Choice of contracts in the British National Health Service: An empirical study

Following major reforms of the British National Health Service (NHS) in 1990, the roles of purchasing and providing health services were separated, with the relationship between purchasers and providers governed by contracts. Using a mixed multinomial logit analysis, we show how this policy shift led to a selection of contracts that is consistent with the predictions of a simple model, based on contract theory, in which the characteristics of the health services being purchased and of the contracting parties influence the choice of contract form. The paper thus provides evidence in support of the practical relevance of theory in understanding health care market reform. © 2008 Elsevier B.V. All rights reserved.

Mesoporous SSZ-13 zeolite prepared by a dual-template method with improved performance in the methanol-to-olefins reaction

Hierarchical SSZ-13 zeolites were synthesized by combining N,N,N-trimethyl-1-adamantanammonium hydroxide (TMAdOH) as the structure-directing agent for chabazite formation with mono- and diquaternary ammonium-type and organosilane mesoporogens and extensively characterized for their structural, textural, and catalytic properties. Mesoporous SSZ-13 zeolites can be synthesized in one step by combining TMAdOH and the diquaternary ammonium-type surfactant C22-4-4Br2. The mesopore volume increases with the mesoporogen/SDA ratio. The hierarchical zeolites are highly crystalline and exhibit similar Brønsted acidity as SSZ-13. Hierarchical SSZ-13 zeolites display increased lifetime in packed-bed MTO experiments than conventional SSZ-13 at similar light olefins yield. The increased lifetime is due to better utilization of the micropore space. With increasing mesoporosity, the micropore space is used more efficiently, but also the rate of coke formation at the crystal periphery increases. Accordingly, the most stable zeolite is obtained at a relatively low C22-4-4Br2/SDA ratio. These zeolite catalysts can be regenerated without substantial loss of activity.

Cognitive and task-related EEG correlates of arithmetic performance in adolescents

Cognitive and neurophysiological correlates of arithmetic calculation, concepts, and applications were examined in 41 adolescents, ages 12-15 years. Psychological and task-related EEG measures which correctly distinguished children who scored low vs. high (using a median split) in each arithmetic subarea were interpreted as indicative of processes involved. Calculation was related to visual-motor sequencing, spatial visualization, theta activity measured during visual-perceptual and verbal tasks at right- and left-hemisphere locations, and right-hemisphere alpha activity measured during a verbal task. Performance on arithmetic word problems was related to spatial visualization and perception, vocabulary, and right-hemisphere alpha activity measured during a verbal task. Results suggest a complex interplay of spatial and sequential operations in arithmetic performance, consistent with processing model concepts of lateralized brain function.

Advances in our understanding of diabetic retinopathy

Diabetic retinopathy remains the most common complication of diabetes mellitus and is a leading cause of visual loss in industrialized nations. The clinicopathology of the diabetic retina has been extensively studied, although the precise pathogenesis and cellular and molecular defects that lead to retinal vascular, neural and glial cell dysfunction remain somewhat elusive. This lack of understanding has seriously limited the therapeutic options available for the ophthalmologist and there is a need to identify the definitive pathways that initiate retinal cell damage and drive progression to overt retinopathy. The present review begins by outlining the natural history of diabetic retinopathy, the clinical features and risk factors. Reviewing the histopathological data from clinical specimens and animal models, the recent paradigm that neuroretinal dysfunction may play an important role in the early development of the disease is discussed. The review then focuses on the molecular pathogenesis of diabetic retinopathy with perspective provided on new advances that have furthered our understanding of the key mechanisms underlying early changes in the diabetic retina. Studies have also emerged in the past year suggesting that defective repair of injured retinal vessels by endothelial progenitor cells may contribute to the pathogenesis of diabetic retinopathy. We assess these findings and discuss how they could eventually lead to new therapeutic options for diabetic retinopathy.

Testate amoebae (thecamoebians) as water quality indicators in lakes: development of a modern distributional dataset from the Greater Toronto Area

Thecamoebians were examined from 123 surface sediment samples collected from 45 lakes in the Greater Toronto Area (GTA) and the surrounding region to i) elucidate the controls on faunal distribution in modern lake environments; and ii) to consider the utility of thecamoebians in quantitative studies of water quality change. This area was chosen because it includes a high density of lakes that are threatened by urban development and where water quality has deteriorated locally as a result of contaminant inputs, particularly nutrients. Canonical Correspondence analysis (CCA) and a series of partial CCAs were used to examine species-environment relationships. Twenty-four environmental variables were considered, including water properties (e.g. pH, DO, conductivity), substrate characteristics, nutrient loading, and environmentally available metals. The thecamoebian assemblages showed a strong association with Olsen's Phosphorus, reflecting the eutrophic status of many of the lakes, and locally to elevated conductivity measurements, which appear to reflect road salt inputs associated with winter de-icing operations. A transfer function was developed for Olsen P using this training set based on weighted averaging with inverse deshrinking (WA Inv). The model was applied to infer past changes in Phosphorus enrichment in core samples from several lakes, including eutrophic Haynes Lake within the GTA. Thecamoebian-inferred changes in sedimentary Phosphorus from a 210Pb dated core from Haynes Lake are related to i) widespread introduction of chemical fertilizers to agricultural land in the post WWII era; ii) a steep decline in Phosphorous with a change in agricultural practices in the late 1970s; and iii) the construction of a golf course in close proximity to the lake in the early 1990s. This preliminary study confirms that thecamoebians have considerable potential as indicators of eutrophication in lakes and can provide an estimate of baseline conditions.

