Nurse telephone triage for same day appointments in general practice: multiple interrupted time series trial of effect on workload and costs

OBJECTIVE: To compare the workloads of general practitioners and nurses and costs of patient care for nurse telephone triage and standard management of requests for same day appointments in routine primary care. DESIGN: Multiple interrupted time series using sequential introduction of experimental triage system in different sites with repeated measures taken one week in every month for 12 months. SETTING: Three primary care sites in York. Participants: 4685 patients: 1233 in standard management, 3452 in the triage system. All patients requesting same day appointments during study weeks were included in the trial. MAIN OUTCOME MEASURES: Type of consultation (telephone, appointment, or visit), time taken for consultation, presenting complaints, use of services during the month after same day contact, and costs of drugs and same day, follow up, and emergency care. RESULTS: The triage system reduced appointments with general practitioner by 29-44%. Compared with standard management, the triage system had a relative risk (95% confidence interval) of 0.85 (0.72 to 1.00) for home visits, 2.41 (2.08 to 2.80) for telephone care, and 3.79 (3.21 to 4.48) for nurse care. Mean overall time in the triage system was 1.70 minutes longer, but mean general practitioner time was reduced by 2.45 minutes. Routine appointments and nursing time increased, as did out of hours and accident and emergency attendance. Costs did not differ significantly between standard management and triage: mean difference £1.48 more per patient for triage (95% confidence interval -0.19 to 3.15). CONCLUSIONS: Triage reduced the number of same day appointments with general practitioners but resulted in busier routine surgeries, increased nursing time, and a small but significant increase in out of hours and accident and emergency attendance. Consequently, triage does not reduce overall costs per patient for managing same day appointments

Discovery Potential for New Phenomena

We examine the ability of future facilities to discover and interpret non-supersymmetric new phenomena. We first explore explicit manifestations of new physics, including extended gauge sectors, leptoquarks, exotic fermions, and technicolor models. We then take a more general approach where new physics only reveals itself through the existence of effective interactions at lower energy scales. [Summary Report of the New Phenomena Working Group. To appear in the Proceedings of the 1996 DPF/DPB Summer Study on New Directions for High Energy Physics - Snowmass96, Snowmass, CO, 25 June - 12 July 1996.

Properties of the Strange Axial Mesons in the Relativized Quark Model

We studied properties of the strange axial mesons in the relativized quark model. We calculated the $K_1$ decay constant in the quark model and showed how it can be used to extract the $K_1 (^3P_1) - K_1 (^1P_1)$ mixing angle ($\theta_K$) from the weak decay $\tau \to K_1 \nu_\tau$. The ratio $BR(\tau \to \nu_\tau K_1 (1270))/BR(\tau\to \nu_\tau K_1(1400))$ is the most sensitive measurement and also the most reliable since the largest of the theoretical uncertainties factor out. However the current bounds extracted from the TPC/Two-Gamma collaboration measurements are rather weak: we typically obtain $-30^o \lesssim \theta_K \lesssim 50^o$ at 68\% C.L. We also calculated the strong OZI-allowed decays in the pseudoscalar emission model and the flux-tube breaking model and extracted a $^3P_1 - ^1P_1$ mixing angle of $\theta_K \simeq 45^o$. Our analysis also indicates that the heavy quark limit does not give a good description of the strange mesons.Comment: Revised version to be published in Phys. Rev. D. Minor changes. Latex file uses revtex version 3 and epsfig, 4 postcript figures are attached. The full postcript version with embedded figures is available at ftp://ftp.physics.carleton.ca/pub/theory/godfrey/ocipc9512.ps.

Lemur Biorhythms and Life History Evolution

Skeletal histology supports the hypothesis that primate life histories are regulated by a neuroendocrine rhythm, the Havers-Halberg Oscillation (HHO). Interestingly, subfossil lemurs are outliers in HHO scaling relationships that have been discovered for haplorhine primates and other mammals. We present new data to determine whether these species represent the general lemur or strepsirrhine condition and to inform models about neuroendocrine-mediated life history evolution. We gathered the largest sample to date of HHO data from histological sections of primate teeth (including the subfossil lemurs) to assess the relationship of these chronobiological measures with life history-related variables including body mass, brain size, age at first female reproduction, and activity level. For anthropoids, these variables show strong correlations with HHO conforming to predictions, though body mass and endocranial volume are strongly correlated with HHO periodicity in this group. However, lemurs (possibly excepting Daubentonia) do not follow this pattern and show markedly less variability in HHO periodicity and lower correlation coefficients and slopes. Moreover, body mass is uncorrelated, and brain size and activity levels are more strongly correlated with HHO periodicity in these animals. We argue that lemurs evolved this pattern due to selection for risk-averse life histories driven by the unpredictability of the environment in Madagascar. These results reinforce the idea that HHO influences life history evolution differently in response to specific ecological selection regimes

