Design and performance of a multicentre, randomized controlled trial of teleconsulting.

We have designed and performed a multicentre, randomized controlled trial of teleconsulting. The trial investigated the effectiveness and cost implications in rural and inner-city settings of using videoconferencing as an alternative to general practitioner referral to a hospital specialist. The participating general practitioners referred a total of 3170 patients who satisfied the entry criteria. Of these, 1040 (33%) failed to provide consent or otherwise refused to participate in the trial. Of the patients recruited to the trial, a total of 1902 (91%) completed and returned the baseline questionnaire. Although the trial was successful in recruiting sufficient patients and in obtaining high questionnaire response rates, the findings will require careful interpretation to take account of the limits which the protocol placed on the ability of general practitioners to select patients for referral

Herbicide Evaluation for Control of Kochia and Palmer Amaranth in Teff Grass

Eleven postemergence herbicide treatments were applied to teff grown for forage to evaluate Palmer amaranth and kochia control, as well as crop tolerance. Effective Palmer amaranth control was achieved with all herbicide treatments, while less than satisfactory kochia control was obtained with atrazine and Harmony. Clarity, 2,4-D, and Huskie applied alone appeared to control kochia, but kochia density was low in the plots. Had the kochia population been higher, similar efficacy ratings may have been attained. Huskie or atrazine caused the most injury to teff. The first harvest suggests these herbicides reduced forage yield to less than 3,000 lb/a

Joint teleconsultations (virtual outreach) versus standard outpatient appointments for patients referred by their general practitioner for a specialist opinion: a randomised trial.

BACKGROUND: The current model of general practitioner referral of patients to hospital specialists in the UK is sometimes associated with unnecessary duplication of investigations and treatments. We aimed to compare joint teleconsultations between general practitioners, specialists, and patients (virtual outreach) with standard outpatient referral. METHODS: Virtual outreach services were established in London and Shrewsbury. The general practitioners referred 3170 patients, of whom 2094 consented to participate in the study and were eligible for inclusion. 1051 patients were randomly assigned virtual outreach, and 1043 standard outpatient appointments. We followed up the patients for 6 months after their index consultation. The primary outcome measure was the offer of a follow-up outpatient appointment. Analysis was by intention to treat. FINDINGS: More patients in the virtual outreach group than the standard group were offered a follow-up appointment (502 [52%] vs 400 [41%], odds ratio 1.52 [95% CI 1.27-1.82], p<0.0001). Significant differences in effects were observed between the two sites (p=0.009) and across different specialties (p<0.0001). Virtual outreach increased the offers of follow-up appointments more in Shrewsbury than in London, and more in ear, nose, and throat surgery and orthopaedics than in the other specialties. Fewer tests and investigations were ordered in the virtual outreach group by an average of 0.79 per patient (0.37-1.21, p=0.0002). Patients' satisfaction (analysed per protocol) was greater after a virtual outreach consultation than after a standard outpatient consultation (mean difference 0.33 scale points [95% CI 0.23-0.43], p<0.0001), with no heterogeneity between specialties or sites. INTERPRETATION: The trial showed that allocation of patients to virtual outreach consultations is variably associated with increased offers of follow-up appointments according to site and specialty, but leads to significant increases in patients' satisfaction and substantial reductions in tests and investigations. Efficient operation of such services will require appropriate selection of patients, significant service reorganisation, and provision of logistical support

New times, new politics: history and memory during the final years of the CPGB

This article examines the relationship between collective memory, historical interpretation and political identity. It focuses on the dissolution of the Communist Party of Great Britain (CPGB) as constructed through collective narrative memory, and on Marxist interpretations of history. The divisions within the party and the wider Marxist community, stretching from 1956 until 1991, were often framed around questions of historical interpretation. The events of 1989–1991 created an historical and mnemonic crisis for CPGB members who struggled to reconcile their past identities with their present situation. Unlike the outward-facing revisionism of other political parties, this was an intensely personal affair. The solution for many was to emphasise the need to find new ways to progress socialist aims, without relying on a discredited grand narrative. In contrast, other Communist parties, such as the Communist Party of Britain, which had been established (or ‘re-established’) in 1988, fared rather better. By adhering to the international party line of renewal and continued struggle, the party was able to hold its narrative together, condemning the excesses of totalitarian regimes, while reaffirming the need for international class struggle

A search for the radio counterpart of the unidentified gamma-ray source 3EG J1410-6147

We have made radio continuum, HI and X-ray observations in the direction of the unidentified EGRET source 3EG J1410-6147, using the Australia Telescope Compact Array and the Chandra X-ray Observatory. The observations encompass the supernova remnant (SNR) G312.4-0.4 and the two young pulsars PSRs J1412-6145 and J1413-6141. We derive a lower distance limit of 6 kpc to the SNR, although interpretation of positive velocity features in the HI spectrum may imply the SNR is more distant than 14 kpc. PSR J1412-6145, with an age of 50 kyr, is the pulsar most likely associated with SNR G312.4-0.4. X-rays are not detected from either pulsar and diffuse X-ray emission near the bright western edge of the SNR is weak. Although there is circumstantial evidence that this western region is a pulsar wind nebula (PWN), the embedded pulsar PSR J1412-6145 is apparently not sufficiently powerful to explain the radio enhancement. The origin of the electron acceleration in this region and of the gamma-rays remain unidentified, unless the distance to PSR J1413-6141 is at least a factor of 3 lower than its dispersion measure distance.Comment: 10 pages, plus 5 jpeg figures, MNRAS, in press. Full postscript or pdf including all figures is available at http://www.ast.cam.ac.uk/~m

