Predicting patterns of service utilization within children\u27s mental health agencies

Background: Some children with mental health (MH) problems have been found to receive ongoing care, either continuously or episodically. We sought to replicate patterns of MH service use over extended time periods, and test predictors of these patterns. Methods: Latent class analyses were applied to 4 years of visit data from five MH agencies and nearly 6000 children, 4-to 13-years-old at their first visit. Results: Five patterns of service use were identified, replicating previous findings. Overall, 14% of cases had two or more episodes of care and 23% were involved for more than 2 years. Most children (53%) were seen for just a few visits within a few months. Two patterns represented cases with two or more episodes of care spanning multiple years. In the two remaining patterns, children tended to have just one episode of care, but the number of sessions and length of involvement varied. Using discriminant function analyses, we were able to predict with just over 50% accuracy children\u27s pattern of service use. Severe externalizing behaviors, high impairment, and high family burden predicted service use patterns with long durations of involvement and frequent visits. Conclusions: Optimal treatment approaches for children seen for repeated episodes of care or for care lasting multiple years need to be developed. Children with the highest level of need (severe pathology, impairment, and burden) are probably best served by providing high intensity services at the start of care

Rb-87-stabilized 375-MHz Yb:fiber femtosecond frequency comb

We report a fully stabilized 1030-nm Yb-fiber frequency comb operating at a pulse repetition frequency of 375 MHz. The comb spacing was referenced to a Rb-stabilized microwave synthesizer and the comb offset was stabilized by generating a super-continuum containing a coherent component at 780.2 nm which was heterodyned with a 87Rb-stabilized external cavity diode laser to produce a radio-frequency beat used to actuate the carrier-envelope offset frequency of the Yb-fiber laser. The two-sample frequency deviation of the locked comb was 235 kHz for an averaging time of 50 seconds, and the comb remained locked for over 60 minutes with a root mean squared deviation of 236 kHz

Site-specific prolapse surgery. I. Reliability and durability of native tissue paravaginal repair

Introduction and hypothesis: This study aims to compare native tissue abdominal and vaginal paravaginal repair, and to investigate whether surgical outcome was independent of operative route. Methods: Retrospective comparison of 111 displacement cysto-urethrocoeles, repaired between 1997 and 2007. Treatment was by surgeon assignment, 52 women having abdominal (APVR) and 59 vaginal paravaginal repairs. Main outcome measures were same-site prolapse recurrence, time to failure and surgical complications. Initial reliability was evaluated by chi-square test, 10-year durability by Kaplan-Meier survival analysis and Cox proportional hazards model. Results: When examined in the Cox proportional hazards model, anatomic results of APVR were more durable than a mechanically analogous transvaginal operation done [95% CI=1.029-2.708 (p value=0.038)]. Kaplan-Meier curves plateaued within 38 months. Symptom resolution was broadly equivalent. Surgical complication rate was 3.6%. Conclusions: Site-specific re-suture of torn native tissue has genuine curative potential. Most of the long-term success was attributable to site-specific repair, rather than nonspecific scar formation.9 page(s

An Infrared Coronagraphic Survey for Substellar Companions

We have used the F160W filter (1.4-1.8 um) and the coronagraph on the Near-InfraRed Camera and Multi-Object Spectrometer (NICMOS) on the Hubble Space Telescope (HST) to survey 45 single stars with a median age of 0.15 Gyr, an average distance of 30 pc, and an average H-magnitude of 7 mag. For the median age we were capable of detecting a 30 M_Jup companion at separations between 15 and 200 AU. A 5 M_Jup object could have been detected at 30 AU around 36% of our primaries. For several of our targets that were less than 30 Myr old, the lower mass limit was as low as a Jupiter mass, well into the high mass planet region. Results of the entire survey include the proper motion verification of five low-mass stellar companions, two brown dwarfs (HR7329B and TWA5B) and one possible brown dwarf binary (Gl 577B/C).Comment: 11 figures, accepted by A

Evaluating the potential for the environmentally sustainable control of foot and mouth disease in Sub-Saharan Africa

Strategies to control transboundary diseases have in the past generated unintended negative consequences for both the environment and local human populations. Integrating perspectives from across disciplines, including livestock, veterinary and conservation sectors, is necessary for identifying disease control strategies that optimise environmental goods and services at the wildlife-livestock interface. Prompted by the recent development of a global strategy for the control and elimination of foot-and-mouth disease (FMD), this paper seeks insight into the consequences of, and rational options for potential FMD control measures in relation to environmental, conservation and human poverty considerations in Africa. We suggest a more environmentally nuanced process of FMD control that safe-guards the integrity of wild populations and the ecosystem dynamics on which human livelihoods depend while simultaneously improving socio-economic conditions of rural people. In particular, we outline five major issues that need to be considered: 1) improved understanding of the different FMD viral strains and how they circulate between domestic and wildlife populations; 2) an appreciation for the economic value of wildlife for many African countries whose presence might preclude the country from ever achieving an FMD-free status; 3) exploring ways in which livestock production can be improved without compromising wildlife such as implementing commodity-based trading schemes; 4) introducing a participatory approach involving local farmers and the national veterinary services in the control of FMD; and 5) finally the possibility that transfrontier conservation might offer new hope of integrating decision-making at the wildlife-livestock interface

