Dates of birth and seasonal changes in well-being among 4904 subjects completing the seasonal pattern assessment questionnaire

Background: Abnormal distributions of birthdates, suggesting intrauterine aetiological factors, have been found in several psychiatric disorders, including one study of out-patients with Seasonal Affective Disorder (S.A.D.). We investigated birthdate distribution in relation to seasonal changes in well-being among a cohort who had completed the Seasonal Pattern Assessment Questionnaire (SPAQ). Method: A sample of 4904 subjects, aged 16 to 64, completed the SPAQ. 476 were cases of S.A.D. on the SPAQ and 580 were cases of sub-syndromal S.A.D. (S-S.A.D.). 92 were interview confirmed cases of S.A.D. Months and dates of birth were compared between S.A.D. cases and all others, between S.A.D. and S-S.A.D. cases combined and all others, and between interview confirmed cases and all others. Seasonality, as measured through seasonal fluctuations in well-being on the Global Seasonality Scores (GSS) of the SPAQ, was compared for all subjects by month and season of birth. Results: There was no evidence of an atypical pattern of birthdates for subjects fulfilling criteria for S.A.D., for the combined S.A.D. / S-S.A.D. group or for interview confirmed cases. There was also no relationship between seasonality on the GSS and month or season of birth. Limitations: Diagnoses of S.A.D. made by SPAQ criteria are likely to be overinclusive. Conclusion: Our findings differ from studies of patients with more severe mood disorders, including psychiatric out-patients with S.A.D. The lack of association between seasonality and birthdates in our study adds credence to the view that the aetiology of S.A.D. relates to separable factors predisposing to affective disorders and to seasonality

Cost effectiveness analysis of different approaches of screening for familial hypercholesterolaemia

Objectives To assess the cost effectiveness of strategies to screen for and treat familial hypercholesterolaemia. Design Cost effectiveness analysis. A care pathway for each patient was delineated and the associated probabilities, benefits, and costs were calculated. Participants Simulated population aged 16­54 years in England and Wales. Interventions Identification and treatment of patients with familial hypercholesterolaemia by universal screening, opportunistic screening in primary care, screening of people admitted to hospital with premature myocardial infarction, or tracing family members of affected patients. Main outcome measure Cost effectiveness calculated as cost per life year gained (extension of life expectancy resulting from intervention) including estimated costs of screening and treatment. Results Tracing of family members was the most cost effective strategy (£3097 (&5066, $4479) per life year gained) as 2.6 individuals need to be screened to identify one case at a cost of £133 per case detected. If the genetic mutation was known within the family then the cost per life year gained (£4914) was only slightly increased by genetic confirmation of the diagnosis. Universal population screening was least cost effective (£13 029 per life year gained) as 1365 individuals need to be screened at a cost of £9754 per case detected. For each strategy it was more cost effective to screen younger people and women. Targeted strategies were more expensive per person screened, but the cost per case detected was lower. Population screening of 16 year olds only was as cost effective as family tracing (£2777 with a clinical confirmation). Conclusions Screening family members of people with familial hypercholesterolaemia is the most cost effective option for detecting cases across the whole population

The Effects of Orbital Motion on LISA Time Delay Interferometry

In an effort to eliminate laser phase noise in laser interferometer spaceborne gravitational wave detectors, several combinations of signals have been found that allow the laser noise to be canceled out while gravitational wave signals remain. This process is called time delay interferometry (TDI). In the papers that defined the TDI variables, their performance was evaluated in the limit that the gravitational wave detector is fixed in space. However, the performance depends on certain symmetries in the armlengths that are available if the detector is fixed in space, but that will be broken in the actual rotating and flexing configuration produced by the LISA orbits. In this paper we investigate the performance of these TDI variables for the real LISA orbits. First, addressing the effects of rotation, we verify Daniel Shaddock's result that the Sagnac variables will not cancel out the laser phase noise, and we also find the same result for the symmetric Sagnac variable. The loss of the latter variable would be particularly unfortunate since this variable also cancels out gravitational wave signal, allowing instrument noise in the detector to be isolated and measured. Fortunately, we have found a set of more complicated TDI variables, which we call Delta-Sagnac variables, one of which accomplishes the same goal as the symmetric Sagnac variable to good accuracy. Finally, however, as we investigate the effects of the flexing of the detector arms due to non-circular orbital motion, we show that all variables, including the interferometer variables, which survive the rotation-induced loss of direction symmetry, will not completely cancel laser phase noise when the armlengths are changing with time. This unavoidable problem will place a stringent requirement on laser stability of 5 Hz per root Hz.Comment: 12 pages, 2 figure

PHOENIX: Public Health and Obesity in England – the New Infrastructure eXamined First interim report: the scoping review

