Developing a best practice model for partnership practice between specialist palliative care and intellectual disability services: a mixed methods study

Background: The lack of access to good quality palliative care for people with intellectual disabilities is highlighted in the international literature. In response, more partnership practice in end-of-life care is proposed. 
Aim: This study aimed to develop a best practice model to guide and promote partnership practice between specialist palliative care and intellectual disability services. 
Design: A mixed methods research design involving two phases was used, underpinned by a conceptual model for partnership practice. 
Setting/participants: Phase 1 involved scoping end-of-life care to people with intellectual disability, based on self-completed questionnaires. In all, 47 of 66 (71.2%) services responded. In Phase 2, semi-structured interviews were undertaken with a purposive sample recruited of 30 health and social care professionals working in intellectual disability and palliative care services, who had provided palliative care to someone with intellectual disability. For both phases, data were collected from primary and secondary care in one region of the United Kingdom. 
Results: In Phase 1, examples of good practice were apparent. However, partnership practice was infrequent and unmet educational needs were identified. Four themes emerged from the interviews in Phase 2: challenges and issues in end-of-life care, sharing and learning, supporting and empowering and partnership in practice. 
Conclusion: Joint working and learning between intellectual disability and specialist palliative care were seen as key and fundamental. A framework for partnership practice between both services has been developed which could have international applicability and should be explored with other services in end-of-life care.

Millimeter-wave communications for 5G: fundamentals: Part I [Guest Editorial]

The widespread availability and demand for multimedia capable devices and multimedia content have fueled the need for high-speed wireless connectivity beyond the capabilities of existing commercial standards. While fiber optic data transfer links can provide multigigabit- per-second data rates, cost and deployment are often prohibitive in many applications. Wireless links, on the contrary, can provide a cost-effective fiber alternative to interconnect the outlining areas beyond the reach of the fiber rollout. With this in mind, the ever increasing demand for multi-gigabit wireless applications, fiber segment replacement mobile backhauling and aggregation, and covering the last mile have posed enormous challenges for next generation wireless technologies. In particular, the unbalanced temporal and geographical variations of spectrum usage along with the rapid proliferation of bandwidth- hungry mobile applications, such as video streaming with high definition television (HDTV) and ultra-high definition video (UHDV), have inspired millimeter-wave (mmWave) communications as a promising technology to alleviate the pressure of scarce spectrum resources for fifth generation (5G) mobile broadband.

Improving signal reliability for indoor off–body communications using spatial diversity at the base station

In this paper, we investigate the potential improvement in signal reliability for indoor off-body communications when using spatial diversity at the base station. In particular, we utilize two hypothetical indoor base stations operating at 5.8 GHz each featuring four antennas which are spaced at either half- or one-wavelength apart. Three on-body locations are considered along with four types of user movement. The cross-correlation between the received signal envelopes observed at each base station antenna element was calculated and found to be always less than 0.5. Selection, maximal ratio, and equal gain combining of the received signal has shown that the greatest improvement is obtained when the user is mobile, with a maximum diversity gain of 11.34 dB achievable when using a four branch receiver. To model the fading envelope obtained at the output of the virtual combiners, we use diversity specific, theoretical probability density functions for multi-branch receivers operating in Nakagami-m fading channels. It is shown that these equations provide an excellent fit to the measured channel data.

A statistical characterization of shadowed device-to-device communications in an indoor environment

This paper presents the results of a measurement campaign aimed at characterizing and modeling the indoor radio channel between two hypothetical cellular handsets. The device-to-device channel measurements were made at 868 MHz and investigated a number of different everyday scenarios such as the devices being held at the user's heads, placed in a pocket and one of the devices placed on a desktop. The recently proposed shadowed k-μ fading model was used to characterize these channels and was shown to provide a good description of the measured data. It was also evident from the experiments, that the device-to-device communications channel is susceptible to shadowing caused by the human body.

A statistical analysis of person–to–vehicle communications channels in an urban environment at 5.8 GHz

In recent years, the embracement of smart devices carried or worn by people have transformed how society interact with one another. This trend has also been observed in the advancement of vehicular networks. Here, developments in wireless technologies for vehicle-to-vehicle (V2V) and vehicle-to-roadside (V2R) communications are leading to a new generation of vehicular networks. A natural extension of both types of networks will be their eventual wireless integration. Both people and vehicles will undoubtedly form integral parts of future mobile networks of people and things. Central to this will be the person-to-vehicle (P2V) communications channel. As the P2V channel will be subject to different signal propagation characteristics than either type of communication system considered in isolation, it is imperative the characteristics of the wireless channel must first be fully understood. To the best of the author's knowledge, this is a topic which has not yet been addressed in the open literature. In this paper we will present our most recent research on the statistical characterization of the 5.8 GHz person-to-vehicle channel in an urban environment.

