The price, quality and distribution of mortgage payment protection insurance: a hedonic pricing approach

Mortgage payment protection insurance (hereafter MPPI) provides varying combinations of accident, sickness and unemployment insurance and is used to protect the mortgage payments of policyholders in the event of a fall in income. Despite alleviating housing market failures, this service has been heavily criticised for providing poor value for money and being associated with unhelpful sales techniques especially when sold jointly with a mortgage in the UK. Consequently, the Competition Commission (2009) ruled that after February 2011 MPPI should not be sold jointly with mortgage lending within seven days of the credit transaction. We examine whether this prohibition was justified and if the form of distribution, either jointly with the mortgage or independently influences the premium levels. This assessment uses a hedonic pricing approach with details and premiums of MPPI policies in 2010 and 2012. Despite the success in reducing MPPI premium levels, we conclude that the Competition Commission judgement has raised concerns as to mortgagee protection

Streamlining pathways for minor injuries in emergency departments through radiographer-led discharge

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.Diagnostic imaging services are essential to the diagnosis pathway for many patients arriving at hospital emergency departments with a suspected fracture. Commonly, these patients need to be seen again by a doctor or emergency nurse practitioner after an X-ray image has been taken in order to finalise the diagnosis and determine the next stage in the patients’ pathway. Here, significant waiting times can accrue for these follow-up consultations after radiographic imaging although the vast majority of patients are discharged. Research evidence from pilot studies suggests that patients with minor appendicular injuries could be safely discharged by a suitably qualified radiographer directly after imaging thereby avoiding queues for repeated consultation. In this study, we model patient pathways through an emergency department (ED) at a hospital in the South West of England using process mapping, interviews with ED staff and discrete event simulation (DES). The DES model allowed us to compare the current practice at the hospital with scenarios using radiographer-led discharge of patients directly after imaging and assess the reduction in patients’ length of stay in ED. We also quantified trade-offs between the provision of radiographer-led discharge and its effects, i.e. reduction in waiting times and ED workload. Finally, we discuss how this decision support tool can be used to support understanding for patients and members of staff.Part of this research, i.e. the work of Martin Pitt and Sebastian Rachuba, was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula (NIHR CLAHRC South West Peninsula)

SYSTEMS-2: a randomised phase II study of radiotherapy dose escalation for pain control in malignant pleural mesothelioma

SYSTEMS-2 is a randomised study of radiotherapy dose escalation for pain control in 112 patients with malignant pleural mesothelioma (MPM). Standard palliative (20Gy/5#) or dose escalated treatment (36Gy/6#) will be delivered using advanced radiotherapy techniques and pain responses will be compared at week 5. Data will guide optimal palliative radiotherapy in MPM

Species-habitat associations in a Sri Lankan dipterocarp forest

Forest structure and species distribution patterns were examined among eight topographically defined habitats for the 205 species with stems ≥ 1 cm dbh inhabiting a 25-ha plot in the Sinharaja rain forest, Sri Lanka. The habitats were steep spurs, less-steep spurs, steep gullies and less-steep gullies, all at either lower or upper elevations. Mean stem density was significantly greater on the upper spurs than in the lower, less-steep gullies. Stem density was also higher on spurs than in gullies within each elevation category and in each upper-elevation habitat than in its corresponding lower-elevation habitat. Basal area varied less among habitats, but followed similar trends to stem density. Species richness and Fisher\u27s alpha were lower in the upper-elevation habitats than in the lower-elevation habitats. These differences appeared to be related to the abundances of the dominant species. Of the 125 species subjected to torus-translation tests, 99 species (abundant and less abundant and those in different strata) showed at least one positive or negative association to one or more of the habitats. Species associations were relatively more frequent with the lower-elevation gullies. These and the previous findings on seedling ecophysiology, morphology and anatomy of some of the habitat specialists suggest that edaphic and hydrological variation related to topography, accompanied by canopy disturbances of varying intensity, type and extent along the catenal landscape, plays a major role in habitat partitioning in this forest. Copyright © 2006 Cambridge University Press

'I just want a job' : what do we really know about young people in jobs without training?

