Modeling crash types: New insights into the effects of covariates on crashes at rural intersections

Many studies focused on the development of crash prediction models have resulted in aggregate crash prediction models to quantify the safety effects of geometric, traffic, and environmental factors on the expected number of total, fatal, injury, and/or property damage crashes at specific locations. Crash prediction models focused on predicting different crash types, however, have rarely been developed. Crash type models are useful for at least three reasons. The first is motivated by the need to identify sites that are high risk with respect to specific crash types but that may not be revealed through crash totals. Second, countermeasures are likely to affect only a subset of all crashes—usually called target crashes—and so examination of crash types will lead to improved ability to identify effective countermeasures. Finally, there is a priori reason to believe that different crash types (e.g., rear-end, angle, etc.) are associated with road geometry, the environment, and traffic variables in different ways and as a result justify the estimation of individual predictive models. The objectives of this paper are to (1) demonstrate that different crash types are associated to predictor variables in different ways (as theorized) and (2) show that estimation of crash type models may lead to greater insights regarding crash occurrence and countermeasure effectiveness. This paper first describes the estimation results of crash prediction models for angle, head-on, rear-end, sideswipe (same direction and opposite direction), and pedestrian-involved crash types. Serving as a basis for comparison, a crash prediction model is estimated for total crashes. Based on 837 motor vehicle crashes collected on two-lane rural intersections in the state of Georgia, six prediction models are estimated resulting in two Poisson (P) models and four NB (NB) models. The analysis reveals that factors such as the annual average daily traffic, the presence of turning lanes, and the number of driveways have a positive association with each type of crash, whereas median widths and the presence of lighting are negatively associated. For the best fitting models covariates are related to crash types in different ways, suggesting that crash types are associated with different precrash conditions and that modeling total crash frequency may not be helpful for identifying specific countermeasures.

The use of ZIP and CART to model cryptosporidiosis in relation to climatic variables

This research assesses the potential impact of weekly weather variability on the incidence of cryptosporidiosis disease using time series zero-inflated Poisson (ZIP) and classification and regression tree (CART) models. Data on weather variables, notified cryptosporidiosis cases and population size in Brisbane were supplied by the Australian Bureau of Meteorology, Queensland Department of Health, and Australian Bureau of Statistics, respectively. Both time series ZIP and CART models show a clear association between weather variables (maximum temperature, relative humidity, rainfall and wind speed) and cryptosporidiosis disease. The time series CART models indicated that, when weekly maximum temperature exceeded 31°C and relative humidity was less than 63%, the relative risk of cryptosporidiosis rose by 13.64 (expected morbidity: 39.4; 95% confidence interval: 30.9–47.9). These findings may have applications as a decision support tool in planning disease control and risk management programs for cryptosporidiosis disease.

Operation and control of hybrid microgrid with angle droop controller

This paper compares the performance of two droop control schemes in a hybrid microgrid. With presence of both converter interfaced and inertial sources, the droop controller share power in a decentralized fashion. Both the droop controllers facilitate reactive power sharing based on voltage droop. However in frequency droop control, the real power sharing depends on the frequency, while in angle droop control, it depends on output voltage angle. For converter interfaced sources this reference voltage is tracked while for inertial DG, reference power for the prime mover is calculated from the reference angle with the proposed angle control scheme. This coordinated control scheme shows significant improvement in system performance. The comparison with the conventional frequency droop shows that the angle control scheme shares power with much lower frequency deviation. This is a significant improvement particularly in a frequent load changing scenario.

Robust multidisciplinary design optimisation using CFD and advanced evolutionary algorithms

Computation Fluid Dynamics (CFD) has become an important tool in optimization and has seen successful in many real world applications. Most important among these is in the optimisation of aerodynamic surfaces which has become Multi-Objective (MO) and Multidisciplinary (MDO) in nature. Most of these have been carried out for a given set of input parameters such as free stream Mach number and angle of attack. One cannot ignore the fact that in aerospace engineering one frequently deals with situations where the design input parameters and flight/flow conditions have some amount of uncertainty attached to them. When the optimisation is carried out for fixed values of design variables and parameters however, one arrives at an optimised solution that results in good performance at design condition but poor drag or lift to drag ratio at slightly off-design conditions. The challenge is still to develop a robust design that accounts for uncertainty in the design in aerospace applications. In this paper this issue is taken up and an attempt is made to prevent the fluctuation of objective performance by using robust design technique or Uncertainty.

