A weekday intervention to reduce missed appointments

The burden of missed healthcare appointments is so great that even small reductions in Did Not Attend (DNA) rate can secure tangible benefits. Previous studies have identified demographic factors that predict DNA rate. However, it is not obvious that these insights can be used to improve attendance, as healthcare providers do not control patient demographics. One factor that providers do control is appointment scheduling. We previously reported that appointments at the beginning of the week are more likely to be missed than appointments at the end of the week. This observation suggests a simple intervention to reduce DNA rate: schedule appointments for later in the week. Using data from a UK mental health hospital, we compared attendance rates for 12-months before and 12-months after the intervention began (916 appointments in total). Overall DNA rate fell from 34.2% pre-intervention to 23.4% post-intervention [χ2 (1, N = 916) = 13.01, p < 0.001; Relative Risk Reduction, 31.6%]. This effect was carried mainly by female patients, for whom more appointments could be moved to later in the week. Our findings confirm that DNA rate can be significantly reduced by loading appointments onto high-attendance days

Umbrella systematic review finds limited evidence that school absence explains the association between chronic health conditions and lower academic attainment

INTRODUCTION: Absence from school is more frequent for children with chronic health conditions (CHCs) than their peers and may be one reason why average academic attainment scores are lower among children with CHCs. METHODS: We determined whether school absence explains the association between CHCs and academic attainment through a systematic review of systematic reviews of comparative studies involving children with or without CHCs and academic attainment. We extracted results from any studies that tested whether school absence mediated the association between CHCs and academic attainment. RESULTS: We identified 27 systematic reviews which included 441 unique studies of 7, 549, 267 children from 47 jurisdictions. Reviews either covered CHCs generally or were condition-specific (e.g., chronic pain, depression, or asthma). Whereas reviews found an association between a range of CHCs (CHCs generally, cystic fibrosis, hemophilia A, end-stage renal disease (pre-transplant), end-stage kidney disease (pre-transplant), spina bifida, congenital heart disease, orofacial clefts, mental disorders, depression, and chronic pain) and academic attainment, and though it was widely hypothesized that absence was a mediator in these associations, only 7 of 441 studies tested this, and all findings show no evidence of absence mediation. CONCLUSION: CHCs are associated with lower academic attainment, but we found limited evidence of whether school absence mediates this association. Policies that focus solely on reducing school absence, without adequate additional support, are unlikely to benefit children with CHCs. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=285031, identifier: CRD42021285031

Relativistic Modified Newtonian Dynamics from String Theory?

We argue that TeVeS-like vector fields appear naturally in certain string theory backgrounds involving D0-branes, as a result of the recoil velocity field, expressing the interaction of neutrino string matter with point-like branes. However, the similarity with TeVeS models is restricted only to the bi-metric properties of space time, namely the difference of the background metric from the one felt by (some) matter fields interacting, in a topologically non-trivial manner, with the D0-brane defects. In our approach, neutrinos appear as dark matter candidates that could be ``captured'' by the D0 branes, as a result of stringy properties, and thus couple with the recoil-vector fields. Moreover, we argue in support of a possibly preferential role of neutrinos in inducing novel non-perturbative contributions to ``vacuum'' (dark) energy, in addition to their ordinary dark matter contribution. In fact, the role of neutrinos as providing substantial contributions to dark matter and dark energy components of the Universe, suggested by our approach, appears also to be necessitated by the need to reproduce the peaks in the Cosmic Microwave Background radiation spectrum, as claimed recently in the literature. Thus, our framework may be viewed as providing a microscopic explanation of such phenomenological conclusions concerning TeVeS-like, Lorentz-violating models.Comment: 6 pages; slightly amended version to appear in Physics Letters

Lifelong links: embedding practice

This further work was designed to build on the previous evaluation by exploring how Lifelong Links is being implemented and embedded into practice. The evaluation extension also provided an opportunity to examine some child level outcomes over a longer time period in two of the local authorities

The Age Spread of Quiescent Galaxies with the NEWFIRM Medium-band Survey: Identification of the Oldest Galaxies out to z~2

With a complete, mass-selected sample of quiescent galaxies from the NEWFIRM Medium-Band Survey (NMBS), we study the stellar populations of the oldest and most massive galaxies (>10^11 Msun) to high redshift. The sample includes 570 quiescent galaxies selected based on their extinction-corrected U-V colors out to z=2.2, with accurate photometric redshifts, sigma_z/(1+z)~2%, and rest-frame colors, sigma_U-V~0.06 mag. We measure an increase in the intrinsic scatter of the rest-frame U-V colors of quiescent galaxies with redshift. This scatter in color arises from the spread in ages of the quiescent galaxies, where we see both relatively quiescent red, old galaxies and quiescent blue, younger galaxies towards higher redshift. The trends between color and age are consistent with the observed composite rest-frame spectral energy distributions (SEDs) of these galaxies. The composite SEDs of the reddest and bluest quiescent galaxies are fundamentally different, with remarkably well-defined 4000A- and Balmer-breaks, respectively. Some of the quiescent galaxies may be up to 4 times older than the average age- and up to the age of the universe, if the assumption of solar metallicity is correct. By matching the scatter predicted by models that include growth of the red sequence by the transformation of blue galaxies to the observed intrinsic scatter, the data indicate that most early-type galaxies formed their stars at high redshift with a burst of star formation prior to migrating to the red sequence. The observed U-V color evolution with redshift is weaker than passive evolution predicts; possible mechanisms to slow the color evolution include increasing amounts of dust in quiescent galaxies towards higher redshift, red mergers at z<1, and a frosting of relatively young stars from star formation at later times.Comment: 20 pages, 20 figures, accepted for publication in Ap

