Quantifying the dynamics of failure across science, startups and security.

Human achievements are often preceded by repeated attempts that fail, but little is known about the mechanisms that govern the dynamics of failure. Here, building on previous research relating to innovation1-7, human dynamics8-11 and learning12-17, we develop a simple one-parameter model that mimics how successful future attempts build on past efforts. Solving this model analytically suggests that a phase transition separates the dynamics of failure into regions of progression or stagnation and predicts that, near the critical threshold, agents who share similar characteristics and learning strategies may experience fundamentally different outcomes following failures. Above the critical point, agents exploit incremental refinements to systematically advance towards success, whereas below it, they explore disjoint opportunities without a pattern of improvement. The model makes several empirically testable predictions, demonstrating that those who eventually succeed and those who do not may initially appear similar, but can be characterized by fundamentally distinct failure dynamics in terms of the efficiency and quality associated with each subsequent attempt. We collected large-scale data from three disparate domains and traced repeated attempts by investigators to obtain National Institutes of Health (NIH) grants to fund their research, innovators to successfully exit their startup ventures, and terrorist organizations to claim casualties in violent attacks. We find broadly consistent empirical support across all three domains, which systematically verifies each prediction of our model. Together, our findings unveil detectable yet previously unknown early signals that enable us to identify failure dynamics that will lead to ultimate success or failure. Given the ubiquitous nature of failure and the paucity of quantitative approaches to understand it, these results represent an initial step towards the deeper understanding of the complex dynamics underlying failure.

Insecurity, polio vaccination rates, and polio incidence in northwest Pakistan.

Pakistan is one of three countries in which endemic transmission of poliovirus has never been stopped. Insecurity is often cited but poorly studied as a barrier to eradicating polio. We analyzed routinely collected health data from 32 districts of northwest Pakistan and constructed an index of insecurity based on journalistic reports of the monthly number of deaths and injuries resulting from conflict-related security incidents. The primary outcomes were the monthly incidence of paralytic polio cases within each district between 2007 and 2014 and the polio vaccination percentage from 666 district-level vaccination campaigns between 2007 and 2009, targeting ∼5.7 million children. Multilevel Poisson regression controlling for time and district fixed effects was used to model the association between insecurity, vaccinator access, vaccination rates, and polio incidence. The number of children inaccessible to vaccinators was 19.7% greater (95% CI: 19.2-20.2%), and vaccination rates were 5.3% lower (95% CI: 5.2-5.3%) in "high-insecurity" campaigns compared with "secure" campaigns. The unadjusted mean vaccination rate was 96.3% (SD = 8.6) in secure campaigns and 88.3% (SD = 19.2) in high-insecurity campaigns. Polio incidence was 73.0% greater (95% CI: 30-131%) during high-insecurity months (unadjusted mean = 0.13 cases per million people, SD = 0.71) compared with secure months (unadjusted mean = 1.23 cases per million people, SD = 4.28). Thus, insecurity was associated with reduced vaccinator access, reduced polio vaccination, and increased polio incidence in northwest Pakistan. These findings demonstrate that insecurity is an important obstacle to global polio eradication.

"If you are on duty, you may be afraid to come out to attend to a person": fear of crime and security challenges in maternal acute care in Nigeria from a realist perspective.

BACKGROUND: Maternal and Child Health is a global priority. Access and utilization of facility-based health services remain a challenge in low and middle-income countries. Evidence on barriers to providing and accessing services omits information on the role of security within facilities. This paper explores the role of security in the provision and use of maternal health services in primary healthcare facilities in Nigeria. METHODS: Study was carried out in Anambra state, Nigeria. Qualitative data were initially collected from 35 in-depth interviews and 24 focus groups with purposively identified key informants. Information gathered was used to build a programme theory that was tested with another round of interviews (17) and focus group (4) discussions. Data analysis and reporting were based on the Context-Mechanism-Outcome heuristic of Realist Evaluation methodology. RESULTS: The presence of a male security guard in the facility was the most important security factor that facilitated provision and uptake of services. Others include perimeter fencing, lighting and staff accommodation. Lack of these components constrained provision and use of services, by impacting on behaviour of staff and patients. Security concerns of facility staff who did not feel safe to let in people into unguarded facilities, mirrored those of pregnant women who did not utilize health facilities because of fear of not being let in and attended to by facility staff. CONCLUSION: Health facility security should be key consideration in programme planning, to avert staff and women's fear of crime which currently constrains provision and use of maternal healthcare at health facilities.

