175 research outputs found
Fast computation by block permanents of cumulative distribution functions of order statistics from several populations
The joint cumulative distribution function for order statistics arising from
several different populations is given in terms of the distribution function of
the populations. The computational cost of the formula in the case of two
populations is still exponential in the worst case, but it is a dramatic
improvement compared to the general formula by Bapat and Beg. In the case when
only the joint distribution function of a subset of the order statistics of
fixed size is needed, the complexity is polynomial, for the case of two
populations.Comment: 21 pages, 3 figure
Quantifying Timing Leaks and Cost Optimisation
We develop a new notion of security against timing attacks where the attacker
is able to simultaneously observe the execution time of a program and the
probability of the values of low variables. We then show how to measure the
security of a program with respect to this notion via a computable estimate of
the timing leakage and use this estimate for cost optimisation.Comment: 16 pages, 2 figures, 4 tables. A shorter version is included in the
proceedings of ICICS'08 - 10th International Conference on Information and
Communications Security, 20-22 October, 2008 Birmingham, U
Communal irrigation systems in South-Eastern Africa: findings on productivity and profitability
Significant expansion of irrigated agriculture is planned in Africa,
though existing smallholder schemes perform poorly. Research at
six schemes in Mozambique, Tanzania and Zimbabwe shows that
a range of problems are exacerbated by poor management, with
limited market linkages leading to underutilization and a lack of
profit. Improving sustainability of these complex systems will require:
multiple interventions at different scales; investing in people and
institutions as much as hardware; clarity in governments’ objectives
for their smallholder irrigation schemes; appropriate business models
to enable farmers; and better market linkages
Using realist review to inform intervention development: Methodological illustration and conceptual platform for collaborative care in offender mental health
BackgroundThis paper reports how we used a realist review, as part of a wider project to improve collaborative mental health care for prisoners with common mental health problems, to develop a conceptual platform. The importance of offenders gaining support for their mental health, and the need for practitioners across the health service, the criminal justice system, and the third sector to work together to achieve this is recognised internationally. However, the literature does not provide coherent analyses of how these ambitions can be achieved. This paper demonstrates how a realist review can be applied to inform complex intervention development that spans different locations, organisations, professions, and care sectors.MethodsWe applied and developed a realist review for the purposes of intervention development, using a three-stage process. (1) An iterative database search strategy (extending beyond criminal justice and offender health) and groups of academics, practitioners, and people with lived experience were used to identify explanatory accounts (n = 347). (2) From these accounts, we developed consolidated explanatory accounts (n = 75). (3) The identified interactions between practitioners and offenders (within their organisational, social, and cultural contexts) were specified in a conceptual platform. We also specify, step by step, how these explanatory accounts were documented, consolidated, and built into a conceptual platform. This addresses an important methodological gap for social scientists and intervention developers about how to develop and articulate programme and implementation theory underpinning complex interventions.ResultsAn integrated person-centred system is proposed to improve collaborative mental health care for offenders with common mental health problems (near to and after release) by achieving consistency between the goals of different sectors and practitioners, enabling practitioners to apply scientific and experiential knowledge in working judiciously and reflectively, and building systems and aligning resources that are centred on offenders’ health and social care needs.ConclusionsAs part of a broader programme of work, a realist review can make an important contribution to the specification of theoretically informed interventions that have the potential to improve health outcomes. Our conceptual platform has potential application in related systems of health and social care where integrated, and person-centred care is a goal
Do agricultural innovation platforms and soil moisture and nutrient monitoring tools improve the production and livelihood of smallholder irrigators in Mozambique?
