Barriers and facilitators to replicating an evidence-based palliative care model.

Science.gov (United States)

Davis, E Maxwell; Jamison, Paula; Brumley, Richard; Enguídanos, Susan

2006-01-01

Recognition of the difficulties involved in replicating evidence- based interventions is well documented in the literature within the medical field. Promising research findings are often not translated into practice, and if they are, there is a significant time gap between study conclusion and practice adoption. The purpose of this article is to describe the barriers and facilitators encountered by two managed care organizations while replicating an evidence-based end of life in-home palliative care model. Using Diffusion of Innovation Theory as a theoretical framework, results from focus groups and interviews with the project's clinical, administrative and research teams are presented and recommendations made for improving translational efforts. The process of replicating the end of life in-home palliative care model clearly illustrated the key elements required for successfully diffusing innovation. These key elements include marketing and communication, leadership, organizational support and training and mentorship. This qualitative process study provides clear, real world perspectives of the myriad of challenges encountered in replicating an evidence-based project.

Mapping allied health evidence-based practice: providing a basis for organisational realignment.

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Ziviani, Jenny; Wilkinson, Shelley A; Hinchliffe, Fiona; Feeney, Rachel

2015-06-01

Ahead of the convergence of two major paediatric services, we examined evidence-based practice (EBP) self-efficacy, outcome expectance, knowledge and use among allied health (AH) staff in two major Queensland (Qld) paediatric services. This was to determine whether any differences existed based on organisational affiliation, profession and any previous training to inform a strategy to enhance AH EBP within the new organisational setting. All AH staff from the two Brisbane (Qld) tertiary paedritic hospitals were invited to participate in the survey. Using a cross-sectional design EBP self-efficacy, outcome expectancy, knowledge and use, as well as previous EBP training, were assessed with an online survey. Background demographic information obtained included professional discipline and hospital. One hundreD and thirty-eight health practitioners completed the survey (37% respone rate). Most practioners had accessed EBP training. Mean scores for EBP attitudes (self-efficacy and outcome expectancy) and knowledge were higher than for EBP use scores. Greater variation was observed across professional disciplines than organisations. Training impacted positively on EBP measures but explained a small proportion of total variance in regression models. The results underscore the need to provide organisational supports to AH staff ro EBP implementation. Strategies other than training are requred to maximally enhance EBP attitudes. The new organisational structure provides an oppotunity for this cultural shift to occur.

Sworn testimony of the model evidence: Gaussian Mixture Importance (GAME) sampling

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Volpi, Elena; Schoups, Gerrit; Firmani, Giovanni; Vrugt, Jasper A.

2017-07-01

What is the "best" model? The answer to this question lies in part in the eyes of the beholder, nevertheless a good model must blend rigorous theory with redeeming qualities such as parsimony and quality of fit. Model selection is used to make inferences, via weighted averaging, from a set of K candidate models, Mk; k=>(1,…,K>), and help identify which model is most supported by the observed data, Y>˜=>(y˜1,…,y˜n>). Here, we introduce a new and robust estimator of the model evidence, p>(Y>˜|Mk>), which acts as normalizing constant in the denominator of Bayes' theorem and provides a single quantitative measure of relative support for each hypothesis that integrates model accuracy, uncertainty, and complexity. However, p>(Y>˜|Mk>) is analytically intractable for most practical modeling problems. Our method, coined GAussian Mixture importancE (GAME) sampling, uses bridge sampling of a mixture distribution fitted to samples of the posterior model parameter distribution derived from MCMC simulation. We benchmark the accuracy and reliability of GAME sampling by application to a diverse set of multivariate target distributions (up to 100 dimensions) with known values of p>(Y>˜|Mk>) and to hypothesis testing using numerical modeling of the rainfall-runoff transformation of the Leaf River watershed in Mississippi, USA. These case studies demonstrate that GAME sampling provides robust and unbiased estimates of the evidence at a relatively small computational cost outperforming commonly used estimators. The GAME sampler is implemented in the MATLAB package of DREAM and simplifies considerably scientific inquiry through hypothesis testing and model selection.

Customer-Provider Strategic Alignment: A Maturity Model

Science.gov (United States)

Luftman, Jerry; Brown, Carol V.; Balaji, S.

