Herschel dust emission as a probe of starless cores mass: MCLD 123.5+24.9 of the Polaris Flare

We present newly processed archival Herschel images of molecular cloud MCLD 123.5+24.9 in the Polaris Flare. This cloud contains five starless cores. Using the spectral synthesis code Cloudy, we explore uncertainties in the derivation of column densities, hence, masses of molecular cores from Herschel data. We first consider several detailed grain models that predict far-IR grain opacities. Opacities predicted by the models differ by more than a factor of two, leading to uncertainties in derived column densities by the same factor. Then we consider uncertainties associated with the modified blackbody fitting process used by observers to estimate column densities. For high column density clouds (N(H) $\gg$ 10$^{22}$ cm$^{-2}$), this fitting technique can underestimate column densities by about a factor of three. Finally, we consider the virial stability of the five starless cores in MCLD 123.5+24.9. All of these cores appear to have strongly sub-virial masses, assuming, as we argue, that $^{13}$CO line data provide reliable estimates of velocity dispersions. Evidently, they are not self-gravitating, so it is no surprise that they are starless.Comment: ApJ, Accepted. Minor typographical errors corrected and figures 6 & 7 updated in v

Estimating the location of the open-closed magnetic field line boundary from auroral images

The open-closed magnetic field line boundary (OCB) delimits the region of open magnetic flux forming the polar cap in the Earth’s ionosphere. We present a reliable, automated method for determining the location of the poleward auroral luminosity boundary (PALB) from far ultraviolet (FUV) images of the aurora, which we use as a proxy for the OCB. This technique models latitudinal profiles of auroral luminosity as both a single and double Gaussian function with a quadratic background to produce estimates of the PALB without prior knowledge of the level of auroral activity or of the presence of bifurcation in the auroral oval. We have applied this technique to FUV images recorded by the IMAGE satellite from May 2000 until August 2002 to produce a database of over a million PALB location estimates, which is freely available to download. From this database, we assess and illustrate the accuracy and reliability of this technique during varying geomagnetic conditions. We find that up to 35% of our PALB estimates are made from double Gaussian fits to latitudinal intensity profiles, in preference to single Gaussian fits, in nightside magnetic local time (MLT) sectors. The accuracy of our PALBs as a proxy for the location of the OCB is evaluated by comparison with particle precipitation boundary (PPB) proxies from the DMSP satellites. We demonstrate the value of this technique in estimating the total rate of magnetic reconnection from the time variation of the polar cap area calculated from our OCB estimates

Language spoken at home and the association between ethnicity and doctor-patient communication in primary care: analysis of survey data for South Asian and White British patients.

OBJECTIVES: To investigate if language spoken at home mediates the relationship between ethnicity and doctor-patient communication for South Asian and White British patients. METHODS: We conducted secondary analysis of patient experience survey data collected from 5870 patients across 25 English general practices. Mixed effect linear regression estimated the difference in composite general practitioner-patient communication scores between White British and South Asian patients, controlling for practice, patient demographics and patient language. RESULTS: There was strong evidence of an association between doctor-patient communication scores and ethnicity. South Asian patients reported scores averaging 3.0 percentage points lower (scale of 0-100) than White British patients (95% CI -4.9 to -1.1, p=0.002). This difference reduced to 1.4 points (95% CI -3.1 to 0.4) after accounting for speaking a non-English language at home; respondents who spoke a non-English language at home reported lower scores than English-speakers (adjusted difference 3.3 points, 95% CI -6.4 to -0.2). CONCLUSIONS: South Asian patients rate communication lower than White British patients within the same practices and with similar demographics. Our analysis further shows that this disparity is largely mediated by language.The work was conducted as part of an MPhil course, and involved secondary analysis of survey data designed and collected by a collaboration between the Cambridge Centre for Health Services Research at the University of Cambridge and the University of Exeter Medical School. KB was not employed by the University of Cambridge, nor did she receive any funding at any time during the project. GA and JB were funded for the original NIHR grant which funded the original survey but received no funding for this specific work. All authors read and approved the final manuscript. This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. The survey on which this secondary analysis was based was funded by a National Institute for Health Research Programme Grant for Applied Research (NIHR PGfAR) programme (RP-PG-0608-10050). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health.This is the final version of the article. It first appeared from BMJ Group via http://dx.doi.org/10.1136/bmjopen-2015-01004

Determining the H\u3csup\u3e+\u3c/sup\u3e Region / PDR Equation of State in Star-forming Regions

