Recurrent violent injury: magnitude, risk factors, and opportunities for intervention from a statewide analysis.

INTRODUCTION: Although preventing recurrent violent injury is an important component of a public health approach to interpersonal violence and a common focus of violence intervention programs, the true incidence of recurrent violent injury is unknown. Prior studies have reported recurrence rates from 0.8% to 44%, and risk factors for recurrence are not well established. METHODS: We used a statewide, all-payer database to perform a retrospective cohort study of emergency department visits for injury due to interpersonal violence in Florida, following up patients injured in 2010 for recurrence through 2012. We assessed risk factors for recurrence with multivariable logistic regression and estimated time to recurrence with the Kaplan-Meier method. We tabulated hospital charges and costs for index and recurrent visits. RESULTS: Of 53 908 patients presenting for violent injury in 2010, 11.1% had a recurrent violent injury during the study period. Trauma centers treated 31.8%, including 55.9% of severe injuries. Among recurrers, 58.9% went to a different hospital for their second injury. Low income, homelessness, Medicaid or uninsurance, and black race were associated with increased odds of recurrence. Patients with visits for mental and behavioral health and unintentional injury also had increased odds of recurrence. Index injuries accounted for $105 million in costs, and recurrent injuries accounted for another$25.3 million. CONCLUSIONS: Recurrent violent injury is a common and costly phenomenon, and effective violence prevention programs are needed. Prevention must include the nontrauma centers where many patients seek care

The Light Stop Scenario from Gauge Mediation

In this paper we embed the light stop scenario, a MSSM framework which explains the baryon asymmetry of the universe through a strong first order electroweak phase transition, in a top-down approach. The required low energy spectrum consists in the light SM-like Higgs, the right-handed stop, the gauginos and the Higgsinos while the remaining scalars are heavy. This spectrum is naturally driven by renormalization group evolution starting from a heavy scalar spectrum at high energies. The latter is obtained through a supersymmetry-breaking mix of gauge mediation, which provides the scalars masses by new gauge interactions, and gravity mediation, which generates gaugino and Higgsino masses. This supersymmetry breaking also explains the \mu\ and B_\mu\ parameters necessary for electroweak breaking and predicts small tri-linear mixing terms A_t in agreement with electroweak baryogenesis requirements. The minimal embedding predicts a Higgs mass around its experimental lower bound and by a small extension higher masses m_H\lesssim 127 GeV can be accommodated.Comment: 20 pages, 3 figures; v2: changes in the conventions; v3: more details on the Higgs mass prediction, version published in JHE

Multinational tagging efforts illustrate regional scale of distribution and threats for east pacific green turtles (Chelonia mydas agassizii).

Published onlineJournal ArticleResearch Support, Non-U.S. Gov'tThis is the final version of the article. Available from Public Library of Science via the DOI in this record.To further describe movement patterns and distribution of East Pacific green turtles (Chelonia mydas agassizii) and to determine threat levels for this species within the Eastern Pacific. In order to do this we combined published data from existing flipper tagging and early satellite tracking studies with data from an additional 12 satellite tracked green turtles (1996-2006). Three of these were tracked from their foraging grounds in the Gulf of California along the east coast of the Baja California peninsula to their breeding grounds in Michoacán (1337-2928 km). In addition, three post-nesting females were satellite tracked from Colola beach, Michoacán to their foraging grounds in southern Mexico and Central America (941.3-3020 km). A further six turtles were tracked in the Gulf of California within their foraging grounds giving insights into the scale of ranging behaviour. Turtles undertaking long-distance migrations showed a tendency to follow the coastline. Turtles tracked within foraging grounds showed that foraging individuals typically ranged up to 691.6 km (maximum) from release site location. Additionally, we carried out threat analysis (using the cumulative global human impact in the Eastern Pacific) clustering pre-existing satellite tracking studies from Galapagos, Costa Rica, and data obtained from this study; this indicated that turtles foraging and nesting in Central American waters are subject to the highest anthropogenic impact. Considering that turtles from all three rookeries were found to migrate towards Central America, it is highly important to implement conservation plans in Central American coastal areas to ensure the survival of the remaining green turtles in the Eastern Pacific. Finally, by combining satellite tracking data from this and previous studies, and data of tag returns we created the best available distributional patterns for this particular sea turtle species, which emphasized that conservation measures in key areas may have positive consequences on a regional scale.The work was supported by Earthwatch Institute, David and Lucile Packard Foundation, Wallace Research Foundation, PADI Foundation and the Arizona-Sonora Desert Museum. C. E. H. received a Masters degree bursary from the University of Exeter and the European Social Fund and would like to thank Consejo Nacional de Ciencia y Tecnología (Mexico) for support through a PhD scholarship. W. J. N. was supported by a Fulbright Fellowship and a Marshall Fellowship during the period field research in Baja California was conducted. B. J. G. is supported by the Darwin Initiative, European Social Fund and The Natural Environment Research Council. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

The Effective Lagrangian for Bulk Fermions in Models with Extra Dimensions

We compute the dimension 6 effective Lagrangian arising from the tree level integration of an arbitrary number of bulk fermions in models with warped extra dimensions. The coefficients of the effective operators are written in terms of simple integrals of the metric and are valid for arbitrary warp factors, with or without an infrared brane, and for a general Higgs profile. All relevant tree level fermion effects in electroweak and flavor observables can be computed using this effective Lagrangian.Comment: 22 pages. V2: typos corrected, matches published versio

