Background: Specialist palliative care services have various configurations of staff, processes and interventions, which determine how care is delivered. Currently, there is no consistent way to define and distinguish these different models of care. Aim: To identify the core components that characterise and differentiate existing models of specialist palliative care in the United Kingdom. Design: Mixed-methods study: (1) semi-structured interviews to identify criteria, (2) two-round Delphi study to rank/refine criteria, and (3) structured interviews to test/refine criteria. Setting/participants: Specialist palliative care stakeholders from hospice inpatient, hospital advisory, and community settings. Results: (1) Semi-structured interviews with 14 clinical leads, from eight UK organisations (five hospice inpatient units, two hospital advisory teams, five community teams), provided 34 preliminary criteria. (2) Delphi study: Round 1 (54 participants): thirty-four criteria presented, seven removed and seven added. Round 2 (30 participants): these 34 criteria were ranked with the 15 highest ranked criteria, including setting, type of care, size of service, diagnoses, disciplines, mode of care, types of interventions, ‘out-of-hours’ components (referrals, times, disciplines, mode of care, type of care), external education, use of measures, bereavement follow-up and complex grief provision. (3) Structured interviews with 21 UK service leads (six hospice inpatients, four hospital advisory and nine community teams) refined the criteria from (1) and (2), and provided four further contextual criteria (team purpose, funding, self-referral acceptance and discharge). Conclusion: In this innovative study, we derive 20 criteria to characterise and differentiate models of specialist palliative care – a major paradigm shift to enable accurate reporting and comparison in practice and research.
Future space telescopes with diameter over 20 m will require new approaches: either high-precision formation flying or in-orbit assembly. We believe the latter holds promise at a potentially lower cost and more practical solution in the near term, provided much of the assembly can be carried out autonomously. To gain experience, and to provide risk reduction, we propose a combined micro/nano-satellite demonstration mission that will focus on the required optical technology (adaptive mirrors, phase-sensitive detectors) and autonomous rendezvous and docking technology (inter-satellite links, relative position sensing, automated docking mechanisms). The mission will involve two "3U" CubeSat-like nanosatellites ("MirrorSats") each carrying an electrically actuated adaptive mirror, and each capable of autonomous un-docking and re-docking with a small central "15U" class micro/nano-satellite core, which houses two fixed mirrors and a boom-deployed focal plane assembly. All three spacecrafts will be launched as a single ~40 kg micro-satellite package. The spacecraft busses are based on heritage from Surrey's SNAP-1 and STRaND-1 missions (launched in 2000 and 2013 respectively), whilst the optics, imaging sensors and shape adjusting adaptive mirrors (with their associated adjustment mechanisms) are provided by CalTech/JPL. The spacecraft busses provide precise orbit and attitude control, with inter-satellite links and optical navigation to mediate the docking process. The docking system itself is based on the electromagnetic docking system being developed at the Surrey Space Centre (SSC), together with rendezvous sensing technology developed for STRaND-2. On orbit, the mission profile will firstly establish the imaging capability of the compound spacecraft before undocking, and then autonomously re-docking a single MirrorSat. This will test the docking system, autonomous navigation and system identification technology. If successful, the next stage will see the two MirrorSat spacecraft undock and re-dock to the core spacecraft in a linear formation to represent a large (but sparse) aperture for high resolution imaging. The imaging of stars is the primary objective, but other celestial and terrestrial targets are being considered. Teams at CalTech and SSC are currently working on the mission planning and development of space hardware. The autonomous rendezvous and docking system is currently under test on a 2D air-bearing table at SSC, and the propulsion and precision attitude control system is currently in development. Launch is planned for 2016. This paper details the mission concept; technology involved and progress to date, focussing on the spacecraft buses
Developments in technologies, attitudes and investment are transforming the space environment, achieving greater accessibility for an increasing number of parties. New and proposed constellations will increase the in-orbit satellite population by the order of thousands, expanding the threat landscape of the space industry. This article analyses past satellite security threats and incidents to assess the motivations and characteristics of adversarial threats to satellites. The ground and radio frequency communications were the most favoured targets; however, the boom of satellites constellations in the upcoming years may shift this focus towards the space segment which must be addressed. Key technology advancements and open issues in the satellite industry related to security and operational requirements are also discussed.
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