The Slow, Lingering Death of the English NHS; Comment on “Who Killed the English National Health Service?”

The death of the English National Health Service (NHS) may be slow in coming but that does not mean that it is not the Conservative-led UK government’s desired end state. The government is displaying tactical cunning in achieving its long-term purpose to remould the British state. Powell seeks greater clarity amidst the confusion but the lack of clarity is a principal weapon in the government’s assault on the public realm, including the NHS. Moreover, there is ample supporting evidence to caution against Powell’s tendency to complacency concerning the ultimate fate of the NHS

From joint anatomy to clinical outcomes in osteoarthritis and cartilage repair: summary of the fifth annual osteoarthritis imaging workshop

SummaryObjectiveThis white paper constitutes an overview of presentations and discussions from the fifth Annual Workshop on Imaging in Osteoarthritis (OA) held in Salzburg June eighth to eleventh 2011.DesignThis workshop brought together the communities of basic OA researchers, orthopedists and rheumatologists, imaging scientists, instrument manufacturers, and pharmaceutical representatives to focus on three overlapping themes of joint anatomy, cartilage repair and clinical validation of imaging biomarkers.ResultsThe workshop was held on the campus of the Paracelsus Medical University in Salzburg, Austria from June 8–11, 2011; 133 attendees participated, representing 17 countries. The meeting was successful in facilitating discussion, raising awareness and consolidating knowledge about application of imaging in OA research studies and cartilage repair.ConclusionsThe OA research communities need to work alongside the regulatory, pharmaceutical, and MRI industries to support the new ideas and engage in the positive reinforcement of resources to further the new studies. A number of new initiatives were discussed to further break down obstacles to clinical trial utility of imaging biomarkers

Partial discharge testing of defective three-phase PILC cable under rated conditions

The ability to accurately monitor the health of power distribution plant is a very attractive prospect for utility companies. This capability would provide a system that engineers could use to assess the real-time state of the network. Analysis of the data produced could allow for more informed decisions to be made in the areas of asset replacement and maintenance scheduling amongst others. It is widely accepted that partial discharge activity is linked with the electrical ageing/degradation of high voltage equipment. Work at Southampton is focused on obtaining a better understanding of the characteristics and trends of partial discharge events associated with medium voltage cables under, 'real life' conditions. An experiment has been developed that allows for service conditions to be applied to defective paper insulated lead covered cable samples. The samples under investigation were exposed to mechanical damage designed to replicate typical problems found on an active circuit. Partial discharge measurement was undertaken during the stressing process

Partial discharge analysis of defective three-phase cable

Power distribution cable networks represent a dynamic and complex challenge with regard to the issues of maintenance and providing a reliable, high quality supply of electrical power. Utilities historically used regular off-line testing to investigate the health of their assets. This method of testing is reasonably effective for this purpose but does have certain drawbacks associated with it; customer supply can be interrupted during the testing process and the cables are generally not tested under normal operating conditions. Meaning that the test data is not representative of the Partial discharge (PD) activity that is apparent under on-line conditions and the testing activity itself could trigger previously dormant PD sources. The modern approach for understanding the health of medium voltage (MV) cable distribution networks is to continuously monitor the assets whilst on-line. Analysis if the field data is then used to inform decisions regarding asset replacement and maintenance strategies. PD activity is widely recognised as a symptom linked to the degradation of the dielectric properties of high voltage plant. UK Power Networks sponsored research is being undertaken to investigate the evolution of PD activity within three-phase paper insulated lead covered (PILC) cables containing introduced defects. An experiment has been designed to stress cable lengths in a manner that is representative of the conditions met by on-line circuits [1]. A cable section containing a defect that is known to lead to the premature failure of in-service cables has been PD tested over a range of operating temperatures. The experiment utilizes three-phase energization at rated voltage as well as thermal cycling of the cable to replicate the daily load pattern experienced by circuits in the field. The extension to this work involves PD testing cable samples containing a range of defects to produce a data set consisting of PD pulses produced by varied sources. Analysis of this data should lead to a better understanding of the signals produced by the premature ageing of these types of cable

