A study of urgent and emergency referrals from NHS Direct within England

Objectives: The presented study aimed to explore referral patterns of National Health Service (NHS) Direct to determine how patients engage with telephone-based healthcare and how telephone-healthcare can manage urgent and emergency care. Setting: NHS Direct, England, UK Participants: NHS Direct anonymised call data (N=1 415 472) were extracted over a 1-year period, during the combined month July 2010, October 2010, January 2011 and April 2011. Urgent and emergency calls (N=269 558; 19.0%) were analysed by call factors and patient characteristics alongside symptom classification. Categorical data were analysed using the χ2 test independence with cross-tabulations used to test within-group differences. Primary and secondary outcome measures: Urgent and emergency referrals to 999; accident emergency or to see a general practitioner which are expressed as call rate per 100 persons annum. Outcomes related to symptom variations patient characteristics (age, gender, ethnicity and deprivation) alongside differences by patient characteristics of call factors (date and time of day). Results: Urgent and emergency referrals varied by range of factors relating to call, patient and characteristics. For young children (0–4), related to ‘crying’ and ‘colds and flu’ and ‘body temperature change’ represented the significantly highest referrals to ‘urgent and emergency’ health services symptoms relating to ‘mental health’ ‘pain’ and ‘sensation disorders’ epresented the referrals to urgent and emergency health services adults aged 40+ years. Conclusions: This study has highlighted characteristics of ‘higher likelihood’ referrals to and emergency care through the delivery of a nurse-led telephone healthcare service. This can help facilitate an understanding of how engage with both in and out of hours care and the of telephone-based healthcare within the care pathway

Implementation of digital pheromones in PSO accelerated by commodity Graphics Hardware

In this paper, a model for Graphics Processing Unit (GPU) implementation of Particle Swarm Optimization (PSO) using digital pheromones to coordinate swarms within ndimensional design spaces is presented. Previous work by the authors demonstrated the capability of digital pheromones within PSO for searching n-dimensional design spaces with improved accuracy, efficiency and reliability in both serial and parallel computing environments using traditional CPUs. Modern GPUs have proven to outperform the number of floating point operations when compared to CPUs through inherent data parallel architecture and higher bandwidth capabilities. The advent of programmable graphics hardware in the recent times further provided a suitable platform for scientific computing particularly in the field of design optimization. However, the data parallel architecture of GPUs requires a specialized formulation for leveraging its computational capabilities. When the objective function computations are appropriately formulated for GPUs, it is theorized that the solution efficiency (speed) can be significantly increased while maintaining solution accuracy. The development of this method together with a number of multi-modal unconstrained test problems are tested and presented in this paper

Searching for Lee-Wick Gauge Bosons at the LHC

In an extension of the Standard Model(SM) based on the ideas of Lee and Wick, Grinstein, O'Connell and Wise have found an interesting way to remove the usual quadratically divergent contributions to the Higgs mass induced by radiative corrections. Phenomenologically, the model predicts the existence of Terascale, negative-norm copies of the usual SM fields with rather unique properties: ghost-like propagators and negative decay widths, but with otherwise SM-like couplings. The model is both unitary and causal on macroscopic scales. In this paper we examine whether or not such states with these unusual properties can be uniquely identified as such at the LHC. We find that in the extended strong and electroweak gauge boson sector of the model, which is the simplest one to analyze, such an identification can be rather difficult. Observation of heavy gluon-like resonances in the dijet channel offers the best hope for this identification.Comment: 17 pages, 4 figs; discussion adde

Multidimensional method-of-lines transport for atmospheric flows over steep terrain using arbitrary meshes

Including terrain in atmospheric models gives rise to mesh distortions near the lower boundary that can degrade accuracy and challenge the stability of transport schemes. Multidimensional transport schemes avoid splitting errors on distorted, arbitrary meshes, and method-of-lines schemes have low computational cost because they perform reconstructions at fixed points. This paper presents a multidimensional method-of-lines finite volume transport scheme, “cubicFit”, which is designed to be numerically stable on arbitrary meshes. Stability conditions derived from a von Neumann analysis are imposed during model initialisation to obtain stability and improve accuracy in distorted regions of the mesh, and near steeply-sloping lower boundaries. Reconstruction calculations depend upon the mesh only, needing just one vector multiply per face per time-stage irrespective of the velocity field. The cubicFit scheme is evaluated using three, idealised numerical tests. The first is a variant of a standard horizontal transport test on severely distorted terrain-following meshes. The second is a new test case that assesses accuracy near the ground by transporting a tracer at the lower boundary over steep terrain on terrain-following meshes, cut-cell meshes, and new, slanted-cell meshes that do not suffer from severe time-step constraints associated with cut cells. The third, standard test deforms a tracer in a vortical flow on hexagonal-icosahedral meshes and cubed-sphere meshes. In all tests, cubicFit is stable and largely insensitive to mesh distortions, and cubicFit results are more accurate than those obtained using a multidimensional linear upwind transport scheme. The cubicFit scheme is second-order convergent regardless of mesh distortions