On leadership development in the national health service Scotland

The National Health Service (NHS), which delivers healthcare to all in the UK, is undergoing profound change, from the role of the primary-care providers, the general practitioners, to the specialist hospital managers. There is a drive that ranges from greater care in the community to more effective use of highly specialist resources in hospitals. This is linked to the restructuring of the management in the NHS, requiring a new breed of leaders to achieve organisational change, and to attain development and growth. To develop the new cadre of managers, an exciting Programme is being established for Leadership and Organisational Development. This paper reflects on the background to the change in the NHS, and provides an account of the Leadership Development Programme that is being implemented in the NHS Scotland

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: A systematic analysis for the Global Burden of Disease Study 2015

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods: We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings: Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation: Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding: Bill & Melinda Gates Foundation

Constraint adaptive natural gradient algorithm (Cana) for adaptive array processing

A novel Constraint Adaptive Natural Gradient Algorithm (CANA) is proposed based on the Natural Gradient technique, which is capable of rapidly adjusting the response of an array of sensors to a signal coming from Direction of Interest (DoI) and suppressing noises coming from other directions. Constrained optimization techniques have been extended to enhance the look direction signal in the presence of interference using adaptive natural gradient techniques. Mathematical analysis and realistic MATLAB simulations are developed to confirm the fast convergence of the adaptive weights, and the suitability of algorithm for operations in adverse environments

Bluetooth throughput improvement using a slave-to-slave piconet formation

This paper addresses issues for the establishment of multihop ad-hoc networks based on Scatternet formation using bluetooth. We describe a new approach of inter-piconet communication. Differing from existing protocols, the design allows the slave to establish contact with other slaves present in the piconet without passing through the master. All new piconet clock synchronization will depend on only one master leader. This will increase the capacity of slave to switch from one piconet to another every slot, increasing consequently the traffic data transfer. We perform a simulation that provides evidence of improving average throughput

Copulas for bivariate probability distributions

Copulas offer interesting insights into the dependence structures between the distributions of random variables. This report introduces new copulas, and provides an analysis for copulas, associated with bivariate exponential and Rayleigh distributions that have relevance to signal processing

Message from program chairs of IEMC2004

IEEE International Engineering Management Conference3iii-IEMC

Broadband constraint natural gradient based adaptive processing

Novel Broadband Constraint Adaptive Natural Gradient Array (BroCANA) Processing has been developed. The algorithm has been found capable of discriminating the desired signal among the broadband interference and noise sources. Mathematical analysis and MATLAB simulations confirm the suitability of algorithm for broadband applications. The technique has been further extended to the variable step size broadband array processing. A brief section on Wave number processing is also included

Intellectual capital and technology strategy

In the new economy, exploiting the traditional factors of production is no longer sufficient. The key to success is huge investment flows into human capital as well as information technology and, stunningly, neither of these appear as positive values in traditional accounting. Rather, it is often just the opposite. Consequently, knowledge-based companies are undervalued by traditional accounting methods, sometimes this is by a relatively small percentage, but Market:book ratios are more commonly in single figures, however there is enough here to suggest that focusing too intently on financial data might be missing the point. This is the reason for the popularity of new concepts such as Intellectual Capital and the Balanced Scorecard. This paper reviews current issues concerned with Intellectual Capital as an essential ingredient of the knowledge economy, and through illustration, embeds these issues into a strategic framework that takes into account both tangible and intellectual assets in formulating a Technology Strategy for hi-tech companies

Blind MIMO channel equalisation using matrix momentum natural gradient adaptation

In this paper the problem of single input multiple output (SIMO) and multiple input multiple output (MIMO) channel equalisation in a frequency selective environment is addressed using blind source separation techniques. Using blind techniques removes the requirement for a training sequence giving an increase in the spectral efficiency of the system. Direction of arrival (DOA) information is not required as the statistical independence of the signals is the only requirement for the separation and equalisation of the source signals. The natural gradient algorithm is embedded within the matrix momentum method to improve the convergence of the standard algorithm. The performance of the algorithm is demonstrated for DPSK signals