Experimenting with the Coxian Phase-Type Distribution to Uncover Suitable Fits

In the past few decades, Coxian phase-type distributions have become increasingly more popular as a means of representing survival times. In healthcare, they are considered suitable for modelling the length of stay of patients in hospital and more recently for modelling the patient waiting times in Accident and Emergency Departments. The Coxian phase-type distribution has not only been shown to provide a good representation of real survival data, but its interpretation seems reasonably initiative to the medical experts. The drawback, however, is fitting the distribution to the data. There have been many attempts at accurately estimating the Coxian phase-type parameters. This paper wishes to examine the most promising of the approaches reported in the literature to determine the most accurate. Three performance measures are introduced to assess the fitting process of the algorithms along with the likelihood values and AIC to examine the goodness of fit and complexity of the model. Previous research suggests that the fitting process is strongly influenced by the initial parameter estimates and the data itself being quite variable. To overcome this, one experiment in this research paper will use the same initial parameter values for each estimation and perform the fits on the data simulated from a Coxian phase-type distribution with known parameters.

Categorising Korean Cult: The Reputation and Reception of Save the Green Planet!

This article examines the international release of the South Korean film Save the Green Planet! and argues that this is an example of a film whose cult reputation was pre-sold to audiences on the basis of constructed associations between Korean cinema and excessive violence. This article also considers the divided critical reception of Save the Green Planet! as experts from different fields argued over the value and meaning of the film.

Philadelphia-Negative Classical Myeloproliferative Neoplasms: Critical Concepts and Management Recommendations From European LeukemiaNet

We present a review of critical concepts and produce recommendations on the management of Philadelphia-negative classical myeloproliferative neoplasms, including monitoring, response definition, first-and second-line therapy, and therapy for special issues. Key questions were selected according the criterion of clinical relevance. Statements were produced using a Delphi process, and two consensus conferences involving a panel of 21 experts appointed by the European LeukemiaNet (ELN) were convened. Patients with polycythemia vera (PV) and essential thrombocythemia (ET) should be defined as high risk if age is greater than 60 years or there is a history of previous thrombosis. Risk stratification in primary myelofibrosis (PMF) should start with the International Prognostic Scoring System (IPSS) for newly diagnosed patients and dynamic IPSS for patients being seen during their disease course, with the addition of cytogenetics evaluation and transfusion status. High-risk patients with PV should be managed with phlebotomy, low-dose aspirin, and cytoreduction, with either hydroxyurea or interferon at any age. High-risk patients with ET should be managed with cytoreduction, using hydroxyurea at any age. Monitoring response in PV and ET should use the ELN clinicohematologic criteria. Corticosteroids, androgens, erythropoiesis-stimulating agents, and immunomodulators are recommended to treat anemia of PMF, whereas hydroxyurea is the first-line treatment of PMF-associated splenomegaly. Indications for splenectomy include symptomatic portal hypertension, drug-refractory painful splenomegaly, and frequent RBC transfusions. The risk of allogeneic stem-cell transplantation-related complications is justified in transplantation-eligible patients whose median survival time is expected to be less than 5 years.

Do conflict management systems matter?

The most influential current idea in the theory of conflict management concerns the design features and supposed superior outcomes of conflict management systems combining interest-based and rights-based practices for resolving conflict in organizations. Yet much of the literature in the area is highly prescriptive and draws heavily either on exemplary case studies or descriptive data. Using focus groups of HR practitioners and experts in conflict resolution to develop a questionnaire covering the main conflict management practices associated with the theory of conflict management systems, the study analyzes data from a survey of firms in the Republic of Ireland to examine quantitatively the effects of conflict management systems on organizational outcomes. While proactive line management and supervisory engagement in conflict resolution as a key dimension of conflict management systems is found to be positively associated with a range of organizational outcomes, no evidence is found for the kind of system effects proposed in the theoretical and prescriptive literature. © 2012 Wiley Periodicals, Inc.

Public Administration, Science and Risk Assessment: A Case Study of the U.K. Bovine Spongiform Encephalopathy Crisis

The bovine spongiform encephalopathy (BSE) outbreak in the United Kingdom is regarded as one of the worst public policy crises the British government has experienced during the postwar era. In material terms, it has led to the slaughter of 3.3 million cattle and estimated economic losses of £3.7 billion. In administrative terms, the crisis brought about the dissolution of the Ministry of Agriculture, Fisheries and Food. This article examines the istitutional context in which decisions about the scientific evidence on BSE were made. The authors argue that a centralized system in which government agencies control science for government is inherently vulnerable to alliances of experts and interest groups that undermine the credible assessment of public health and safety risks. Specific societal conditions may encourage risk-opportunistic behavior among policy makers that is conducive to delays and inaction until such time as the evidence of a health risk becomes overwhelming.

