A First Map of the CMB at 0.5Deg Resolution

We use a Maximum Entropy technique to reconstruct a map of the microwave sky near the star Gamma Ursae Minoris, based on data from flights 2, 3 and 4 of the Millimeter-wave Anisotropy eXperiment (MAX).Comment: 5 pages plus 3 postscript figures, uuencoded compressed postscript, CfPA-94-TH-5

Detailed Simulation of the Cochlea: Recent Progress Using Large Shared Memory Parallel Computers

We have developed and are refining a detailed three-dimensional computational model of the human cochlea. The model uses the immersed boundary method to calculate the fluid-structure interactions produced in response to incoming sound waves. An accurate cochlear geometry obtained from physical measurements is incorporated. The model includes a detailed and realistic description of the various elastic structures present. Initially, a macro-mechanical computational model was developed for execution on a CRAY T90 at the San Diego Supercomputing Center. This code was ported to the latest generation of shared memory high performance servers from Hewlett Packard. Using compiler generated threads and OpenMP directives, we have achieved a high degree of parallelism in the executable, which has made possible to run several large scale numerical simulation experiments to study the interesting features of the cochlear system. In this paper, we outline the methods, algorithms and software tools that were used to implement and fine tune the code, and discuss some of the simulation results

The COBE Normalization for Standard CDM

The COBE detection of CMB anisotropies provides the best way of fixing the amplitude of fluctuations on the largest scales. This normalization is usually given for an n=1 spectrum, including only the anisotropy caused by the Sachs- Wolfe effect. This is certainly not a good approximation for a model containing any reasonable amount of baryonic matter. In fact, even tilted S-W spectra are not a good fit to models like CDM. Here we normalize standard CDM (sCDM) to the 2-year COBE data, and quote the best amplitude in terms of the conventionally used measures of power. We also give normalizations for some specific variants of this standard model, and we indicate how the normalization depends on the assumed values of n, Omega_B and H_0. For sCDM we find =19.9\pm1.5uK, corresponding to sigma_8=1.34\pm0.10, with the normalization at large scales being B=(8.16\pm1.04)\times10^5 (Mpc/h)^4, and other numbers given in the Table. The measured rms temperature fluctuation smoothed on 10deg is a little low relative to this normalization. This is mainly due to the low quadrupole in the data: when the quadrupole is removed, the measured value of sigma(10) is quite consistent with the best-fitting . The use of should be preferred over sigma(10), when its value can be determined for a particular theory, since it makes full use of the data.Comment: 4 pages compressed uuencoded postscript. We have corrected an error in our analysi

Maximum likelihood analysis of systematic errors in interferometric observations of the cosmic microwave background

We investigate the impact of instrumental systematic errors in interferometric measurements of the cosmic microwave background (CMB) temperature and polarization power spectra. We simulate interferometric CMB observations to generate mock visibilities and estimate power spectra using the statistically optimal maximum likelihood technique. We define a quadratic error measure to determine allowable levels of systematic error that do not induce power spectrum errors beyond a given tolerance. As an example, in this study we focus on differential pointing errors. The effects of other systematics can be simulated by this pipeline in a straightforward manner. We find that, in order to accurately recover the underlying B-modes for r=0.01 at 28<l<384, Gaussian-distributed pointing errors must be controlled to 0.7^\circ rms for an interferometer with an antenna configuration similar to QUBIC, in agreement with analytical estimates. Only the statistical uncertainty for 28<l<88 would be changed at ~10% level. With the same instrumental configuration, we find the pointing errors would slightly bias the 2-\sigma upper limit of the tensor-to-scalar ratio r by ~10%. We also show that the impact of pointing errors on the TB and EB measurements is negligibly small.Comment: 10 pages, 4 figures, accepted for publication in ApJS. Includes improvements in clarity of presentation and Fig.4 added, in response to refere

Sensitivity of a Bolometric Interferometer to the CMB power spectrum

Context. The search for B-mode polarization fluctuations in the Cosmic Microwave Background is one of the main challenges of modern cosmology. The expected level of the B-mode signal is very low and therefore requires the development of highly sensitive instruments with low systematic errors. An appealing possibility is bolometric interferometry. Aims. We compare in this article the sensitivity on the CMB angular power spectrum achieved with direct imaging, heterodyne and bolometric interferometry. Methods. Using a simple power spectrum estimator, we calculate its variance leading to the counterpart for bolometric interferometry of the well known Knox formula for direct imaging. Results. We find that bolometric interferometry is less sensitive than direct imaging. However, as expected, it is finally more sensitive than heterodyne interferometry due to the low noise of the bolometers. It therefore appears as an alternative to direct imagers with different and possibly lower systematic errors, mainly due to the absence of an optical setup in front of the horns.Comment: 5 pages, 3 figures. This last version matches the published version (Astronomy and Astrophysics 491 3 (2008) 923-927). Sensitivity of Heterodyne Interferometers modified by a factor of tw