Shadowed fading in body–to–body communications channels in an outdoor environment at 2.45 GHz

In this paper a number of outdoor body-to-body communications channels at 2.45 GHz which are deemed to be susceptible to shadowed fading are analyzed. The newlyproposed shadowed K-Il model is used to characterize thesechannels. Its probability density function is shown to provide an improved fit to the distribution of the signal fading compared to established models such as lognormal, Nakagamiand Rice.

Small–scale fading characteristics of diversity combining schemes used for body–to–body communications within an urban environment at 2.45 GHz

In this paper, an analysis of spatial diversity and small-scale fading characteristics for body-to-bodycommunications is presented. The measurements were made at 2.45 GHz in an urban environment with uncontrolled pedestrian and vehicular traffic. The virtual array of four distributed receive antennas where situated on the centralchest, central waist, left waist and left wrist of the user’s body. Combining of the received signal measured at each ofthe antennas in the virtual array has shown that an average diversity gain of up to 11.8 dB can be achieved when usingfour distributed antennas and a maximal ratio combining scheme. To model the small-scale fading characteristics obtained at the output of the virtual combiners, we use diversity specific, theoretical probability density functions for multi-branch receivers operating in Nakagami-m fading channels. It is shown that these equations provide an excellent fit to the measured channel data.

Indoor off–body communications at 5.8 GHz with multiple antennas at the base station: a statistical characterization using the Nakagami–m fading model

In this paper we investigate the first and second order characteristics of the received signal at the output ofhypothetical selection, equal gain and maximal ratio combiners which utilize spatially separated antennas at the basestation. Considering a range of human body movements, we model the model the small-scale fading characteristics ofthe signal using diversity specific analytical equations which take into account the number of available signal branchesat the receiver. It is shown that these equations provide an excellent fit to the measured channel data. Furthermore, formany hypothetical diversity receiver configurations, the Nakagami-m parameter was found to be close to 1.

Channel measurements of device–to–device communications in an urban outdoor environment

In this paper, the results of radio channel measurements between two hypothetical cellular handsets in an outdoor urban environment are reported. The device-to-device channel measurements were made at 868 MHz and investigated a number of different everyday usage scenarios such as the devices being held at the user's heads, placed in a pocket while one of the users rotated or both moved randomly. It was found that shadowing of the main signal path caused by the human body will be an important factor in future device-to-device communications at this frequency. The recently proposed shadowed κ-μ fading model was used to characterize these channels and shown to provide a good description of the measured data.

Characteristics of shadowed fading in off–body communications channels at 2.45 GHz

In this paper, a number of off-body channels which are susceptible to shadowing caused by the human body are investigated. In particular, the recently proposed shadowed κ–μ fading model is fitted to data obtained from field trials performed in low multipath conditions at 2.45 GHz. It is shown that this model provides a significantly improved fit to off-body channels which are subject to shadowing when compared to other fading models such as lognormal, Nakagami-m and Rice which are commonly applied to model fading in body centric communications channels.

Human body shadowing in cellular device-to-device communications: channel modeling using the shadowed κ−μ fading model

Using device-to-device communications as an underlay for cellular communications will provide an exciting opportunity to increase network capacity as well as improving spectral efficiency. The unique geometry of device-to-device links, where user equipment is often held or carried at low elevation and in close proximity to the human body, will mean that they are particularly susceptible to shadowing events caused not only by the local environment but also by the user's body. In this paper, the shadowed κ - μ fading model is proposed, which is capable of characterizing shadowed fading in wireless communication channels. In this model, the statistics of the received signal are manifested by the clustering of multipath components. Within each of these clusters, a dominant signal component with arbitrary power may exist. The resultant dominant signal component, which is formed by the phasor addition of these leading contributions, is assumed to follow a Nakagami- m distribution. The probability density function, moments, and the moment-generating function are also derived. The new model is then applied to device-to-device links operating at 868 MHz in an outdoor urban environment. It was found that shadowing of the resultant dominant component can vary significantly depending upon the position of the user equipment relative to the body and the link geometry. Overall, the shadowed κ - μ fading model is shown to provide a good fit to the field data as well as providing a useful insight into the characteristics of the received signal.

Changing the intellectual climate

Calls for more broad-based, integrated, useful knowledge now abound in the world of global environmental change science. They evidence many scientists' desire to help humanity confront the momentous biophysical implications of its own actions. But they also reveal a limited conception of social science and virtually ignore the humanities. They thereby endorse a stunted conception of 'human dimensions' at a time when the challenges posed by global environmental change are increasing in magnitude, scale and scope. Here, we make the case for a richer conception predicated on broader intellectual engagement and identify some preconditions for its practical fulfilment. Interdisciplinary dialogue, we suggest, should engender plural representations of Earth's present and future that are reflective of divergent human values and aspirations. In turn, this might insure publics and decision-makers against overly narrow conceptions of what is possible and desirable as they consider the profound questions raised by global environmental change.