1,874 research outputs found
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 in the atmosphere based on the chosen parameters. The
model can achieve a temperature range exceeding C to 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
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.
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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
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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
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
Registration and Analysis of Vascular Images
We have developed a method for rigidly aligning images of tubes. This paper presents an evaluation of the consistency of that method for three-dimensional images of human vasculature. Vascular images may contain alignment ambiguities, poorly corresponding vascular networks, and non-rigid deformations, yet the Monte Carlo experiments presented in this paper show that our method provides registrations with sub-voxel consistency in less than one minute. Our registration method builds on the principals of our ridges-and-widths tube modeling work; this registration method operates by aligning models of the tubes in a source image with subsequent target images. The registration method’s consistency results from incorporate multi-scale ridge and width measures into the model-image match metric. The method’s speed comes from the use of coarse-to-fine registration strategies that are directly enabled by our tube models and the model-image match metric. In this paper we also show that the method’s insensitivity to local, non-rigid deformations enables the visualization and quantification of the effects of such deformations
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