Ethics and geographical equity in health care

Important variations in access to health care and health outcomes are associated with geography, giving rise to profound ethical concerns. This paper discusses the consequences of such concerns for the allocation of health care finance to geographical regions. Specifically, it examines the ethical drivers underlying capitation systems, which have become the principal method of allocating health care finance to regions in most countries. Although most capitation systems are based on empirical models of health care expenditure, there is much debate about which needs factors to include in (or exclude from) such models. This concern with legitimate and illegitimate drivers of health care expenditure reflects the ethical concerns underlying the geographical distribution of health care finance

Statistical analysis of EQ-5D profiles: does the use of value sets bias inference?

Health state profile data, such as those provided by the EQ-5D, are widely collected in clinical trials, population surveys and a growing range of other important health sector applications. However, these profile data are difficult to summarise to give an overall view of the health of a given population that can be analysed for differences between groups or within groups over time. A common way of short-cutting this problem is to transform profiles into a single number, or index, using sets of weights, often elicited from the general public in the form of values. Are there any problems with this procedure? In this paper we demonstrate the underlying effects of the use of value sets as a means of weighting profile data. We show that any set of weights introduces an exogenous source of variance to health profile data. These can distort findings about the significance of changes in health between groups or over time. No set of weights is neutral its effect. If a summary of patient reported outcomes is required, it may be better to use an instrument that yields this directly – such as the EQ VAS – along with the descriptive instrument. If this is not possible, researchers should have a clear rationale for their choice of weights; and be aware that those weighs may exert a non-trivial effect on their analysis. This paper focuses on the EQ-5D, but the arguments and their implications for statistical analysis are relevant to all health state descriptive systems

Apollo experience report: Safety activities

A description is given of the flight safety experiences gained during the Apollo Program and safety, from the viewpoint of program management, engineering, mission planning, and ground test operations was discussed. Emphasis is placed on the methods used to identify the risks involved in flight and in certain ground test operations. In addition, there are discussions on the management and engineering activities used to eliminate or reduce these risks

Strain localization driven by thermal decomposition during seismic shear

Field and laboratory observations show that shear deformation is often extremely localized at seismic slip rates, with a typical deforming zone width on the order of a few tens of microns. This extreme localization can be understood in terms of thermally driven weakening mechanisms. A zone of initially high strain rate will experience more shear heating and thus weaken faster, making it more likely to accommodate subsequent deformation. Fault zones often contain thermally unstable minerals such as clays or carbonates, which devolatilize at the high temperatures attained during seismic slip. In this paper, we investigate how these thermal decomposition reactions drive strain localization when coupled to a model for thermal pressurization of in situ groundwater. Building on Rice et al. (2014), we use a linear stability analysis to predict a localized zone thickness that depends on a combination of hydraulic, frictional, and thermochemical properties of the deforming fault rock. Numerical simulations show that the onset of thermal decomposition drives additional strain localization when compared with thermal pressurization alone and predict localized zone thicknesses of ∼7 and ∼13 μm for lizardite and calcite, respectively. Finally we show how thermal diffusion and the endothermic reaction combine to limit the peak temperature of the fault and that the pore fluid released by the reaction provides additional weakening of ∼20–40% of the initial strength

Sick of work or too sick to work? Evidence on health shocks and early retirement from the BHPS

We follow individuals as they retire using discrete-time hazard models applied to a stock sample from 12 waves of the British Household Panel Survey. Results confirm that health shocks are a determinant of retirement age and are quantitatively more important than pension entitlement. This is the case for both men and women and is observed for both a measure of health limitations and a measure of latent health status obtained from a generalized ordered probit model. Further, our results provide evidence that, for women, the health status of their partner impacts on their retirement decisions; an effect that is not evident for men

The part-through surface crack in an elastic plate

Tensile stretching and bending of elastic plate containing surface crac

Spin susceptibility of underdoped cuprates: the case of Ortho-II YBa_2Cu_3O_{6.5}

Recent inelastic neutron scattering measurements found that the spin susceptibility of detwinned and highly ordered ortho-II YBa_2Cu_3O_{6.5} exhibits, in both the normal and superconducting states, one-dimensional incommensurate modulations at low energies which were interpreted as a signature of dynamic stripes. We propose an alternative model based on quasiparticle transitions between the arcs of a truncated Fermi surface. Such transitions are resonantly enhanced by scattering to the triplet spin resonance. We show that the anisotropy in the experimental spin response is consistent with this model if the gap at the saddle points is anisotropic.Comment: 5 fives, 3 postscript figure

Accurate statistics of a flexible polymer chain in shear flow

We present exact and analytically accurate results for the problem of a flexible polymer chain in shear flow. Under such a flow the polymer tumbles, and the probability distribution of the tumbling times $\tau$ of the polymer decays exponentially as $\sim \exp(-\alpha \tau/\tau_0)$ (where $\tau_0$ is the longest relaxation time). We show that for a Rouse chain, this nontrivial constant $\alpha$ can be calculated in the limit of large Weissenberg number (high shear rate) and is in excellent agreement with our simulation result of $\alpha \simeq 0.324$. We also derive exactly the distribution functions for the length and the orientational angles of the end-to-end vector of the polymer.Comment: 4 pages, 2 figures. Minor changes. Texts differ slightly from the PRL published versio