Spatial aspects of MRSA epidemiology:A case study using stochastic simulation, kernel estimation and SaTScan

The identification of disease clusters in space or space-time is of vital importance for public health policy and action. In the case of methicillin-resistant Staphylococcus aureus (MRSA), it is particularly important to distinguish between community and health care-associated infections, and to identify reservoirs of infection. 832 cases of MRSA in the West Midlands (UK) were tested for clustering and evidence of community transmission, after being geo-located to the centroids of UK unit postcodes (postal areas roughly equivalent to Zip+4 zip code areas). An age-stratified analysis was also carried out at the coarser spatial resolution of UK Census Output Areas. Stochastic simulation and kernel density estimation were combined to identify significant local clusters of MRSA (p<0.025), which were supported by SaTScan spatial and spatio-temporal scan. In order to investigate local sampling effort, a spatial 'random labelling' approach was used, with MRSA as cases and MSSA (methicillin-sensitive S. aureus) as controls. Heavy sampling in general was a response to MRSA outbreaks, which in turn appeared to be associated with medical care environments. The significance of clusters identified by kernel estimation was independently supported by information on the locations and client groups of nursing homes, and by preliminary molecular typing of isolates. In the absence of occupational/ lifestyle data on patients, the assumption was made that an individual's location and consequent risk is adequately represented by their residential postcode. The problems of this assumption are discussed, with recommendations for future data collection.

Risk homeostasis theory in simulated environments

This thesis has two aims. First, it sets out to develop an alternative methodology for the investigation of risk homeostasis theory (RHT). It is argued that the current methodologies of the pseudo-experimental design and post hoc analysis of road-traffic accident data both have their limitations, and that the newer 'game' type simulation exercises are also, but for different reasons, incapable of testing RHT predictions. The alternative methodology described here is based on the simulation of physical risk with intrinsic reward rather than a 'points pay-off'. The second aim of the thesis is to examine a number of predictions made by RHT through the use of this alternative methodology. Since the pseudo-experimental design and post hoc analysis of road-traffic data are both ill-suited to the investigation of that part of RHT which deals with the role of utility in determining risk-taking behaviour in response to a change in environmental risk, and since the concept of utility is critical to RHT, the methodology reported here is applied to the specific investigation of utility. Attention too is given to the question of which behavioural pathways carry the homeostasis effect, and whether those pathways are 'local' to the nature of the change in environmental risk. It is suggested that investigating RHT through this new methodology holds a number of advantages and should be developed further in an attempt to answer the RHT question. It is suggested too that the methodology allows RHT to be seen in a psychological context, rather than the statistical context that has so far characterised its investigation. The experimental findings reported here are in support of hypotheses derived from RHT and would therefore seem to argue for the importance of the individual and collective target level of risk, as opposed to the level of environmental risk, as the major determinant of accident loss.

A modelling and simulation environment for self-aware and self-expressive systems

Self-awareness and self-expression are promising architectural concepts for embedded systems to be equipped with to match them with dedicated application scenarios and constraints in the avionic and space-flight industry. Typically, these systems operate in largely undefined environments and are not reachable after deployment for a long time or even never ever again. This paper introduces a reference architecture as well as a novel modelling and simulation environment for self-aware and self-expressive systems with transaction level modelling, simulation and detailed modelling capabilities for hardware aspects, precise process chronology execution as well as fine timing resolutions. Furthermore, industrial relevant system sizes with several self-aware and self-expressive nodes can be handled by the modelling and simulation environment.

Simulation and experimental analysis of a brushless electrically excited synchronous machine with a hybrid rotor

Electrically excited synchronous machines with brushes and slip rings are popular but hardly used in inflammable and explosive environments. This paper proposes a new brushless electrically excited synchronous motor with a hybrid rotor. It eliminates the use of brushes and slip rings so as to improve the reliability and cost-effectiveness of the traction drive. The proposed motor is characterized with two sets of stator windings with two different pole numbers to provide excitation and drive torque independently. This paper introduces the structure and operating principle of the machine, followed by the analysis of the air-gap magnetic field using the finite-element method. The influence of the excitation winding's pole number on the coupling capability is studied and the operating characteristics of the machine are simulated. These are further examined by the experimental tests on a 16 kW prototype motor. The machine is proved to have good static and dynamic performance, which meets the stringent requirements for traction applications.