Optimization of resources for H.323 endpoints and terminals over VoIP networks

Abstract: We suggest a method of optimizing resource allocation for real time protocol traffic in general, and VoIP in particular, within an H.323 environment. There are two options in the packet network to allocate resources: aggregate peak demand and statistical multiplexing. Statistical multiplexing, our choice for this case, allows the efficient use of the network resources but however exhibits greater packet delay variation and packet transfer delay. These delays are often the result of correlations or time dependency experienced by the system’s queue due to the variations observed in different point processes that occur at a point of time. To address these issues, we suggest a queuing method based on the diffusion process approximated by Orstein-Ulenbeck and the non-validated results of Ren and Kobayashi

Modelling distances between genetically related languages using an extended weighted Levenshtein distance

Abstract: This article proposes the use of an extended weighted Levenshtein distance to model the time depth between parent and direct descendant languages and also the dialectal separation between sibling languages. The parent language is usually a proto-language, a hypothetical reconstructed language, whose precise date is usually conjectural. Phonology is used as an indicator of language difference, which is modelled by means of an extended weighted Levenshtein distance. This idea is applied specifically to the Iranian language family

Genetic risk estimation by healthcare professionals

OBJECTIVES: To assess whether healthcare professionals correctly incorporate the relevance of a favourable test outcome in a close relative when determining the level of risk for individuals at risk for Huntington's disease. DESIGN AND SETTING: Survey of clinical geneticists and genetic counsellors from 12 centres of clinical genetics (United Kingdom, 6; The Netherlands, 4; Italy, 1; Australia, 1) in May-June 2002. Participants were asked to assess risk of specific individuals in 10 pedigrees, three of which required use of Bayes' theorem. PARTICIPANTS: 71 clinical geneticists and 41 other healthcare professionals involved in genetic counselling. MAIN OUTCOME MEASURES: Proportion of respondents correctly assessing risk in the three target pedigrees; proportion of respondents who were confident of their estimate. RESULTS: 50%-64% of respondents (for the three targets separately) did not include the favourable test information and inc

A note on non-binary multiple insertion/deletion correcting codes

Abstract: We propose the construction of a non-binary multiple insertion/deletion correcting code based on a binary multiple insertion/deletion correcting code. In essence, it is a generalisation of Tenengol’ts’ non-binary single insertion/deletion correcting code. We evaluate the cardinality of the proposed construction based on the asymptotic upper bound on the cardinality of a maximal binary multiple insertion/deletion correcting code derived by Levenshtein

Children’s Gender Identity in Lesbian and Heterosexual Two-Parent Families

This study compared gender identity, anticipated future heterosexual romantic involvement, and psychosocial adjustment of children in lesbian and heterosexual families; it was furthermore assessed whether associations between these aspects differed between family types. Data were obtained in the Netherlands from children in 63 lesbian families and 68 heterosexual families. All children were between 8 and 12 years old. Children in lesbian families felt less parental pressure to conform to gender stereotypes, were less likely to experience their own gender as superior and were more likely to be uncertain about future heterosexual romantic involvement. No differences were found on psychosocial adjustment. Gender typicality, gender contentedness and anticipated future heterosexual romantic involvement were significant predictors of psychosocial adjustment in both family types

Fuel cell technology for domestic built environment applications: state of-the-art review

Fuel cells produce heat when generating electricity, thus they are of particular interest for combined heat and power (CHP) and combined cooling heat and power (CCHP) applications, also known as tri-generation systems. CHP and tri-generation systems offer high energy conversion efficiency and hence the potential to reduce fuel costs and CO2 emissions. This article serves to provide a state-of-the-art review of fuel cell technology operating in the domestic built environment in CHP and tri-generation system applications. The review aims to carry out an assessment of the following topics: (1) the operational advantages fuel cells offer in CHP and tri-generation system configurations, specifically, compared to conventional combustion-based technologies such as Stirling engines, (2) how decarbonisation, running cost and energy security in the domestic built environment may be addressed through the use of fuel cell technology, and (3) what has been done to date and what needs to be done in the future. The article commences with a review of fuel cell technology, then moves on to examine fuel cell CHP systems operating in the domestic built environment, and finally explores fuel cell tri-generation systems in domestic built environment applications. The article concludes with an assessment of the present development of, and future challenges for, domestic fuel cells operating in CHP and tri-generation systems. As fuel cells are an emergent technology the article draws on a breadth of literature, data and experience, mostly from the United Kingdom, Germany, Japan, America and Australia. Fuel cells are a technology of the future here today, providing a change in the way heat and power are supplied to end users. Fuel cells operating in CHP and tri-generation systems in domestic built environment applications could finally provide the means by which energy generation can transfer from centralised to decentralised locales in a sustainable and effective manner

Seasonal influenza vaccination of healthcare workers : Systematic review of qualitative evidence

