Statistical methods for NHS incident reporting data

The National Reporting and Learning System (NRLS) is the English and Welsh NHS’ national repository of incident reports from healthcare. It aims to capture details of incident reports, at national level, and facilitate clinical review and learning to improve patient safety. These incident reports range from minor ‘near-misses’ to critical incidents that may lead to severe harm or death. NRLS data are currently reported as crude counts and proportions, but their major use is clinical review of the free-text descriptions of incidents. There are few well-developed quantitative analysis approaches for NRLS, and this thesis investigates these methods. A literature review revealed a wealth of clinical detail, but also systematic constraints of NRLS’ structure, including non-mandatory reporting, missing data and misclassification. Summary statistics for reports from 2010/11 – 2016/17 supported this and suggest NRLS was not suitable for statistical modelling in isolation. Modelling methods were advanced by creating a hybrid dataset using other sources of hospital casemix data from Hospital Episode Statistics (HES). A theoretical model was established, based on ‘exposure’ variables (using casemix proxies), and ‘culture’ as a random-effect. The initial modelling approach examined Poisson regression, mixture and multilevel models. Overdispersion was significant, generated mainly by clustering and aggregation in the hybrid dataset, but models were chosen to reflect these structures. Further modelling approaches were examined, using Generalized Additive Models to smooth predictor variables, regression tree-based models including Random Forests, and Artificial Neural Networks. Models were also extended to examine a subset of death and severe harm incidents, exploring how sparse counts affect models. Text mining techniques were examined for analysis of incident descriptions and showed how term frequency might be used. Terms were used to generate latent topics models used, in-turn, to predict the harm level of incidents. Model outputs were used to create a ‘Standardised Incident Reporting Ratio’ (SIRR) and cast this in the mould of current regulatory frameworks, using process control techniques such as funnel plots and cusum charts. A prototype online reporting tool was developed to allow NHS organisations to examine their SIRRs, provide supporting analyses, and link data points back to individual incident reports

Interaktive latenzkritische Anwendungen in mobilen Ad-hoc Netzen

In this thesis we discuss the challenges that latency-sensitive interactive applications face in mobile ad-hoc networks. By using multi-player games as an example, we argue that the traditional client-server architecture is unsuitable for this new environment. We consequently create a novel communication architecture as well as quality of service mechanisms that can support the network requirements of such applications in mobile environments. By using a number of distributed zone servers that are selected and managed dynamically by our server selection algorithm, we provide a scalable approach that offers the necessary redundancy. Furthermore, we propose additional quality of service mechanisms to reduce latency and packet loss for interactive applications. We evaluate our approach through network simulation and realistic mobile gaming scenarios. The performance of our evaluation is checked against real-world measurements.In dieser Arbeit werden die Probleme und Herausforderungen von latenz-kritischen interactiven Computeranwendungen in mobilen Ad-hoc Netzen untersucht. Am Beispiel von Mehrbenutzercomputerspielen zeigen wir, dass traditionelle Client-Server Architekturen für diese neuen Umgebungen ungeeignet sind. Im Rahmen dieser Arbeit wird daher eine neue Kommunikationsarchitektur sowie verschiedene Mechanismen zur Erhöhung der Dienstgüte vorgeschlagen. Mit Hilfe von Zonenserver, die durch den Serverauswahlalgorithmus ausgesucht und verwaltet werden zeigen wir einen Ansatz auf, der sowohl bezüglich der Netzgröße skalierbar ist als auch die notwendige Redundanz bereitstellt. Wir zeigen die Funktionalität und die Leistung unseres Ansatzes mit Hilfe von Netzsimulationen bei denen realistische Szenarien für mobiles Spielen simuliert werden. Der hierbei benutze Netzsimulator wurde dafür auf Basis von eigenen Messungen verbessert und für das jeweilige Szenario passend eingestellt

Migrating into Financial Markets: How Remittances Became a Development Tool

We understand very little about the billions of dollars that flow throughout the world from migrants back to their home countries. In this rigorous and illuminating work, Matt Bakker, an economic sociologist, examines how these migrant remittances—the resources of some of the world’s least affluent people—have come to be seen in recent years as a fundamental contributor to development in the migrant‑sending states of the global south. This book analyzes how the connection between remittances and development was forged through the concrete political and intellectual practices of policy entrepreneurs within a variety of institutional settings, from national government agencies and international development organizations to nongovernmental policy foundations and think tanks

Mainstreaming of Nature-Based Solutions for the mitigation of hydro-meteorological hazard: governance analysis of a socio- technical change

The Nature-Based Solutions (NBS) concept and approach were developed to simultaneously face challenges such as risk mitigation and biodiversity conservation and restoration. NBSs have been endorsed by major International Organizations such as the EU, the FAO and World Bank that are pushing to enable a mainstreaming process. However, a shift from traditional engineering “grey” solutions to wider and standard adoption of NBS encounters technical, social, cultural, and normative barriers that have been identified with a qualitative content analysis of policy documents, reports and expert interviews. The case of the region Emilia-Romagna was studied by developing an analytical framework that brought together the social-ecological context, the governance system and the characteristics of specific NBSs

Federal Register

Daily publication of the U.S. Office of the Federal Register contains rules and regulations, proposed legislation and rule changes, and other notices, including "Presidential proclamations and Executive Orders, Federal agency documents having general applicability and legal effect, documents required to be published by act of Congress, and other Federal agency documents of public interest" (p. ii). Table of Contents starts on page iii