Earth-Like: An education & outreach tool for exploring the diversity of planets like our own

Earth-Like is an interactive website and twitter bot that allows users to explore changes in the average global surface temperature of an Earth-like planet due to variations in the surface oceans and emerged land coverage, rate of volcanism (degassing), and the level of the received solar radiation. The temperature is calculated using a simple carbon-silicate cycle model to change the level of $\rm CO_2$ in the atmosphere based on the chosen parameters. The model can achieve a temperature range exceeding $-100^\circ$C to $100^\circ$C by varying all three parameters, including freeze-thaw cycles for a planet with our present-day volcanism rate and emerged land fraction situated at the outer edge of the habitable zone. To increase engagement, the planet is visualised by using a neural network to render an animated globe, based on the calculated average surface temperature and chosen values for land fraction and volcanism. The website and bot can be found at earthlike.world and on twitter as @earthlikeworld. Initial feedback via a user survey suggested that Earth-Like is effective at demonstrating that minor changes in planetary properties can strongly impact the surface environment. The goal of the project is to increase understanding of the challenges we face in finding another habitable planet due to the likely diversity of conditions on rocky worlds within our Galaxy.Comment: Accepted for publication in the International Journal of Astrobiology (IJA

Evaluation of the personal health budget pilot programme

1. The personal health budget initiative is a key aspect of personalisation across health care services in England. Its aim is to improve patient outcomes, by placing patients at the centre of decisions about their care. Giving people greater choice and control, with patients working alongside health service professionals to develop and execute a care plan, given a known budget, is intended to encourage more responsiveness of the health and care system. 2. The personal health budget programme was launched by the Department of Health in 2009 after the publication of the 2008 Next Stage Review. An independent evaluation was commissioned alongside the pilot programme with the aim of identifying whether personal health budgets ensured better health and care outcomes when compared to conventional service delivery and, if so, the best way for personal health budgets to be implemented

Spectral triples for higher-rank graph C*-algebras

Author's accepted version (postprint).This is an Accepted Manuscript of an article published by Royal Danish Library in Mathematica Scandinavica on 06/05/2020.Available online: https://www.mscand.dk/article/view/119260acceptedVersio

The Key Events Dose-Response Framework: A Foundation for Examining Variability in Elicitation Thresholds for Food Allergens

Food allergies are caused by immunological reactions in individuals sensitized to normal protein components of foods. For any given sensitized individual, the severity of a reaction is generally assumed to be proportional to the dose of allergenic protein. There is substantial clinical evidence that “threshold” doses exist for the elicitation of an allergic reaction; however, the threshold (i.e., lowest dose that elicits a reaction) varies substantially across the sensitized population. Current approaches to protecting sensitized individuals from exposure to food allergens are highly qualitative (i.e., they rely on food avoidance). The Key Events Dose-Response Framework is an analytical approach for refining understanding of the biological basis of the dose-response. Application of this approach to food allergy provides a foundation for a more rigorous quantitative understanding of variability in allergic response. This study reviews the allergic disease process and the current approaches to identifying thresholds for food allergens. The pathway of key biological events occurring between food intake and allergic response is considered, along with factors that may determine the nature and severity of response to food allergens. Data needs, as well as implications for identifying thresholds, and for characterizing variability in thresholds, are also discussed

Implementing personal health budgets within substance misuse services [final report]