Evaluation of financial incentives as a quality improvement strategy in the public hospital context : clinician attitudes, design variables, and economic costs

In 2008, a three-year pilot ‘pay for performance’ (P4P) program, known as ‘Clinical Practice Improvement Payment’ (CPIP) was introduced into Queensland Health (QHealth). QHealth is a large public health sector provider of acute, community, and public health services in Queensland, Australia. The organisation has recently embarked on a significant reform agenda including a review of existing funding arrangements (Duckett et al., 2008). Partly in response to this reform agenda, a casemix funding model has been implemented to reconnect health care funding with outcomes. CPIP was conceptualised as a performance-based scheme that rewarded quality with financial incentives. This is the first time such a scheme has been implemented into the public health sector in Australia with a focus on rewarding quality, and it is unique in that it has a large state-wide focus and includes 15 Districts. CPIP initially targeted five acute and community clinical areas including Mental Health, Discharge Medication, Emergency Department, Chronic Obstructive Pulmonary Disease, and Stroke. The CPIP scheme was designed around key concepts including the identification of clinical indicators that met the set criteria of: high disease burden, a well defined single diagnostic group or intervention, significant variations in clinical outcomes and/or practices, a good evidence, and clinician control and support (Ward, Daniels, Walker & Duckett, 2007). This evaluative research targeted Phase One of implementation of the CPIP scheme from January 2008 to March 2009. A formative evaluation utilising a mixed methodology and complementarity analysis was undertaken. The research involved three research questions and aimed to determine the knowledge, understanding, and attitudes of clinicians; identify improvements to the design, administration, and monitoring of CPIP; and determine the financial and economic costs of the scheme. Three key studies were undertaken to ascertain responses to the key research questions. Firstly, a survey of clinicians was undertaken to examine levels of knowledge and understanding and their attitudes to the scheme. Secondly, the study sought to apply Statistical Process Control (SPC) to the process indicators to assess if this enhanced the scheme and a third study examined a simple economic cost analysis. The CPIP Survey of clinicians elicited 192 clinician respondents. Over 70% of these respondents were supportive of the continuation of the CPIP scheme. This finding was also supported by the results of a quantitative altitude survey that identified positive attitudes in 6 of the 7 domains-including impact, awareness and understanding and clinical relevance, all being scored positive across the combined respondent group. SPC as a trending tool may play an important role in the early identification of indicator weakness for the CPIP scheme. This evaluative research study supports a previously identified need in the literature for a phased introduction of Pay for Performance (P4P) type programs. It further highlights the value of undertaking a formal risk assessment of clinician, management, and systemic levels of literacy and competency with measurement and monitoring of quality prior to a phased implementation. This phasing can then be guided by a P4P Design Variable Matrix which provides a selection of program design options such as indicator target and payment mechanisms. It became evident that a clear process is required to standardise how clinical indicators evolve over time and direct movement towards more rigorous ‘pay for performance’ targets and the development of an optimal funding model. Use of this matrix will enable the scheme to mature and build the literacy and competency of clinicians and the organisation as implementation progresses. Furthermore, the research identified that CPIP created a spotlight on clinical indicators and incentive payments of over five million from a potential ten million was secured across the five clinical areas in the first 15 months of the scheme. This indicates that quality was rewarded in the new QHealth funding model, and despite issues being identified with the payment mechanism, funding was distributed. The economic model used identified a relative low cost of reporting (under $8,000) as opposed to funds secured of over $300,000 for mental health as an example. Movement to a full cost effectiveness study of CPIP is supported. Overall the introduction of the CPIP scheme into QHealth has been a positive and effective strategy for engaging clinicians in quality and has been the catalyst for the identification and monitoring of valuable clinical process indicators. This research has highlighted that clinicians are supportive of the scheme in general; however, there are some significant risks that include the functioning of the CPIP payment mechanism. Given clinician support for the use of a pay–for-performance methodology in QHealth, the CPIP scheme has the potential to be a powerful addition to a multi-faceted suite of quality improvement initiatives within QHealth.

Variables governing the dynamics of attacker-defender systems in team sport

This project was a step forward in the examination and identification of key variables on the perception, decision making and action of team sport athletes through theoretical insights provided by the ecological dynamics perspective. The methodology drew on experiential knowledge of elite coaches to drive further empirical investigation into the specific task, environmental and personal constraints that shape the behaviour of athletes in specific performance contexts. The thesis has provided an effective rationale for further investigation into the emergent perception, decision making and action demanded of athletes in these unpredictable, fluent, fast-paced environments.