Making geography mobile: using location aware technology to improve student performance in physical geography

With the increased availability of new technologies, geography educators are revisiting their pedagogical approaches to teaching and calling for opportunities to share local and international practices which will enhance the learning experience and improve students’ performance. This paper reports on the use of handheld mobile devices, fitted with GPS, by secondary (high) school pupils in geography. Two location-aware activities were completed over one academic year (one per semester) and pre-test and post-test scores for both topics revealed a statistically significant increase in pupils’ performance as measured by the standard national assessments. A learner centred educational approach was adopted with the first mobile learning activity being created by the teacher as an exemplar of effective mobile learning design. Pupils built on their experiences of using mobile learning when they were required to created their own location aware learning task for peer use. An analysis of the qualitative data from the pupils’ journals, group diaries and focus group interviews revealed the five pillars of learner centred education are addressed when using location aware technologies and the use of handheld mobile devices offered greater flexibility and autonomy to the pupils thus altering the level of power and control away from the teacher. Due to the relatively small number of participants in the study, the results are more informative than generalisable however in light of the growing interest in geo-spatial technologies in geography education, this paper offers encouragement and insight into the use of location aware technology in a compulsory school context

Compromising Spatial Quality: Modernity in the Era of National State Building in Cairo

The paper examines the imposition of western ideals of urbanism within colonial Cairo between1882-1952. It looks at the ideologies of capitalism, state control, and utopian idealism, which were vital tools to create modern built environments in the city. The argument is that principles of Western urbanism were at work and deeply influenced the institutional and professional practices of the Egyptian planners, who were mostly educated in Europe; however the outcomes revealed a major shift towards more inflexible solutions described as more open to compromise with the existing conditions. The paper analyses the case of a re-planning scheme drafted in the 1920s by the first Egyptian director of the Ministry of Town Planning under the British occupation. The scheme represented the superimposition of a western-style neighbourhood model on a historically rooted traditional quarter in Cairo. The paper largely relies on original archival materials, maps, documents and accounts to support the historical narrative of urban planning in Cairo. It reports that westernization approaches for planning Cairo were introduced to offer a new imagery representation, which remained central to the development of planning practices in postcolonial Egypt through different practical applications.

The value of water quality improvements in the region Berlin-Brandenburg as a function of distance and state residency

This study uses a discrete choice experiment (DCE) to elicit willingness to pay estimates for changes in the water quality of three rivers. As many regions the metropolitan region Berlin-Brandenburg struggles to achieve the objectives of the Water Framework Directive until 2015. A major problem is the high load of nutrients. As the region is part of two states (Länder) and the river sections are common throughout the whole region we account for the spatial context twofold. Firstly, we incorporate the distance between each respondent and all river stretches in all MNL and RPL models, and, secondly, we consider whether respondents reside in the state of Berlin or Brandenburg. The compensating variation (CV) calculated for various scenarios shows that overall people would significantly benefit from improved water quality. The CV measures, however, also reveal that not considering the spatial context would result in severely biased welfare measures. While the distance decay effect lowers CV, state residency is connected to the frequency of status quo choices and not accounting for residency would underestimate possible welfare gains in one state. Another finding is that the extent of the market varies with respect to attributes (river stretches) and attribute levels (water quality levels).

Tools for Finding Inconsistencies in Real-world Logic-based Systems

Currently there is extensive theoretical work on inconsistencies in logic-based systems. Recently, algorithms for identifying inconsistent clauses in a single conjunctive formula have demonstrated that practical application of this work is possible. However, these algorithms have not been extended for full knowledge base systems and have not been applied to real-world knowledge. To address these issues, we propose a new algorithm for finding the inconsistencies in a knowledge base using existing algorithms for finding inconsistent clauses in a formula. An implementation of this algorithm is then presented as an automated tool for finding inconsistencies in a knowledge base and measuring the inconsistency of formulae. Finally, we look at a case study of a network security rule set for exploit detection (QRadar) and suggest how these automated tools can be applied.