Evaluating the Perceived Efficacy of Randomized Security Measures at Airports.

Both the increase in traveler numbers and the heightened threat posed by terrorism in recent years represent significant challenges to airport security measures. To ensure that a high level of security is maintained, randomized security checks have been proposed as a promising alternative to traditional security approaches. The use of randomized checks means that only a specific number of people are selected for security screening. However, the likely effects of such a change in security procedures on travelers' security perceptions and on the deterrence of criminal activities remain unclear. Thus, the present study examines how varying the percentage of people screened during security checks influences people's security perceptions. In two online experiments, the participants were asked to imagine that they sought to smuggle an explosive dummy past an airport security check. The only information provided was the number of people screened during security checks, which was manipulated between-subjects in the first experiment and within-subjects in the second experiment. The participants then had to rate their security perception (i.e., the perceived likelihood of successfully smuggling the explosive dummy). The findings show that people perceive traditional security checks to be safer than randomized checks, irrespective of whether 90% or 30% of people are screened. Hence, if randomized security checks would indeed be implemented, it would automatically lead to a decreased perception of security. Furthermore, this decreased security perception might lead to an actual reduction in security, as the deterrence of criminal activities could also be reduced.

Role of security guards in Code Black events in medical and surgical settings: A retrospective chart audit.

The prevalence of security guards in health care settings is growing worldwide. There is a need to explore and understand their role and actions to inform policy and training and support least restrictive practices in health care. The aim of this study was to conduct a retrospective chart audit of security guard logs to investigate security guard involvement in Code Blacks, called in emergency situations of personal threats including patient and/or visitor violence, in medical and surgical wards in a large metropolitan health network in South Australia. Security guards attended 1664 Code Blacks (0.63% of admissions) over the 2.5-year study period. Events were more frequently reported in medical than surgical wards. The most common reasons for security guard attendance were patients threatening/harming staff and patients threatening/harming themselves. The most frequent security guard actions were "Attend only/standby," "Physical restraint," and "Patient located and returned to the ward." The most frequent outcomes were physical restraint, chemical restraint, and de-escalation respectively. Results highlight the imperative that health services maintain and increase efforts to support least restrictive practice through policy directives and staff training.

Establishing a theoretical foundation for measuring global health security: a scoping review.

BACKGROUND: Since the 2014-2016 West Africa Ebola epidemic, the concept of measuring health security capacity has become increasingly important within the broader context of health systems-strengthening, enhancing responses to public health emergencies, and reducing global catastrophic biological risks. Efforts to regularly and sustainably track the evolution of health security capabilities and capacities over time - while also accounting for political, social, and environmental risks - could help countries progress toward eliminating sources of health insecurity. We sought to aggregate evidence-based principles that capture a country's baseline public health and healthcare capabilities, its health security system performance before and during infectious disease crises, and its broader social, political, security, and ecological risk environments. METHODS: We conducted a scoping review of English-language scholarly and gray literature to identify evidence- and practice-based indicators and proxies for measuring health security at the country level over time. We then used a qualitative coding framework to identify recurrent themes in the literature and synthesize foundational principles for measuring global health security. Documents reviewed included English-language literature published after 2001 until the end of the research period-September 2017-to ensure relevance to the current global health security landscape; literature examining acute infectious disease threats with potential for transnational spread; and literature addressing global health security efforts at the country level. RESULTS: We synthesized four foundational principles for measuring global health security: measurement requires assessment of existing capacities, as well as efforts to build core public health, healthcare, and biosecurity capabilities; assessments of national programs and efforts to mitigate a critical subset of priority threats could inform efforts to generate useful metrics for global health security; there are measurable enabling factors facilitating health security-strengthening efforts; and finally, measurement requires consideration of social, political, and ecological risk environments. CONCLUSION: The themes identified in this review could inform efforts to systematically assess the impacts and effectiveness of activities undertaken to strengthen global health security.

How secure are the secure psychiatric units in New South Wales?

OBJECTIVES:: To evaluate the therapeutic security characteristics of the secure forensic mental health inpatient units in New South Wales, Australia. METHODS:: This study evaluated all eight secure inpatient units in New South Wales using a validated tool, the Security Needs Assessment Profile. RESULTS:: A pattern of decreasing therapeutic security across the secure units was found, consistent with their intended security levels, from high security through to open security. However, important inconsistencies across and between levels of security were highlighted. CONCLUSIONS:: This study clarifies the therapeutic security structure of the New South Wales forensic mental health service, which is an essential first step in service development and reform.