LOFAR observations of 4C+19.44. On the discovery of low frequency spectral curvature in relativistic jet knots

We present the first LOFAR observations of the radio jet in the quasar 4C+19.44 (a.k.a. PKS 1354+19) obtained with the long baselines. The achieved resolution is very well matched to that of archival Jansky Very Large Array (JVLA) observations at higher radio frequencies as well as the archival X-ray images obtained with {\it Chandra}. We found that, for several knots along the jet, the radio flux densities measured at hundreds of MHz lie well below the values estimated by extrapolating the GHz spectra. This clearly indicates the presence of spectral curvature. Radio spectral curvature has been already observed in different source classes and/or extended radio structures and it has been often interpreted as due to intrinsic processes, as a curved particle energy distribution, rather than absorption mechanisms ({ Razin-Tsytovich} effect, free-free or synchrotron self absorption to name a few). Here we discuss our results according to the scenario where particles undergo stochastic acceleration mechanisms also in quasar jet knots.Comment: 13 pages, 4 tables, 4 figures, pre-proof version, published on the Astrophysical Journal (Harris, et al. 2019 ApJ, 873, 21

Multi-transition study and new detections of class II methanol masers

We have used the ATNF Mopra antenna and the SEST antenna to search in the directions of several class II methanol maser sources for emission from six methanol transitions in the frequency range 85-115 GHz. The transitions were selected from excitation studies as potential maser candidates. Methanol emission at one or more frequencies was detected from five of the maser sources, as well as from Orion KL. Although the lines are weak, we find evidence of maser origin for three new lines in G345.01+1.79, and possibly one new line in G9.62+0.20. The observations, together with published maser observations at other frequencies, are compared with methanol maser modelling for G345.01+1.79 and NGC6334F. We find that the majority of observations in both sources are consistent with a warm dust (175 K) pumping model at hydrogen density ~10^6 cm^-3 and methanol column density ~5 x 10^17 cm^-2. The substantial differences between the maser spectra in the two sources can be attributed to the geometry of the maser region.Comment: 13 pages, 6 figures, Accepted for publication in MNRA

Novel technique for monitoring the performance of the LAT instrument on board the GLAST satellite

The Gamma-ray Large Area Space Telescope (GLAST) is an observatory designed to perform gamma-ray astronomy in the energy range 20 MeV to 300 GeV, with supporting measurements for gamma-ray bursts from 10 keV to 25 MeV. GLAST will be launched at the end of 2007, opening a new and important window on a wide variety of high energy astrophysical phenomena . The main instrument of GLAST is the Large Area Telescope (LAT), which provides break-through high-energy measurements using techniques typically used in particle detectors for collider experiments. The LAT consists of 16 identical towers in a four-by-four grid, each one containing a pair conversion tracker and a hodoscopic crystal calorimeter, all covered by a segmented plastic scintillator anti-coincidence shield. The scientific return of the instrument depends very much on how accurately we know its performance, and how well we can monitor it and correct potential problems promptly. We report on a novel technique that we are developing to help in the characterization and monitoring of LAT by using the power of classification trees to pinpoint in a short time potential problems in the recorded data. The same technique could also be used to evaluate the effect on the overall LAT performance produced by potential instrumental problems.Comment: 2 pages, 1 figure, manuscript submitted on behalf of the GLAST/LAT collaboration to First GLAST symposium proceeding

Logarithmic growth dynamics in software networks

In a recent paper, Krapivsky and Redner (Phys. Rev. E, 71 (2005) 036118) proposed a new growing network model with new nodes being attached to a randomly selected node, as well to all ancestors of the target node. The model leads to a sparse graph with an average degree growing logarithmically with the system size. Here we present compeling evidence for software networks being the result of a similar class of growing dynamics. The predicted pattern of network growth, as well as the stationary in- and out-degree distributions are consistent with the model. Our results confirm the view of large-scale software topology being generated through duplication-rewiring mechanisms. Implications of these findings are outlined.Comment: 7 pages, 3 figures, published in Europhysics Letters (2005