A new method for automatic Multiple Partial Discharge Classification

A new wavelet based feature parameter have been developed to represent the characteristics of PD activities, i.e. the wavelet decomposition energy of PD pulses measured from non-conventional ultra wide bandwidth PD sensors such as capacitive couplers (CC) or high frequency current transformers (HFCT). The generated feature vectors can contain different dimensions depending on the length of recorded pulses. These high dimensional feature vectors can then be processed using Principal Component Analysis (PCA) to map the data into a three dimensional space whilst the first three most significant components representing the feature vector are preserved. In the three dimensional mapped space, an automatic Density-Based Spatial Clustering of Applications with Noise (DBSCAN) algorithm is then applied to classify the data cluster(s) produced by the PCA. As the procedure is undertaken in a three dimensional space, the obtained clustering results can be easily assessed. The classified PD sub-data sets are then reconstructed in the time domain as phase-resolved patterns to facilitate PD source type identification. The proposed approach has been successfully applied to PD data measured from electrical machines and power cables where measurements were undertaken in different laboratories

Using interactive workshops to prompt knowledge exchange: a realist evaluation of a knowledge to action initiative

Introduction: Interactive workshops are often the default mechanism for sharing knowledge across professional and sector boundaries; yet we understand little about if, and how, they work. Between 2009 and 2011, the Research to Reality programme in North East England ran eight stand-alone facilitated multi-agency workshops focused on priority public health issues. Local authorities, the health service, and academe collaborated on the programme to share latest evidence and best practice. Methods: A realist evaluation asked the overarching question ‘what worked where, for whom, and under what conditions’ regarding the knowledge exchange (KE) mechanisms underpinning any changes. Data were collected from fifty-one interviews, six observations, and analysis of programme documentation. Results: 191 delegates attended (local authority 46%, NHS 24%, academia 22%, third sector 6%, other 2%). The programme theory was that awareness raising and critical discussion would facilitate ownership and evidence uptake. KE activity included: research digests, academic and senior practitioner presentations, and facilitated round-table discussions. Joint action planning was used to prompt informed follow-up action. Participants valued the digests, expert input, opportunities for discussion, networking and ‘space to think’. However, within a few months, sustainability was lost. There was no evidence of direct changes to practice. Multiple barriers to research utilization emerged. Discussion: The findings suggest that in pressured contexts exacerbated by structural reform providing evidence summaries, input from academic and practice experts, conversational spaces and personal action planning are necessary to create enthusiasm on the day, but are insufficient to prompt practice change in the medium term. The findings question makes assumptions about the instrumental, linear use of knowledge and of change focused on individuals as a driver for organizational change. Delegates' views of ‘what would work’ are shared. Mechanisms that would enhance interactive formats are discussed

Systematic review of the use of data from national childhood obesity surveillance programmes in primary care: a conceptual synthesis

This study reviewed the use in primary care of national surveillance data for children to determine the data's potential utility to inform policy and practice decisions on how to prevent and treat childhood obesity. We reviewed the 28 countries identified by the World Obesity Federation as having high-quality comparable body mass index data for children. Literature published from any period up to December 2013 was included. Peer review literature was searched using Web of Science (Core Collection, MEDLINE). Grey literature was searched using the Internet by country name, programme name and national health and government websites. We included studies that (i) use national surveillance obesity data in primary care, or (ii) explore practitioner or parent perspectives about the use of such data. The main uses of national surveillance data in primary care were to identify and recruit obese children and their parents to participate in school and general practice-based research and/or interventions, and to inform families of children's measurements. Findings indicate a need for school staff and practitioners to receive additional training and support to sensitively communicate with families. Translation of these findings into policy and practice could help to improve current uses of national child obesity surveillance data in primary care