Why governments cannot afford Codentify to support their track and trace solutions.

BACKGROUND: In anticipation of the Protocol to Eliminate Illicit Trade in Tobacco Products (ITP) entering into force in 2018, there is a growing demand for information on track and trace (T&T) solutions for tobacco products. This article contrasts the efficacy of Codentify from the perspective of authentication with that of material-based multilayered security technologies. METHOD: To calculate the probability of detecting one fraudulent pack under Codentify, we relied on a modified Bernoulli trial experiment with independent repeated sampling without replenishment. The probability is calculated using a multinomial distribution formula adjusted for the fact that both legitimate and non-legitimate packs may be sold in the market. RESULTS: In a relatively small market, a law enforcement authority would have to inspect over 27 000 (almost 31 000) packs per week to have a 90% (95%) certainty that it did not miss a fraudulent pack under the Codentify system. A material based T&T solution would require only 45 (59) pack inspections a week to have the same level of confidence. CONCLUSIONS: This study demonstrates the inefficiency of Codentify compared to other solutions that incorporate material-based security features. Signatories to the ITP should reject Codentify due to both its low efficacy and its clear violation of the ITP's requirement that T&T shall not be performed by or delegated to the tobacco industry or its front groups.

School Security Measures and Longitudinal Trends in Adolescents' Experiences of Victimization.

Although school security measures have become a common fixture in public schools across the United States, research on the relationship between security and adolescent victimization is mixed, with very few studies examining trends in adolescent victimization across time. Using two waves of data from the Educational Longitudinal Study 2002 (N = 7659; 50.6% female; 56.7% White, 13.3% Black, 13.5% Hispanic, 11.3% Asian American, 5.4% other race), results from a series of multi-level models demonstrate that adolescents in schools with more security measures report higher odds of being threatened with harm, and no difference in odds of being in a physical altercation or having something stolen over time. Although prior research has established racial disparities in using school security measures, results demonstrate inconsistent patterns in the extent to which adolescents' race conditions the relationship between security and victimization. The findings are discussed in light of existing theoretical and empirical work, and implications for both research and practice are offered.

Effectiveness of Conducted Electrical Weapons to Prevent Violence-Related Injuries in the Hospital.

INTRODUCTION: Health care workers suffer higher rates of violence-related injuries than workers in other industries, with hospital security officers and ED personnel at particularly high risk for injury. Arming hospital security workers with conducted electrical weapons, such as tasers, has been suggested as an intervention to decrease violence-related injuries in the hospital. METHODS: A retrospective cohort of all security and ED nursing staff at an urban level 1 trauma center was identified from human resources data for the period 4 years before and 7 years after security workers were armed with conducted electrical weapons. A violence-related rate of injury was calculated as all violence-related injuries incurred by each employee for the numerator and the productive hours worked by each person during the study period as the denominator. RESULTS: The hospital employed approximately 30 security staff and 200 nursing staff at the time, with a total of 98 security officers and 468 nursing staff members over the 11 years of study. During the total nursing study period, 98 security officers contributed 452,901 hours; 265 registered nurses from the emergency department contributed 1,535,044 hours; and 203 health care assistants contributed 624,805 hours. Security officers' violence-related rate of injury was 13 times higher than that of the nursing staff. The risk ratio was 1.0 (95% confidence interval [CI] 0.7-1.4) between the 2 examination periods for security officers, with similar results for nurses. However, among security workers, the cost of the injuries decreased in the period after implementation. CONCLUSION: Carrying conducted electrical weapons by hospital security staff appears to have limited capacity to decrease overall rates of violence-related injury but may decrease the severity of violence-related injuries. The latter could decease costs to health care organizations as well as morbidity of injured staff. Contribution to Emergency Nursing Practice.

Effect of Door-Locking Policy on Inpatient Treatment of Substance Use and Dual Disorders.

