A classification for incidents and accidents in the health-care system

Problems that arise from health-care management, rather than from a disease process, are now recognized as making a substantial contribution to patient morbidity and mortality and to the cost of health care. However, most classifications of these problems do not provide sufficient detail to allow comparisons or to develop better strategies for the prevention, detection and management of these problems. A 'Generic Occurrence Classification' was developed to record their salient features, place them in context and elicit any system or human error-based contributing factors. This was done by an iterative process in which 'natural categories', identified from over 2000 incidents and 800 adverse events, were placed in a hierarchical structure created using software written in Microsoft Visual Basic; data were stored in a Microsoft Access database. This was shown to be a valid and reliable way to compare incidents and accidents from different sources and to allow sufficient detail to be retrieved to develop preventive strategies.     

Native valve infective endocarditis in elderly and younger adult patients: comparison of clinical features and outcomes with use of the Duke criteria and the Duke Endocarditis Database

The effect of age on the presentation and outcome of infective endocarditis (IE) is unclear. Many of the available data are based on analyses of mixed populations of patients including intravenous drug users or those with prosthetic valve endocarditis or native valve IE. We used the Duke criteria to compare the characteristics of 44 episodes of definite native valve IE in elderly patients (> 64 years old) with the characteristics of 64 similarly defined episodes of native valve IE in younger, nonintravenous-drug-using adult patients (> 29 years and < 60 years old). Our data suggest that the clinical presentation, characteristics, and outcome of native valve IE are similar for elderly patients and younger adult patients, although elderly patients were hospitalized an average of 12 days longer. Although we found that the occurrence of renal failure and cerebral embolism during an episode of IE was associated with higher rates of death (odds ratios, 4.8 and 4.0, respectively), age was not a significant contributor to mortality.     

Advanced concepts flight simulation facility

The cockpit environment is changing rapidly. New technology allows airborne computerised information, flight automation and data transfer with the ground. By 1995, not only will the pilot's task have changed, but also the tools for doing that task. To provide knowledge and direction for these changes, the National Aeronautics and Space Administration (NASA) and the Lockheed-Georgia Company have completed three identical Advanced Concepts Flight Simulation Facilities.

Many advanced features have been incorporated into the simulators — e g, cathode ray tube (CRT) displays of flight and systems information operated via touch-screen or voice, print-outs of clearances, cockpit traffic displays, current databases containing navigational charts, weather and flight plan information, and fuel-efficient autopilot control from take-off to touchdown. More importantly, this cockpit is a versatile test bed for studying displays, controls, procedures and crew management in a full-mission context. The facility also has an air traffic control simulation, with radio and data communications, and an outside visual scene with variable weather conditions. These provide a veridical flight environment to evaluate accurately advanced concepts in flight stations.     

Subroutine based detection of APT malware

Statistical detection of mass malware has been shown to be highly successful. However, this type of malware is less interesting to cyber security officers of larger organizations, who are more concerned with detecting malware indicative of a targeted attack. Here we investigate the potential of statistically based approaches to detect such malware using a malware family associated with a large number of targeted network intrusions. Our approach is complementary to the bulk of statistical based malware classifiers, which are typically based on measures of overall similarity between executable files. One problem with this approach is that a malicious executable that shares some, but limited, functionality with known malware is likely to be misclassified as benign. Here a new approach to malware classification is introduced that classifies programs based on their similarity with known malware subroutines. It is illustrated that malware and benign programs can share a substantial amount of code, implying that classification should be based on malicious subroutines that occur infrequently, or not at all in benign programs. Various approaches to accomplishing this task are investigated, and a particularly simple approach appears the most effective. This approach simply computes the fraction of subroutines of a program that are similar to malware subroutines whose likes have not been found in a larger benign set. If this fraction exceeds around 1.5 %, the corresponding program can be classified as malicious at a 1 in 1000 false alarm rate. It is further shown that combining a local and overall similarity based approach can lead to considerably better prediction due to the relatively low correlation of their predictions.     

