Healthcare systems require continuous monitoring of risk to prevent adverse events. Risk analysis is a time consuming activity that depends on the background of analysts and available data. Patient safety data is often incomplete and biased. This research proposes systematic approaches to monitor risk in healthcare using available patient safety data. The methodologies combine traditional healthcare risk analysis methods with safety theory concepts, in an innovative manner, to allocate available evidence to potential risk sources throughout the system. We propose the use of data mining to analyze near-miss reports and guide the identification of risk sources. In addition, we propose a Maximum-Entropy based approach to monitor risk sources and prioritize investigation efforts accordingly. The products of this research are intended to facilitate risk analysis and allow for timely identification of risks to prevent harm to patients.

L’accouchement et ses conséquences demeurent une des principales causes d’incapacité et de décès pour les femmes dans les pays en développement et comprendre l’utilisation tardive des soins obstétricaux d’urgence au moment d’une complication obstétricale constitue un véritable défi en santé publique. La présente étude qualitative relate l’expérience d’accouchement difficile au Mali, en milieu rural. Dans un contexte de pluralité de systèmes de soins, l’objet de cette étude consiste à déterminer les raisons de l’arrivée tardive des femmes au centre de santé de 1ier ligne, à saisir la compréhension qu’elles ont de l’utilisation des services sanitaires, enfin à reconstruire les processus de prise de décisions de recourir aux soins modernes. Cette étude s’inscrit dans une démarche de type ethnographique. Des entretiens semi dirigés et l’observation des interactions entre les femmes et les professionnels de santé ont constitué le corpus de données. Nous retenons qu’une série de facteurs entrent en jeu pour comprendre le problème de l’utilisation tardive des soins obstétricaux d’urgence. Des contraintes exogènes liées à la distance et l’immédiateté de l’urgence obstétricale c'est-à-dire la mobilisation des ressources et des moyens de transport, accompagnées de contraintes endogènes telles que la subordination des femmes au consentement familial, la perception de la qualité des soins et de la compétence des soignants, influencent systématiquement le choix de recourir aux soins modernes. Le phénomène de gestion collective de la complication obstétricale s’inscrit dans un contexte d’intéractions complexes où l’opinion des femmes est totalement minimisée. / Childbirth and its consequences remain a leading cause of disability and death for women in developing countries and the late use of emergency obstetric care during obstetric complications is a challenge in public health. This qualitative study describes the experience of difficult childbirth in Mali, in rural areas. In a context of multiple systems of care, the purpose of this study is first to determine the reasons for the late arrival of women in the health center, to grasp their understanding of the use of health care services, and finally to reconstruct the decision making process to use modern health care. This study is part of an ethnographic approach. Semi-structured interviews and observation of interactions between women and health professionals were conducted. Numerous factors come into play to understand the problem of late use of emergency obstetric care. Exogenous constraints related to the distance and immediacy of the obstetric emergency that is to say the mobilization of resources and means of transport, influence the choice of women to use modern obstetric cares. In the same way, endogenous constraints such as the subordination of women in the family consent, perception of quality of care and skill of caregivers, systematically influence the choice to use modern health care. Collective management of obstetric complications we have observed, occur in a context where the opinion of women is completely minimized.

The Catalyst 6500 is a modern commercial switch, capable of processing millions of packets per second through the utilization of specialized hardware. One of the main hardware components aiding the switch in performing its task is the Ternary Content Addressable Memory (TCAM). TCAMs update themselves with data relevant to routing and switching based on the traffic flowing through the switch. This enables the switch to forward future packets destined to a location that has already been previously discovered - at a very high speed. The problem is TCAMs have a limited size, and once they reach their capacity, the switch has to rely on software to perform the switching and routing - a much slower process than performing Hardware Switching that utilizes the TCAM. A framework has been developed to analyze the switch’s performance once the TCAM has reached its capacity, as well as measure the penalty associated with a cache miss. This thesis concludes with some recommendations and future work.

