Visualising variation in mortality rates across the life course and by sex, USA and comparator states, 1933–2010

Background Previous research showed that younger adult males in the USA have, since the 1950s, died at a faster rate than females of the same age. In this paper, we quantify this difference, and explore possible explanations for the differences at different ages and in different years. Methods Using data from the Human Mortality Database (HMD), the number of additional male deaths per 10 000 female deaths was calculated for each year from 1933 to 2010, and for each year of age from 0 to 60 years, for the USA, and a number of other countries for comparison. The data were explored visually using shaded contour plots. Results Gender differences in excess mortality have increased. Coming of age (between the ages of 15 and 25 years of age) is especially perilous for men relative to women now compared with the past in the USA; the visualisations highlight this change as important. Conclusions Sex differences in mortality risks at various ages are not static. While women may today have an advantage when it comes to life expectancy, in the USA, this has greatly increased since the 1930s. Just as young adulthood for women has been made safer through safer antenatal and childbirth practices, changes in public policy can make the social environment safer for men

A Taylor rule and the Greenspan era

Federal funds rate ; Inflation (Finance) ; Interest rates

An extended abstract: A heuristic repair method for constraint-satisfaction and scheduling problems

The work described in this paper was inspired by a surprisingly effective neural network developed for scheduling astronomical observations on the Hubble Space Telescope. Our heuristic constraint satisfaction problem (CSP) method was distilled from an analysis of the network. In the process of carrying out the analysis, we discovered that the effectiveness of the network has little to do with its connectionist implementation. Furthermore, the ideas employed in the network can be implemented very efficiently within a symbolic CSP framework. The symbolic implementation is extremely simple. It also has the advantage that several different search strategies can be employed, although we have found that hill-climbing methods are particularly well-suited for the applications that we have investigated. We begin the paper with a brief review of the neural network. Following this, we describe our symbolic method for heuristic repair

The min-conflicts heuristic: Experimental and theoretical results

This paper describes a simple heuristic method for solving large-scale constraint satisfaction and scheduling problems. Given an initial assignment for the variables in a problem, the method operates by searching through the space of possible repairs. The search is guided by an ordering heuristic, the min-conflicts heuristic, that attempts to minimize the number of constraint violations after each step. We demonstrate empirically that the method performs orders of magnitude better than traditional backtracking techniques on certain standard problems. For example, the one million queens problem can be solved rapidly using our approach. We also describe practical scheduling applications where the method has been successfully applied. A theoretical analysis is presented to explain why the method works so well on certain types of problems and to predict when it is likely to be most effective

End-of-life care in a psychiatric hospital.

Since the Liverpool Care Pathway has been withdrawn in the UK, clinicians supporting the palliative needs of patients have faced further challenges, particularly for patients with dementia who are unable to go to a hospice owing to challenging behaviours. It is becoming more important for different services to provide long-term palliative care for patients with dementia. Mental health trusts should construct end-of-life care policies and train staff members accordingly. Through collaborative working, dying patients may be kept where they are best suited. We present the case study of a patient who received end-of-life care at a psychiatric hospital in the UK. We aim to demonstrate how effective end-of-life care might be provided in a psychiatric hospital, in accordance with recent new palliative care guidelines, and highlight potential barriers

A qualitative study of patients’ feedback about Outpatient Parenteral Antimicrobial Therapy (OPAT) services in Northern England : implications for service improvement

AbstractObjective Outpatient parenteral antimicrobial therapy (OPAT) provides opportunities for improved cost savings, but in the UK, implementation is patchy and a variety of service models are in use. The slow uptake in the UK and Europe is due to a number of clinical, financial and logistical issues, including concern about patient safety. The measurement of patient experience data is commonly used to inform commissioning decisions, but these focus on functional aspects of services and fail to examine the relational aspects of care. This qualitative study examines patients’ experiences of OPAT.Design In-depth, semistructured interviews.Setting Purposive sample of OPAT patients recruited from four acute National Health Service (NHS) Trusts in Northern England. These NHS Trusts between them represented both well-established and recently set-up services running nurse at home, hospital outpatient and/or self-administration models.Participants We undertook 28 semistructured interviews and one focus group (n=4).Results Despite good patient outcomes, experiences were coloured by patients' personal situation and material circumstances. Many found looking after themselves at home more difficult than they expected, while others continued to work despite their infection. Expensive car parking, late running services and the inconvenience of waiting in for the nurse to arrive frustrated patients, while efficient services, staffed by nurses with the specialist skills needed to manage intravenous treatment had the opposite effect. Many patients felt a local, general practitioner or community health centre based service would resolve many of the practical difficulties that made OPAT inconvenient. Patients could find OPAT anxiety provoking but this could be ameliorated by staff taking the time to reassure patients and provide tailored information.Conclusion Services configurations must accommodate the diversity of the local population. Poor communication can leave patients lacking the confidence needed to be a competent collaborator in their own care and affect their perceptions of the service.This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0

Teaching periodontal pocket charting to dental students: a comparison of computer assisted learning and traditional tutorials

AIM: The aim of this study was to compare the effectiveness of a computer assisted learning (CAL) programme with that of traditional small group tutorials in teaching theoretical and practical aspects of periodontal pocket charting. METHOD: Sixty-one third year undergraduate dental students were randomized to either receive a tutorial or to work through the CAL programme. Students using the CAL programme completed questionnaires relating to previous computer experience and the ease of use of the programme. All students were assessed immediately after the intervention by means of a confidence log, a practical exercise and a further confidence log. They were assessed again three weeks later by means of a confidence log and a multiple-choice written test. RESULTS: There were very few significant differences between groups for any of the assessments used. However, subjective comments indicated that students occasionally felt disadvantaged if they had not received a tutorial. CONCLUSION: CAL and traditional teaching methods are equally effective in teaching periodontal pocket charting to undergraduate dental students

The evolution of city population density in the United States

Population

EU Membership for Central Europe: Commitments, Speed, and Conditionality

This paper gives a motivation and a method for a fast integration of the reforming countries of central Europe into the European Union. The motivation is based on the idea of self-fulfilling prophecies where the expectation of the entry can trigger the coordination of expectations towards a fast-growth, catch-up equilibrium, and help central Europe avoid the stagnation equilibrium. The method is a target data which enhances the credibility of the integration and a set of conditions and modalities which stimulates the reforms in the applicant countries and ensures that they will contribute to its development