Over four years, a research-for-development project was implemented
at the 25 de Setembro irrigation scheme in Mozambique. The
project introduced agricultural innovation platforms to overcome
barriers to production such as input and output supply chains and
poorly maintained irrigation canals. Soil moisture and nutrient
monitoring tools were provided so that farmers could improve
their irrigation and fertilizer management. The farmers increased
their crop production through the use of the tools and better
irrigation infrastructure, and increased their income and overall
well-being through better links to markets and new information
sources facilitated by the agricultural innovation platforms
Policy-making tool for optimization of transit priority lanes in urban network
Transit improvement is an effective way to relieve traffic congestion and decrease greenhouse gas emissions. Improvement can be in the form of new facilities or giving on-road priority to transit. Although construction of off-road mass transit is not always viable, giving priority to transit can be a low-cost alternative. A framework is introduced for optimization of bus priority at the network level. The framework identifies links on which a bus lane should be located. Allocation of a lane to transit vehicles would increase the utility of transit, although this can be a disadvantage to auto traffic. The approach balances the impact on all stakeholders. Automobile advocates would like to increase traffic road space, and the total travel time of users and total emissions of the network could be reduced by a stronger priority scheme. A bilevel optimization is applied that encompasses an objective function at the upper level and a mode choice, a traffic assignment, and a transit assignment model at the lower level. The proposed optimization helps transport authorities to quantify the outcomes of various strategies of transit priority. A detailed sensitivity analysis is carried out on the relative weight of each factor in the objective function. The proposed framework can also be applied in the context of high-occupancy-vehicle lanes and heavy-vehicle priority lanes
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Economic evaluation of a complex intervention (Engager) for prisoners with common mental health problems, near to and after release: a cost-utility and cost-consequences analysis
Background: People in prison experience a range of physical and mental health problems. Evaluating the effectiveness and efficiency of prison-based interventions presents a number of methodological challenges. We present a case study of an economic evaluation of a prison-based intervention (“Engager”) to address common mental health problems.
Methods: Two hundred and eighty people were recruited from prisons in England and randomised to Engager plus usual care or usual care. Participants were followed up for 12 months following release from prison. The primary analysis is the cost per quality-adjusted life year (QALY) gained of Engager compared to usual care from a National Health Service (NHS) perspective with QALYs calculated using the CORE 6 Dimension. A cost-consequences analysis evaluated cross-sectoral costs and a range of outcomes.
Results: From an NHS perspective, Engager cost an additional £2737 per participant (95% of iterations between £1029 and £4718) with a mean QALY difference of − 0.014 (95% of iterations between − 0.045 and 0.017). For the cost-consequences, there was evidence of improved access to substance misuse services 12 months post-release (odds ratio 2.244, 95% confidence Interval 1.304–3.861).
Conclusion: Engager provides a rare example of a cost-utility analysis conducted in prisons and the community using patient-completed measures. Although the results from this trial show no evidence that Engager is cost-effective, the results of the cost-consequences analysis suggest that follow-up beyond 12 months post-release using routine data may provide additional insights into the effectiveness of the intervention and the importance of including a wide range of costs and outcomes in prison-based economic evaluations.
Trial registration: (ISRCTN11707331)
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Interrogating intervention delivery and participants' emotional states to improve engagement and implementation: A realist informed multiple case study evaluation of Engager.
