Equity of access to adult hospice inpatient care within north-west England.

There is a growing debate about the question of equity of access to hospice and palliative care services. Even countries with relatively well developed palliative care systems are considered to have problems of access and inequity of provision. Despite these concerns, we still lack a relevant evidence base to serve as a guide to action. We present an analysis of access to adult hospice inpatient provision in the north-west region of England that employs Geographical Information Systems (GIS). Measures of the possible demand for, and supply of, hospice inpatient services are used to determine the potential accessibility of cancer patients, assessed at the level of small areas (electoral wards). Further, the use of deprivation scores permits an analysis of the equity of access to adult inpatient hospice care, leading to the identification of areas where additional service provision may be warranted. Our research is subject to a number of caveats�it is limited to inpatient hospice provision and does not include other kinds of inpatient and community-based palliative care services. Likewise, we recognise that not everyone with cancer will require palliative care and also that palliative care needs exist among those with nonmalignant conditions. Nevertheless, our methodology is one that can also be applied more generally

General purpose airborne simulator - Conceptual design report

General purpose airborne simulator with capabilities for model controlled and response feedback types of variable stability operatio

Final-state interactions and superscaling in the semi-relativistic approach to quasielastic electron and neutrino scattering

The semi-relativistic approach to electron and neutrino quasielastic scattering from nuclei is extended to include final-state interactions. Starting with the usual non-relativistic continuum shell model, the problem is relativized by using the semi-relativistic expansion of the current in powers of the initial nucleon momentum and relativistic kinematics. Two different approaches are considered for the final-state interactions: the Smith-Wambach 2p-2h damping model and the Dirac-equation-based potential extracted from a relativistic mean-field plus the Darwin factor. Using the latter the scaling properties of $(e,e')$ and $(\nu_\mu,\mu^-)$ cross sections for intermediate momentum transfers are investigated.Comment: 36 pages, 17 figure

Effect of polarization on superfluidity in low density neutron matter

It is shown that, contrary to an earlier estimate, the polarizability of the neutron medium tends to suppress rather than enhance the isotropic energy gap in low-density neutron-star matter

On the Origin of the Absorption Features in SS433

We present high-resolution optical spectroscopy of the X-ray binary system SS433, obtained over a wide range of orbital phases. The spectra display numerous weak absorption features, and include the clearest example seen to date of those features, resembling a mid-A type supergiant spectrum, that have previously been associated with the mass donor star. However, the new data preclude the hypothesis that these features originate solely within the photosphere of the putative mass donor, indicating that there may be more than one region within the system producing an A supergiant-like spectrum, probably an accretion disc wind. Indeed, whilst we cannot confirm the possibility that the companion star is visible at certain phase combinations, it is possible that all supergiant-like features observed thus far are produced solely in a wind. We conclude that great care must be taken when interpreting the behaviour of these weak features.Comment: Accepted for publication in MNRAS, 8 pages, 6 figure

Hardware for digitally controlled scanned probe microscopes

The design and implementation of a flexible and modular digital control and data acquisition system for scanned probe microscopes (SPMs) is presented. The measured performance of the system shows it to be capable of 14-bit data acquisition at a 100-kHz rate and a full 18-bit output resolution resulting in less than 0.02-Å rms position noise while maintaining a scan range in excess of 1 µm in both the X and Y dimensions. This level of performance achieves the goal of making the noise of the microscope control system an insignificant factor for most experiments. The adaptation of the system to various types of SPM experiments is discussed. Advances in audio electronics and digital signal processors have made the construction of such high performance systems possible at low cost

A pilot study of the S-MAP (Solutions for Medications Adherence Problems) intervention for older adults prescribed polypharmacy in primary care: Study protocol

Background: Adhering to multiple medications as prescribed is challenging for older patients (aged ≥ 65 years) and a difficult behaviour to improve. Previous interventions designed to address this have been largely complex in nature but have shown limited effectiveness and have rarely used theory in their design. It has been recognised that theory ('a systematic way of understanding events or situations') can guide intervention development and help researchers better understand how complex adherence interventions work. This pilot study aims to test a novel community pharmacy-based intervention that has been systematically developed using the Theoretical Domains Framework (12-domain version) of behaviour change. Methods: As part of a non-randomised pilot study, pharmacists in 12 community pharmacies across Northern Ireland (n = 6) and London, England (n = 6), will be trained to deliver the intervention to older patients who are prescribed ≥ 4 regular medicines and are non-adherent (self-reported). Ten patients will be recruited per pharmacy (n = 120) and offered up to four tailored one-to-one sessions, in the pharmacy or via telephone depending on their adherence, over a 3-4-month period. Guided by an electronic application (app) on iPads, the intervention content will be tailored to each patient's underlying reasons for non-adherence and mapped to the most appropriate solutions using established behaviour change techniques. This study will assess the feasibility of collecting data on the primary outcome of medication adherence (self-report and dispensing data) and secondary outcomes (health-related quality of life and unplanned hospitalisations). An embedded process evaluation will assess training fidelity for pharmacy staff, intervention fidelity, acceptability to patients and pharmacists and the intervention's mechanism of action. Process evaluation data will include audio-recordings of training workshops, intervention sessions, feedback interviews and patient surveys. Analysis will be largely descriptive. Discussion: Using pre-defined progression criteria, the findings from this pilot study will guide the decision whether to proceed to a cluster randomised controlled trial to test the effectiveness of the S-MAP intervention in comparison to usual care in community pharmacies. The study will also explore how the intervention components may work to bring about change in older patients' adherence behaviour and guide further refinement of the intervention and study procedures. Trial registration: This study is registered at ISRCTN: https://doi.org/10.1186/ISRCTN7383153

Similarity of Source Code in the Presence of Pervasive Modifications

Source code analysis to detect code cloning, code plagiarism, and code reuse suffers from the problem of pervasive code modifications, i.e. transformations that may have a global effect. We compare 30 similarity detection techniques and tools against pervasive code modifications. We evaluate the tools using two experimental scenarios for Java source code. These are (1) pervasive modifications created with tools for source code and bytecode obfuscation and (2) source code normalisation through compilation and decompilation using different decompilers. Our experimental results show that highly specialised source code similarity detection techniques and tools can perform better than more general, textual similarity measures. Our study strongly validates the use of compilation/decompilation as a normalisation technique. Its use reduced false classifications to zero for six of the tools. This broad, thorough study is the largest in existence and potentially an invaluable guide for future users of similarity detection in source code