Deloitte (United Kingdom)

本研究では、津波浸水域指定区域の設定に伴った、区域内の人口増減の実態とその要因について明らかにした。統計的な有意差の観点からほぼ全ての地域で、津波浸水想定区域の指定後では、指定区域内で相対的に人口減少が進行したことから、結果としては区域指定が人の居住に一定の影響を及ぼした可能性が指摘できる。特に一定の人口流入のある都市的性格の強いエリアにおいては、立地選好の過程で津波浸水想定区域がネガティブに機能し、より区域内外での人口変化の差が表れたのではないかと考えられる。他方で、人口流入の少ないそれ以外のエリアでは、移転等の積極的な人口移動は限定的であったことから、区域内外で大きな差が出にくかったと見られる。すなわち、津波浸水想定区域の公表は、外部からの流入の抑制には一定の効果を及ぼした可能性はあるが、内部からの転出を促進する効果は弱いと推測される。このため、各地方自治体においては区域内の居住者の津波対策や移転等の補助について複合的に政策を実施し、津波災害からの安全性を高めていく必要があると言える。

Definição do Problema -Possibilidade de baixa eficiência operacional com eventuais perdas futuras de produtividade e competitividade Análise do Problema -De acordo com a literatura e com o mercado, empresas do setor biofarmacêutico que não implantarem conceitos e ferramentas tecnológicas de ponta para avaliação de seus processos correm o risco de perderem eficiência produtiva e competitividade Solução do Problema -Construção de Simulações Virtuais, como base da jornada do Digital Twin, para prévia avaliação detalhada de processos fabris a serem realizados nas plantas atual e futura de Bio-Manguinhos/Fiocruz Avaliação e Lições Aprendidas -A conclusão foi considerada satisfatória dado os resultados alcançados e a complexidade do estudo que, além de avaliar uma linha da planta atual, precisou também coletar e utilizar informações de uma fábrica (CIBS) que ainda está sob projeto.

Background and aimOpportunities to participate in leadership and management with protected time can be limited for clinical trainees. The aim of this fellowship was to gain experience of gold standard healthcare management by becoming part of multidisciplinary teams working to deliver transformational change in the National Health Service (NHS).MethodsA 6-month pilot fellowship, structured as an Out of Programme Experience was created for two registrars to be seconded to the healthcare division of Deloitte, a leading professional services firm. Competitive selection was jointly administered by the Director of Medical Education at St Bartholomew’s Hospital and Deloitte.ResultsThe successful candidates worked on service-led and digital transformation projects, interfacing with senior NHS executives and directors. Trainees gained direct experience and understanding of high-level decision making in the NHS, tackling complex service delivery problems and the practical realities of delivering change within a constrained budget. One impact of this pilot has been completion of a business case to scale up the fellowship into an established programme that can allow other trainees to apply.ConclusionThis innovative fellowship has allowed interested trainees an opportunity to broaden the relevant skills and experience in leadership and management required in specialty training curriculum with real-life application in the NHS.

BackgroundReal-world data, such as claims, electronic medical records (EMRs), and electronic health records (EHRs), are increasingly being used in clinical epidemiology. Understanding the current status of existing approaches can help in designing high-quality epidemiological studies.ObjectiveWe conducted a comprehensive narrative literature review to clarify the secondary use of claims, EMRs, and EHRs in clinical epidemiology in Japan.MethodsWe searched peer-reviewed publications in PubMed from January 1, 2006, to June 30, 2021 (the date of search), which met the following 3 inclusion criteria: involvement of claims, EMRs, EHRs, or medical receipt data; mention of Japan; and published from January 1, 2006, to June 30, 2021. Eligible articles that met any of the following 6 exclusion criteria were filtered: review articles; non–disease-related articles; articles in which the Japanese population is not the sample; articles without claims, EMRs, or EHRs; full text not available; and articles without statistical analysis. Investigations of the titles, abstracts, and full texts of eligible articles were conducted automatically or manually, from which 7 categories of key information were collected. The information included organization, study design, real-world data type, database, disease, outcome, and statistical method.ResultsA total of 620 eligible articles were identified for this narrative literature review. The results of the 7 categories suggested that most of the studies were conducted by academic institutes (n=429); the cohort study was the primary design that longitudinally measured outcomes of proper patients (n=533); 594 studies used claims data; the use of databases was concentrated in well-known commercial and public databases; infections (n=105), cardiovascular diseases (n=100), neoplasms (n=78), and nutritional and metabolic diseases (n=75) were the most studied diseases; most studies have focused on measuring treatment patterns (n=218), physiological or clinical characteristics (n=184), and mortality (n=137); and multivariate models were commonly used (n=414). Most (375/414, 90.6%) of these multivariate modeling studies were performed for confounder adjustment. Logistic regression was the first choice for assessing many of the outcomes, with the exception of hospitalization or hospital stay and resource use or costs, for both of which linear regression was commonly used.ConclusionsThis literature review provides a good understanding of the current status and trends in the use of claims, EMRs, and EHRs data in clinical epidemiology in Japan. The results demonstrated appropriate statistical methods regarding different outcomes, Japan-specific trends of disease areas, and the lack of use of artificial intelligence techniques in existing studies. In the future, a more precise comparison of relevant domestic research with worldwide research will be conducted to clarify the Japan-specific status and challenges.

ABSTRACT Clinicians typically view the intersection between hepatitis C and injection drug use in terms of simultaneity – with transmission occurring via shared needles – or sequentially – with some states requiring that people stop using drugs prior to treatment. Yet, for patients, the connection between substance use and HCV infection can follow a more complex temporal pathway. In this article, we explore the non-linear temporality of “reliving” as it shapes HCV illness experience, its complex intersection with injection drug use, and the barriers patients face as they reckon with existing healthcare system responses and treatment modalities.

As artificial intelligence (AI) is increasingly being deployed in almost all aspects of our daily lives, the discourse around the pervasiveness of algorithmic tools and automated decision-making appears to be almost a trivial one. This chapter investigates limits and opportunities within existing debates and examines the rapidly evolving legal landscape and recent court cases. The authors suggest that a viable approach to fairness, which ultimately remains a choice that organizations have to make, could be rooted in a new measurable and accountable responsible business framework.

The anticipated widespread use of unmanned aerial vehicles (UAVs) raises significant safety and security concerns, including trespassing in restricted areas, colliding with other UAVs, and disrupting high-traffic airspaces. To mitigate these risks, geofences have been proposed as one line of defence, which limit UAVs from flying into the perimeters of other UAVs and restricted locations. In this paper, we address the concern that existing geometric geofencing algorithms lack accuracy during the calculation of complex geofences, particularly in dynamic urban environments. We propose a new algorithm based on alpha shapes and Voronoi diagrams, which we integrate into an on-drone framework using an open-source mapping database from OpenStreetMap. To demonstrate its efficacy, we present performance results using Microsoft's AirSim and a low-cost commercial UAV platform in a real-world urban environment.

As of December 2017, the European Union has a common list of non-cooperative jurisdictions for tax purposes (the “EU List”). The EU List functions as a tool to improve tax good governance globally and to promote the EU standards and values vis-à-vis third countries. This article examines the development of the EU List and the role it plays in the various Member States in terms of their (future) national legislation, including national legislative defensive tax measures taken by the Member States in respect of the listed non-cooperative jurisdictions.