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

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

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

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.

A Multi-Wavelength Study of the Jet, Lobes and Core of the Quasar PKS 2101-490

We present a detailed study of the X-ray, optical and radio emission from the jet, lobes and core of the quasar PKS 2101-490 as revealed by new Chandra, HST and ATCA images. We extract the radio to X-ray spectral energy distributions from seven regions of the 13 arcsecond jet, and model the jet X-ray emission in terms of Doppler beamed inverse Compton scattering of the cosmic microwave background (IC/CMB) for a jet in a state of equipartition between particle and magnetic field energy densities. This model implies that the jet remains highly relativistic hundreds of kpc from the nucleus, with a bulk Lorentz factor Gamma ~ 6 and magnetic field of order 30 microGauss. We detect an apparent radiative cooling break in the synchrotron spectrum of one of the jet knots, and are able to interpret this in terms of a standard one-zone continuous injection model, based on jet parameters derived from the IC/CMB model. However, we note apparent substructure in the bright optical knot in one of the HST bands. We confront the IC/CMB model with independent estimates of the jet power, and find that the IC/CMB model jet power is consistent with the independent estimates, provided that the minimum electron Lorentz factor gamma_min > 50, and the knots are significantly longer than the jet width, as implied by de-projection of the observed knot lengths.Comment: 16 pages, 10 figures, 6 table

Low Cost and Compact Quantum Cryptography

We present the design of a novel free-space quantum cryptography system, complete with purpose-built software, that can operate in daylight conditions. The transmitter and receiver modules are built using inexpensive off-the-shelf components. Both modules are compact allowing the generation of renewed shared secrets on demand over a short range of a few metres. An analysis of the software is shown as well as results of error rates and therefore shared secret yields at varying background light levels. As the system is designed to eventually work in short-range consumer applications, we also present a use scenario where the consumer can regularly 'top up' a store of secrets for use in a variety of one-time-pad and authentication protocols.Comment: 18 pages, 9 figures, to be published in New Journal of Physic

Fine structure splittings of excited P and D states in charmonium

It is shown that the fine structure splittings of the $2 ^3P_J$ and $3 ^3P_J$ excited states in charmonium are as large as those of the $1^3P_J$ state if the same $\alpha_s(\mu)\approx 0.36$ is used. The predicted mass $M(2 ^3P_0)=3.84$ GeV appears to be 120 MeV lower that the center of gravity of the $2 ^3P_J$ multiplet and lies below the $D\bar D^*$ threshold. Our value of $M(2 ^3P_0)$ is approximately 80 MeV lower than that from the paper by Godfrey and Isgur while the differences in the other masses are \la 20 MeV. Relativistic kinematics plays an important role in our analysis.Comment: 12 page

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

t-channel production of heavy charged leptons

We study the pair production of heavy charged exotic leptons at e+ e- colliders in the SU(2)_L x SU(2)_I x U(1)_Y model. This gauge group is a subgroup of the grand unification group E6; SU(2)_I commutes with the electric charge operator, and the three corresponding gauge bosons are electrically neutral. In addition to the standard photon and Z boson contributions, we also include the contributions from extra neutral gauge bosons. A t-channel contribution due to W_I-boson exchange, which is unsuppressed by mixing angles, is quite important. We calculate the left-right and forward-backward asymmetries, and discuss how to differentiate different models.Comment: Increased discussion of experimental signatures. Version accepted by PR