Depoliticisation, Resilience and the Herceptin Post-code Lottery Crisis: Holding Back the Tide

This article: Covers new empirical terrain in the study of depoliticisation, with an in-depth case study of health technology regulation; Analyses depoliticisation from a novel analytical perspective, examining how depoliticised institutions are resilient to external pressure for politicisation; Posits a distinctive framework for analysing resilience, drawing on cognate literatures on policy networks and agencification; Raises interesting and distinctive questions about the nature of depoliticisation in advanced liberal democracies, arguing it is more contested than commonly acknowledged. Depoliticisation as a concept offers distinctive insights into how governments attempt to relieve political pressures in liberal democracies. Analysis has examined the effects of depoliticisation tactics on the public, but not how those tactics are sustained during moments of political tension. Drawing on policy networks and agencification literatures, this article examines how these tactics are resilient against pressure for politicisation. Using an in-depth case study of the controversial appraisal of cancer drug Herceptin in 2005/6 by the National Institute for Health and Clinical Excellence (NICE), the article examines how ‘resilient’ NICE was to external politicisation. It is argued that NICE was resilient because it was effectively ‘insulated’ by formal procedures and informal norms of deference to scientific expertise. This mechanism is termed ‘institutional double glazing’. The conclusion suggests developments to the conceptual and methodological framework of depoliticisation, and highlights theoretical insights into the nature of ‘anti-politics’ in contemporary democracies

Neutron-Rich Nuclei in Heaven and Earth

An accurately calibrated relativistic parametrization is introduced to compute the ground state properties of finite nuclei, their linear response, and the structure of neutron stars. While similar in spirit to the successful NL3 parameter set, it produces an equation of state that is considerably softer -- both for symmetric nuclear matter and for the symmetry energy. This softening appears to be required for an accurate description of several collective modes having different neutron-to-proton ratios. Among the predictions of this model are a symmetric nuclear-matter incompressibility of K=230 MeV and a neutron skin thickness in 208Pb of Rn-Rp=0.21 fm. Further, the impact of such a softening on the properties of neutron stars is as follows: the model predicts a limiting neutron star mass of Mmax=1.72 Msun, a radius of R=12.66 km for a ``canonical'' M=1.4 Msun neutron star, and no (nucleon) direct Urca cooling in neutrons stars with masses below M=1.3 Msun.Comment: 4 pages, 3 tables, and no figure

High-density Skyrmion matter and Neutron Stars

We examine neutron star properties based on a model of dense matter composed of B=1 skyrmions immersed in a mesonic mean field background. The model realizes spontaneous chiral symmetry breaking non-linearly and incorporates scale-breaking of QCD through a dilaton VEV that also affects the mean fields. Quartic self-interactions among the vector mesons are introduced on grounds of naturalness in the corresponding effective field theory. Within a plausible range of the quartic couplings, the model generates neutron star masses and radii that are consistent with a preponderance of observational constraints, including recent ones that point to the existence of relatively massive neutron stars with mass M 1.7 Msun and radius R (12-14) km. If the existence of neutron stars with such dimensions is confirmed, matter at supra-nuclear density is stiffer than extrapolations of most microscopic models suggest.Comment: 27 pages, 5 figures, AASTeX style; to be published in The Astrophysical Journa

Do people with intellectual disabilities understand their prescription medication? A scoping review

© 2019 The Authors. Journal of Applied Research in Intellectual Disabilities Published by John Wiley & Sons Ltd.Background: People with intellectual disabilities are more likely to experience poor health than the general population and are frequently prescribed multiple medications. Therefore, it is important that people with intellectual disabilities understand their medication and potential adverse effects. Method: A scoping review explored people with intellectual disabilities' knowledge of prescription medications, their risks and how medication understanding can be improved. Results: Ten journal articles were included. People with intellectual disabilities often lacked understanding of their medication, including its name, purpose and when and how to take it. Participants were often confused or unaware of adverse effects associated with their medication. Information was sometimes explained to carers rather than people with intellectual disabilities. Some interventions and accessible information helped to improve knowledge in people with intellectual disabilities. Conclusion: There is a need for accessible and tailored information about medication to be discussed with people with intellectual disabilities in order to meet legal and best practice standards.Peer reviewe

