The Rediscovery of Machiavelli in Napoleon’s Germany. Heinrich von Kleist and his Contemporaries

Successive defeats by Napoleon's armies, and the occupation of Prussia by the French after the battle of Jena, inspired a new interest in Machiavelli among German thinkers. Hegel, in his unpublished essay on the German constitution, compared the fragmented state of Germany to that of Machiavelli’s Italy. Fichte, in his essay on Machiavelli, drew a comparison with the French invasion of Italy in 1494, and argued that Germany needed to be unified under a powerful ruler, as Machiavelli had recommended for Italy. He and F.L. Jahn were inspired by Machiavelli's concept of the democratic nation composed of patriotic citizens who were always ready to fight for it. Finally, Kleist who probably absorbed Machiavellian ideas indirectly via Rousseau, celebrated the unscrupulous Machiavellian liberator in Die Herrmannschlacht, gave a more critical portrayal of Machiavellian statecraft in Prinz Friedrich von Homburg. and, in the latter play, developed the idea of the military republic united by patriotism

Protocol for the effective feedback to improve primary care prescribing safety (EFIPPS) study : a cluster randomised controlled trial using ePrescribing data

High-risk prescribing in primary care is common and causes considerable harm. Feedback interventions to improve care are attractive because they are relatively cheap to widely implement. There is good evidence that feedback has small to moderate effects, but the most recent Cochrane review called for more high-quality, large trials that explicitly test different forms of feedback. The study is a three-arm cluster-randomised trial with general practices being randomised and outcomes measured at patient level. 262 practices in three Scottish Health Board areas have been randomised (94% of all possible practices). The two active arms receive different forms of prescribing safety data feedback, with rates of high-risk prescribing compared with a ‘usual care’ arm. Sample size estimation used baseline data from participating practices. With 85 practices randomised to each arm, then there is 93% power to detect a 25% difference in the percentage of high-risk prescribing (from 6.1% to 4.5%) between the usual care arm and each intervention arm. The primary outcome is a composite of six high-risk prescribing measures (antipsychotic prescribing to people aged ≥75 years; non-steroidal anti-inflammatory drug (NSAID) prescribing to people aged ≥75 without gastroprotection; NSAID prescribing to people prescribed aspirin/clopidogrel without gastroprotection; NSAID prescribing to people prescribed an ACE inhibitor/angiotensin receptor blocker and a diuretic; NSAID prescription to people prescribed an oral anticoagulant without gastroprotection; aspirin/clopidogrel prescription to people prescribed an oral anticoagulant without gastroprotection). The primary analysis will use multilevel modelling to account for repeated measurement of outcomes in patients clustered within practices. The study was reviewed and approved by the NHS Tayside Committee on Medical Research Ethics B (11/ES/0001). The study will be disseminated via a final report to the funder with a publicly available research summary, and peer reviewed publications

A new transfer function analyser

This thesis investigates the concept and design of a portable on-line transfer function analyser (TFA). It is eminently suitable for the identification of plants and other controlled feedback systems in which normal operating records are available. A point by point representation in the frequency domain, requiring a maximum of three records, allows Nyquist plots to be carried out, either visually or by plotter facilities. The basic theory relies heavily upon statistical concepts whereby, least squares estimates of the transfer function are obtained from a combination of heterodyning, exact filtering and adaptive loops. The resultant output, on both channels (real and imaginary), is the culmination of the solution to two linear differential equations with stochastic coefficients, so mechanised when the adaptive loops reach a stable equilibrium. Throughout, emphasis is placed upon the electronics combining the best of analog and digital techniques, in order that six parallel paths may be analysed in similar mode. This is especially true of the heterodyning and filtering operations. Practical shortcomings of the instrument noted by comparing estimates with those from the best currently available commercial apparatus, operating on deterministic signals. Examples of a feedback loop, subjected to both deterministic and random stimuli, with and without the presence of extraneous noise sources, are used to illustrate the ease and simplicity by which the instrument can be used in place of complex computing schemes, which tend, in consequence, to be solely of local academic interest. The practical features of the thesis have led to the submission of four papers to the technical press. Two of them deal, exclusively, with a capacitor ratio commutated filter – not apparently described in publications to date - which is also the subject of a proposed patent application in conjunction with NRDC. It is intended, in the near future, to submit the complete instrument as the basis for a second patent proposal

Evaluating Sensitivities of Economic Factors through Coupled Economics-ALMANAC Model System

