Monetary Policy and Uncertainty

Central banks must cope with considerable uncertainty about what will happen in the economy when formulating monetary policy. This article describes the different types of uncertainty that arise and looks at examples of uncertainty that the Bank has recently encountered. It then reviews the strategies employed by the Bank to deal with this problem. The other articles in this special issue focus on three of these major strategies.

Native Web Communication Protocols and Their Effects on the Performance of Web Services and Systems

Native Web communication protocols are the pivotal components of Web services, applications and systems. In particular, HTTP is a de facto protocol standard used in almost all Web services and systems. Consequently, it is one of the crucial protocols responsible for the performance of Web services and systems. HTTP/1.1 has been successfully deployed in Web services and systems for the last two decades. However, one of the most significant issues with HTTP/1.1 is the Round Trip Time and Web latency. To resolve this issue, two successor protocols SPDY and HTTP/2 have been developed recently, with some studies suggesting that SPDY improved the performance of Web services and systems, whilst some did not find significant improvements in the performance. HTTP/2 is a relatively new protocol and has yet to be tested with any rigour. Therefore, it is important to investigate the effects of these two enhanced protocols SPDY and HTTP/2 on the performance of Web services and systems. This paper conducts a number of practical investigations to evaluate the performance of Web services and systems with and without the support of SPDY and HTTP/2 protocols at the client and server. This study investigates the impact of SPDY and HTTP/2 on the overall performance of Web services and systems from the end-user's perspective

Mental health: future challenges

The aim of the Foresight Project on Mental Capital and Wellbeing(www.foresight.gov.uk) is to advise the Government on how to achieve the best possible mental development and mental wellbeing for everyone in the UK in the future. The starting point of the Project was to generate an understanding of the science of mental capital and wellbeing (MCW) and to develop a vision for how the size and nature of the challenges exposed by the Project could evolve over the next 20 years. To make this analysis tractable, the work was divided into five broad areas: ● Mental capital through life ● Learning through life ● Mental health ● Wellbeing and work, and ● Learning difficulties. This report presents the findings for “Mental health” and draws upon a comprehensive assessment of the scientific state-of-the art: overall, around 80 reviews have been commissioned across the five areas. Mental health is a term which is used in a number of different ways and which has unfortunately acquired a substantial stigma in all layers of society. While the main focus of this report is on mental ill-health, positive mental health is also vitally important and is also discussed. However, a more comprehensive consideration of positive mental health has been performed in other parts of the Project (as commissioned reviews and in the context of the future of work. This report starts by looking at the situation today, examining the prevalence of important categories of mental disorder. It then considers the risk and protective factors which influence mental ill health, and determines how its prevalence and impact could change in the future, if existing policies and expenditure remain broadly unchanged. An assessment of strategic choices and interventions to meet the future challenges of mental health (and the challenges associated with the other four areas listed above) will be documented in the final Project report which is due for publication in the autumn of 2008

Cost comparison of orthopaedic fracture pathways using discrete event simulation in a Glasgow hospital

Objective: Healthcare faces the continual challenge of improving outcome whilst aiming to reduce cost. The aim of this study was to determine the micro cost differences of the Glasgow non-operative trauma virtual pathway in comparison to a traditional pathway. Design:  Discrete event simulation was used to model and analyse cost and resource utilisation with an activity based costing approach. Data for a full comparison before the process change was unavailable so we utilised a modelling approach, comparing a Virtual Fracture Clinic (VFC) to a simulated Traditional Fracture Clinic (TFC). Setting:  The orthopaedic unit VFC pathway pioneered at Glasgow Royal Infirmary has attracted significant attention and interest and is the focus of this cost study. Outcome measures: Our study focused exclusively on non-operative trauma patients attending Emergency Department or the minor injuries unit and the subsequent step in the patient pathway. Retrospective studies of patient outcomes as a result of the protocol introductions for specific injuries in association with activity costs from the models.ResultsPatients are satisfied with the new pathway, the information provided and the outcome of their injuries (Evidence Level IV). There was a 65% reduction in the number of first outpatient face-to-face attendances in orthopaedics. In the VFC pathway, the resources required per day were significantly lower for all staff groups (p=<0.001). The overall cost per patient of the VFC pathway was £22.84 (95% CI: 21.74, 23.92) per patient compared with £36.81 (95% CI: 35.65, 37.97) for the TFC pathway.  Conclusions:  Our results give a clearer picture of the cost comparison of the virtual pathway over a wholly traditional face-to-face clinic system. The use of simulation-based stochastic costings in healthcare economic analysis has been limited to date, but this study provides evidence for adoption of this method as a basis for its application in other healthcare settings

Microglial KCa3.1 Channels as a Potential Therapeutic Target for Alzheimer's Disease

