State of the States 2009

Highlights state election results and policy developments in 2008 and projects trends for 2009. Considers how the recession and the new administration's policies may affect states on energy, education, Medicaid, the social safety net, and other issues

Treatment patterns among non-active users of maintenance asthma medication in the United Kingdom : a retrospective cohort study in the Clinical Practice Research Datalink

The authors are also grateful to Dr Michael Gibbs for providing a review of an early draft of this manuscript. Funding Editorial support was provided by Kate Hollingworth of Continuous Improvement Ltd and funded by GlaxoSmithKline (GSK). This study was funded by GSK. DCG, BA, JFB, and MF are employees of GSK and hold GSK shares.Peer reviewedPublisher PD

Thermal divergences on the event horizons of two-dimensional black holes

The expectation value of the stress-energy tensor \langleT_{\mu\nu}\rangle of a free conformally invariant scalar field is computed in a general static two-dimensional black hole spacetime when the field is in either a zero temperature vacuum state or a thermal state at a nonzero temperature. It is found that for every static two-dimensional black hole the stress-energy diverges strongly on the event horizon unless the field is in a state at the natural black hole temperature which is defined by the surface gravity of the event horizon. This implies that both extreme and nonextreme two-dimensional black holes can only be in equilibrium with radiation at the natural black hole temperature.Comment: 13 pages, REVTe

Access to general practice and visits to accident and emergency departments in England: cross-sectional analysis of a national patient survey.

BACKGROUND: The annual number of unplanned attendances at accident and emergency (A&E) departments in England increased by 11% (2.2 million attendances) between 2008-2009 and 2012-2013. A national review of urgent and emergency care has emphasised the role of access to primary care services in preventing A&E attendances. AIM: To estimate the number of A&E attendances in England in 2012-2013 that were preceded by the attending patient being unable to obtain an appointment or a convenient appointment at their general practice. DESIGN AND SETTING: Cross-sectional analysis of a national survey of adults registered with a GP in England. METHOD: The number of general practice consultations in England in 2012-2013 was estimated by extrapolating the linear trend of published data for 2000-2001 to 2008-2009. This parameter was multiplied by the ratio of attempts to obtain a general practice appointment that resulted in an A&E attendance to attempts that resulted in a general practice consultation estimated using the GP Patient Survey 2012-2013. A sensitivity analysis varied the number of consultations by ±12% and the ratio by ±25%. RESULTS: An estimated 5.77 million (99.9% confidence interval = 5.49 to 6.05 million) A&E attendances were preceded by the attending patient being unable to obtain a general practice appointment or a convenient appointment, comprising 26.5% of unplanned A&E attendances in England in 2012-2013. The sensitivity analysis produced values between 17.5% and 37.2% of unplanned A&E attendances. CONCLUSION: A large number of A&E attendances are likely to be preceded by unsuccessful attempts to obtain convenient general practice appointments in England each year

de Sitter Supersymmetry Revisited

We present the basic $\mathcal{N} =1$ superconformal field theories in four-dimensional de Sitter space-time, namely the non-abelian super Yang-Mills theory and the chiral multiplet theory with gauge interactions or cubic superpotential. These theories have eight supercharges and are invariant under the full $SO(4,2)$ group of conformal symmetries, which includes the de Sitter isometry group $SO(4,1)$ as a subgroup. The theories are ghost-free and the anti-commutator $\sum_\alpha\{Q_\alpha, Q^{\alpha\dagger}\}$ is positive. SUSY Ward identities uniquely select the Bunch-Davies vacuum state. This vacuum state is invariant under superconformal transformations, despite the fact that de Sitter space has non-zero Hawking temperature. The $\mathcal{N}=1$ theories are classically invariant under the $SU(2,2|1)$ superconformal group, but this symmetry is broken by radiative corrections. However, no such difficulty is expected in the $\mathcal{N}=4$ theory, which is presented in appendix B.Comment: 21 pages, 2 figure

Wrapped branes with fluxes in 8d gauged supergravity

We study the gravity dual of several wrapped D-brane configurations in presence of 4-form RR fluxes partially piercing the unwrapped directions. We present a systematic approach to obtain these solutions from those without fluxes. We use D=8 gauged supergravity as a starting point to build up these solutions. The configurations include (smeared) M2-branes at the tip of a G_2 cone on S^3 x S^3, D2-D6 branes with the latter wrapping a special Lagrangian 3-cycle of the complex deformed conifold and an holomorphic sphere in its cotangent bundle T^*S^2, D3-branes at the tip of the generalized resolved conifold, and others obtained by means of T duality and KK reduction. We elaborate on the corresponding N=1 and N=2 field theories in 2+1 dimensions.Comment: 32 pages, LateX, v2: minor changes, reference added, v3: section 3.5.2 improve

Rapid testing and treatment for sexually transmitted infections improve patient care and yield public health benefits

A service evaluation of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) testing and result notification in patients attending a rapid testing service (Dean Street Express [DSE]) compared with those attending an existing ‘standard’ sexual health clinic (56 Dean Street [56DS]), and modelling the impact of the new service from 1 June 2014 to 31 May 2015. Primary outcome: time from patients’ sample collection to notification of test results at DSE compared with 56DS. Secondary outcomes estimated using a model: number of transmissions prevented and the number of new partner visits avoided and associated cost savings achieved due to rapid testing at DSE. In 2014/15, there were a total of 81,352 visits for CT/NG testing across 56DS (21,086) and DSE (60,266). Rapid testing resulted in a reduced mean time to notification of 8.68 days: 8.95 days for 56DS (95% CI 8.91–8.99) compared to 0.27 days for DSE (95% CI 0.26–0.28). Our model estimates that rapid testing at DSE would lead to 196 CT and/or NG transmissions prevented (2.5–97.5% centile range = 6–956) and lead to annual savings attributable to reduced numbers of partner attendances of £124,283 (2.5–97.5% centile range = £4260–590,331). DSE, a rapid testing service for asymptomatic infections, delivers faster time to result notification for CT and/or NG which enables faster treatment, reduces infectious periods and leads to fewer transmissions, partner attendances and clinic costs. </jats:p

Oxidised cosmic acceleration

We give detailed proofs of several new no-go theorems for constructing flat four-dimensional accelerating universes from warped dimensional reduction. These new theorems improve upon previous ones by weakening the energy conditions, by including time-dependent compactifications, and by treating accelerated expansion that is not precisely de Sitter. We show that de Sitter expansion violates the higher-dimensional null energy condition (NEC) if the compactification manifold M is one-dimensional, if its intrinsic Ricci scalar R vanishes everywhere, or if R and the warp function satisfy a simple limit condition. If expansion is not de Sitter, we establish threshold equation-of-state parameters w below which accelerated expansion must be transient. Below the threshold w there are bounds on the number of e-foldings of expansion. If M is one-dimensional or R everywhere vanishing, exceeding the bound implies the NEC is violated. If R does not vanish everywhere on M, exceeding the bound implies the strong energy condition (SEC) is violated. Observationally, the w thresholds indicate that experiments with finite resolution in w can cleanly discriminate between different models which satisfy or violate the relevant energy conditions.Comment: v2: corrections, references adde