Stating Appointment Costs in SMS Reminders Reduces Missed Hospital Appointments: Findings from Two Randomised Controlled Trials

BACKGROUND: Missed hospital appointments are a major cause of inefficiency worldwide. Healthcare providers are increasingly using Short Message Service reminders to reduce 'Did Not Attend' (DNA) rates. Systematic reviews show that sending such reminders is effective, but there is no evidence on whether their impact is affected by their content. Accordingly, we undertook two randomised controlled trials that tested the impact of rephrasing appointment reminders on DNA rates in the United Kingdom. TRIAL METHODS: Participants were outpatients with a valid mobile telephone number and an outpatient appointment between November 2013 and January 2014 (Trial One, 10,111 participants) or March and May 2014 (Trial Two, 9,848 participants). Appointments were randomly allocated to one of four reminder messages, which were issued five days in advance. Message assignment was then compared against appointment outcomes (appointment attendance, DNA, cancellation by patient). RESULTS: In Trial One, a message including the cost of a missed appointment to the health system produced a DNA rate of 8.4%, compared to 11.1% for the existing message (OR 0.74, 95% CI 0.61-0.89, P<0.01). Trial Two replicated this effect (DNA rate 8.2%), but also found that expressing the same concept in general terms was significantly less effective (DNA rate 9.9%, OR 1.22, 95% CI 1.00-1.48, P<0.05). Moving from the existing reminder to the more effective costs message would result in 5,800 fewer missed appointments per year in the National Health Service Trust in question, at no additional cost. The study's main limitations are that it took place in a single location in England, and that it required accurate phone records, which were only obtained for 20% of eligible patients. We conclude that missed appointments can be reduced, for no additional cost, by introducing persuasive messages to appointment reminders. Future studies could examine the impact of varying reminder messages in other health systems. TRIAL REGISTRATION: Controlled-Trials.com 49432571

Seasonal variations in Greenland Ice Sheet motion : Inland extent and behaviour at higher elevations

Peer reviewedPreprin

Why Low-Mass Black-Hole Binaries Are Transient

We consider transient behavior in low-mass X-ray binaries. In short-period neutron-star systems (orbital period less than ~ 1d) irradiation of the accretion disk by the central source suppresses this except at very low mass transfer rates. Formation constraints however imply that a significant fraction of these neutron star systems have nuclear-evolved main-sequence secondaries and thus mass transfer rates low enough to be transient. But most short-period low-mass black-hole systems will form with unevolved main-sequence companions and have much higher mass transfer rates. The fact that essentially all of them are nevertheless transient shows that irradiation is weaker, as a direct consequence of the fundamental black-hole property - the lack of a hard stellar surface.Comment: 13 pages (including 3 figures); accepted for publication in Ap

Centrifugally driven electrostatic instability in extragalactic jets

The stability problem of the rotation induced electrostatic wave in extragalactic jets is presented. Solving a set of equations describing dynamics of a relativistic plasma flow of AGN jets, an expression of the instability rate has been derived and analyzed for typical values of AGNs. The growth rate was studied versus the wave length and the inclination angle and it has been found that the instability process is much efficient with respect to the accretion disk evolution, indicating high efficiency of the instability.Comment: 7 pages, 4 figure

Accretion Rates and Beaming in Ultraluminous X-ray Sources

I show that extreme beaming factors $b$ are not needed to explain ULXs as stellar--mass binaries. For neutron star accretors one typically requires $b \sim 0.13$, and for black holes almost no beaming ($b \sim 0.8$). The main reason for the high apparent luminosity is the logarithmic increase in the limiting luminosity for super--Eddington accretion. The required accretion rates are explicable in terms of thermal--timescale mass transfer from donor stars of mass 6 - 10\msun, or possibly transient outbursts. Beaming factors \la 0.1 would be needed to explain luminosities significantly above $10^{40}L_{40}$ erg s$^{-1}$, but these requirements are relaxed somewhat if the accreting matter has low hydrogen content.Comment: MNRAS Letters, in pres

Calibration of radii and masses of open clusters with a simulation

Context: A recent new approach to apply a simple dynamical mass estimate of tidally limited star clusters is based on the identification of the tidal radius in a King profile with the dynamical Jacobi radius. The application to an unbiased open cluster catalogue yields significantly higher cluster masses compared to the classical methods. Aims: We quantify the bias in the mass determination as function of projection direction and cluster age by analysing a simulated star cluster. Methods: We use direct $N$-body simulations of a star cluster including stellar evolution in an analytic Milky Way potential and apply a best fit to the projected number density of cluster stars. Results: We obtain significantly overestimated star cluster masses which depend strongly on the viewing direction. The overestimation is typically in the range of 10-50 percent and reaches a factor of 3.5 for young clusters. Mass segregation reduces the derived limiting radii systematically.Comment: 9 pages, 10+1 figures, accepted by Astronomy and Astrophysic

Direct radiative capture of p-wave neutrons

The neutron direct radiative capture (DRC) process is investigated, highlighting the role of incident p-wave neutrons. A set of calculations is shown for the 12-C(n,gamma) process at incoming neutron energies up to 500 keV, a crucial region for astrophysics. The cross section for neutron capture leading to loosely bound s, p and d orbits of 13-C is well reproduced by the DRC model demonstrating the feasibility of using this reaction channel to study the properties of nuclear wave functions on and outside the nuclear surface. A sensitivity analysis of the results on the neutron-nucleus interaction is performed for incident s- as well as p-waves. It turned out that the DRC cross section for p-wave neutrons is insensitive to this interaction, contrary to the case of incident s-wave neutrons. PACS number(s): 25.40Lw,21.10Gv,23.40.HcComment: 16 pages, REVTeX file, PostScript file, .dvi fil

Reversibility conditions for quantum channels and their applications

A necessary condition for reversibility (sufficiency) of a quantum channel with respect to complete families of states with bounded rank is obtained. A full description (up to isometrical equivalence) of all quantum channels reversible with respect to orthogonal and nonorthogonal complete families of pure states is given. Some applications in quantum information theory are considered. The main results can be formulated in terms of the operator algebras theory (as conditions for reversibility of channels between algebras of all bounded operators).Comment: 28 pages, this version contains strengthened results of the previous one and of arXiv:1106.3297; to appear in Sbornik: Mathematics, 204:7 (2013

A Comparison of Deep HST Luminosity Functions of Four Globular Clusters

From deep color-magnitude arrays made from V and I images taken with the Hubble Space Telescope's WFPC2 camera we have determined luminosity functions (LFs) down to a level that corresponds to about 0.13 solar masses, for the low-metal-abundance globular clusters M15, M30, M92, and NGC 6397. Because of the similarity of the metallicities of these clusters, differences in their luminosity functions directly trace differences in their mass functions. The LFs of M15, M30, and M92 agree closely over the entire observed range, whereas that of NGC 6397 drops away sharply at the faintest magnitudes. We suggest that the deficiency of low-mass stars in NGC 6397 is due to tidal shocks, to ejection through internal relaxation, or to a combination of the two. With the presently available mass-luminosity relations, we find that even in M15, M30, and M92 the mass functions probably do not rise so fast as to make the low-mass end dominant