59,010 research outputs found
Their Voices: Adolescents in Morelos, Mexico Speak About a School Based HIV/AIDS Intervention
Modelling the impact of referral guideline changes for mild dyskaryosis on colposcopy services in England
Objectives: This model examines the effects of changing referral strategies within the established structure of NHS cervical screening driven colposcopy practice. It considers the effects of the new strategy on colposcopy workload, patient waiting times, and associated costs and health benefits.
Methods: By postal survey, the current operational strategies of colposcopy services were established by questionnaire with respect to referral practices and management protocols. After first-cut piloting, and utilising published and original research, a Markovian model was constructed, and the impact of the new strategy was determined on colposcopy workload and patient waiting times for three hypothetical clinic types. Expected costs and benefits of the new policy were assessed through the adaptation of a previous ScHARR cervical screening model.
Results: Clinic workload is expected to increase by between 21% and 35% within three years of the policy change, depending on clinic efficiency in other areas; the majority of this impact would be seen within the first year. It is predicted that particularly inefficient clinics would struggle to meet the existing waiting time requirements for women referred with low-grade disease, owing to the increased level of workload seen throughout the patient pathway as a result of the implementation of the new policy.
The impact of the new policy can, however, be mitigated through improving the efficiency of existing clinics, by altering policies relating to surveillance of low grade disease, post-treatment follow-up, treatment policy (whether or not treatment is performed at the initial colposcopy visit), and through adherence to national guidelines.
A cost-effectiveness analysis using the ScHARR liquid-based cytology model suggests that the policy change is likely to be have a cost per quality-adjusted lifeyear gained of between £1,400 and £5,500 per quality-adjusted life-year gained (excluding the costs of follow-up), which would be deemed acceptable to organisations such as the National Institute for Health and Clinical Excellence
A Completely Invariant SUSY Transform of Supersymmetric QED
We study the SUSY breaking of the covariant gauge-fixing term in SUSY QED and
observe that this corresponds to a breaking of the Lorentz gauge condition by
SUSY. Reasoning by analogy with SUSY's violation of the Wess-Zumino gauge, we
argue that the SUSY transformation, already modified to preserve Wess-Zumino
gauge, should be further modified by another gauge transformation which
restores the Lorentz gauge condition. We derive this modification and use the
resulting transformation to derive a Ward identitiy relating the photon and
photino propagators without using ghost fields. Our transformation also
fulfills the SUSY algebra, modulo terms that vanish in Lorentz gauge
A survey of unified constitutive theories
The state of the art of time temperature dependent elastic viscoplastic constitutive theories which are based on the unified approach werre assessed. This class of constitutive theories is characterized by the use of kinetic equations and internal variables with appropriate evolutionary equations for treating all aspects of inelastic deformation including plasticity, creep, and stress relaxation. More than 10 such unified theories which are shown to satisfy the uniqueness and stability criteria imposed by Drucker's postulate and Ponter's inequalities are identified. The theories are compared for the types of flow law, kinetic equation, evolutionary equation of the internal variables, and treatment of temperature dependence. The similarities and differences of these theories are outlined in terms of mathematical formulations and illustrated by comparisons of theoretical calculations with experimental results which include monotonic stress-strain curves, cyclic hysteresis loops, creep and stress relaxation rates, and thermomechanical loops. Numerical methods used for integrating these stiff time temperature dependent constitutive equations are reviewed
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