Economic analysis of Perlite versus super insulation in liquid hydrogen storage and run vessels for the M-1 Program

Cost comparison of perlite and multilayer aluminum foil relective insulation in liquid hydrogen storage dewars for M-1 engin

Is the Medical Brain Drain Beneficial? Evidence from Overseas Doctors in the UK

The ¿beneficial brain drain¿ hypothesis suggests that skilled migration can be good for a sending countrybecause the incentives it creates for training increase that country¿s supply of skilled labour. To work, thishypothesis requires that the degree of screening of migrants by the host country is limited and that thepossibility of migration actually encourages home country residents to obtain education. We studied theimplications of doctors¿ migration by conducting a survey among overseas doctors in the UK. The resultssuggest that the overseas doctors who come to the UK are carefully screened and that only a minority of doctorsfrom developing countries considered the possibility of migration when they chose to obtain medical education.The incentive effect is thus probably not large enough to increase the skills-supply in developing countries.Doctors do, however, remit income to their home countries and many intend to return after completing theirtraining in the UK, so there could be benefits via these routes.brain drain, international labour market, professional labour markets, doctors, physicians,international migration

Improving mental health outcomes: achieving equity through quality improvement

Objective. To investigate equity of patient outcomes in a psychological therapy service, following increased access achieved by a quality improvement (QI) initiative. Design. Retrospective service evaluation of health outcomes; data analysed by ANOVA, chi-squared and Statistical Process Control. Setting. A psychological therapy service in Westminster, London, UK. Participants. People living in the Borough of Westminster, London, attending the service (from either healthcare professional or self-referral) between February 2009 and May 2012. Intervention(s). Social marketing interventions were used to increase referrals, including the promotion of the service through local media and through existing social networks. Main Outcome Measure(s). (i) Severity of depression on entry using Patient Health Questionnaire-9 (PHQ9). (ii) Changes to severity of depression following treatment (ΔPHQ9). (iii) Changes in attainment of a meaningful improvement in condition assessed by a key performance indicator. Results. Patients from areas of high deprivation entered the service with more severe depression (M = 15.47, SD = 6.75), com-pared with patients from areas of low (M = 13.20, SD = 6.75) and medium (M = 14.44, SD = 6.64) deprivation. Patients in low

Decontamination and decommissioning of the EBR-I complex. Topical report No. 3. NAK disposal pilot plant test

Decontamination and decommissioning of the Experimental Breeder Reactor No. 1 (EBR-I) requires processing of the primary coolant, an eutectic solution of sodium and potassium (NaK), remaining in the EBR-I primary and secondary coolant systems. While developing design criteria for the NaK processing system, reasonable justification was provided for the development of a pilot test plant for field testing some of the process concepts and proposed hardware. The objective of this activity was to prove the process concept on a low-cost, small- scale test bed. The pilot test plant criteria provided a general description of the test including: the purpose, location, description of test equipment available, waste disposal requirements, and a flow diagram and conceptual equipment layout. The pilot plant test operations procedure provided a detailed step-by-step procedure for operation of the pilot plant to obtain the desired test data and operational experience. It also spelled out the safety precautions to be used by operating personnel, including the requirement for alkali metals training certification, use of protective clothing, availability of fire protection equipment, and caustic handling procedures. The pilot plant test was performed on May 16, 1974. During the test, 32.5 gallons or 240 lb of NaK was successfully converted to caustic by reaction with water in a caustic solution. (auth

Pneumothorax after computed tomography-guided lung biopsy: Utility of immediate post-procedure computed tomography and one-hour delayed chest radiography

