Risk adjustment for hospital use using social security data: cross sectional small area analysis

Objectives: To identify demographic and socioeconomic determinants of need for acute hospital treatment at small area level. To establish whether there is a relation between poverty and use of inpatient services. To devise a risk adjustment formula for distributing public funds for hospital services using, as far as possible, variables that can be updated between censuses. Design: Cross sectional analysis. Spatial interactive modelling was used to quantify the proximity of the population to health service facilities. Two stage weighted least squares regression was used to model use against supply of hospital and community services and a wide range of potential needs drivers including health, socioeconomic census variables, uptake of income support and family credit, and religious denomination. Setting: Northern Ireland. Main outcome measure: Intensity of use of inpatient services. Results: After endogeneity of supply and use was taken into account, a statistical model was produced that predicted use based on five variables: income support, family credit, elderly people living alone, all ages standardised mortality ratio, and low birth weight. The main effect of the formula produced is to move resources from urban to rural areas. Conclusions: This work has produced a population risk adjustment formula for acute hospital treatment in which four of the five variables can be updated annually rather than relying on census derived data. Inclusion of the social security data makes a substantial difference to the model and to the results produced by the formula.

WLAN Security Processor

A novel wireless local area network (WLAN) security processor is described in this paper. It is designed to offload security encapsulation processing from the host microprocessor in an IEEE 802.11i compliant medium access control layer to a programmable hardware accelerator. The unique design, which comprises dedicated cryptographic instructions and hardware coprocessors, is capable of performing wired equivalent privacy, temporal key integrity protocol, counter mode with cipher block chaining message authentication code protocol, and wireless robust authentication protocol. Existing solutions to wireless security have been implemented on hardware devices and target specific WLAN protocols whereas the programmable security processor proposed in this paper provides support for all WLAN protocols and thus, can offer backwards compatibility as well as future upgrade ability as standards evolve. It provides this additional functionality while still achieving equivalent throughput rates to existing architectures. © 2006 IEEE.

Experimental observation of dissociative electron attachment to S2O and S2O2 with a new spectrometer for unstable molecules

A new spectrometer, electron radical interaction chamber, has been developed to study dissociative electron attachment to unstable molecules such as free radicals. It includes a trochoidal electron monochromator and a time-of-flight mass spectrometer. Radicals are generated with a microwave discharge at 2.45 GHz. Preliminary data are presented for radicals formed when a mixture of helium and sulphur dioxide was passed through the microwave discharge. Several new resonances are observed with the discharge on. Resonances at 0 eV (S-), 0.8, 1.2, 3.0 eV (SO-) and 3.7 eV (SO- and S2O-) are assigned to the radical S2O2 and a resonance at 1.6 eV (S-) is assigned to S2O. No new resonances have been assigned to SO, which was also generated in the microwave discharge.

Dissociative electron attachment to HCCCN

Dissociative electron attachment to cyanoacetylene (propiolonitrile) HCCCN has been observed in the electron energy range 0-12 eV. Negative ions are formed in two main bands with maxima at similar to 1.6 eV (CCCN-) and similar to 5.3 eV (CCCN-, CN-, HCC- and CC-). There are also weaker resonances which lead to dissociative electron attachment to form CN-, HCC- and CC- with a maximum intensity at similar to 8.1 eV and CCCN-, CN- and CC- at similar to 11.2 eV. A trace of CCN- is observed at similar to 9.1 eV. The positions of the main dissociative attachment bands observed are close to positions of pi* resonances recently calculated by Sommerfeld and Knecht. Calculations have also been performed in this work, which confirm the position of the p* orbitals. The electron affinity of the CCCN radical is determined as 4.59 +/- 0.25 eV from the threshold for CCCN- formation at 1.32 +/- 0.15 eV. Dissociative electron attachment to this molecule will act as a source of negative ions in extraterrestrial environments where electrons are present with more than 1.3 eV energy.

Demographic Change, Social Security Systems, and Savings

Abstract In theory, improvements in healthy life expectancy should generate increases in the average age of retirement, with little effect on savings rates. In many countries, however, retirement incentives in social security programs prevent retirement ages from keeping pace with changes in life expectancy, leading to an increased need for life-cycle savings. Analyzing a cross-country panel of macroeconomic data, we find that increased longevity raises aggregate savings rates in countries with universal pension coverage and retirement incentives, though the effect disappears in countries with pay-as-you-go systems and high replacement rates.

Attachment Style in Adults who Failed to Thrive as Children: Outcomes of a 20 Year Follow-up Study of Factors Influencing Maintenance or Change in Attachment Style

A group of children identified as non-organic failure-to-thrive between 1977 and 1980 were investigated, assessed and provided with social work intervention and treatment. Those children and their families have been followed up for the last 20 years. The current paper examines the stability of an internal working model in a sample of individuals who had failed to thrive as children, by comparing each individual's adult attachment style with their childhood attachment to their mother. In this sample, several cases showed changes from insecure to secure attachment styles. Possible reasons are discussed for positive and negative changes, as well as cases when there was no change in attachment style. These include the effectiveness of intervention in addition to changes in life circumstances. The findings suggest that when appropriate support and intervention is provided, or when different circumstances or relationships are experienced, internal working models can change.

Maternal appraisals of risk, coping and prenatal attachment among women hospitalised with pregnancy complications

One goal of pregnancy is the development of maternal emotional attachment to
the unborn baby, and this attachment has been shown to be related to later
relationships and development. There are many factors which may hinder the
development of prenatal attachment, including the presence of complications,
hospitalisation, and anxiety. However, women’s appraisals of risk may not be
congruent with medical assessments of risk. The current study sought to model
the relationships between risk (maternal perceptions and medical ratings), coping, psychological well-being, and maternal–foetal attachment among 87 women hospitalised for pregnancy-related complications. Analysis indicated that positive appraisal as a coping strategy mediates the relationship between maternal appraisals of risk and maternal–foetal attachment, and that medical ratings of risk were not predictive of maternal–foetal attachment. Awareness of the potential incongruence between patients’ and health professionals’ perceptions of risk is important within the clinical environment. The potential benefits of promoting positive appraisal in high-risk pregnancy merit further research.