Background: The proportion of older individuals in the driving population is predicted to increase in the next 50 years. This has important implications for driving safety as abilities which are important for safe driving, such as vision (which accounts for the majority of the sensory input required for driving), processing ability and cognition have been shown to decline with age. The current methods employed for screening older drivers upon re-licensure are also vision based. This study, which investigated social, behavioural and professional aspects involved with older drivers, aimed to determine: (i) if the current visual standards in place for testing upon re-licensure are effective in reducing the older driver fatality rate in Australia; (ii) if the recommended visual standards are actually implemented as part of the testing procedures by Australian optometrists; and (iii) if there are other non-standardised tests which may be better at predicting the on-road incident-risk (including near misses and minor incidents) in older drivers than those tests recommended in the standards. Methods: For the first phase of the study, state-based age- and gender-stratified numbers of older driver fatalities for 2000-2003 were obtained from the Australian Transportation Safety Bureau database. Poisson regression analyses of fatality rates were considered by renewal frequency and jurisdiction (as separate models), adjusting for possible confounding variables of age, gender and year. For the second phase, all practising optometrists in Australia were surveyed on the vision tests they conduct in consultations relating to driving and their knowledge of vision requirements for older drivers. Finally, for the third phase of the study to investigate determinants of on-road incident risk, a stratified random sample of 600 Brisbane residents aged 60 years and were selected and invited to participate using an introductory letter explaining the project requirements. In order to capture the number and type of road incidents which occurred for each participant over 12 months (including near misses and minor incidents), an important component of the prospective research study was the development and validation of a driving diary. The diary was a tool in which incidents that occurred could be logged at that time (or very close in time to which they occurred) and thus, in comparison with relying on participant memory over time, recall bias of incident occurrence was minimised. Association between all visual tests, cognition and scores obtained for non-standard functional tests with retrospective and prospective incident occurrence was investigated. Results: In the first phase,rivers aged 60-69 years had a 33% lower fatality risk (Rate Ratio [RR] = 0.75, 95% CI 0.32-1.77) in states with vision testing upon re-licensure compared with states with no vision testing upon re-licensure, however, because the CIs are wide, crossing 1.00, this result should be regarded with caution. However, overall fatality rates and fatality rates for those aged 70 years and older (RR=1.17, CI 0.64-2.13) did not differ between states with and without license renewal procedures, indicating no apparent benefit in vision testing legislation. For the second phase of the study, nearly all optometrists measured visual acuity (VA) as part of a vision assessment for re-licensing, however, 20% of optometrists did not perform any visual field (VF) testing and only 20% routinely performed automated VF on older drivers, despite the standards for licensing advocating automated VF as part of the vision standard. This demonstrates the need for more effective communication between the policy makers and those responsible for carrying out the standards. It may also indicate that the overall higher driver fatality rate in jurisdictions with vision testing requirements is resultant as the tests recommended by the standards are only partially being conducted by optometrists. Hence a standardised protocol for the screening of older drivers for re-licensure across the nation must be established. The opinions of Australian optometrists with regard to the responsibility of reporting older drivers who fail to meet the licensing standards highlighted the conflict between maintaining patient confidentiality or upholding public safety. Mandatory reporting requirements of those drivers who fail to reach the standards necessary for driving would minimise potential conflict between the patient and their practitioner, and help maintain patient trust and goodwill. The final phase of the PhD program investigated the efficacy of vision, functional and cognitive tests to discriminate between at-risk and safe older drivers. Nearly 80% of the participants experienced an incident of some form over the prospective 12 months, with the total incident rate being 4.65/10 000 km. Sixty-three percent reported having a near miss and 28% had a minor incident. The results from the prospective diary study indicate that the current vision screening tests (VA and VF) used for re-licensure do not accurately predict older drivers who are at increased odds of having an on-road incident. However, the variation in visual measurements of the cohort was narrow, also affecting the results seen with the visual functon questionnaires. Hence a larger cohort with greater variability should be considered for a future study. A slightly lower cognitive level (as measured with the Mini-Mental State Examination [MMSE]) did show an association with incident involvement as did slower reaction time (RT), however the Useful-Field-of-View (UFOV) provided the most compelling results of the study. Cut-off values of UFOV processing (>23.3ms), divided attention (>113ms), selective attention (>258ms) and overall score (moderate/ high/ very high risk) were effective in determining older drivers at increased odds of having any on-road incident and the occurrence of minor incidents. Discussion: The results have shown that for the 60-69 year age-group, there is a potential benefit in testing vision upon licence renewal. However, overall fatality rates and fatality rates for those aged 70 years and older indicated no benefit in vision testing legislation and suggests a need for inclusion of screening tests which better predict on-road incidents. Although VA is routinely performed by Australian optometrists on older drivers renewing their licence, VF is not. Therefore there is a need for a protocol to be developed and administered which would result in standardised methods conducted throughout the nation for the screening of older drivers upon re-licensure. Communication between the community, policy makers and those conducting the protocol should be maximised. By implementing a standardised screening protocol which incorporates a level of mandatory reporting by the practitioner, the ethical dilemma of breaching patient confidentiality would also be resolved. The tests which should be included in this screening protocol, however, cannot solely be ones which have been implemented in the past. In this investigation, RT, MMSE and UFOV were shown to be better determinants of on-road incidents in older drivers than VA and VF, however, as previously mentioned, there was a lack of variability in visual status within the cohort. Nevertheless, it is the recommendation from this investigation, that subject to appropriate sensitivity and specificity being demonstrated in the future using a cohort with wider variation in vision, functional performance and cognition, these tests of cognition and information processing should be added to the current protocol for the screening of older drivers which may be conducted at licensing centres across the nation.

