1,146 research outputs found
Patterns of Health Care Use among Rural-Urban Medicare Beneficiaries Age 85 and Older, 2010-2017
The purpose of this study was to examine rural-urban differences in health care use among Medicare beneficiaries age 85+. Understanding these differences, and the socioeconomic characteristics that contribute to them, can have important implications for Medicare policies aimed at serving the age 85+ population. Using the Medicare Current Beneficiary Survey 2010-13 Cost and Use and 2015-17 Cost Supplement Files, we examined whether and how rural and urban Medicare beneficiaries age 85+ differ in terms of their: socioeconomic and health characteristics that may inform health care use; trends in health care use, including use of inpatient and emergency department (ED) care; outpatient and prescription services; specialists and dentists; and home health and durable medical equipment.
Although the percentage of older adults (age 65+) remains higher in rural areas of the U.S., we found that adults over age 85 comprise a similar proportion of the Medicare population in rural and urban areas. Findings showed that rural and urban beneficiaries age 85+ had similar health (general health, chronic conditions) and functional outcomes (ADLs, and IADLs) across the study years and that the average number of visits to primary care providers for both rural and urban beneficiaries decreased over time. However, compared with urban beneficiaries, rural beneficiaries were significantly less likely to visit specialists, dentists, and receive outpatient services. Rural-urban differences in the percentage of beneficiaries who visited the Emergency Department were higher in all study years, with significant differences in 2011, 2012, and 2017.
FMI: Yvonne Jonk, PhD, Deputy Director, Maine Rural Health Research Center
New Constraints (and Motivations) for Abelian Gauge Bosons in the MeV-TeV Mass Range
We survey the phenomenological constraints on abelian gauge bosons having
masses in the MeV to multi-GeV mass range (using precision electroweak
measurements, neutrino-electron and neutrino-nucleon scattering, electron and
muon anomalous magnetic moments, upsilon decay, beam dump experiments, atomic
parity violation, low-energy neutron scattering and primordial
nucleosynthesis). We compute their implications for the three parameters that
in general describe the low-energy properties of such bosons: their mass and
their two possible types of dimensionless couplings (direct couplings to
ordinary fermions and kinetic mixing with Standard Model hypercharge). We argue
that gauge bosons with very small couplings to ordinary fermions in this mass
range are natural in string compactifications and are likely to be generic in
theories for which the gravity scale is systematically smaller than the Planck
mass - such as in extra-dimensional models - because of the necessity to
suppress proton decay. Furthermore, because its couplings are weak, in the
low-energy theory relevant to experiments at and below TeV scales the charge
gauged by the new boson can appear to be broken, both by classical effects and
by anomalies. In particular, if the new gauge charge appears to be anomalous,
anomaly cancellation does not also require the introduction of new light
fermions in the low-energy theory. Furthermore, the charge can appear to be
conserved in the low-energy theory, despite the corresponding gauge boson
having a mass. Our results reduce to those of other authors in the special
cases where there is no kinetic mixing or there is no direct coupling to
ordinary fermions, such as for recently proposed dark-matter scenarios.Comment: 49 pages + appendix, 21 figures. This is the final version which
appears in JHE
Recommended from our members
Myosin-I nomenclature.
We suggest that the vertebrate myosin-I field adopt a common nomenclature system based on the names adopted by the Human Genome Organization (HUGO). At present, the myosin-I nomenclature is very confusing; not only are several systems in use, but several different genes have been given the same name. Despite their faults, we believe that the names adopted by the HUGO nomenclature group for genome annotation are the best compromise, and we recommend universal adoption
EFT beyond the horizon: stochastic inflation and how primordial quantum fluctuations go classical
We identify the effective theory describing inflationary super-Hubble scales and show it to be a special case of effective field theories appropriate to open systems. Open systems allow information to be exchanged between the degrees of freedom of interest and those that are integrated out, such as for particles moving through a fluid. Strictly speaking they cannot in general be described by an effective lagrangian; rather the appropriate `low-energy' limit is instead a Lindblad equation describing the evolution of the density matrix of the slow degrees of freedom. We derive the equation relevant to super-Hubble modes of quantum fields in near-de Sitter spacetimes and derive two implications. We show the evolution of the diagonal density-matrix elements quickly approaches the Fokker-Planck equation of Starobinsky's stochastic inflationary picture. This provides an alternative first-principles derivation of this picture's stochastic noise and drift, as well as its leading corrections. (An application computes the noise for systems with a sub-luminal sound speed.) We argue that the presence of interactions drives the off-diagonal density-matrix elements to zero in the field basis. This shows why the field basis is the `pointer basis' for the decoherence of primordial quantum fluctuations while they are outside the horizon, thus allowing them to re-enter as classical fluctuations, as assumed when analyzing CMB data. The decoherence process is efficient, occurring after several Hubble times even for interactions as weak as gravitational-strength. Crucially, the details of the interactions largely control only the decoherence time and not the nature of the final late-time stochastic state, much as interactions can control the equilibration time for thermal systems but are largely irrelevant to the properties of the resulting equilibrium state
Flavor Phenomenology in General 5D Warped Spaces
We have considered a general 5D warped model with SM fields propagating in
the bulk and computed explicit expressions for oblique and non-oblique
electroweak observables as well as for flavor and CP violating effective