Effective attacking strategies in rugby union

Evasive change-of-direction manoeuvres (agility skills) are a fundamental ability in rugby union. In this study, we explored the attributes of agility skill execution as they relate to effective attacking strategies in rugby union. Seven Super 14 games were coded using variables that assessed team patterns and individual movement characteristics during attacking ball carries. The results indicated that tackle-breaks are a key determinant of try-scoring ability and team success in rugby union. The ability of the attacking ball carrier to receive the ball at high speed with at least two body lengths from the defence line against an isolated defender promoted tackle-breaks. Furthermore, the execution of a side-step evasive manoeuvre at a change of direction angle of 20–60° and a distance of one to two body lengths from the defence, and then straightening the running line following the initial direction change at an angle of 20–60°, was associated with tackle-breaks. This study provides critical insight regarding the attributes of agility skill execution that are associated with effective ball carries in rugby union.

Hamstring strain injuries : factors that lead to injury and re-injury

Hamstring strain injuries (HSIs) are common in a number of sports and incidence rates have not declined in recent times. Additionally, the high rate of recurrent injuries suggests that our current understanding of HSI and re-injury risk is incomplete. Whilst the multifactoral nature of HSIs is agreed upon by many, often individual risk factors and/or causes of injury are examined in isolation. This review aims to bring together the causes, risk factors and interventions associated with HSIs to better understand why HSIs are so prevalent. Running is often identified as the primary activity type for HSIs and given the high eccentric forces and moderate muscle strain placed on the hamstrings during running these factors are considered to be part of the aetiology of HSIs. However, the exact causes of HSIs remain unknown and whilst eccentric contraction and muscle strain purportedly play a role, accumulated muscle damage and/or a single injurious event may also contribute. Potentially, all of these factors interact to varying degrees depending on the injurious activity type (i.e. running, kicking). Furthermore, anatomical factors, such as the biarticular organization, the dual innervations of biceps femoris (BF), fibre type distribution, muscle architecture and the degree of anterior pelvic tilt, have all been implicated. Each of these variables impact upon HSI risk via a number of different mechanisms that include increasing hamstring muscle strain and altering the susceptibility of the hamstrings to muscle damage. Reported risk factors for HSIs include age, previous injury, ethnicity, strength imbalances, flexibility and fatigue. Of these, little is known, definitively, about why previous injury increases the risk of future HSIs. Nevertheless, interventions put in place to reduce the incidence of HSIs by addressing modifiable risk factors have focused primarily on increasing eccentric strength, correcting strength imbalances and improving flexibility. The response to these intervention programmes has been mixed with varied levels of success reported. A conceptual framework is presented suggesting that neuromuscular inhibition following HSIs may impede the rehabilitation process and subsequently lead to maladaptation of hamstring muscle structure and function, including preferentially eccentric weakness, atrophy of the previously injured muscles and alterations in the angle of peak knee flexor torque. This remains an area for future research and practitioners need to remain aware of the multifactoral nature of HSIs if injury rates are to decline.

Use of the iPhone for Cobb angle measurement in scoliosis

Purpose: The Cobb technique is the universally accepted method for measuring the severity of spinal deformities. Traditionally, Cobb angles have been measured using protractor and pencil on hardcopy radiographic films. The new generation of mobile phones make accurate angle measurement possible using an integrated accelerometer, providing a potentially useful clinical tool for assessing Cobb angles. The purpose of this study was to compare Cobb angle measurements performed using an Apple iPhone and traditional protractor in a series of twenty Adolescent Idiopathic Scoliosis patients. Methods: Seven observers measured major Cobb angles on twenty pre-operative postero-anterior radiographs of Adolescent Idiopathic Scoliosis patients with both a standard protractor and using an Apple iPhone. Five of the observers repeated the measurements at least a week after the original measurements. Results: The mean absolute difference between pairs of iPhone/protractor measurements was 2.1°, with a small (1°) bias toward lower Cobb angles with the iPhone. 95% confidence intervals for intra-observer variability were ±3.3° for the protractor and ±3.9° for the iPhone. 95% confidence intervals for inter-observer variability were ±8.3° for the iPhone and ±7.1° for the protractor. Both of these confidence intervals were within the range of previously published Cobb measurement studies. Conclusions: We conclude that the iPhone is an equivalent Cobb measurement tool to the manual protractor, and measurement times are about 15% less. The widespread availability of inclinometer-equipped mobile phones and the ability to store measurements in later versions of the angle measurement software may make these new technologies attractive for clinical measurement applications.

Profiling and characterisation of key weather variables and their implication on building design

Local climate is a critical element in the design of buildings. In this paper, ten years of historical weather data in Australia's all eight capital cities are analyzed to characterize the variation profiles of climatic variables. The method of descriptive statistics is employed. Either the pattern of cumulative distribution and/or the profile of percentage distribution are used to graphically illustrate the similarity and difference between different study locations. It is found that although the weather variables vary with different locations, except for the extreme parts, there is often a good, nearly linear relation between weather variable and its cumulative percentage for the majority of middle part. The implication of these extreme parts and the slopes of the middle parts on building design is also discussed.