National Telemedicine Initiatives: Essential to Healthcare Reform

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78116/1/tmj.2009.9960.pd

PTF10iya: A short-lived, luminous flare from the nuclear region of a star-forming galaxy

We present the discovery and characterisation of PTF10iya, a short-lived (dt ~ 10 d, with an optical decay rate of ~ 0.3 mag per d), luminous (M_g ~ -21 mag) transient source found by the Palomar Transient Factory. The ultraviolet/optical spectral energy distribution is reasonably well fit by a blackbody with T ~ 1-2 x 10^4 K and peak bolometric luminosity L_BB ~ 1-5 x 10^44 erg per s (depending on the details of the extinction correction). A comparable amount of energy is radiated in the X-ray band that appears to result from a distinct physical process. The location of PTF10iya is consistent with the nucleus of a star-forming galaxy (z = 0.22405 +/- 0.00006) to within 350 mas (99.7 per cent confidence radius), or a projected distance of less than 1.2 kpc. At first glance, these properties appear reminiscent of the characteristic "big blue bump" seen in the near-ultraviolet spectra of many active galactic nuclei (AGNs). However, emission-line diagnostics of the host galaxy, along with a historical light curve extending back to 2007, show no evidence for AGN-like activity. We therefore consider whether the tidal disruption of a star by an otherwise quiescent supermassive black hole may account for our observations. Though with limited temporal information, PTF10iya appears broadly consistent with the predictions for the early "super-Eddington" phase of a solar-type star disrupted by a ~ 10^7 M_sun black hole. Regardless of the precise physical origin of the accreting material, the large luminosity and short duration suggest that otherwise quiescent galaxies can transition extremely rapidly to radiate near the Eddington limit; many such outbursts may have been missed by previous surveys lacking sufficient cadence.Comment: 18 pages, 8 figures; revised following referee's comment

AGN-stimulated cooling of hot gas in elliptical galaxies

We study the impact of relatively weak active galactic nucleus (AGN) feedback on the interstellar medium (ISM) of intermediate and massive elliptical galaxies. We find that the AGN activity, while globally heating the ISM, naturally stimulates some degree of hot gas cooling on scales of several kpc. This process generates the persistent presence of a cold ISM phase, with mass ranging between 104and 73 5 7 107M 99, where the latter value is appropriate for group centred, massive galaxies. Widespread cooling occurs where the ratio of cooling to free-fall time before the activation of the AGN feedback satisfies tcool/tff 72 70, that is we find a less restrictive threshold than commonly quoted in the literature. This process helps explaining the body of observations of cold gas (both ionized and neutral/molecular) in Ellipticals and, perhaps, the residual star formation detected in many early-type galaxies. The amount and distribution of the off-centre cold gas vary irregularly with time. The cold ISM velocity field is irregular, initially sharing the (outflowing) turbulent hot gas motion. Typical velocity dispersions of the cold gas lie in the range 100-200 km s-1. Freshly generated cold gas often forms a cold outflow and can appear kinematically misaligned with respect to the stars. We also follow the dust evolution in the hot and cold gas. We find that the internally generated cold ISM has a very low dust content, with representative values of the dust-to-gas ratio of 10-4-10-5. Therefore, this cold gas can escape detection in the traditional dust-absorption maps

Search for anomalous t t-bar production in the highly-boosted all-hadronic final state

A search is presented for a massive particle, generically referred to as a Z', decaying into a t t-bar pair. The search focuses on Z' resonances that are sufficiently massive to produce highly Lorentz-boosted top quarks, which yield collimated decay products that are partially or fully merged into single jets. The analysis uses new methods to analyze jet substructure, providing suppression of the non-top multijet backgrounds. The analysis is based on a data sample of proton-proton collisions at a center-of-mass energy of 7 TeV, corresponding to an integrated luminosity of 5 inverse femtobarns. Upper limits in the range of 1 pb are set on the product of the production cross section and branching fraction for a topcolor Z' modeled for several widths, as well as for a Randall--Sundrum Kaluza--Klein gluon. In addition, the results constrain any enhancement in t t-bar production beyond expectations of the standard model for t t-bar invariant masses larger than 1 TeV.Comment: Submitted to the Journal of High Energy Physics; this version includes a minor typo correction that will be submitted as an erratu