The emission-line regions of starburst galaxies and active nuclei reveal a wealth of spectroscopic information. A unified picture of the relationship among ionized, atomic, and molecular gas makes it possible to better understand these observations. We performed a series of calculations designed to determine the equation of state-the relationship among density, temperature, and pressure-through emission-line diagnostic ratios that form in the H+ region and the photodissociation region (PDR). We consider a wide range of physical conditions in the H+ region. We connect the H+ region to the PDR by considering two constant pressure cases: one with no magnetic field and one in which the magnetic field overwhelms the thermal pressure. We show that diagnostic ratios can yield the equation of state for single H+ regions adjacent to single PDRs, with the results being more ambiguous when considering observations of entire galaxies. As a test, we apply our calculations to the Orion H+/PDR region behind the Trapezium. We find the ratio of thermal to magnetic pressure in the PDR to be ~1.2. If magnetic and turbulent energy are in equipartition, our results mean that the magnetic field is not the cause of the unexplained broadening in M42, but may significantly affect line broadening in the PDR. Since Orion is often used to understand physical processes in extragalactic environments, our calculations suggest that magnetic pressure should be considered in modeling such regions

Can Patient Reported Outcomes (PROs) from Population Surveys Provide Accurate Estimates of Pre-Admission Health Status of Emergency Hospital Admissions?

INTRODUCTION: The use of PROs for assessing the outcomes of emergency hospital admissions requires a means of estimating patients' pre-admission health status. A possible alternative to asking patients to recall how their health was before the incident causing admission is to use estimates derived from matched samples from population surveys. Our aims were to explore the impact of different methods of matching and to compare the results with estimates based on retrospective reporting. METHODS: First, elective hip arthroplasty patients were matched to respondents to the General Practice Patient Survey using age, sex, socio-economic status and number of comorbidities. The impact of restricting matching for locality and specific co-morbidities was explored. Second, the best matching method was applied to emergency admissions for laparotomy and for percutaneous coronary intervention (PCI) after acute myocardial infarction. Data were stratified by patient characteristics. Differences in mean EQ-5D scores between the patients and matched population respondents were tested using t tests. RESULTS: Modifying the most basic form of matching by also taking locality and the specific comorbid conditions into account made no significant difference to the mean EQ-5D score for hip arthroplasty patients. Even using the most detailed matching possible, patients' mean EQ-5D score was significantly different to that of the general population for all three cohorts. The difference was greatest for elective hip arthroplasty (0.22 v 0.64), less so for emergency laparotomy (0.56 v 0.72) and least for PCI (0.79 v 0.71). This reflects hip arthroplasty patients having a long-standing condition characterised by pain and limited mobility, whereas the other two cohorts may have enjoyed reasonable health until an unexpected acute episode led to their emergency admission. CONCLUSION: Routine PRO data acquired from population surveys cannot be used as an accurate alternative to retrospectively reported PROMs by patients during their emergency admission episode

Truancy and teenage pregnancy in English adolescent girls: can we identify those at risk?

BACKGROUND: Truancy has been linked to risky sexual behaviours in teenagers. However, no studies in England have examined the association between truancy and teenage pregnancy, and the use of truancy as a marker of teenagers at risk of pregnancy. METHODS: Using logistic regression, we investigated the association between truancy at age 15 and the likelihood of teenage pregnancy by age 19 among 3837 female teenagers who participated in the Longitudinal Study of Young People of England. We calculated the areas under the ROC curves of four models to determine how useful truancy would be as a marker of future teenage pregnancy. RESULTS: Truancy showed a dose-response association with teenage pregnancy after adjusting for ethnicity, educational intentions at age 16, parental socioeconomic status and family composition ('several days at a time' versus 'none', odds ratio 3.48 95% confidence interval 1.90-6.36, P < 0.001). Inclusion of risk behaviours improved the accuracy of predictive models only marginally (area under the ROC curve 0.76 full model versus 0.71 sociodemographic characteristics only). CONCLUSIONS: Truancy is independently associated with teenage pregnancy among English adolescent girls. However, the discriminatory powers of models were low, suggesting that interventions addressing the whole population, rather than targeting high-risk individuals, might be more effective in reducing teenage pregnancy rates.The work by Y.Z. is supported by an Academic Clinical Fellowship awarded by Health Education East of England (HEEoE). The work by D.I.P. is supported by the Economic and Social Science Research Council (ESRC) Grant ES.J004898.1.This is the final published version. It first appeared at http://dx.doi.org/10.1093/pubmed/fdv02

A study guide to aid students preparing for the general and ocular pharmacology areas of the basic sciences test administered by the National Board of Examiners in optometry

For many optometry students across the nation, much systemic and ocular pharmacology is not presented in their school\u27s curriculum until after they have taken the Basic Sciences Test of the National Board Exam. The Pharmacology sections of the popular study guides in use today have been described by most students as overwhelming and confusing. This guide follows the outline of the Candidate Guide to provide a clear, concise study aid of drug groupings, drug uses, mechanisms of action, possible adverse reactions, contraindications and precautions, and the primary drug of treatment for specific conditions and alternate drugs for use when the primary drug is contraindicated

Post-sampling mortality and non-response patterns in the English Cancer Patient Experience Survey: Implications for epidemiological studies based on surveys of cancer patients.

