University of York

About: University of York is a education organization based out in York, York, United Kingdom. It is known for research contribution in the topics: Population & Health care. The organization has 22089 authors who have published 56925 publications receiving 2458285 citations. The organization is also known as: York University & Ebor..

On the unintended consequences of publishing performance data in the public sector

Abstract: Most performance indicator schemes in the public sector have been implemented on the assumption that they will yield benefits in terms of efficiency and equity. Less attention has been paid to the potential costs of such schemes. Drawing on experience from a range of sources, this paper identifies eight consequences of publishing performance data that are not necessarily intended, and which are likely to be dysfunctional. The paper gives examples of such phenomena from the UK public sector, and suggests ways in which they can be mitigated. While not challenging the desirability of publishing performance data, the paper concludes that the performance indicator philosophy is based on inadequate models of production and control. Most performance indicator schemes will therefore fail unless serious consideration is given to the deficiencies described in this paper.

Estimating mean QALYs in trial-based cost-effectiveness analysis : the importance of controlling for baseline utility

Abstract: In trial-based cost-effectiveness analysis baseline mean utility values are invariably imbalanced between treatment arms. A patient's baseline utility is likely to be highly correlated with their quality-adjusted life-years (QALYs) over the follow-up period, not least because it typically contributes to the QALY calculation. Therefore, imbalance in baseline utility needs to be accounted for in the estimation of mean differential QALYs, and failure to control for this imbalance can result in a misleading incremental cost-effectiveness ratio. This paper discusses the approaches that have been used in the cost-effectiveness literature to estimate absolute and differential mean QALYs alongside randomised trials, and illustrates the implications of baseline mean utility imbalance for QALY calculation. Using data from a recently conducted trial-based cost-effectiveness study and a micro-simulation exercise, the relative performance of alternative estimators is compared, showing that widely used methods to calculate differential QALYs provide incorrect results in the presence of baseline mean utility imbalance regardless of whether these differences are formally statistically significant. It is demonstrated that multiple regression methods can be usefully applied to generate appropriate estimates of differential mean QALYs and an associated measure of sampling variability, while controlling for differences in baseline mean utility between treatment arms in the trial.

Atomic origins of the high catalytic activity of nanoporous gold

Abstract: Distinct from inert bulk gold, nanoparticulate gold has been found to possess remarkable catalytic activity towards oxidation reactions. The catalytic performance of nanoparticulate gold strongly depends on size and support, and catalytic activity usually cannot be observed at characteristic sizes larger than 5 nm. Interestingly, significant catalytic activity can be retained in dealloyed nanoporous gold (NPG) even when its feature lengths are larger than 30 nm. Here we report atomic insights of the NPG catalysis, characterized by spherical-aberration-corrected transmission electron microscopy (TEM) and environmental TEM. A high density of atomic steps and kinks is observed on the curved surfaces of NPG, comparable to 3-5 nm nanoparticles, which are stabilized by hyperboloid-like gold ligaments. In situ TEM observations provide compelling evidence that the surface defects are active sites for the catalytic oxidation of CO and residual Ag stabilizes the atomic steps by suppressing {111} faceting kinetics.