Spatial displacement and diffusion of benefits among geographically focused policing initiatives

One of the most common criticisms of spatially focused policing efforts (such as Problem-Oriented Policing, police 'crackdowns' or hotspots policing) is that crime will simply relocate to other times and places since the ―root causes‖ of crime were not addressed. This phenomenon—called crime displacement—has important implications for many policing projects. By far, spatial displacement (movement of crime from a treatment area to an area nearby) is the form most commonly recognized. At the extreme, widespread displacement stands to undermine the effects of geographically focused policing actions. More often, however, research suggests that crime displacement is rarely total. On the other end of the displacement continuum is the phenomenon of ‗diffusion of crime control benefits‘ (a term coined by Ron Clarke and David Weisburd in 1994). Diffusion occurs when reductions of crime (or other improvements) are achieved in areas that are close to crime prevention interventions, even though those areas were not actually targeted by the intervention itself. Objectives: To synthesize the evidence concerning the degree to which geographically focused policing initiatives are related to spatial displacement of crime or diffusion of the crime control benefits. Main results: The main findings of the meta-analysis suggested that on average geographically focused policing initiatives for which data were available were (1) associated with significant reductions in crime and disorder and that (2) overall, changes in catchment areas were non-significant but there was a trend in favour of a diffusion of benefit. For the weighted displacement quotient analyses, the weight of the evidence suggests that where changes are observed in catchment areas that exceed those that might be expected in the absence of intervention, a diffusion of crime control benefit rather than displacement appears to be the more likely outcome. The results of the proportional change analysis suggest that the majority of eligible studies experienced a decrease in crime in the treatment area indicating possible success of the scheme. The majority also experience a decrease in the catchment areas suggesting the possibility of a diffusion of benefit. These findings, which could not be statistically tested, are consistent with all others reported here, and with those from the narrative review

Velocity and spatial biases in CDM subhalo distributions

We present a statistical study of substructure within a sample of LCDM clusters and galaxies simulated with up to 25 million particles. With thousands of subhalos per object we can accurately measure their spatial clustering and velocity distribution functions and compare these with observational data. The substructure properties of galactic halos closely resembles those of galaxy clusters with a small scatter in the mass and circular velocity functions. The velocity distribution function is non-Maxwellian and flat topped with a negative kurtosis of about -0.7. Within the virial radius the velocity bias $b=\sigma_{\rm sub}/\sigma_{\rm DM}\sim 1.12 \pm 0.04$, increasing to b > 1.3 within the halo centers. Slow subhalos are much less common, due to physical disruption by gravitational tides early in the merging history. This leads to a spatially anti-biased subhalo distribution that is well fitted by a cored isothermal. Observations of cluster galaxies do not show such biases which we interpret as a limitation of pure dark matter simulations - we estimate that we are missing half of the halo population which has been destroyed by physical overmerging. High resolution hydrodynamical simulations are required to study these issues further. If CDM is correct then the cluster galaxies must survive the tidal field, perhaps due to baryonic inflow during elliptical galaxy formation. Spirals can never exist near the cluster centers and the elliptical galaxies there will have little remaining dark matter. This implies that the morphology-density relation is set {\it before} the cluster forms, rather than a subsequent transformation of disks to S0's by virtue of the cluster environment.Comment: MNRAS accepted version. Due to an error in the initial conditions these simulations have a lower sigma_8 than the published value, 0.7 instead of 0.9. We thank Mike Kuhlen who helped us finding this mistake. See the erratum at http://www-theorie.physik.unizh.ch/~diemand/suberr.pdf . Images and movies available at http://www-theorie.physik.unizh.ch/~diemand/clusters

Reach, Usage, and Effectiveness of a Medicaid Patient Navigator Intervention to Increase Colorectal Cancer Screening, Cape Fear, North Carolina, 2011

IntroductionScreening for colorectal cancer can reduce incidence and death, but screening is underused, especially among vulnerable groups such as Medicaid patients. Effective interventions are needed to increase screening frequency. Our study consisted of a controlled trial of an intervention designed to improve colorectal cancer screening among Medicaid patients in North Carolina.MethodsThe intervention included a mailed screening reminder letter and decision aid followed by telephone support from an offsite, Medicaid-based, patient navigator. The study included 12 clinical practices, 6 as intervention practices and 6 as matched controls. Eligible patients were aged 50 years or older, covered by Medicaid, and identified from Medicaid claims data as not current with colorectal cancer screening recommendations. We reviewed Medicaid claims data at 6 months and conducted multivariate logistic regression to compare participant screening in intervention practices with participants in control practices. We controlled for sociodemographic characteristics.ResultsMost of the sample was black (53.1%) and female (57.2%); the average age was 56.5 years. On the basis of Medicaid claims, 9.2% of intervention participants (n = 22/240) had had a colorectal cancer screening at the 6-month review, compared with 7.5% of control patients (n = 13/174). The adjusted odds ratio when controlling for age, comorbidities, race, sex, and continuous Medicaid eligibility was 1.44 (95% confidence interval, 0.68–3.06). The patient navigator reached 44 participants (27.6%).ConclusionThe intervention had limited reach and little effect after 6 months on the number of participants screened. Higher-intensity interventions, such as use of practice-based navigators, may be needed to reach and improve screening rates in vulnerable populations

