Potential economic impacts from improving breastfeeding rates in the UK

This article has been made available through the Brunel Open Access Publishing Fund.RATIONALE: Studies suggest that increased breastfeeding rates can provide substantial financial savings, but the scale of such savings in the UK is not known. OBJECTIVE: To calculate potential cost savings attributable to increases in breastfeeding rates from the National Health Service perspective. DESIGN AND SETTINGS: Cost savings focussed on where evidence of health benefit is strongest: reductions in gastrointestinal and lower respiratory tract infections, acute otitis media in infants, necrotising enterocolitis in preterm babies and breast cancer (BC) in women. Savings were estimated using a seven-step framework in which an incidence-based disease model determined the number of cases that could have been avoided if breastfeeding rates were increased. Point estimates of cost savings were subject to a deterministic sensitivity analysis. RESULTS: Treating the four acute diseases in children costs the UK at least £89 million annually. The 2009-2010 value of lifetime costs of treating maternal BC is estimated at £959 million. Supporting mothers who are exclusively breast feeding at 1 week to continue breast feeding until 4 months can be expected to reduce the incidence of three childhood infectious diseases and save at least £11 million annually. Doubling the proportion of mothers currently breast feeding for 7-18 months in their lifetime is likely to reduce the incidence of maternal BC and save at least £31 million at 2009-2010 value. CONCLUSIONS: The economic impact of low breastfeeding rates is substantial. Investing in services that support women who want to breast feed for longer is potentially cost saving

Quantifying the Relationship between Capability and Health in Older People: Can't Map, Won't Map

BACKGROUND: Intuitively, health and capability are distinct but linked concepts. This study aimed to quantify the link between a measure of health status (EQ-5D-3L) and capability (ICECAP-O) using regression-based methods. METHODS: EQ-5D-3L and ICECAP-O data were collected from a sample of older people ( n = 584), aged over 65 years, requiring a hospital visit and/or care home resident, and recruited to one of 3 studies forming the Medical Crisis in Older People (MCOP) program in England. The link of EQ-5D-3L with 1) ICECAP-O tariff scores were estimated using ordinary least squares (OLS) or censored least absolute deviation (CLAD) regression models; and 2) ICECAP-O domain scores was estimated using multinomial logistic (MNL) regression. Mean absolute error (MAE), root mean squared error (RMSE), absolute difference (AD) between mean observed and estimated values, and the R(2) statistic were used to judge model performance. RESULTS: In this sample of older people ( n = 584), higher scores on the EQ-5D-3L were shown to be linked with higher ICECAP-O scores when using linear regression. An OLS-regression model was identified to be the best performing model with the lowest error statistics (AD = 0.0000; MAE = 0.1208; MSE = 0.1626) and highest goodness of fit ( R(2) = 0.3532); model performance was poor when predicting the lower ICECAP-O tariff scores. The three domains of the EQ-5D-3L showing a statistically significant quantifiable link with the ICECAP-O tariff score were self-care, usual activities, and anxiety/depression. CONCLUSION: A quantifiable, but weak, link between health (EQ-5D-3L) and capability (ICECAP-O) was identified. The findings from this study add further support that the ICECAP-O is providing complimentary information to the EQ-5D-3L. Mapping between the 2 measures is not advisable and the measures should not be used as direct substitutes to capture the impact of interventions in economic evaluations

Arecibo timing and single-pulse observations of 17 pulsars

We report on timing and single-pulse observations of 17 pulsars discovered at the Arecibo observatory. The highlights of our sample are the recycled pulsars J1829+2456, J1944+0907 and the drifting subpulses observed in PSR J0815+0939. For the double neutron star binary J1829+2456, in addition to improving upon our existing measurement of relativistic periastron advance, we have now measured the pulsar's spin period derivative. This new result sets an upper limit on the transverse speed of 120 km/s and a lower limit on the characteristic age of 12.4 Gyr. From our measurement of proper motion of the isolated 5.2-ms pulsar J1944+0907, we infer a transverse speed of 188 +/- 65 km/s. This is higher than that of any other isolated millisecond pulsar. An estimate of the speed, using interstellar scintillation, of 235 +/- 45 km/s indicates that the scattering medium along the line of sight is non-uniform. We discuss the drifting subpulses detected from three pulsars in the sample, in particular the remarkable drifting subpulse properties of the 645-ms pulsar J0815+0939. Drifting is observed in all four components of the pulse profile, with the sense of drift varying among the different components. This unusual `bi-drifting'' behaviour challenges standard explanations of the drifting subpulse phenomenon.Comment: 9 pages, 6 figures. Accepted for publication in MNRA

