The social negotiation of fitness for work: tensions in doctor-patient relationships over medical certification of chronic pain

The UK government is promoting the health benefits of work, in order to change doctors' and patients' behaviour and reduce sickness absence. The rationale is that many people 'off sick' would have better outcomes by staying at work; but reducing the costs of health care and benefits is also an imperative. Replacement of the 'sick note' with the 'fit note' and a national educational programme are intended to reduce sickness-certification rates, but how will these initiatives impact on doctor-patient relationships and the existing tension between the doctor as patient advocate and gate-keeper to services and benefits? This tension is particularly acute for problems like chronic pain where diagnosis, prognosis and work capacity can be unclear. We interviewed 13 doctors and 30 chronic pain patients about their experiences of negotiating medical certification for work absence and their views of the new policies. Our findings highlight the limitations of naïve rationalist approaches to judgements of work absence and fitness for work for people with chronic pain. Moral, socio-cultural and practical factors are invoked by doctors and patients to contest decisions, and although both groups support the fit note's focus on capacity, they doubt it will overcome tensions in the consultation. Doctors value tacit skills of persuasion and negotiation that can change how patients conceptualise their illness and respond to it. Policy-makers increasingly recognise the role of this tacit knowledge and we conclude that sick-listing can be improved by further developing these skills and acknowledging the structural context within which protagonists negotiate sick-listin

Confronting the sacred cow : the politics of work-related tax deductions

A common theme among recent proposals to reform Australia’s personal income tax system is that lower personal income tax rates (or increased thresholds) could be partially funded through the elimination of work-related tax deductions. While such base broadening represents good tax policy in that a well-designed reform package has the potential to improve the efficiency of the income tax system without necessarily reducing progressivity, the analysis presented in this article suggests that such proposals are fraught with political difficulties

Stability Safety Margin Based Design of Low Noise Microwave Amplifiers

In low noise microwave amplifier design, particularly when using conditionally stable transistors, it is impossible to simultaneously achieve maximum gain, minimum noise figure and maximum port match. Hence it is necessary to trade-off these performance parameters which is usually accomplished with the aid of stability, gain, noise figure and mismatch (or VSWR) circles described on the reflection coefficient planes. However, use of these graphical aids is often subjective, necessitating final optimisation using circuit design software. In this paper, we propose a different approach whereby the functional behaviour of two objective functions involving gain, noise figure and port mismatch are described as functions of the stability safety margin. This approach leads to an optimum design without requiring sophisticated optimisation algorithms and includes stability safety margin as a design parameter

Four-transistor interleaved Doherty amplifier

A Doherty amplifier that combines four transistors is proposed. Two transistors are operated in class-B and are interleaved with another two operated in class-C. The interleaved transistors are driven by a travelling-wave feed and their output currents are combined using a single distributed power combiner

Whose idea was it anyway? The dynamics of international policy transfer and the case of consumption tax reform.

There are a number of unresolved debates among scholars concerning the nature of policy transfer and its implications for policy analysis. For example, scholars of a rational functionalist orientation see the exchange of policy knowledge in positive terms – providing governments with evidence of the benefits and problems associated with policy experiments elsewhere. On the other hand, scholars of a more critical orientation regard policy transfer as having the potential to constrain policy choices and privilege structurally dominant actors in the policy process. Empirically it would seem that many different processes result in policy transfer and that models of policy transfer are best regarded as heuristic devices used to guide research into the policy transfer process. This paper employs such an approach by using the policy transfer literature to gain insights into the origins of one of the most politically contested policy agendas both in Australia and across most industrialised nations in recent years – the introduction of VAT-style consumption taxes. The paper begins by mapping the proliferation of VAT-style taxes in the final decades of the 20th Century. The paper then briefly reviews the policy transfer literature before using it to guide a detailed examination of process of policy transfer that led to the proliferation of VATs. The paper concludes by assessing the implications of the VAT case study for both theoretical debates within the policy transfer literature and broader debates about the nature of the policy process

Linear Polarized Matched-Input Active Integrated Transmit Antenna

This paper shows the development of an active integrated transmit antenna which has linear polarization and a matched input. The active antenna comprises a rectangular microstrip patch that is fed by two FETs directly connected to its non-radiating edge. The FETs are driven equally but with a 180 degree phase difference by a modified branch-line coupler. Simulations of a 2.45 GHz active integrated antenna demonstrate the feasibility