Force Posture and Dissuasion; Strategic Insights, v. 3 issue 10 (October 2004)

This article appeared in Strategic Insights, v.3 issue 10 (October 2004)PROBLEM BITSTREA

The nursing contribution to chronic disease management: a whole systems approach: Report for the National Institute for Health Research Service Delivery and Organisation programme

Background Transforming the delivery of care for people with Long Term Conditions (LTCs) requires understanding about how health care policies in England and historical patterns of service delivery have led to different models of chronic disease management (CDM). It is also essential in this transformation to analyse and critique the models that have emerged to provide a more detailed evidence base for future decision making and better patient care. Nurses have made, and continue to make, a particular contribution to the management of chronic diseases. In the context of this study, there is a particular focus on the origins of each CDM model examined, the processes by which nursing care is developed, sustained and mainstreamed, and the outcomes of each case study as experienced by service users and carers. Aims To explore, identify and characterise the origins, processes and outcomes of effective CDM models and the nursing contribution to such models using a whole systems approach Methods The study was divided into three phases: Phase 1: Systematic mapping of published and web-based literature. Phase 2: A consensus conference of nurses working within CDM. Sampling criteria were derived from the conference and selected nurses attended a follow up workshop where case study sites were identified. Phase 3: Multiple case study evaluation Sample: 7 case studies representing 4 CDM models. These were: i) public health nursing model; ii) primary care nursing model; iii) condition specific nurse specialist model; iv) community matron model. Methods: Evaluative case study design with the unit of analysis the CDM model (Yin, 2003): • semi-structured interviews with practitioners, patients, their carers, managers and commissioners • documentary analysis • psycho-social and clinical outcome data from specific conditions • children and young people: focus groups, age-specific survey tools. Benchmarking outcomes: Adults benchmarked against the Health Outcomes Data Repository (HODaR) dataset (Currie et al, 2005). Young people were benchmarked against the Health Behaviour of School aged Children Survey (Currie et al, 2008). Cost analysis: Due to limitations in the available data, a simple costing exercise was undertaken to ascertain the per patient cost of the nurse contribution to CDM in each of the models, and to explore patterns of health and social care utilisation. Analysis: A whole system methodology was used to establish the principles of CDM. i) The causal system is a “network of causal relationships” and focuses on long term trends and processes. ii) The data system recognises that for many important areas there is very little data. Where a particular explanatory factor is important but precise data are lacking, a range of methods should be employed to illuminate each factor as much as possible. iii) The organisational whole system emphasises how various parts of the health and social care system function together as a single system rather than as parallel systems. iv) The patient experience recognises that the whole system comes together and is embodied in the experience of each patient. Key findings While all the models strove to be patient centred in their implementation, all were linked at a causal level to disease centric principles of care which dominated the patient experience. Public Health Model • The users (both parents and children) experienced a well organised and coordinated service that is crossing health and education sectors. • The lead school nurse has provided a vision for asthma management in school-aged children. This has led to the implementation of the school asthma strategy, and the ensuing impacts including growing awareness, prevention of hospital admissions, confidence in schools about asthma management and healthier children. Primary Care Model • GP practices are providing planned and routine management of chronic disease, tending to focus on single diseases treated in isolation. Care is geared to the needs of the uncomplicated stable patient. • More complex cases tend to be escalated to secondary care where they may remain even after the patient has stabilised. • Patients with multiple diagnoses continue to experience difficulty in accessing services or practice that is designed to provide a coherent response to the idiosyncratic range of diseases with which they present. This is as true for secondary care as for primary care. • While the QOF system has clearly been instrumental in developing and sustaining a primary care nursing model of CDM, it has also limited the scope of the model to single diseases recordable on a register, rather than focus on patient centred care needs. Nurse Specialist Model • The model works under a disease focused system underpinned by evidence based medicine exemplified by NICE guidelines and NSF’s. • The model follows a template drawn from medicine and sustainability is significantly dependent on the championship and protectionism offered by senior medical clinicians. • A focus on self-management in LTCs gives particular impetus to nurse-led enablement of self-management. • The shift of LTC services from secondary care to primary care has often not been accompanied by a shift in expertise. Community Matron Model • The community matron model was distinctive in that it had been implemented as a top down initiative. • The model has been championed by the community matrons themselves, and the pressure to deliver observable results such as hospital admission reductions has been significant. • This model was the only one that consistently resulted in open access (albeit not 24 hours) and first point of contact for patients for the management of their ongoing condition. Survey Findings Compared to patients from our case studies those within HODaR visited the GP, practice nurse or NHS walk-in centres more, but had less home visits from nurses or social services within the six weeks prior to survey. HODaR patients also took significantly more time off work and away from normal activities, and needed more care from friends/ relatives than patients from our study within the last six weeks. The differences between the HODaR and case study patients in service use cannot easily be explained but it could be speculated when referring to the qualitative data that the case study patients are benefiting from nurse-led care. Cost analysis – The nurse costs per patient are at least ten times higher for community matrons conducting CDM than for nurses working in other CDM models. The pattern of service utilisation is consistent with the focus of the community matron role to provide intensive input to vulnerable patients. Conclusions Nurses are spearheading the kind of approaches at the heart of current health policies (Department of Health, 2008a). However, tensions in health policy and inherent contradictions in the context of health care delivery are hampering the implementation of CDM models and limiting the contribution nurses are able to make to CDM. These include: ? data systems that were incompatible and recorded patients as a disease entity ? QOF reinforced a disease centric approach ? practice based commissioning was resulting in increasing difficulties in cross health sector working in some sites ? the value of the public health model may not be captured in evaluation tools which focus on the individual patient experience. Recommendations Commissioners and providers 1. Disseminate new roles and innovations and articulate how the role or service fits and enhances existing provision. 2. Promote the role of the nurses in LTC management to patients and the wider community. 3. Actively engage with service users in shaping LTC services to meet patients’ needs. 4. Improve the support and supervision for nurses working within new roles. 5. Develop training and skills of nurses working in the community to enable them to take a more central role in LTC management. 6. Develop organisations that are enabling of innovation and actively seek funding for initiatives that provide an environment where nurses can reach their potential in improving LTC services. 7. Work towards data systems that are compatible between sectors and groups of professionals. Explore ways of enabling patients to access data and information systems for test results and latest information. 8. Promote horizontal as well as vertical integration of LTC services. Practitioners 1. Increase awareness of patient identified needs through active engagement with the service user. 2. Work to develop appropriate measures of nursing outcomes in LTC management including not only bureaucratic and physiological outcomes, but patient-identified outcomes. Implications of research findings 1. Investment should be made into changing patient perceptions about the traditional division of labour, the nurses’ role and skills, and the expertise available in primary care for CDM. 2. Development and evaluation of patient accessible websites where patients can access a range of information, their latest test results and ways of interpreting these. 3. Long-term funding of prospective evaluations to enable identification of CDM outcomes. 4. Mapping of patient experience and patient satisfaction so that the conceptual differences between these two related ideas can be demonstrated. 5. Development of appropriate measures of patient experience that can be used as part of the quality outcome measures. 6. Cost evaluation/effectiveness studies carried out over time that includes national quality outcome indicators and valid measures of patient experience. 7. The importance of whole system working needs to be identified in the planning of services. 8. Research into the role of the health visitor in chronic disease management within a public health model

