A systemic approach to multi-agency community safety

In this paper we examine a multi-paradigm systemic approach to multi-agency community safety. A detailed case study was undertaken of a multi-agency partnership involving a fire and rescue service, a local council, an NHS primary care trust and a police force in the North West region of the UK. The community safety project studied was funded by the UK Department of Communities and Local Government over an eighteen month period. The multi-paradigm approach used was beneficial for understanding the nature of community safety, and its application in actual practice. The project involved the development of a novel customer segmentation approach based upon combined fire risk, health risk, social care risk, and crime risk to support identification of at-risk social groups in order to enable more targeted and co-ordinated provision of preventative measures for community safety by the public sector agencies involved

Discrepancies in autologous bone marrow stem cell trials and enhancement of ejection fraction (DAMASCENE): weighted regression and meta-analysis

Objective To investigate whether discrepancies in trials of use of bone marrow stem cells in patients with heart disease account for the variation in reported effect size in improvement of left ventricular function. Design Identification and counting of factual discrepancies in trial reports, and sample size weighted regression against therapeutic effect size. Meta-analysis of trials that provided sufficient information. Data sources PubMed and Embase from inception to April 2013. Eligibility for selecting studies Randomised controlled trials evaluating the effect of autologous bone marrow stem cells for heart disease on mean left ventricular ejection fraction. Results There were over 600 discrepancies in 133 reports from 49 trials. There was a significant association between the number of discrepancies and the reported increment in EF with bone marrow stem cell therapy (Spearman’s r=0.4, P=0.005). Trials with no discrepancies were a small minority (five trials) and showed a mean EF effect size of −0.4%. The 24 trials with 1-10 discrepancies showed a mean effect size of 2.1%. The 12 with 11-20 discrepancies showed a mean effect of size 3.0%. The three with 21-30 discrepancies showed a mean effect size of 5.7%. The high discrepancy group, comprising five trials with over 30 discrepancies each, showed a mean effect size of 7.7%. Conclusions Avoiding discrepancies is difficult but is important because discrepancy count is related to effect size. The mechanism is unknown but should be explored in the design of future trials because in the five trials without discrepancies the effect of bone marrow stem cell therapy on ejection fraction is zero

Effect on cardiovascular risk of high density lipoprotein targeted drug treatments niacin, fibrates, and CETP inhibitors: meta-analysis of randomised controlled trials including 117 411 patients

Objective To investigate the effects on cardiovascular outcomes of drug interventions that increase high density lipoprotein levels. Design Meta-analysis. Studies reviewed Therapeutic benefit of niacin, fibrates, and cholesteryl ester transfer protein (CETP) inhibitors on cardiovascular events (all cause mortality, coronary heart disease mortality, non-fatal myocardial infarction, and stroke). Results 117 411 patients were randomised in a total of 39 trials. All interventions increased the levels of high density lipoprotein cholesterol. No significant effect was seen on all cause mortality for niacin (odds ratio 1.03, 95% confidence interval 0.92 to 1.15, P=0.59), fibrates (0.98, 0.89 to 1.08, P=0.66), or CETP inhibitors (1.16, 0.93 to 1.44, P=0.19); on coronary heart disease mortality for niacin (0.93, 0.76 to 1.12, P=0.44), fibrates (0.92, 0.81 to 1.04, P=0.19), or CETP inhibitors (1.00, 0.80 to 1.24, P=0.99); or on stroke outcomes for niacin (0.96, 0.75 to 1.22, P=0.72), fibrates (1.01, 0.90 to 1.13, P=0.84), or CETP inhibitors (1.14, 0.90 to 1.45, P=0.29). In studies with patients not receiving statins (before the statin era), niacin was associated with a significant reduction in non-fatal myocardial infarction (0.69, 0.56 to 0.85, P=0.0004). However, in studies where statins were already being taken, niacin showed no significant effect (0.96, 0.85 to 1.09, P=0.52). A significant difference was seen between these subgroups (P=0.007). A similar trend relating to non-fatal myocardial infarction was seen with fibrates: without statin treatment (0.78, 0.71 to 0.86, P<0.001) and with all or some patients taking statins (0.83, 0.69 to 1.01, P=0.07); P=0.58 for difference. Conclusions Neither niacin, fibrates, nor CETP inhibitors, three highly effective agents for increasing high density lipoprotein levels, reduced all cause mortality, coronary heart disease mortality, myocardial infarction, or stroke in patients treated with statins. Although observational studies might suggest a simplistic hypothesis for high density lipoprotein cholesterol, that increasing the levels pharmacologically would generally reduce cardiovascular events, in the current era of widespread use of statins in dyslipidaemia, substantial trials of these three agents do not support this concept