There exists an urgent need for new target discovery to treat Alzheimer's disease (AD); however, recent clinical trials based on anti-Aβ and anti-inflammatory strategies have yielded disappointing results. To expedite new drug discovery, we propose reposition targets which have been previously pursued by both industry and academia for indications other than AD. One such target is the calcium-activated potassium channel KCa3.1 (KCNN4), which in the brain is primarily expressed in microglia and is significantly upregulated when microglia are activated. We here review the existing evidence supporting that KCa3.1 inhibition could block microglial neurotoxicity without affecting their neuroprotective phagocytosis activity and without being broadly immunosuppressive. The anti-inflammatory and neuroprotective effects of KCa3.1 blockade would be suitable for treating AD as well as cerebrovascular and traumatic brain injuries, two well-known risk factors contributing to the dementia in AD patients presenting with mixed pathologies. Importantly, the pharmacokinetics and pharmacodynamics of several KCa3.1 blockers are well known, and a KCa3.1 blocker has been proven safe in clinical trials. It is therefore promising to reposition old or new KCa3.1 blockers for AD preclinical and clinical trials

Detecting Social Desirability Bias with Human-Computer Interaction: A Mouse-Tracking Study

Social desirability bias undermines self-report accuracy, necessitating novel approaches to detect and mitigate its impact. This study aimed to investigate the influence of social desirability on questionnaire responses by analyzing mouse cursor movements and answering behaviors. Respondents (n=238) completed a health and wellness questionnaire while their mouse cursor data was recorded. The results revealed that individuals under a higher social desirability treatment exhibited significantly longer response times and slower mouse cursor speeds, supporting the hypothesis that they may engage in more cautious and deliberate responding. However, no significant differences were found in terms of mouse cursor deviations or answer switches between the two groups. These findings suggest that analyzing mouse cursor movements can provide valuable insights into the influence of social desirability bias on questionnaire responses, offering a potentially scalable method for detection and future intervention

Building pathways to Success for Low-Skill Adult Students: Lessons for Community College Policy and Practice from a Statewide Longitudinal Tracking Study

This report is based on a first-of-its-kind study of the progress and outcomes of low-skill adults in community colleges. The study uses student record information from the Washington State Community and Technical College System to track two cohorts of adult students 25 or older with at most a high school education who entered one of the state's community or technical colleges for the first time in 1996-97 or 1997-98. The study examines the educational attainment of the students in both cohorts as well as their earnings five years after they enrolled. Key findings from this study are: Attending college for at least a year and earning a credential provides a substantial boost in earnings for adults who begin with a high school diploma or less. Short-term training, such as that often provided to welfare recipients, may help individuals get into the labor market, but does not seem to help them advance beyond low-paying jobs. Neither adult basic skills education by itself nor a limited number of college-level courses provides much benefit in terms of earnings. These findings, which are consistent with previous research, suggest that community and technical colleges ought to make taking at least one year of college-level courses and earning a certificate or other credential a minimum goal for all of the many low-skill adults they serve

Understanding of prognosis in non-metastatic prostate cancer: a randomised comparative study of clinician estimates measured against the PREDICT prostate prognostic model

Abstract: PREDICT Prostate is an individualised prognostic model that provides long-term survival estimates for men diagnosed with non-metastatic prostate cancer (www.prostate.predict.nhs.uk). In this study clinician estimates of survival were compared against model predictions and its potential value as a clinical tool was assessed. Prostate cancer (PCa) specialists were invited to participate in the study. 190 clinicians (63% urologists, 17% oncologists, 20% other) were randomised into two groups and shown 12 clinical vignettes through an online portal. Each group viewed opposing vignettes with clinical information alone, or alongside PREDICT Prostate estimates. 15-year clinician survival estimates were compared against model predictions and reported treatment recommendations with and without seeing PREDICT estimates were compared. 155 respondents (81.6%) reported counselling new PCa patients at least weekly. Clinician estimates of PCa-specific mortality exceeded PREDICT estimates in 10/12 vignettes. Their estimates for treatment survival benefit at 15 years were over-optimistic in every vignette, with mean clinician estimates more than 5-fold higher than PREDICT Prostate estimates. Concomitantly seeing PREDICT Prostate estimates led to significantly lower reported likelihoods of recommending radical treatment in 7/12 (58%) vignettes, particularly in older patients. These data suggest clinicians overestimate cancer-related mortality and radical treatment benefit. Using an individualised prognostic tool may help reduce overtreatment

Influence of tides on melting and freezing beneath Filchner-Ronne Ice Shelf, Antarctica

An isopycnic coordinate ocean circulation model is applied to the ocean cavity beneath Filchner-Ronne Ice Shelf, investigating the role of tides on sub-ice shelf circulation and ice shelf basal mass balance. Including tidal forcing causes a significant intensification in the sub-ice shelf circulation, with an increase in melting (3-fold) and refreezing (6-fold); the net melt rate and seawater flux through the cavity approximately doubles. With tidal forcing, the spatial pattern and magnitude of basal melting and freezing generally match observations. The 0.22 m a(-1) net melt rate is close to satellite-derived estimates and at the lower end of oceanographic values. The Ice Shelf Water outflow mixes with shelf waters, forming a cold (<-1.9 degrees C), dense overflow (0.83 Sv) that spills down the continental slope. These results demonstrate that tidal forcing is fundamental to both ice shelf-ocean interactions and deep-water formation in the southern Weddell Sea. Citation: Makinson, K., P. R. Holland, A. Jenkins, K. W. Nicholls, and D. M. Holland (2011), Influence of tides on melting and freezing beneath Filchner-Ronne Ice Shelf, Antarctica, Geophys. Res. Lett., 38, L06601, doi: 10.1029/2010GL046462