The causes of prescribing errors in English general practices: a qualitative study

Background: Few detailed studies exist of the underlying causes of prescribing errors in the UK. Aim: To examine the causes of prescribing and monitoring errors in general practice and provide recommendations for how they may be overcome. Design and setting: Qualitative interview and focus group study with purposive sampling of English general practices. Method: General practice staff from 15 general practices across three PCTs in England participated in a combination of semi-structured interviews (n = 34) and six focus groups (n = 46). Thematic analysis informed by Reason’s Accident Causation Model was used. Results: Seven categories of high-level error-producing conditions were identified: the prescriber, the patient, the team, the working environment, the task, the computer system, and the primary–secondary care interface. These were broken down to reveal various error-producing conditions: the prescriber’s therapeutic training, drug knowledge and experience, knowledge of the patient, perception of risk, and their physical and emotional health; the patient’s characteristics and the complexity of the individual clinical case; the importance of feeling comfortable within the practice team was highlighted, as well as the safety implications of GPs signing prescriptions generated by nurses when they had not seen the patient for themselves; the working environment with its extensive workload, time pressures, and interruptions; and computer-related issues associated with mis-selecting drugs from electronic pick-lists and overriding alerts were all highlighted as possible causes of prescribing errors and were often interconnected. Conclusion: Complex underlying causes of prescribing and monitoring errors in general practices were highlighted, several of which are amenable to intervention

Radiative Neutralino Decay in Supersymmetric Models

The radiative decay Z2-> Z1 gamma proceeds at the one-loop level in the MSSM. It can be the dominant decay mode for the second lightest neutralino Z2 in certain regions of parameter space of supersymmetric models, where either a dynamical and/or kinematic enhancement of the branching fraction occurs. We perform an updated numerical study of this decay mode in both the minimal supergravity model (mSUGRA) and in the more general MSSM framework. In mSUGRA, the largest rates are found in the ``focus point'' region, where the mu parameter becomes small, and the lightest neutralinos become higgsino-like; in this case, radiative branching fraction can reach the 1% level. Our MSSM analysis includes a scan over independent positive and negative gaugino masses. We show branching fractions can reach the 10-100% level even for large values of the parameter tan(beta). These regions of parameter space are realized in supergravity models with non-universal gaugino masses. Measurement of the radiative neutralino branching fraction may help pin down underlying parameters of the fundamental supersymmetric model.Comment: 19 page JHEP file with 8 PS figures; previous version contained figure misplacemen

An Asymmetric Cone Model for Halo Coronal Mass Ejections

Due to projection effects, coronagraphic observations cannot uniquely determine parameters relevant to the geoeffectiveness of CMEs, such as the true propagation speed, width, or source location. The Cone Model for Coronal Mass Ejections (CMEs) has been studied in this respect and it could be used to obtain these parameters. There are evidences that some CMEs initiate from a flux-rope topology. It seems that these CMEs should be elongated along the flux-rope axis and the cross section of the cone base should be rather elliptical than circular. In the present paper we applied an asymmetric cone model to get the real space parameters of frontsided halo CMEs (HCMEs) recorded by SOHO/LASCO coronagraphs in 2002. The cone model parameters are generated through a fitting procedure to the projected speeds measured at different position angles on the plane of the sky. We consider models with the apex of the cone located at the center and surface of the Sun. The results are compared to the standard symmetric cone model

Fluctuations of an evaporating black hole from back reaction of its Hawking radiation: Questioning a premise in earlier work

This paper delineates the first steps in a systematic quantitative study of the spacetime fluctuations induced by quantum fields in an evaporating black hole. We explain how the stochastic gravity formalism can be a useful tool for that purpose within a low-energy effective field theory approach to quantum gravity. As an explicit example we apply it to the study of the spherically-symmetric sector of metric perturbations around an evaporating black hole background geometry. For macroscopic black holes we find that those fluctuations grow and eventually become important when considering sufficiently long periods of time (of the order of the evaporation time), but well before the Planckian regime is reached. In addition, the assumption of a simple correlation between the fluctuations of the energy flux crossing the horizon and far from it, which was made in earlier work on spherically-symmetric induced fluctuations, is carefully analyzed and found to be invalid. Our analysis suggests the existence of an infinite amplitude for the fluctuations of the horizon as a three-dimensional hypersurface. We emphasize the need for understanding and designing operational ways of probing quantum metric fluctuations near the horizon and extracting physically meaningful information.Comment: 10 pages, REVTeX; minor changes, a few references added and a brief discussion of their relevance included. To appear in the proceedings of the 10th Peyresq meeting. Dedicated to Rafael Sorkin on the occasion of his 60th birthda