Executive summary 1. The personal health budget initiative is a key aspect of personalisation across health care services in England. Its aim is to improve patient outcomes, by placing patients at the centre of decisions about their care. 2. In 2009 the Department of Health invited PCTs to become pilot sites to join a programme which would explore the opportunities offered by personal health budgets. The Department of Health commissioned an independent evaluation to run alongside the pilot programme to provide information on how personal health budgets are best implemented, where and when they are most appropriate, and what support is required for individuals. 3. Two pilot sites within the pilot programme explored whether personal health budgets had an impact on outcomes and experiences compared to conventional service delivery among individuals with substance misuse problems. Study design and methodology 4. The evaluation adopted a longitudinal approach, and included people with drug and/or alcohol addiction. 5. The study used a controlled trial with a pragmatic design to compare the experiences of people receiving a personal health budget with the experiences of people continuing under the current substance misuse treatment support arrangements. After applying initial selection criteria, in one pilot site people were randomised into the personal health budget group or a control group. In the second pilot site, the personal health budget group was recruited from patients of those health care professionals in the pilot offering budgets, and a control group was recruited from patients of nonparticipating health care professionals. 6. A mixed design was followed where both quantitative and qualitative methodologies were used to explore patient outcomes and experiences, service use and costs, as well as the experiences of those implementing the initiative. In total, an active sample of 166 participants was recruited: 119 in the personal health budget group and 47 in the control group. Within the active study sample, 55 participants had drug and alcohol addictions and 111 participants had an alcohol addiction only. 7. The qualitative analysis involved interviews with personal health budget holders and organisational representatives. Data were analysed using the framework approach, with the data organised by themes according to the topic guides used in the interviews. 8. The difference-in-difference approach was used to explore whether personal health budgets had an impact on an individual’s quality of life and relapse rates. The analysis subtracted an individual’s follow-up outcome scores from their baseline score. Due to the small sample size, the analysis did not include exploring difference-in-difference multivariate models and therefore we were unable to control for confounding baseline differences. The content of support plans 9. Among the personal health budget group, 103 support plans were returned from the two pilot sites. In terms of the size of the budget, 41 budgets were worth between £1,000 and £5,000 per year, while 4 budgets were worth more than £10,000. 2 10. The majority of care/support plans were managed notionally. While one of the pilot sites did have approval to offer direct payments, we did not find evidence this deployment was offered during the pilot programme. 11. Residential detox was the largest single cost category. The more innovative uses of the personal health budget included driving lessons, alternative therapies, leisure activities and educational courses. Enabling people to access community detox rather than residential detox could also be regarded as an innovative use of their budget. The impact of personal health budgets on relapse rates, quality of life and service quality 12. The shortened version of the Alcohol Use Disorders Identification Test (AUDIT-C) was used to detect signs of hazardous and harmful drinking. Difference-in-difference analysis indicated that individuals in the personal health budget group had reduced their excessive drinking at follow-up compared to those in the control group. Similar results were found with the change in drug consumption at followup. 13. Difference-in-difference analysis indicated that there were greater improvements in care-related quality of life (ASCOT) and psychological well-being (GHQ12) for individuals in the personal health budget group compared to those in the control group, although the difference was not statistically significant. 14. Individuals in the personal health budget group were more satisfied with the help paid for by the budget and the care/support planning process than those receiving conventional services. 15. While the quantitative results highlighted the positive impact of receiving a personal health budget, firm conclusions around the impact of personal health budgets compared to conventional service delivery could not be made, due to the small sample size. Views from patients 16. Qualitative in-depth interviews indicated that personal health budgets had a positive impact on service quality, relationships with health professionals and views on what could be achieved compared with conventional service detox delivery. 17. The importance of effective implementation was highlighted, both in terms of providing the necessary information to enable budget holders to make an informed choice and also to minimise any delays in the process of obtaining and using a budget. Individuals reported that delays could potentially lead to anxiety and distress. 18. A list of suggestions of possible uses of personal health budgets would have been useful during the support/care planning stage. 19. Personal budget holders reported a lack of after-care services available with this treatment route which could potentially have a longer-term impact on relapse rates. This desire for post-detox care to prevent relapse was especially prevalent at follow-up, when patients had completed their detoxification and required relapse prevention services. 20. Individuals receiving conventional detox services expressed more negative views of the relationship they had with health professionals and their experiences of services. Views from the system 21. Organisational representatives believed that personal health budgets had a positive impact on outcomes for budget holders: the way they accessed services, and to a certain extent the content or 3 quality of those services. Organisational representatives attributed these impacts to the personal health budgets enabling: increased choice and control for budget holders; increased flexibility; encouraging innovation and creativity; greater ‘person-centred’ care/support planning; and the opportunity to reduce costs by accessing alternative services or providers of services. 22. A number of challenges within the implementation process were mentioned by organisational representatives. These included: the length of time required to conduct the care/support planning process; the time point at which a personal health budget should be introduced; deciding what can and cannot be included, in particular considering whether the budget should be used for relapse prevention; managing attitudes to risk and the cultural change required for patients in the system; the logistics of managing multi-agencies involved in a person’s care; and establishing integration between services and creating a jointly-funded budget. Recommendations for policy and practice 23. A number of recommendations can be made regarding a possible roll-out of personal health budgets within the area of substance misuse from the results of this study: Personal health budgets increased service satisfaction, facilitated a positive relationship with health professionals and improved quality of life supporting a wider roll-out. The budget-holders we interviewed emphasised the value of information and guidance from operational representatives about the size and operation of their budgets, including what services were covered. Direct payments were viewed as playing a critical role in the success of personal health budgets for people with substance misuse problems. However, managing the anxiety and practical challenges around offering this deployment option may need consideration