OBJECTIVE: Substance use treatment is often performed inside locked wards. We investigate the effects of adopting a policy of open-door treatment for a substance use treatment and dual diagnosis ward. METHODS: This is a prospective open-label study investigating 3-month study periods before opening (P1), immediately after (P2), and 1 year after the first period (P3). Data on committed patients, coercion (seclusion, forced medication, absconding events with subsequent police search), violence, and substance use was collected daily. We applied generalised estimating equation models. RESULTS: The mean daily number of patients with ongoing commitment changed from 2.64 (P1) to 2.12 (P2) to 0.96 (P3), corresponding to a reduction of relative risk (RR) for having an ongoing commitment by 20% in P2 (RR 0.80; 95% CI 0.66-0.98) and 67% in P3 (RR 0.33; 95% CI 0.25-0.42). The mean daily number of coercive events was 0.29, 0.13, and 0.05, corresponding to a risk for undergoing coercive measures reduced by 56% (RR 0.44; 95% CI 0.22-0.90) and 85% (RR 0.15; 95% CI 0.05-0.45). Substance use, violence or ward atmosphere did not differ significantly. CONCLUSIONS: Our results support findings from general psychiatric wards of reduced coercion after adopting a primarily open-door policy. However, coercive events were rare during all periods. The widespread practice of restricting the freedom of inpatients with substance use disorders by locking ward doors is highly questionable.

Eradicating polio in Pakistan: an analysis of the challenges and solutions to this security and health issue.

Since the launch of the Global Polio Eradication Initiative (GPEI) in 1988 the global incidence of poliomyelitis has fallen by nearly 99 %. From a situation where wild type poliovirus was endemic in 125 countries across five continents, transmission is now limited to regions of just three countries - Pakistan, Afghanistan and Nigeria. A sharp increase in Pakistan's poliomyelitis cases in 2014 prompted the International Health Regulations Emergency Committee to declare the situation a 'public health emergency of international concern'. Global polio eradication hinges on Pakistan's ability to address the religious, political and socioeconomic barriers to immunisation; including discrepancies in vaccine coverage, a poor health infrastructure, and conflict in polio-endemic regions of the country. This analysis provides an overview of the GPEI, focusing on the historical and contemporary challenges facing Pakistan's polio eradication programme and the impact of conflict and insecurity, and sheds light on strategies to combat vaccine hesitancy, engage local communities and build on recent progress towards polio eradication in Pakistan.

Visible School Security Measures and Student Academic Performance, Attendance, and Postsecondary Aspirations.

Many U.S. schools use visible security measures (security cameras, metal detectors, security personnel) in an effort to keep schools safe and promote adolescents' academic success. This study examined how different patterns of visible security utilization were associated with U.S. middle and high school students' academic performance, attendance, and postsecondary educational aspirations. The data for this study came from two large national surveys--the School Crime Supplement to the National Crime Victimization Survey (N = 38,707 students; 51% male, 77% White, MAge = 14.72) and the School Survey on Crime and Safety (N = 10,340 schools; average student composition of 50% male, 57% White). The results provided no evidence that visible security measures had consistent beneficial effects on adolescents' academic outcomes; some security utilization patterns had modest detrimental effects on adolescents' academic outcomes, particularly the heavy surveillance patterns observed in a small subset of high schools serving predominantly low socioeconomic students. The findings of this study provide no evidence that visible security measures have any sizeable effects on academic performance, attendance, or postsecondary aspirations among U.S. middle and high school students.

Do school crossing guards make crossing roads safer? A quasi-experimental study of pedestrian-motor vehicle collisions in Toronto, Canada.

BACKGROUND: The presence of school crossing guards has been associated with more walking and more pedestrian-motor vehicle collisions (PMVCs) in area-level cross-sectional analyses. The objectives of the study were to (1) Determine the effect on PMVC rates of newly implemented crossing guards in Toronto, Canada (2) Determine where collisions were located in relation to crossing guards throughout the city, and whether they occurred during school travel times. METHODS: School crossing guards with 50 m buffers were mapped along with police-reported child PMVCs from 2000-2011. (1) A quasi-experimental study identified all age collision counts near newly implemented guards before and after implementation, modeled using repeated measures Poisson regression adjusted for season and built environment variables. (2) A retrospective cohort study of all child PMVCS throughout the city to determine the proportions of child PMVCs which occurred during school travel times and at guard locations. RESULTS: There were 27,827 PMVCs, with 260 PMVCs at the locations of 58 newly implemented guards. Repeated measures adjusted Poisson regression found PMVCs rates remained unchanged at guard locations after implementation (IRR 1.02, 95 % CI 0.74, 1.39). There were 568 guards citywide with 1850 child PMVCs that occurred at guard locations. The majority of child PMVCs occurred outside school travel times (n = 1155, 62 %) and of those that occurred during school travel times, only 95 (13.7 %) were at a guard location. CONCLUSIONS: School crossing guards are a simple roadway modification to increase walking to school without apparent detrimental safety effects. Other more permanent interventions are necessary to address the frequency of child PMVCs occurring away from the location of crossing guards, and outside of school travel times.

Research on the food security condition and food supply capacity of Egypt.

