Cost-Effectiveness of Pain Management Strategies in Advanced Cancer

Objectives Uncontrolled pain in advanced cancer is a common problem and has significant impact on individuals’ quality of life and use of healthcare resources. Interventions to help manage pain at the end of life are available, but there is limited economic evidence to support their wider implementation. We conducted a case study economic evaluation of two pain self-management interventions (PainCheck and Tackling Cancer Pain Toolkit [TCPT]) compared with usual care. Methods We generated a decision-analytic model to facilitate the evaluation. This modelled the survival of individuals at the end of life as they moved through pain severity categories. Intervention effectiveness was based on published meta-analyses results. The evaluation was conducted from the perspective of the U.K. health service provider and reported cost per quality-adjusted life-year (QALY). Results PainCheck and TCPT were cheaper (respective incremental costs -GBP148 [-EUR168.53] and -GBP474 [-EUR539.74]) and more effective (respective incremental QALYs of 0.010 and 0.013) than usual care. There was a 65 percent and 99.5 percent chance of cost-effectiveness for PainCheck and TCPT, respectively. Results were relatively robust to sensitivity analyses. The most important driver of cost-effectiveness was level of pain reduction (intervention effectiveness). Although cost savings were modest per patient, these were considerable when accounting for the number of potential intervention beneficiaries. Conclusions Educational and monitoring/feedback interventions have the potential to be cost-effective. Economic evaluations based on estimates of effectiveness from published meta-analyses and using a decision modeling approach can support commissioning decisions and implementation of pain management strategies

On Loops in Inflation II: IR Effects in Single Clock Inflation

In single clock models of inflation the coupling between modes of very different scales does not have any significant dynamical effect during inflation. It leads to interesting projection effects. Larger and smaller modes change the relation between the scale a mode of interest will appear in the post-inflationary universe and will also change the time of horizon crossing of that mode. We argue that there are no infrared projection effects in physical questions, that there are no effects from modes of longer wavelength than the one of interest. These potential effects cancel when computing fluctuations as a function of physically measurable scales. Modes on scales smaller than the one of interest change the mapping between horizon crossing time and scale. The correction to the mapping computed in the absence of fluctuations is enhanced by a factor N_e, the number of e-folds of inflation between horizon crossing and reheating. The new mapping is stochastic in nature but its variance is not enhanced by N_e.Comment: 13 pages, 1 figure; v2: JHEP published version, added minor comments and reference

UV friendly T-parity in the SU(6)/Sp(6) little Higgs model

Electroweak precision tests put stringent constraints on the parameter space of little Higgs models. Tree-level exchange of TeV scale particles in a generic little Higgs model produce higher dimensional operators that make contributions to electroweak observables that are typically too large. To avoid this problem a discrete symmetry dubbed T-parity can be introduced to forbid the dangerous couplings. However, it was realized that in simple group models such as the littlest Higgs model, the implementation of T-parity in a UV completion could present some challenges. The situation is analogous to the one in QCD where the pion can easily be defined as being odd under a new $Z_2$ symmetry in the chiral Lagrangian, but this $Z_2$ is not a symmetry of the quark Lagrangian. In this paper we examine the possibility of implementing a T-parity in the low energy $SU(6)/Sp(6)$ model that might be easier to realize in the UV. In our model, the T-parity acts on the low energy non-linear sigma model field in way which is different to what was originally proposed for the Littlest Higgs, and lead to a different low energy theory. In particular, the Higgs sector of this model is a inert two Higgs doublets model with an approximate custodial symmetry. We examine the contributions of the various sectors of the model to electroweak precision data, and to the dark matter abundance.Comment: 21 pages,4 figures. Clarifications added, typos corrected and references added. Published in JHE

Author correction : a global database for metacommunity ecology, integrating species, traits, environment and space

Correction to: Scientific Data https://doi.org/10.1038/s41597-019-0344-7, published online 08 January 202

Betting is loving and bettors are predators: a conceptual metaphor approach to online sports betting advertising

The legalisation of online gambling in multiple territories has caused a growth in the exposure of consumers to online sports betting (OSB) advertising. While some efforts have been made to understand the visible structure of betting promotional messages, little is known about the latent components of OSB advertisements. The present study sought to address this issue by examining the metaphorical conceptualisation of OSB advertising. A sample of Spanish and British television OSB advertisements from 2014 to 2016 was analysed (N = 133). Following Lakoff and Johnson’s conceptual metaphor theory, four main structural metaphors that shaped how OSB advertising can be understood were identified: betting as (1) an act of love, (2) a market, (3) a sport, and (4) a natural environment. In general, these metaphors, which were found widely across 29 different betting brands, facilitated the perception of bettors as active players, with an executive role in the sport events bet upon, and greater control over bet outcomes

Author correction : a global database for metacommunity ecology, integrating species, traits, environment and space

Correction to: Scientific Data https://doi.org/10.1038/s41597-019-0344-7, published online 08 January 202

General Gauge and Anomaly Mediated Supersymmetry Breaking in Grand Unified Theories with Vector-Like Particles

In Grand Unified Theories (GUTs) from orbifold and various string constructions the generic vector-like particles do not need to form complete SU(5) or SO(10) representations. To realize them concretely, we present orbifold SU(5) models, orbifold SO(10) models where the gauge symmetry can be broken down to flipped SU(5) X U(1)_X or Pati-Salam SU(4)_C X SU(2)_L X SU(2)_R gauge symmetries, and F-theory SU(5) models. Interestingly, these vector-like particles can be at the TeV-scale so that the lightest CP-even Higgs boson mass can be lifted, or play the messenger fields in the Gauge Mediated Supersymmetry Breaking (GMSB). Considering GMSB, ultraviolet insensitive Anomaly Mediated Supersymmetry Breaking (AMSB), and the deflected AMSB, we study the general gaugino mass relations and their indices, which are valid from the GUT scale to the electroweak scale at one loop, in the SU(5) models, the flipped SU(5) X U(1)_X models, and the Pati-Salam SU(4)_C X SU(2)_L X SU(2)_R models. In the deflected AMSB, we also define the new indices for the gaugino mass relations, and calculate them as well. Using these gaugino mass relations and their indices, we may probe the messenger fields at intermediate scale in the GMSB and deflected AMSB, determine the supersymmetry breaking mediation mechanisms, and distinguish the four-dimensional GUTs, orbifold GUTs, and F-theory GUTs.Comment: RevTex4, 45 pages, 15 tables, version to appear in JHE