Practical statistical methods for call centres with a case study addressing urgent medical care delivery

Our interest is in forecasting for call centres, and in particular out-of-hours call centres (OOHCC) which deal with patient requests for medical advice outside normal working hours. Planning needs accurate forecasts of incoming call volumes. These vary by hour, day, and season, and must account for calendar effects such as Christmas. Using historical data, we explain how to use simple regression models to forecast call volumes arriving on specified days, taking into account calendar effects. We then show how we forecast the pattern of arrivals of calls during a specified day. These result in predictions for volumes of calls arriving for each day of the year, and their pattern of arrival during the day. We show how simulation models may then be used for resource allocation, uncertainty analysis, and staff scheduling. The data are details of call numbers and queue lengths from all parts of the patient-advice process for around five years, for a call centre based in Newcastle-upon-Tyne. There are around 350,000 complete cases in total. The methods are easily extended to other kinds of call centre. We describe the impact Swine flu had on call volumes in the summer of 2009, and our reactions to amend models in order to maintain forecast quality

Distribution, Characteristics, and Use of Earth Dens and Related Excavations by Polar Bears on the Western Hudson Bay Lowlands

Polar bears fasting on land along the western coast of Hudson Bay during the open water period, from late July through early November, excavate three different types of structures, which we termed pits, deep dens, and shallow dens. Pits were shallow excavations found on the tops of banks or beach ridges, whereas both deep and shallow dens were dug into frozen peat banks. Pits were used as temporary resting places. The function of shallow dens is less clear, although some bears have been observed resting in them. Deep dens, which have an entrance tunnel and an enlarged inner chamber, are similar in size and structure to maternity dens dug in snow by female poplar bears elsewhere in their range. Deep and shallow dens are primarily occupied by lone females, most of which are pregnant, while pits are generally occupied by adult males and are used more during summer than in autumn. Pregnant polar bears in western Hudson Bay give birth between mid-November and mid-December, by which time snowdrifts suitable for the construction of maternity dens have not yet formed in most years. Thus, because earth dens represent the only consistently suitable environment available at the time of parturition, we suggest most cubs in western Hudson Bay are born in them. Consequently, the availability of suitable habitat for the construction and use of earth dens is probably critical to the survival of the polar bear population in Western Hudson Bay. Secondary benefits of earth dens to pregnant females, and to other bears during the warm weather in late summer, are that they help the bears to conserve energy by remaining cool and to avoid insect harassment.Les ours polaires qui jeûnent sur la terre ferme le long de la côte occidentale de la baie d'Hudson durant la période d'eau libre (fin juillet à début novembre), creusent trois types de structures différentes que nous appelons fosses, tanières profondes et tanières peu profondes. Les fosses sont des creux peu profonds que l'on a trouvé en haut des talus ou des crêtes de plage, alors que les tanières profondes et peu profondes étaient creusées dans de la tourbe gelée. Les fosses étaient utilisées comme lieux de repos temporaires. La fonction que remplissaient les tanières peu profondes n'est pas claire, bien qu'on y ait observé des ours qui s'y reposaient. Les tanières profondes, qui ont une entrée en forme de tunnel s'élargissant en une chambre intérieure, sont semblables, par leur dimension et leur forme, aux tanières de mise bas creusées dans la neige par les ourses polaires ailleurs dans leur territoire. Les tanières profondes et peu profondes sont surtout occupées par les femelles solitaires, dont la plupart sont pleines, tandis que les fosses sont en général occupées par des mâles adultes et sont plus utilisées en été qu'en automne. Dans la baie d'Hudson occidentale, les ourses pleines mettent bas entre la mi-novembre et la mi-décembre, date à laquelle, la majorité des années, les bancs de neige propres à la construction de tanières de mise bas ne sont pas encore formés. Par conséquent, vu que les tanières dans la terre représentent le seul milieu convenable régulièrement disponible au moment de la parturition, on suggère que, dans la baie d'Hudson occidentale, la plupart des oursons y naissent. La disponibilité d'un habitat approprié à la construction et l'utilisation des tanières de terre est donc probablement critique à la survie de la population de l'ours polaire dans la baie d'Hudson occidentale. Un autre bénéfice que représentent les tanières de terre pour les femelles pleines, ainsi que pour les autres ours durant la saison chaude à la fin de l'été, est que ces tanières aident les ours à conserver leur énergie en les maintenant au frais et à les mettant à l'abri des insectes

Challenges in monitoring and managing engineered slopes in a changing climate

Geotechnical asset owners need to know which parts of their asset network are vulnerable to climate change induced failure in order to optimise future investment. Protecting these vulnerable slopes requires monitoring systems capable of identifying and alerting to asset operators changes in the internal conditions that precede failure. Current monitoring systems are heavily reliant on point sensors which can be difficult to interpret across slope scale. This paper presents challenges to producing such a system and research being carried out to address some of these using electrical resistance tomography (ERT). Experimental results show that whilst it is possible to measure soil water content indirectly via resistivity the relationship between resistivity and water content will change over time for a given slope. If geotechnical parameters such as pore water pressure are to be estimated using this method then ERT systems will require integrating with more conventional geotechnical instrumentation to ensure correct representative information is provided. The paper also presents examples of how such data can be processed and communicated to asset owners for the purposes of asset management

