1,758 research outputs found
Are violent events responsible of a Galaxy Morphological loop?
We use cosmological SPH simulations to investigate the effects of mergers and
interactions on the formation of the bulge and disc components of galactic
systems. We find that secular evolution during mergers seems to be a key
process in the formation of stable disc-bulge systems with observational
counterparts and contributes to establish the fundamental relations observed in
galaxies. Our findings suggest that the secular evolution phase couples the
formation mechanisms of the bulge and disc components. According to our
results, depending on the particular stability properties and merger
parameters, violents events could drive a morphological loop in which the
outcome could be a disc or a spheroid.Comment: 2 pages. To appear in the proceedings of the IAUC198 "Near-Field
Cosmology with Dwarf Elliptical Galaxies", 14 - 18 March 2005, Les
Diablerets, Switzerlan
Circulatory disease in the NHS: measuring trends in hospital costs and output
EXECUTIVE SUMMARY
1. Following the publication of the Atkinson Review of the measurement of government outputs in
the National Accounts, there has been great interest in measuring the productivity growth of the
National Health Service. Such macro measures of productivity are important when deciding how
much public money to devote to the NHS, and in holding the NHS to account. However, it is also
important to gain an understanding of the productivity of individual programmes of care, so as to
ensure that resources are allocated efficiently within the NHS. Hitherto, such information has not
been available. This report is an exploratory study of the feasibility and usefulness of developing
measures of growth in outputs, costs and productivity of a single programme of care within the
NHS: hospital treatment of circulatory diseases.
2. In this context, productivity is defined as the ratio of an aggregate measure of outputs to an
aggregate measure of inputs for the chosen programme of care. The key methodological
challenges are (i) choosing the appropriate measures of NHS activities, (ii) adjusting those
measures for the âqualityâ of care, (iii) aggregating the measures into a single measure of output,
(iv) identifying the associated inputs, in the form of a single measure of costs, (v) tracking these
measures consistently over time.
3. The building blocks of the study are the measures of hospital âcontinuous inpatient spellsâ (CIPs)
of hospital treatment, which include emergency, elective and day case treatment. These capture
trends in the volume of activity of the NHS over a six year period, 1998/99 to 2003/04. The type of
spell is indicated by diagnosis, as indicated by the Hospital Resource Group (HRG) for the spell.
The analysis embraces all HRGs relevant to circulatory disease, including cerebrovascular
disease, coronary heart disease, and associated investigations.
4. The value to the patient of these activities is crucially dependent on the quality of the outcome
achieved. The only consistent, universal and reliable measures of outcome currently available in
the NHS relate to mortality, either within the hospital spell, or within 30 days of admission. Where
appropriate, we therefore use these outcome measures to adjust the crude measures of activity
for the quality of outcome achieved.
5. Ideally, we should also like to incorporate other measures of health outcome into the analysis,
such as gains in the quality of life following treatment. Unfortunately, the NHS does not routinely
collect health outcome data. However, using a small sample of outcome data for two procedures
collected by BUPA, we demonstrate how health outcome data could be used to augment
measures of NHS output, and argue that the NHS should move rapidly towards routine collection
of such data.
6. The diverse activities (CIPs) that make up this programme of care do not confer equal patient
benefits. They must therefore be aggregated using some system of weights that reflects their
relative contribution to aggregate NHS output. In principle, these weights should reflect the
average âhealth gainâ of the treatment. In practice, this is rarely available. We therefore follow
conventional practice in aggregating treatments according to their estimated costs,acknowledging that this is far from ideal.
7. It is relatively straightforward to identify the total physical inputs consumed by the NHS as a whole,
for example in the form of capital, labour and drugs. However, identifying the part of these inputs
that is attributable to an individual programme of care is a major challenge. In particular, specific
measures of the physical inputs used by the circulatory disease hospital programme are not
available. Instead, as an indicator of inputs consumed, we had to use the measures of reference
costs developed by the NHS for the HRGs under consideration. These offer some insights into
trends in the volume of physical resources consumed, but may suffer from arbitrary accounting
choices and variations in methodology over time.
8. Chapter 5 of the report presents a large amount of material from the datasets used in this study,
in particular trends in the volume of activity, costs and survival rates for selected high-volume
HRGs. The general pattern is for activity to remain static or decline in the early years of the study,
but to recover by the end of the six year period. Trends in costs are more difficult to describe, as
much depends on how account is taken of price inflation over the period. For those treatments
with significant mortality rates, there is generally an improvement in outcome over the study
period.
9. Chapter 6 presents estimates of aggregate measures of outputs and inputs for the programme of
care. Over the study period, activity alone (as measured by the cost-weighted activity index) has
increased by 3.90% per annum. Adjusting this for the improvement in 30 day mortality rates
increases the annual growth to 4.48%, reflecting the major improvement in outcomes over the
study period. The experimental use of BUPA health outcome measures for coronary artery
bypass surgery (CABG) and percutaneous transluminal coronary angioplasty (PTCA) suggests a
further improvement of about 0.2% per annum, but we emphasize that these are highly
speculative and partial estimates.
