An invitation to grieve: reconsidering critical incident responses by support teams in the school setting

This paper proposes that consideration could be given to an invitational intervention rather than an expectational intervention when support personnel respond to a critical incident in schools. Intuitively many practitioners know that it is necessary for guidance/counselling personnel to intervene in schools in and following times of trauma. Most educational authorities in Australia have mandated the formulation of a critical incident intervention plan. This paper defines the term critical incident and then outlines current intervention processes, discussing the efficacy of debriefing interventions. Recent literature suggests that even though it is accepted that a planned intervention is necessary, there is scant evidence as to the effectiveness of debriefing interventions in stemming later symptoms of post traumatic stress disorder. The authors of this paper advocate for an expressive therapy intervention that is invitational rather than expectational, arguing that not all people respond to trauma in the same way and to expect that they will need to recall and retell what has happened is most likely a dangerous assumption. A model of invitation using Howard Gardner’s (1983) multiple intelligences is proposed so that students are invited to grieve and understand emotionally what is happening to them following a critical incident

Flavour physics constraints in the BMSSM

We study the implications of the presence of the two leading-order, non-renormalizable operators in the Higgs sector of the MSSM to flavour physics observables. We identify the constraints of flavour physics on the parameters of the BMSSM when we: a) focus on a region of parameters for which electroweak baryogenesis is feasible, b) use a CMSSM-like parametrization, and c) consider the case of a generic NUHM-type model. We find significant differences as compared to the standard MSSM case.Comment: 22 pages, 7 figure

International comparison of spending and utilization at the end of life for hip fracture patients.

ObjectiveTo identify and explore differences in spending and utilization of key health services at the end of life among hip fracture patients across seven developed countries.Data sourcesIndividual-level claims data from the inpatient and outpatient health care sectors compiled by the International Collaborative on Costs, Outcomes, and Needs in Care (ICCONIC).Study designWe retrospectively analyzed utilization and spending from acute hospital care, emergency department, outpatient primary care and specialty physician visits, and outpatient drugs. Patterns of spending and utilization were compared in the last 30, 90, and 180 days across Australia, Canada, England, Germany, New Zealand, Spain, and the United States. We employed linear regression models to measure age- and sex-specific effects within and across countries. In addition, we analyzed hospital-centricity, that is, the days spent in hospital and site of death.Data collection/extraction methodsWe identified patients who sustained a hip fracture in 2016 and died within 12 months from date of admission.Principal findingsResource use, costs, and the proportion of deaths in hospital showed large variability being high in England and Spain, while low in New Zealand. Days in hospital significantly decreased with increasing age in Canada, Germany, Spain, and the United States. Hospital spending near date of death was significantly lower for women in Canada, Germany, and the United States. The age gradient and the sex effect were less pronounced in utilization and spending of emergency care, outpatient care, and drugs.ConclusionsAcross seven countries, we find important variations in end-of-life care for patients who sustained a hip fracture, with some differences explained by sex and age. Our work sheds important insights that may help ongoing health policy discussions on equity, efficiency, and reimbursement in health care systems

Higgs boson decay into 2 photons in the type~II Seesaw Model

We study the two photon decay channel of the Standard Model-like component of the CP-even Higgs bosons present in the type II Seesaw Model. The corresponding cross-section is found to be significantly enhanced in parts of the parameter space, due to the (doubly-)charged Higgs bosons' $(H^{\pm \pm})H^\pm$ virtual contributions, while all the other Higgs decay channels remain Standard Model(SM)-like. In other parts of the parameter space $H^{\pm \pm}$ (and $H^{\pm}$) interfere destructively, reducing the two photon branching ratio tremendously below the SM prediction. Such properties allow to account for any excess such as the one reported by ATLAS/CMS at $\approx 125$ GeV if confirmed by future data; if not, for the fact that a SM-like Higgs exclusion in the diphoton channel around 114-115 GeV as reported by ATLAS, does not contradict a SM-like Higgs at LEP(!), and at any rate, for the fact that ATLAS/CMS exclusion limits put stringent lower bounds on the $H^{\pm \pm}$ mass, particularly in the parameter space regions where the direct limits from same-sign leptonic decays of $H^{\pm \pm}$ do not apply.Comment: 26 pages, 7 figure

What Does It Drive the Relationship Between Suicides and Economic Conditions? New Evidence from Spain

In this paper we analyse suicides across the 17 Spanish regions over the period 2002?2013. In doing so, we estimate count panel data models considering gender differences taking into account before and during economic crisis periods. A range of aggregate socioeconomic regional-level factors have been considered. Our empirical results show that: (1) a socioeconomic urban?rural suicide differentials exist, (2) there exists a Mediterranean suicide pattern; and (3) unemployment levels have a marked importance during the crisis period. The results of this study may have usefulness for suicide prevention in Spain

International comparison of health spending and utilization among people with complex multimorbidity.

OBJECTIVE: The objective of this study was to explore cross-country differences in spending and utilization across different domains of care for a multimorbid persona with heart failure and diabetes. DATA SOURCES: We used individual-level administrative claims or registry data from inpatient and outpatient health care sectors compiled by the International Collaborative on Costs, Outcomes, and Needs in Care (ICCONIC) across 11 countries: Australia, Canada, England, France, Germany, the Netherlands, New Zealand, Spain, Sweden, Switzerland, and the United States (US). DATA COLLECTION/EXTRACTION METHODS: Data collected by ICCONIC partners. STUDY DESIGN: We retrospectively analyzed age-sex standardized utilization and spending of an older person (65-90 years) hospitalized with a heart failure exacerbation and a secondary diagnosis of diabetes across five domains of care: hospital care, primary care, outpatient specialty care, post-acute rehabilitative care, and outpatient drugs. PRINCIPAL FINDINGS: Sample sizes ranged from n = 1270 in Spain to n = 21,803 in the United States. Mean age (standard deviation [SD]) ranged from 76.2 (5.6) in the Netherlands to 80.3 (6.8) in Sweden. We observed substantial variation in spending and utilization across care settings. On average, England spent $10,956 per person in hospital care while the United States spent$30,877. The United States had a shorter length of stay over the year (18.9 days) compared to France (32.9) and Germany (33.4). The United States spent more days in facility-based rehabilitative care than other countries. Australia spent $421 per person in primary care, while Spain (Aragon) spent$1557. The United States and Canada had proportionately more visits to specialist providers than primary care providers. Across almost all sectors, the United States spent more than other countries, suggesting higher prices per unit. CONCLUSION: Across 11 countries, there is substantial variation in health care spending and utilization for a complex multimorbid persona with heart failure and diabetes. Drivers of spending vary across countries, with the United States being the most expensive country due to high prices and higher use of facility-based rehabilitative care