A ten year audit of clinical psychology referrals in the regional Adult Cystic Fibrosis Unit in Northern Ireland

Objectives: A retrospective audit was conducted into Clinical Psychology referrals made by the adult cystic fibrosis (CF) team over a ten year period from 2001-2010. The aim of the audit was to examine the psychological difficulties referred to Clinical Psychology and identify any trends.
Methods: A database of all referrals received over a ten year period was created. A coding template was created by KR and AC which allowed for the categorisation of referrals into three main themes: Mood disturbance, CF related events and non-CF related events. The same coding template was used to categorise referrals to the children’s CF service. Descriptive statistics were used to interpret the data.
Results: In 2009/10, 11% of the adult CF population in Northern Ireland were referred to Clinical Psychology. In the past 10 years there were 200 referrals and 105 adults who accessed Clinical Psychology services. The majority of referrals (67%) were re-referrals (range 2-7). More females were referred and they were also more likely to be referred repeatedly The main reason for referral was anxiety. Depression, adherence and end of life/transplant issues also accounted for a large proportion of referrals. A small proportion of referrals were due to non CF related events. There were age and gender differences in the reasons for referral.
Conclusion: A minority of CF patients attending the regional unit were referred to Clinical Psychology. Those who accessed the services appear to be at increased risk of psychological morbidity as re-referral rates are high. The gender difference in referral and re-referral rates may reflect a difference in psychological morbidity or males not accessing services.

Novel Radio Link Buffer Management Schemes for End-User Multi-class Traffic in High Speed Packet Access Networks

The requirement to provide multimedia services with QoS support in mobile networks has led to standardization and deployment of high speed data access technologies such as the High Speed Downlink Packet Access (HSDPA) system. HSDPA improves downlink packet data and multimedia services support in WCDMA-based cellular networks. As is the trend in emerging wireless access technologies, HSDPA supports end-user multi-class sessions comprising parallel flows with diverse Quality of Service (QoS) requirements, such as real-time (RT) voice or video streaming concurrent with non real-time (NRT) data service being transmitted to the same user, with differentiated queuing at the radio link interface. Hence, in this paper we present and evaluate novel radio link buffer management schemes for QoS control of multimedia traffic comprising concurrent RT and NRT flows in the same HSDPA end-user session. The new buffer management schemes—Enhanced Time Space Priority (E-TSP) and Dynamic Time Space Priority (D-TSP)—are designed to improve radio link and network resource utilization as well as optimize end-to-end QoS performance of both RT and NRT flows in the end-user session. Both schemes are based on a Time-Space Priority (TSP) queuing system, which provides joint delay and loss differentiation between the flows by queuing (partially) loss tolerant RT flow packets for higher transmission priority but with restricted access to the buffer space, whilst allowing unlimited access to the buffer space for delay-tolerant NRT flow but with queuing for lower transmission priority. Experiments by means of extensive system-level HSDPA simulations demonstrates that with the proposed TSP-based radio link buffer management schemes, significant end-to-end QoS performance gains accrue to end-user traffic with simultaneous RT and NRT flows, in addition to improved resource utilization in the radio access network.

End-to-End QoS Enhancement ofHSDPA End-User Multi-flow Traffic Using RAN Buffer Management

High speed downlink packet access (HSDPA) was introduced to UMTS radio access segment to provide higher capacity for new packet switched services. As a result, packet switched sessions with multiple diverse traffic flows such as concurrent voice and data, or video and data being transmitted to the same user are a likely commonplace cellular packet data scenario. In HSDPA, radio access network (RAN) buffer management schemes are essential to support the end-to-end QoS of such sessions. Hence in this paper we present the end-to-end performance study of a proposed RAN buffer management scheme for multi-flow sessions via dynamic system-level HSDPA simulations. The scheme is an enhancement of a time-space priority (TSP) queuing strategy applied to the node B MAC-hs buffer allocated to an end user with concurrent real-time (RT) and non-real-time (NRT) flows during a multi-flow session. The experimental multi- flow scenario is a packet voice call with concurrent TCP-based file download to the same user. Results show that with the proposed enhancements to the TSP-based RAN buffer management, end-to-end QoS performance gains accrue to the NRT flow without compromising RT flow QoS of the same end user session

Stated choices and benefit estimates in the context of traffic calming schemes:Utility maximization, regret minimization, or both?

This paper proposes a discrete mixture model which assigns individuals, up to a probability, to either a class of random utility (RU) maximizers or a class of random regret (RR) minimizers, on the basis of their sequence of observed choices. Our proposed model advances the state of the art of RU-RR mixture models by (i) adding and simultaneously estimating a membership model which predicts the probability of belonging to a RU or RR class; (ii) adding a layer of random taste heterogeneity within each behavioural class; and (iii) deriving a welfare measure associated with the RU-RR mixture model and consistent with referendum-voting, which is the adequate mechanism of provision for such local public goods. The context of our empirical application is a stated choice experiment concerning traffic calming schemes. We find that the random parameter RU-RR mixture model not only outperforms its fixed coefficient counterpart in terms of fit-as expected-but also in terms of plausibility of membership determinants of behavioural class. In line with psychological theories of regret, we find that, compared to respondents who are familiar with the choice context (i.e. the traffic calming scheme), unfamiliar respondents are more likely to be regret minimizers than utility maximizers. © 2014 Elsevier Ltd.

A Lagrangian approach for modeling road collisions using second-order models of traffic flow

In [M. Herty, A. Klein, S. Moutari, V. Schleper, and G. Steinaur, IMA J. Appl. Math., 78(5), 1087–1108, 2013] and [M. Herty and V. Schleper, ZAMM J. Appl. Math. Mech., 91, 763–776, 2011], a macroscopic approach, derived from fluid-dynamics models, has been introduced to infer traffic conditions prone to road traffic collisions along highways’ sections. In these studies, the governing equations are coupled within an Eulerian framework, which assumes fixed interfaces between the models. A coupling in Lagrangian coordinates would enable us to get rid of this (not very realistic) assumption. In this paper, we investigate the well-posedness and the suitability of the coupling of the governing equations within the Lagrangian framework. Further, we illustrate some features of the proposed approach through some numerical simulations.