Patient-Centered Care: An Examination of Provider–Patient Communication Over Time

Objective: To examine the quality of provider communication over time considering the increasing emphasis on patient-centered care (PCC). Patient-centered care has been shown to have a positive impact on health outcomes, care experiences, quality-of-life, as well as decreased costs. Given this emphasis, we expect that provider–patient communication has improved over time. Data Source: We collected primary data by self-report surveys between summer 2017 and fall 2018. Study Design: We use a quantitative retrospective cohort study of a national sample of 353 patients who had an ostomy surgery. Data Extraction Method: We measure provider communication from open-ended self-reports from patients of the number of stated inadequacies in their care. Principal Findings: Results show that the time since patients had their surgery is related to higher quality provider communication. That is, patients who had their surgery further back in time reported higher quality provider communication compared with patients who had their surgery performed more recently. Conclusion: Results suggest that the quality of provider communication has not improved even with an emphasis on PCC.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The research was funded by a “Graduate College Foundation Fellowship from the Department of Sociology and the Graduate College at the University of Oklahoma” to Leslie Miller. The funding does not impact the study in any way. Open Access fees paid for in whole or in part by the University of Oklahoma Libraries.Ye

High-mass X-ray binaries and OB-runaway stars

High-mass X-ray binaries (HMXBs) represent an important phase in the evolution of massive binary systems. HMXBs provide unique diagnostics to test massive-star evolution, to probe the physics of radiation-driven winds, to study the process of mass accretion, and to measure fundamental parameters of compact objects. As a consequence of the supernova explosion that produced the neutron star (or black hole) in these systems, HMXBs have high space velocities and thus are runaways. Alternatively, OB-runaway stars can be ejected from a cluster through dynamical interactions. Observations obtained with the Hipparcos satellite indicate that both scenarios are at work. Only for a minority of the OB runaways (and HMXBs) a wind bow shock has been detected. This might be explained by the varying local conditions of the interstellar medium.Comment: 15 pages, latex (sty file included) with 5 embedded figures (one in jpg format), to appear in Proc. "Influence of binaries on stellar population studies", Eds. Vanbeveren, Van Rensberge

Maze solvers demystified and some other thoughts

There is a growing interest towards implementation of maze solving in spatially-extended physical, chemical and living systems. Several reports of prototypes attracted great publicity, e.g. maze solving with slime mould and epithelial cells, maze navigating droplets. We show that most prototypes utilise one of two phenomena: a shortest path in a maze is a path of the least resistance for fluid and current flow, and a shortest path is a path of the steepest gradient of chemoattractants. We discuss that substrates with so-called maze-solving capabilities simply trace flow currents or chemical diffusion gradients. We illustrate our thoughts with a model of flow and experiments with slime mould. The chapter ends with a discussion of experiments on maze solving with plant roots and leeches which show limitations of the chemical diffusion maze-solving approach.Comment: This is a preliminary version of the chapter to be published in Adamatzky A. (Ed.) Shortest path solvers. From software to wetware. Springer, 201

Nature of light correlations in ghost imaging

We investigate the nature of correlations in Gaussian light sources used for ghost imaging. We adopt methods from quantum information theory to distinguish genuinely quantum from classical correlations. Combining a microscopic analysis of speckle-speckle correlations with an effective coarse-grained description of the beams, we show that quantum correlations exist even in `classical'-like thermal light sources, and appear relevant for the implementation of ghost imaging in the regime of low illumination. We further demonstrate that the total correlations in the thermal source beams effectively determine the quality of the imaging, as quantified by the signal-to-noise ratio.Comment: 12 pages, 5 figures. To appear in Scientific Reports (NPG

Neonatal-onset multisystem inflammatory disease responsive to interleukin-1 beta inhibition

BACKGROUND:Neonatal-onset multisystem inflammatory disease is characterized by fever, urticarial rash, aseptic meningitis, deforming arthropathy, hearing loss, and mental retardation. Many patients have mutations in the cold-induced autoinflammatory syndrome 1 (CIAS1) gene, encoding cryopyrin, a protein that regulates inflammation.METHODS:We selected 18 patients with neonatal-onset multisystem inflammatory disease (12 with identifiable CIAS1 mutations) to receive anakinra, an interleukin-1-receptor antagonist (1 to 2 mg per kilogram of body weight per day subcutaneously). In 11 patients, anakinra was withdrawn at three months until a flare occurred. The primary end points included changes in scores in a daily diary of symptoms, serum levels of amyloid A and C-reactive protein, and the erythrocyte sedimentation rate from baseline to month 3 and from month 3 until a disease flare.RESULTS:All 18 patients had a rapid response to anakinra, with disappearance of rash. Diary scores improved (P<0.001) and serum amyloid A (from a median of 174 mg to 8 mg per liter), C-reactive protein (from a median of 5.29 mg to 0.34 mg per deciliter), and the erythrocyte sedimentation rate decreased at month 3 (all P<0.001), and remained low at month 6. Magnetic resonance imaging showed improvement in cochlear and leptomeningeal lesions as compared with baseline. Withdrawal of anakinra uniformly resulted in relapse within days; retreatment led to rapid improvement. There were no drug-related serious adverse events.CONCLUSIONS:Daily injections of anakinra markedly improved clinical and laboratory manifestations in patients with neonatal-onset multisystem inflammatory disease, with or without CIAS1 mutations

