Impact of high-cost drugs for individual patient use

To document and describe the individual patient use (IPU) scheme at St Vincent's Hospital, Sydney in terms of submissions and approvals and assess the financial impact of the scheme on the hospital drug expenditure. Method: All submissions for IPU approvals received between January 1997 and December 2001 were reviewed. Submissions were collected on a calendar year basis. Data collection and analysis included identification of approved medication and indication, off- label or approved indication, prescriber, ward, outcome of therapy, person deciding the approval, approval date duration and expiry, amount of medication dispensed and the cost of therapy. The annual cost and proportion of overall drug expenditure for each approval was calculated. Results: The number of approvals had a trend to increase each year. 67.1% of the IPU approvals were for off-label indications. Requested feedback on clinical outcomes was provided only in 18% of cases. The drug acquisition cost of the IPU scheme more than doubled in the period between 1999 and 2001. Similarly the proportion of the drug expenditure on IPU drugs increased significantly (p<0.001) from 1.6% in 1999 to 3.6% in 2001. Conclusion: The results indicated that the number of approvals and submissions for IPU had a tendency to increase. The financial impact of the IPU scheme increased over the years reviewed

Design and characterisation of titanium nitride sub-arrays of kinetic inductance detectors for passive terahertz imaging

We report on the investigation of titanium nitride (TiN) thin films deposited via atomic layer deposition (ALD) for microwave kinetic inductance detectors (MKID). Using our in-house ALD process, we have grown a sequence of TiN thin films (thickness 15, 30, 60 nm). The films have been characterised in terms of superconducting transition temperature Tc , sheet resistance Rs and microstructure. We have fabricated test resonator structures and characterised them at a temperature of 300 mK. At 350 GHz, we report an optical noise equivalent power NEPopt≈2.3×10−15 W/√Hz , which is promising for passive terahertz imaging applications

Valley to valley: the biological connection between prehispanic residents of Cochabamba, Bolivia, and Azapa, Chile

One of the most interesting problems facing the interpretation of south central Andean prehistory is to de- cipher the genetic relationships among ancient groups that inhabited this region. This study evaluates the biological relationships between the ancient inhabitants of the coast and interior valleys of the Azapa region in northern Chile and the Cochabamba valleys of Bolivia, with reference to highland Tiwanaku groups. Craniometric data (N = 299) were statistically evaluated to compute group means using Mahalanobis (D2) values. Results demonstrate that there is a notable difference between coastal and interior valley populations of the Azapa region; whereas a close biological association exists between groups from the Cochabamba valleys and the interior Azapa valleys, especially for those associated with the Formative and Tiwanaku Periods.Fil: Varela, Hector H.. Universidad Nacional de Rio Cuarto. Facultad de Cs.exactas Fisicoquimicas y Naturales. Departamento de Cs.naturales; Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina;Fil: Cocilovo, Jose Alberto. Universidad Nacional de Rio Cuarto. Facultad de Cs.exactas Fisicoquimicas y Naturales. Departamento de Cs.naturales; Argentina;Fil: O'brien, Tyler G.. University Of Iowa; Estados Unidos de América

A point mass in an isotropic universe: III. The region R≤2mR\leq 2m

McVittie's solution of Einstein's field equations, representing a point mass embedded into an isotropic universe, possesses a scalar curvature singularity at proper radius $R=2m$. The singularity is space-like and precedes, in the expanding case, all other events in the space-time. It is shown here that this singularity is gravitationally weak, and the possible structure of the region $R\leq 2m$ is investigated. A characterization of this solution which does not involve asymptotics is given.Comment: Revtex, 11pp. To appear in Class.Quant.Grav. Paper II appeared as Class. Quant. Grav. 16 (1999) 122

