8,962 research outputs found

    The impact of private sector provision on equitable provision of coronary revascularisation

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    Objective: To investigate the impact of including private sector data on assessments of equity of coronary revascularisation provision using NHS data only. Design: Analyses of Hospital Episodes Statistics and private sector data by age, sex, and PCT of residence. For each PCT, the share of London's total population and revascularisations (all admissions, NHS-funded, and privately-funded admissions) were calculated. GINI coefficients were derived to provide an index of inequality across sub-populations, with parametric bootstrapping to estimate confidence intervals. Setting: London Participants London residents undergoing coronary revascularisation April 2001 - December 2003. Intervention Coronary artery bypass graft or angioplasty Main outcome measures: Directly-standardised revascularisation rates, GINI coefficients. Results: NHS-funded age-standardised revascularisation rates varied from 95.2 to 193.9 per 100,000 and privately funded procedures from 7.6 to 57.6. Although the age distribution did not vary by funding, the proportion of revascularisations among women that were privately funded (11.0%) was lower than among men (17.0%). Privately funded rates were highest in PCTs with the lowest death rates (p=0.053). NHS-funded admission rates were not related to deprivation nor age-standardised deaths rates from coronary heart disease. Privately-funded admission rates were lower in more deprived PCTs. NHS provision was significantly more egalitarian (Gini coefficient 0.12) than the private sector (0.35). Including all procedures was significantly less equal (0.13) than NHS funded care alone. Conclusion: Private provision exacerbates geographical inequalities. Those responsible for commissioning care for defined populations must have access to consistent data on provision of treatment wherever it takes place

    An analysis of the shapes of interstellar extinction curves. VII Milky Way spectrophotometric optical-through-ultraviolet extinction and its R-dependence

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    We produce a set of 72 NIR-through-UV extinction curves by combining new Hubble Space Telescope/STIS optical spectrophotometry with existing International Ultraviolet Explorer spectrophotometry (yielding gapless coverage from 1150 to 10000 ?) and NIR photometry. These curves are used to determine a new, internally consistent NIR-through-UV Milky Way mean curve and to characterize how the shapes of the extinction curves depend on R(V). We emphasize that while this dependence captures much of the curve variability, considerable variation remains that is independent of R(V). We use the optical spectrophotometry to verify the presence of structure at intermediate wavelength scales in the curves. The fact that the optical-through-UV portions of the curves are sampled at relatively high resolution makes them very useful for determining how extinction affects different broadband systems, and we provide several examples. Finally, we compare our results to previous investigations

    Lessons from crossing symmetry at large N

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    20 pages, v2: Assumptions stated more clearly, version published in JHEPWe consider the four-point correlator of the stress tensor multiplet in N=4 SYM. We construct all solutions consistent with crossing symmetry in the limit of large central charge c ~ N^2 and large g^2 N. While we find an infinite tower of solutions, we argue most of them are suppressed by an extra scale \Delta_{gap} and are consistent with the upper bounds for the scaling dimension of unprotected operators observed in the numerical superconformal bootstrap at large central charge. These solutions organize as a double expansion in 1/c and 1/\Delta_{gap}. Our solutions are valid to leading order in 1/c and to all orders in 1/\Delta_{gap} and reproduce, in particular, instanton corrections previously found. Furthermore, we find a connection between such upper bounds and positivity constraints arising from causality in flat space. Finally, we show that certain relations derived from causality constraints for scattering in AdS follow from crossing symmetry.Peer reviewe

    Not Just a Theory—The Utility of Mathematical Models in Evolutionary Biology

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    Models have made numerous contributions to evolutionary biology, but misunderstandings persist regarding their purpose. By formally testing the logic of verbal hypotheses, proof-of-concept models clarify thinking, uncover hidden assumptions, and spur new directions of study. thumbnail image credit: modified from the Biodiversity Heritage Librar

    Potassium for Subterranean clover

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    There are a number of areas in the south-western portion of the State where, although adequate quantities of superphosphate and trace elements have been applied, the growth of pasture species, particularly subterranean clover, has declined. In some cases, subterranean clover has disappeared completely. Investigations have shown that in many instances the decreased production is due to potassium deficiency

    Integrated care and the working record

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    By default, many discussions and specifications of electronic health records or integrated care records often conceptualize the record as a passive information repository. This article presents data from a case study of work in a medical unit in a major metropolitan hospital. It shows how the clinicians tailored, re-presented and augmented clinical information to support their own roles in the delivery of care for individual patients. This is referred to as the working record: a set of complexly interrelated clinician-centred documents that are locally evolved, maintained and used to support delivery of care in conjunction with the more patient-centred chart that will be stored in the medical records department on the patient’s discharge. Implications are drawn for how an integrated care record could support the local tailorability and flexibility that underpin this working record and hence underpin practice
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