A precise mass measurement of the intermediate-mass binary pulsar PSR J1802-2124

PSR J1802-2124 is a 12.6-ms pulsar in a 16.8-hour binary orbit with a relatively massive white dwarf (WD) companion. These properties make it a member of the intermediate-mass class of binary pulsar (IMBP) systems. We have been timing this pulsar since its discovery in 2002. Concentrated observations at the Green Bank Telescope, augmented with data from the Parkes and Nancay observatories, have allowed us to determine the general relativistic Shapiro delay. This has yielded pulsar and white dwarf mass measurements of 1.24(11) and 0.78(4) solar masses (68% confidence), respectively. The low mass of the pulsar, the high mass of the WD companion, the short orbital period, and the pulsar spin period may be explained by the system having gone through a common-envelope phase in its evolution. We argue that selection effects may contribute to the relatively small number of known IMBPs.Comment: 9 pages, 4 figures, 3 tables, accepted for publication in the Astrophysical Journa

The Parkes Multibeam Pulsar Survey: PSR J1811-1736 - a pulsar in a highly eccentric binary system

We are undertaking a high-frequency survey of the Galactic plane for radio pulsars, using the 13-element multibeam receiver on the 64-m Parkes radio telescope. We describe briefly the survey system and some of the initial results. PSR J1811-1736, one of the first pulsars discovered with this system, has a rotation period of 104 ms. Subsequent timing observations using the 76-m radio telescope at Jodrell Bank show that it is in an 18.8-day, highly-eccentric binary orbit. We have measured the rate of advance of periastron which indicates a total system mass of 2.6 +- 0.9 Msun, and the minimum companion mass is about 0.7 Msun. This, the high orbital eccentricity and the recycled nature of the pulsar suggests that this system is composed of two neutron stars, only the fourth or fifth such system known in the disk of the Galaxy.Comment: 6 pages, 3 embedded EPS figures, to be published in MNRA

The effects of PTSD treatment during pregnancy: systematic review and case study

Background: PTSD in pregnant women is associated with adverse outcomes for mothers and their children. It is unknown whether pregnant women with PTSD, or symptoms of PTSD, can receive targeted treatment that is safe and effective. Objective: The purpose of the present paper was to assess the effectiveness and safety of treatment for (symptoms of) PTSD in pregnant women. Method: A systematic review was conducted in accordance with the PRISMA guidelines in Pubmed, Embase, PsychINFO, and Cochrane. In addition, a case is presented of a pregnant woman with PTSD who received eye-movement desensitization and reprocessing (EMDR) therapy aimed at processing the memories of a previous distressing childbirth. Results: In total, 13 studies were included, involving eight types of interventions (i.e. trauma-focused cognitive behavioural therapy, exposure therapy, EMDR therapy, interpersonal psychotherapy, explorative therapy, self-hypnosis and relaxation, Survivor Moms Companion, and Seeking Safety Intervention). In three studies, the traumatic event pertained to a previous childbirth. Five studies reported obstetrical outcomes. After requesting additional information, authors of five studies indicated an absence of serious adverse events. PTSD symptoms improved in 10 studies. However, most studies carried a high risk of bias. In our case study, a pregnant woman with a PTSD diagnosis based on DSM-5 no longer fulfilled the criteria of PTSD after three sessions of EMDR therapy. She had an uncomplicated pregnancy and delivery. Conclusion: Despite the fact that case studies as the one presented here report no adverse events, and treatment is likely safe, due to the poor methodological quality of most studies it is impossible to allow inferences on the effects of any particular treatment of PTSD (symptoms) during pregnancy. Yet, given the elevated maternal stress and cortisol levels in pregnant women with PTSD, and the fact that so far no adverse effects on the unborn child have been reported associated with the application of trauma-focused therapy, treatment of PTSD during pregnancy is most likely safe

How strange are compact star interiors ?

