Density and Velocity Fields from the PSCz Survey

We present the results for the predicted density and peculiar velocity fields and the dipole from the PSCz survey of 15,000 IRAS galaxies over 84% of the sky. We find a significant component to the dipole arising between 6000 and 15,000 km/s, but no significant component from greater distances. The misalignment with the CMB is 20 degrees. The most remarkable feature of the PSCz model velocity field is a coherent large-scale flow along the baseline connecting Perseus-Pisces, the Local Supercluster, Great Attractor and the Shapley Concentration. We have measured the parameter beta using the amplitude of the dipole, bulk flow and point by point comparisons between the individual velocities of galaxies in the MarkIII and SFI datasets, and the large-scale clustering distortion in redshift space.All our results are consistent with beta = 0.6 +- 0.1.Comment: 8 pages, 8 figures. To appear in 'Towards an Understanding of Cosmic Flows', Victoria, July 1999, eds Courteau,S., Strauss,M., Willick,J. PAS

To GP or not to GP: a natural experiment in children triaged to see a GP in a tertiary paediatric emergency department (ED)

Objective: To evaluate the impact of integrating a general practitioner (GP) into a tertiary paediatric emergency department (ED) on admissions, waiting times and antibiotic prescriptions. Design: Retrospective cohort study. Setting: Alder Hey Children’s NHS Foundation Trust, a tertiary paediatric hospital in Liverpool, UK. Participants: From October 2014, a GP was colocated within the ED, from 14:00 to 22:00 hours, 7 days a week. Children triaged green on the Manchester Triage System without any comorbidities were classed as ‘GP appropriate’. The natural experiment compared patients triaged as ‘GP appropriate’ and able to be seen by a GP between 14:00 and 22:00 hours (GP group) to patients triaged as ‘GP appropriate’ seen outside of the hours when a GP was available (ED group). Intention-to-treat (ITT) analysis was used to assess the main outcomes. Results: 5223 patients were designated as ‘GP appropriate’—18.2% of the total attendances to the ED over the study period. There were 2821 (54%) in the GP group and 2402 (46%) in the ED group. The median duration of stay in the ED was 94 min (IQR 63–141) for the GP group compared with 113 min (IQR 70–167) for the ED group (p<0.0005). Using the ITT analysis equivalent, we demonstrated that the GP group were less likely to: be admitted to hospital (2.2% vs 6.5%, OR 0.32, 95% CI 0.24 to 0.44), wait longer than 4 hours (2.3% vs 5.1%, OR 0.45, 95% CI 0.33 to 0.61) or leave before being seen (3.1% vs 5.7%, OR 0.53, 95% CI 0.41 to 0.70), but more likely to receive antibiotics (26.1% vs 20.5%, OR 1.37, 95% CI 1.10 to 1.56). Sensitivity analyses yielded similar results. Conclusions: Introducing a GP to a paediatric ED service can significantly reduce waiting times and admissions, but may lead to more antibiotic prescribing. This study demonstrates a novel, potentially more efficient ED care pathway in the current context of rising demand for children’s emergency services

Applying organizational psychology as a design science: A method for predicting malfunctions in socio-technical systems (PreMiSTS)

As a discipline, design science has traditionally focused on designing products and associated technical processes to improve usability and performance. Although significant progress has been made in these areas, little research has yet examined the role of human behaviour in the design of socio-technical systems (e.g., organizations). Here, we argue that applying organizational psychology as a design science can address this omission and enhance the capability of both disciplines. Specifically, we propose a method to predict malfunctions in socio-technical systems (PreMiSTS), thereby enabling them to be designed out or mitigated. We introduce this method, describe its nine stages, and illustrate its application with reference to two high-profile case studies of such malfunctions: (1) the severe breakdowns in patient care at the UK’s Mid-Staffordshire NHS Foundation Trust hospital in the period 2005–2009, and (2) the fatal Grayrigg rail accident in Cumbria, UK, in 2007. Having first identified the socio-technical and behavioural antecedents of these malfunctions, we then consider how the PreMiSTS method could be used to predict and prevent future malfunctions of this nature. Finally, we evaluate the method, consider its advantages and disadvantages, and suggest where it can be most usefully applied

A deformation of AdS_5 x S^5

We analyse a one parameter family of supersymmetric solutions of type IIB supergravity that includes AdS_5 x S^5. For small values of the parameter the solutions are causally well-behaved, but beyond a critical value closed timelike curves (CTC's) appear. The solutions are holographically dual to N=4 supersymmetric Yang-Mills theory on a non-conformally flat background with non-vanishing R-currents. We compute the holographic energy-momentum tensor for the spacetime and show that it remains finite even when the CTC's appear. The solutions, as well as the uplift of some recently discovered AdS_5 black hole solutions, are shown to preserve precisely two supersymmetries.Comment: 16 pages, v2: typos corrected and references adde

Are interventions to promote healthy eating equally effective for all? Systematic review of socioeconomic inequalities in impact.