Chernobyl: Living with Risk and Uncertainty

The nuclear accident in Chernobyl in 1986 is a dramatic example of the type of incidents that are characteristic of a risk society. The consequences of the incident are indeterminate, the causes complex and future developments unpredictable. Nothing can compensate for its effects and it affects a broad population indiscriminately. This paper examines the lived experience of those who experienced biographical disruption as residents of the region on the basis of qualitative case studies carried out in 2003 in the Chernobyl regions of Russia, Ukraine and Belarus. Our analysis indicates that informants tend to view their future as highly uncertain and unpredictable; they experience uncertainty about whether they are already contaminated, and they have to take hazardous decisions about where to go and what to eat. Fear, rumours and experts compete in supplying information to residents about the actual and potential consequences of the disaster, but there is little trust in, and only limited awareness of, the information that is provided. Most informants continue with their lives and do what they must or even what they like, even where the risks are known. They often describe their behaviour as being due to economic circumstances; where there is extreme poverty, even hazardous food sources are better than none. Unlike previous studies, we identify a pronounced tendency among informants not to separate the problems associated with the disaster from the hardships that have resulted from the break-up of the USSR, with both events creating a deep-seated sense of resignation and fatalism. Although most informants hold their governments to blame for lack of information, support and preventive measures, there is little or no collective action to have these put in place. This contrasts with previous research which has suggested that populations affected by disasters attribute crucial significance to that incident and, as a consequence, become increasingly politicized with regard to related policy agendas.

The privatisation of council housing: Stock transfer and the struggle for accountable housing

A central element in the privatization of council housing has been the development of stock transfer policy. A variety of perspectives on this process have been explored including the impact on accountability relations; however, the tenants’ experience is almost completely absent from this literature. The paper develops a case study that draws on the experience of the tenants involved in a stock transfer. In the process stock transfers, and related accountability relations, are shown to be contested with tenant-led campaigns challenging this neoliberal inspired policy. The case study illustrates the power and financial resource asymmetries in transfer campaigns with a range of anti-democratic tactics employed by those pursuing the transfer. On the basis of a critique of neoliberalism, the stock transfer process is seen as an attack on the previous democratic control of council housing, which is replaced with ‘governance by experts and elites’ and private sector inspired corporate governance forms of accountability. Thus the paper seeks to answer two questions; how democratic is the transfer process and what are the long-term implications for democratic accountability in the social housing sector.

Establishing a minimum dataset for prospective registration of systematic reviews: an international consultation

Background: In response to growing recognition of the value of prospective registration of systematic review protocols, we planned to develop a web-based open access international register. In order for the register to fulfil its aims of reducing unplanned duplication, reducing publication bias, and providing greater transparency, it was important to ensure the appropriate data were collected. We therefore undertook a consultation process with experts in the field to identify a minimum dataset for registration. Methods and Findings: A two-round electronic modified Delphi survey design was used. The international panel surveyed included experts from areas relevant to systematic review including commissioners, clinical and academic researchers, methodologists, statisticians, information specialists, journal editors and users of systematic reviews. Direct invitations to participate were sent out to 315 people in the first round and 322 in the second round. Responses to an open invitation to participate were collected separately. There were 194 (143 invited and 51 open) respondents with a 100% completion rate in the first round and 209 (169 invited and 40 open) respondents with a 91% completion rate in the second round. In the second round, 113 (54%) of the participants reported having previously taken part in the first round. Participants were asked to indicate whether a series of potential items should be designated as optional or required registration items, or should not be included in the register. After the second round, a 70% or greater agreement was reached on the designation of 30 of 36 items. Conclusions: The results of the Delphi exercise have established a dataset of 22 required items for the prospective registration of systematic reviews, and 18 optional items. The dataset captures the key attributes of review design as well as the administrative details necessary for registration.

Behavioural and cognitive behavioural training interventions for assisting foster carers in the management of difficult behaviour.

