Market reforms and privatisation in the English National Health Service

The article examines developments in the marketisation and privatisation of the English National Health Service, primarily since 1997. It explores the use of competition and contracting out in ancillary services and the levering into public services of private finance for capital developments through the Private Finance Initiative. A substantial part of the article examines the repeated restructuring of the health service as a market in clinical services, initially as an internal market but subsequently as a market increasing opened up to private sector involvement. Some of the implications of market processes for NHS staff and for increased privatisation are discussed. The article examines one episode of popular resistance to these developments, namely the movement of opposition to the 2011 health and social care legislative proposals. The article concludes with a discussion of the implications of these system reforms for the founding principles of the NHS and the sustainability of the service.

Radio frequency communication and fault detection for railway signalling

The continuous and swift progression of both wireless and wired communication technologies in today's world owes its success to the foundational systems established earlier. These systems serve as the building blocks that enable the enhancement of services to cater to evolving requirements. Studying the vulnerabilities of previously designed systems and their current usage leads to the development of new communication technologies replacing the old ones such as GSM-R in the railway field. The current industrial research has a specific focus on finding an appropriate telecommunication solution for railway communications that will replace the GSM-R standard which will be switched off in the next years. Various standardization organizations are currently exploring and designing a radiofrequency technology based standard solution to serve railway communications in the form of FRMCS (Future Railway Mobile Communication System) to substitute the current GSM-R. Bearing on this topic, the primary strategic objective of the research is to assess the feasibility to leverage on the current public network technologies such as LTE to cater to mission and safety critical communication for low density lines. The research aims to identify the constraints, define a service level agreement with telecom operators, and establish the necessary implementations to make the system as reliable as possible over an open and public network, while considering safety and cybersecurity aspects. The LTE infrastructure would be utilized to transmit the vital data for the communication of a railway system and to gather and transmit all the field measurements to the control room for maintenance purposes. Given the significance of maintenance activities in the railway sector, the ongoing research includes the implementation of a machine learning algorithm to detect railway equipment faults, reducing time and human analysis errors due to the large volume of measurements from the field.

Loading and damage modelling for an integrated SHM system of a prestressed concrete railway bridge in Naples

The thesis explores recent technology developments in the field of structural health monitoring and its application to railway bridge projects. It focuses on two main topics. First, service loads and effect of environmental actions are modelled. In particular, the train moving load and its interaction with rail track is considered with different degrees of detail. Hence, results are compared with real-time experimental measurements. Secondly, the work concerns the identification, definition and modelling process of damages for a prestressed concrete railway bridge, and their implementation inside FEM models. Along with a critical interpretation of the in-field measurements, this approach results in the development of undamaged and damaged databases for the AI-aided detection of anomalies and the definition of threshold levels to prompt automatic alert interventions. In conclusion, an innovative solution for the development of the railway weight-in-motion system is proposed.

Performance Analysis of 5G based Positioning in Railway Applications

Rail transportation has significant importance in the future world. This importance is tightly bounded to accessible, sustainable, efficient and safe railway systems. Precise positioning in railway applications is essential for increasing railway traffic, train-track control, collision avoidance, train management and autonomous train driving. Hence, precise train positioning is a safety-critical application. Nowadays, positioning in railway applications highly depends on a cellular-based system called GSM-R, a railway-specific version of Global System for Mobile Communications (GSM). However, GSM-R is a relatively outdated technology and does not provide enough capacity and precision demanded by future railway networks. One option for positioning is mounting Global Navigation Satellite System (GNSS) receivers on trains as a low-cost solution. Nevertheless, GNSS can not provide continuous service due to signal interruption by harsh environments, tunnels etc. Another option is exploiting cellular-based positioning methods. The most recent cellular technology, 5G, provides high network capacity, low latency, high accuracy and high availability suitable for train positioning. In this thesis, an approach to 5G-based positioning for railway systems is discussed and simulated. Observed Time Difference of Arrival (OTDOA) method and 5G Positioning Reference Signal (PRS) are used. Simulations run using MATLAB, based on existing code developed for 5G positioning by extending it for Non Line of Sight (NLOS) link detection and base station exclusion algorithms. Performance analysis for different configurations is completed. Results show that efficient NLOS detection improves positioning accuracy and implementing a base station exclusion algorithm helps for further increase.

