Stating Appointment Costs in SMS Reminders Reduces Missed Hospital Appointments: Findings from Two Randomised Controlled Trials

BACKGROUND: Missed hospital appointments are a major cause of inefficiency worldwide. Healthcare providers are increasingly using Short Message Service reminders to reduce 'Did Not Attend' (DNA) rates. Systematic reviews show that sending such reminders is effective, but there is no evidence on whether their impact is affected by their content. Accordingly, we undertook two randomised controlled trials that tested the impact of rephrasing appointment reminders on DNA rates in the United Kingdom. TRIAL METHODS: Participants were outpatients with a valid mobile telephone number and an outpatient appointment between November 2013 and January 2014 (Trial One, 10,111 participants) or March and May 2014 (Trial Two, 9,848 participants). Appointments were randomly allocated to one of four reminder messages, which were issued five days in advance. Message assignment was then compared against appointment outcomes (appointment attendance, DNA, cancellation by patient). RESULTS: In Trial One, a message including the cost of a missed appointment to the health system produced a DNA rate of 8.4%, compared to 11.1% for the existing message (OR 0.74, 95% CI 0.61-0.89, P<0.01). Trial Two replicated this effect (DNA rate 8.2%), but also found that expressing the same concept in general terms was significantly less effective (DNA rate 9.9%, OR 1.22, 95% CI 1.00-1.48, P<0.05). Moving from the existing reminder to the more effective costs message would result in 5,800 fewer missed appointments per year in the National Health Service Trust in question, at no additional cost. The study's main limitations are that it took place in a single location in England, and that it required accurate phone records, which were only obtained for 20% of eligible patients. We conclude that missed appointments can be reduced, for no additional cost, by introducing persuasive messages to appointment reminders. Future studies could examine the impact of varying reminder messages in other health systems. TRIAL REGISTRATION: Controlled-Trials.com 49432571

Representations of the Weyl group and Wigner functions for SU(3)

Bases for SU(3) irreps are constructed on a space of three-particle tensor products of two-dimensional harmonic oscillator wave functions. The Weyl group is represented as the symmetric group of permutations of the particle coordinates of these space. Wigner functions for SU(3) are expressed as products of SU(2) Wigner functions and matrix elements of Weyl transformations. The constructions make explicit use of dual reductive pairs which are shown to be particularly relevant to problems in optics and quantum interferometry.Comment: : RevTex file, 11 pages with 2 figure

Forming Galaxies with MOND

Beginning with a simple model for the growth of structure, I consider the dissipationless evolution of a MOND-dominated region in an expanding Universe by means of a spherically symmetric N-body code. I demonstrate that the final virialized objects resemble elliptical galaxies with well-defined relationships between the mass, radius, and velocity dispersion. These calculations suggest that, in the context of MOND, massive elliptical galaxies may be formed early (z > 10) as a result of monolithic dissipationless collapse. Then I reconsider the classic argument that a galaxy of stars results from cooling and fragmentation of a gas cloud on a time scale shorter than that of dynamical collapse. Qualitatively, the results are similar to that of the traditional picture; moreover, the existence, in MOND, of a density-temperature relation for virialized, near isothermal objects as well as a mass-temperature relation implies that there is a definite limit to the mass of a gas cloud where this condition can be met-- an upper limit corresponding to that of presently observed massive galaxies.Comment: 9 pages, 9 figures, revised in response to comments of referee. Table added, extended discussion, accepted MNRA

Study protocol: evaluation of a parenting and stress management programme: a randomised controlled trial of Triple P discussion groups and stress control

&lt;br&gt;Background: Children displaying psychosocial problems are at an increased risk of negative developmental outcomes. Parenting practices are closely linked with child development and behaviour, and parenting programmes have been recommended in the treatment of child psychosocial problems. However, parental mental health also needs to be addressed when delivering parenting programmes as it is linked with parenting practices, child outcomes, and treatment outcomes of parenting programmes. This paper describes the protocol of a study examining the effects of a combined intervention of a parenting programme and a cognitive behavioural intervention for mental health problems.&lt;/br&gt; &lt;br&gt;Methods: The effects of a combined intervention of Triple P Discussion Groups and Stress Control will be examined using a randomised controlled trial design. Parents with a child aged 3?8?years will be recruited to take part in the study. After obtaining informed consent and pre-intervention measures, participants will be randomly assigned to either an intervention or a waitlist condition. The two primary outcomes for this study are change in dysfunctional/ineffective parenting practices and change in symptoms of depression, anxiety, and stress. Secondary outcomes are child behaviour problems, parenting experiences, parental self-efficacy, family relationships, and positive parental mental health. Demographic information, participant satisfaction with the intervention, and treatment fidelity data will also be collected. Data will be collected at pre-intervention, mid-intervention, post-intervention, and 3-month follow-up.&lt;/br&gt; &lt;br&gt;Discussion: The aim of this paper is to describe the study protocol of a randomised controlled trial evaluating the effects of a combined intervention of Triple P Discussion Groups and Stress Control in comparison to a waitlist condition. This study is important because it will provide evidence about the effects of this combined intervention for parents with 3?8?year old children. The results of the study could be used to inform policy about parenting support and support for parents with mental health problems. Trial registration ClinicalTrial.gov: NCT01777724, UTN: U1111-1137-1053.&lt;/br&gt

Steering effect on the shape of islands for homoepitaxial growth of Cu on Cu(100)

The steering effect on the growth of islands is investigated by combining molecular dynamics (MD) and kinetic Monte Carlo (KMC) simulations. Dynamics of depositing atoms and kinetics of atoms on a substrate are realized by MD and KMC, respectively. The reported experimental results on the asymmetric island growth [van Dijken {\it et al.}, Phys. Rev. Lett. {\bf 82}, 4038 (1999).] is well reproduced. A salient phenomenon, the reversal of the asymmetry, is found as the island size increases, and attributed to the asymmetric flux on the lower terrace of island.Comment: 5 figur

Using a simple expert system to assist a powered wheelchair user

A simple expert system is described that helps wheelchair users to drive their wheelchairs. The expert system takes data in from sensors and a joystick, identifies obstacles and then recommends a safe route. Wheelchair users were timed while driving around a variety of routes and using a joystick controlling their wheelchair via the simple expert system. Ultrasonic sensors are used to detect the obstacles. The simple expert system performed better than other recently published systems. In more difficult situations, wheelchair drivers did better when there was help from a sensor system. Wheelchair users completed routes with the sensors and expert system and results are compared with the same users driving without any assistance. The new systems show a significant improvement

Complete Characterization of Quantum-Optical Processes

The technologies of quantum information and quantum control are rapidly improving, but full exploitation of their capabilities requires complete characterization and assessment of processes that occur within quantum devices. We present a method for characterizing, with arbitrarily high accuracy, any quantum optical process. Our protocol recovers complete knowledge of the process by studying, via homodyne tomography, its effect on a set of coherent states, i.e. classical fields produced by common laser sources. We demonstrate the capability of our protocol by evaluating and experimentally verifying the effect of a test process on squeezed vacuum.Comment: 5 pages, 4 figure