BACKGROUND: 'Engager' is an innovative 'through-the-gate' complex care intervention for male prison-leavers with common mental health problems. In parallel to the randomised-controlled trial of Engager (Trial registration number: ISRCTN11707331), a set of process evaluation analyses were undertaken. This paper reports on the depth multiple case study analysis part of the process evaluation, exploring how a sub-sample of prison-leavers engaged and responded to the intervention offer of one-to-one support during their re-integration into the community. METHODS: To understand intervention delivery and what response it elicited in individuals, we used a realist-informed qualitative multiple 'case' studies approach. We scrutinised how intervention component delivery lead to outcomes by examining underlying causal pathways or 'mechanisms' that promoted or hindered progress towards personal outcomes. 'Cases' (n = 24) were prison-leavers from the intervention arm of the trial. We collected practitioner activity logs and conducted semi-structured interviews with prison-leavers and Engager/other service practitioners. We mapped data for each case against the intervention logic model and then used Bhaskar's (2016) 'DREIC' analytic process to categorise cases according to extent of intervention delivery, outcomes evidenced, and contributing factors behind engagement or disengagement and progress achieved. RESULTS: There were variations in the dose and session focus of the intervention delivery, and how different participants responded. Participants sustaining long-term engagement and sustained change reached a state of 'crises but coping'. We found evidence that several components of the intervention were key to achieving this: trusting relationships, therapeutic work delivered well and over time; and an in-depth shared understanding of needs, concerns, and goals between the practitioner and participants. Those who disengaged were in one of the following states: 'Crises and chaos', 'Resigned acceptance', 'Honeymoon' or 'Wilful withdrawal'. CONCLUSIONS: We demonstrate that the 'implementability' of an intervention can be explained by examining the delivery of core intervention components in relation to the responses elicited in the participants. Core delivery mechanisms often had to be 'triggered' numerous times to produce sustained change. The improvements achieved, sustained, and valued by participants were not always reflected in the quantitative measures recorded in the RCT. The compatibility between the practitioner, participant and setting were continually at risk of being undermined by implementation failure as well as changing external circumstances and participants' own weaknesses. TRIAL REGISTRATION NUMBER: ISRCTN11707331, Wales Research Ethics Committee, Registered 02-04-2016-Retrospectively registered https://doi.org/10.1186/ISRCTN11707331
Evaluation of a complex intervention (Engager) for prisoners with common mental health problems, near to and after release: study protocol for a randomised controlled trial.
INTRODUCTION: The 'Engager' programme is a 'through-the-gate' intervention designed to support prisoners with common mental health problems as they transition from prison back into the community. The trial will evaluate the clinical and cost-effectiveness of the Engager intervention. METHODS AND ANALYSIS: The study is a parallel two-group randomised controlled trial with 1:1 individual allocation to either: (a) the Engager intervention plus standard care (intervention group) or (b) standard care alone (control group) across two investigation centres (South West and North West of England). Two hundred and eighty prisoners meeting eligibility criteria will take part. Engager is a person-centred complex intervention delivered by practitioners and aimed at addressing offenders' mental health and social care needs. It comprises one-to-one support for participants prior to release from prison and for up to 20 weeks postrelease. The primary outcome is change in psychological distress measured by the Clinical Outcomes in Routine Evaluation-Outcome Measure at 6 months postrelease. Secondary outcomes include: assessment of subjective met/unmet need, drug and alcohol use, health-related quality of life and well-being-related quality of life measured at 3, 6 and 12 months postrelease; change in objective social domains, drug and alcohol dependence, service utilisation and perceived helpfulness of services and change in psychological constructs related to desistence at 6 and 12 months postrelease; and recidivism at 12 months postrelease. A process evaluation will assess fidelity of intervention delivery, test hypothesised mechanisms of action and look for unintended consequences. An economic evaluation will estimate the cost-effectiveness. ETHICS AND DISSEMINATION: This study has been approved by the Wales Research Ethics Committee 3 (ref: 15/WA/0314) and the National Offender Management Service (ref: 2015-283). Findings will be disseminated to commissioners, clinicians and service users via papers and presentations. TRIAL REGISTRATION NUMBER: ISRCTN11707331; Pre-results
Irrigating Africa: policy barriers and opportunities for enhanced productivity of smallholder farmers
African governments have ambitious plans to expand irrigated agriculture, though existing smallholder schemes have largely failed to use land and water sustainably or become profitable. Six government-owned irrigation schemes in Mozambique, Tanzania and Zimbabwe were assessed to identify common policy barriers and opportunities for higher productivity among smallholder farmers. Issues like insecure land tenure systems, unclear institutional arrangements and poor access to markets have contributed to limited profitability. Reform of currently insecure land tenure, strengthening farmer organizations and reforming policies are recommended so that governments step back from scheme management and foster market linkages to enable more profitable irrigated agriculture
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