A paediatric telecardiology service for district hospitals in south-east England: an observational study.

The attached article is a Publisher version of the final published version which may be accessed at the link below. Copyright © 2010 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health. All rights reservedOBJECTIVES: To compare caseloads of new patients assessed by paediatric cardiologists face-to-face or during teleconferences, and assess NHS costs for the alternative referral arrangements. DESIGN: Prospective cohort study over 15 months. SETTING: Four district hospitals in south-east England and a London paediatric cardiology centre. PATIENTS: Babies and children. INTERVENTION: A telecardiology service introduced alongside outreach clinics. MEASUREMENTS: Clinical outcomes and mean NHS costs per patient. RESULTS: 266 new patients were studied: 75 had teleconsultations (19 of 42 newborns and 56 of 224 infants and children). Teleconsultation patients generally were younger (49% being under 1 year compared with 32% seen personally (p = 0.025)) and their symptoms were not as severe. A cardiac intervention was undertaken immediately or planned for five telemedicine patients (7%) and 30 conventional patients (16%). However, similar proportions of patients were discharged after being assessed (32% telemedicine and 39% conventional). During scheduled teleconferences the mean duration of time per patient in sessions involving real-time echocardiography was 14.4 min, and 8.5 min in sessions where pre-recorded videos were transmitted. Mean cost comparisons for telemedicine and face-to-face patients over 14-day and 6-month follow-up showed the telecardiology service to be cost-neutral for the three hospitals with infrequently-held outreach clinics (1519 UK pounds vs 1724 UK pounds respectively after 14 days). CONCLUSION: Paediatric cardiology centres with small cadres of specialists are under pressure to cope with ever-expanding caseloads of new patients with suspected anomalies. Innovative use of telecardiology alongside conventional outreach services should suitably, and economically, enhance access to these specialists.The Department of Health and the Charitable Funds Committee of the Royal Brompton and Harefield NHS Trust funded the project

Community-Based Heritage Education, Training and Research : Preliminary Report On The Tungatsivvik Archaeological Project

Despite an immediate need for northerners trained in cultural resource management and the strong desire of many northern communities to direct historical research, there continue to be few opportunities for students to receive formal training in heritage research. A promising new approach is the Tungatsivvik Archaeological Project, which since 1991 has been part of the Environmental Technology Program offered through Arctic College's Nunatta Campus in cooperation with the community of Iqaluit. Integrating lectures, field exercises, lab analyses, and community reporting, the program allows students and community members alike to acquire technical knowledge and skills they can use to develop community-based heritage programs. The more than 100 features identified at the site, where excavations in the first two seasons have yielded more than 2000 artifacts and 7000 animal bones, include late prehistoric (Thule culture) dwellings, food caches, kayak stands, and burials. Results of the project are being actively integrated into local educational and interpretative structures, as community members from elders to school children participate in "making history come alive."Key words: Baffin Island, archaeology, Arctic College, community-based research, cultural resource management, heritage training, NunavutMalgré le manque actuel de résidents du Grand Nord formés en gestion des ressources culturelles et le désir très fort de nombreuses communautés nordiques de diriger la recherche historique, il y a toujours peu d'occasions pour des étudiants de recevoir une formation formelle en recherche sur le patrimoine. Le projet archéologique de Tungatsivvik représente une nouvelle approche prometteuse. Il a fait partie du programme de technologie de l'environnement offert depuis 1991 par le campus Nunatta de l'Arctic College, en coopération avec la communauté d'Iqaluit. Le programme intègre cours, exercices sur le terrain, analyses en laboratoire et reportages communautaires, et permet aux étudiants, ainsi qu'aux membres de la communauté, d'acquérir des connaissances et des habiletés techniques qu'ils peuvent utiliser pour mettre au point des programmes sur le patrimoine d'inspiration communautaire. Parmi les plus de cent caractéristiques identifiées sur le site où les deux premières saisons d'excavation ont livré plus de 2000 artefacts et 7000 os d'animaux, on retrouve des logements datant de juste avant la période historique (culture Thulé), des caches de nourriture, des supports de kayak et des sites d'enterrement. Les résultats du projet sont en cours d'intégration dans les structures d'éducation et d'interprétation locales, alors que des membres de la communauté, allant des anciens aux écoliers, participent au projet de «faire revivre l'histoire».Mots clés: Île Baffin, archéologie, Arctic College, recherche d’inspiration communautaire, gestion des ressources culturelles, formation en patrimoine, Nunavu

Unveiling a Population of X-ray Non-Detected AGN

We define a sample of 27 radio-excess AGN in the Chandra Deep Field North by selecting galaxies that do not obey the radio/infrared correlation for radio-quiet AGN and star-forming galaxies. Approximately 60% of these radio-excess AGN are X-ray undetected in the 2 Ms Chandra catalog, even at exposures of > 1 Ms; 25% lack even 2-sigma X-ray detections. The absorbing columns to the faint X-ray-detected objects are 10^22 cm^-2 < N_H < 10^24 cm^-2, i.e., they are obscured but unlikely to be Compton thick. Using a local sample of radio-selected AGN, we show that a low ratio of X-ray to radio emission, as seen in the X-ray weakly- and non-detected samples, is correlated with the viewing angle of the central engine, and therefore with obscuration. Our technique can explore the proportion of obscured AGN in the distant Universe; the results reported here for radio-excess objects are consistent with but at the low end of the overall theoretical predictions for Compton-thick objects.Comment: Accepted for publication in the Astrophysical Journal, 15 pages, 10 figures, 4 table

