Incentives and Targets in Hospital Care: Evidence from a Natural Experiment

Performance targets are commonly used in the public sector, despite their well known problems when organisations have multiple objectives and performance is difficult to measure. It is possible that such targets may work where there is considerable consensus that performance needs to be improved. We investigate this possibility by examining the response of the English National Health Service (NHS) to waiting time targets. Long waiting times have been a key issue for the NHS for many years. Using a natural policy experiment exploiting differences between countries of the UK, supplemented with a panel of data on English hospitals, we examine whether high profile targets to reduce waiting times met their goals of reducing waiting times without diverting activity from other less well monitored aspects of health care. Using this robust design, we find that targets led to a fall in waiting times without apparent reductions in other aspects of patient care.health care, waiting times, targets, incentives

The trypanosome infections of Glossina pallidipes in the Umfolosi Game Reserve, Zululand

Further dissections of Glossina pallidipes Aust., trapped in the Umfolosi Game Reserve in Zululand, were carried out between October 1932 and June 1933 and the results compared with those obtained between November 1931 and April 1932 [ R.A.E., B 21 107]. The percentage of trypanosome infection appeared to have increased from 3.42 in the first period to 5.14 in the second, and whereas in the former period 3.31 per cent. of the males and 3.46 of the females showed infections, in the latter the respective percentages were 6.87 and 4.45. A comparison between an area where intensive trapping was being carried out and one in which trapping had been abandoned and fly conditions were consequently returning to normal showed a fly density of 1.8 flies per trap per day in the first area and 60.2 in the second, a regularly higher percentage of infection in the latter, and differences in the distribution of the three species of trypanosomes ( Trypanosoma vivax, T. congolense and T. brucei). As these variations occurred in localities only about 5 miles apart, they appear to indicate that flies do not pass with any regularity from one focus to another. Proboscis infection in tsetse-fly in Zululand appears to occur throughout the year, but fluctuates in frequency from month to month. In 87 per cent. of the infected flies, the hypopharynx contained trypanosomes, and it is therefore assumed that the majority of the flies were capable of transmitting i them. With regard to the effect on the trypanosome infections of the reduction of fly population by trapping, the general results appear to show that as the population becomes less dense the percentage of infected flies increases, the increase occurring in the number of males infected. It is possible that this may be due to the greater attraction of the traps for females, the young females being removed more rapidly than the males, which therefore have a longer period in which to acquire infection. Out of 18 flies examined from an area of low fly density outside the Reserve, 4 were infected, and again more males were infected than females. Three of the flies were infected with T. congolense and one with T. brucei; it thus appears that the most pathogenic trypanosomes are being carried far from their source in the Game Reserve. The author describes an anomaly in the structure of the salivary glands and hypopharynx occurring in 2.8 per cent. of the flies examined and discusses its possible bearing on the transmission of trypanosomes. During an outbreak of trypanosomiasis of cattle in the winter of 1932, Stomoxys was present in large numbers in the locality and persistently attacked cattle, some of which were infected with T. congolense and T. brucei. Flies of this genus that fed on a donkey with numerous trypanosomes in its peripheral blood readily became infected. Trypanosomes ( T. congolense) remained active in the gut of Stomoxys for a maximum of 20 hours, and 8 per cent. of the Stomoxys interrupted while feeding on a donkey heavily infected with T. brucei showed trypanosomes in both gut and proboscisThe articles have been scanned in colour with a HP Scanjet 5590; 600dpi. Adobe Acrobat XI Pro was used to OCR the text and also for the merging and conversion to the final presentation PDF-format.mn201

Psychological distress in disease-free breast cancer survivors completing tamoxifen therapy: The contribution of illness and treatment representations to psychological morbidity and research portfolio

This retrospective audit aimed to highlight the current demands placed on the existing Adult Mental Health speciality within the Dumfries and Galloway Psychology service in terms of patient and referrer need since the reconfiguration of service provisions and to detail how the needs are currently being met. Specific aims of this audit were; to examine referral characteristics and referral outcomes received during a one-year period (between October 2002 and September 2003), examine service utilisation per geographical area, and to highlight differences in referral characteristics and referral outcome between geographical area and referring agents. Specific referral characteristics examined were: patient characteristics (age and gender) and referring problem (primary problem, chronicity, severity and complexity). Discharge forms, completed by AMH speciality staff as standard, provided the outcome of each referral, detailing reason for discharge, session attendance and subjective clinical judgment of outcome. A total number of 1303 referrals were referred to the speciality within the one-year period. There were three major referral agents to the AMH speciality, namely. General Practitioners (GP) Community Mental Health Teams (CMHT) and Psychiatric Medical Practitioners (PMP). Referrals were sent for a variety of psychological difficulties however one quarter of referrals were primarily experiencing an anxiety disorder (24.9%) and one quarter with a depressive disorder (24.6%). Attendance varied across referrals, however there were a high percentage of referrals discharged due to non-attendance (37.8%). Geographically, referrals did not differ in terms of age, sex, attendance or outcome. They did however differ in terms of severity, complexity, and chronicity of referral, which may be a reflection of referring agents in different areas or differences in AMH speciality staff rating methods. Referrals examined between referral agents did not differ in terms of age, sex, attendance or outcome. They did however differ in terms of severity, complexity, and chronicity of referral, which may be a reflection of primary and secondary caregivers or differences between AMH speciality staff rating methods. The reliability and validity of outcome ratings are questionable due to being subjective and not calibrated. Discrepancies between outcome frequencies were found and interpretations of data were difficult. The need to revise outcome categories, rating procedures, and to implement guidelines for rating referral characteristics and outcome categories for AMH speciality staff was highlighted, which may reduce future discrepancies between reported data. Staff training to enable consistent and appropriate scoring of discharge forms was recommended. AMH speciality staff inter-rater and intra-rater reliability research, with regards to scoring discharge forms, was also recommended for the department to undertake

