Risk adjustment for hospital use using social security data: cross sectional small area analysis

OBJECTIVES: To identify demographic and socioeconomic determinants of need for acute hospital treatment at small area level. To establish whether there is a relation between poverty and use of inpatient services. To devise a risk adjustment formula for distributing public funds for hospital services using, as far as possible, variables that can be updated between censuses. DESIGN: Cross sectional analysis. Spatial interactive modelling was used to quantify the proximity of the population to health service facilities. Two stage weighted least squares regression was used to model use against supply of hospital and community services and a wide range of potential needs drivers including health, socioeconomic census variables, uptake of income support and family credit, and religious denomination. SETTING: Northern Ireland. MAIN OUTCOME MEASURE: Intensity of use of inpatient services. RESULTS: After endogeneity of supply and use was taken into account, a statistical model was produced that predicted use based on five variables: income support, family credit, elderly people living alone, all ages standardised mortality ratio, and low birth weight. The main effect of the formula produced is to move resources from urban to rural areas. CONCLUSIONS: This work has produced a population risk adjustment formula for acute hospital treatment in which four of the five variables can be updated annually rather than relying on census derived data. Inclusion of the social security data makes a substantial difference to the model and to the results produced by the formula

Phase diagram of two interacting helical states

We consider two coupled time-reversal-invariant helical edge modes of the same helicity, such as would occur on two stacked quantum spin Hall insulators. In the presence of interaction, the low-energy physics is described by two collective modes, one corresponding to the total current flowing around the edge and the other one describing relative fluctuations between the two edges.We find that quite generically, the relative mode becomes gapped at low temperatures, but only when tunneling between the two helical modes is nonzero. There are two distinct possibilities for the gapped state depending on the relative size of different interactions. If the intraedge interaction is stronger than the interedge interaction, the state is characterized as a spin-nematic phase. However, in the opposite limit, when the interaction between the helical edge modes is strong compared to the interaction within each mode, a spin-density wave forms, with emergent topological properties. First, the gap protects the conducting phase against localization by weak nonmagnetic impurities; second, the protected phase hosts localized zero modes on the ends of the edge that may be created by sufficiently strong nonmagnetic impurities

A Holographic Animation of Compressible Flow Interferograms

Prize Winning Entry in ﾓGallery of Fluid Motionﾔ, Physics of Fluids, Vol. 4, No. 9, Sep. 1992, pp. 1869 - 1882

Keratoacanthoma management: results of a survey of UK dermatologists and surgeons.

Distinction of keratoacanthoma (KA) from squamous cell carcinoma (SCC) is challenging. Management is controversial, with some advocating prompt surgical excision and others monitoring to allow for spontaneous resolution(1) . The controversy is compounded by rare reports of metastasis(2) . And yet the benign natural history of KA is supported by various studies, including a systematic review of 455 cases with no cases of metastasis or death(1) , and observational studies confirming spontaneous resolution(1)

Formation of soliton trains in Bose-Einstein condensates as a nonlinear Fresnel diffraction of matter waves

The problem of generation of atomic soliton trains in elongated Bose-Einstein condensates is considered in framework of Whitham theory of modulations of nonlinear waves. Complete analytical solution is presented for the case when the initial density distribution has sharp enough boundaries. In this case the process of soliton train formation can be viewed as a nonlinear Fresnel diffraction of matter waves. Theoretical predictions are compared with results of numerical simulations of one- and three-dimensional Gross-Pitaevskii equation and with experimental data on formation of Bose-Einstein bright solitons in cigar-shaped traps.Comment: 8 pages, 3 figure

Prototype Development of a Solid Propellant Rocket Motor and an Electronic Safing and Arming Device for Nanosatellite (NANOSAT) Missions

Recently, there has been an increased interest in using nanosatellites in space science missions due to many unique science mission architectures that are only possible with a nanosatellite constellation. Hundreds of small and lightweight nanosatellites can form an intelligent constellation acting as a distributed network of instruments. In this way, measurements can be obtained that are not possible with traditional single spacecraft architectures. Such a constellation could take simultaneous, in situ measurements of dynamic phenomena in the Earth’s magnetosphere. This type of data is considered to be a critical element in the NASA Sun-Earth Connection (SEC) roadmap. Currently, the SEC roadmap features several nanosatellite constellation missions under consideration for potential future use. One such mission currently in a study phase at NASA’s Goddard Space Flight Center (NASA/GSFC) is the Magnetospheric Constellation (MagCon) mission

Impact of Arrivals on Departure Taxi Operations at Airports

Aircraft taxi operations are a major source of fuel burn and emissions on the ground. Given rising fuel prices and growing concerns about the contributions of aviation to air pollution and greenhouse gas emissions, recent research aims to develop strategies to reduce fuel burn at airports. In order to develop such strategies, an understanding of taxi operations and the factors that affect taxi-out times is required. This paper describes an analysis of taxi-out times at two major U.S. airports in order to identify the primary causal factors affecting the duration of taxi-out operations. Through an analysis of departures out of John F. Kennedy International Airport and Boston Logan International Airport, several variables affecting taxi-out times were identified, including primarily the number of arrivals and number of departures during the taxi-out operation of an aircraft. Previous literature suggests that the number of arrivals on the surface has limited influence on taxi-out times; however, this analysis demonstrates that the number of arrivals is in fact significantly correlated with taxi-out times. Furthermore, we find that arrivals have a greater impact on taxi-out times under runway configurations where there is increased interaction between arrivals and departures