Purpose To evaluate the utility of immediate post-procedure computed tomography (IPP-CT) and routine one-hour chest radiography (1HR-CXR) for detecting and managing pneumothorax in patients undergoing computed tomography (CT)-guided percutaneous lung biopsy. Materials and methods All CT-guided percutaneous lung biopsies performed between May 2014 and August 2021 at a single institution were included. Data from 275 procedures performed on 267 patients (147 men; mean age: 63.5 ± 14.1 years; range 18–91 years) who underwent routine 1HR-CXR were reviewed. Incidences of pneumothorax and procedure-related complications on IPP-CT and 1HR-CXR were recorded. Associated variables, including tract embolization methods, needle diameter/type, access site, lesion size, needle tract distance, and number of biopsy samples obtained were analyzed and compared between groups with and without pneumothorax. Results Post-procedure complications included pneumothorax (30.9%, 85/275) and hemoptysis (0.7%, 2/275). Pneumothorax was detected on IPP-CT and 1HR-CXR in 89.4% (76/85) and 100% (85/85), respectively. A chest tube was placed in 4% (11/275) of the cases. In 3.3% (9/275) of the cases, delayed pneumothorax was detected only on 1HR-CXR, but no patient in this group necessitated chest tube placement. The incidence of pneumothorax was not significantly different between tract embolization methods (p = 0.36), needle diameters (p = 0.36) and types (p = 0.33), access sites (p = 0.07), and lesion sizes (p = 0.88). On logistic regression, a lower biopsy sample number (OR = 0.49) was a protective factor, but a longer needle tract distance (OR = 1.16) was a significant risk factor for pneumothorax. Conclusion Following CT-guided percutaneous lung biopsy, pneumothorax detected on IPP-CT strongly indicates persistent pneumothorax on 1HR-CXR and possible chest tube placement. If no pneumothorax is identified on IPP-CT, follow-up 1HR-CXR may be required only for those who develop symptoms of pneumothorax

'Reaching the hard to reach' - lessons learned from the VCS (voluntary and community Sector). A qualitative study.

Background The notion 'hard to reach' is a contested and ambiguous term that is commonly used within the spheres of social care and health, especially in discourse around health and social inequalities. There is a need to address health inequalities and to engage in services the marginalized and socially excluded sectors of society. Methods This paper describes a pilot study involving interviews with representatives from eight Voluntary and Community Sector (VCS) organisations . The purpose of the study was to explore the notion of 'hard to reach' and perceptions of the barriers and facilitators to accessing services for 'hard to reach' groups from a voluntary and community sector perspective. Results The 'hard to reach' may include drug users, people living with HIV, people from sexual minority communities, asylum seekers, refugees, people from black and ethnic minority communities, and homeless people although defining the notion of the 'hard to reach' is not straight forward. It may be that certain groups resist engaging in treatment services and are deemed hard to reach by a particular service or from a societal stance. There are a number of potential barriers for people who may try and access services, including people having bad experiences in the past; location and opening times of services and how services are funded and managed. A number of areas of commonality are found in terms of how access to services for 'hard to reach' individuals and groups could be improved including: respectful treatment of service users, establishing trust with service users, offering service flexibility, partnership working with other organisations and harnessing service user involvement. Conclusions: If health services are to engage with groups that are deemed 'hard to reach' and marginalised from mainstream health services, the experiences and practices for engagement from within the VCS may serve as useful lessons for service improvement for statutory health services

Do 'alternative' help-seeking strategies affect primary care service use? A survey of help-seeking for mental distress

http://creativecommons.org/licenses/by/2.0

Inequality, Fiscal Capacity and the Political Regime: Lessons from the Post-Communist Transition

Using panel data for twenty-seven post-communist economies between 1987-2003, we examine the nexus of relationships between inequality, fiscal capacity (defined as the ability to raise taxes efficiently) and the political regime. Investigating the impact of political reform we find that full political freedom is associated with lower levels of income inequality. Under more oligarchic (authoritarian) regimes, the level of inequality is conditioned by the state’s fiscal capacity. Specifically, oligarchic regimes with more developed fiscal systems are able to defend the prevailing vested interests at a lower cost in terms of social injustice. This empirical finding is consistent with the model developed by Acemoglu (2006). We also find that transition countries undertaking early macroeconomic stabilisation now enjoy lower levels of inequality; we confirm that education fosters equality and the suggestion of Commander et al (1999) that larger countries are prone to higher levels of inequality.http://deepblue.lib.umich.edu/bitstream/2027.42/57211/1/wp831 .pd

Preliminary Safety Analysis Report for the Tokamak Physics Experiment

This Preliminary Safety Analysis Report (PSAR), includes an indication of the magnitude of facility hazards, complexity of facility operations, and the stage of the facility life-cycle. It presents the results of safety analyses, safety assurance programs, identified vulnerabilities, compensatory measures, and, in general, the rationale describing why the Tokamak Physics Experiment (TPX) can be safely operated. It discusses application of the graded approach to the TPX safety analysis, including the basis for using Department of Energy (DOE) Order 5480.23 and DOE-STD-3009-94 in the development of the PSAR