An Imaging Fabry-Perot System for the Robert Stobie Spectrograph on the Southern African Large Telescope

We present the design of the Fabry-Perot system of the Robert Stobie Spectrograph on the 10-meter class Southern African Large Telescope and its characterization as measured in the laboratory. This system provides spectroscopic imaging at any desired wavelength spanning a bandpass 430 - 860 nm, at four different spectral resolving powers ranging from 300 to 9000. Our laboratory tests revealed a wavelength dependence of the etalon gap and parallelism with a maximum variation between 600 - 720 nm that arises because of the complex structure of the broadband multi-layer dielectric coatings. We also report an unanticipated optical effect of this multi-layer coating structure that produces a significant, and wavelength dependent, change in the apparent shape of the etalon plates. This change is caused by two effects: the physical non-uniformities or thickness variations in the coating layers, and the wavelength dependence of the phase change upon refection that can amplify these non-uniformities. We discuss the impact of these coating effects on the resolving power, finesse, and throughput of the system. This Fabry-Perot system will provide a powerful tool for imaging spectroscopy on one of the world's largest telescopes.Comment: 17 pages, 14 figures, accepted for publication in The Astronomical Journa

A Metadata description of the data in "A metabolomic comparison of urinary changes in type 2 diabetes in mouse, rat, and human.".

BACKGROUND: Metabolomics is a rapidly developing functional genomic tool that has a wide range of applications in diverse fields in biology and medicine. However, unlike transcriptomics and proteomics there is currently no central repository for the depositing of data despite efforts by the Metabolomics Standard Initiative (MSI) to develop a standardised description of a metabolomic experiment. FINDINGS: In this manuscript we describe how the MSI description has been applied to a published dataset involving the identification of cross-species metabolic biomarkers associated with type II diabetes. The study describes sample collection of urine from mice, rats and human volunteers, and the subsequent acquisition of data by high resolution 1H NMR spectroscopy. The metadata is described to demonstrate how the MSI descriptions could be applied in a manuscript and the spectra have also been made available for the mouse and rat studies to allow others to process the data. CONCLUSIONS: The intention of this manuscript is to stimulate discussion as to whether the MSI description is sufficient to describe the metadata associated with metabolomic experiments and encourage others to make their data available to other researchers

Testing the Expert Based Weights Used in the UK’s Index of Multiple Deprivation (IMD) Against Three Preference-Based Methods

The paper has benefitted from helpful comments and suggestions from Koen Decancq, Rainer Schulz, and participants at the Weighting in Multidimensional Measures workshop at OPHI, Oxford, the Overseas Development Workshop at ODI, London, seminar participants at Universiteit Antwerpen, and conference participants at New Directions in Welfare III, Paris. Any errors or omissions, of course, remain the responsibility of the authors. The project was funded by the Department of the Communities and Local Government. The Chief Scientist Office of the Scottish Government Health and Social Care Directorates funds HERU. The views expressed in this paper are those of the authors only and not those of the funding bodies.Peer reviewedPostprin

Alternatives to the face-to-face consultation in general practice: Focused ethnographic case study

© British Journal of General Practice. Background NHS policy encourages general practices to introduce alternatives to the face-to-face consultation, such as telephone, email, e-consultation systems, or internet video. Most have been slow to adopt these, citing concerns about workload. This project builds on previous research by focusing on the experiences of patients and practitioners who have used one or more of these alternatives. Aim To understand how, under what conditions, for which patients, and in what ways, alternatives to face-to-face consultations present benefits and challenges to patients and practitioners in general practice. Design and setting Focused ethnographic case studies took place in eight UK general practices between June 2015 and March 2016. Method Non-participant observation, informal conversations with staff, and semi-structured interviews with staff and patients were conducted. Practice documents and protocols were reviewed. Data were analysed through charting and the 'one sheet of paper' mind-map method to identify the line of argument in each thematic report. Results Case study practices had different rationales for offering alternatives to the face-to-face consultation. Beliefs varied about which patients and health issues were suitable. Co-workers were often unaware of each other's practice; for example, practice policies for use of e-consultations systems with patients were not known about or followed. Patients reported benefits including convenience and access. Staff and some patients regarded the face-toface consultation as the ideal. Conclusion Experience of implementing alternatives to the face-to-face consultation suggests that changes in patient access and staff workload may be both modest and gradual. Practices planning to implement them should consider carefully their reasons for doing so and involve the whole practice team

Proliferation of private online healthcare companies:Should the NHS try to keep up?

With an app for just about everything, why not one for contacting your doctor? In the United Kingdom, private companies offering primary healthcare are proliferating, with Dr Morton, a website offering email or telephone consultations, and Dr Now, a smartphone app offering video consultations. Companies in the United States are offering an Uber-type experience, where instead of a car, a doctor appears at your door. These companies operate in a climate where patients want convenience, flexibility, and speed of access, features which overstretched general practitioners in the UK are struggling to provide. Meanwhile, new companies are appearing regularly, with the UK digital health market currently worth £2bn (€2.6bn; $2.8bn) and expected to grow to £2.9bn by 2018.2 What are the implications for the NHS

The health and well-being of people with a previous diagnosis of cancer: A record-linkage study in Scotland

