The Gamma Detector Response and Analysis Software (GADRAS) applies a Detector Response Function (DRF) to compute the output of gamma-ray and neutron detectors when they are exposed to radiation sources. The DRF is fundamental to the ability to perform forward calculations (i.e., computation of the response of a detector to a known source), as well as the ability to analyze spectra to deduce the types and quantities of radioactive material to which the detectors are exposed. This document describes how gamma-ray spectra are computed and the significance of response function parameters that define characteristics of particular detectors.

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Radiation portals normally incorporate a dedicated neutron counter and a gamma-ray detector with at least some spectroscopic capability. This paper describes the design and presents characterization data for a detection system called PVT-NG, which uses large polyvinyl toluene (PVT) detectors to monitor both types of radiation. The detector material is surrounded by polyvinyl chloride (PVC), which emits highenergy gamma rays following neutron capture reactions. Assessments based on high-energy gamma rays are well suited for the detection of neutron sources, particularly in border security applications, because few isotopes in the normal stream of commerce have significant gamma ray yields above 3 MeV. Therefore, an increased count rate for high-energy gamma rays is a strong indicator for the presence of a neutron source. The sensitivity of the PVT-NG sensor to bare 252 Cf is 1.9 counts per second per nanogram (cps/ng) and the sensitivity for 252 Cf surrounded by 2.5 cm of polyethylene is 2.3 cps/ng. The PVT-NG sensor is a proof-of-principal sensor that was not fully optimized. The neutron detector sensitivity could be improved, for instance, by using additional moderator.The PVT-NG detectors and associated electronics are designed to provide improved resolution, gain stability, and performance at high-count rates relative to PVT detectors in typical radiation portals. As well as addressing the needs for neutron detection, these characteristics are also desirable for analysis of the gamma-ray spectra. Accurate isotope identification results were obtained despite the common impression that the absence of photopeaks makes data collected by PVT detectors unsuitable for spectroscopic analysis. The PVT detectors in the PVT-NG unit are used for both gamma-ray and neutron detection, so the sensitive volume exceeds the volume of the detection elements in portals that use dedicated components to detect each type of radiation.

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Radiation sensing applications for SNM detection, identification, and characterization all face the same fundamental problem: each to varying degrees must infer the presence, identity, and configuration of a radiation source given a set of radiation signatures. This is a problem of inverse radiation transport: given the outcome of a measurement, what was the source and transport medium that caused that observation? This paper presents a framework for solving inverse radiation transport problems, describes its essential components, and illustrates its features and performance.

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Transforming Urgent and Emergency Care and the Vanguard Initiative For more information on this publication, visit www.rand.org/t/RR2062 Published by the RAND Corporation, Santa Monica, Calif., and Cambridge, UK © Copyright 2017 RAND Corporation R® is a registered trademark. RAND Europe is a not-for-profit organisation whose mission is to help improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors. Limited Print and Electronic Distribution Rights This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited. Permission is given to duplicate this document for personal use only, as long as it is unaltered and complete. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial use. For information on reprint and linking permissions, please visit www.rand.org/pubs/permissions. Support RAND Make a tax-deductible charitable contribution at www.rand.org/giving/contribute www.rand.org www.rand.org/randeurope iii Preface Urgent and Emergency Care (UEC) vanguards were established in August 2015 as part of the new models of care programme that is considered key to delivering NHS England's Five Year Forward View. They aim to improve the quality, efficiency and effectiveness of UEC services so that patients receive the most appropriate care at the right time and in the right place, and so that unnecessary admissions to accident and emergency (A&E) and hospitals are reduced. The Southern Cluster comprises three such UEC vanguards: those led by Barking and Dagenham, Havering and Redbridge System Resilience Group; Cambridgeshire and Peterborough Clinical Commissioning Group (CCG); and South Devon and Torbay CCG. RAND Europe, together with EY and Julian Elston of the University of Plymouth, were commissioned by the Southern Cluster to evaluate these three vanguards. The evaluation aims to examine the impacts of the vanguards, the processes underpinning delivery (and associated enablers and challenges), and implications for future policy and practice. In doing so, it aims to help inform the continued development of UEC services in these areas and to provide learning of relevance for both local and national level decisionmakers. The primary audiences for this report are commissioners and providers of UEC services, and policy stakeholders such as NHS England. The report may also be of interest to a wider audience of UEC stakeholders, those with a more general interest in the integrated provision of services, researchers, and the wider public. In Section 1 of this report we set out the background and context to UEC service improvement efforts and to the UEC vanguards initiative, and the aims, methods and limitations of this evaluation. We then describe our findings from each of the three Southern Cluster vanguar...