[principles Of Universality, Comprehensiveness And Equity In A Hearing Health Care Service].

This article analyzed whether the practices of hearing health care were consistent with the principles of universality, comprehensiveness and equity from the standpoint of professionals. It involved qualitative research conducted at a Medium Complexity Hearing Health Care Center. A social worker, three speech therapists, a physician and a psychologist constituted the study subjects. Interviews were conducted as well as observation registered in a field diary. The thematic analysis technique was used in the analysis of the material. The analysis of interviews resulted in the construction of the following themes: Universality and access to hearing health, Comprehensive Hearing Health Care and Hearing Health and Equity. The study identified issues that interfere with the quality of service and run counter to the principles of Brazilian Unified Health System. The conclusion reached was that a relatively simple investment in training and professional qualification can bring about significant changes in order to promote a more universal, comprehensive and equitable health service.

A retrospective study of Traumatic Dental Injuries in a Brazilian dental urgency service

Epidemiologic aspects of traumatic dental injuries (TDI) were evaluated in the permanent dentition in a sample of 847 patients treated at the Dental Urgency Service of the Dental School of the Federal University of Goiás, Brazil, between May 2000 and May 2008. The statistical treatment analyzed data from frequency distribution and chi-square test. The level of significance was set at 5% for all analyses. The results showed a higher incident among males (610; 72.01%) with mean age of 6-10 year-old. Uncomplicated crown fracture (without pulp exposure) (502; 26.95%), avulsion (341; 18.30%) and complicated crown fracture (with pulp exposure) (330; 17.71%) were the most prevalent TDI. The prevalence of trauma throughout the years showed proportionality, being observed a larger number of cases between July and September (249; 29.39%). The most affected teeth were the maxillary central incisors (65.65%), followed by the maxillary left lateral incisors (19.67%). In 311 participants (18.25%), only one tooth was involved, while in most patients (536; 81.75%), TDI occurred in more than one tooth. Significant proportion (82.27%) of traumatized teeth presented completely formed root apex. The main etiologic factors involved in TDI were falls (51.71%), traffic accidents (22.90%) and violence (5.67%). Based on the obtained data, it may be concluded that accurate policies of TDI prevention must be established, capable of stimulating the exposure of appropriate protocols for management of these lesions. The prevalence of TDI in Goiânia subpopulation is compared to the prevalence reported in epidemiological studies in others populations.

The Process of Simulation Authoring/Creation by Chemistry Teachers: A Service Learning Experience

Two case studies are presented to describe the process of public school teachers authoring and creating chemistry simulations. They are part of the Virtual Didactic Laboratory for Chemistry, a project developed by the School of the Future of the University of Sao Paulo. the documental analysis of the material produced by two groups of teachers reflects different selection process for both themes and problem-situations when creating simulations. The study demonstrates the potential for chemistry learning with an approach that takes students' everyday lives into account and is based on collaborative work among teachers and researches. Also, from the teachers' perspectives, the possibilities of interaction that a simulation offers for classroom activities are considered.

MODELING OF AN INFORMATION SYSTEM FOR WINE TRACEABILITY BASED ON A SERVICE ORIENTED ARCHITECTURE

The purpose is to present a scientific research that led to the modeling of an information system which aimed at the maintenance of traceability data in the Brazilian wine industry, according to the principles of a service-oriented architecture (SOA). Since 2005, traceability data maintenance is an obligation for all producers that intend to export to any European Union country. Also, final customers, including the Brazilian ones, have been asking for information about food products. A solution that collectively contemplated the industry was sought in order to permit that producer consortiums of associations could share the costs and benefits of such a solution. Following an extensive bibliographic review, a series of interviews conducted with Brazilian researchers and wine producers in Bento Goncalves - RS, Brazil, elucidated many aspects associated with the wine production process. Information technology issues related to the theme were also researched. The software was modeled with the Unified Modeling Language (UML) and uses web services for data exchange. A model for the wine production process was also proposed. A functional prototype showed that the adopted model is able to fulfill the demands of wine producers. The good results obtained lead us to consider the use of this model in other domains.