Flipping Failure: A case study on building resilience and confidence through 'Failureship Strategies' in theory and practiceat the University of Salford

This paper presents the Flipping Failure project, which aims to challenge the negative perception of failure and promote its benefits for building resilience, insight, and action. The project involved students and staff who participated in failure-focused events that explored different aspects of failure in various contexts. We discuss the theory and practice of flipping failure to present it more positively and provide a practical toolkit with resources to help others adopt failure as a transferable skill-set. In sharing the outcomes and insights of the project, and its further development at The Festival of Learning and Teaching, we suggest ways to enhance and extend this work in the future

The vegetable diet theory of Glossina pallidipes

In view of the statement recently made by A. Davidson that Glossina pallidipes Aust., can feed on the latex of Euphorbia tirucalli and Sarcostemnus viminale the authors discuss the digestive anatomy of the fly and describe experiments in Zululand designed to test this theory. Preliminary tests showed that the temperature of the surface of these plants was lower or only slightly higher than that of the surrounding atmosphere, whereas the temperature of the surface of a mammal is generally much higher. As tsetse-flies apparently do not probe a cool object unless acutely hungry, it was found necessary to warm the naturally cool surface of the plants used in the experiments. The results obtained show that the flies are incapable of piercing the plant tissues and, if given an opportunity to feed on latex as it occurs in nature, soon die without reproducing. Moreover, the latex had an undoubtedly toxic effect on those flies that were artificially induced to feed on it through a membrane.The articles have been scanned in colour with a HP Scanjet 5590; 600dpi. Adobe Acrobat XI Pro was used to OCR the text and also for the merging and conversion to the final presentation PDF-format.mn201

Flipping Failure: A case study on building resilience and confidence through 'Failureship Strategies' in theory and practice at the University of Salford.

This paper presents the Flipping Failure project, which aims to challenge the negative perception of failure and promote its benefits for building resilience, insight, and action. The project involved students and staff who participated in failure-focused events that explored different aspects of failure in various contexts. We discuss the theory and practice of flipping failure to present it more positively and provide a practical toolkit with resources to help others adopt failure as a transferable skill-set. In sharing the outcomes and insights of the project, and its further development at The Festival of Learning and Teaching, we suggest ways to enhance and extend this work in the future

Q&A: Epistasis

Molecular and Cellular Biolog

Coordinating UoS engagement events

This booklet is Coordinating UoS Engagement Events and provides further information and details on ways in which diverse teams across the University can help you to maximise the impact of your public & community engagement activities. Aims of this eBook: • Specifically focuses on how to get started with planning and running an engagement event, with links • Provides guidance and advice on evaluating and documenting your engagement event • Provides information about the training & development and internal funding available • Encourages reflection and self-evaluation throughout the development process • Sign-posts to useful internal and external resources, tools, tips and techniques • Promotes goal setting and development of confidence and capabilit

Towards practical tools for side channel aware software engineering:'grey box' modelling for instruction leakages

Power (along with EM, cache and timing) leaks are of considerable concern for developers who have to deal with cryptographic components as part of their overall software implementation, in particular in the context of embedded devices. Whilst there exist some compiler tools to detect timing leaks, similar progress towards pinpointing power and EM leaks has been hampered by limits on the amount of information available about the physical components from which such leaks originate. We suggest a novel modelling technique capable of producing high-quality instruction-level power (and/or EM) models without requiring a detailed hardware description of a processor nor information about the used process technology (access to both of which is typically restricted). We show that our methodology is effective at capturing differential data-dependent effects as neighbouring instructions in a sequence vary. We also explore register effects, and verify our models across several measurement boards to comment on board effects and portability. We confirm its versatility by demonstrating the basic technique on two processors (the ARM Cortex-M0 and M4), and use the M0 models to develop ELMO, the first leakage simulator for the ARM Cortex M0.</p