator in the \phi x \phi OPE, and we
discuss SCFTs and the 3d Ising Model as examples. Additionally, we show that
the OPE coefficients of other large spin operators appearing in the OPE are
bounded as l -> infinity. We interpret these results as a statement about
superhorizon locality in AdS for general CFTs.Comment: 33 pages, no figures; V2 citations adde
(Extra)Ordinary Gauge Mediation
We study models of "(extra)ordinary gauge mediation," which consist of taking
ordinary gauge mediation and extending the messenger superpotential to include
all renormalizable couplings consistent with SM gauge invariance and an
R-symmetry. We classify all such models and find that their phenomenology can
differ significantly from that of ordinary gauge mediation. Some highlights
include: arbitrary modifications of the squark/slepton mass relations, small mu
and Higgsino NLSP's, and the possibility of having fewer than one effective
messenger. We also show how these models lead naturally to extremely simple
examples of direct gauge mediation, where SUSY and R-symmetry breaking occur
not in a hidden sector, but due to the dynamics of the messenger sector itself.Comment: 50 pages, 11 figure
Discrimination and synthesis of recursive quantum states in high-dimensional Hilbert spaces
We propose an interferometric method for statistically discriminating between
nonorthogonal states in high dimensional Hilbert spaces for use in quantum
information processing. The method is illustrated for the case of photon
orbital angular momentum (OAM) states. These states belong to pairs of bases
that are mutually unbiased on a sequence of two-dimensional subspaces of the
full Hilbert space, but the vectors within the same basis are not necessarily
orthogonal to each other. Over multiple trials, this method allows
distinguishing OAM eigenstates from superpositions of multiple such
eigenstates. Variations of the same method are then shown to be capable of
preparing and detecting arbitrary linear combinations of states in Hilbert
space. One further variation allows the construction of chains of states
obeying recurrence relations on the Hilbert space itself, opening a new range
of possibilities for more abstract information-coding algorithms to be carried
out experimentally in a simple manner. Among other applications, we show that
this approach provides a simplified means of switching between pairs of
high-dimensional mutually unbiased OAM bases
Hypoglycaemic emergencies attended by the Scottish Ambulance Service: a multiple methods investigation.
Background
Changing service demands require United Kingdom ambulance services to redefine their role and response strategies, in order to reduce unnecessary Emergency Department attendances. Treat and Refer guidelines have been developed with this aim in mind. However, these guidelines have been developed in the absence of reliable evidence or guiding mid-range theory. This has resulted in inconsistencies in clinical practice. One condition frequently included in Treat and Refer guidelines is hypoglycaemia. Therefore this thesis aimed to investigate prehospital hypoglycaemic emergencies in order to develop an evidence base for future interventions and guideline development.
Research approach
A pragmatic and inductive applied health services research approach was employed. Multiple methods were used in a sequential explanatory design. Three linked studies were undertaken with the results of previous studies informing the development of the next.
Study one: A scoping review of prehospital treatment of hypoglycaemic events.
Aims: i) To describe the demographics of the patient population requiring ambulance service assistance for hypoglycaemic emergencies; ii) To determine the extent to which post-hypoglycaemic patients with diabetes, who are prescribed oral hypoglycaemic agents (OHA), experience repeat hypoglycaemic events (RHE) after being treated in the prehospital environment.
Methods: A scoping literature review was conducted using an overlapping retrieval strategy that included both published and unpublished literature.
Findings: Twenty-three papers and other relevant material were included. Hypoglycaemia related ambulance calls account for 1.3% to 5.2% of ambulance calls internationally. Transportation rates varied between studies (25%-73%). Repeat hypoglycaemic emergencies are experienced by 2-7% of patients within 48 hours. There was insufficient detail to determine any relationship between repeat events and OHA. The low quality of included papers means that the results should be cautiously interpreted. The safety of leaving patients on OHA at home post hypoglycaemic emergency is unknown. Consequently patients taking OHAs who experience a hypoglycaemic emergency should be transported to hospital for observation. There was a lack of knowledge about the Scottish demographics of the patient population.
Study two: A retrospective cross-sectional observational study of diabetes related emergency calls.
Aims: To investigate i) the patient demographics and characteristics of hypoglycaemia related emergency calls; ii) the incidence of repeat hypoglycaemic events; and iii) the factors associated with emergency calls that result in individuals being left at home.
Methods: A retrospective observational cross-sectional study conducted using Medical Priority Dispatch System® call data from West of Scotland Ambulance Control Centre over a 12 month period. Data were extracted on age, gender, dispatch code, time of call, deprivation category, and immediate outcome (home or hospital). Multiple regression analysis was used to determine predictors of remaining at home.
Findings: 1319 calls for hypoglycaemia were received. Patient demographics were similar to the scoping review findings. Most patients remained at home (N = 916 vs N = 380; p < .001). RHE’s were experience by 3.1% within 48 hours, and 10.6% within two weeks. The most significant independent predictor for patients remaining at home was a prior call to the ambulance service (OR of 2.4 [95%CI 1.5 to 3.7]). Patients’ reasons for remaining at home and the causes of subsequent severe events are unknown. It is likely that non-clinical factors may explain some of this behaviour.
Study 3: Investigating patients’ experiences of prehospital hypoglycaemic care.
Aim: To investigate the experiences of patients who are attended by ambulance clinicians for a hypoglycaemic emergency.
Methods: In-depth interviews with adults with diabetes who had recently experienced a hypoglycaemic emergency treated by ambulance clinicians. Participants were recruited from Greater Glasgow and Clyde and Lanarkshire Health Board areas. Data were analysed using Framework Analysis.
Findings: Twenty six patients were interviewed. Three key themes were developed. Firstly, an explanation for help seeking behaviour; patients’ impaired awareness of hypoglycaemia as well as the inability of friends and relatives to cope can contribute to an ambulance call-out. Secondly, the perceptions of ambulance service care; patients felt the service provided was good; however ambulance clinicians’ advice was inconsistent. Thirdly, the influences on uptake of follow-up care; patient preferences for follow-up care were influenced by previous experiences of home, hospital and primary care. Post-hoc analysis identified three psychological theories that may explain these findings and provide a useful basis for intervention development: Common Sense Model (Leventhal et al, 1998); Health Belief Model (Rosenstock, 1966); Ley’s cognitive hypothesis model of communication (Ley and Llewelyn, 1995; 1981).
Conclusion
Most people treated for severe hypoglycaemia by ambulance clinicians remain at home and do not follow-up their care. A few experience repeat hypoglycaemic emergencies. Key causal, but modifiable factors, contributing to this include:- impaired awareness of hypoglycaemia; inconsistent delivery of ambulance clinician referral advice; and patients’ perceptions of the costs and benefits of follow-up care. Ambulance services cannot address all these factors in isolation. The studies in this thesis have generated an evidence base and identified plausible candidate theories. This will support the future development of novel interventions to improve severe hypoglycaemic emergency follow-up
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