Physicians in leadership: the association between medical director involvement and staff-to-patient ratios

In a hospital environment that demands a careful balance between commercial and clinical interests, the extent to which physicians are involved in hospital leadership varies greatly. This paper assesses the influence of the extent of this involvement on staff-to-patient ratios. Using data gathered from 604 hospitals across Germany, this study evidences the positive relationship between a full-time medical director (MD) or heavily involved part-time MD and a higher staff-to-patient ratio. The data allows us to control for a range of confounding variables, such as size, rural/urban location, ownership structure, and case-mix. The results contribute to the sparse body of empirical research on the effect of clinical leadership on organizational outcomes.

THEORETICAL ROAD DAMAGE DUE TO DYNAMIC TYRE FORCES OF HEAVY VEHICLES. PART 2: SIMULATED DAMAGE CAUSED BY A TANDEM-AXLE VEHICLE.

The literature relating to road surface failure and design is briefly reviewed and the conventional methods for assessing the road damaging effects of dynamic tire forces are examined. A new time domain technique for analyzing dynamic tire forces and four associated road damage criteria are presented. The force criteria are used to examine the road damaging characteristics of a simple tandem-axle vehicle model for a range of speed and road roughness conditions. It is concluded that for the proposed criteria, the theoretical service life of road surfaces that are prone to fatigue failure may be reduced significantly by the dynamic component of wheel forces. The damage done to approximately five per cent of the road surface area during the passage of a theoretical model vehicle at typical highway speeds may be increased by as much as four times.

Modified Kanerva model. Results for real time word recognition

This paper describes results obtained using the modified Kanerva model to perform word recognition in continuous speech after being trained on the multi-speaker Alvey 'Hotel' speech corpus. Theoretical discoveries have recently enabled us to increase the speed of execution of part of the model by two orders of magnitude over that previously reported by Prager & Fallside. The memory required for the operation of the model has been similarly reduced. The recognition accuracy reaches 95% without syntactic constraints when tested on different data from seven trained speakers. Real time simulation of a model with 9,734 active units is now possible in both training and recognition modes using the Alvey PARSIFAL transputer array. The modified Kanerva model is a static network consisting of a fixed nonlinear mapping (location matching) followed by a single layer of conventional adaptive links. A section of preprocessed speech is transformed by the non-linear mapping to a high dimensional representation. From this intermediate representation a simple linear mapping is able to perform complex pattern discrimination to form the output, indicating the nature of the speech features present in the input window.

Unsteady transition in an axial-flow turbine. Part 1. Measurements on the turbine rotor

Previously published measurements in a low-speed, single-stage, axial-flow turbine have been reanalyzed in the light of more recent understanding. The measurements include time-resolved hot-wire traverses and surface hot film gage measurements at the midspan of the rotor suction surface with three different rotor-stator spacings. This paper investigates the suction surface boundary layer transition process, using surface-distance time plots and boundary layer cross sections to demonstrate the unsteady and two-dimensional nature of the process.

Wake, shock and potential field interactions in a 1.5 stage turbine: Part I: Vane-rotor and rotor-vane interaction

The composition of the time-resolved surface pressure field around a high-pressure rotor blade caused by the presence of neighboring blade rows was studied, with the individual effects of wake, shock and potential field interaction being determined. Two test geometries were considered: first, a high-pressure turbine stage coupled with a swan-necked diffuser exit duct; secondly, the same high-pressure stage but with a vane located in the downstream duct. Both tests were carried out at engine-representative Mach and Reynolds numbers. By comparing the results to time-resolved computational predictions of the flowfield, the accuracy with which the computation predicts blade interaction was determined. It was found that in addition to upstream vane-rotor and rotor-downstream vane interactions, a new interaction mechanism was found resulting from the interaction between the downstream vane's potential field and the upstream vane's trailing edge potential field and shock.

Wake, shock and potential field interactions in a 1.5 stage turbine: Part II: Vane-vane interaction and discussion of results

The composition of the time-resolved surface pressure field around a high-pressure rotor blade caused by the presence of neighboring blade rows was studied, with the individual effects of wake, shock and potential field interaction being determined. Two test geometries were considered: first, a high-pressure turbine stage coupled with a swan-necked diffuser exit duct; secondly, the same high-pressure stage but with a vane located in the downstream duct. Both tests were carried out at engine-representative Mach and Reynolds numbers. By comparing the results to time-resolved computational predictions of the flowfield, the accuracy with which the computation predicts blade interaction was determined. Evidence was obtained that for a large downstream vane, the flow conditions in the rotor passage, at any instant in time, are close to being steady state.