Supersymmetry discovery potential of the LHC at s=\sqrt{s}=10 and 14 TeV without and with missing ETE_T

We examine the supersymmetry (SUSY) reach of the CERN LHC operating at $\sqrt{s}=10$ and 14 TeV within the framework of the minimal supergravity model. We improve upon previous reach projections by incorporating updated background calculations including a variety of $2\to n$ Standard Model (SM) processes. We show that SUSY discovery is possible even before the detectors are understood well enough to utilize either $E_T^{\rm miss}$ or electrons in the signal. We evaluate the early SUSY reach of the LHC at $\sqrt{s}=10$ TeV by examining multi-muon plus $\ge4$ jets and also dijet events with {\it no} missing $E_T$ cuts and show that the greatest reach in terms of $m_{1/2}$ occurs in the dijet channel. The reach in multi-muons is slightly smaller in $m_{1/2}$, but extends to higher values of $m_0$. We find that an observable multi-muon signal will first appear in the opposite-sign dimuon channel, but as the integrated luminosity increases the relatively background-free but rate-limited same-sign dimuon, and ultimately the trimuon channel yield the highest reach. We show characteristic distributions in these channels that serve to distinguish the signal from the SM background, and also help to corroborate its SUSY origin. We then evaluate the LHC reach in various no-lepton and multi-lepton plus jets channels {\it including} missing $E_T$ cuts for $\sqrt{s}=10$ and 14 TeV, and plot the reach for integrated luminosities ranging up to 3000 fb$^{-1}$ at the SLHC. For $\sqrt{s}=10$ TeV, the LHC reach extends to $m_{gluino}=1.9, 2.3, 2.8$ and 2.9 TeV for $m_{squark}\sim m_{gluino}$ and integrated luminosities of 10, 100, 1000 and 3000 fb$^{-1}$, respectively. For $\sqrt{s}=14$ TeV, the LHC reach for the same integrated luminosities is to m_{gluino}=2.4,\3.1, 3.7 and 4.0 TeV.Comment: 34 pages, 25 figures. Revised projections for the SUSY reach for ab^-1 integrated luminosities, with minor corrections of references and text. 2 figures added. To appear in JHE

How Many CMEs Have Flux Ropes? Deciphering the Signatures of Shocks, Flux Ropes, and Prominences in Coronagraph Observations of CMEs

We intend to provide a comprehensive answer to the question on whether all Coronal Mass Ejections (CMEs) have flux rope structure. To achieve this, we present a synthesis of the LASCO CME observations over the last sixteen years, assisted by 3D MHD simulations of the breakout model, EUV and coronagraphic observations from STEREO and SDO, and statistics from a revised LASCO CME database. We argue that the bright loop often seen as the CME leading edge is the result of pileup at the boundary of the erupting flux rope irrespective of whether a cavity or, more generally, a 3-part CME can be identified. Based on our previous work on white light shock detection and supported by the MHD simulations, we identify a new type of morphology, the `two-front' morphology. It consists of a faint front followed by diffuse emission and the bright loop-like CME leading edge. We show that the faint front is caused by density compression at a wave (or possibly shock) front driven by the CME. We also present high-detailed multi-wavelength EUV observations that clarify the relative positioning of the prominence at the bottom of a coronal cavity with clear flux rope structure. Finally, we visually check the full LASCO CME database for flux rope structures. In the process, we classify the events into two clear flux rope classes (`3-part', `Loop'), jets and outflows (no clear structure). We find that at least 40% of the observed CMEs have clear flux rope structures. We propose a new definition for flux rope CMEs (FR-CMEs) as a coherent magnetic, twist-carrying coronal structure with angular width of at least 40 deg and able to reach beyond 10 Rsun which erupts on a time scale of a few minutes to several hours. We conclude that flux ropes are a common occurrence in CMEs and pose a challenge for future studies to identify CMEs that are clearly not FR-CMEs.Comment: 26 pages, 9 figs, to be published in Solar Physics Topical Issue "Flux Rope Structure of CMEs

High-contrast imaging constraints on gas giant planet formation - The Herbig Ae/Be star opportunity

