A Fixed-Point Algorithm for Closed Queueing Networks

In this paper we propose a new efficient iterative scheme for solving closed queueing networks with phase-type service time distributions. The method is especially efficient and accurate in case of large numbers of nodes and large customer populations. We present the method, put it in perspective, and validate it through a large number of test scenarios. In most cases, the method provides accuracies within 5% relative error (in comparison to discrete-event simulation)

Autonomous Car Acceptance: Safety vs. Personal Driving Enjoyment

Due to the passiveness of the passengers, autonomous cars promise benefits in terms of traffic safety, but also drawbacks in terms of the enjoyment people experience when driving a car themselves. We postulate that both Perceived Traffic Safety and Personal Driving Enjoyment play an important role in people’s acceptance of autonomous cars. After collecting 100 questionnaires and applying a SEM approach, our findings indicate that Personal Driving Enjoyment has a negative influence on the Perceived Enjoyment of autonomous cars and that Perceived Traffic Safety has a positive influence on both their Perceived Usefulness and Perceived Enjoyment. Additionally, both Perceived Usefulness and Perceived Enjoyment were confirmed to positively influence autonomous car acceptance. These findings suggest that autonomous cars should optionally enable people to act as drivers, that manufacturers need to actively manage people’s safety perceptions, and that they also need to emphasize the alternative hedonic benefits that the driverless experience offers

Replicable parallel branch and bound search

Combinatorial branch and bound searches are a common technique for solving global optimisation and decision problems. Their performance often depends on good search order heuristics, refined over decades of algorithms research. Parallel search necessarily deviates from the sequential search order, sometimes dramatically and unpredictably, e.g. by distributing work at random. This can disrupt effective search order heuristics and lead to unexpected and highly variable parallel performance. The variability makes it hard to reason about the parallel performance of combinatorial searches. This paper presents a generic parallel branch and bound skeleton, implemented in Haskell, with replicable parallel performance. The skeleton aims to preserve the search order heuristic by distributing work in an ordered fashion, closely following the sequential search order. We demonstrate the generality of the approach by applying the skeleton to 40 instances of three combinatorial problems: Maximum Clique, 0/1 Knapsack and Travelling Salesperson. The overheads of our Haskell skeleton are reasonable: giving slowdown factors of between 1.9 and 6.2 compared with a class-leading, dedicated, and highly optimised C++ Maximum Clique solver. We demonstrate scaling up to 200 cores of a Beowulf cluster, achieving speedups of 100x for several Maximum Clique instances. We demonstrate low variance of parallel performance across all instances of the three combinatorial problems and at all scales up to 200 cores, with median Relative Standard Deviation (RSD) below 2%. Parallel solvers that do not follow the sequential search order exhibit far higher variance, with median RSD exceeding 85% for Knapsack

A realist analysis of hospital patient safety in Wales:Applied learning for alternative contexts from a multisite case study

Background: Hospital patient safety is a major social problem. In the UK, policy responses focus on the introduction of improvement programmes that seek to implement evidence-based clinical practices using the Model for Improvement, Plan-Do-Study-Act cycle. Empirical evidence that the outcomes of such programmes vary across hospitals demonstrates that the context of their implementation matters. However, the relationships between features of context and the implementation of safety programmes are both undertheorised and poorly understood in empirical terms. Objectives: This study is designed to address gaps in conceptual, methodological and empirical knowledge about the influence of context on the local implementation of patient safety programmes. Design: We used concepts from critical realism and institutional analysis to conduct a qualitative comparative-intensive case study involving 21 hospitals across all seven Welsh health boards. We focused on the local implementation of three focal interventions from the 1000 Lives+ patient safety programme: Improving Leadership for Quality Improvement, Reducing Surgical Complications and Reducing Health-care Associated Infection. Our main sources of data were 160 semistructured interviews, observation and 1700 health policy and organisational documents. These data were analysed using the realist approaches of abstraction, abduction and retroduction. Setting: Welsh Government and NHS Wales. Participants: Interviews were conducted with 160 participants including government policy leads, health managers and professionals, partner agencies with strategic oversight of patient safety, advocacy groups and academics with expertise in patient safety. Main outcome measures: Identification of the contextual factors pertinent to the local implementation of the 1000 Lives+ patient safety programme in Welsh NHS hospitals. Results: An innovative conceptual framework harnessing realist social theory and institutional theory was produced to address challenges identified within previous applications of realist inquiry in patient safety research. This involved the development and use of an explanatory intervention–context–mechanism–agency–outcome (I-CMAO) configuration to illustrate the processes behind implementation of a change programme. Our findings, illustrated by multiple nested I-CMAO configurations, show how local implementation of patient safety interventions are impacted and modified by particular aspects of context: specifically, isomorphism, by which an intervention becomes adapted to the environment in which it is implemented; institutional logics, the beliefs and values underpinning the intervention and its source, and their perceived legitimacy among different groups of health-care professionals; and the relational structure and power dynamics of the functional group, that is, those tasked with implementing the initiative. This dynamic interplay shapes and guides actions leading to the normalisation or the rejection of the patient safety programme. Conclusions: Heightened awareness of the influence of context on the local implementation of patient safety programmes is required to inform the design of such interventions and to ensure their effective implementation and operationalisation in the day-to-day practice of health-care teams. Future work is required to elaborate our conceptual model and findings in similar settings where different interventions are introduced, and in different settings where similar innovations are implemented. Funding: The National Institute for Health Research Health Services and Delivery Research programme