Assessing the relationship between district and state policies and school nutrition promotion-related practices in the United States

School environments are an optimal setting to promote healthy student diets, yet it is unclear what role state and district policies play in shaping school contexts. This study examined how state and district policies are associated with school-reported practices for promoting student participation in school lunch programs. School nutrition manager data were obtained from the School Nutrition and Meal Cost Study\u27s (SNMCS) sample of 1210 schools in 46 states and the District of Columbia (DC) during school year 2014-2015. Relevant state laws and district policies were compiled and coded. Multivariable logistic and Poisson regressions, controlling for school characteristics, examined the relationship between state/district laws/policies and school practices. Compared to schools in districts or states with no policies/laws, respectively, schools were more likely to provide nutritional information on school meals (AOR = 2.59, 95% CI = 1.33, 5.05) in districts with strong policies, and to promote school meals at school events (AOR = 1.93, CI = 1.07, 3.46) in states with strong laws. Schools in states with any laws related to strategies to increase participation in school meals were more likely to seek student involvement in menu planning (AOR = 2.02, CI = 1.24, 3.31) and vegetable offerings (AOR = 2.00, CI = 1.23, 3.24). The findings support the association of laws/policies with school practices

Tiled Algorithms for Matrix Computations on Multicore Architectures

The current computer architecture has moved towards the multi/many-core structure. However, the algorithms in the current sequential dense numerical linear algebra libraries (e.g. LAPACK) do not parallelize well on multi/many-core architectures. A new family of algorithms, the tile algorithms, has recently been introduced to circumvent this problem. Previous research has shown that it is possible to write efficient and scalable tile algorithms for performing a Cholesky factorization, a (pseudo) LU factorization, and a QR factorization. The goal of this thesis is to study tiled algorithms in a multi/many-core setting and to provide new algorithms which exploit the current architecture to improve performance relative to current state-of-the-art libraries while maintaining the stability and robustness of these libraries.Comment: PhD Thesis, 2012 http://math.ucdenver.ed

Above and beyond the call. Long-term real earnings effects of British male military conscription in the post-war years

We add to the literature on the long-term economic effects of male military service. We concentrate on post-war British conscription into the armed services from 1949 to 1960. It was called National Service and applied to males aged 18 to 26. Based on a regression discontinuity design we estimate the effect of military service on the earnings of those required to serve through conscription. We argue that, in general, we should not expect to find large long-term real earnings among conscripts compared to later birth cohorts of males who were not eligible for call-up. Our empirical evidence firmly rejects the view that conscription entails relative long-term real earnings differences

Coming Out to Care: Caregivers of Gay and Lesbian Seniors in Canada

Purpose: This article reports on the findings of a study whose purpose was to explore the experiences of caregivers of gay and lesbian seniors living in the community and to identify issues that emerged from an exploration of access to and equity in health care services for these populations. Design and Methods: The study used a qualitative methodology based upon principles of grounded theory in which open-ended interviews were undertaken with 17 caregivers living in three different cities across Canada. Results: Findings indicated several critical themes, including the impact of felt and anticipated discrimination, complex processes of coming out, the role of caregivers, self-identification as a caregiver, and support. Implications:  We consider several recommendations for change in light of emerging themes, including expanding the definition of caregivers to be more inclusive of gay and lesbian realities, developing specialized services, and advocating to eliminate discrimination faced by these populations