Discourse or dialogue? Habermas, the Bakhtin Circle, and the question of concrete utterances

This is the author's accepted manuscript. The final publication is available at Springer via the link below.This article argues that the Bakhtin Circle presents a more realistic theory of concrete dialogue than the theory of discourse elaborated by Habermas. The Bakhtin Circle places speech within the “concrete whole utterance” and by this phrase they mean that the study of everyday language should be analyzed through the mediations of historical social systems such as capitalism. These mediations are also characterized by a determinate set of contradictions—the capital-labor contradiction in capitalism, for example—that are reproduced in unique ways in more concrete forms of life (the state, education, religion, culture, and so on). Utterances always dialectically refract these processes and as such are internal concrete moments, or concrete social forms, of them. Moreover, new and unrepeatable dialogic events arise in these concrete social forms in order to overcome and understand the constant dialectical flux of social life. But this theory of dialogue is different from that expounded by Habermas, who tends to explore speech acts by reproducing a dualism between repeatable and universal “abstract” discursive processes (commonly known as the ideal speech situation) and empirical uses of discourse. These critical points against Habermas are developed by focusing on six main areas: sentences and utterances; the lifeworld and background language; active versus passive understandings of language; validity claims; obligation and relevance in language; and dialectical universalism

Microscopic Dynamics in a Strongly Interacting Bose-Einstein Condensate

An initially stable 85Rb Bose-Einstein condensate (BEC) was subjected to a carefully controlled magnetic field pulse in the vicinity of a Feshbach resonance. This pulse probed the strongly interacting regime for the condensate, with calculated values for the diluteness parameter (na^3) ranging from 0.01 to 0.5. The field pulse was observed to cause loss of atoms from the condensate on remarkably short time scales (>=10 microsec). The dependence of this loss on magnetic field pulse shape and amplitude was measured. For triangular pulses shorter than 1 ms, decreasing the pulse length actually increased the loss, until extremely short time scales (a few tens of microseconds) were reached. Such time scales and dependencies are very different from those expected in traditional condensate inelastic loss processes, suggesting the presence of new microscopic BEC physics.Comment: 4 pages in latex2E, 4 eps figures; revised Fig.1, revised scatt.lengths, added discussion, new refs., resubmitted to PR

Molecular line profiles as diagnostics of protostellar collapse: modelling the `blue asymmetry' in inside-out infall

The evolution of star-forming core analogues undergoing inside-out collapse is studied with a multi-point chemodynamical model which self-consistently computes the abundance distribution of chemical species in the core. For several collapse periods the output chemistry of infall tracer species such as HCO+, CS, and N2H+, is then coupled to an accelerated Lambda-iteration radiative transfer code, which predicts the emerging molecular line profiles using two different input gas/dust temperature distributions. We investigate the sensitivity of the predicted spectral line profiles and line asymmetry ratios to the core temperature distribution, the time-dependent model chemistry, as well as to ad hoc abundance distributions. The line asymmetry is found to be strongly dependent on the adopted chemical abundance distribution. In general, models with a warm central region show higher values of blue asymmetry in optically thick HCO+ and CS lines than models with a starless core temperature profile. We find that in the formal context of Shu-type inside-out infall, and in the absence of rotation or outflows, the relative blue asymmetry of certain HCO+ and CS transitions is a function of time and, subject to the foregoing caveats, can act as a collapse chronometer. The sensitivity of simulated HCO+ line profiles to linear radial variations, subsonic or supersonic, of the internal turbulence field is investigated in the separate case of static cores.Comment: Accepted to MNRAS; 20 pages, 13 fig

Time-distance analysis of the emerging active region NOAA 10790

We investigate the emergence of Active Region NOAA 10790 by means of time – distance helioseismology. Shallow regions of increased sound speed at the location of increased magnetic activity are observed, with regions becoming deeper at the locations of sunspot pores. We also see a long-lasting region of decreased sound speed located underneath the region of the flux emergence, possibly relating to a temperature perturbation due to magnetic quenching of eddy diffusivity, or to a dense flux tube. We detect and track an object in the subsurface layers of the Sun characterised by increased sound speed which could be related to emerging magnetic-flux and thus obtain a provisional estimate of the speed of emergence of around 1 km s−1

Production of cold molecules via magnetically tunable Feshbach resonances

Magnetically tunable Feshbach resonances were employed to associate cold diatomic molecules in a series of experiments involving both atomic Bose as well as two spin component Fermi gases. This review illustrates theoretical concepts of both the particular nature of the highly excited Feshbach molecules produced and the techniques for their association from unbound atom pairs. Coupled channels theory provides the rigorous formulation of the microscopic physics of Feshbach resonances in cold gases. Concepts of dressed versus bare energy states, universal properties of Feshbach molecules, as well as the classification in terms of entrance- and closed-channel dominated resonances are introduced on the basis of practical two-channel approaches. Their significance is illustrated for several experimental observations, such as binding energies and lifetimes with respect to collisional relaxation. Molecular association and dissociation are discussed in the context of techniques involving linear magnetic field sweeps in cold Bose and Fermi gases as well as pulse sequences leading to Ramsey-type interference fringes. Their descriptions in terms of Landau-Zener, two-level mean field as well as beyond mean field approaches are reviewed in detail, including the associated ranges of validity.Comment: 50 pages, 26 figures, to be published in Reviews of Modern Physics, final version with updated reference