PVT-NG sensor final report.

This document is a final report for the polyvinyl toluene (PVT) neutron-gamma (PVT-NG) project, which was sponsored by the Domestic Nuclear Detection Office (DNDO). The PVT-NG sensor uses PVT detectors for both gamma and neutron detection. The sensor exhibits excellent spectral resolution and gain stabilization, which are features that are beneficial for detection of both gamma-ray and neutron sources. In fact, the ability to perform isotope identification based on spectra that were measured by the PVT-NG sensor was demonstrated. As described in a previous report, the neutron sensitivity of the first version of the prototype was about 25% less than the DNDO requirement of 2.5 cps/ng for bare Cf-252. This document describes design modifications that were expected to improve the neutron sensitivity by about 50% relative to the PVT-NG prototype. However, the project was terminated before execution of the design modifications after portal vendors demonstrated other technologies that enable neutron detection without the use of He-3. Nevertheless, the PVT-NG sensor development demonstrated several performance goals that may be useful in future portal designs

TB STIGMA – MEASUREMENT GUIDANCE

TB is the most deadly infectious disease in the world, and stigma continues to play a significant role in worsening the epidemic. Stigma and discrimination not only stop people from seeking care but also make it more difficult for those on treatment to continue, both of which make the disease more difficult to treat in the long-term and mean those infected are more likely to transmit the disease to those around them. TB Stigma – Measurement Guidance is a manual to help generate enough information about stigma issues to design and monitor and evaluate efforts to reduce TB stigma. It can help in planning TB stigma baseline measurements and monitoring trends to capture the outcomes of TB stigma reduction efforts. This manual is designed for health workers, professional or management staff, people who advocate for those with TB, and all who need to understand and respond to TB stigma

Systematic review assessing the evidence for the use of stem cells in fracture healing

Background Bone demonstrates good healing capacity, with a variety of strategies being utilised to enhance this healing. One potential strategy that has been suggested is the use of stem cells to accelerate healing. Objectives Identify and assess the current evidence for the use of stem cells in fracture healing, focussing on the intervention procedure and outcome measurement. Data Sources MEDLINE, CENTRAL, EMBASE, Cochrane Database of Systematic Reviews, WHO-ICTRP, ClinicalTrials.gov, and reference checking of included studies. Study Eligibility Criteria Population: Any adults who have sustained a fracture, not including those with pre-existing bone defects. Intervention: Use of stem cells from any source in the fracture site by any mechanism. Control: Fracture healing without the use of stem cells. Studies without a comparator were also included. Outcome: Any reported outcomes. Study design: Randomised Controlled Trials (RCTs), non-randomised or observational studies, and case series. Synthesis Ninety-four eligible studies were identified. The clinical and methodological aspects of the studies were too heterogeneous for a meta-analysis to be undertaken. A narrative synthesis examined study characteristics, stem cell methods (source, aspiration, concentration, application) and outcomes. Conclusions: Insufficient high-quality evidence is available to determine the efficacy of stem cells for fracture healing. The studies were heterogeneous in population, methods, and outcomes. Work to address these issues and establish standards for future research should be undertaken. Registration ID: CRD4201914204

Quality improvement and hospital financial performance

The objective of this study was to examine the association between the scope and intensity of Quality improvement (QI) implementation in hospitals and organizational performance. A sample of 1,784 community hospitals was used to assess relationships between QI implementation approach and two hospital-level performance indicators: cash flow and cost per case. Two-stage instrumental variables estimation, in which predicted values (instruments) of eight QI intensity and scope variables plus control (exogenous) variables were used to estimate hospital-level performance indicators. Our results suggest that QI has a measurable impact on global measures of organizational performance and that both control and leaning approaches to QI matter in these settings. Hospitals that implement QI effectively can reasonably expect to improve their financial and cost performance, or at least not place the hospital at risk for investing in quality improvement. These outcomes are specific to QI strategies that emphasize both control and learning. Copyright © 2006 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/55840/1/401_ftp.pd

Impact of oral cyclophosphamide on health-related quality of life in patients with active scleroderma lung disease: Results from the scleroderma lung study

