Milton Keynes: an outline cost-benefit study

This is a preliminary survey of some of the factors which would need to be investigated in the design and cost-benefit analysis of alternative transport systems for Milton Keynes. It outlines the framework within which further work can be developed and provides some order-of-magnitude estimates for basic elements in the transport cost-benefit equations

Milton Keynes - preliminary estimates of regional traffic flows in 1981

The Milton Keynes Development Corporation and their planning consultants have asked the College Transport Group to investigate the scale of likely regional traffic flows into and out of Milton Keynes. At this stage the emphasis is on providing information for the preparation of a Master Plan for the city itself, rather than detailed traffic estimates for planning transport systems in the surrounding region. Population estimates for 1981 have been obtained from County Councils for areas within a 20 mile radius of the new city, and the proportions attracted to Milton Keynes for work and shopping assessed using gravity model techniques. Separate estimates have been made of work journeys from the city to regional employment and to London. Possible upper and lower limits to these forecasts are included to account for many uncertainties in the absolute and relative growth of population, employment and shopping opportunities in the city itself and in the surrounding region. The results are presented as traffic flews into and out of octant sectors around the city. Flows to the east are greater than to the west with work trip flows of the order of 2,500 person trips each way in the most heavily loaded sectors. A 1981 city population of 150,000 is likely to produce at least 1,500 daily commuters to London using the fast rail service, with an additional 200 commuters from the region using Milton Keynes railway station

Identifying the challenges and facilitators of implementing a COPD care bundle.

BACKGROUND: Care bundles have been shown to improve outcomes, reduce hospital readmissions and reduce length of hospital stay; therefore increasing the speed of uptake and delivery of care bundles should be a priority in order to deliver more timely improvements and consistent high-quality care. Previous studies have detailed the difficulties of obtaining full compliance to bundle elements but few have described the underlying reasons for this. In order to improve future implementation this paper investigates the challenges encountered by clinical teams implementing a chronic obstructive pulmonary disease (COPD) care bundle and describes actions taken to overcome these challenges. METHODS: An initial retrospective documentary analysis of data from seven clinical implementation teams was undertaken to review the challenges faced by the clinical teams. Three focus groups with healthcare professionals and managers explored solutions to these challenges developed during the project. RESULTS: Documentary analysis identified 28 challenges which directly impacted implementation of the COPD care bundle within five themes; staffing, infrastructure, process, use of improvement methodology and patient and public involvement. Focus groups revealed that the five most significant challenges for all groups were: staff too busy, staff shortages, lack of staff engagement, added workload of the bundle and patient coding issues. The participants shared facilitating factors used to overcome issues including: shifting perceptions to improve engagement, further education sessions to increase staff participation and gaining buy-in from managers through payment frameworks. CONCLUSIONS: Maximising the impact of a care bundle relies on its successful and timely implementation. Teams implementing the COPD care bundle encountered challenges that were common to all teams and sites. Understanding and learning from the challenges faced by previous endeavours and identifying the facilitators to overcoming these barriers provides an opportunity to mitigate issues that waste time and resources, and ensures that training can be tailored to the anticipated challenges

Evidence for a Gradual Decline in the Universal Rest-Frame UV Luminosity Density for z < 1

We have utilized various magnitude-limited samples drawn from an extremely deep and highly complete spectroscopic redshift survey of galaxies observed in seven colors in the Hawaii Survey Fields and the Hubble Deep Field to investigate the evolution of the universal rest-frame ultraviolet luminosity density from z = 1 to the present. The multi-color data (U', B, V, R, I, J, HK') enable the sample selection to be made in the rest-frame ultraviolet for the entire redshift range. Due to the large sample size and depth (U_{AB} = 24.75, B_{AB} = 24.75, I_{AB} = 23.5), we are able to accurately determine the luminosity density to z = 1. We do not confirm the very steep evolution reported by Lilly et al. (1996) but instead find a shallower slope, approximately (1+z)^{1.5} for q0 = 0.5, which would imply that galaxy formation is continuing smoothly to the present time rather than peaking at z = 1. Much of the present formation is taking place in smaller galaxies. Detailed comparisons with other recent determinations of the evolution are presented.Comment: 37 pages including 18 figures. Also available at http://www.ifa.hawaii.edu/~acowie/uvlum.html To be published in the August, 1999 Astronomical Journal (accepted April 22, 1999

Opinion Shopping and Audit Committees

This paper tests whether companies engage in opinion shopping and examines the role of audit committees when auditors are dismissed (1996-98). There are three findings. First, US companies strategically dismiss when incumbent auditors are more likely to issue unfavorable audit opinions compared to newly appointed auditors. I estimate opinion shopping motivates 17% of auditor dismissals, and I find opinion shopping dismissals occur significantly later in the reporting period than other dismissals. Second, audit committees are more likely to disapprove of auditor dismissals that are motivated by opinion shopping. This is consistent with the argument that audit committees help maintain the integrity of the audit reporting process. Third, independent audit committee members are more likely to leave committees that disapprove of opinion shopping. This suggests either senior management dismiss audit committee members who oppose opinion shopping, or committee members resign because they do not wish to be associated with opinion shopping.

Comprehensive health assessments during de-institutionalization: An observational study

Background: People with intellectual disability (ID) leaving institutions pass through a transition stage that makes them vulnerable to inadequate health care. They enter into community care under general practitioners (GPs) who are often untrained and inexperienced in their needs. Specifically designed health reviews may be of assistance to both them and their new GPs as they go through that phase

Do PCAOB Inspections Improve the Quality of Internal Control Audits?

We investigate whether Public Company Accounting Oversight Board (PCAOB) inspections affect the quality of internal control audits. Our research design improves on prior studies by exploiting both cross-sectional and time-series variation in the content of PCAOB inspection reports, while also controlling for audit firm and year fixed effects, effectively achieving a difference-in-differences research design. We find that when PCAOB inspectors report higher rates of deficiencies in internal control audits, auditors respond by increasing the issuance of adverse internal control opinions. We also find that auditors issue more adverse internal control opinions to clients with concurrent misstatements, who thus genuinely warrant adverse opinions. We further find that higher inspection deficiency rates lead to higher audit fees, consistent with PCAOB inspections prompting auditors to undertake costly remediation efforts. Taken together, our results are consistent with the PCAOB inspections improving the quality of internal control audits by prompting auditors to remediate deficiencies in their audits of internal controls.</p