We discuss a Nambu--Jona-Lasinio (NJL) type quantum field theoretical approach to the quark matter equation of state with color superconductivity and construct hybrid star models on this basis. It has recently been demonstrated that with increasing baryon density, the different quark flavors may occur sequentially, starting with down-quarks only, before the second light quark flavor and at highest densities also the strange quark flavor appears. We find that color superconducting phases are favorable over non-superconducting ones which entails consequences for thermodynamic and transport properties of hybrid star matter. In particular, for NJL-type models no strange quark matter phases can occur in compact star interiors due to mechanical instability against gravitational collapse, unless a sufficiently strong flavor mixing as provided by the Kobayashi-Maskawa-'t Hooft determinant interaction is present in the model. We discuss observational data on mass-radius relationships of compact stars which can put constraints on the properties of dense matter equation of state.Comment: 7 pages, 2 figures, to appear in the Proceedings of the International Conference SQM2009, Buzios, Rio de Janeiro, Brazil, Sep.27-Oct.2, 200

Discovery of 10 pulsars in an Arecibo drift-scan survey

We present the results of a 430-MHz survey for pulsars conducted during the upgrade to the 305-m Arecibo radio telescope. Our survey covered a total of 1147 square degrees of sky using a drift-scan technique. We detected 33 pulsars, 10 of which were not known prior to the survey observations. The highlight of the new discoveries is PSR J0407+1607, which has a spin period of 25.7 ms, a characteristic age of 1.5 Gyr and is in a 1.8-yr orbit about a low-mass (>0.2 Msun) companion. The long orbital period and small eccentricity (e = 0.0009) make the binary system an important new addition to the ensemble of binary pulsars suitable to test for violations of the strong equivalence principle. We also report on our initially unsuccessful attempts to detect optically the companion to J0407+1607 which imply that its absolute visual magnitude is > 12.1. If, as expected on evolutionary grounds, the companion is an He white dwarf, our non-detection imples a cooling age of least 1 Gyr.Comment: 8 pages, 3 figures, accepted for publication in MNRA

The two-hour orbit of a binary millisecond X-ray pulsar

Typical radio pulsars are magnetized neutron stars that are born rapidly rotating and slow down as they age on time scales of 10 to 100 million years. However, millisecond radio pulsars spin very rapidly even though many are billions of years old. The most compelling explanation is that they have been "spun up" by the transfer of angular momentum during accretion of material from a companion star in so-called low-mass X-ray binary systems, LMXBs. (LMXBs consist of a neutron star or black hole accreting from a companion less than one solar mass.) The recent detection of coherent X-ray pulsations with a millisecond period from a suspected LMXB system appears to confirm this link. Here we report observations showing that the orbital period of this binary system is two hours, which establishes it as an LMXB. We also find an apparent modulation of the X-ray flux at the orbital period (at the two per cent level), with a broad minimum when the pulsar is behind this low-mass companion star. This system seems closely related to the "black widow" millisecond radio pulsars, which are evaporating their companions through irradiation. It may appear as an eclipsing radio pulsar during periods of X-ray quiescence.Comment: 4 pages with 1 figure. Style files included. Fig. 2 deleted and text revised. To appear in Nature. Press embargo until 18:00 GMT on 1998 July 2

Measurement of Relativistic Orbital Decay in the PSR B1534+12 Binary System

We have made timing observations of binary pulsar PSR B1534+12 with radio telescopes at Arecibo, Green Bank, and Jodrell Bank. By combining our new observations with data collected up to seven years earlier, we obtain a significantly improved solution for the astrometric, spin, and orbital parameters of the system. For the first time in any binary pulsar system, no fewer than five relativistic or "post-Keplerian" orbital parameters are measurable with useful accuracies in a theory-independent way. We find the orbital period of the system to be decreasing at a rate close to that expected from gravitational radiation damping, according to general relativity, although the precision of this test is limited to about 15% by the otherwise poorly known distance to the pulsar. The remaining post-Keplerian parameters are all consistent with one another and all but one of them have fractional accuracies better than 1%. By assuming that general relativity is the correct theory of gravity, at least to the accuracy demanded by this experiment, we find the masses of the pulsar and companion star each to be 1.339+-0.003 Msun and the system's distance to be d = 1.1+-0.2 kpc, marginally larger than the d ~ 0.7 kpc estimated from the dispersion measure. The increased distance reduces estimates of the projected rate of coalescence of double neutron-star systems in the universe, a quantity of considerable interest for experiments with terrestrial gravitational wave detectors such as LIGO.Comment: 17 pages, 4 figures, submitted to the Ap