Business models in health care: Accounting for the sustainability of palliative and end of life care provision by voluntary hospices' in England

This study evaluates the sustainability of palliative and end of life care provision by voluntary hospices in England. Using a mixed methods, inductive approach, we construct a ‘descriptive business model’ for hospices which is grounded in analysis of relevant accounting information, and supported by narratives extracted from interviews with senior clinical and non clinical managers from four large and medium sized hospices. The study reveals the strengths and weaknesses of the hospice business model and evaluates its robustness against forthcoming challenges. Our findings highlight the gradual transition from a basic voluntary sector business model to a complex, highly sophisticated, and institutionalized care establishment, sharing many of the characteristics found in large private and public organizations. The sustainability however of the business model is threatened due to its exposure to a number of contradictory forces. Whilst demand for palliative and end of life care going forward is set to increase, due to both demographic and regulatory factors, hospices' voluntary income is highly volatile. Dependency on sustaining a complex network of stakeholder groups to underwrite income, challenges the hospice business model’s ability to cope with the anticipated challenges

Ascertaining the impact of endogenous and exogenous factors on the performance of students taking non-specialist accounting courses

This study aims to evaluate the potential determinants of academic performance of non-specialist accounting students. Considering both actual and initially expected performance, in conjunction with students’ learning styles and preferences, we use two econometric methods - Ordinal Probit and Ordinary Least Squared - in order to investigate and assess the impact of endogenous and the exogenous factors on the students’ academic achievement. Eventually, based on the results of our estimations, and by dividing the non-specialist students into segments, according to their demographic characteristics, we run a series of simulations to estimate empirically the likelihood of the students to report an academic performance weaker, in line, better, and considerably better than what they expected

Does understanding individuals require idiographic judgement?

Idiographic understanding has been proposed as a response to concern that criteriological diagnosis cannot capture the nature of human individuality. It can seem that understanding individuals requires, instead, a distinct form of ‘individualised’ judgement and this claim receives endorsement by the inventor of the term ‘idiographic’, Wilhelm Windelband. I argue, however, that none of the options for specifying a model of individualised judgement, to explain what idiographic judgement might be, will work. I suggest, at the end, that narrative, rather than idiographic, understanding is a more promising response to the limitations of criteriological diagnosis

Separation of foregrounds from cosmic microwave background observations with the MAP satellite

Simulated observations of a 10\dg \times 10\dg field by the Microwave Anisotropy Probe (MAP) are analysed in order to separate cosmic microwave background (CMB) emission from foreground contaminants and instrumental noise and thereby determine how accurately the CMB emission can be recovered. The simulations include emission from the CMB, the kinetic and thermal Sunyaev-Zel'dovich (SZ) effects from galaxy clusters, as well as Galactic dust, free-free and synchrotron. We find that, even in the presence of these contaminating foregrounds, the CMB map is reconstructed with an rms accuracy of about 20 $\mu$K per 12.6 arcmin pixel, which represents a substantial improvement as compared to the individual temperature sensitivities of the raw data channels. We also find, for the single 10\dg \times 10\dg field, that the CMB power spectrum is accurately recovered for \ell \la 600.Comment: 7 pages, 7 figures, MNRAS submitte

Acoustic emission monitoring of a soil slope: comparisons with continuous deformation measurements

Acoustic emission (AE) has become an established approach to monitor the stability of soil slopes. However, the challenge has been to develop strategies to interpret and quantify deformation behaviour from the measured AE. This paper presents the first comparison of continuous AE (measured using an active waveguide) and continuous subsurface deformation measurements. The active waveguide is installed in a borehole through a slope and comprises a metal waveguide rod or tube with a granular backfill surround. When the host slope deforms, the column of granular backfill also deforms, generating AE that can propagate along the waveguide. This paper presents results from a field trial at a reactivated soil slope in North Yorkshire, UK. The measurements confirm that AE rates generated are directly proportional to the velocity of slope movement (e.g. the AE rate versus velocity relationship determined for a series of slope movement events produced an R 2 value of 0·8) and demonstrate the performance of AE monitoring of active waveguides to provide continuous information on slope displacements and displacement rates with high temporal resolution

Industrial waste-heat recovery through integrated computer-aided working-fluid and ORC system optimisation using SAFT-Γ Mie

