The challenges of joint working: lessons from the Supporting People Health Pilot evaluation

Purpose: This paper reports the findings of the evaluation of the Supporting People Health Pilots programme, which was established to demonstrate the policy links between housing support services and health and social care services by encouraging the development of integrated services. The paper highlights the challenges Method: The evaluation of the six health pilots rested on two main sources of data collection: Quarterly Project Evaluation Reports collected process data as well as reporting progress against aims and objectives. Semi-structured interviews—conducted across all key professional stakeholder groups and agencies and with people who used services—explored their experiences of these new services. Results: The ability of pilots to work across organisational boundaries to achieve their aims and objectives was associated not only with agencies sharing an understanding of the purpose of the joint venture, a history of joint working and clear and efficient governance arrangements but on two other characteristics: the extent and nature of statutory sector participation and, whether or not the service is defined by a history of voluntary sector involvement. In particular the pilots demonstrated how voluntary sector agencies appeared to be less constrained by organisational priorities and professional agenda and more able to respond flexibly to meet the complex needs of individuals. Conclusion and discussion: The pilots demonstrate that integrating services to support people with complex needs works best

Multiple Luminaire Identification in Airborne Images of Airport’s Approach Lighting Using Mathematical Morphology With Variable Length Structuring Element

The increasing demand for fast air transportation around the clock
has increased the number of night flights in civil aviation over
the past few decades. In night aviation, to land an aircraft, a
pilot needs to be able to identify an airport. The approach
lighting system (ALS) at an airport is used to provide
identification and guidance to pilots from a distance. ALS
consists of more than $100$ luminaires which are installed in a
defined pattern following strict guidelines by the International
Civil Aviation Organization (ICAO). ICAO also has strict
regulations for maintaining the performance level of the
luminaires. However, once installed, to date there is no automated
technique by which to monitor the performance of the lighting. We
suggest using images of the lighting pattern captured using a camera
placed inside an aircraft. Based on the information contained
within these images, the performance of the luminaires has to be
evaluated which requires identification of over $100$ luminaires
within the pattern of ALS image. This research proposes analysis
of the pattern using morphology filters which use a variable
length structuring element (VLSE). The dimension of the VLSE changes
continuously within an image and varies for different images.
A novel
technique for automatic determination of the VLSE is proposed and
it allows successful identification of the luminaires from the
image data as verified through the use of simulated and real data.

Multipair Full-Duplex Relaying with Massive Arrays and Linear Processing

We consider a multipair decode-and-forward relay channel, where multiple sources transmit simultaneously their signals to multiple destinations with the help of a full-duplex relay station. We assume that the relay station is equipped with massive arrays, while all sources and destinations have a single antenna. The relay station uses channel estimates obtained from received pilots and zero-forcing (ZF) or maximum-ratio combining/maximum-ratio transmission (MRC/MRT) to process the signals. To reduce significantly the loop interference effect, we propose two techniques: i) using a massive receive antenna array; or ii) using a massive transmit antenna array together with very low transmit power at the relay station. We derive an exact achievable rate in closed-form for MRC/MRT processing and an analytical approximation of the achievable rate for ZF processing. This approximation is very tight, especially for large number of relay station antennas. These closed-form expressions enable us to determine the regions where the full-duplex mode outperforms the half-duplex mode, as well as, to design an optimal power allocation scheme. This optimal power allocation scheme aims to maximize the energy efficiency for a given sum spectral efficiency and under peak power constraints at the relay station and sources. Numerical results verify the effectiveness of the optimal power allocation scheme. Furthermore, we show that, by doubling the number of transmit/receive antennas at the relay station, the transmit power of each source and of the relay station can be reduced by 1.5dB if the pilot power is equal to the signal power, and by 3dB if the pilot power is kept fixed, while maintaining a given quality-of-service.

Understanding the practice nurse’s role in the cancer care tapestry

Background: The are currently 2 million people in the UK living with or
after cancer, and this number is expected to double by 2030 (Maddams et
al, 2012). However, many report unmet physical and psychological needs.

Aim: To determine the learning needs of practice nurses to take on an
enhanced role with people affected by cancer, particularly after primary
treatment, and to develop a course to meet these needs.

Method: The Macmillan Steering Group designed and developed a course for practice
nurses to identify their learning needs, enabling participating practice
nurses to work collaboratively with each other and the course facilitator.
There was strong patient involvement throughout. The course was
evaluated by self-assessment of knowledge, skills and confidence, patient
satisfaction questionnaires and in-depth, qualitative telephone interviews
with the participants and their supporting GPs.

Results: The practice nurses reported changed practice, with increased confidence in discussing
issues relating to cancer and its treatment with patients and relatives.
They understood the importance of supported self-management and were
able to signpost patients to appropriate sources of information and
support. Many of the practice nurses started initiating and undertaking
Cancer Care Reviews, both as planned appointments and opportunistically.
Over the past year, a further nine pilots have been completed throughout
the UK, demonstrating that these results are reproducible in other settings.

Conclusions: With appropriate support and training and protected time
to include cancer care into their everyday work, practice nurses can take
on an important role in the support and care of people affected by cancer