Sleep apnoea and its impact on public health

In 1997 we published a systematic review on the health effects of obstructive sleep apnoea and the effectiveness of treatment with CPAP. This generated much controversy and considerable correspondence. About half the letters received by the authors suggested that the paper was just stating the obvious, the other half that the paper was completely inaccurate. To help clarify our findings this paper will discuss the public health impact of sleep apnoea and the rationale behind systematic reviews

The Medicaid Buy-In for Working People With Disabilities: Individuals With Disabilities Can Earn Significant Wages and Qualify for This Important Health Care Benefit

This policy-to-practice brief provides an in-depth illustrated description of the Plan for Achieving Self-Support (PASS) work incentives. This brief reviews how the PASS can be used to promote a work goal; the criteria for approving a PASS; and how the PASS can be used in conjunction with other programs to promote and achieve vocational success. Throughout the brief, examples are used to illustrate principles and provide an example in the appendices to show how to propose a PASS that meets all of SSA’s criteria for approval. Extensive citations to law, regulation, and policy appear in footnotes to maximize the usefulness of this publication to benefits planners who are engaged in writing PASS proposals for individuals

T-Branes and Geometry

T-branes are a non-abelian generalization of intersecting branes in which the matrix of normal deformations is nilpotent along some subspace. In this paper we study the geometric remnant of this open string data for six-dimensional F-theory vacua. We show that in the dual M-theory / IIA compactification on a smooth Calabi-Yau threefold X, the geometric remnant of T-brane data translates to periods of the three-form potential valued in the intermediate Jacobian of X. Starting from a smoothing of a singular Calabi-Yau, we show how to track this data in singular limits using the theory of limiting mixed Hodge structures, which in turn directly points to an emergent Hitchin-like system coupled to defects. We argue that the physical data of an F-theory compactification on a singular threefold involves specifying both a geometry as well as the remnant of three-form potential moduli and flux which is localized on the discriminant. We give examples of T-branes in compact F-theory models with heterotic duals, and comment on the extension of our results to four-dimensional vacua.Comment: v2: 80 pages, 2 figures, clarifications and references added, typos correcte

Launching Literacy in After-School Programs: Early Lessons from the CORAL Initiative

The James Irvine Foundation launched the Communities Organizing Resources to Advance Learning (CORAL) initiative in 1999 with the goal of improving the academic achievement of children in the lowest-performing schools in five California cities. In 2004, CORAL adopted a more targeted approach toward reaching this goal by integrating a regular schedule of literacy instruction into its after-school programs. This interim report, based on research conducted between Fall 2004 and Summer 2005, documents CORALs progress toward implementing high-quality and consistent literacy programming. The report presents early results in terms of youths positive reading gains and describes the program components that appear to have contributed to these gains. It also identifies challenges CORAL sites faced and successful strategies for addressing those challenges

Effects of Velocity-Dependent Dark Matter Annihilation on the Energy Spectrum of the Extragalactic Gamma-ray Background

We calculate the effects of velocity-dependent dark matter annihilation cross sections on the intensity of the extragalactic gamma-ray background. Our formalism does not assume a locally thermal distribution of dark matter particles in phase space, and is valid for arbitrary velocity-dependent annihilation. As concrete examples, we calculate the effects of p-wave annihilation (with the $v$-weighted cross section of $\sigma v=a+bv^2$) on the mean intensity of extragalactic gamma rays produced in cosmological dark matter halos. This velocity variation makes the shape of the energy spectrum harder, but this change in the shape is too small to see unless b/a\agt 10^6. While we find no such models in the parameter space of the Minimal Supersymmetric Standard Model (MSSM), we show that it is possible to find b/a\agt 10^6 in the extension MSSM$\otimes U(1)_{B-L}$. However, we find that the most dominant effect of the p-wave annihilation is the suppression of the amplitude of the gamma-ray background. A non-zero $b$ at the dark matter freeze-out epoch requires a smaller value of $a$ in order for the relic density constraint to be satisfied, suppressing the amplitude by a factor as low as $10^{-6}$ for a thermal relic. Non-thermal relics will have weaker amplitude suppression. As another velocity-dependent effect, we calculate the spectrum for s-wave annihilation into fermions enhanced by the attractive Sommerfeld effect. Resonances associated with this effect result in significantly enhanced intensities, with a slightly softer energy spectrum.Comment: 18 pages, 10 figure

Vertical Market Structure, Commodity Exports and Trade Reform

In the analysis of commodity markets, comparatively little attention is paid to the fact that commodity exports are intermediates that form inputs into the food processing and retail sectors in developed countries. Exporting countries correspondingly argue that access to developed country markets are determined by market structure characteristics of the downstream food sector. Given the vertical nature of these markets, they are most appropriately characterised by successive oligopoly and/or oligopsony. We explore trade policy issues facing commodity exporters, and show that the impact of tariff reform on commodity exporters is determined by the market structure characteristics of the downstream sectors.vertical market structure, trade reform, Industrial Organization, International Relations/Trade, F12, Q17,

Evaluation of the implementation of the alert issued by the UK National Patient Safety Agency on the storage and handling of potassium chloride concentrate solution

Objectives: To assess the effectiveness of the response of NHS hospital trusts to an alert issued by the National Patient Safety Agency designed to limit the availability of concentrated potassium chloride in hospitals in England and Wales, and to determine the nature of any unintended consequences. Design: Multi-method study involving interviews and a physical inspection of clinical areas. Setting: 207 clinical areas in 20 randomly selected acute NHS trusts in England and Wales between 31 October 2002 and 31 January 2003. Participants: Senior managers and ward based medical and nursing staff. Main outcome measures: Degree of staff awareness of and compliance with the requirements of the national alert, withdrawal of concentrated potassium chloride solutions from non-critical areas, provision of pre-diluted alternatives, storage and recording in accordance with controlled drug legislation. Results: All trusts required that potassium chloride concentrate be stored in a separate locked cupboard from common injectable diluents (100% compliance). Unauthorised stocks of potassium chloride were found in five clinical areas not authorised by the trust (98% compliance). All trusts required documentation control of potassium chloride concentrate in clinical areas, but errors were recorded in 20 of the 207 clinical areas visited (90% compliance). Of those interviewed, 78% of nurses and 30% of junior doctors were aware of the alert. Conclusions: The NPSA alert was effective and resulted in rapid development and implementation of local policies to reduce the availability of concentrated potassium chloride solutions. The success is likely to be partly due to the nature of the proposed changes and it cannot be assumed that future alerts will be equally effective. Continued vigilance will be necessary to help sustain the changes