Funding models in palliative care: lessons from international experience

Background:Funding models influence provision and development of palliative care services. As palliative care integrates into mainstream health care provision, opportunities to develop funding mechanisms arise. However, little has been reported on what funding models exist or how we can learn from them.Aim:To assess national models and methods for financing and reimbursing palliative care.Design:Initial literature scoping yielded limited evidence on the subject as national policy documents are difficult to identify, access and interpret. We undertook expert consultations to appraise national models of palliative care financing in England, Germany, Hungary, Republic of Ireland, New Zealand, The Netherlands, Norway, Poland, Spain, Sweden, Switzerland, the United States and Wales. These represent different levels of service development and a variety of funding mechanisms.Results:Funding mechanisms reflect country-specific context and local variations in care provision. Patterns emerging include the following:Provider payment is rarely linked to population need and often perpetuates existing inequitable patterns in service provision.Funding is frequently characterised as a mixed system of charitable, public and private payers.The basis on which providers are paid for services rarely reflects individual care input or patient needs.Conclusion:Funding mechanisms need to be well understood and used with caution to ensure best practice and minimise perverse incentives. Before we can conduct cross-national comparisons of costs and impact of palliative care, we need to understand the funding and policy context for palliative care in each country of interest

Double Exponential Instability of Triangular Arbitrage Systems

If financial markets displayed the informational efficiency postulated in the efficient markets hypothesis (EMH), arbitrage operations would be self-extinguishing. The present paper considers arbitrage sequences in foreign exchange (FX) markets, in which trading platforms and information are fragmented. In Kozyakin et al. (2010) and Cross et al. (2012) it was shown that sequences of triangular arbitrage operations in FX markets containing 4 currencies and trader-arbitrageurs tend to display periodicity or grow exponentially rather than being self-extinguishing. This paper extends the analysis to 5 or higher-order currency worlds. The key findings are that in a 5-currency world arbitrage sequences may also follow an exponential law as well as display periodicity, but that in higher-order currency worlds a double exponential law may additionally apply. There is an "inheritance of instability" in the higher-order currency worlds. Profitable arbitrage operations are thus endemic rather that displaying the self-extinguishing properties implied by the EMH.Comment: 22 pages, 22 bibliography references, expanded Introduction and Conclusion, added bibliohraphy reference

Naturalness and Fine Tuning in the NMSSM: Implications of Early LHC Results

We study the fine tuning in the parameter space of the semi-constrained NMSSM, where most soft Susy breaking parameters are universal at the GUT scale. We discuss the dependence of the fine tuning on the soft Susy breaking parameters M_1/2 and m0, and on the Higgs masses in NMSSM specific scenarios involving large singlet-doublet Higgs mixing or dominant Higgs-to-Higgs decays. Whereas these latter scenarios allow a priori for considerably less fine tuning than the constrained MSSM, the early LHC results rule out a large part of the parameter space of the semi-constrained NMSSM corresponding to low values of the fine tuning.Comment: 19 pages, 10 figures, bounds from Susy searches with ~1/fb include

Neutralino Dark Matter in BMSSM Effective Theory

We study thermal neutralino dark matter in an effective field theory extension of the MSSM, called "Beyond the MSSM" (BMSSM) in Dine, Seiberg and Thomas (2007). In this class of effective field theories, the field content of the MSSM is unchanged, but the little hierarchy problem is alleviated by allowing small corrections to the Higgs/higgsino part of the Lagrangian. We perform parameter scans and compute the dark matter relic density. The light Higgsino LSP scenario is modified the most; we find new regions of parameter space compared to the standard MSSM. This involves interesting interplay between the WMAP dark matter bounds and the LEP chargino bound. We also find some changes for gaugino LSPs, partly due to annihilation through a Higgs resonance, and partly due to coannihilation with light stops in models that are ruled in by the new effective terms.Comment: 37 pages + appendi

Updated Measurement of the Strong Phase in D0 --> K+pi- Decay Using Quantum Correlations in e+e- --> D0 D0bar at CLEO

We analyze a sample of 3 million quantum-correlated D0 D0bar pairs from 818 pb^-1 of e+e- collision data collected with the CLEO-c detector at E_cm = 3.77 GeV, to give an updated measurement of \cos\delta and a first determination of \sin\delta, where \delta is the relative strong phase between doubly Cabibbo-suppressed D0 --> K+pi- and Cabibbo-favored D0bar --> K+pi- decay amplitudes. With no inputs from other experiments, we find \cos\delta = 0.81 +0.22+0.07 -0.18-0.05, \sin\delta = -0.01 +- 0.41 +- 0.04, and |\delta| = 10 +28+13 -53-0 degrees. By including external measurements of mixing parameters, we find alternative values of \cos\delta = 1.15 +0.19+0.00 -0.17-0.08, \sin\delta = 0.56 +0.32+0.21 -0.31-0.20, and \delta = (18 +11-17) degrees. Our results can be used to improve the world average uncertainty on the mixing parameter y by approximately 10%.Comment: Minor revisions, version accepted by PR

On non-universal Goldstino couplings to matter

Using the constrained superfields formalism to describe the interactions of a light goldstino to matter fields in supersymmetric models, we identify generalised, higher-order holomorphic superfield constraints that project out the superpartners and capture the non-universal couplings of the goldstino to matter fields. These arise from microscopic theories in which heavy superpartners masses are of the order of the supersymmetry breaking scale (\sqrt f). In the decoupling limit of infinite superpartners masses, these constraints reduce to the familiar, lower-order universal constraints discussed recently, that describe the universal goldstino-matter fields couplings, suppressed by inverse powers of \sqrt f. We initiate the study of the couplings of the Standard Model (SM) fields to goldstino in the constrained superfields formalism.Comment: 28 pages; one comment adde

Gate Drive For High Speed, High Power IGBTs

A new gate drive for high-voltage, high-power IGBTs has been developed for the SLAC NLC (Next Linear Collider) Solid State Induction Modulator. This paper describes the design and implementation of a driver that allows an IGBT module rated at 800A/3300V to switch up to 3000A at 2200V in 3{micro}S with a rate of current rise of more than 10000A/{micro}S, while still being short circuit protected. Issues regarding fast turn on, high de-saturation voltage detection, and low short circuit peak current will be presented. A novel approach is also used to counter the effect of unequal current sharing between parallel chips inside most high-power IGBT modules. It effectively reduces the collector-emitter peak current, and thus protects the IGBT from being destroyed during soft short circuit conditions at high di/dt

Direct CP Violation in K_L --> \pi^0 e^+e^- Beyond Leading Logarithms

We analyze the direct CP violation in the rare decay K_L --> Pi^0 e+e- with QCD effects taken into account consistently in the next-to-leading order. We calculate the two-loop mixing between the four-quark \Delta S=1 operators and the operator Q_7V = (sd)_(V-A)(ee)_V in the NDR and HV renormalization schemes. Using the known two-loop anomalous dimension matrix of the four-quark operators, we find that the coefficient C_7V(\mu) depends only very weakly on \mu, renormalization scheme and \Lambda_MSbar. The next-to-leading QCD corrections enhance the direct CP violating contribution over its leading order estimate so that it remains dominant in spite of the recent decrease of |V_ub/V_cb| and |V_cb|. We expect typically BR(K_L --> \pi^0 e^+ e^-)_dir ~ 6*10^(-12), although values as high as 10^(-11) are not yet excluded.Comment: 35 pages (with 9 PostScript figures available separately), Munich Technical University preprint TUM-T31-60/94, Max-Planck Institute preprint MPI-Ph/94-1