Soliton formation from a pulse passing the zero-dispersion point in a nonlinear Schr\"odinger equation

We consider in detail the self-trapping of a soliton from a wave pulse that passes from a defocussing region into a focussing one in a spatially inhomogeneous nonlinear waveguide, described by a nonlinear Schrodinger equation in which the dispersion coefficient changes its sign from normal to anomalous. The model has direct applications to dispersion-decreasing nonlinear optical fibers, and to natural waveguides for internal waves in the ocean. It is found that, depending on the (conserved) energy and (nonconserved) mass of the initial pulse, four qualitatively different outcomes of the pulse transformation are possible: decay into radiation; self-trapping into a single soliton; formation of a breather; and formation of a pair of counterpropagating solitons. A corresponding chart is drawn on a parametric plane, which demonstrates some unexpected features. In particular, it is found that any kind of soliton(s) (including the breather and counterpropagating pair) eventually decays into pure radiation with the increase of the energy, the initial mass being kept constant. It is also noteworthy that a virtually direct transition from a single soliton into a pair of symmetric counterpropagating ones seems possible. An explanation for these features is proposed. In two cases when analytical approximations apply, viz., a simple perturbation theory for broad initial pulses, or the variational approximation for narrow ones, comparison with the direct simulations shows reasonable agreement.Comment: 18 pages, 10 figures, 1 table. Phys. Rev. E, in pres

Evaluation of the fidelity of an interactive face-to-face educational intervention to improve general practitioner management of back pain

OBJECTIVES: Implementation intervention effects can only be fully realised and understood if they are faithfully delivered. However the evaluation of implementation intervention fidelity is not commonly undertaken. The IMPLEMENT intervention was designed to improve the management of low back pain by general medical practitioners. It consisted of a two-session interactive workshop, including didactic presentations and small group discussions by trained facilitators. This study aimed to evaluate the fidelity of the IMPLEMENT intervention by assessing: (1) observed facilitator adherence to planned behaviour change techniques (BCTs); (2) comparison of observed and self-reported adherence to planned BCTs and (3) variation across different facilitators and different BCTs. DESIGN: The study compared planned and actual, and observed versus self-assessed delivery of BCTs during the IMPLEMENT workshops. METHOD: Workshop sessions were audiorecorded and transcribed verbatim. Observed adherence of facilitators to the planned intervention was assessed by analysing the workshop transcripts in terms of BCTs delivered. Self-reported adherence was measured using a checklist completed at the end of each workshop session and was compared with the 'gold standard' of observed adherence using sensitivity and specificity analyses. RESULTS: The overall observed adherence to planned BCTs was 79%, representing moderate-to-high intervention fidelity. There was no significant difference in adherence to BCTs between the facilitators. Sensitivity of self-reported adherence was 95% (95% CI 88 to 98) and specificity was 30% (95% CI 11 to 60). CONCLUSIONS: The findings suggest that the IMPLEMENT intervention was delivered with high levels of adherence to the planned intervention protocol. TRIAL REGISTRATION NUMBER: The IMPLEMENT trial was registered in the Australian New Zealand Clinical Trials Registry, ACTRN012606000098538 (http://www.anzctr.org.au/trial_view.aspx?ID=1162)

Cuspons, peakons and regular gap solitons between three dispersion curves

A general wave model with the cubic nonlinearity is introduced to describe a situation when the linear dispersion relation has three branches, which would intersect in the absence of linear couplings between the three waves. Actually, the system contains two waves with a strong linear coupling between them, to which a third wave is then coupled. This model has two gaps in its linear spectrum. Realizations of this model can be made in terms of temporal or spatial evolution of optical fields in, respectively, a planar waveguide or a bulk-layered medium resembling a photonic-crystal fiber. Another physical system described by the same model is a set of three internal wave modes in a density-stratified fluid. A nonlinear analysis is performed for solitons which have zero velocity in the reference frame in which the group velocity of the third wave vanishes. Disregarding the self-phase modulation (SPM) term in the equation for the third wave, we find two coexisting families of solitons: regular ones, which may be regarded as a smooth deformation of the usual gap solitons in a two-wave system, and cuspons with a singularity in the first derivative at their center. Even in the limit when the linear coupling of the third wave to the first two vanishes, the soliton family remains drastically different from that in the linearly uncoupled system; in this limit, regular solitons whose amplitude exceeds a certain critical value are replaced by peakons. While the regular solitons, cuspons, and peakons are found in an exact analytical form, their stability is tested numerically, which shows that they all may be stable. If the SPM terms are retained, we find that there again coexist two different families of generic stable soliton solutions, namely, regular ones and peakons.Comment: a latex file with the text and 10 pdf files with figures. Physical Review E, in pres