Massive landsliding in Narrabeen sandstones in the Watagan region

The Narrabeen Group is a thick sequence of bedded Triassic sandstones which occupies the stratigraphic interval between the Permian coal measures and the Hawkesbury Sandstone in the Sydney Basin. In the northern Sydney Basin it is laterally extensive, extending throughout the southern Hunter Valley from the Central Coast to beyond the Great Divide. In the Watagans region, a unique situation arises where a disconformity causes the Narrabeen group to be underlain directly by Permian upper marine sediments. The result is a dramatic occurrence of ancient massive landsliding, leading to steep sandstone slopes that break to an elevated detrital plane, of considerable lateral extent. This paper describes the unusual geomorphic features associated with the landslide mass and interprets a variety of individual mass-movement and rockfall mechanisms which have contributed to these impressive features in the various stages of its development

Why Optically--Faint AGN Are Faint: The Spitzer Perspective

Optically--faint X-ray sources (those with f_X/f_R > 10) constitute about 20% of X-ray sources in deep surveys, and are potentially highly obscured and/or at high redshift. Their faint optical fluxes are generally beyond the reach of spectroscopy. For a sample of 20 optically--faint sources in CDFS, we compile 0.4--24 um photometry, relying heavily on Spitzer. We estimate photometric redshifts for 17 of these 20 sources. We find that these AGN are optically--faint both because they lie at significantly higher redshifts (median z ~ 1.6) than most X-ray--selected AGN, and because their spectra are much redder than standard AGN. They have 2--8 keV X-ray luminosities in the Seyfert range, unlike the QSO--luminosities of optically--faint AGN found in shallow, wide--field surveys. Their contribution to the X-ray Seyfert luminosity function is comparable to that of z>1 optically--bright AGN.Comment: Accepted for publication in the Astrophysical Journa

High Resolution STIS/HST and HIRES/Keck Spectra of Three Weak MgII Absorbers Toward PG 1634+706

High resolution optical (HIRES/Keck) and UV (STIS/HST) spectra, covering a large range of chemical transitions, are analyzed for three single-cloud weak MgII absorption systems along the line of sight toward the quasar PG 1634+706. Weak MgII absorption lines in quasar spectra trace metal-enriched environments that are rarely closely associated with the most luminous galaxies (>0.05L^*). The two weak MgII systems at z=0.81 and z=0.90 are constrained to have >=solar metallicity, while the metallicity of the z=0.65 system is not as well-constrained, but is consistent with >1/10th solar. These weak MgII clouds are likely to be local pockets of high metallicity in a lower metallicity environment. All three systems have two phases of gas, a higher density region that produces narrower absorption lines for low ionization transitions, such as MgII, and a lower density region that produces broader absorption lines for high ionization transitions, such as CIV. The CIV profile for one system (at z=0.81) can be fit with a single broad component (b~10 km/s), but those for the other two systems require one or two additional offset high ionization clouds. Two possible physical pictures for the phase structure are discussed: one with a low-ionization, denser phase embedded in a lower density surrounding medium, and the other with the denser clumps surrounding more highly ionized gas.Comment: 32 pages, 4 figures; to appear in ApJ on May 20, 200

Stellar Populations of Highly Magnified Lensed Galaxies: Young Starbursts at z~2

We present a comprehensive analysis of the rest-frame UV to near-IR spectral energy distributions and rest-frame optical spectra of four of the brightest gravitationally lensed galaxies in the literature: RCSGA 032727-132609 at z=1.70, MS1512-cB58 at z=2.73, SGAS J152745.1+065219 at z=2.76 and SGAS J122651.3+215220 at z=2.92. This includes new Spitzer imaging for RCSGA0327 as well as new spectra, near-IR imaging and Spitzer imaging for SGAS1527 and SGAS1226. Lensing magnifications of 3-4 magnitudes allow a detailed study of the stellar populations and physical conditions. We compare star formation rates as measured from the SED fit, the H-alpha and [OII] emission lines, and the UV+IR bolometric luminosity where 24 micron photometry is available. The SFR estimate from the SED fit is consistently higher than the other indicators, which suggests that the Calzetti dust extinction law used in the SED fitting is too flat for young star-forming galaxies at z~2. Our analysis finds similar stellar population parameters for all four lensed galaxies: stellar masses 3-7*10^9 M_sun, young ages ~ 100 Myr, little dust content E(B-V)=0.10-0.25, and star formation rates around 20-100 M_sun/yr. Compared to typical values for the galaxy population at z~2, this suggests we are looking at newly formed, starbursting systems that have only recently started the build-up of stellar mass. These results constitute the first detailed, uniform analysis of a sample of the growing number of strongly lensed galaxies known at z~2.Comment: 13 pages, 8 figures, Accepted to Ap