Background The provision of training for foster carers is now seen as an important factor contributing to the successful outcome of foster care placements. Since the late 1960s, foster carer training programs have proliferated, and few of the many published and unpublished training curricula have been systematically evaluated. The advent of cognitive-behavioural therapy (CBT) and the research evidence demonstrating its effectiveness as a psychotherapeutic treatment of choice for a range of emotional and behavioural problems, has prompted the development of CBT-based training programmes. CBT approaches to foster care training derive from a ’skill-based’ training format that also seeks to identify and correct problematic thinking patterns that are associated with dysfunctional behaviour by changing and/or challenging maladaptive thoughts and beliefs. Objectives To assess the effectiveness of cognitive-behavioural training interventions in improving a) looked-after children’s behavioural/relationship problems, b) foster carers’ psychological well-being and functioning, c) foster family functioning, d) foster agency outcomes. Search methods We searched databases including: CENTRAL (Cochrane Library Issue 3, 2006), MEDLINE (January 1966 to September 2006), EMBASE (January 1980 to September 2006), CINAHL (January 1982 to September 2006), PsycINFO (January 1872 to September 2006), ASSIA (January 1987 to September 2006), LILACS (up to September 2006), ERIC (January 1965 to September 2006), Sociological Abstracts (January 1963 to September 2006), and the National Research Register 2006 (Issue 3).We contacted experts in the field concerning current research. Selection criteria Random or quasi randomised studies comparing behavioural or cognitive-behavioural-base Data collection and analysis Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information. Main results Six trials involving 463 foster carers were included. Behavioural and cognitive-behavioural training interventions evaluated to date appear to have very little effect on outcomes relating to looked-after children, assessed in relation to psychological functioning, extent of behavioural problems and interpersonal functioning. Results relating to foster carer(s) outcomes also show no evidence of effectiveness in measures of behavioural management skills, attitudes and psychological functioning. Analysis pertaining to fostering agency outcomes did not show any significant results. However, caution is needed in interpreting these findings as their confidence intervals are wide. Authors’ conclusions There is currently little evidence about the efficacy of behavioural or cognitive-behavioural training intervention for foster carers. The need for further research in this area is highlighted.

Mediation within Irish Construction Industry: Identifying Success Factors for Appropriate Competencies and Processes

The construction industry notoriously excels at dispute creation both in Ireland and abroad. This paper examines mediation in the Irish construction industry as a means of conflict and dispute resolution. It aims to identify success factors for appropriate competencies and processes required by mediators and other parties operating in the construction industry. Methodology includes a thorough review of the literature, followed by detailed interviews from industry experts to elicit and highlight the core competencies required. To aid in the analysis, qualitative analysis using mind mapping software was used. The findings suggest that facilitative mediation was best suited for the Irish construction industry. 13 and 17 success factors were identified as key skills necessary for a mediator and for a successful mediation process. For the skills, it ranges across behavioural, technical and intellectual skills. The mediation process factors can be split into actions of the mediator and other parties in the dispute. The results are similar to those identified in other countries and provide a good reference point for the development of the global construction industry. By following the findings of this report mediators and parties in dispute can improve processes and be more successful in mediation outcomes as a means of resolving conflicts and dispute.

Cystic fibrosis research in allied health and nursing professions

This report is the result of the "Allied Health and Nursing Professions Working Group" meeting which took place in Verona, Italy, November 2009, which was organised by the European Cystic Fibrosis Society, and involved 32 experts. The meeting was designed to provide a "roadmap" of high priority research questions that can be addressed by Allied Health Professionals (AHP) and nursing. The other goal was to identify research skills that would be beneficial to AHP and nursing researchers and would ultimately improve the research capacity and capability of these professions. The following tasks were accomplished: 1) a Delphi survey was used to identify high priority research areas and themes, 2) common research designs used in AHP and nursing research were evaluated in terms of their strengths and weaknesses, 3) methods for assessing the clinimetric and psychometric properties, as well as feasibility, of relevant outcome measures were reviewed, and 4) a common skill set for AHPs and nurses undertaking clinical research was agreed on and will guide the planning of future research opportunities. This report has identified important areas and themes for future research which include: adherence; physical activity/exercise; nutritional interventions; interventions for the newborn with CF and evaluation of outcome measures for use in AHP and nursing research. It has highlighted the significant challenges AHPs and nurses experience in conducting clinical research, and proposes strategies to overcome these challenges. It is hoped that this report will encourage research initiatives that assess the efficacy/effectiveness of AHP and nursing interventions in order to improve the evidence base. This should increase the quality of research conducted by these professions, justify services they currently provide, and expand their skills in new areas, with the ultimate goal of improving care for patients with CF.