The PHOENIX project aims to examine the impact of structural changes to the health and care system in England on the functioning of the public health system, and on the approaches taken to improving the public’s health. The scoping review has now been completed. During this phase we analysed: Department of Health policy documents (2010-2013), as well as responses to those documents from a range of stakeholders; data from 22 semi-structured interviews with key informants; and the oral and written evidence presented at the House of Commons Communities and Local Government Committee on the role of local authorities in health issues. We also gathered data from local authority (LA) and Health and Wellbeing Board (HWB) websites and other sources to start to develop a picture of how the new structures are developing, and to collate demographic and other data on local authorities. A number of important themes were identified and explored during this phase. In summary, some key points related to three themes - governance, relationships and new ways of working - were: The reforms have had a profound effect on leadership within the public health system. Whilst LAs are now the local leaders for public health, in a more fragmented system, leadership for public health appears to be more dispersed amongst a range of organisations and a range of people within the LA. At national level, the leadership role is complex and not yet developed (from a local perspective). Accountability mechanisms have changed dramatically within public health, and many people still seem to be unclear about them. Some performance management mechanisms have disappeared, and much accountability now appears to rely on transparency and the democratic accountability that this would (theoretically) enable. The extent to which ‘system leaders’ within PHE are able to influence local decisions and performance will depend on the strength of relationships principally between the LA and the local Public Health England centre. These relationships will take time to develop. Many people have faced new ways of working, in new settings, and with new relationships to build. Public health teams in LAs have faced the most profound of these changes, having gone from a position of ‘expert voice’ to a position where they must defend their opinions and activities in the context of competing demands and severely restricted resources. Public health staff may require new skills, and may need to seek new ‘allies’ to thrive in the new environment. HWBs could be crucial in bringing together a fragmented system and dispersed leadership. The next phase of data collection will begin in March with the initiation of case study work. National surveys will be conducted in June/July this year (2014), and at the same time the following year. In this work, we will further explore the following themes: relationships, governance, decision making, new ways of working, and opportunities and difficulties

The decay of excited He from Stochastic Density-Functional Theory: a quantum measurement theory interpretation

Recently, time-dependent current-density functional theory has been extended to include the dynamical interaction of quantum systems with external environments [Phys. Rev. Lett. {\bf 98}, 226403 (2007)]. Here we show that such a theory allows us to study a fundamentally important class of phenomena previously inaccessible by standard density-functional methods: the decay of excited systems. As an example we study the decay of an ensemble of excited He atoms, and discuss these results in the context of quantum measurement theory.Comment: 4 pages, 2 figure

Squelched Galaxies and Dark Halos

There is accumulating evidence that the faint end of the galaxy luminosity function might be very different in different locations. The luminosity function might be rising in rich clusters and flat or declining in regions of low density. If galaxies form according to the model of hierarchical clustering then there should be many small halos compared to the number of big halos. If this theory is valid then there must be a mechanism that eliminates at least the visible component of galaxies in low density regions. A plausible mechanism is photoionization of the intergalactic medium at a time before the epoch that most dwarf galaxies form in low density regions but after the epoch of formation for similar systems that ultimately end up in rich clusters. The dynamical timescales are found to accommodate this hypothesis in a flat universe with Omega_m < 0.4. If small halos exist but simply cannot be located because they have never become the sites of significant star formation, they still might have dynamical manifestations. These manifestations are hard to identify in normal groups of galaxies because small halos do not make a significant contribution to the global mass budget. However, it could be entertained that there are clusters of halos where there are only small systems, clusters that are at the low mass end of the hierarchical tree. There may be places where only a few small galaxies managed to form, enough for us to identify and use as test probes of the potential. It turns out that such environments might be common. Four probable groups of dwarfs are identified within 5 Mpc and the assumption they are gravitationally bound suggests M/L_B ~ 300 - 1200 M_sun/L_sun, 6 +/- factor 2 times higher than typical values for groups with luminous galaxies.Comment: Accepted ApJ 569, (April 20), 2002, 12 pages, 6 figures, 1 tabl

Model for monitoring of a charge qubit using a radio-frequency quantum point contact including experimental imperfections

The extension of quantum trajectory theory to incorporate realistic imperfections in the measurement of solid-state qubits is important for quantum computation, particularly for the purposes of state preparation and error-correction as well as for readout of computations. Previously this has been achieved for low-frequency (dc) weak measurements. In this paper we extend realistic quantum trajectory theory to include radio frequency (rf) weak measurements where a low-transparency quantum point contact (QPC), coupled to a charge qubit, is used to damp a classical oscillator circuit. The resulting realistic quantum trajectory equation must be solved numerically. We present an analytical result for the limit of large dissipation within the oscillator (relative to the QPC), where the oscillator slaves to the qubit. The rf+dc mode of operation is considered. Here the QPC is biased (dc) as well as subjected to a small-amplitude sinusoidal carrier signal (rf). The rf+dc QPC is shown to be a low-efficiency charge-qubit detector, that may nevertheless be higher than the dc-QPC (which is subject to 1/f noise).Comment: 12 pages, 2 colour figures. v3 is published version (minor changes since v2