Planet formation studies are often focused on solar-type stars, implicitly considering our Sun as reference point. This approach overlooks, however, that Herbig Ae/Be stars are in some sense much better targets to study planet formation processes empirically, with their disks generally being larger, brighter and simply easier to observe across a large wavelength range. In addition, massive gas giant planets have been found on wide orbits around early type stars, triggering the question if these objects did indeed form there and, if so, by what process. In the following I briefly review what we currently know about the occurrence rate of planets around intermediate mass stars, before discussing recent results from Herbig Ae/Be stars in the context of planet formation. The main emphasis is put on spatially resolved polarized light images of potentially planet forming disks and how these images - in combination with other data - can be used to empirically constrain (parts of) the planet formation process. Of particular interest are two objects, HD100546 and HD169142, where, in addition to intriguing morphological structures in the disks, direct observational evidence for (very) young planets has been reported. I conclude with an outlook, what further progress we can expect in the very near future with the next generation of high-contrast imagers at 8-m class telescopes and their synergies with ALMA.Comment: Accepted by Astrophysics and Space Science as invited short review in special issue about Herbig Ae/Be stars; 12 pages incl. 5 figures, 2 tables and reference

Some general properties of the renormalized stress-energy tensor for static quantum states on (n+1)-dimensional spherically symmetric black holes

We study the renormalized stress-energy tensor (RSET) for static quantum states on (n+1)-dimensional, static, spherically symmetric black holes. By solving the conservation equations, we are able to write the stress-energy tensor in terms of a single unknown function of the radial co-ordinate, plus two arbitrary constants. Conditions for the stress-energy tensor to be regular at event horizons (including the extremal and ``ultra-extremal'' cases) are then derived using generalized Kruskal-like co-ordinates. These results should be useful for future calculations of the RSET for static quantum states on spherically symmetric black hole geometries in any number of space-time dimensions.Comment: 9 pages, no figures, RevTeX4, references added, accepted for publication in General Relativity and Gravitatio

Updated Constraints on the Minimal Supergravity Model

Recently, refinements have been made on both the theoretical and experimental determinations of the i.) mass of the lightest Higgs scalar (m_h), ii.) relic density of cold dark matter in the universe (Omega_CDM h^2), iii.) branching fraction for radiative B decay BF(b \to s \gamma), iv.) muon anomalous magnetic moment (a_\mu), and v.) flavor violating decay B_s \to \mu^+\mu^-. Each of these quantities can be predicted in the MSSM, and each depends in a non-trivial way on the spectra of SUSY particles. In this paper, we present updated constraints from each of these quantities on the minimal supergravity (mSUGRA) model as embedded in the computer program ISAJET. The combination of constraints points to certain favored regions of model parameter space where collider and non-accelerator SUSY searches may be more focussed.Comment: 20 pages, 6 figures. Version published in JHE

The Reach of the Fermilab Tevatron and CERN LHC for Gaugino Mediated SUSY Breaking Models

In supersymmetric models with gaugino mediated SUSY breaking (inoMSB), it is assumed that SUSY breaking on a hidden brane is communicated to the visible brane via gauge superfields which propagate in the bulk. This leads to GUT models where the common gaugino mass $m_{1/2}$ is the only soft SUSY breaking term to receive contributions at tree level. To obtain a viable phenomenology, it is assumed that the gaugino mass is induced at some scale $M_c$ beyond the GUT scale, and that additional renormalization group running takes place between $M_c$ and $M_{GUT}$ as in a SUSY GUT. We assume an SU(5) SUSY GUT above the GUT scale, and compute the SUSY particle spectrum expected in models with inoMSB. We use the Monte Carlo program ISAJET to simulate signals within the inoMSB model, and compute the SUSY reach including cuts and triggers approriate to Fermilab Tevatron and CERN LHC experiments. We find no reach for SUSY by the Tevatron collider in the trilepton channel. %either with or without %identified tau leptons. At the CERN LHC, values of $m_{1/2}=1000$ (1160) GeV can be probed with 10 (100) fb$^{-1}$ of integrated luminosity, corresponding to a reach in terms of $m_{\tg}$ of 2150 (2500) GeV. The inoMSB model and mSUGRA can likely only be differentiated at a linear $e^+e^-$ collider with sufficient energy to produce sleptons and charginos.Comment: 17 page revtex file with 9 PS figure