The evolution substructure I: a new identification method

We describe our new "MLAPM-halo-finder" (MHF) which is based on the adaptive grid structure of the N-body code MLAPM. We then extend the MHF code in order to track the orbital evolution of gravitationally bound objects through any given cosmological N-body simulation - our so-called "MLAPM-halo-tracker" (MHT). The mode of operation of MHT is demonstrated using a series of eight high-resolution N-body simulations of galaxy clusters. Each of these halos hosts more than one million particles within their virial radii Rvir. We use MHT as well as MHF to follow the temporal evolution of hundreds of individual satellites, and show that the radial distribution of these substructure satellites follows a "universal" radial distribution irrespective of the host halo's environment and formation history. This in fact might pose another problem for simulations of CDM structure formation as there are recent findings by Taylor et al. (2003) that the Milky Way satellites are found preferentially closer to the galactic centre and simulations underestimate the amount of central substructure, respectively. Further, this universal substructure profile is anti-biased with respect to the underlying dark matter profile. Both the halo finder MHF and the halo tracker MHT will become part of the open source MLAPM distribution.Comment: 12 pages, 10 figures, MNRAS in press, the halo finder MHF is available from http://astronomy.swin.edu.au/MLAP

Galaxy Formation Theory

We review the current theory of how galaxies form within the cosmological framework provided by the cold dark matter paradigm for structure formation. Beginning with the pre-galactic evolution of baryonic material we describe the analytical and numerical understanding of how baryons condense into galaxies, what determines the structure of those galaxies and how internal and external processes (including star formation, merging, active galactic nuclei etc.) determine their gross properties and evolution. Throughout, we highlight successes and failings of current galaxy formation theory. We include a review of computational implementations of galaxy formation theory and assess their ability to provide reliable modelling of this complex phenomenon. We finish with a discussion of several "hot topics" in contemporary galaxy formation theory and assess future directions for this field.Comment: 58 pages, to appear in Physics Reports. This version includes minor corrections and a handful of additional reference

What has changed in canine pyoderma? A narrative review

Canine pyoderma is a common presentation in small animal practice and frequently leads to prescription of systemic antimicrobial agents. A good foundation of knowledge on pyoderma was established during the 1970s and 1980s, when treatment of infection provided relatively few challenges. However, the ability to treat canine pyoderma effectively is now limited substantially by the emergence of multidrug-resistant, methicillin-resistant staphylococci (MRS) and, in some countries, by restrictions on antimicrobial prescribing for pets. The threat from rising antimicrobial resistance and the zoonotic potential of MRS add a new dimension of public health implications to the management of canine pyoderma and necessitate a revisit and the search for new best management strategies. This narrative review focusses on the impact of MRS on how canine pyoderma is managed and how traditional treatment recommendations need to be updated in the interest of good antimicrobial stewardship. Background information on clinical characteristics, pathogens, and appropriate clinical and microbiological diagnostic techniques, are reviewed in so far as they can support early identification of multidrug-resistant pathogens. The potential of new approaches for the control and treatment of bacterial skin infections is examined and the role of owner education and hygiene is highlighted. Dogs with pyoderma offer opportunities for good antimicrobial stewardship by making use of the unique accessibility of the skin through cytology, bacterial culture and topical therapy. In order to achieve long term success and to limit the spread of multidrug resistance, there is a need to focus on identification and correction of underlying diseases that trigger pyoderma in order to avoid repeated treatment

Procalcitonin Is Not a Reliable Biomarker of Bacterial Coinfection in People With Coronavirus Disease 2019 Undergoing Microbiological Investigation at the Time of Hospital Admission

Abstract Admission procalcitonin measurements and microbiology results were available for 1040 hospitalized adults with coronavirus disease 2019 (from 48 902 included in the International Severe Acute Respiratory and Emerging Infections Consortium World Health Organization Clinical Characterisation Protocol UK study). Although procalcitonin was higher in bacterial coinfection, this was neither clinically significant (median [IQR], 0.33 [0.11–1.70] ng/mL vs 0.24 [0.10–0.90] ng/mL) nor diagnostically useful (area under the receiver operating characteristic curve, 0.56 [95% confidence interval, .51–.60]).</jats:p

Implementation of corticosteroids in treating COVID-19 in the ISARIC WHO Clinical Characterisation Protocol UK:prospective observational cohort study

BACKGROUND: Dexamethasone was the first intervention proven to reduce mortality in patients with COVID-19 being treated in hospital. We aimed to evaluate the adoption of corticosteroids in the treatment of COVID-19 in the UK after the RECOVERY trial publication on June 16, 2020, and to identify discrepancies in care. METHODS: We did an audit of clinical implementation of corticosteroids in a prospective, observational, cohort study in 237 UK acute care hospitals between March 16, 2020, and April 14, 2021, restricted to patients aged 18 years or older with proven or high likelihood of COVID-19, who received supplementary oxygen. The primary outcome was administration of dexamethasone, prednisolone, hydrocortisone, or methylprednisolone. This study is registered with ISRCTN, ISRCTN66726260. FINDINGS: Between June 17, 2020, and April 14, 2021, 47 795 (75·2%) of 63 525 of patients on supplementary oxygen received corticosteroids, higher among patients requiring critical care than in those who received ward care (11 185 [86·6%] of 12 909 vs 36 415 [72·4%] of 50 278). Patients 50 years or older were significantly less likely to receive corticosteroids than those younger than 50 years (adjusted odds ratio 0·79 [95% CI 0·70–0·89], p=0·0001, for 70–79 years; 0·52 [0·46–0·58], p80 years), independent of patient demographics and illness severity. 84 (54·2%) of 155 pregnant women received corticosteroids. Rates of corticosteroid administration increased from 27·5% in the week before June 16, 2020, to 75–80% in January, 2021. INTERPRETATION: Implementation of corticosteroids into clinical practice in the UK for patients with COVID-19 has been successful, but not universal. Patients older than 70 years, independent of illness severity, chronic neurological disease, and dementia, were less likely to receive corticosteroids than those who were younger, as were pregnant women. This could reflect appropriate clinical decision making, but the possibility of inequitable access to life-saving care should be considered. FUNDING: UK National Institute for Health Research and UK Medical Research Council