BACKGROUND: Interventions to promote healthy eating make a potentially powerful contribution to the primary prevention of non communicable diseases. It is not known whether healthy eating interventions are equally effective among all sections of the population, nor whether they narrow or widen the health gap between rich and poor. We undertook a systematic review of interventions to promote healthy eating to identify whether impacts differ by socioeconomic position (SEP). METHODS: We searched five bibliographic databases using a pre-piloted search strategy. Retrieved articles were screened independently by two reviewers. Healthier diets were defined as the reduced intake of salt, sugar, trans-fats, saturated fat, total fat, or total calories, or increased consumption of fruit, vegetables and wholegrain. Studies were only included if quantitative results were presented by a measure of SEP. Extracted data were categorised with a modified version of the "4Ps" marketing mix, expanded to 6 "Ps": "Price, Place, Product, Prescriptive, Promotion, and Person". RESULTS: Our search identified 31,887 articles. Following screening, 36 studies were included: 18 "Price" interventions, 6 "Place" interventions, 1 "Product" intervention, zero "Prescriptive" interventions, 4 "Promotion" interventions, and 18 "Person" interventions. "Price" interventions were most effective in groups with lower SEP, and may therefore appear likely to reduce inequalities. All interventions that combined taxes and subsidies consistently decreased inequalities. Conversely, interventions categorised as "Person" had a greater impact with increasing SEP, and may therefore appear likely to reduce inequalities. All four dietary counselling interventions appear likely to widen inequalities. We did not find any "Prescriptive" interventions and only one "Product" intervention that presented differential results and had no impact by SEP. More "Place" interventions were identified and none of these interventions were judged as likely to widen inequalities. CONCLUSIONS: Interventions categorised by a "6 Ps" framework show differential effects on healthy eating outcomes by SEP. "Upstream" interventions categorised as "Price" appeared to decrease inequalities, and "downstream" "Person" interventions, especially dietary counselling seemed to increase inequalities. However the vast majority of studies identified did not explore differential effects by SEP. Interventions aimed at improving population health should be routinely evaluated for differential socioeconomic impact

A distributed simulation methodological framework for OR/MS applications

Distributed Simulation (DS) allows existing models to be composed together to form sim- ulations of large-scale systems, or large models to be divided into models that execute on separate computers. Among its claimed benefits are model reuse, speedup, data pri- vacy and data consistency. DS is arguably widely used in the defence sector. However, it is rarely used in Operations Research and Management Science (OR/MS) applications in areas such as manufacturing and healthcare, despite its potential advantages. The main barriers to use DS in OR/MS are the technical complexity in implementation and a gap between the world views of DS and OR/MS communities. In this paper, we propose a new method that attempts to link together the methodological practices of OR/MS and DS. Using a rep- resentative case study, we show that our methodological framework simplifies significantly DS implementation.This research was funded by the Multidisciplinary Assessment of Technology Centre for Healthcare (MATCH), an Innova- tive Manufacturing Research Centre (IMRC) funded by the Engineering and Physical Sciences Research Council (EPSRC) (Ref: EP/F063822/1 )

Sustainable Health Development Goals (SHDG): breaking down the walls

The world's governments failed to achieve the Health for All 2000 goals from the Alma Ata Declaration of 1978. Although a lot of milestones have been covered since 2000, the world's governing authorities are unlikely to achieve the current Millennium Development Goals (MDGs) which expire by the end of this year. The inability to achieve these goals may be linked to the multiplicity of health-related directives and fragmentation of health systems in many countries. However, with the proposed 17 sustainability development goals, health has only one universal aim: to ensure healthy lives and promote wellbeing for all at all ages. Accomplishing this will require a focus on health systems (system-thinking), commonization of services and full integration of services with total dismantling of vertical programs across the world.Pan African Medical Journal 2015; 2