Polarized Parton Distributions in the Nucleon

The distribution of the spin of the nucleon among its constituents can be parametrized in the form of polarized parton distribution functions for quarks and gluons. Using all available data on the polarized structure function $g_1(x,Q^2)$, we determine these distributions both at leading and next-to-leading order in perturbation theory. We suggest three different, equally possible scenarios for the polarized gluon distribution, which is found to be only loosely constrained by current experimental data. We examine various possibilities of measuring polarized parton distributions at future experiments.Comment: 18 pages, LATEX, 6 figures available as .uu fil

Toward a 21st-century health care system: Recommendations for health care reform

The coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a series of workshops during which physicians, health policy experts, health insurance executives, business leaders, hospital administrators, economists, and others who represent diverse perspectives came together. This group agreed that the following 8 recommendations are fundamental to successful reform: 1. Replace the current fee-for-service payment system with a payment system that encourages and rewards innovation in the efficient delivery of quality care. The new payment system should invest in the development of outcome measures to guide payment. 2. Establish a securely funded, independent agency to sponsor and evaluate research on the comparative effectiveness of drugs, devices, and other medical interventions. 3. Simplify and rationalize federal and state laws and regulations to facilitate organizational innovation, support care coordination, and streamline financial and administrative functions. 4. Develop a health information technology infrastructure with national standards of interoperability to promote data exchange. 5. Create a national health database with the participation of all payers, delivery systems, and others who own health care data. Agree on methods to make de-identified information from this database on clinical interventions, patient outcomes, and costs available to researchers. 6. Identify revenue sources, including a cap on the tax exclusion of employer-based health insurance, to subsidize health care coverage with the goal of insuring all Americans. 7. Create state or regional insurance exchanges to pool risk, so that Americans without access to employer-based or other group insurance could obtain a standard benefits package through these exchanges. Employers should also be allowed to participate in these exchanges for their employees' coverage. 8. Create a health coverage board with broad stakeholder representation to determine and periodically update the affordable standard benefit package available through state or regional insurance exchanges

Impact of castor meal on root-knot and free-living nematodes

Soil amendment may enhance soil quality as well as reduce plant-parasitic nematode. Despite the many applications already undertaken using castor meal, its efficiency in controlling root-knot nematodes (RKN, Meloidogyne incognita) when applied to melon (Cucumis melo) is still not clear. Three different amounts of castor meal (Ricinus communis) applied were evaluated in microplots planted with melon either with or without RKN. The impact of castor meal on soil free-living nematode communities was also determined. Total nematode genera richness was estimated as 37 for the entire set of microplots sampled across both sampling dates. Rarefaction analysis resulted in 12 collector's curves out of the total of 30 that reached the horizontal asymptote. Univariate ANOVA with two factors yielded differences (p < 0.05) only with regard to the time factor. Simpson, Shannon, Evenness and Equitability indices showed a trend toward moderate increases by the end of the experiment, while the other indices were higher for tomato in pre-transplant sampling compared to harvest. Nematode community and diversity changed during the course of the experiment, although there was substantial confounding heterogeneity within and between the factorial combinations from the beginning. Root knot population was not reduced by the castor meal but increased throughout the period, regardless of treatment. RKN reduced melon yield, number and weight of melon

Root‐lesion nematodes of potato: current status of diagnostics, pathogenicity and management

Root‐lesion nematodes of the genus Pratylenchus are migratory endoparasites with worldwide economic impact on several important crops including potato, where certain species like P. penetrans, P. neglectus and P. scribneri reduce the yield and quality of potato tubers. Morphological identification of Pratylenchus spp. is challenging, and recent advancements in molecular techniques provide robust and rapid diagnostics to differentiate species without need of specialist skills. However, the fact that molecular diagnostics are not available for all Pratylenchus species means that there are limitations in worldwide application. In general, root‐lesion nematodes are difficult to manage once introduced into agricultural land and damage can be related to pathogenicity and population densities. In addition, root‐lesion nematodes interact with fungi such as V. dahliae, resulting in disease complexes that enhance the damage inflicted on the potato crop. Management interventions are often focused on limiting nematode reproduction before planting crops and include the application of nematicides, and cultural practices such as crop rotation, cover crops, biofumigation, and biological control. Understanding the limitations of the available crop protection strategies is important and there are many gaps for further study. This review discusses the status of the diagnosis, distribution, pathogenicity and management of the main species of root‐lesion nematodes, reported to infect potatoes worldwide, and highlights areas for potential future research

Nitrogen and phosphorus fertilization of forage oats in the Maranoa region of southern Queensland

Six rates of nitrogen (0, 10, 20, 40, 80 and 160 kg N ha-1) and four rates of phosphorus (O, 7.5, 15 and 30 kg P ha-1) were applied to oats at planting in a full factorial design on six sites during 1973 and 1974. Prior to planting, the nitrate-nitrogen concentrations in soil (0 to 20 cm) varied from 4 to 44 ppm and 'available' phosphorus (bicarbonate method, 0 to 10 cm) varied from 6 to 34.5 ppm; soils ranged in clay content from 17 to 58%

Intimate caring skills Urinary and faecal incontinence; a heightened problem when dementia is a factor

SIGLEAvailable from British Library Document Supply Centre-DSC:99/31728 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Intimate caring skills Urinary and faecal incontinence; a heightened problem when dementia is a factor

SIGLEAvailable from British Library Document Supply Centre-DSC:99/31728 / BLDSC - British Library Document Supply CentreGBUnited Kingdo