EPG-representations with small grid-size

In an EPG-representation of a graph $G$ each vertex is represented by a path in the rectangular grid, and $(v,w)$ is an edge in $G$ if and only if the paths representing $v$ an $w$ share a grid-edge. Requiring paths representing edges to be x-monotone or, even stronger, both x- and y-monotone gives rise to three natural variants of EPG-representations, one where edges have no monotonicity requirements and two with the aforementioned monotonicity requirements. The focus of this paper is understanding how small a grid can be achieved for such EPG-representations with respect to various graph parameters. We show that there are $m$-edge graphs that require a grid of area $\Omega(m)$ in any variant of EPG-representations. Similarly there are pathwidth-$k$ graphs that require height $\Omega(k)$ and area $\Omega(kn)$ in any variant of EPG-representations. We prove a matching upper bound of $O(kn)$ area for all pathwidth-$k$ graphs in the strongest model, the one where edges are required to be both x- and y-monotone. Thus in this strongest model, the result implies, for example, $O(n)$, $O(n \log n)$ and $O(n^{3/2})$ area bounds for bounded pathwidth graphs, bounded treewidth graphs and all classes of graphs that exclude a fixed minor, respectively. For the model with no restrictions on the monotonicity of the edges, stronger results can be achieved for some graph classes, for example an $O(n)$ area bound for bounded treewidth graphs and $O(n \log^2 n)$ bound for graphs of bounded genus.Comment: Appears in the Proceedings of the 25th International Symposium on Graph Drawing and Network Visualization (GD 2017

An exploration of community and culture related fire injury risks

There can be different types and different levels of fire injury risks relating to different communities and cultures. In this paper we examine the fire injury risks associated with different communities and cultures in the Greater Manchester area within the UK over the period 2010 to 2015. Typically ethnicity data is only recorded for fire injuries rather than fire incidents. In particular, the research reported in this paper examines the fire injury risks relating to age, cooking practices, candle and incense use, alcohol consumption rates, and smoking rates across different communities and cultures. Overall there appeared to be significant differences between the injury risk of alcohol related fires, smoking related fires, and kitchen fires between the different community and cultural groups within the area studied over the given time period. In addition fire injury risk appears significantly higher for elderly individuals in the White British and White Irish community groups

Visualdrives Forensic Tool

Visualdrives is a tool for visualising files stored on a hard drive. The application combines a 3D interactive game-style visualisation combined with a LeapMotion input device providing gesture control over the interface. The purpose of the tool is to understand the potential for abstract digital forensics data to be visualised in a richer, more interactive environment than has traditionally been the case

An exploration of alcohol related fire incidences

In this paper we examine an operational research project concerning the analysis of the characteristics of alcohol related fire instances attended by a UK Fire and Rescue Service in the North West region of England and the development of a geographical information system for fire prevention support. The research project examined the circumstances of alcohol related fires, their geographical distribution and the socio-economic characteristics of such fire incidences within the region studied, and also involved the design and implementation of a geographical information system for supporting prevention of such fires. Overall, it was found that cooking fires involving ‘harmful’ or ‘hazardous’ levels of alcohol consumption were most likely to be found amongst younger urban residents living in high levels of deprivation, students living in city centre locations and young families with high benefit need within the region studied

The evolution of geographical information systems for fire prevention support

Geographical information systems (GIS) provide visual map based analysis and reporting information implemented in map layers. Geographical information systems evolve by incorporating new and enhanced means of analysing and presenting location based information. In this paper we examine the evolution of a geographical information system for fire prevention support that evolved through transitions of the underlying approach to the analysis of dwelling fire risk over a six year period 2007 to 2013. The novel theoretical contribution of this paper is the examination of the evolution of GIS analysis and modelling approaches, and in the specific context of fire and rescue services, the examination of the evolution of a fire prevention support GIS. Keywords Geographical Information System; Evolution; Dwelling; Fire ris

Optimal solutions to matrix-valued Nehari problems and related limit theorems

In a 1990 paper Helton and Young showed that under certain conditions the optimal solution of the Nehari problem corresponding to a finite rank Hankel operator with scalar entries can be efficiently approximated by certain functions defined in terms of finite dimensional restrictions of the Hankel operator. In this paper it is shown that these approximants appear as optimal solutions to restricted Nehari problems. The latter problems can be solved using relaxed commutant lifting theory. This observation is used to extent the Helton and Young approximation result to a matrix-valued setting. As in the Helton and Young paper the rate of convergence depends on the choice of the initial space in the approximation scheme.Comment: 22 page

How robust are recommended waiting times to pacing after cardiac surgery that are derived from observational data?

AIMS: For bradycardic patients after cardiac surgery, it is unknown how long to wait before implanting a permanent pacemaker (PPM). Current recommendations vary and are based on observational studies. This study aims to examine why this variation may exist. METHODS AND RESULTS: We conducted first a study of patients in our institution and second a systematic review of studies examining conduction disturbance and pacing after cardiac surgery. Of 5849 operations over a 6-year period, 103 (1.8%) patients required PPM implantation. Only pacing dependence at implant and time from surgery to implant were associated with 30-day pacing dependence. The only predictor of regression of pacing dependence was time from surgery to implant. We then applied the conventional procedure of receiver operating characteristic (ROC) analysis, seeking an optimal time point for decision-making. This suggested the optimal waiting time was 12.5 days for predicting pacing dependence at 30 days for all patients (area under the ROC curve (AUC) 0.620, P = 0.031) and for predicting regression of pacing dependence in patients who were pacing-dependent at implant (AUC 0.769, P < 0.001). However, our systematic review showed that recommended optimal decision-making time points were strongly correlated with the average implant time point of those individual studies (R = 0.96, P < 0.001). We further conducted modelling which revealed that in any such study, the ROC method is strongly biased to indicate a value near to the median time to implant as optimal. CONCLUSION: When commonly used automated statistical methods are applied to observational data with the aim of defining the optimal time to pacing after cardiac surgery, the suggested answer is likely to be similar to the average time to pacing in that cohort