This chapter presents a new model for assessing the maturity of a ­customer-provider relationship from a collaborative service delivery perspective: the Customer-Provider Strategic Alignment Maturity (CPSAM) Model. This model builds on recent research for effectively managing the customer-provider relationship in IT service outsourcing contexts and a validated model for assessing alignment across internal IT service units and their business customers within the same organization. After reviewing relevant literature by service science and information systems researchers, the six overarching components of the maturity model are presented: value measurements, governance, partnership, communications, human resources and skills, and scope and architecture. A key assumption of the model is that all of the components need be addressed to assess and improve customer-provider alignment. Examples of specific metrics for measuring the maturity level of each component over the five levels of maturity are also presented.

Semantic Modelling of Digital Forensic Evidence

Science.gov (United States)

Kahvedžić, Damir; Kechadi, Tahar

The reporting of digital investigation results are traditionally carried out in prose and in a large investigation may require successive communication of findings between different parties. Popular forensic suites aid in the reporting process by storing provenance and positional data but do not automatically encode why the evidence is considered important. In this paper we introduce an evidence management methodology to encode the semantic information of evidence. A structured vocabulary of terms, ontology, is used to model the results in a logical and predefined manner. The descriptions are application independent and automatically organised. The encoded descriptions aim to help the investigation in the task of report writing and evidence communication and can be used in addition to existing evidence management techniques.

Regulators as agents: Modelling personality and power as evidence is brokered to support decisions on environmental risk

Energy Technology Data Exchange (ETDEWEB)

Davies, G.J. [Cranfield University, Centre for Environmental Risks and Futures, School of Applied Sciences, Cranfield MK43 0AL (United Kingdom); Kendall, G. [University of Nottingham, School of Computer Science, Nottingham NG8 1BB (United Kingdom); University of Nottingham Malaysia Campus, Jalan Broga, 43500 Semenyih, Selangor Darul Ehsan (Malaysia); Soane, E. [London School of Economics and Political Science, Department of Management, London WC2A 2AE (United Kingdom); Li, J. [University of Nottingham, School of Computer Science, Nottingham NG8 1BB (United Kingdom); Rocks, S.A.; Jude, S.R. [Cranfield University, Centre for Environmental Risks and Futures, School of Applied Sciences, Cranfield MK43 0AL (United Kingdom); Pollard, S.J.T., E-mail: s.pollard@cranfield.ac.uk [Cranfield University, Centre for Environmental Risks and Futures, School of Applied Sciences, Cranfield MK43 0AL (United Kingdom)

2014-01-01

Complex regulatory decisions about risk rely on the brokering of evidence between providers and recipients, and involve personality and power relationships that influence the confidence that recipients may place in the sufficiency of evidence and, therefore, the decision outcome. We explore these relationships in an agent-based model; drawing on concepts from environmental risk science, decision psychology and computer simulation. A two-agent model that accounts for the sufficiency of evidence is applied to decisions about salt intake, animal carcass disposal and radioactive waste. A dynamic version of the model assigned personality traits to agents, to explore their receptivity to evidence. Agents with ‘aggressor’ personality sets were most able to imbue fellow agents with enhanced receptivity (with ‘avoider’ personality sets less so) and clear confidence in the sufficiency of evidence. In a dynamic version of the model, when both recipient and provider were assigned the ‘aggressor’ personality set, this resulted in 10 successful evidence submissions in 71 days, compared with 96 days when both agents were assigned the ‘avoider’ personality set. These insights suggest implications for improving the efficiency and quality of regulatory decision making by understanding the role of personality and power. - Highlights: •The role of personality and power in regulatory decision-making is poorly represented. •We built a rudimentary two-agent model to explore environmental risk decisions. •Our two agent model accounted for decisions about the sufficiency of evidence. •We examined the influence personality and power has on confidence gained. •By giving agents personality we might predict the time taken to reach consensus.

Regulators as agents: Modelling personality and power as evidence is brokered to support decisions on environmental risk

International Nuclear Information System (INIS)

Davies, G.J.; Kendall, G.; Soane, E.; Li, J.; Rocks, S.A.; Jude, S.R.; Pollard, S.J.T.