Working with physical therapists to develop and evaluate an evidence-based online module for Developmental Coordination Disorder (DCD): bridging the knowledge-to-practice gap

Aims: Developmental Coordination Disorder (DCD) is a chronic condition with potential negative health consequences. Clinicians working with children with DCD need access to tailored, synthesized, evidence-based DCD information; however a knowledge-to-practice gap exists. The aim of this study was to develop and evaluate an evidence-based online DCD module tailored to physical therapists’ (PTs) identified needs. Methods: Guided by the Knowledge to Action framework, we interviewed PTs working with children with DCD (n=9) to identify their information needs. Their recommendations, along with synthesized DCD research evidence, informed module development. PTs (n=50) responded to scaled items and open-ended questions to evaluate module usefulness. Results: The module incorporated important PT DCD content areas including: 1) Identification; 2) Planning Interventions and Goals; 3) Evidence-Based Practice; 4) Management; and, 5) Resources. Case scenarios, clinical applications, interactive media, links to resources, and interactive learning opportunities were also embedded. PTs perceived the module to be comprehensive and useful and provided feedback to improve module navigation. Conclusions: Involving end-users throughout the development and evaluation of an online PT DCD module contributed to its relevance, applicability, and utility. The ongoing clinical use of this module may have the potential to improve the quality of PT DCD services

Developing the content of two behavioural interventions : using theory-based interventions to promote GP management of upper respiratory tract infection without prescribing antibiotics #1

Background: Evidence shows that antibiotics have limited effectiveness in the management of upper respiratory tract infection (URTI) yet GPs continue to prescribe antibiotics. Implementation research does not currently provide a strong evidence base to guide the choice of interventions to promote the uptake of such evidence-based practice by health professionals. While systematic reviews demonstrate that interventions to change clinical practice can be effective, heterogeneity between studies hinders generalisation to routine practice. Psychological models of behaviour change that have been used successfully to predict variation in behaviour in the general population can also predict the clinical behaviour of healthcare professionals. The purpose of this study was to design two theoretically-based interventions to promote the management of upper respiratory tract infection (URTI) without prescribing antibiotics. Method: Interventions were developed using a systematic, empirically informed approach in which we: selected theoretical frameworks; identified modifiable behavioural antecedents that predicted GPs intended and actual management of URTI; mapped these target antecedents on to evidence-based behaviour change techniques; and operationalised intervention components in a format suitable for delivery by postal questionnaire. Results: We identified two psychological constructs that predicted GP management of URTI: "Self-efficacy," representing belief in one's capabilities, and "Anticipated consequences," representing beliefs about the consequences of one's actions. Behavioural techniques known to be effective in changing these beliefs were used in the design of two paper-based, interactive interventions. Intervention 1 targeted self-efficacy and required GPs to consider progressively more difficult situations in a "graded task" and to develop an "action plan" of what to do when next presented with one of these situations. Intervention 2 targeted anticipated consequences and required GPs to respond to a "persuasive communication" containing a series of pictures representing the consequences of managing URTI with and without antibiotics. Conclusion: It is feasible to systematically develop theoretically-based interventions to change professional practice. Two interventions were designed that differentially target generalisable constructs predictive of GP management of URTI. Our detailed and scientific rationale for the choice and design of our interventions will provide a basis for understanding any effects identified in their evaluation. Trial registration: Clinicaltrials.gov NCT00376142This study is funded by the European Commission Research Directorate as part of a multi-partner program: Research Based Education and Quality Improvement (ReBEQI): A Framework and tools to develop effective quality improvement programs in European healthcare. (Proposal No: QLRT-2001-00657)

Unsteady undular bores in fully nonlinear shallow-water theory

We consider unsteady undular bores for a pair of coupled equations of Boussinesq-type which contain the familiar fully nonlinear dissipationless shallow-water dynamics and the leading-order fully nonlinear dispersive terms. This system contains one horizontal space dimension and time and can be systematically derived from the full Euler equations for irrotational flows with a free surface using a standard long-wave asymptotic expansion. In this context the system was first derived by Su and Gardner. It coincides with the one-dimensional flat-bottom reduction of the Green-Naghdi system and, additionally, has recently found a number of fluid dynamics applications other than the present context of shallow-water gravity waves. We then use the Whitham modulation theory for a one-phase periodic travelling wave to obtain an asymptotic analytical description of an undular bore in the Su-Gardner system for a full range of "depth" ratios across the bore. The positions of the leading and trailing edges of the undular bore and the amplitude of the leading solitary wave of the bore are found as functions of this "depth ratio". The formation of a partial undular bore with a rapidly-varying finite-amplitude trailing wave front is predicted for ``depth ratios'' across the bore exceeding 1.43. The analytical results from the modulation theory are shown to be in excellent agreement with full numerical solutions for the development of an undular bore in the Su-Gardner system.Comment: Revised version accepted for publication in Phys. Fluids, 51 pages, 9 figure