BACKGROUND: Surveys of the experience of cancer patients are increasingly being introduced in different countries and used in cancer epidemiology research. Sampling processes, post-sampling mortality and survey non-response can influence the representativeness of cancer patient surveys. METHODS: We examined predictors of post-sampling mortality and non-response among patients initially included in the sampling frame of the English Cancer Patient Experience Survey. We also compared the respondents' diagnostic case-mix to other relevant populations of cancer patients, including incident and prevalent cases. RESULTS: Of 109,477 initially sampled cancer patients, 6273 (5.7%) died between sampling and survey mail-out. Older age and diagnosis of brain, lung and pancreatic cancer were associated with higher risk of post-sampling mortality. The overall response rate was 67% (67,713 respondents), being >70% for the most affluent patients and those diagnosed with colon or breast cancer and <50% for Asian or Black patients, those under 35 and those diagnosed with brain cancer. The diagnostic case-mix of respondents varied substantially from incident or prevalent cancer cases. CONCLUSIONS: Respondents to the English Cancer Patient Experience Survey represent a population of recently treated cancer survivors. Although patient survey data can provide unique insights for improving cancer care quality, features of survey populations need to be acknowledged when analysing and interpreting findings from studies using such data.The authors wish to thank the Department of Health as the principal investigator of the 2010 Cancer Patient Experience Survey, Quality Health as the data collector and for making available the anonymous sampling frame, and all the National Health Service Acute Trusts in England who supported the survey. GL is supported by a Cancer Research UK Clinician Scientist Fellowship (A18180). The views expressed in this publication are those of the authors and not necessarily those of any funder or any other organisation or institution.This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.canep.2015.12.01

What explains worse patient experience in London? Evidence from secondary analysis of the Cancer Patient Experience Survey.

OBJECTIVE: To explore why patients with cancer treated by London hospitals report worse experiences of care compared with those treated in other English regions. DESIGN: Secondary analysis of the 2011/2012 National Cancer Patient Experience Survey (n=69 086). SETTING AND PARTICIPANTS: Patients with cancer treated by the English National Health Service (NHS) hospitals. MAIN OUTCOME MEASURES: 64 patient experience measures covering all aspects of cancer care (pre-diagnosis to discharge). METHODS: Using mixed effects logistic regression, we explored whether poorer scores in London hospitals could be explained by patient case-mix (age, gender, ethnicity and cancer type). Because patients referred to tertiary centres and/or with complex medical problems may report more critical experiences, we also explored whether the experiences reported in London may reflect higher concentration of teaching hospitals in the capital. Finally, using the data from the (general) Adult Inpatients Survey, we explored whether the extent of poorer experience reported by London patients was similar for respondents to either survey. RESULTS: For 52/64 questions, there was evidence of poorer experience in London, with the percentage of patients reporting a positive experience being lower compared with the rest of England by a median of 3.7% (IQR 2.5-5.4%). After case-mix adjustment there was still evidence for worse experience in London for 45/64 question [corrected]. In addition, adjusting for teaching hospital status made trivial difference to the case-mix-adjusted findings. There was evidence that London versus rest-of-England differences were greater for patients with cancer compared with (general) hospital inpatients for 10 of 16 questions in both the Cancer Patient Experience and the Adult Inpatients Surveys. CONCLUSIONS: Patients with cancer treated by London hospitals report worse care experiences and by and large these differences are not explained by patient case-mix or teaching hospital status. Efforts to improve care in London should aim to meet patient expectations and improve care quality.This work was supported by funding from the European Community Seventh Framework Programme under grant agreement 223175 (HEALTH-F2_2009-223175). The funding source had no role in the writing of this report or the decision to submit the paper for publication for which all authors had responsibility. All authors except PP and NP are employed by the PHG Foundation, which is the working name of the Foundation for Genomics and Population Health, a charitable company registered in England and Wales, charity No. 1118664 company No. 5823194