Experimental investigation on the dynamic behaviour of a railway vehicle travelling through a turnout

Track critical locations with respect to the railway vehicle safety are the passages through the turnouts. The purpose of this investigation is to evaluate the safety of a railway vehicle crossing a turnout. In this study, the topography of a track turnout lay-out has been experimentally measured, and its geometric properties were synthesised. Results show that a constant wavelength vehicle oscillation occurs on the switches in the turnout and that the maximum lateral force at 65 km/h is almost 65% greater than those at low speeds (under 30 km/h).

Safety of a railway wheelset - derailment simulation with increasing lateral force

The motivation for this research is to make a comparison between dynamic results of a free railway wheelset derailment and safety limits. For this purpose, a numerical simulation of a wheelset derailment submitted to increasing lateral force is used to compare with the safety limit, using different criteria. A simplified wheelset model is used to simulate derailments with different adhesion conditions. The contact force components, including the longitudinal and spin effects, are identified in a steady-state condition on the verge of a derailment. The contact force ratios are used in a three-dimensional (3D) analytical formula to calculate the safety limits. Simulation results obtained with two contact methods were compared with the published results and the safety limit was identified with the two criteria. Results confirm Nadal`s conservative aspect and show that safety 3D analytical formula presents slightly higher safety limits for lower friction coefficients and smaller limits for high friction, in comparison with the simulation results with Fastsim.

Application of the essential work of fracture method in ranking the performance in service of high-density polyethylene resins employed in pressure pipes

High-density polyethylene resins have increasingly been used in the production of pipes for water- and gas-pressurized distribution systems and are expected to remain in service for several years, but they eventually fail prematurely by creep fracture. Usual standard methods used to rank resins in terms of their resistance to fracture are expensive and non-practical for quality control purposes, justifying the search for alternative methods. Essential work of fracture (EWF) method provides a relatively simple procedure to characterize the fracture behavior of ductile polymers, such as polyethylene resins. In the present work, six resins were analyzed using the EWF methodology. The results show that the plastic work dissipation factor, beta w(p), is the most reliable parameter to evaluate the performance. Attention must be given to specimen preparation that might result in excessive dispersion in the results, especially for the essential work of fracture w(e).

Expo 1988 Information Service Centre, Brisbane

View to service centre during Expo 1988.

Perceptions of mental health service delivery among staff and Indigenous consumers: it's still about communication

Objective: A needs analysis was undertaken to determine the quality and effectiveness of mental health services to Indigenous consumers within a health district of Southern Queensland. The study focussed on identifying gaps in the service provision for Indigenous consumers. Tools and methodologies were developed to achieve this. Method: Data were collected through the distribution of questionnaires to the target populations: district health service staff and Indigenous consumers. Questionnaires were developed through consultation with the community and the Steering Committee in order to achieve culturally appropriate wording. Of prime importance was the adaptation of questionnaire language so it would be fully understood by Indigenous consumers. Both questionnaires were designed to provide a balanced perspective of current mental health service needs for Indigenous people within the mental health service. Results: Results suggest that existing mental health services do not adequately meet the needs of Indigenous people. Conclusions: Recommendations arising from this study indicate a need for better communication and genuine partnerships between the mental health service and Indigenous people that reflect respect of cultural heritage and recognises the importance of including Indigenous people in the design and management of mental health services. Attention to the recommendations from this study will help ensure a culturally appropriate and effective mental health service for Indigenous consumers.