Self-management interventions to improve skin care for pressure ulcer prevention in people with spinal cord injuries: A systematic review protocol

Background: Pressure ulcers are a serious, common, lifelong, and costly secondary complication of spinal cord injury (SCI). Community-dwelling people with a SCI can prevent them with appropriate skin care (i.e. pressure relieving activities, skin checks). Adherence to skin care remains suboptimal however, and self-management interventions that focus on improving this have been designed. Little is known on their content, effectiveness, or theoretical basis. The aim of the proposed systematic review is to synthesize the literature on self-management interventions to improve skin care in people with a SCI. Specific objectives are to describe these interventions in relation to their content, effectiveness, theory base, and adherence to reporting guidelines for intervention description. Methods: The search strategy will combine an electronic search of nine bibliographic databases (MEDLINE, Embase, PsycInfo, CENTRAL, CINAHL, Rehabdata, CIRRIE, PEDro, ERIC) and two trial registers with a manual search of relevant reference lists. Predefined eligibility criteria will be applied in a two-phase selection process involving title and abstract screening, followed by full-text screening. A data extraction spreadsheet will be applied to included papers. Intervention content will be coded using two taxonomies (behaviour change taxonomy; PRISMS self-management support taxonomy). A validated tool (Theory Coding Scheme) and the Template for Intervention Description and Replication (TIDieR) will be used to examine theoretical basis and assess adherence to reporting guidelines for intervention description. A small number of heterogeneous studies are likely to be included in this review therefore a narrative synthesis is planned. Discussion: This systematic review will help identify the gaps and priorities to guide future research activities in this area. Systematic review registration: PROSPERO CRD4201603319

Noise induced oscillations in non-equilibrium steady state systems

We consider effect of stochastic sources upon self-organization process being initiated with creation of the limit cycle. General expressions obtained are applied to the stochastic Lorenz system to show that departure from equilibrium steady state can destroy the limit cycle at certain relation between characteristic scales of temporal variation of principle variables. Noise induced resonance related to the limit cycle is found to appear if the fastest variations displays a principle variable, which is coupled with two different degrees of freedom or more.Comment: 11 pages, 4 figures. Submitted to Physica Script

The impact of Cochrane Systematic Reviews : a mixed method evaluation of outputs from Cochrane Review Groups supported by the UK National Institute for Health Research

© 2014 Bunn et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background: There has been a growing emphasis on evidence-informed decision making in health care. Systematic reviews, such as those produced by the Cochrane Collaboration, have been a key component of this movement. The UK National Institute for Health Research (NIHR) Systematic Review Programme currently supports 20 Cochrane Review Groups (CRGs). The aim of this study was to identify the impacts of Cochrane reviews published by NIHR funded CRGs during the years 2007-11. Methods: We sent questionnaires to CRGs and review authors, interviewed guideline developers and used bibliometrics and documentary review to get an overview of CRG impact and to evaluate the impact of a sample of 60 Cochrane reviews. We used a framework with four categories (knowledge production, research targeting, informing policy development, and impact on practice/services). Results: A total of 1502 new and updated reviews were produced by the 20 NIHR funded CRGs between 2007-11. The clearest impacts were on policy with a total of 483 systematic reviews cited in 247 sets of guidance; 62 were international, 175 national (87 from the UK) and 10 local. Review authors and CRGs provided some examples of impact on practice or services, for example safer use of medication, the identification of new effective drugs or treatments and potential economic benefits through the reduction in the use of unproven or unnecessary procedures. However, such impacts are difficult to objectively document and the majority of reviewers were unsure if their review had produced specific impacts. Qualitative data suggested that Cochrane reviews often play an instrumental role in informing guidance although a poor fit with guideline scope or methods, reviews being out of date and a lack of communication between CRGs and guideline developers were barriers to their use. Conclusions: Health and economic impacts of research are generally difficult to measure. We found that to be the case with this evaluation. Impacts on knowledge production and clinical guidance were easier to identify and substantiate than those on clinical practice. Questions remain about how we define and measure impact and more work is needed to develop suitable methods for impact analysis.Peer reviewe