A mixed-integer non-linear programming optimisation framework is formulated and developed that combines a molecular-based, group-contribution equation of state, SAFT-γ Mie, with a thermodynamic description of an organic Rankine cycle (ORC) power system. In this framework, a set of working fluids is described by its constituent functional groups (e.g., since we are focussing here on hydrocarbons: –CH3, –CH2–, etc.), and integer optimisation variables are introduced in the description the working-fluid structure. Molecular feasibility constraints are then defined to ensure all feasible working-fluid candidates can be found. This optimisation framework facilitates combining the computer-aided molecular design of the working fluid with the power-system optimisation into a single framework, thus removing subjective and pre-emptive screening criteria, and simultaneously moving towards the next generation of tailored working fluids and optimised systems for waste-heat recovery applications. SAFT-γ Mie has not been previously employed in such a framework. The optimisation framework, which is based here on hydrocarbon functional groups, is first validated against an alternative formulation that uses (pseudo-experimental) thermodynamic property predictions from REFPROP, and against an optimisation study taken from the literature. The framework is then applied to three industrial waste-heat recovery applications. It is found that simple molecules, such as propane and propene, are the optimal ORC working fluids for a low-grade (150 °C) heat source, whilst molecules with increasing molecular complexity are favoured at higher temperatures. Specifically, 2-alkenes emerge as the optimal working fluids for medium- and higher-grade heat-sources in the 250–350 °C temperature range. Ultimately, the results demonstrate the potential of this framework to drive the search for the next generation of ORC systems, and to provide meaningful insights into identifying the working fluids that represent the optimal choices for targeted applications. Finally, the effects of the working-fluid structure on the expander and pump are investigated, and the suitability of group-contribution methods for evaluating the transport properties of hydrocarbon working-fluids are considered, in the context of performing complete thermoeconomic evaluations of these systems

Discovery of 35 New Supernova Remnants in the Inner Galaxy

We report the discovery of up to 35 new supernova remnants (SNRs) from a 42 arcsec resolution 90cm multi-configuration Very Large Array survey of the Galactic plane covering 4.5 deg< l <22.0 deg and |b| < 1.25 deg. Archival 20cm, 11cm, and 8 micron data have also been used to identify the SNRs and constrain their properties. The 90cm image is sensitive to SNRs with diameters 2.5 arcmin to 50 arcmin and down to a surface brightness limit of about 10^{-21} W m^{-2} Hz^{-1} sr^{-1}. This survey has nearly tripled the number of SNRs known in this part of the Galaxy, and represents an overall 15% increase in the total number of Galactic SNRs. These results suggest that further deep low frequency surveys of the inner Galaxy will solve the discrepancy between the expected number of Galactic SNRs and the significantly smaller number of currently known SNRs.Comment: 5 pages; Accepted to ApJL, high resolution figures available from http://www.ifa.hawaii.edu/~cbrogan/high_res

Evidence for a Weak Galactic Center Magnetic Field from Diffuse Low Frequency Nonthermal Radio Emission

New low-frequency 74 and 330 MHz observations of the Galactic center (GC) region reveal the presence of a large-scale (6\arcdeg\times 2\arcdeg) diffuse source of nonthermal synchrotron emission. A minimum energy analysis of this emission yields a total energy of $\sim (\phi^{4/7}f^{3/7})\times 10^{52}$ ergs and a magnetic field strength of $\sim 6(\phi/f)^{2/7}$ \muG (where $\phi$ is the proton to electron energy ratio and $f$ is the filling factor of the synchrotron emitting gas). The equipartition particle energy density is $1.2(\phi/f)^{2/7}$ \evcm, a value consistent with cosmic-ray data. However, the derived magnetic field is several orders of magnitude below the 1 mG field commonly invoked for the GC. With this field the source can be maintained with the SN rate inferred from the GC star formation. Furthermore, a strong magnetic field implies an abnormally low GC cosmic-ray energy density. We conclude that the mean magnetic field in the GC region must be weak, of order 10 \muG (at least on size scales \ga 125\arcsec).Comment: 12 pages, 1 JPEG figure, uses aastex.sty; Accepted for publication, ApJL (2005, published

DASI Three-Year Cosmic Microwave Background Polarization Results

We present the analysis of the complete 3-year data set obtained with the Degree Angular Scale Interferometer (DASI) polarization experiment, operating from the Amundsen-Scott South Pole research station. Additional data obtained at the end of the 2002 Austral winter and throughout the 2003 season were added to the data from which the first detection of polarization of the cosmic microwave background radiation was reported. The analysis of the combined data supports, with increased statistical power, all of the conclusions drawn from the initial data set. In particular, the detection of E-mode polarization is increased to 6.3 sigma confidence level, TE cross-polarization is detected at 2.9 sigma, and B-mode polarization is consistent with zero, with an upper limit well below the level of the detected E-mode polarization. The results are in excellent agreement with the predictions of the cosmological model that has emerged from CMB temperature measurements. The analysis also demonstrates that contamination of the data by known sources of foreground emission is insignificant.Comment: 13 pages Latex, 10 figures, submitted to Ap