Diss. (sammanfattning) Uppsala : Sveriges lantbruksuniv., 2007. / Härtill 4 uppsatser.

Thesis (Ph. D. in Software Engineering)--Naval Postgraduate School, Sept. 2004. / Thesis Advisor(s): Luqi. Includes bibliographical references. Also available online.

Thesis (M.A.) - Carleton University, 2006. / Includes bibliographical references (p. 86-94). Also available in electronic format on the Internet.

Thesis (Ph. D.)--University of California, San Diego, 2006. / Title from first page of PDF file (viewed September 20, 2006). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (p. 125-132).

Flood events have caused detrimental impacts to humans' lives and anthropogenic climate change is anticipated to exacerbate the impact. It has been recognized that a long-term planning through risk-based optimization of flood defence will lead to a cost-effective solution for managing flood risk, but the prevailing assumption of stationarity may lead to an erroneous solution. In attempt to investigate the potential impact of the uncertain underlying statistical characteristics of extreme flow series to flood protection decisions, this research explores risk-based flood protection decisions in the context of climatic variability and change. In particular, the implications of persistence series and nonstationarity were investigated through hypothetical and real case studies. Monte Carlo simulation approach was adopted to capture the uncertainty due to the natural variability. For persistence model, AR(1) was integrated with the GEV model to simulate extreme flow series with persistence. To test the effects of nonstationary, GEV models with a linear location parameter and time as covariate were adopted. Rational decision makers' behaviours were simulated through a designed decision analysis framework. One of the main findings from the research is that the traditional stationary assumption should remain the basic assumption due to insignificant difference of the decisions' economic performance. However, exploration of the nonstationarity assumption enabled identification of options that are robust to climate uncertainties. It is also found that optimized protection of combined measures of flood defence and property-level protection may provide a cost-effective solution for local flood protection. Overall, the simulation and case studies enlighten practitioners and decision makers with new evidence, and may guide to practical enhancement of long term flood risk management decision making.

Cisco 2014 Annual Security Report clearly outlines the evolution of the threat landscape and the increase of the number of attacks. The UK government in 2012 recognised the cyber threat as Tier-1 threat since about 50 government departments have been either subjected to an attack or a direct threat from an attack. The cyberspace has become the platform of choice for businesses, schools, universities, colleges, hospitals and other sectors for business activities. One of the major problems identified by the Department of Homeland Security is the lack of clear security metrics. The recent cyber security breach of the US retail giant TARGET is a typical example that demonstrates the weaknesses of qualitative security, also considered by some security experts as fuzzy security. High, medium or low as measures of security levels do not give a quantitative representation of the network security level of a company. In this thesis, a method is developed to quantify the security risk level of known and unknown attacks in an enterprise network in an effort to solve this problem. The identified vulnerabilities in a case study of a UK based company are classified according to their severity risk levels using common vulnerability scoring system (CVSS) and open web application security project (OWASP). Probability theory is applied against known attacks to create the security metrics and, detection and prevention method is suggested for company network against unknown attacks. Our security metrics are clear and repeatable that can be verified scientifically.