Efficient minimum manoeuvre time optimisation of an oversteering vehicle at constant forward speed

A receding horizon steering controller is presented, capable of pushing an oversteering nonlinear vehicle model to its handling limit while travelling at constant forward speed. The controller is able to optimise the vehicle path, using a computationally efficient and robust technique, so that the vehicle progression along a track is maximised as a function of time. The resultant method forms part of the solution to the motor racing objective of minimising lap time. © 2011 AACC American Automatic Control Council.

Contact and channel modelling using part and function libraries in a function-based design approach

To support the development and analysis of engineering designs at the embodiment stage, designers work iteratively with representations of those designs as they consider the function and form of their constituent parts. Detailed descriptions of "what a machine does" usually include flows of forces and active principles within the technical system, and their localization within parts and across the interfaces between them. This means that a representation should assist a designer in considering form and function at the same time and at different levels of abstraction. This paper describes a design modelling approach that enables designers to break down a system architecture into its subsystems and parts, while assigning functions and flows to parts and the interfaces between them. In turn, this may reveal further requirements to fulfil functions in order to complete the design. The approach is implemented in a software tool which provides a uniform, computable language allowing the user to describe functions and flows as they are iteratively discovered, created and embodied. A database of parts allows the user to search for existing design solutions. The approach is illustrated through an example: modelling the complex mechanisms within a humanoid robot. Copyright © 2010 by ASME.

Metal-polymer composite sensors for volatile organic compounds: Part 1. Flow-through chemi-resistors

A new type of chemi-resistor based on a novel metal-polymer composite is described. The composite contains nickel particles with sharp nano-scale surface features, which are intimately coated by the polymer matrix so that they do not come into direct physical contact. No conductive chains of filler particles are formed even at loadings above the percolation threshold and the composite is intrinsically insulating. However, when subjected to compression the composite becomes conductive, with sample resistance falling from ≥ 1012 Ω to < 0.01 Ω. The composite can be formed into insulating granules, which display similar properties to the bulk form. A bed of granules compressed between permeable frits provides a porous structure with a start resistance set by the degree of compression while the granules are free to swell when exposed to volatile organic compounds (VOCs). The granular bed presents a large surface area for the adsorption of VOCs from the gas stream flowing through it. The response of this system to a variety of vapours has been studied for two different sizes of the granular bed and for different matrix polymers. Large responses, ΔR/R0 ≥ 10^7, are observed when saturated vapours are passed through the chemi-resistor. Rapid response allows real time sensing of VOCs and the initial state is recovered in a few seconds by purging with an inert gas stream. The variation in response as a function of VOC concentration is determined.

Air quality and public health impacts of UK airports. Part I: Emissions

The potential adverse human health and climate impacts of emissions from UK airports have become a significant political issue, yet the emissions, air quality impacts and health impacts attributable to UK airports remain largely unstudied. We produce an inventory of UK airport emissions - including aircraft landing and takeoff (LTO) operations and airside support equipment - with uncertainties quantified. The airports studied account for more than 95% of UK air passengers in 2005. We estimate that in 2005, UK airports emitted 10.2 Gg [-23 to +29%] of NOx, 0.73 Gg [-29 to +32%] of SO2, 11.7 Gg [-42 to +77%] of CO, 1.8 Gg [-59 to +155%] of HC, 2.4 Tg [-13 to +12%] of CO2, and 0.31 Gg [-36 to +45%] of PM2.5. This translates to 2.5 Tg [-12 to +12%] CO2-eq using Global Warming Potentials for a 100-year time horizon. Uncertainty estimates were based on analysis of data from aircraft emissions measurement campaigns and analyses of aircraft operations.The First-Order Approximation (FOA3) - currently the standard approach used to estimate particulate matter emissions from aircraft - is compared to measurements and it is shown that there are discrepancies greater than an order of magnitude for 40% of cases for both organic carbon and black carbon emissions indices. Modified methods to approximate organic carbon emissions, arising from incomplete combustion and lubrication oil, and black carbon are proposed. These alterations lead to factor 8 and a 44% increase in the annual emissions estimates of black and organic carbon particulate matter, respectively, leading to a factor 3.4 increase in total PM2.5 emissions compared to the current FOA3 methodology. Our estimates of emissions are used in Part II to quantify the air quality and health impacts of UK airports, to assess mitigation options, and to estimate the impacts of a potential London airport expansion. © 2011 Elsevier Ltd.

