Homogeneous cosmologies in generalized modified gravity

Dynamical system methods are used in the study of the stability of spatially flat homogeneous cosmologies within a large class of generalized modified gravity models in the presence of a relativistic matter-radiation fluid. The present approach can be considered as the generalization of previous works in which only $F(R)$ cases were considered. Models described by an arbitrary function of all possible geometric invariants are investigated and general equations giving all critical points are derived.Comment: 13 pages, no figure

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

Reshaping employment relations in the UK voluntary sector: an exploratory study into the impact of best value

This paper provides exploratory insights into the impact of the UK government's Best Value policy on employment policies in voluntary organisations. Best Value is one of a number of institutional pressures on HR policies within the sector: many of which have positive implications for the conduct of HR and delivering care. However, the data also reveal tensions in this institutional environment with regard to meeting demands of twenty-four hour care and family-friendly policies for the workforce. Moreover, continuation of aspects of the New Public Management agenda within Best Value means that pressure on pay and conditions in the sector persist, raising concerns regarding worker morale and quality of care