The decisions made by Mental Health Professionals (MHPs) are of utmost significance for providing the highest quality care to service users. The assessment of risk is one of the pivotal processes that MHPs undertake frequently, as per government policy guidelines, and in order to safeguard patients and the public. Although Risk Assessment Proformas (RAPs) consume a proportion of MHP time and resources, very little research has been undertaken to address factors that might affect their most optimal utilisation in practice. Previous literature suggests that medical decisions, like decision making of other kinds, is fraught with difficulty including being susceptible to the influence of cognitive biases, pre-decisional affect, overconfidence, and subjectively held attitudes towards organisational policies and regulations. Specifically, the presentation of risk information can influence decisions. It has also been suggested that anxiety has the capacity to elicit risk aversive responses, and that overconfidence and negative attitude may lead to complacency in undertaking policy-led responsibilities and produce non-compliance for the same. However, much of what is known about medical decision making has been gleaned from outside of context of mental health. As such, the current programme of research aimed to explore decision making in mental health settings and with a view to raise awareness of the complexity of decision making amongst MHPs. The implementation of quantitative and qualitative techniques (studies 1 and 2) revealed negative attitudes from psychiatrists towards Risk Assessment Proformas (RAPs), which are essentially structured decision making aids. Psychiatrist, compared to other MHPs, spent less time completing RAPs, which may reflect their differing attitudes towards their usefulness, something that was consistently emphasised during in-depth qualitative exploration. It was also found that experience was an additional differentiating factor between MHPs. Relationships between experience and other factors such as anxiety, confidence and complacency were found via conversations with MPHs, experience members of staff being less inclined to provide comprehensive and detailed accounts of service user risk in RAPs. This is problematic since although there is, in the UK, a policy led requirement that RAPs are completed for each service user, it is clear that there are inter-professional variations in how RAPs are being used and this acts to inhibit the best information sharing between all those involved in patient care. Following previous work in the area of cognitive bias and its influence upon general and medical decisions, a clinical vignette was also developed (study 3) to establish whether the presentation of risk information influences psychiatric admission decisions. The current findings supported previous work in that decisions were susceptible to the framing effect. The findings here, and previously in the literature, reveal a necessity for MHPs to be informed of bias in decision making in an attempt to improve objectivity in risk assessment practices. The unearthing of the framing effect also further signals the need for proper use of RAPs, where many MHPs may not be using them to their full potential - i.e. an aid to the systematic consideration of a range of information about a service user. The final part of the thesis (study 4) turned to the piloting of an educational module incorporating content around the factors affecting decision making in an attempt to raise awareness amongst MHPs. The rationale being better awareness of the complexity of decision making may act to enhance decision making processes. Pre and post intervention analyses revealed an improvement of baseline to follow-up knowledge of decision making bias and statistical concepts and this knowledge was maintained to a moderate level at four weeks follow-up. Although individuals maintained their susceptibility to the framing effect, the bias was less prevalent in those who knew of its presence before taking part in the study. Overall the findings give some support to the use of education as an approach to raising awareness about decision making processes in MHPs, although what remains to be seen is whether such education acts to bring about changes in behaviour - for example, different use of RAPs. The PhD programme suggests that MHPs are just as susceptible to cognitive biases, such as the framing effect, as has been demonstrated in both general population and other groups of health practitioners. At the same time, attitudes to RAPs differ depending on exact job role, which psychiatrist being least likely to spend time on their completion and reporting them as a tool for noting decisions reached as opposed to an aid to the process. This acts reduce the quality and quantity of reported information shared with colleagues about a service user. It is possible that MHP behaviour aligns with general attitude-behaviour models, such as the Theory of Planned Behaviour. As such, whilst the current work has demonstrated that educational interventions may act to improve awareness of decision making processes and their influences, further research would benefit from considering if these types of approach affect actual behaviour. For example, improved used of RAPs as decision-aids, reduced susceptibility to framing effects, consciousness around how information is represented in RAPs given knowledge of how the information may be used by others.

Introduction: Oral mucositis is an inflammatory and frequently ulcerative side effect of cancer therapy, which has been identified by patients as the most debilitating side effect of their treatment. Mucositis is a dose limiting toxicity which exerts a substantial clinical and economic impact and negatively affects patient quality of life. The patient experience of mucositis is under-reported in the literature. To date, no interventions have been identified that have proven successful in the prevention of mucositis for patients receiving all types of therapy. Vitamin E has shown conflicting results in clinical trials. This thesis combines appraisal of the literature and empirical research,and uses lessons learned from previous studies together with the results of a feasibility study to identify a best practice model for future trials. Methods: The Cochrane risk of bias (ROB) instrument was used to assess the ROB in the studies included in the Cochrane prevention review. A sensitivity analysis was conducted after studies assessed at unclear or high risk of overall bias were excluded. A systematic review of assessment instruments was conducted which identified 50 instruments. Consideration of the appropriateness of these instruments for the use in a clinical trial for the prevention of mucositis was based on the practicality, comparability, and reproducibility, and the impact of these instruments on patients. Three of these instruments were chosen for use in a clinical trial of adults undergoing stem cell transplant. Finally, a feasibility study was designed, developed and conducted which investigated vitamin E for the prevention of mucositis in patients undergoing conditioning for bone marrow transplantation. Through lessons learned from previous studies, consultations with medical professional, the MHRA, ethics committee and suppliers, a protocol was developed for a double blind RCT. The process of gaining MHRA and ethical approval, and the repackaging of intervention and placebo products to meet MA-IMP requirements are described. Results: 130 articles were assessed for risk of bias. Only ten studies were assessed as being at low overall risk of bias. Blinding of outcome assessors and adequate allocation concealment were identified to be important considerations in the planning of future studies. Although only nine patients were recruited into the feasibility study, a number of issues affecting the design and conduct of future trials were identified. Recruitment in particular was identified to be problematic. Strategies for overcoming this problem in future trials were discussed. The methods of blinding and allocation concealment employed were found to be feasible for use in future trials. Expected adverse events patients undergoing stem cell transplantation were also reported. Conclusion: Further studies are required to investigate interventions for the prevention of mucositis. It is of upmost importance that these trials are rigorous in both their methodology and subsequent reporting in order to elicit the maximum benefit for patients taking part in clinical trials, and future patients undergoing therapy for cancer.