Using appreciative inquiry as a framework to enhance the patient experience

The following case depicts the journey of a non-profit hospital in an under-served community and its attempts to turn around suffering patient experience. The Hospital turned to the theories of Appreciative Inquiry and the power of a strengths-based approach to create a framework to support the patient experience initiatives. Hospital leadership led the formation of a Patient Experience Team to implement ten initiatives in order increase the top box score in the domain of willingness to recommend the hospital, as that was selected as a global measure of success for the overall improvement project

Reducing Constraints in a Higher Dimensional Extension of the Randall and Sundrum Model

In order to investigate the phenomenological implications of warped spaces in more than five dimensions, we consider a $4+1+\delta$ dimensional extension to the Randall and Sundrum model in which the space is warped with respect to a single direction by the presence of an anisotropic bulk cosmological constant. The Einstein equations are solved, giving rise to a range of possible spaces in which the $\delta$ additional spaces are warped. Here we consider models in which the gauge fields are free to propagate into such spaces. After carrying out the Kaluza Klein (KK) decomposition of such fields it is found that the KK mass spectrum changes significantly depending on how the $\delta$ additional dimensions are warped. We proceed to compute the lower bound on the KK mass scale from electroweak observables for models with a bulk $SU(2)\times U(1)$ gauge symmetry and models with a bulk $SU(2)_R\times SU(2)_L\times U(1)$ gauge symmetry. It is found that in both cases the most favourable bounds are approximately $M_{KK}\gtrsim 2$ TeV, corresponding to a mass of the first gauge boson excitation of about 4-6 TeV. Hence additional warped dimensions offer a new way of reducing the constraints on the KK scale.Comment: 27 pages, 15 figures, v3: Additional comments in sections 1, 2 and 4. New appendix added. Five additional figures. References adde

Electroweak Constraints on Warped Geometry in Five Dimensions and Beyond

Here we consider the tree level corrections to electroweak (EW) observables from standard model (SM) particles propagating in generic warped extra dimensions. The scale of these corrections is found to be dominated by three parameters, the Kaluza-Klein (KK) mass scale, the relative coupling of the KK gauge fields to the Higgs and the relative coupling of the KK gauge fields to fermion zero modes. It is found that 5D spaces that resolve the hierarchy problem through warping typically have large gauge-Higgs coupling. It is also found in $D>5$ where the additional dimensions are warped the relative gauge-Higgs coupling scales as a function of the warp factor. If the warp factor of the additional spaces is contracting towards the IR brane, both the relative gauge-Higgs coupling and resulting EW corrections will be large. Conversely EW constraints could be reduced by finding a space where the additional dimension's warp factor is increasing towards the IR brane. We demonstrate that the Klebanov Strassler solution belongs to the former of these possibilities.Comment: 18 pages, 3 figures (references added) version to appear in JHE

Flavor Phenomenology in General 5D Warped Spaces

We have considered a general 5D warped model with SM fields propagating in the bulk and computed explicit expressions for oblique and non-oblique electroweak observables as well as for flavor and CP violating effective four-fermion operators. We have compared the resulting lower bounds on the Kaluza-Klein (KK) scale in the RS model and a recently proposed model with a metric modified towards the IR brane, which is consistent with oblique parameters without the need for a custodial symmetry. We have randomly generated 40,000 sets of O(1) 5D Yukawa couplings and made a fit of the quark masses and CKM matrix elements in both models. This method allows to identify the percentage of points consistent with a given KK mass, which in turn provides us with a measure for the required fine-tuning. Comparison with current experimental data on Rb, FCNC and CP violating operators exhibits an improved behavior of our model with respect to the RS model. In particular, allowing 10% fine-tuning the combined results point towards upper bounds on the KK gauge boson masses around 3.3 TeV in our model as compared with 13 TeV in the RS model. One reason for this improvement is that fermions in our model are shifted, with respect to fermions in the RS model, towards the UV brane thus decreasing the strength of the modifications of electroweak observables.Comment: 28 pages, 7 figures, 4 table

The Custodial Randall-Sundrum Model: From Precision Tests to Higgs Physics

We reexamine the Randall-Sundrum (RS) model with enlarged gauge symmetry SU(2)_L x SU(2)_R x U(1)_X x P_LR in the presence of a brane-localized Higgs sector. In contrast to the existing literature, we perform the Kaluza-Klein (KK) decomposition within the mass basis, which avoids the truncation of the KK towers. Expanding the low-energy spectrum as well as the gauge couplings in powers of the Higgs vacuum expectation value, we obtain analytic formulas which allow for a deep understanding of the model-specific protection mechanisms of the T parameter and the left-handed Z-boson couplings. In particular, in the latter case we explain which contributions escape protection and identify them with the irreducible sources of P_LR symmetry breaking. We furthermore show explicitly that no protection mechanism is present in the charged-current sector confirming existing model-independent findings. The main focus of the phenomenological part of our work is a detailed discussion of Higgs-boson couplings and their impact on physics at the CERN Large Hadron Collider. For the first time, a complete one-loop calculation of all relevant Higgs-boson production and decay channels is presented, incorporating the effects stemming from the extended electroweak gauge-boson and fermion sectors.Comment: 74 pages, 13 figures, 3 tables. v2: Matches version published in JHE

Naturalness bounds in extensions of the MSSM without a light Higgs boson

Adopting a bottom-up point of view, we make a comparative study of the simplest extensions of the MSSM with extra tree level contributions to the lightest Higgs boson mass. We show to what extent a relatively heavy Higgs boson, up to 200-350 GeV, can be compatible with data and naturalness. The price to pay is that the theory undergoes some change of regime at a relatively low scale. Bounds on these models come from electroweak precision tests and naturalness, which often requires the scale at which the soft terms are generated to be relatively low.Comment: 18 pages, 5 figures. v2: minor revision, added references. v3,v4: some numerical correction