Non-global logarithms and jet algorithms in high-pT jet shapes

We consider jet-shape observables of the type proposed recently, where the shapes of one or more high-pT jets, produced in a multi-jet event with definite jet multiplicity, may be measured leaving other jets in the event unmeasured. We point out the structure of the full next-to-leading logarithmic resummation specifically including resummation of non-global logarithms in the leading-Nc limit and emphasising their properties. We also point out differences between jet algorithms in the context of soft gluon resummation for such observables.Comment: 22 pages, 4 figures. Title and a few words changed. Several typos corrected. Version accepted by JHE

Routine breast screening for women aged 65–69: results from evaluation of the demonstration sites

Routine programme data and specially designed surveys from 3 demonstration sites were analysed to determine the implications of extending the NHS Breast Screening Programme (NHSBSP), to include routine invitations for women up to 69 years. All women aged 65–69 and registered with GPs in these areas received routine invitations for breast screening along with those aged 50–64. Overall uptake was 71% in women aged 65–69 compared with 78% in younger women, but was ≥ 90% in both groups who had previously attended within 5 years. Recall rates were lower for older women, but with a higher positive predictive value for cancer. The percentages of invasive cancer in different prognostic categories were similar in the 2 age groups. Older women took no longer to screen than younger women. The costs per woman invited or per woman screened were also similar to those for women aged 50–64, whilst the cost per cancer detected was some 34% lower in older women. Breast screening is as cost effective for women aged 65–69 as for those aged 50–64, with a higher cancer detection rate balancing shorter life expectancy. The proposed extension to the national programme will have considerable workforce implications for the NHSBSP and require additional resources. © 2001 Cancer Research Campaig

Non-Global Logarithms in Filtered Jet Algorithms

We analytically and numerically study the effect of perturbative gluons emission on the "Filtering analysis", which is part of a subjet analysis procedure proposed two years ago to possibly identify a low-mass Higgs boson decaying into b\bar{b} at the LHC. This leads us to examine the non-global structure of the resulting perturbative series in the leading single-log large-N_c approximation, including all-orders numerical results, simple analytical approximations to them and comments on the structure of their series expansion. We then use these results to semi-analytically optimize the parameters of the Filtering analysis so as to suppress as much as possible the effect of underlying event and pile-up on the Higgs mass peak reconstruction while keeping the major part of the perturbative radiation from the b\bar{b} dipole.Comment: 47 pages, 25 figures, 1 figure and a few comments added, version accepted for publication in JHE

A Simulated Annealing Approach to Approximate Bayes Computations

Approximate Bayes Computations (ABC) are used for parameter inference when the likelihood function of the model is expensive to evaluate but relatively cheap to sample from. In particle ABC, an ensemble of particles in the product space of model outputs and parameters is propagated in such a way that its output marginal approaches a delta function at the data and its parameter marginal approaches the posterior distribution. Inspired by Simulated Annealing, we present a new class of particle algorithms for ABC, based on a sequence of Metropolis kernels, associated with a decreasing sequence of tolerances w.r.t. the data. Unlike other algorithms, our class of algorithms is not based on importance sampling. Hence, it does not suffer from a loss of effective sample size due to re-sampling. We prove convergence under a condition on the speed at which the tolerance is decreased. Furthermore, we present a scheme that adapts the tolerance and the jump distribution in parameter space according to some mean-fields of the ensemble, which preserves the statistical independence of the particles, in the limit of infinite sample size. This adaptive scheme aims at converging as close as possible to the correct result with as few system updates as possible via minimizing the entropy production in the system. The performance of this new class of algorithms is compared against two other recent algorithms on two toy examples.Comment: 20 pages, 2 figure

Heavy Squarks at the LHC

The LHC, with its seven-fold increase in energy over the Tevatron, is capable of probing regions of SUSY parameter space exhibiting qualitatively new collider phenomenology. Here we investigate one such region in which first generation squarks are very heavy compared to the other superpartners. We find that the production of these squarks, which is dominantly associative, only becomes rate-limited at mSquark > 4(5) TeV for L~10(100) fb-1. However, discovery of this scenario is complicated because heavy squarks decay primarily into a jet and boosted gluino, yielding a dijet-like topology with missing energy (MET) pointing along the direction of the second hardest jet. The result is that many signal events are removed by standard jet/MET anti-alignment cuts designed to guard against jet mismeasurement errors. We suggest replacing these anti-alignment cuts with a measurement of jet substructure that can significantly extend the reach of this channel while still removing much of the background. We study a selection of benchmark points in detail, demonstrating that mSquark= 4(5) TeV first generation squarks can be discovered at the LHC with L~10(100)fb-1