Over recent years, a central concern of policy has been to drive up post-16 participation rates in full-time education and address the needs of young people not in education, employment or training (NEET). As a result, young people who enter work which is classified as 'without training' at 16/17 have largely been ignored. However, the decision to Raise the Participation Age (RPA) for continuing in learning for all 17-year olds from 2013 and for all 18-year olds from 2015 in England, together with a growing unease about the impact of the current recession on youth unemployment rates, have revived interest in the 'jobs without training' (JWT) group. This paper draws on the findings from two studies: first, a qualitative study in two contrasting local labour markets, of young people in JWT, together with their employers and parents; and second, an evaluation of the Learning Agreement Pilots (LAP), which was the first policy initiative in England targeted at the JWT group. Both studies reveal a dearth of understanding about early labour market entrants and a lack of policy intervention and infrastructure to support the needs of the JWT group throughout the UK. From this, it is concluded that questionable assumptions have been made about the composition and the aspirations of young people in JWT, and their employers, on the basis of little or no evidence. As a consequence, a policy 'quick fix' to satisfy the RPA agenda will not easily be achieved. If the decision to raise the participation age is adopted also by the Welsh and Scottish parliaments, similar challenges may have to be faced

Adverse Childhood Experiences and their impact on health-harming behaviours in the Welsh adult population

This report is one in a series of reports examining the prevalence of Adverse Childhood Experiences (ACEs) in the Welsh adult population and their impact on health and well-being across the life course. Substantial proportions of the Welsh population reported suffering abuse, neglect and other ACEs during their childhood with 47% reporting having experienced at least one ACE and 14% experiencing four or more ACEs. This report focuses on: alcohol use, drug use, violence, sexual behaviour, incarceration, smoking and poor diet

Regulation of stanniocalcin-1 secretion by BeWo cells and first trimester human placental tissue from normal pregnancies and those at increased risk of developing preeclampsia.

Stanniocalcin-1 (STC-1) is a multi-functional glycosylated peptide present in the plasma of healthy women postpartum and increased further in pregnancies complicated by preeclampsia. Although the STC-1 gene is expressed by the placenta what regulates its secretion and from which cells at the feto-maternal interface is unknown. Here, we demonstrate for the first time that the syncytiotrophoblast and cytotrophoblast are a major site of STC-1 protein expression in first trimester placental tissue. Further, in response to low oxygen, first trimester chorionic villous tissue from pregnancies at increased risk of developing preeclampsia secreted significantly more STC-1 than normal tissue under the same conditions. Using the human trophoblast cell line BeWo we have shown that low oxygen increased the secretion of STC-1 but it required co-stimulation with the Adenosine-3', 5'-cyclic monophosphate (cAMP) analogue, 8-Bromo adenosine-3', 5'-cyclic monophosphate cAMP (8 Br-cAMP) to reach significance. Inhibition of Hypoxia inducible factor 2α (HIF-2α) and the Phosphatidylinositol-3 kinase (PI3 -Kinase)/AKT/Serum and glucocorticoid-induced kinase-1(SGK-1) pathway resulted in significant inhibition of STC-1 secretion. As both low oxygen and cAMP are known to play a central role in placental function, their regulation of STC-1 points to a potentially important role in the maintenance of a normal healthy pregnancy and we would hypothesize that it may act to protect against prolonged placental hypoxia seen in preeclampsia

Diffractive Contribution to the Elasticity and the Nucleonic Flux in the Atmosphere

We calculate the average elasticity considering non-diffractive and single diffractive interactions and perform an analysis of the cosmic-ray flux by means of an analytical solution for the nucleonic diffusion equation. We show that the diffractive contribution is important for the adequate description of the nucleonic and hadronic fluxes in the atmosphere.Comment: 10 pages, latex, 2 figures (uuencoded PostScript

Fabrication of One-Dimensional Programmable-Height Nanostructures via Dynamic Stencil Deposition

Dynamic stencil deposition (DSD) techniques offer a variety of fabrication advantages not possible with traditional lithographic processing, such as the the ability to directly deposit nanostructures with programmable height profiles. However, DSD systems have not enjoyed widespread usage due to their complexity. We demonstrate a simple, low-profile, portable, one-dimensional nanotranslation system that facilitates access to nanoscale DSD abilities. Furthermore we show a variety of fabricated programmable-height nanostructures, including parallel arrays of such structures, and suggest other applications that exploit the unique capabilities of DSD fabrication methods.Comment: 6 pages, 5 figure