On the Structural Differences between Disk and Dwarf Galaxies

Gas-rich dwarf and disk galaxies overlap in numerous physical quantities that make their classification subjective. We report the discovery of a separation between dwarfs and disks into two unique sequences in the mass (luminosity) versus scale length plane. This provides an objective classification scheme for late-type galaxies that only requires optical or near-IR surface photometry of a galaxy. Since the baryonic Tully-Fisher relation for these samples produces a continuous relation between baryonic mass and rotational velocity, we conclude that the difference between dwarfs and disks must be because of their distribution of stellar light such that dwarfs are more diffuse than disk galaxies. This structural separation may be due to a primordial difference between low and high mass galaxies or produced by hierarchical mergers where disks are built up from dwarfs. Structural differences between dwarf and disk galaxies may also be driven by the underlying kinematics where the strong rotation in disks produces an axial symmetric object that undergoes highly efficient star formation in contrast to the lower rotation, more disordered motion of dwarfs that produces a diffuse, triaxial object with a history of inefficient star formation.Comment: 16 pages, 2 figures, AJ in press, AASTeX5.

Medication Errors in Adolescents Using Asthma Controller Medications

The purpose of this study was to describe the number and types of errors that adolescents and caregivers report making when using asthma controller medications. A total of 319 adolescents ages 11 to 17 with persistent asthma and their caregivers participated in this cross-sectional study. Adolescent and caregiver reports of asthma medication use were compared to the prescribed directions in the medical record. An error was defined as discrepancies between reported use and the prescribed directions. About 38% of adolescents reported 1 error in using asthma controller medications, 16% reported 2 errors, and 5% reported 3 or more errors. About 42% of caregivers reported 1 error in adolescents using asthma controller medications, 14% reported 2 errors, while 6% reported 3 or more errors. The type of error most frequently reported by both was not taking the medication at all. Providers should ask open-ended questions of adolescents with asthma during visits so they can detect and educate families on how to overcome errors in taking controller medication use

Galactic Spiral Shocks with Thermal Instability

Using one-dimensional hydrodynamic simulations including interstellar heating, cooling, and thermal conduction, we investigate nonlinear evolution of gas flow across galactic spiral arms. We model the gas as a non-self-gravitating, unmagnetized fluid, and follow its interaction with a stellar spiral potential in a local frame comoving with the stellar pattern. Initially uniform gas rapidly separates into warm and cold phases as a result of thermal instability (TI), and also forms a quasi-steady shock that prompts phase transitions. After saturation, the flow follows a recurring cycle: warm and cold phases in the interarm region are shocked and immediately cool to become a denser cold medium in the arm; post-shock expansion reduces the mean density to the unstable regime in the transition zone and TI subsequently mediates evolution back into warm and cold interarm phases. For our standard model with n_0 = 2 cm^-3, the gas resides in the dense arm, thermally-unstable transition zone, and interarm region for 14%, 22%, 64% of the arm-to-arm crossing time. These regions occupy 1%, 16%, and 83% of the arm-to-arm distance, respectively. Gas at intermediate temperatures represents ~25-30% of the total mass, similar to the fractions estimated from HI observations. Despite transient features and multiphase structure, the time-averaged shock profiles can be matched to that of a diffusive isothermal medium with temperature 1,000 K and "particle" mean free path of l_0 = 100 pc. Finally, we quantify numerical conductivity associated with translational motion of phase-separated gas on the grid, and show that convergence of numerical results requires the numerical conductivity to be comparable to or smaller than the physical conductivity. (Abridged)Comment: 41 pages, 13 figures, 1 table. Accepted for publication in Astrophysical Journal. PDF version with higher resolution figures is available at http://astro.snu.ac.kr/~kimcg/AST/GSS_TI.pd

Development of a new diabetes medication self-efficacy scale and its association with both reported problems in using diabetes medications and self-reported adherence

Background: Although there are several different general diabetes self-efficacy scales, there is a need to develop a self-efficacy scale that providers can use to assess patient’s self-efficacy regarding medication use. The purpose of this study was to: 1) develop a new diabetes medication self-efficacy scale and 2) examine how diabetes medication self-efficacy is associated with patient-reported problems in using diabetes medications and self-reported adherence. Patients and methods: Adult English-speaking patients with type 2 diabetes were recruited from a family medicine clinic and a pharmacy in Eastern North Carolina, USA. The patients were eligible if they reported being nonadherent to their diabetes medicines on a visual analog scale. Multivariable regression was used to examine the relationship between self-efficacy and the number of reported diabetes medication problems and adherence. Results: The diabetes medication self-efficacy scale had strong reliability (Cronbach’s alpha =0.86). Among a sample (N=51) of mostly African-American female patients, diabetes medication problems were common (6.1±3.1) and a greater number of diabetes medications were associated with lower medication adherence (odds ratio: 0.35; 95% confidence interval: 0.13, 0.89). Higher medication self-efficacy was significantly related to medication adherence (odds ratio: 1.17; 95% confidence interval: 1.05, 1.30) and inversely related to the number of self-reported medication problems (β=-0.13; P=0.006). Conclusion: Higher diabetes medication self-efficacy was associated with fewer patient- reported medication problems and better medication adherence. Assessing medication-specific self-efficacy may help to identify medication-related problems that providers can help the patients address, potentially improving adherence and patient outcomes. Keywords: diabetes, adherence, self-efficacy, literac

Star Formation from Galaxies to Globules

The empirical laws of star formation suggest that galactic-scale gravity is involved, but they do not identify the actual triggering mechanisms for clusters in the final stages. Many other triggering processes satisfy the empirical laws too, including turbulence compression and expanding shell collapse. The self-similar nature of the gas and associated young stars suggests that turbulence is more directly involved, but the small scale morphology of gas around most embedded clusters does not look like a random turbulent flow. Most clusters look triggered by other nearby stars. Such a prominent local influence makes it difficult to understand the universality of the Kennicutt and Schmidt laws on galactic scales. A unified view of multi-scale star formation avoids most of these problems. Ambient self-gravity produces spiral arms and drives much of the turbulence that leads to self-similar structures, while localized energy input from existing clusters and field supernovae triggers new clusters in pre-existing clouds. The hierarchical structure in the gas made by turbulence ensures that the triggering time scales with size, giving the Schmidt law over a wide range of scales and the size-duration correlation for young star fields. The efficiency of star formation is determined by the fraction of the gas above a critical density of around 10^5 m(H2)/cc. Star formation is saturated to its largest possible value given the fractal nature of the interstellar medium.Comment: accepted for ApJ, 42 pages, Dannie Heineman prize lecture, January 200

Treatment Use and Costs among Privately-Insured Youth with Bipolar Diagnoses

Recent evidence suggests that children are increasingly diagnosed with bipolar disorder, yet no studies have quantified treatment costs for pediatric patients. The objectives are to identify one-year health services utilization and treatment costs among youth with new bipolar diagnoses

Observations of velocities, sand concentrations, and fluxes under velocity-asymmetric oscillatory flows

Peer reviewedPublisher PD