Multi-telescope timing of PSR J1518+4904

PSR J1518+4904 is one of only 9 known double neutron star systems. These systems are highly valuable for measuring the masses of neutron stars, measuring the effects of gravity, and testing gravitational theories. We determine an improved timing solution for a mildly relativistic double neutron star system, combining data from multiple telescopes. We set better constraints on relativistic parameters and the separate masses of the system, and discuss the evolution of PSR J1518+4904 in the context of other double neutron star systems. PSR J1518+4904 has been regularly observed for more than 10 years by the European Pulsar Timing Array (EPTA) network using the Westerbork, Jodrell Bank, Effelsberg and Nancay radio telescopes. The data were analysed using the updated timing software Tempo2. We have improved the timing solution for this double neutron star system. The periastron advance has been refined and a significant detection of proper motion is presented. It is not likely that more post-Keplerian parameters, with which the individual neutron star masses and the inclination angle of the system can be determined separately, can be measured in the near future. Using a combination of the high-quality data sets present in the EPTA collaboration, extended with the original GBT data, we have constrained the masses in the system to m_p1.55 msun (95.4% confidence), and the inclination angle of the orbit to be less than 47 degrees (99%). From this we derive that the pulsar in this system possibly has one of the lowest neutron star masses measured to date. From evolutionary considerations it seems likely that the companion star, despite its high mass, was formed in an electron-capture supernova.Comment: 11 pages, 8 figures, accepted by A&

The identification and psychological treatment of panic disorder in adolescents: a survey of CAMHS clinicians

Background Panic disorder is experienced by around 1% of adolescents, and has a significant impact on social and academic functioning. Preliminary evidence supports the effectiveness of panic disorder specific treatment in adolescents with panic disorder, however panic disorder may be overlooked in adolescents due to overlapping symptoms with other anxiety disorders and other difficulties being more noticeable to others. The aim of this study was to establish what training National Health Service (NHS) Child and Adolescent Mental Health Services (CAMHS) clinicians have received in psychological therapies and panic disorder and how they identify and treat panic disorder in adolescents. Method CAMHS clinicians from a range of professions (n = 427), who were delivering psychological treatments to children and adolescents with anxiety disorders, participated. They completed a cross-sectional, online survey, including a vignette describing an adolescent with panic disorder, and were asked to identify the main diagnosis or presenting problem. Results Less than half the clinicians (48.6%) identified panic disorder or panic symptoms as the main presenting problem from the vignette. The majority of clinicians suggested CBT would be their treatment approach. However, few identified an evidence-based treatment protocol for working with young people with panic disorder. Almost half the sample had received no training in cognitive behaviour therapy (CBT) and around a fifth had received no training in delivering psychological treatments. Conclusions Only half of CAMHS clinicians identified panic disorder from a vignette and although CBT treatments are widely offered, only a minority of adolescents with panic disorder are receiving treatments developed for, and evaluated with young people with panic disorder. There is a vital need for clinician training, the use of tools that aid identification and the implementation of evidence-based treatments within CAMHS

Radio Pulses along the Galactic Plane

We have surveyed 68 deg^2 along the Galactic Plane for single, dispersed radio pulses. Each of 3027 independent pointings was observed for 68 s using the Arecibo telescope at 430 MHz. Spectra were collected at intervals of 0.5 ms and examined for pulses with duration 0.5 to 8 ms. Such single pulse analysis is the most sensitive method of detecting highly scattered or highly dispersed signals from pulsars with large pulse-to-pulse intensity variations. A total of 36 individual pulses from five previously known pulsars were detected, along with a single pulse not associated with a previously known source. Follow-up observations discovered a pulsar, PSR J1918+08, from which the pulse originated. This pulsar has period 2.130 s and dispersion measure 30 pc cm^-3, and has been seen to emit single pulses with strength up to 8 times the average.Comment: 14 pages, 5 figures, AASTeX, accepted by the Astrophysical Journa

Stability window and mass-radius relation for magnetized strange quark stars

The stability of magnetized strange quark matter (MSQM) is investigated within the phenomenological MIT bag model, taking into account the variation of the relevant input parameters, namely, the strange quark mass, baryon density, magnetic field and bag parameter. We obtain that the energy per baryon decreases as the magnetic field increases, and its minimum value at vanishing pressure is lower than the value found for SQM. This implies that MSQM is more stable than non-magnetized SQM. Furthermore, the stability window of MSQM is found to be wider than the corresponding one of SQM. The mass-radius relation for magnetized strange quark stars is also derived in this framework.Comment: 12 pages, 6 figures, 3 table

A precise mass measurement of the intermediate-mass binary pulsar PSR J1802-2124

PSR J1802-2124 is a 12.6-ms pulsar in a 16.8-hour binary orbit with a relatively massive white dwarf (WD) companion. These properties make it a member of the intermediate-mass class of binary pulsar (IMBP) systems. We have been timing this pulsar since its discovery in 2002. Concentrated observations at the Green Bank Telescope, augmented with data from the Parkes and Nancay observatories, have allowed us to determine the general relativistic Shapiro delay. This has yielded pulsar and white dwarf mass measurements of 1.24(11) and 0.78(4) solar masses (68% confidence), respectively. The low mass of the pulsar, the high mass of the WD companion, the short orbital period, and the pulsar spin period may be explained by the system having gone through a common-envelope phase in its evolution. We argue that selection effects may contribute to the relatively small number of known IMBPs.Comment: 9 pages, 4 figures, 3 tables, accepted for publication in the Astrophysical Journa