The shifting roles of medical stakeholders in opioid substitution treatment: a comparison between Denmark and the UK

Purpose – The purpose of this paper is to examine the shifting roles of medical professionals as stakeholders in opioid substitution treatment (OST) policies and practices in Denmark and the UK within the past 15 years. Design/methodology/approach – The paper is based on literature reviews, documentary analyses and key informant interviews with a range of stakeholders involved in OST and policy in Denmark and UK. The study is part of the EU-funded project: Addictions and Lifestyles in Contemporary Europe: Reframing Addictions Project. Findings – Denmark and the UK are amongst those few European countries that have long traditions and elaborate systems for providing OST to heroin users. The UK has a history of dominance of medical professionals in drugs treatment, although this has been recently challenged by the recovery movement. In Denmark, a social problem approach has historically dominated the field, but a recent trend towards medicalisation can be traced. As in all kinds of policy changes, multiple factors are at play when shifts occur. We examine how both countries’ developments around drugs treatment policy and practice relate to broader societal, economic and political changes, how such divergent developments emerge and how medical professionals as stakeholders enhanced their roles as experts in the field through a variety of tactics, including the production and use of “evidence”, which became a key tool to promote specific stakeholder’s perspectives in these processes. Originality/value – The paper contributes to current policy and practice debates by providing comparative analyses of drug policies and examination of stakeholder influences on policy processes

Caladan: a distributed meta-OS for data center disaggregation

Data center resource disaggregation promises cost savings by pool-ing compute, storage and memory resources into separate, net-worked nodes. The benefits of this model are clear, but a closer lookshows that its full performance and efficiency potential cannot beeasily realized. Existing systems use CPUs pervasively to interface ar-bitrary devices with the network and to orchestrate communicationamong them, reducing the benefits of disaggregation.In this paper we presentCaladan, a novel system with a trusteduni-versal resource fabricthat interconnects all resources and efficientlyoffloads the system and application control planes to SmartNICs,freeing server CPUs to execute application logic. Caladan offersthree core services: capability-driven distributed name space, virtualdevices, and direct inter-device communications. These servicesare implemented in a trustedmeta-kernelthat executes in per-nodeSmartNICs. Low-level device drivers running on the commodity hostOS are used for setting up accelerators and I/O devices, and exposingthem to Caladan. Applications run in a distributed fashion acrossCPUs and multiple accelerators, which in turn can directly performI/O, i.e., access files, other accelerators or host services. Our dis-tributed dataflow runtime runs on top of this substrate. It orchestratesthe distributed execution, connecting disaggregated resources usingdata transfers and inter-device communication, while eliminatingthe performance bottlenecks of the traditional CPU-centric design

Measurement-Adaptive Cellular Random Access Protocols

This work considers a single-cell random access channel (RACH) in cellular wireless networks. Communications over RACH take place when users try to connect to a base station during a handover or when establishing a new connection. Within the framework of Self-Organizing Networks (SONs), the system should self- adapt to dynamically changing environments (channel fading, mobility, etc.) without human intervention. For the performance improvement of the RACH procedure, we aim here at maximizing throughput or alternatively minimizing the user dropping rate. In the context of SON, we propose protocols which exploit information from measurements and user reports in order to estimate current values of the system unknowns and broadcast global action-related values to all users. The protocols suggest an optimal pair of user actions (transmission power and back-off probability) found by minimizing the drift of a certain function. Numerical results illustrate considerable benefits of the dropping rate, at a very low or even zero cost in power expenditure and delay, as well as the fast adaptability of the protocols to environment changes. Although the proposed protocol is designed to minimize primarily the amount of discarded users per cell, our framework allows for other variations (power or delay minimization) as well.Comment: 31 pages, 13 figures, 3 tables. Springer Wireless Networks 201

Feto-Placental Atherosclerotic Lesions in Intrauterine Fetal Demise: Role of Parental Cigarette Smoking

The atherogenic effect of cigarette smoking is already recognizable in coronary arteries of fetuses in the last gestational weeks. In this study we analyzed the atherogenic effect of mother’s and father’s smoking habit on coronary arteries and even on adnexa of 30 human fresh fetuses died from 32 to 41 gestational weeks. In 12 cases only the mothers of the victims were cigarette smokers, in 7 cases only the fathers were smokers, whereas in 11 cases nobody smoked

Self-Organized Branching Processes: A Mean-Field Theory for Avalanches

We discuss mean-field theories for self-organized criticality and the connection with the general theory of branching processes. We point out that the nature of the self-organization is not addressed properly by the previously proposed mean-field theories. We introduce a new mean-field model that explicitly takes the boundary conditions into account; in this way, the local dynamical rules are coupled to a global equation that drives the control parameter to its critical value. We study the model numerically, and analytically we compute the avalanche distributions.Comment: 4 pages + 4 ps figure

Large deviations for a damped telegraph process

In this paper we consider a slight generalization of the damped telegraph process in Di Crescenzo and Martinucci (2010). We prove a large deviation principle for this process and an asymptotic result for its level crossing probabilities (as the level goes to infinity). Finally we compare our results with the analogous well-known results for the standard telegraph process

Queues with Lévy input and hysteretic control

We consider a (doubly) reflected Lévy process where the Lévy exponent is controlled by a hysteretic policy consisting of two stages. In each stage there is typically a different service speed, drift parameter, or arrival rate. We determine the steady-state performance, both for systems with finite and infinite capacity. Thereby, we unify and extend many existing results in the literature, focusing on the special cases of M/G/1 queues and Brownian motion. © The Author(s) 2009