Preventing Insider Theft: Lessons from the Casino and Pharmaceutical Industries

Through structured interviews and a literature review, we assess which approaches to protection against insider thefts in the casino and pharmaceutical industries could be usefully applied to strengthen protections against insider theft in the nuclear industry, where insider thefts could have very high consequences. Among other measures, we suggest consideration of constant video surveillance of all vaults and insider-material interactions; frequent and rigorous material accounting; requiring everyone who touches material to sign for it; implementing an expanded two-person rule; rewarding attention to security; and establishing incident databases and experience sharing. While many of these measures are in place for some operations with weapons-usable material in some countries, they should be considered for more universal application

Inflation and the cosmic microwave background

I give a status report and outlook concerning the use of the cosmic microwave background anisotropies to constrain the inflationary cosmology, and stress its crucial role as an underlying paradigm for the estimation of cosmological parameters.Comment: 8 pages LaTeX file, with two figures incorporated using epsf. To appear, proceedings of `The non-sleeping universe', Porto (Astrophysics and Space Science

Proceedings of the Spacecraft Charging Technology Conference: Executive Summary

Aerospace environments are reviewed in reference to spacecraft charging. Modelling, a theoretical scheme which can be used to describe the structure of the sheath around the spacecraft and to calculate the charging currents within, is discussed. Materials characterization is considered for experimental determination of the behavior of typical spacecraft materials when exposed to simulated geomagnetic substorm conditions. Materials development is also examined for controlling and minimizing spacecraft charging or at least for distributing the charge in an equipotential manner, using electrical conductive surfaces for materials exposed to space environment