Objective To assess the impact of cyclophosphamide (CYC) on the health-related quality of life (HRQOL) of patients with scleroderma after 12 months of treatment. Methods One hundred fifty-eight subjects participated in the Scleroderma Lung Study, with 79 each randomized to CYC and placebo arms. The study evaluated the results of 3 measures of health status: the Short Form 36 (SF-36), the Health Assessment Questionnaire (HAQ) disability index (DI), and Mahler's dyspnea index, and the results of 1 preference-based measure, the SF-6D. The differences in the HRQOL between the 2 groups at 12 months were calculated using a linear mixed model. Responsiveness was evaluated using the effect size. The proportion of subjects in each treatment group whose scores improved at least as much as or more than the minimum clinically important difference (MCID) in HRQOL measures was assessed. Results After adjustment for baseline scores, differences in the HAQ DI, SF-36 role physical, general health, vitality, role emotional, mental health scales, and SF-36 mental component summary (MCS) score were statistically significant for CYC versus placebo ( P < 0.05). Effect sizes were negligible (<0.20) for all of the scales of the SF-36, HAQ DI, and SF-6D at 12 months. In contrast, a higher proportion of patients who received CYC achieved the MCID compared with placebo in the HAQ DI score (30.9% versus 14.8%), transitional dyspnea index score (46.4% versus 12.7%), SF-36 MCS score (33.3% versus 18.5%), and SF-6D score (21.3% versus 3.8%). Conclusion One year of treatment with CYC leads to an improvement in HRQOL in patients with scleroderma lung disease.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/56039/1/22580_ftp.pd

‘You can’t show impact with a new pair of shoes’: negotiating disadvantage through Pupil Premium

The Pupil Premium policy was introduced in 2010 by the UK coalition government to tackle the attainment gap disproportionately affecting children from low-income families. Semi-structured interviews and policy documents are examined for the way the policy has been enacted in a single comprehensive secondary school in England. In 2014, this school had a lower population of Pupil Premium pupils (18%) compared to (29%) nationally and (25%) countywide. Despite this, the study provides evidence that the Pupil Premium has become invested within and gives rise to, a number of neoliberal techniques, technologies and practices. The study bridges insights from Mitchell Dean’s ‘analytics of government’ and Ball et al.’s work on policy enactment to provide an in-depth, grounded analysis of the way the policy plays out within this school’s context. It argues that the combination of national accountability measures used to show impact for Pupil Premium, and the school’s ongoing struggle to raise overall attainment, leads school leaders and staff members to rethink the concept of disadvantage for their school population. This results in disadvantage being reconceptualised to fit a matrix of moral/pastoral obligations and efficiency/economic competitiveness, in which the tensions between these two orientations are uncomfortable and unresolved

Catching Element Formation In The Act

Gamma-ray astronomy explores the most energetic photons in nature to address some of the most pressing puzzles in contemporary astrophysics. It encompasses a wide range of objects and phenomena: stars, supernovae, novae, neutron stars, stellar-mass black holes, nucleosynthesis, the interstellar medium, cosmic rays and relativistic-particle acceleration, and the evolution of galaxies. MeV gamma-rays provide a unique probe of nuclear processes in astronomy, directly measuring radioactive decay, nuclear de-excitation, and positron annihilation. The substantial information carried by gamma-ray photons allows us to see deeper into these objects, the bulk of the power is often emitted at gamma-ray energies, and radioactivity provides a natural physical clock that adds unique information. New science will be driven by time-domain population studies at gamma-ray energies. This science is enabled by next-generation gamma-ray instruments with one to two orders of magnitude better sensitivity, larger sky coverage, and faster cadence than all previous gamma-ray instruments. This transformative capability permits: (a) the accurate identification of the gamma-ray emitting objects and correlations with observations taken at other wavelengths and with other messengers; (b) construction of new gamma-ray maps of the Milky Way and other nearby galaxies where extended regions are distinguished from point sources; and (c) considerable serendipitous science of scarce events -- nearby neutron star mergers, for example. Advances in technology push the performance of new gamma-ray instruments to address a wide set of astrophysical questions.Comment: 14 pages including 3 figure