Development of modelling method selection tool for health services management: From problem structuring methods to modelling and simulation methods

Background: There is an increasing recognition that modelling and simulation can assist in the process of designing health care policies, strategies and operations. However, the current use is limited and answers to questions such as what methods to use and when remain somewhat underdeveloped. Aim. The aim of this study is to provide a mechanism for decision makers in health services planning and management to compare a broad range of modelling and simulation methods so that they can better select and use them or better commission relevant modelling and simulation work. Methods. This paper proposes a modelling and simulation method comparison and selection tool developed from a comprehensive literature review, the research team's extensive expertise and inputs from potential users. Twenty-eight different methods were identified, characterised by their relevance to different application areas, project life cycle stages, types of output and levels of insight, and four input resources required (time, money, knowledge and data). Results: The characterisation is presented in matrix forms to allow quick comparison and selection. This paper also highlights significant knowledge gaps in the existing literature when assessing the applicability of particular approaches to health services management, where modelling and simulation skills are scarce let alone money and time. Conclusions: A modelling and simulation method comparison and selection tool is developed to assist with the selection of methods appropriate to supporting specific decision making processes. In particular it addresses the issue of which method is most appropriate to which specific health services management problem, what the user might expect to be obtained from the method, and what is required to use the method. In summary, we believe the tool adds value to the scarce existing literature on methods comparison and selection. © 2011 Jun et al.

Evidence-informed development of engineering practical work: Effecting change through staff and student engagement

This paper discusses innovations in curriculum development in the Department of Engineering at the University of Cambridge as a participant in the Teaching for Learning Network (TFLN), a teaching and learning development initiative funded by the Cambridge-MIT Institute a pedagogic collaboration and brokerage network. A year-long research and development project investigated the practical experiences through which students traditionally explore engineering disciplines, apply and extend the knowledge gained in lectures and other settings, and begin to develop their professional expertise. The research project evaluated current practice in these sessions and developed an evidence-base to identify requirements for new activities, student support and staff development. The evidence collected included a novel student 'practice-value' survey highlighting effective practice and areas of concern, classroom observation of practicals, semi-structured interviews with staff, a student focus group and informal discussions with staff. Analysis of the data identified three potentially 'high-leverage' strategies for improvement: development of a more integrated teaching framework, within which practical work could be contextualised in relation to other learning; a more transparent and integrated conceptual framework where theory and practice were more closely linked; development of practical work more reflective of the complex problems facing professional engineers. This paper sets out key elements of the evidence collected and the changes that have been informed by this evidence and analysis, leading to the creation of a suite of integrated practical sessions carefully linked to other course elements and reinforcing central concepts in engineering, accompanied by a training and support programme for teaching staff.

Development of the 2003 CU-HTK conversational telephone speech transcription system

This paper describes the development of the 2003 CU-HTK large vocabulary speech recognition system for Conversational Telephone Speech (CTS). The system was designed based on a multi-pass, multi-branch structure where the output of all branches is combined using system combination. A number of advanced modelling techniques such as Speaker Adaptive Training, Heteroscedastic Linear Discriminant Analysis, Minimum Phone Error estimation and specially constructed Single Pronunciation dictionaries were employed. The effectiveness of each of these techniques and their potential contribution to the result of system combination was evaluated in the framework of a state-of-the-art LVCSR system with sophisticated adaptation. The final 2003 CU-HTK CTS system constructed from some of these models is described and its performance on the DARPA/NIST 2003 Rich Transcription (RT-03) evaluation test set is discussed.

Development of a classical force field for the oxidized Si surface: application to hydrophilic wafer bonding.

We have developed a classical two- and three-body interaction potential to simulate the hydroxylated, natively oxidized Si surface in contact with water solutions, based on the combination and extension of the Stillinger-Weber potential and of a potential originally developed to simulate SiO(2) polymorphs. The potential parameters are chosen to reproduce the structure, charge distribution, tensile surface stress, and interactions with single water molecules of a natively oxidized Si surface model previously obtained by means of accurate density functional theory simulations. We have applied the potential to the case of hydrophilic silicon wafer bonding at room temperature, revealing maximum room temperature work of adhesion values for natively oxidized and amorphous silica surfaces of 97 and 90 mJm(2), respectively, at a water adsorption coverage of approximately 1 ML. The difference arises from the stronger interaction of the natively oxidized surface with liquid water, resulting in a higher heat of immersion (203 vs 166 mJm(2)), and may be explained in terms of the more pronounced water structuring close to the surface in alternating layers of larger and smaller densities with respect to the liquid bulk. The computed force-displacement bonding curves may be a useful input for cohesive zone models where both the topographic details of the surfaces and the dependence of the attractive force on the initial surface separation and wetting can be taken into account.

Development of an ex vivo organ culture model using human gastro-intestinal tissue and Campylobacter jejuni.

Campylobacter jejuni is an important food-borne pathogen. However, relatively little is understood regarding its pathogenesis, and research is hampered by the lack of a suitable model. Recently, a number of groups have developed assays to study the pathogenic mechanisms of C. jejuni using cell culture models. Here, we report the development of an ex vivo organ culture model, allowing for the maintenance of intestinal mucosal tissue, to permit more complex host-bacterium interactions to be studied. Ex vivo organ culture highlights the propensity for C. jejuni to adhere to mucosal tissue via the flagellum, either as discrete colonies or as multicellular units.

Development of all metal electrothermal actuator and its applications

The in-plane motion of microelectrothermal actuator ("heatuator") has been analyzed for Si-based and metallic devices. It was found that the lateral deflection of a heatuator made of a Ni metal is about ∼60% larger than that of a Si-based actuator under the same power consumption. Metals are much better for thermal actuators as they provide a relatively large deflection and large force, for a low operating temperature and power consumption. Electroplated Ni films were used to fabricate heatuators. The electrical and mechanical properties of electroplated Ni thin films have been investigated as a function of temperature and plating current density, and the process conditions have been optimized to obtain stress-free films suitable for microelectromechanical systems applications. Lateral thermal actuators have been successfully fabricated, and electrically tested. Microswitches and microtweezers utilizing the heatuator have also been fabricated and tested. © 2005 Society of Photo-Optical Instrumentation Engineers.