The Development of a National Paediatric Psycho-Oncology Service.

Aims To investigate the psychological care provided to children and young adolescents with cancer and their families within the National Children's Cancer Service (NCCS), Ireland, in respect of the national and international standards of care. Methods A retrospective audit of 316 referrals made over 32 months by the NCCS to the psychology service in malignant haematology and oncology was performed. Results The audit revealed that out of 316 patients, a yearly average of 189 (50%) of urgently referred patients received psychological support within the NCCS between January 2013 and August 2016. Furthermore only 20 (22%) undergoing haematopoietic stem cell transplantation (HSCT), 14 (22%) referred to the paediatric palliative care team, and 84 (62%) of teenage patients received psychological input during this timeframe. Conclusion The audit revealed that the current psychology service provision is failing to meet the international standards of care. Due to the data provided by this audit, in conjunction with a clinical risk assessment of the service, funds for the post of principal psychologist have been secured. Further psychology posts (HSCT, late-effects and neuropsychology), and development of the psycho-oncology model of care are required to ensure equality of access and evidence-based psychological care for all children with cancer.

Mathematical model of Zika virus with vertical transmission.

Zika is a flavivirus transmitted to humans through either the bites of infected Aedes mosquitoes or sexual transmission. Zika has been linked to congenital anomalies such as microcephaly. In this paper, we analyze a new system of ordinary differential equations which incorporates human vertical transmission of Zika virus, the birth of babies with microcephaly and asymptomatically infected individuals. The Zika model is locally and globally asymptotically stable when the basic reproduction number is less than unity. Our model shows that asymptomatic individuals amplify the disease burden in the community, and the most important parameters for ZIKV spread are the death rate of mosquitoes, the mosquito biting rate, the mosquito recruitment rate, and the transmission per contact to mosquitoes and to adult humans. Scenario exploration indicates that personal-protection is a more effective control strategy than mosquito-reduction strategy. It also shows that delaying conception reduces the number of microcephaly cases, although this does little to prevent Zika transmission in the broader community. However, by coupling aggressive vector control and personal protection use, it is possible to reduce both microcephaly and Zika transmission. 2000 Mathematics Subject Classifications: 92B05, 93A30, 93C15.

Peierls transitions in ionic organic charge-transfer crystals with spin and charge degrees of freedom.

The quasi-one-dimensional electronic structure of organic charge-transfer (CT) salts rationalizes Peierls transitions in mixed or segregated stacks of pi-electron donors (D) and acceptors (A). A microscopic Peierls-Hubbard model, HCT, is presented for CT salts with mixed stacks (Drho+Arho-)n and ionicity rho > 0.7. Dimerization opens a Peierls gap that, due to electron correlation, is the singlet-triplet gap, EST. In contrast to spin-Peierls systems, such as Heisenberg spin chains with rho = 1 and TSP < 20 K, Peierls transitions in CT salts with rho < 1 occur at higher TP and involve both spin and charge degrees of freedom. Linear electron-phonon coupling and an adiabatic approximation for a harmonic lattice are used to model the dimerization amplitude deltaT for T < TP, the magnetic (spin) susceptibility chiT, and the relative infrared intensity of totally symmetric molecular modes. Exact thermodynamics of HCT for stacks up to N = 12 sites are applied to two CT salts with TP approximately 50 and 120 K whose magnetism and infrared have not been modeled previously and to CT salts with inaccessibly high TP > 350 K whose description has been difficult. Ionic CT salts are correlated Peierls systems with a degenerate ground state (GS) at T = 0 whose elementary excitations are spin solitons, while dimerized ion-radical stacks that support triplet-spin excitons have nondegenerate GS. In less ionic CT salts, modulation of HCT parameters on cooling or under pressure leads to Peierls and/or neutral-ionic transitions of the GS, without appreciable thermal population of excited states. Correlations change the gap equation that relates EST at T = 0 to TP compared to free electrons, and size convergence is fast in stacks with large delta0 and high TP.

Disorder in organic charge-transfer single crystals: dipolar disorder in ClMePD-DMeDCNQI.

The unusual electronic, vibrational, and structural properties of the title compound are associated with the polar donor D=2-chloro-5-methyl-p-phenylenediamine, which is twofold disordered in single crystals. Its 3 D dipole generates random site energies with standard deviation sigma=0.35 eV that significantly alter the standard description of charge-transfer (CT) salts with nonpolar donors and acceptors. The average structure at 298 and 150 K is centrosymmetric, space group P1, and consistent with increasing degree of CT (or ionicity rho) on cooling. Vibrational spectra indicate that rho increases from approximately 0.3 at 400 K to approximately 0.6 at 80 K, with coincident Raman and infrared (IR) molecular modes in contrast with the centrosymmetric structure. Dipolar disorder is modeled by adding random site energies to Peierls-Hubbard models of CT salts, and sigma=0.35 eV is shown to suppress the Peierls instability for typical bandwidth and lattice stiffness, in agreement with the structural data. Disorder also breaks inversion symmetry and rationalizes coincident Raman and IR modes. The combination of site energies xp and the dipole operator P for systems with periodic boundary conditions leads at molecule p to (partial differentialP/ partial differentialxp)2 for the IR intensity polarized along the DA stack. The ensemble average of (partial differentialP/ partial differentialxp)2 for sigma=0.35 eV as a function of the ground-state ionicity rho accounts for the intensity variations of totally symmetric molecular modes of D and A, either on cooling at ambient pressure or on squeezing at ambient temperature.