Ventilation effectiveness measures based on heat removal: Part 1. Definitions

The effectiveness of ventilation flows is considered from the perspective of buoyancy (or heat) removal from a space. This perspective is distinct from the standard in which the effectiveness is based on the concentrations of a neutrally buoyant contaminant/passive tracer. Three new measures of effectiveness are proposed based on the ability of a flow to flush buoyancy from a ventilated space. These measures provide estimates of instantaneous and time-averaged effectiveness for the entire space, and local effectiveness at any height of interest. From a generalisation of the latter, a vertical profile of effectiveness is defined. These measures enable quantitative comparisons to be made between different flows and they are applicable when there is a difference in density (as is typical due to temperature differences) between the interior environment and the replacement air. Applications, therefore, include natural ventilation, hybrid ventilation and a range of forced ventilation flows. Finally, we demonstrate how the ventilation effectiveness of a room may be assessed from simple traces of temperature versus time. © 2006 Elsevier Ltd. All rights reserved.

Ageing, Adaption and Accessibility: Time for the Inclusive Revolution!

Information and Communication Technology (ICT) is becoming increasingly central to many people’s lives, making it possible to be connected in any place at any time, be unceasingly and instantly informed, and benefit from greater economic and educational opportunities. With all the benefits afforded by these new-found capabilities, however, come potential drawbacks. A plethora of new PCs, laptops, tablets, smartphones, Bluetooth, the internet, Wi-Fi (the list goes on) expect us to know or be able to guess, what, where and when to connect, click, double-click, tap, flick, scroll, in order to realise these benefits, and to have the physical and cognitive capability to do all these things. One of the groups most affected by this increase in high-demand technology is older people. They do not understand and use technology in the same way that younger generations do, because they grew up in the simpler electro-mechanical era and embedded that particular model of the world in their minds. Any consequential difficulty in familiarising themselves with modern ICT and effectively applying it to their needs can also be exacerbated by age-related changes in vision, motor control and cognitive functioning. Such challenges lead to digital exclusion. Much has been written about this topic over the years, usually by academics from the area of inclusive product design. The issue is complex and it is fair to say that no one researcher has the whole picture. It is difficult to understand and adequately address the issue of digital exclusion among the older generation without looking across disciplines and at industry’s and government’s understanding, motivation and efforts toward resolving this important problem. To do otherwise is to risk misunderstanding the true impact that ICT has and could have on people’s lives across all generations. In this European year of Active Ageing and Solidarity between Generations and as the British government is moving forward with its Digital by Default initiative as part of a wider objective to make ICT accessible to as many people as possible by 2015, the Engineering Design Centre (EDC) at the University of Cambridge collaborated with BT to produce a book of thought pieces to address, and where appropriate redress, these important and long-standing issues. “Ageing, Adaption and Accessibility: Time for the Inclusive Revolution!” brings together opinions and insights from twenty one prominent thought leaders from government, industry and academia regarding the problems, opportunities and strategies for combating digital exclusion among senior citizens. The contributing experts were selected as individuals, rather than representatives of organisations, to provide the broadest possible range of perspectives. They are renowned in their respective fields and their opinions are formed not only from their own work, but also from the contributions of others in their area. Their views were elicited through conversations conducted by the editors of this book who then drafted the thought pieces to be edited and approved by the experts. We hope that this unique collection of thought pieces will give you a broader perspective on ageing, people’s adaption to the ever changing world of technology and insights into better ways of designing digital devices and services for the older population.

Accelerating Bayesian hierarchical clustering of time series data with a randomised algorithm.

We live in an era of abundant data. This has necessitated the development of new and innovative statistical algorithms to get the most from experimental data. For example, faster algorithms make practical the analysis of larger genomic data sets, allowing us to extend the utility of cutting-edge statistical methods. We present a randomised algorithm that accelerates the clustering of time series data using the Bayesian Hierarchical Clustering (BHC) statistical method. BHC is a general method for clustering any discretely sampled time series data. In this paper we focus on a particular application to microarray gene expression data. We define and analyse the randomised algorithm, before presenting results on both synthetic and real biological data sets. We show that the randomised algorithm leads to substantial gains in speed with minimal loss in clustering quality. The randomised time series BHC algorithm is available as part of the R package BHC, which is available for download from Bioconductor (version 2.10 and above) via http://bioconductor.org/packages/2.10/bioc/html/BHC.html. We have also made available a set of R scripts which can be used to reproduce the analyses carried out in this paper. These are available from the following URL. https://sites.google.com/site/randomisedbhc/.

Diesel smoke transient control using a real-time smoke sensor

A novel real time smoke sensor is described, which is mounted in the exhaust manifold and detects the smoke by virtue of the natural electrical charge which is carried on the smoke. The somewhat obscure origin of the charge on the smoke is briefly considered, as well as the operation of the sensor itself. The use of the sensor as part of a feedback control shows that it can be very effective in reducing smoke puffs. Copyright © 1987 Society of Automotive Engineers, Inc.