Food security is chronically guaranteed in Egypt because of the food subsidy policy of the country. However, the increasing Egyptian population is straining the food supply. To study changes in Egyptian food security and future food supply capacity, we analysed the historical grain production, yield per unit, grain-cultivated area, and per capita grain possession of Egypt. The GM (1,1) model of the grey system was used to predict the future population. Thereafter, the result was combined with scenario analysis to forecast the grain possession and population carrying capacity of Egypt under different scenarios. Results show that the increasing population and limitations in cultivated land will strain Egyptian food security. Only in high cultivated areas and high grain yield scenarios before 2020, or in high cultivated areas and mid grain yield scenarios before 2015, can food supply be basically satisfied (assurance rate ≥ 80%) under a standard of 400 kg per capita. Population carrying capacity in 2030 is between 51.45 and 89.35 million. Thus, we propose the use of advanced technologies in agriculture and the adjustment of plant structure and cropping systems to improve land utilization efficiency. Furthermore, urbanization and other uses of cultivated land should be strictly controlled to ensure the planting of grains.

[Persons held in preventive detention (§ 66 Criminal Code): characteristics of offenders and the impact on prospects for successful completion of therapy]. / Sicherungsverwahrte (§ 66 StGB): Merkmale der Täter und ihre Bedeutung für die Erfolgsaussichten eines therapeutischen Vollzugs.

With its verdict in May 2011 the German Federal Constitutional Court declared the current law for preventive detention unconstitutional and obliged the legislative bodies to undertake a freedom- and treatment-oriented reform. Psychiatrists and psychotherapists are bound to provide therapeutic concepts. Currently there is a lack of information on the intended clientele. In our study we examined 26 persons serving preventive detention, 32 regular prisoners and 29 non-delinquent probands. The groups were matched according to age and intelligence. We gathered sociodemographic data, criminal records and conducted the tests SCID I, SCID II und PCL-R, K-FAF and BIS-11 to obtain diagnoses and characteristics. Based on this information, the HCR-20 and GAF were performed. In comparison to regular prisoners and non-delinquents, the group of those serving preventive detention is characterised by medium to advanced age, antisociality, psychopathy, substance abuse or addiction, aggressivity, a strong criminal record, years of imprisonment, insufficient educational and vocational training and a high risk of recidivism. In our examination of persons serving preventive detention, we demonstrate that this clientele is a group of recidivists difficult to treat. The current laws and a lack of early intervention programs have prevented and delayed their timely and possibly successful treatment. From a psychiatric point of view, there is a strong need for new therapeutic concepts to meet this challenge.

Linking gender, climate change and security in the Pacific Islands Region: A systematic review.

This systematic review aims to address gaps in understanding how concepts of gender, climate change and security are given meaning and linked in empirical scholarship within the Pacific Islands Region. The review assesses the 53 articles returned through Web of Science, SCOPUS and ProQuest databases that are derived from empirical research and refer to gender, climate change and security. The findings indicate that this is an emerging topic in a region that is one of the most vulnerable to climate change across the globe. Most frequently gender analysis is given superficial treatment; there is limited literature that connects gendered vulnerabilities to historical legacies and structural inequalities; and women's critical roles that create security are often overlooked and devalued. The review indicates that greater work is needed to question perceived threats to security and to reveal how climate change, gendered institutions, systems and spaces, historical legacies and politics interact to construct security in the Pacific Islands Region.

Emergency department security programs, community crime, and employee assaults.

BACKGROUND: Violence against health care workers is a serious occupational health hazard, especially for emergency department (ED) employees. A significant degree of variability in security programs among hospital EDs is present in part due to the absence of federal legislation requiring baseline security features. Nationally, only voluntary guidelines from the Occupational Safety and Health Administration (OSHA) for the protection of health care workers exist. OBJECTIVES: The purpose of this study was to examine ED security programs and employee assault rates among EDs with different financial resources, size, and background community crime rates. METHODS: This cross-sectional survey was conducted among large and small hospitals located in communities with low or high rates of community crime. Hospital financial data were collected through the state health department, and employee assault data were abstracted from hospital OSHA logs. Comparisons were made using a chi-squared or Wilcoxon test. RESULTS: Small hospitals located in towns with low community crime rates implemented the fewest security program features despite having the second highest rate of assault-related OSHA-recordable injuries among ED employees (0.66 per 100,000 staff hours). CONCLUSION: Due to the highly stressful workplace characteristics of EDs, the risk of employee assault is universal among all hospital sizes in all types of communities.