Background Most countries recommend that healthcare workers (HCWs) are vaccinated seasonally against influenza in order to protect themselves and patients. However, in many cases coverage remains low. A range of strategies have been implemented to increase uptake. Qualitative evidence can help in understanding the context of interventions, including why interventions may fail to achieve the desired effect. This study aimed to synthesise evidence on HCWs’ perceptions and experiences of vaccination for seasonal influenza. Methods Systematic review of qualitative evidence. We searched MEDLINE, EMBASE and CINAHL and included English-language studies which reported substantive qualitative data on the vaccination of HCWs for seasonal influenza. Findings were synthesised thematically. Results Twenty-five studies were included in the review. HCWs may be motivated to accept vaccination to protect themselves and their patients against infection. However, a range of beliefs may act as barriers to vaccine uptake, including concerns about side-effects, scepticism about vaccine effectiveness, and the belief that influenza is not a serious illness. HCWs value their autonomy and professional responsibility in making decisions about vaccination. The implementation of interventions to promote vaccination uptake may face barriers both from HCWs’ personal beliefs and from the relationships between management and employees within the targeted organisations. Conclusions HCWs’ vaccination behaviour needs to be understood in the context of HCWs’ relationships with each other, with management and with patients. Interventions to promote vaccination should take into account both the individual beliefs of targeted HCWs and the organisational context within which they are implemented

Patient safety culture measurement in general practice. Clinimetric properties of 'SCOPE'

<p>Abstract</p> <p>Background</p> <p>A supportive patient safety culture is considered to be an essential condition for improving patient safety. Assessing the current safety culture in general practice may be a first step to target improvements. To that end, we studied internal consistency and construct validity of a safety culture questionnaire for general practice (SCOPE) which was derived from a comparable questionnaire for hospitals (Dutch-HSOPS).</p> <p>Methods</p> <p>The survey was conducted among caregivers of Dutch general practice as part of an ongoing quality accreditation process using a 46 item questionnaire. We conducted factor analyses and studied validity by calculating correlations between the subscales and testing the hypothesis that respondents' <it>patient safety grade </it>of their practices correlated with their scores on the questionnaire.</p> <p>Results</p> <p>Of 72 practices 294 respondents completed the questionnaire. Eight factors were identified concerning <it>handover and teamwork, support and fellowship, communication openness, feedback and learning from error, intention to report events, adequate procedures and staffing, overall perceptions of patient safety </it>and <it>expectations and actions of managers</it>. Cronbach's alpha of the factors rated between 0.64 and 0.85. The subscales intercorrelated moderately, except for the factor about intention to report events. Respondents who graded patient safety highly scored significantly higher on the questionnaire than those who did not.</p> <p>Conclusions</p> <p>The SCOPE questionnaire seems an appropriate instrument to assess patient safety culture in general practice. The clinimetric properties of the SCOPE are promising, but future research should confirm the factor structure and construct of the SCOPE and delineate its responsiveness to changes in safety culture over time.</p

Persuasion architectures: Consumer spaces, affective engineering and (criminal) harm

Drawing together recent theoretical work from both within and beyond criminology, this article considers the role of strategically designed consumer spaces in eliciting potentially criminogenic and harmful dispositions and behaviours. First, the article introduces recent work in cultural geography and urban studies, which has drawn attention to the manipulation of affect through spatial design. Second, by way of example, the article considers how such strategies are deployed in three types of consumer environments: shopping malls and retail spaces; casinos and other gambling environments; and the so-called night time economy. Third, the article engages such developments theoretically. It is suggested we rethink the distinctions and interrelationships between human subjectivity and agency and the built environment. The implications of this proposed conceptual reorientation are explored – first, for our understandings of agency, intentionality, moral responsibility and political accountability; and second, for criminological thinking around embodied difference, power and exclusio

Assessing hospitals' clinical risk management: Development of a monitoring instrument

<p>Abstract</p> <p>Background</p> <p>Clinical risk management (CRM) plays a crucial role in enabling hospitals to identify, contain, and manage risks related to patient safety. So far, no instruments are available to measure and monitor the level of implementation of CRM. Therefore, our objective was to develop an instrument for assessing CRM in hospitals.</p> <p>Methods</p> <p>The instrument was developed based on a literature review, which identified key elements of CRM. These elements were then discussed with a panel of patient safety experts. A theoretical model was used to describe the level to which CRM elements have been implemented within the organization. Interviews with CRM practitioners and a pilot evaluation were conducted to revise the instrument. The first nationwide application of the instrument (138 participating Swiss hospitals) was complemented by in-depth interviews with 25 CRM practitioners in selected hospitals, for validation purposes.</p> <p>Results</p> <p>The monitoring instrument consists of 28 main questions organized in three sections: 1) Implementation and organizational integration of CRM, 2) Strategic objectives and operational implementation of CRM at hospital level, and 3) Overview of CRM in different services. The instrument is available in four languages (English, German, French, and Italian). It allows hospitals to gather comprehensive and systematic data on their CRM practice and to identify areas for further improvement.</p> <p>Conclusions</p> <p>We have developed an instrument for assessing development stages of CRM in hospitals that should be feasible for a continuous monitoring of developments in this important area of patient safety.</p