Depoliticisation, Resilience and the Herceptin Post-code Lottery Crisis: Holding Back the Tide

This article: Covers new empirical terrain in the study of depoliticisation, with an in-depth case study of health technology regulation; Analyses depoliticisation from a novel analytical perspective, examining how depoliticised institutions are resilient to external pressure for politicisation; Posits a distinctive framework for analysing resilience, drawing on cognate literatures on policy networks and agencification; Raises interesting and distinctive questions about the nature of depoliticisation in advanced liberal democracies, arguing it is more contested than commonly acknowledged. Depoliticisation as a concept offers distinctive insights into how governments attempt to relieve political pressures in liberal democracies. Analysis has examined the effects of depoliticisation tactics on the public, but not how those tactics are sustained during moments of political tension. Drawing on policy networks and agencification literatures, this article examines how these tactics are resilient against pressure for politicisation. Using an in-depth case study of the controversial appraisal of cancer drug Herceptin in 2005/6 by the National Institute for Health and Clinical Excellence (NICE), the article examines how ‘resilient’ NICE was to external politicisation. It is argued that NICE was resilient because it was effectively ‘insulated’ by formal procedures and informal norms of deference to scientific expertise. This mechanism is termed ‘institutional double glazing’. The conclusion suggests developments to the conceptual and methodological framework of depoliticisation, and highlights theoretical insights into the nature of ‘anti-politics’ in contemporary democracies

Neutron-Rich Nuclei in Heaven and Earth

An accurately calibrated relativistic parametrization is introduced to compute the ground state properties of finite nuclei, their linear response, and the structure of neutron stars. While similar in spirit to the successful NL3 parameter set, it produces an equation of state that is considerably softer -- both for symmetric nuclear matter and for the symmetry energy. This softening appears to be required for an accurate description of several collective modes having different neutron-to-proton ratios. Among the predictions of this model are a symmetric nuclear-matter incompressibility of K=230 MeV and a neutron skin thickness in 208Pb of Rn-Rp=0.21 fm. Further, the impact of such a softening on the properties of neutron stars is as follows: the model predicts a limiting neutron star mass of Mmax=1.72 Msun, a radius of R=12.66 km for a ``canonical'' M=1.4 Msun neutron star, and no (nucleon) direct Urca cooling in neutrons stars with masses below M=1.3 Msun.Comment: 4 pages, 3 tables, and no figure

Do people with intellectual disabilities understand their prescription medication? A scoping review

© 2019 The Authors. Journal of Applied Research in Intellectual Disabilities Published by John Wiley & Sons Ltd.Background: People with intellectual disabilities are more likely to experience poor health than the general population and are frequently prescribed multiple medications. Therefore, it is important that people with intellectual disabilities understand their medication and potential adverse effects. Method: A scoping review explored people with intellectual disabilities' knowledge of prescription medications, their risks and how medication understanding can be improved. Results: Ten journal articles were included. People with intellectual disabilities often lacked understanding of their medication, including its name, purpose and when and how to take it. Participants were often confused or unaware of adverse effects associated with their medication. Information was sometimes explained to carers rather than people with intellectual disabilities. Some interventions and accessible information helped to improve knowledge in people with intellectual disabilities. Conclusion: There is a need for accessible and tailored information about medication to be discussed with people with intellectual disabilities in order to meet legal and best practice standards.Peer reviewe

High-density Skyrmion matter and Neutron Stars

We examine neutron star properties based on a model of dense matter composed of B=1 skyrmions immersed in a mesonic mean field background. The model realizes spontaneous chiral symmetry breaking non-linearly and incorporates scale-breaking of QCD through a dilaton VEV that also affects the mean fields. Quartic self-interactions among the vector mesons are introduced on grounds of naturalness in the corresponding effective field theory. Within a plausible range of the quartic couplings, the model generates neutron star masses and radii that are consistent with a preponderance of observational constraints, including recent ones that point to the existence of relatively massive neutron stars with mass M 1.7 Msun and radius R (12-14) km. If the existence of neutron stars with such dimensions is confirmed, matter at supra-nuclear density is stiffer than extrapolations of most microscopic models suggest.Comment: 27 pages, 5 figures, AASTeX style; to be published in The Astrophysical Journa

Multi-telescope timing of PSR J1518+4904

PSR J1518+4904 is one of only 9 known double neutron star systems. These systems are highly valuable for measuring the masses of neutron stars, measuring the effects of gravity, and testing gravitational theories. We determine an improved timing solution for a mildly relativistic double neutron star system, combining data from multiple telescopes. We set better constraints on relativistic parameters and the separate masses of the system, and discuss the evolution of PSR J1518+4904 in the context of other double neutron star systems. PSR J1518+4904 has been regularly observed for more than 10 years by the European Pulsar Timing Array (EPTA) network using the Westerbork, Jodrell Bank, Effelsberg and Nancay radio telescopes. The data were analysed using the updated timing software Tempo2. We have improved the timing solution for this double neutron star system. The periastron advance has been refined and a significant detection of proper motion is presented. It is not likely that more post-Keplerian parameters, with which the individual neutron star masses and the inclination angle of the system can be determined separately, can be measured in the near future. Using a combination of the high-quality data sets present in the EPTA collaboration, extended with the original GBT data, we have constrained the masses in the system to m_p1.55 msun (95.4% confidence), and the inclination angle of the orbit to be less than 47 degrees (99%). From this we derive that the pulsar in this system possibly has one of the lowest neutron star masses measured to date. From evolutionary considerations it seems likely that the companion star, despite its high mass, was formed in an electron-capture supernova.Comment: 11 pages, 8 figures, accepted by A&