Using crop models to simulate crop growth and productivity at a regional scale is a complex process designed to represent the observed impact of individual farmer decision-making on the agricultural landscape. Typically, during agricultural simulation efforts, the planting acreages have largely been based on a set of predetermined, static scenarios. In this study, we developed a system to dynamically enhance the Agricultural Land Management Alternative with Numerical Assessment Criteria (ALMANAC) crop simulation model through a two-way linkage with an economics land-use model. This coupled model approach integrated farmers’ land-use choices based on relative economic returns and produced dynamic land-use probabilities for ALMANAC simulations through a feedback loop. The coupled model approach was intercompared with static crop modeling through a historic acreage approach, and comparable accuracies were found from both modeling efforts for the 2014 growing season. Furthermore, as a proof-of-concept effort, the method was applied to evaluate the impact of two scenarios on crop simulations: major crops (maize, soybean, and wheat) intensification through price increases (e.g., market change) and incentivized grassland conservation (e.g., policy change). The results of this sensitivity study suggest that the coupled system has the capability to integrate economic factors into traditional crop simulation, allowing for insight into the impacts of changes in markets and policies on agricultural landscapes and crop yields

Try Living in the Real World: the importance of experimental radar systems and data collection trials

While simulations of increasingly high fidelity are an important tool in radar science, experimentation is still needed as a source of validation for simulation, to explore complex phenomena which cannot be accurately simulated and ultimately in turning theory and simulation into a real world system with real world applications. Experimental systems can range from laboratory based, installations on the ground with limited fields of view all the way up to flying demonstrators which may be prototypes for radar products. In this paper we will discuss the importance of experimentation in the development of radar science and radar products with examples of systems used by a sub-set of the members of the UK EMSIG

Seasonal Influenza Vaccine Effectiveness in the community (SIVE): protocol for a cohort study exploiting a unique national linked data set

Introduction Seasonal influenza vaccination is recommended for all individuals aged 65 years and over and in individuals younger than 65 years with comorbidities. There is good evidence of vaccine effectiveness (VE) in young healthy individuals but less robust evidence for effectiveness in the populations targeted for influenza vaccination. Undertaking a randomised controlled trial to assess VE is now impractical due to the presence of national vaccination programmes. Quasi-experimental designs offer the potential to advance the evidence base in such scenarios, and the authors have therefore been commissioned to undertake a naturalistic national evaluation of seasonal influenza VE by using data derived from linkage of a number of Scottish health databases. The aim of this study is to examine the effectiveness of the seasonal influenza vaccination in the Scottish population. Methods and analysis A cohort study design will be used pooling data over nine seasons. A primary care database covering 4% of the Scottish population for the period 2000–2009 has been linked to the national database of hospital admissions and the death register and is being linked to the Health Protection Scotland virology database. The primary outcome is VE measured in terms of rate of hospital admissions due to respiratory illness. Multivariable regression will be used to produce estimates of VE adjusted for confounders. The major challenge of this approach is addressing the strong effect of confounding due to vaccinated individuals being systematically different from unvaccinated individuals. Analyses using propensity scores and instrumental variables will be undertaken, and the effect of an unknown confounder will be modelled in a sensitivity analysis to assess the robustness of the estimates

Data feedback and behavioural change intervention to improve primary care prescribing safety (EFIPPS):multicentre, three arm, cluster randomised controlled trial

Objective: To evaluate the effectiveness of feedback on safety of prescribing compared with moderately enhanced usual care. Design: Three arm, highly pragmatic cluster randomised trial. Setting and participants: 262/278 (94%) primary care practices in three Scottish health boards. Interventions: Practices were randomised to: "usual care," consisting of emailed educational material with support for searching to identify patients (88 practices at baseline, 86 analysed); usual care plus feedback on practice's high risk prescribing sent quarterly on five occasions (87 practices, 86 analysed); or usual care plus the same feedback incorporating a behavioural change component (87 practices, 86 analysed). Main outcome measures: The primary outcome was a patient level composite of six prescribing measures relating to high risk use of antipsychotics, non-steroidal anti-inflammatories, and antiplatelets. Secondary outcomes were the six individual measures. The primary analysis compared high risk prescribing in the two feedback arms against usual care at 15 months. Secondary analyses examined immediate change and change in trend of high risk prescribing associated with implementation of the intervention within each arm. Results: In the primary analysis, high risk prescribing as measured by the primary outcome fell from 6.0% (3332/55 896) to 5.1% (2845/55 872) in the usual care arm, compared with 5.9% (3341/56 194) to 4.6% (2587/56 478) in the feedback only arm (odds ratio 0.88 (95% confidence interval 0.80 to 0.96) compared with usual care; P=0.007) and 6.2% (3634/58 569) to 4.6% (2686/58 582) in the feedback plus behavioural change component arm (0.86 (0.78 to 0.95); P=0.002). In the pre-specified secondary analysis of change in trend within each arm, the usual care educational intervention had no effect on the existing declining trend in high risk prescribing. Both types of feedback were associated with significantly more rapid decline in high risk prescribing after the intervention compared with before. Conclusions: Feedback of prescribing safety data was effective at reducing high risk prescribing. The intervention would be feasible to implement at scale in contexts where electronic health records are in general use