Sexual dimorphism in prehispanic populations of the Cochabamba Valleys, Bolivia

The expression of sexual dimorphism may vary across time and space, as well as within and between populations depending on genetic and environmental factors that influence growth and development. The objective of the present work is to contribute to the knowledge of factors that determine the physical characteristics of ancient human groups in the eastern valleys of Cochabamba?a key region for cultural development, inter-regional interaction with northern Chile and northwest Argentina, and their noticeable role in the settlement of the south central Andean region. This paper analyzes the differences between males and females crania representing ancient human groups that inhabited the eastern valleys of Cochabamba, Bolivia. Thirty-one craniometric variables are analyzed from a sample of 234 individuals. Differences are evaluated using univariate analysis by ANOVA and multivariate discriminant analysis. The results indicate the existence of higher mean values in males compared to females in most cranial measurements (mean difference 5.3%). The discriminant analysis also reveals a significant morphological difference exists between sexes. Furthermore, by means of the discriminant function, the reclassification of correct sex was 99% of cases. This information indicates that members of this population could live in optimal conditions, with adequate resources to ensure growth and development and normal expression of the phenotype of each sex.Fil: Cocilovo, Jose Alberto. Universidad Nacional de Rio Cuarto. Facultad de Cs.exactas Fisicoquimicas y Naturales. Departamento de Cs.naturales;Fil: Fuchs, Maria Laura. Universidad Nacional de Rio Cuarto. Facultad de Cs.exactas Fisicoquimicas y Naturales. Departamento de Cs.naturales;Fil: O' Brien, T. G.. University of Northern Iowa; Estados Unidos de América;Fil: Varela, Hector Hugo. Universidad Nacional de Rio Cuarto. Facultad de Cs.exactas Fisicoquimicas y Naturales. Departamento de Cs.naturales

Non-radial null geodesics in spherical dust collapse

The issue of the local visibility of the shell-focussing singularity in marginally bound spherical dust collapse is considered from the point of view of the existence of future-directed null geodesics with angular momentum which emanate from the singularity. The initial data (i.e. the initial density profile) at the onset of collapse is taken to be of class $C^3$. Simple necessary and sufficient conditions for the existence of a naked singularity are derived in terms of the data. It is shown that there exist future-directed non-radial null geodesics emanating from the singularity if and only if there exist future-directed radial null geodesics emanating from the singularity. This result can be interpreted as indicating the robustness of previous results on radial geodesics, with respect to the presence of angular momentum.Comment: 26 pages, 1 figur

The Central Singularity in Spherical Collapse

The gravitational strength of the central singularity in spherically symmetric space-times is investigated. Necessary conditions for the singularity to be gravitationally weak are derived and it is shown that these are violated in a wide variety of circumstances. These conditions allow conclusions to be drawn about the nature of the singularity without having to integrate the geodesic equations. In particular, any geodesic with a non-zero amount of angular momentum which impinges on the singularity terminates in a strong curvature singularity.Comment: 17 pages; revised and corrected with improved result

Yang's gravitational theory

Yang's pure space equations (C.N. Yang, Phys. Rev. Lett. v.33, p.445 (1974)) generalize Einstein's gravitational equations, while coming from gauge theory. We study these equations from a number of vantage points: summarizing the work done previously, comparing them with the Einstein equations and investigating their properties. In particular, the initial value problem is discussed and a number of results are presented for these equations with common energy-momentum tensors.Comment: 28 pages, to appear in Gen. Rel. Gra

A Characterisation of Strong Wave Tails in Curved Space-Times

A characterisation of when wave tails are strong is proposed. The existence of a curvature induced tail (i.e. a Green's function term whose support includes the interior of the light-cone) is commonly understood to cause backscattering of the field governed by the relevant wave equation. Strong tails are characterised as those for which the purely radiative part of the field is backscattered. With this definition, it is shown that electromagnetic waves in asymptotically flat space-times and fields governed by tail-free propagation have weak tails, but minimally coupled scalar fields in a cosmological scenario have strong tails.Comment: 17 pages, Revtex, to appear in Classical and Quantum Gravit