Quantifying the Relationship between Capability and Health in Older People: Can't Map, Won't Map

BACKGROUND: Intuitively, health and capability are distinct but linked concepts. This study aimed to quantify the link between a measure of health status (EQ-5D-3L) and capability (ICECAP-O) using regression-based methods. METHODS: EQ-5D-3L and ICECAP-O data were collected from a sample of older people ( n = 584), aged over 65 years, requiring a hospital visit and/or care home resident, and recruited to one of 3 studies forming the Medical Crisis in Older People (MCOP) program in England. The link of EQ-5D-3L with 1) ICECAP-O tariff scores were estimated using ordinary least squares (OLS) or censored least absolute deviation (CLAD) regression models; and 2) ICECAP-O domain scores was estimated using multinomial logistic (MNL) regression. Mean absolute error (MAE), root mean squared error (RMSE), absolute difference (AD) between mean observed and estimated values, and the R(2) statistic were used to judge model performance. RESULTS: In this sample of older people ( n = 584), higher scores on the EQ-5D-3L were shown to be linked with higher ICECAP-O scores when using linear regression. An OLS-regression model was identified to be the best performing model with the lowest error statistics (AD = 0.0000; MAE = 0.1208; MSE = 0.1626) and highest goodness of fit ( R(2) = 0.3532); model performance was poor when predicting the lower ICECAP-O tariff scores. The three domains of the EQ-5D-3L showing a statistically significant quantifiable link with the ICECAP-O tariff score were self-care, usual activities, and anxiety/depression. CONCLUSION: A quantifiable, but weak, link between health (EQ-5D-3L) and capability (ICECAP-O) was identified. The findings from this study add further support that the ICECAP-O is providing complimentary information to the EQ-5D-3L. Mapping between the 2 measures is not advisable and the measures should not be used as direct substitutes to capture the impact of interventions in economic evaluations

How strange are compact star interiors ?

We discuss a Nambu--Jona-Lasinio (NJL) type quantum field theoretical approach to the quark matter equation of state with color superconductivity and construct hybrid star models on this basis. It has recently been demonstrated that with increasing baryon density, the different quark flavors may occur sequentially, starting with down-quarks only, before the second light quark flavor and at highest densities also the strange quark flavor appears. We find that color superconducting phases are favorable over non-superconducting ones which entails consequences for thermodynamic and transport properties of hybrid star matter. In particular, for NJL-type models no strange quark matter phases can occur in compact star interiors due to mechanical instability against gravitational collapse, unless a sufficiently strong flavor mixing as provided by the Kobayashi-Maskawa-'t Hooft determinant interaction is present in the model. We discuss observational data on mass-radius relationships of compact stars which can put constraints on the properties of dense matter equation of state.Comment: 7 pages, 2 figures, to appear in the Proceedings of the International Conference SQM2009, Buzios, Rio de Janeiro, Brazil, Sep.27-Oct.2, 200

Merger of white dwarf-neutron star binaries: Prelude to hydrodynamic simulations in general relativity

White dwarf-neutron star binaries generate detectable gravitational radiation. We construct Newtonian equilibrium models of corotational white dwarf-neutron star (WDNS) binaries in circular orbit and find that these models terminate at the Roche limit. At this point the binary will undergo either stable mass transfer (SMT) and evolve on a secular time scale, or unstable mass transfer (UMT), which results in the tidal disruption of the WD. The path a given binary will follow depends primarily on its mass ratio. We analyze the fate of known WDNS binaries and use population synthesis results to estimate the number of LISA-resolved galactic binaries that will undergo either SMT or UMT. We model the quasistationary SMT epoch by solving a set of simple ordinary differential equations and compute the corresponding gravitational waveforms. Finally, we discuss in general terms the possible fate of binaries that undergo UMT and construct approximate Newtonian equilibrium configurations of merged WDNS remnants. We use these configurations to assess plausible outcomes of our future, fully relativistic simulations of these systems. If sufficient WD debris lands on the NS, the remnant may collapse, whereby the gravitational waves from the inspiral, merger, and collapse phases will sweep from LISA through LIGO frequency bands. If the debris forms a disk about the NS, it may fragment and form planets.Comment: 28 pages, 25 figures, 6 table

Arecibo timing and single-pulse observations of 17 pulsars

We report on timing and single-pulse observations of 17 pulsars discovered at the Arecibo observatory. The highlights of our sample are the recycled pulsars J1829+2456, J1944+0907 and the drifting subpulses observed in PSR J0815+0939. For the double neutron star binary J1829+2456, in addition to improving upon our existing measurement of relativistic periastron advance, we have now measured the pulsar's spin period derivative. This new result sets an upper limit on the transverse speed of 120 km/s and a lower limit on the characteristic age of 12.4 Gyr. From our measurement of proper motion of the isolated 5.2-ms pulsar J1944+0907, we infer a transverse speed of 188 +/- 65 km/s. This is higher than that of any other isolated millisecond pulsar. An estimate of the speed, using interstellar scintillation, of 235 +/- 45 km/s indicates that the scattering medium along the line of sight is non-uniform. We discuss the drifting subpulses detected from three pulsars in the sample, in particular the remarkable drifting subpulse properties of the 645-ms pulsar J0815+0939. Drifting is observed in all four components of the pulse profile, with the sense of drift varying among the different components. This unusual `bi-drifting'' behaviour challenges standard explanations of the drifting subpulse phenomenon.Comment: 9 pages, 6 figures. Accepted for publication in MNRA