2014-01-01

Complex regulatory decisions about risk rely on the brokering of evidence between providers and recipients, and involve personality and power relationships that influence the confidence that recipients may place in the sufficiency of evidence and, therefore, the decision outcome. We explore these relationships in an agent-based model; drawing on concepts from environmental risk science, decision psychology and computer simulation. A two-agent model that accounts for the sufficiency of evidence is applied to decisions about salt intake, animal carcass disposal and radioactive waste. A dynamic version of the model assigned personality traits to agents, to explore their receptivity to evidence. Agents with ‘aggressor’ personality sets were most able to imbue fellow agents with enhanced receptivity (with ‘avoider’ personality sets less so) and clear confidence in the sufficiency of evidence. In a dynamic version of the model, when both recipient and provider were assigned the ‘aggressor’ personality set, this resulted in 10 successful evidence submissions in 71 days, compared with 96 days when both agents were assigned the ‘avoider’ personality set. These insights suggest implications for improving the efficiency and quality of regulatory decision making by understanding the role of personality and power. - Highlights: •The role of personality and power in regulatory decision-making is poorly represented. •We built a rudimentary two-agent model to explore environmental risk decisions. •Our two agent model accounted for decisions about the sufficiency of evidence. •We examined the influence personality and power has on confidence gained. •By giving agents personality we might predict the time taken to reach consensus

Provider-agency fit in substance abuse treatment organizations: implications for learning climate, morale, and evidence-based practice implementation.

Science.gov (United States)

Ramsey, Alex T; van den Berk-Clark, Carissa

2015-05-12

Substance abuse agencies have been slow to adopt and implement evidence-based practices (EBPs), due in part to poor provider morale and organizational climates that are not conducive to successful learning and integration of these practices. Person-organization fit theory suggests that alignment, or fit, between provider- and agency-level characteristics regarding the implementation of EBPs may influence provider morale and organizational learning climate and, thus, implementation success. The current study hypothesized that discrepancies, or lack of fit, between provider- and agency-level contextual factors would negatively predict provider morale and organizational learning climate, outcomes shown to be associated with successful EBP implementation. Direct service providers (n = 120) from four substance abuse treatment agencies responded to a survey involving provider morale, organizational learning climate, agency expectations for EBP use, agency resources for EBP use, and provider attitudes towards EBP use. Difference scores between combinations of provider- and agency-level factors were computed to model provider-agency fit. Quadratic regression analyses were conducted to more adequately and comprehensively model the level of the dependent variables across the entire "fit continuum". Discrepancies, or misfit, between agency expectations and provider attitudes and between agency resources and provider attitudes were associated with poorer provider morale and weaker organizational learning climate. For all hypotheses, the curvilinear model of provider-agency discrepancies significantly predicted provider morale and organizational learning climate, indicating that both directions of misfit (provider factors more favorable than agency factors, and vice-versa) were detrimental to morale and climate. However, outcomes were most negative when providers viewed EBPs favorably, but perceived that agency expectations and resources were less supportive of EBP use. The

Bridging the gap between evidence and policy for infectious diseases: How models can aid public health decision-making

Directory of Open Access Journals (Sweden)

Gwenan M. Knight

2016-01-01

Full Text Available The dominant approach to decision-making in public health policy for infectious diseases relies heavily on expert opinion, which often applies empirical evidence to policy questions in a manner that is neither systematic nor transparent. Although systematic reviews are frequently commissioned to inform specific components of policy (such as efficacy, the same process is rarely applied to the full decision-making process. Mathematical models provide a mechanism through which empirical evidence can be methodically and transparently integrated to address such questions. However, such models are often considered difficult to interpret. In addition, models provide estimates that need to be iteratively re-evaluated as new data or considerations arise. Using the case study of a novel diagnostic for tuberculosis, a framework for improved collaboration between public health decision-makers and mathematical modellers that could lead to more transparent and evidence-driven policy decisions for infectious diseases in the future is proposed. The framework proposes that policymakers should establish long-term collaborations with modellers to address key questions, and that modellers should strive to provide clear explanations of the uncertainty of model structure and outputs. Doing so will improve the applicability of models and clarify their limitations when used to inform real-world public health policy decisions.

Evidence of "Implemented Anticipation" in Mathematising by Beginning Modellers

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Stillman, Gloria; Brown, Jill P.