Project report (D. Min.)--New Orleans Baptist Theological Seminary, 1998. / Abstract. Includes bibliographical references (leaves 128-132).

Thesis (M.A.)--Mississippi State University. Department of Sociology, Anthropology, and Social Work. / Title from title screen. Includes bibliographical references.

Η επιρροή του παράγοντα χρονοαπόσταση σε ένα σύστημα ακολουθίας οχημάτων μπορεί να προσδιορίσει την επικινδυνότητα του πλήγματος που υφίσταται το σύστημα. Με βάση μια παρ’ολίγον οπισθο-μετωπική σύγκρουση σε αυτοκινητόδρομο 3 λωρίδων, εξετάζεται ο ρόλος της χρονοαπόστασης μεταξύ των οχημάτων σε συνδυασμό με τους χρόνους αντίδρασης των οδηγών στην αντίληψη του επικείμενου κινδύνου. Το μοντέλο ακολουθίας οχημάτων κατά Brill, που συσχετίζει την χρονοαπόσταση, τον χρόνο αντίδρασης του οδηγού και την επιβράδυνση με τη συχνότητα των ατυχημάτων, χρησιμοποιείται ως κύριο εργαλείο για την εκτίμηση της ευαισθησίας της πιθανότητας ενός ατυχήματος. Μέσω της μικροσκοπικής ανάλυσης του βίντεο καταγραφής του ατυχήματος και της επεξεργασίας των δεδομένων και με πηγή έμπνευσης τα προγενέστερα επίμαχα ερωτήματα που θέτει και απαντά ο G. Davis και οι συνεργάτες του, προκύπτουν οι απαραίτητες πληροφορίες για την αριθμητική περιγραφή του ατυχήματος. Με τη χρήση έπειτα του λογισμικού προγράμματος OpenBUGS, το οποίο βασίζεται στη μέθοδο Monte Carlo Markov Chain, γίνεται προσομοίωση του προτύπου ατυχήματος και υπολογίζονται οι τιμές των παραμέτρων που επηρεάζουν τη μορφή του πλήγματος. Από τα αποτελέσματα προκύπτει ο βαθμός που ο συνδυαστικός παράγοντας χρονοαπόσταση και χρόνος αντίδρασης επηρεάζει το πλήγμα και αξιολογείται. Τέλος, με συγκεκριμένες επεμβάσεις επιχειρείται η βελτίωση ολόκληρου του συστήματος ακολουθίας οχημάτων. / The influence of time headway on a car-following system can determine the severity of a shockwave. Based on a near-miss rear-end collision on a 3-lane highway, this study examines the importance of time headway in combination with the driver’s reaction time upon perception of the upcoming hazard. The car-following model developed by Ed. Brill, relating driver’s reaction time, temporal headway and deceleration response to accident frequency, is used as a main tool for assessing the sensitivity of collision probability. Through a microscopic analysis of the video record and data processing and inspired by earlier critical questions that G. Davis and his associates have posed and answered, all the necessary information for the arithmetical description of the accident is extracted. Using the OpenBUGS software, and based on the Monte Carlo Markov Chain method, simulation of the collision prototype is achieved along with the calculation of other main parameters that affect the shockwave form. Simulation results, revealing the influence that the combined factor headway-reaction time has on a shockwave are derived and evaluated. Through certain modifications, the improvement of the whole car-following system is attempted.

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The aim of this thesis is to study how gender, race, and nation are represented in Miss Universe Japan 2015. I investigate how the top five participants are represented in relation to Japanese ideal femininity and what these representations contribute to. Furthermore, I examine how global ideals have impacted the outcome of the pageant. The material consists of recordings of the Miss Universe Japan 2015 pageant, which is available on YouTube. The material is analyzed using a context focused textual analysis. Stuart Hall’s theories of representation are used to understand how representations work. Judith Butler’s theory of performative gender and Floya Anthias’ and Nira Yuval-Davies’ theories of how gender relates to nation are used to understand how the construction of the nation intersects with the construction of gender. Michael Billig’s theory of banal nationalism is used to illustrate that beauty pageants are nationalistic practices. Lastly, theories of whiteness, both in the West and Japan, are applied to understand how race and national values interact. The top five participants in Miss Universe Japan 2015 are analyzed one by one and their representations are contrasted to the ideals of the Japanese woman. Moreover, the impact of global ideals on the pageant is discussed. I find that the representation of the top five participants both reproduces and challenges the ideal femininity in Japan, thus widening the limits for the Japanese womanhood. On the other hand, these challenges, and also the reproductions, largely follow global ideals, which leads to an essentialization of global beauty.