3D television: Developing a multi‐modal multi‐viewer TV system of the future

Abstract— Under the European Union funded Advanced Three‐dimensional Television System Technologies (ATTEST) project, De Montfort University (DMU) is developing a 3D display system targeted specifically at domestic television applications. This system uses a modified transmissive LCD panel together with novel backlighting and optics to project multiple viewing regions, or exit pupils, into the viewing space. These exit pupils are located in space using a head tracker. The display accommodates multiple viewers simultaneously and imposes no physical constraints, such as special eyewear. Viewers may move freely over a “typical” room‐sized area. The design of the backlighting facilitates many other display regimes beyond the “standard” 3DTV mode in which each viewer sees the same image pair.     

The challenges of creating actionable knowledge: an action research perspective

Academia has a critical role in developing new knowledge which construction industry practitioners need to envision, undertake and sustain successful innovation. The new knowledge produced by academia, however, often does not satisfy the needs of practitioners. This unsatisfactory state of affairs is frequently taken to be the consequence of the cultural, motivational and operational differences between the two communities. Actionable knowledge is presented as a useful concept which can fuse the expectations, contributions and outputs of academia and practitioners. Within this context, action research is argued to be an appropriate methodology to develop successful actionable knowledge. Results from an action research project are given which provide researchers and practitioners greater understanding of the key factors that shape the degree to which action research produces actionable knowledge: change focus, collaboration capabilities and systematic process. The criteria intrinsic to Mode 2 research (Gibbons et al., 1994 Gibbons, M., Limoges, C., Nowotny, H., Schwartz, S., Scott, P. and Trow, M. 1994. The New Production of Knowledge: The Dynamics of Science and Research in Contemporary Societies, London: Sage.  [Google Scholar]) are demonstrated to have utility in evidencing actionable knowledge. The implication for policy is that there is a need to develop and use appropriate actionable knowledge frameworks and measures to design funding calls, and to evaluate research proposals and outputs.     

Innovation in small construction knowledge‐intensive professional service firms: a case study of an architectural practice

Small construction knowledge‐intensive professional service firms (SCKIPSFs) are becoming increasingly important agents of innovation within the construction industry. The nature and process of innovation in SCKIPSFs, however, is generally considered through the constraining prism of research results generated from significantly different contexts, such as from manufacturing sectors or non‐project based firms. A theory of innovation for SCKIPSFs is developed from a longitudinal 22‐month case study of a small architectural practice. Two forms of knowledge‐based innovation were discerned from the empirical work: exploitative innovation and explorative innovation. ‘Explorative innovation’ was found to be located in immediate ‘new’ project domains, and entailed search, variation, experimentation, activity to solve project‐specific problems; while ‘exploitative innovation’ concentrated on developing generic organisational infrastructure to ‘refine’ and ‘improve the efficiency’ of the firm operations to nurture capability for future activity. The key challenge for SCKIPSFs is to develop and manage an appropriate balance between explorative and exploitative innovation over time in order to generate sustainable competitive advantage.     

Promoting pollution prevention through community-industry dialogues: the good neighbor model in Minnesota

This article examines five attempts by communities to promote pollution prevention through direct negotiations with local manufacturing plants. These projects were Good Neighbor Dialogues spearheaded by Citizens for a Better Environment-Minnesota, an environmental advocacy organization. Three community-company partnerships (a container plant, a foundry, and a cabinet manufacturer) were successful and two (a munitions plant and a petroleum refinery) were not. Successful dialogues all shared certain characteristics: the company was open to negotiating with the community; there was an effective "champion" within the company; a skilled, independent facilitator served as moderator; community participants received independent technical assistance; and both the company and community understood the value of cooperative environmental decision making. Results suggest that Good Neighbor Dialogues can, under the right settings and circumstances, be an effective mechanism for building social capital by fostering greater understanding and trust between companies and communities. They offer the prospect of community-company partnerships that promote pollution prevention and other environmental improvements, while at the same time reinforcing and amplifying traditional pollution control strategies.