four-fermion operators. We have compared the resulting lower bounds on the
Kaluza-Klein (KK) scale in the RS model and a recently proposed model with a
metric modified towards the IR brane, which is consistent with oblique
parameters without the need for a custodial symmetry. We have randomly
generated 40,000 sets of O(1) 5D Yukawa couplings and made a fit of the quark
masses and CKM matrix elements in both models. This method allows to identify
the percentage of points consistent with a given KK mass, which in turn
provides us with a measure for the required fine-tuning. Comparison with
current experimental data on Rb, FCNC and CP violating operators exhibits an
improved behavior of our model with respect to the RS model. In particular,
allowing 10% fine-tuning the combined results point towards upper bounds on the
KK gauge boson masses around 3.3 TeV in our model as compared with 13 TeV in
the RS model. One reason for this improvement is that fermions in our model are
shifted, with respect to fermions in the RS model, towards the UV brane thus
decreasing the strength of the modifications of electroweak observables.Comment: 28 pages, 7 figures, 4 table
Neuromuscular Electrical Stimulation for Intermittent Claudication (NESIC): multicentre, randomized controlled trial
\ua9 The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd. METHODS: This was an open, multicentre, randomized controlled trial. Patients with intermittent claudication attending vascular surgery outpatient clinics were randomized (1:1) to receive either neuromuscular electrical stimulation (NMES) or not in addition to local standard care available at study centres (best medical therapy alone or plus supervised exercise therapy (SET)). The objective of this trial was to investigate the clinical efficacy of an NMES device in addition to local standard care in improving walking distances in patients with claudication. The primary outcome was change in absolute walking distance, measured by a standardized treadmill test at 3 months. Secondary outcomes included intermittent claudication (IC) distance, adherence, quality of life, and haemodynamic changes. RESULTS: Of 200 participants randomized, 160 were included in the primary analysis (intention to treat, Tobit regression model). The square root of absolute walking distance was analysed (due to a right-skewed distribution) and, although adjunctive NMES improved it at 3 months, no statistically significant effect was observed. SET as local standard care seemed to improve distance compared to best medical therapy at 3 months (3.29 units; 95 per cent c.i., 1.77 to 4.82; P < 0.001). Adjunctive NMES improved distance in mild claudication (2.88 units; 95 per cent c.i., 0.51 to 5.25; P = 0.02) compared to local standard care at 3 months. No serious adverse events relating to the device were reported. CONCLUSION: Supervised exercise therapy is effective and NMES may provide further benefit in mild IC.This trial was supported by a grant from the Efficacy and Mechanism Evaluation Program, a Medical Research Council and National Institute for Health and Care Research partnership. Trial registration: ISRCTN18242823.Patients with intermittent claudication experience pain in their legs during walking or exercise which ends with rest. This severely impairs physical activity and quality of life. Treatment for such patients typically involves best medical therapy, which includes exercise advice. This study aimed to determine whether a neuromuscular electrical stimulation device improved the walking distance of patients with intermittent claudication compared to local standard care available (which may include supervised exercise therapy) in a trial. Supervised exercise improved walking distances but there was no difference in those that received a device in this patient group
The mu problem and sneutrino inflation
We consider sneutrino inflation and post-inflation cosmology in the singlet
extension of the MSSM with approximate Peccei-Quinn(PQ) symmetry, assuming that
supersymmetry breaking is mediated by gauge interaction. The PQ symmetry is
broken by the intermediate-scale VEVs of two flaton fields, which are
determined by the interplay between radiative flaton soft masses and higher
order terms. Then, from the flaton VEVs, we obtain the correct mu term and the
right-handed(RH) neutrino masses for see-saw mechanism. We show that the RH
sneutrino with non-minimal gravity coupling drives inflation, thanks to the
same flaton coupling giving rise to the RH neutrino mass. After inflation,
extra vector-like states, that are responsible for the radiative breaking of
the PQ symmetry, results in thermal inflation with the flaton field, solving
the gravitino problem caused by high reheating temperature. Our model predicts
the spectral index to be n_s\simeq 0.96 due to the additional efoldings from
thermal inflation. We show that a right dark matter abundance comes from the
gravitino of 100 keV mass and a successful baryogenesis is possible via
Affleck-Dine leptogenesis.Comment: 27 pages, no figures, To appear in JHE
Correlation Functions of Large N Chern-Simons-Matter Theories and Bosonization in Three Dimensions
We consider the conformal field theory of N complex massless scalars in 2+1
dimensions, coupled to a U(N) Chern-Simons theory at level k. This theory has a
't Hooft large N limit, keeping fixed \lambda = N/k. We compute some
correlation functions in this theory exactly as a function of \lambda, in the
large N (planar) limit. We show that the results match with the general
predictions of Maldacena and Zhiboedov for the correlators of theories that
have high-spin symmetries in the large N limit. It has been suggested in the
past that this theory is dual (in the large N limit) to the Legendre transform
of the theory of fermions coupled to a Chern-Simons gauge field, and our
results allow us to find the precise mapping between the two theories. We find
that in the large N limit the theory of N scalars coupled to a U(N)_k
Chern-Simons theory is equivalent to the Legendre transform of the theory of k
fermions coupled to a U(k)_N Chern-Simons theory, thus providing a bosonization
of the latter theory. We conjecture that perhaps this duality is valid also for
finite values of N and k, where on the fermionic side we should now have (for
N_f flavors) a U(k)_{N-N_f/2} theory. Similar results hold for real scalars
(fermions) coupled to the O(N)_k Chern-Simons theory.Comment: 49 pages, 16 figures. v2: added reference
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