10. Although we are unable to develop measures of physical input growth, we have calculated total
reference costs for the programme over the study period. These increased from ÂŁ1.381 billion to
ÂŁ1.960 billion. Using the GDP index of price change, this implies real growth in expenditure of
5.3% per annum, whilst use of a specific NHS index of price change suggests more modest
growth of 2.5% per annum.
11. Measures of productivity change in the hospital treatment of circulatory disease are therefore
highly dependent on the measure of input growth used. A very tentative conclusion is that the
NHS has used its physical resources more efficiently (to secure annual improvements in physical
productivity of up to 2% per annum). However, because of the increased prices it has paid for its
inputs, the cost-effectiveness of this programme has declined by anything up to 0.8% over the
study period.
12. This study has demonstrated that it is feasible to develop models of productivity growth for a
programme of NHS care. This is an important undertaking for informing resource allocation and
purchasing decisions in the NHS. Our tentative conclusion is that, whilst there will always be
uncertainty in the estimates derived, this represents an important extension of the work in
progress at the Office for National Statistics in measuring whole system productivity change, and
we advocate further investigation of other programmes of care, in particular those embracing
significant community and prescribing activities
Development of the Red Sequence in Galaxy Clusters
We investigate the origin of the color-magnitude relation (CMR) observed in
cluster galaxies by using a combination of a cosmological N-body simulation of
a cluster of galaxies and a semi-analytic model of galaxy formation. The
departure of galaxies in the bright end of the CMR with respect to the trend
defined by less luminous galaxies could be explained by the influence of minor
mergers.Comment: Proceedings IAU Symposium No. 267, 2009. Co-Evolution of Central
Black Holes and Galaxie
On the properties of the interstellar medium in extremely metal-poor blue compact dwarf galaxies: GMOS-IFU spectroscopy and SDSS photometry of the double-knot galaxy HS 2236+1344
The main goal of this study is to carry out a spatially resolved
investigation of the warm interstellar medium (ISM) in the extremely metal-poor
Blue Compact Dwarf (BCD) galaxy HS 2236+1344. Special emphasis is laid on the
analysis of the spatial distribution of chemical abundances, emission-line
ratios and kinematics of the ISM, and to the recent star-forming activity in
this galaxy. This study is based on optical integral field unit spectroscopy
data from Gemini Multi-Object Spectrograph at the Gemini North telescope and
archival Sloan Digital Sky Survey images. The data were obtained in two
different positions across the galaxy, obtaining a total 4 arcsec X 8 arcsec
field which encompasses most of its ISM. Emission-line maps and broad-band
images obtained in this study indicate that HS 2236+1344 hosts three Giant HII
regions. Our data also reveal some faint curved features in the BCD periphery
that might be due to tidal perturbations or expanding ionized-gas shells. The
ISM velocity field shows systematic gradients along the major axis of the BCD,
with its south-eastern and north-western half differing by ~80 km/s in their
recessional velocity. The Ha and Hb equivalent width distribution in the
central part of HS 2236+1344 is consistent with a very young (~3 Myr) burst.
Our surface photometry analysis indicates that the ongoing starburst provides
~50% of the total optical emission, similar to other BCDs. It also reveals an
underlying lower-surface brightness component with moderately red colors, which
suggest that the galaxy has undergone previous star formation. We derive an
integrated oxygen abundance of 12+log(O/H)=7.53\pm0.06 and a nitrogen-to-oxygen
ratio of log(N/O)=-1.57\pm0.19. Our results are consistent, within the
uncertainties, with a homogeneous distribution of oxygen and nitrogen within
the ISM of the galaxy. (abridged)Comment: 15 pages, 16 figures, accepted for publication in A&
Searching for star-forming dwarf galaxies in the Antlia cluster
The formation and evolution of dwarf galaxies in clusters need to be
understood, and this requires large aperture telescopes. In this sense, we
selected the Antlia cluster to continue our previous work in the Virgo, Fornax,
and Hydra clusters and in the Local Volume (LV). Because of the scarce
available literature data, we selected a small sample of five blue compact
dwarf (BCD) candidates in Antlia for observation. Using the Gemini South and
GMOS camera, we acquired the Halpha imaging needed to detect star-forming
regions in this sample. With the long-slit spectroscopic data of the brightest
seven knots detected in three BCD candidates, we derived their basic chemical
properties. Using archival VISTA VHS survey images, we derived K_S magnitudes
and surface brightness profile fits for the whole sample to assess basic
physical properties. FS90-98, FS90-106, and FS90-147 are confirmed as BCDs and
cluster members, based on their morphology, K_S surface photometry, oxygen
abundance, and velocity redshift. FS90-155 and FS90-319 did not show any
H{\alpha} emission, and they could not be confirmed as dwarf cluster
star-forming galaxies. Based on our data, we studied some fundamental relations
to compare star forming dwarfs (BCDs and dIs) in the LV and in the Virgo,
Fornax, Hydra, and Antlia clusters. Star-forming dwarfs in nearby clusters
appear to follow same fundamental relations in the near infrared with similar
objects in the LV, specifically the size-luminosity and the
metallicity-luminosity, while other more fundamental relations could not be
checked in Antlia due to lack of data.Comment: Accepted for publication in A&A (early 2014
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