The USNO-B Catalog

USNO-B is an all-sky catalog that presents positions, proper motions, magnitudes in various optical passbands, and star/galaxy estimators for 1,042,618,261 objects derived from 3,643,201,733 separate observations. The data were obtained from scans of 7,435 Schmidt plates taken for the various sky surveys during the last 50 years. USNO-B1.0 is believed to provide all-sky coverage, completeness down to V = 21, 0.2 arcsecond astrometric accuracy at J2000, 0.3 magnitude photometric accuracy in up to five colors, and 85% accuracy for distinguishing stars from non-stellar objects. A brief discussion of various issues is given here, but the actual data are available from http://www.nofs.navy.mil and other sites.Comment: Accepted by Astronomical Journa

Aspects of ALE Matrix Models and Twisted Matrix Strings

We examine several aspects of the formulation of M(atrix)-Theory on ALE spaces. We argue for the existence of massless vector multiplets in the resolved $A_{n-1}$ spaces, as required by enhanced gauge symmetry in M-Theory, and that these states might have the correct gravitational interactions. We propose a matrix model which describes M-Theory on an ALE space in the presence of wrapped membranes. We also consider orbifold descriptions of matrix string theories, as well as more exotic orbifolds of these models, and present a classification of twisted matrix string theories according to Reid's exact sequences of surface quotient singularities.Comment: 27 pages LaTeX2e, 7 figures, using utarticle.cls (included), array.sty, amsmath.sty, amsfonts.sty, cite.sty, epsf.sty. Bibtex style: utphys.bst (.bbl file included). Section on wrapped membrane states revised and expanded. We now argue for the existence of wrapped membranes and propose a matrix model which describes M-Theory on an ALE space in the presence of wrapped membrane

Multiplicity fluctuations in nuclear collisions at 158 A GeV

System size dependence of multiplicity fluctuations of charged particles produced in nuclear collisions at 158 A GeV was studied in the NA49 CERN experiment. Results indicate a non-monotonic dependence of the scaled variance of the multiplicity distribution with a maximum for semi-peripheral Pb+Pb interactions with number of projectile participants of about 35. This effect is not observed in a string-hadronic model of nuclear collision HIJING.Comment: Presented at "Focus on Multiplicity", 17-19 of June, Bari, Ital

Pilot, randomized, placebo-controlled clinical field study to evaluate the effectiveness of bupivacaine liposome injectable suspension for the provision of post-surgical analgesia in dogs undergoing stifle surgery

Abstract Background Local anesthetics are an important component of perioperative pain management, but the duration of action of available products is limited. We hypothesized that a single local infiltration of a novel bupivacaine liposome injectable suspension (AT-003) would provide clinically effective analgesia over a 72-h period. In a masked, randomized, placebo-controlled, multi-center pilot field study, dogs undergoing lateral retinacular suture placement for cranial cruciate insufficiency were randomly assigned to surgical site infiltration with AT-003 (5.3 mg/kg) or an equivalent volume of saline. Infiltration of the surgical site was done prior to closure. Primary outcome measure was the Glasgow Composite Measure Pain Scale (CMPS-SF) assessed prior to surgery and at 2, 4, 8, 12, 24, 30, 36, 48, 54, 60 and 72 h following surgery by trained individuals. Provision for rescue analgesia was employed. Repeated measures analysis of variance were utilized to test for possible differences between treatment groups and a success/failure analysis was also employed, based on the need for rescue analgesia. Results Forty-six dogs were enrolled and evaluated. For CMPS-SF scores there was a significant overall treatment effect (p = 0.0027) in favor of AT-003. There were significantly more successes in the AT-003 group compared to placebo over each time period (p = 0.0001 for 0–24 h, p = 0.0349 for 0–48 h, and p = 0.0240 for 0-72 h). No significant adverse events were seen. Conclusions AT-003 (bupivacaine liposome injectable suspension) provided measurable local analgesia over a 72-h period following post-stifle surgery surgical site tissue infiltration. Further work is indicated to develop this product for clinical use

Omega and Antiomega production in central Pb+Pb collisions at 40 and 158 AGeV

Results are presented on Omega production in central Pb+Pb collisions at 40 and 158 AGeV beam energy. Given are transverse-mass spectra, rapidity distributions, and total yields for the sum Omega+Antiomega at 40 AGeV and for Omega and Antiomega separately at 158 AGeV. The yields are strongly under-predicted by the string-hadronic UrQMD model and are in better agreement with predictions from a hadron gas models.Comment: 5 papes, 4 figures, 1 table, updated figure 4 and table 1. Final version, including some editorial changes, as published in PR