Routinely collected health care data (the Scottish Cancer Registry) were record-linked to representative survey data on health and health behaviours (the Government-funded Scottish Health Survey) to compare the health and well-being of cancer survivors in Scotland with people who had never had cancer; a methodological approach which has been under-utilised. After adjusting for age, sex and occupational classification, people with a previous diagnosis of cancer (even > 6 years previously) (n = 507) were more likely to have poorer self-assessed health, reduced activity and psychological morbidity than people who had never had cancer (n = 25,631)

The potential of alternatives to face-to-face consultation in general practice, and the impact on different patient groups: a mixed-methods case study

Background: There is international interest in the potential role of different forms of communicationtechnology to provide an alternative to face-to-face consultations in health care. There has beenconsiderable rhetoric about the need for general practices to offer consultations by telephone, e-mail orinternet video. However, little is understood about how, under what conditions, for which patients and inwhat ways these approaches may offer benefits to patients and practitioners in general practice.Objectives: Our objectives were to review existing evidence about alternatives to face-to-face consultation;conduct a scoping exercise to identify the ways in which general practices currently provide these alternatives;recruit eight general practices as case studies for focused ethnographic research, exploring how practicecontext, patient characteristics, type of technology and the purpose of the consultation interact to determinethe impact of these alternatives; and synthesise the findings in order to develop a website resource about theimplementation of alternatives to face-to-face consultations and a framework for subsequent evaluation.Design: Mixed-methods case study.Setting: General practices in England and Scotland with varied experience of implementing alternatives toface-to-face consultations.Participants: Patients and practice staff.Interventions: Alternatives to face-to-face consultations include telephone consultations, e-mail,e-consultations and internet video.Main outcome measures: How context influenced the implementation and impact of alternatives to theface-to-face consultation; the rationale for practices to introduce alternatives; the use of different forms ofconsultation by different patient groups; and the intended benefits/outcomes.Review methods: The conceptual review used an approach informed by realist review, a method forsynthesising research evidence regarding complex interventions.Results: Alternatives to the face-to-face consultation are not in mainstream use in general practice, withlow uptake in our case study practices. We identified the underlying rationales for the use of thesealternatives and have shown that different stakeholders have different perspectives on what they hope toachieve through the use of alternatives to the face-to-face consultation. Through the observation of real-lifeuse of different forms of alternative, we have a clearer understanding of how, under what circumstancesand for which patients alternatives might have a range of intended benefits and potential unintendedadverse consequences. We have also developed a framework for future evaluation.Limitations: The low uptake of alternatives to the face-to-face consultation means that our researchparticipants might be deemed to be early adopters. The case study approach provides an in-depthexamination of a small number of sites, each using alternatives in different ways. The findings aretherefore hypothesis-generating, rather than hypothesis-testing.Conclusions: The current low uptake of alternatives, lack of clarity about purpose and limited evidence ofbenefit may be at odds with current policy, which encourages the use of alternatives. We have highlightedkey issues for practices and policy-makers to consider and have made recommendations about priorities forfurther research to be conducted, before or alongside the future roll-out of alternatives to the face-to-faceconsultation, such as telephone consulting, e-consultation, e-mail and video consulting.Future work: We have synthesised our findings to develop a framework and recommendations aboutfuture evaluation of the use of alternatives to face-to-face consultations.Funding details: The National Institute for Health Research Health Services and DeliveryResearch programme.ABSTRACTNIH

Receptionists' role in new approaches to consultations in primary care: A focused ethnographic study

© British Journal of General Practice. Background The receptionist is pivotal to the smooth running of general practice in the UK, communicating with patients and booking appointments. Aim The authors aimed to explore the role of the receptionist in the implementation of new approaches to consultations in primary care. Design and setting The authors conducted a team-based focused ethnography. Three researchers observed eight general practices across England and Scotland between June 2015 and May 2016. Method Interviews were conducted with 39 patients and 45 staff in the practices, all of which had adopted one or more methods (telephone, email, e-consultation, or internet video) for providing an alternative to face-to-face consultation. Results Receptionists have a key role in facilitating patient awareness regarding new approaches to consultations in primary care, while at the same time ensuring that patients receive a consultation appropriate to their needs. In this study, receptionists' involvement in implementation and planning for the introduction of alternative approaches to faceto-face consultations was minimal, despite the expectation that they would be involved in delivery. Conclusion A shared understanding within practices of the potential difficulties and extra work that might ensue for reception staff was lacking. This might contribute to the low uptake by patients of potentially important innovations in service delivery. Involvement of the wider practice team in planning and piloting changes, supporting team members through service reconfiguration, and providing an opportunity to discuss and contribute to modifications of any new system would ensure that reception staff are suitably prepared to support the introduction of a new approach to consultations

Testing the expert based weights used in the UK’s Index of Multiple Deprivation (IMD) against three preference-based methods

The Index of Multiple Deprivation (IMD), used widely in England, is an important tool for social need and inequality identification. It summarises deprivation across seven dimensions (income, employment, health, education, housing and services, environment, and crime) to measure an area’s multidimensional deprivation. The IMD aggregates the dimensions that are differentially weighted using expert judgement. In this paper, we test how close these weights are to society’s preferences about the relative importance of each dimension to overall deprivation. There is not agreement in the literature on how to do this. This paper, therefore, develops and compares three empirical methods for estimating preference-based weights. We find the weights are similar across the methods, and between our empirical methods and the current IMD, but our findings suggest a change to two of the weights