Probability for Primordial Black Holes Pair in 1/R Gravity

The probability for quantum creation of an inflationary universe with a pair of black holes in 1/R - gravitational theory has been studied. Considering a gravitational action which includes a cosmological constant ($\Lambda$) in addition to $\delta R^{- 1}$ term, the probability has been evaluated in a semiclassical approximation with Hartle-Hawking boundary condition. We obtain instanton solutions determined by the parameters $\delta$ and $\Lambda$ satisfying the constraint $\delta \leq \frac{4 \Lambda^{2}}{3}$. However, we note that two different classes of instanton solutions exists in the region $0 < \delta < \frac{4 \Lambda^{2}}{3}$. The probabilities of creation of such configurations are evaluated. It is found that the probability of creation of a universe with a pair of black holes is strongly suppressed with a positive cosmological constant except in one case when $0 < \delta < \Lambda^{2}$. It is also found that gravitational instanton solution is permitted even with $\Lambda = 0$ but one has to consider $\delta < 0$. However, in the later case a universe with a pair of black holes is less probable.Comment: 15 pages, no figure. submitted to Phys. Rev.

The European Cancer Patient’s Bill of Rights, update and implementation 2016

In this implementation phase of the European Cancer Patient’s Bill of Rights (BoR), we confirm the following three patient-centred principles that underpin this initiative: 1: The right of every European citizen to receive the most accurate information and to be proactively involved in his/her care. 2: The right of every European citizen to optimal and timely access to a diagnosis and to appropriate specialised care, underpinned by research and innovation. 3: The right of every European citizen to receive care in health systems that ensure the best possible cancer prevention, the earliest possible diagnosis of their cancer, improved outcomes, patient rehabilitation, best quality of life and affordable health care. The key aspects of working towards implementing the BoR are: - Agree our high-level goal. The vision of 70% long-term survival for patients with cancer in 2035, promoting cancer prevention and cancer control and the associated progress in ensuring good patient experience and quality of life. - Establish the major mechanisms to underpin its delivery. (1) The systematic and rigorous sharing of best practice between and across European cancer healthcare systems and (2) the active promotion of Research and Innovation focused on improving outcomes; (3) Improving access to new and established cancer care by sharing best practice in the development, approval, procurement and reimbursement of cancer diagnostic tests and treatments. - Work with other organisations to bring into being a Europe based centre that will (1) systematically identify, evaluate and validate and disseminate best practice in cancer management for the different countries and regions and (2) promote Research and Innovation and its translation to maximise its impact to improve outcomes

How to improve efficiency in cancer care: dimensions, methods, and areas of evaluation

Efficiency in healthcare is crucial since available resources are scarce, and the cost of inefficient allocation is measured in prior outcomes. This is particularly relevant for cancer. The aim of this paper is to gain a comprehensive overview of the areas and dimensions to improve efficiency, and establish the indicators, different methods, perspectives, and areas of evaluation, to provide recommendations for how to improve efficiency and measure gains in cancer care.Methods: We conducted a two-phase design. First, a comprehensive scoping literature review was conducted, searching four databases. Studies published between 2000 and 2021 were included if they described experiences and cases of efficiency in cancer care or methods to evaluate efficiency. The results of the literature review were then discussed during two rounds of online consultation with a panel of 15 external experts invited to provide insight and comments to deliberate policy recommendations.Results: 46 papers met the inclusion criteria. Based on the papers retrieved we identified six areas for achieving efficiency gains throughout the entire care pathway and, for each area of efficiency, we categorized the methods and outcomes used to measure efficiency gain.Conclusion: This is the first attempt to systemize a scattered body of literature on how to improve efficiency in cancer care and identify key areas of improvement. Policy summary: There are many opportunities to improve efficiency in cancer care. We defined seven policy recommendations on how to improve efficiency in cancer care throughout the care pathway and how to improve the measurement of efficiency gains

Outpatient visits after retirement in Europe and the US

I conduct an empirical analysis of the relation between retirement and outpatient care use in Europe and the US, and investigate the potential driving factors of that. I link the empirical analysis to a theoretical model of medical care demand. I document that pensioners tend to visit a doctor with higher probability and more often than the rest of the 50+ population. Ceteris paribus, being retired implies 3–10 % more outpatient visits in Europe. The estimates are of similar magnitude in the US. The paper contributes to the understanding of how population ageing plays a part in the rising health care expenditures. I find evidence that retirement related individual characteristics, increasing leisure time and stronger health preferences all contribute to the positive relation between retirement and outpatient care use, which is mainly driven by the healthier individuals. The gatekeeper role of general practitioners can mitigate the increased demand for outpatient care services after retirement

Regulating private health insurance in the European Union: the implications of single market legislation and competition policy

This paper examines the implications of the single market in insurance for regulation of private health insurance in the European Union. It considers areas of uncertainty in interpreting the third non-life insurance directive, particularly with regard to when and how governments may regulate private health insurance, and questions the Directive’s capacity to promote consumer and social protection in health insurance markets. The Directive reflects the regulatory norms of the late 1980s and early 1990s, when boundaries between ‘social security’ and ‘normal economic activity’ were still relatively well defined in most member states. Today these boundaries are increasingly blurred, and as governments look to private health insurance to ease pressure on public budgets, uncertainty about the scope of the Directive and concerns about its restrictions on material regulation are likely to grow