Does responsibility affect the public valuation of health care interventions? A relative valuation approach to health care safety

This article is available open access through the publisher’s website at the link below. Copyright © 2012, International Society for Pharmacoeconomics and Outcomes Research (ISPOR).Objective - Health services often spend more on safety interventions than seems cost-effective. This study investigates whether the public value safety-related health care improvements more highly than the same improvements in contexts where the health care system is not responsible. Method - An online survey was conducted to elicit the relative importance placed on preventing harms caused by 1) health care (hospital-acquired infections, drug administration errors, injuries to health care staff), 2) individuals (personal lifestyle choices, sports-related injuries), and 3) nature (genetic disorders). Direct valuations were obtained from members of the public by using a person trade-off or “matching” method. Participants were asked to choose between two preventative interventions of equal cost and equal health benefit per person for the same number of people, but differing in causation. If participants indicated a preference, their strength of preference was measured by using person trade-off. Results - Responses were obtained from 1030 people, reflecting the sociodemographic mix of the UK population. Participants valued interventions preventing hospital-acquired infections (1.31) more highly than genetic disorders (1.0), although drug errors were valued similarly to genetic disorders (1.07), and interventions to prevent injury to health care staff were given less weight than genetic disorders (0.71). Less weight was also given to interventions related to lifestyle (0.65) and sports injuries (0.41). Conclusion - Our results suggest that people do not attach a simple fixed premium to “safety-related” interventions but that preferences depend more subtly on context. The use of the results of such public preference surveys to directly inform policy would therefore be premature.Brunel University

Local quantum phase transition in the pseudogap Anderson model: scales, scaling and quantum critical dynamics

The pseudogap Anderson impurity model provides a paradigm for understanding local quantum phase transitions, in this case between generalised fermi liquid and degenerate local moment phases. Here we develop a non-perturbative local moment approach to the generic asymmetric model, encompassing all energy scales and interaction strengths and leading thereby to a rich description of the problem. We investigate in particular underlying phase boundaries, the critical behaviour of relevant low-energy scales, and single-particle dynamics embodied in the local spectrum. Particular attention is given to the resultant universal scaling behaviour of dynamics close to the transition in both the GFL and LM phases, the scale-free physics characteristic of the quantum critical point itself, and the relation between the two.Comment: 39 pages, 19 figure

Multi-Wavelength Coverage of State Transitions in the New Black Hole X-Ray Binary Swift J1910.2-0546

Understanding how black holes accrete and supply feedback to their environment is one of the outstanding challenges of modern astrophysics. Swift J1910.2-0546 is a candidate black hole low-mass X-ray binary that was discovered in 2012 when it entered an accretion outburst. To investigate the binary configuration and the accretion morphology we monitored the evolution of the outburst for ~3 months at X-ray, UV, optical (B,V,R,I), and near-infrared (J,H,K) wavelengths using Swift and SMARTS. The source evolved from a hard to a soft X-ray spectral state with a relatively cold accretion disk that peaked at ~0.5 keV. A Chandra/HETG spectrum obtained during this soft state did not reveal signatures of an ionized disk wind. Both the low disk temperature and the absence of a detectable wind could indicate that the system is viewed at relatively low inclination. The multi-wavelength light curves revealed two notable features that appear to be related to X-ray state changes. Firstly, a prominent flux decrease was observed in all wavebands ~1-2 weeks before the source entered the soft state. This dip occurred in (0.6-10 keV) X-rays ~6 days later than at longer wavelengths, which could possibly reflect the viscous time scale of the disk. Secondly, about two weeks after the source transitioned back into the hard state, the UV emission significantly increased while the X-rays steadily decayed. We discuss how these observations may reflect changes in the accretion flow morphology, perhaps related to the quenching/launch of a jet or the collapse/recovery of a hot flow.Comment: 8 pages, 5 figures, 1 table. To be published in Ap

Learning Behavioural Context

The original publication is available at www.springerlink.co

Mathematical stories: Why do more boys than girls choose to study mathematics at AS-level in England?

Copyright @ 2005 Taylor & FrancisIn this paper I address the question: How is it that people come to choose mathematics and in what ways is this process gendered? I draw on the findings of a qualitative research study involving interviews with 43 young people all studying mathematics in post-compulsory education in England. Working within a post-structuralist framework, I argue that gender is a project and one that is achieved in interaction with others. Through a detailed reading of Toni and Claudia’s stories I explore the tensions for young women who are engaging in mathematics, something that is discursively inscribed as masculine, while (understandably) being invested in producing themselves as female. I conclude by arguing that seeing ‘doing mathematics’ as ‘doing masculinity’ is a productive way of understanding why mathematics is so male dominated and by looking at the implications of this understanding for gender and mathematics reform work.This work is funded by the ESR

Effects of Submaximal Intensity Rowing vs Cycling on Cognitive Performance

poste

Polycystic ovary syndrome and leukocyte telomere length: cross-sectional and longitudinal changes

Peer reviewe

Periconceptional environment predicts leukocyte telomere length in a cross-sectional study of 7-9 year old rural Gambian children

Early life exposures are important predictors of adult disease risk. Although the underlying mechanisms are largely unknown, telomere maintenance may be involved. This study investigated the relationship between seasonal differences in parental exposures at time of conception and leukocyte telomere length (LTL) in their offspring. LTL was measured in two cohorts of children aged 2 yrs (N = 487) and 7–9 yrs (N = 218). The association between date of conception and LTL was examined using Fourier regression models, adjusted for age, sex, leukocyte cell composition, and other potential confounders. We observed an effect of season in the older children in all models [likelihood ratio test (LRT) χ²2 = 7.1, p = 0.03; fully adjusted model]. LTL was greatest in children conceived in September (in the rainy season), and smallest in those conceived in March (in the dry season), with an effect size (LTL peak–nadir) of 0.60 z-scores. No effect of season was evident in the younger children (LRT χ²2 = 0.87, p = 0.65). The different results obtained for the two cohorts may reflect a delayed effect of season of conception on postnatal telomere maintenance. Alternatively, they may be explained by unmeasured differences in early life exposures, or the increased telomere attrition rate during infancy