Predicting the outcome of Disability Living Allowance (DLA) adult claims

This working paper considers how well coded data from Disability Living Allowance (DLA) adult claim packs can predict the outcome of these claims. The probability of receiving a care or mobility award is estimated. A range of control variables are considered. First using items that reflect the entitlement criteria for care and mobility awards and then looking at whether additional evidence was required as part of the claim process. Predicted results from these estimates were then compared with real world decisions and those made by Decision Makers on the basis of the coded information from claim packs

Androgen-induced rhox homeobox genes modulate the expression of AR-regulated genes

Rhox5, the founding member of the reproductive homeobox on the X chromosome (Rhox) gene cluster, encodes a homeodomain-containing transcription factor that is selectively expressed in Sertoli cells, where it promotes the survival of male germ cells. To identify Rhox5-regulated genes, we generated 15P-1 Sertoli cell clones expressing physiological levels of Rhox5 from a stably transfected expression vector. Microarray analysis identified many genes altered in expression in response to Rhox5, including those encoding proteins controlling cell cycle regulation, apoptosis, metabolism, and cell-cell interactions. Fifteen of these Rhox5-regulated genes were chosen for further analysis. Analysis of Rhox5-null male mice indicated that at least 9 of these are Rhox5-regulated in the testes in vivo. Many of them have distinct postnatal expression patterns and are regulated by Rhox5 at different postnatal time points. Most of them are expressed in Sertoli cells, indicating that they are candidates to be directly regulated by Rhox5. Transfection analysis with expression vectors encoding different mouse and human Rhox family members revealed that the regulatory response of a subset of these Rhox5-regulated genes is both conserved and redundant. Given that Rhox5 depends on AR for expression in Sertoli cells, we examined whether some Rhox5-regulated genes are also regulated by androgen receptor (AR). We provide several lines of evidence that this is the case, leading us to propose that RHOX5 serves as a key intermediate transcription factor that directs some of the actions of AR in the testes

StochKit-FF: Efficient Systems Biology on Multicore Architectures

The stochastic modelling of biological systems is an informative, and in some cases, very adequate technique, which may however result in being more expensive than other modelling approaches, such as differential equations. We present StochKit-FF, a parallel version of StochKit, a reference toolkit for stochastic simulations. StochKit-FF is based on the FastFlow programming toolkit for multicores and exploits the novel concept of selective memory. We experiment StochKit-FF on a model of HIV infection dynamics, with the aim of extracting information from efficiently run experiments, here in terms of average and variance and, on a longer term, of more structured data.Comment: 14 pages + cover pag

Costs and cost-effectiveness of alternative tuberculosis management strategies in South Africa - Implications for policy

Objective. To conduct an economic analysis of the Hlabisa community-based directly observed therapy management strategy for tuberculosis and to project costs of three alternative strategies. Setting. Hlabisa health district, KwaZulu-Natal, South Africa. Methods. An economic analysis comparing the current tuberculosis management strategy in Hlabisa with three alternative strategies (the Hlabisa strategy prior to 1991 based on hospitalisation, the national strategy and sanatorium care) in terms of costs to both health service and patient and of cost-effectiveness. Results. The current Hlabisa strategy was the most cost-effective (R3 799 per patient cured), compared with R98 307 for the strategy used prior to 1991, R9 940 for the national strategy, and R11 145 for sanatorium care, Between 71% and 88% of treatment costs lie with the health service, and hospitalisation (R119 per day) is the most expensive item. Prolonged hospitalisation is extremely expensive, but community care is cheaper (community clinic visit, R28; community health worker visit, R7). The total cost of supervising a patient in the community under the current Hlabisa strategy was R503, equivalent to 4.2 days in hospital, Drug costs (R157) are equivalent to just 1.3 days in hospital. Conclusion. Cost to both health service and patient can be substantially reduced by using community-based directly observed therapy for tuberculosis, a strategy that is cheap and cost-effective in Hlabisa, These findings have important national implications, supporting the goals of the new tuberculosis control programme.5 page(s

Co‐creating system‐wide improvement for people with traumatic brain injury across one integrated care system in the United Kingdom to initiate a transformation journey through co‐production

Background and Objective There is a need for better integration of services across communities and sectors for people living with traumatic brain injury (TBI) to meet their complex needs. Building on insights gained from earlier pilot work, here we report the outcomes of a participatory workshop that sought to better understand the challenges, barriers and opportunities that currently exist within the care pathway for survivors of TBI. Methods A diverse range of stakeholders from the acute and rehabilitation care pathway and the health and social care system were invited to participate in a 3-h workshop. The participants worked in four mixed subgroups using practice development methodology, which promotes person-centred, inclusive and participatory action. Results Thematic analysis identified shared purposes and values that were used to produce a detailed implementation and impact framework for application at both the level of the care interface and the overarching integrated care system. A variety of enablers were identified that related to collective values and behaviours, case management, team leadership and integrated team working, workforce capability, evidence-based practice and resourcing. The clinical, economic, cultural and social outcomes associated with these enablers were also identified, and included patient safety, independence and well-being, reduced waiting times, re-admission rates, staff retention and professional development. Conclusion The co-produced recommendations made within the implementation and impact framework described here provide a means by which the culture and delivery of health and social care services can be better tailored to meet the needs of people living with TBI. We believe that the recommendations will help shape the formation of new services as well as the development of existing ones. Patient or Public Contribution Patient and public involvement have been established over a 10-year history of relationship building through a joint forum and events involving three charities representing people with TBI, carers, family members, clinicians, service users, researchers and commissioners, culminating in a politically supported event that identified concerns about the needs of people following TBI. These relationships formed the foundation for the interactive workshop, the focus of this publication

Parametric instabilities in the LCGT arm cavity

We evaluated the parametric instabilities of LCGT (Japanese interferometric gravitational wave detector project) arm cavity. The number of unstable modes of LCGT is 10-times smaller than that of Advanced LIGO (U.S.A.). Since the strength of the instabilities of LCGT depends on the mirror curvature more weakly than that of Advanced LIGO, the requirement of the mirror curvature accuracy is easier to be achieved. The difference in the parametric instabilities between LCGT and Advanced LIGO is because of the thermal noise reduction methods (LCGT, cooling sapphire mirrors; Advanced LIGO, fused silica mirrors with larger laser beams), which are the main strategies of the projects. Elastic Q reduction by the barrel surface (0.2 mm thickness Ta$_2$O$_5$) coating is effective to suppress instabilities in the LCGT arm cavity. Therefore, the cryogenic interferometer is a smart solution for the parametric instabilities in addition to thermal noise and thermal lensing.Comment: 6 pages,3 figures. Amaldi7 proceedings, J. Phys.: Conf. Ser. (accepted