Detecting Deception in Movement: The Case of the Side-Step in Rugby

Although coordinated patterns of body movement can be used to communicate action intention, they can also be used to deceive. Often known as deceptive movements, these unpredictable patterns of body movement can give a competitive advantage to an attacker when trying to outwit a defender. In this particular study, we immersed novice and expert rugby players in an interactive virtual rugby environment to understand how the dynamics of deceptive body movement influence a defending player’s decisions about how and when to act. When asked to judge final running direction, expert players who were found to tune into prospective tau-based information specified in the dynamics of ‘honest’ movement signals (Centre of Mass), performed significantly better than novices who tuned into the dynamics of ‘deceptive’ movement signals (upper trunk yaw and out-foot placement) (p<.001). These findings were further corroborated in a second experiment where players were able to move as if to intercept or ‘tackle’ the virtual attacker. An analysis of action responses showed that experts waited significantly longer before initiating movement (p<.001). By waiting longer and picking up more information that would inform about future running direction these experts made significantly fewer errors (p<.05). In this paper we not only present a mathematical model that describes how deception in body-based movement is detected, but we also show how perceptual expertise is manifested in action expertise. We conclude that being able to tune into the ‘honest’ information specifying true running action intention gives a strong competitive advantage.

A design model: the Autism Spectrum Disorder Classroom Design Kit

Architects and designers have a responsibility to provide an inclusive built environment. However for those with a diagnosis of Autism Spectrum Disorder (ASD), the built environment can be a frightening and confusing place, difficult to negotiate and tolerate. The challenge of integrating more fully into society is denied by an alienating built environment. For ASD pupils in a poorly designed school, their environment can distance them from learning. Instead, if more at ease in their surroundings, in an ASD-friendly environment, the ASD pupil stands a greater chance of doing better.

However a difficulty exists in that most architects are not knowledgeable in designing for those with ASD. Any available design guidelines for architects tend, because of the inherent difficulties associated with a spectrum, to be general in their information. Therefore, if wanting to provide an ASD-friendly learning environment, there is a need to ensure that teachers, as the experts, can most clearly and effectively impart their knowledge and requirements to architects.

This paper sets out the challenges and difficulties inherent in the design process when designing for ASD. It then sets out an alternative strategy to the usual method of drawing-centric dialogue between teacher and architect by using models instead as a basis for a more common language. An ASD Classroom Design Kit was designed and developed by Queen’s University of Belfast Architecture students. It was then used by ASD teaching staff from the Southern Education and Library Board in Northern Ireland as a case study to trial its effectiveness. The paper outlines how the study was carried out before concluding with reflections by both teaching staff and architect on using the ASD Classroom Design Kit.

It is hoped that this paper will firstly highlight the need for better dialogue between expert and architect when considering ASD and the Built Environment and secondly, that it may encourage others to consider using models to convey their ideas and knowledge when designing, not just for ASD, but for other Special Educational Needs and disabilities.

Clinical practice with anti-dementia drugs:a revised (second) consensus statement from the British Association for Psychopharmacology

The British Association for Psychopharmacology (BAP) coordinated a meeting of experts to review and revise its first (2006) Guidelines for clinical practice with anti-dementia drugs. As before, levels of evidence were rated using accepted standards which were then translated into grades of recommendation A to D, with A having the strongest evidence base (from randomized controlled trials) and D the weakest (case studies or expert opinion). Current clinical diagnostic criteria for dementia have sufficient accuracy to be applied in clinical practice (B) and brain imaging can improve diagnostic accuracy (B). Cholinesterase inhibitors (donepezil, rivastigmine, and galantamine) are effective for mild to moderate Alzheimer's disease (A) and memantine for moderate to severe Alzheimer's disease (A). Until further evidence is available other drugs, including statins, anti-inflammatory drugs, vitamin E and Ginkgo biloba, cannot be recommended either for the treatment or prevention of Alzheimer's disease (A). Neither cholinesterase inhibitors nor memantine are effective in those with mild cognitive impairment (A). Cholinesterase inhibitors are not effective in frontotemporal dementia and may cause agitation (A), though selective serotonin reuptake inhibitors may help behavioural (but not cognitive) features (B). Cholinesterase inhibitors should be used for the treatment of people with Lewy body dementias (Parkinson's disease dementia and dementia with Lewy bodies (DLB)), especially for neuropsychiatric symptoms (A). Cholinesterase inhibitors and memantine can produce cognitive improvements in DLB (A). There is no clear evidence that any intervention can prevent or delay the onset of dementia. Although the consensus statement focuses on medication, psychological interventions can be effective in addition to pharmacotherapy, both for cognitive and non-cognitive symptoms. Many novel pharmacological approaches involving strategies to reduce amyloid and/or tau deposition are in progress. Although results of pivotal studies are awaited, results to date have been equivocal and no disease-modifying agents are either licensed or can be currently recommended for clinical use.