Many construction projects suffer from mismanagement despite continuous improvement in the field of project risk management. With the construction boom in the Middle East, and especially the Gulf region, construction projects suffer from a high failure rate. The lack of the implementation of standard risk management methods in the construction industry of the Gulf region leads to construction projects that suffer from poor performance, delays, disputes and claims. In order to design a standard risk management model, there is a need for an in-depth study of the construction environment to lay down the foundation for designing a Standard Construction Risk Management Model in the future. This study aims to identify and assess risk factors during the construction phase of construction projects in the Gulf region focusing on two countries of the Gulf region – the State of Kuwait and Kingdom of Bahrain. The risk factors (RF) were identified and assessed and responsiblty shares were allocated to construction parties: clients, consultants and contractors. The research strategy was a Sequential mixed-method. It was adopted by means of interview surveys followed by a questionnaire. The study started with a qualitative approach in which eleven practitioners were interviewed to evaluate and validate a questionnaire. This was followed by questionnaires distributed to a representative sample of 140 consultants, 128 contractors and 139 clients in the State of Kuwait, in addition to 71 consultants, 99 contractors and 78 clients in the Kingdom of Bahrain, to assess the negative impact of the risk factors during the construction phase on the completion of construction projects. Parametric tests were used to analyse the collected data. Including, the Analysis of Variance (ANOVA) test, the independent-samples t-test, and Pearson correlation coefficient (r) test. The study revealed a difference in perception of the risk factors negative impact on project completion between Kuwait and Bahrain, Bahrain perceives highest degree of impact on projects. On the categories level, both countries agreed on the Finance category as the main factor threatening project completion, and the External category as having the least impact. In Kuwait, almost all parties agreed on the negative impact of all categories on project completion except contractors who have different perception on management category. Furthermore, clients and consultants held different perceptions on the impact of design category. Bahrain results reveal significant differences in perceptions on the impact of categories between clients and the other parties, however there are slight differences between consultants and contractors in all categories. The limitations of the study include only large contractors and consultants in Kuwait and Bahrain were included in the study. The study was limited to the construction phase of construction projects and only six categories of risk factors were included in the study and This research was based on practitioners and participants opinions rather than actual occurrences on projects.

Patients infected with the human immunodeficiency virus (HIV+) are living longer and at heightened risk for developing cardiovascular events (CVEs). Commonly used prediction tools appear to misrepresent their CVE risk to varying degrees and in varying directions. Inclusion of markers of cellular infection, chronic immune activation and/or systemic inflammation into risk models might provide better predictive accuracy. Observational studies assessing the relationship of high-sensitivity C-reactive protein (hs-CRP) to CVE in HIV+ patients have reported inconsistent findings. This review of published studies attempted to determine if the available evidence supports its potential use in new models for stable, treated HIV+ patients. We searched the PubMed database using keywords and combinations of "HIV" AND "cardiovascular risk" AND "CRP". Papers presenting original analyses, associating hs-CRP concentration as an independent variable to hard cardiovascular outcomes (myocardial infarction and cardiovascular death), or to hard CVE as part of a composite endpoint, were included. Five observational studies met inclusion/exclusion criteria for review. Three papers identified an association between elevated hs-CRP and CVE, while two others failed to find any significant association. All reports were heterogeneous in terms of independent variables, controls, and designs. The larger and more rigorous studies, employing higher rates of confounder controls and more objective endpoints in their composites, showed positive associations. Though not conclusive, the preponderance of the evidence at this time supports CRP as a potentially valuable factor to be studied in prospective cardiovascular risk prediction investigations in HIV+ patients.