2014-01-01

Data from open modelling sessions for year 10 and 11 students at an extracurricular modelling event and from a year 9 class participating in a programme of structured modelling of real situations were analysed for evidence of Niss's theoretical construct, "implemented anticipation," during mathematisation. Evidence was found for all…

Can lip prints provide biologic evidence?

Science.gov (United States)

Sharma, Preeti; Sharma, Neeraj; Wadhwan, Vijay; Aggarwal, Pooja

2016-01-01

Lip prints are unique and can be used in personal identification. Very few studies are available which establish them as biological evidence in the court of law. Thus, the objective of this study was to attempt to isolate DNA and obtain full short tandem repeat (STR) loci of the individual from the lip prints on different surfaces. Twelve lip prints were procured on different surfaces such as tissue paper, cotton cloth, ceramic tile, and glass surface. Latent lip prints were developed using fingerprint black powder. Lipstick-coated lip prints were also collected on the same supporting items. DNA was isolated, quantified, and amplified using Identifiler™ kit to type 15 STR loci. Ample quantity of DNA was extracted from all the lip print impressions and 15 loci were successfully located in seven samples. Fourteen loci were successfully typed in 3 lip impressions while 13 loci were typed in 2 samples. This study emphasizes the relevance of lip prints at the scene of crime. Extraction of DNA followed by typing of STR loci establishes the lip prints as biological evidence too. Tissue papers, napkins, cups, and glasses may have imprints of the suspect's lips. Thus, the full genetic profile is extremely useful for the forensic team.

A sampling-based computational strategy for the representation of epistemic uncertainty in model predictions with evidence theory.

Energy Technology Data Exchange (ETDEWEB)

Johnson, J. D. (Prostat, Mesa, AZ); Oberkampf, William Louis; Helton, Jon Craig (Arizona State University, Tempe, AZ); Storlie, Curtis B. (North Carolina State University, Raleigh, NC)

2006-10-01

Evidence theory provides an alternative to probability theory for the representation of epistemic uncertainty in model predictions that derives from epistemic uncertainty in model inputs, where the descriptor epistemic is used to indicate uncertainty that derives from a lack of knowledge with respect to the appropriate values to use for various inputs to the model. The potential benefit, and hence appeal, of evidence theory is that it allows a less restrictive specification of uncertainty than is possible within the axiomatic structure on which probability theory is based. Unfortunately, the propagation of an evidence theory representation for uncertainty through a model is more computationally demanding than the propagation of a probabilistic representation for uncertainty, with this difficulty constituting a serious obstacle to the use of evidence theory in the representation of uncertainty in predictions obtained from computationally intensive models. This presentation describes and illustrates a sampling-based computational strategy for the representation of epistemic uncertainty in model predictions with evidence theory. Preliminary trials indicate that the presented strategy can be used to propagate uncertainty representations based on evidence theory in analysis situations where naive sampling-based (i.e., unsophisticated Monte Carlo) procedures are impracticable due to computational cost.

Utilisation of evidence-based practices by ASD early intervention service providers.

Science.gov (United States)

Paynter, Jessica M; Ferguson, Sarah; Fordyce, Kathryn; Joosten, Annette; Paku, Sofia; Stephens, Miranda; Trembath, David; Keen, Deb

2017-02-01

A number of autism intervention practices have been demonstrated to be effective. However, the use of unsupported practices persists in community early intervention settings. Recent research has suggested that personal, professional and workplace factors may influence intervention choices. The aim of this research was to investigate knowledge and use of strategies, organisational culture, individual attitudes, sources of information and considerations informing intervention choices by early intervention providers. An online survey was completed by 72 early intervention providers from four organisations across Australia. Providers reported high levels of trust and access of information from internal professional development, therapists and external professional development. A range of considerations including child factors, family values and research were rated as important in informing intervention choices. Participants reported greater knowledge and use of evidence-based and emerging practices than unsupported. Levels of use were linked to levels of knowledge, as well as some organisational and attitudinal factors. Areas for future research and implications are discussed.

Organizational Culture and Climate and Mental Health Provider Attitudes Toward Evidence-Based Practice.

Science.gov (United States)

Aarons, Gregory A; Sawitzky, Angelina C

2006-02-01

Mental health provider attitudes toward adopting evidence-based practice (EBP) are associated with organizational context and provider individual differences. Organizational culture and climate are contextual factors that can affect staff acceptance of innovation. This study examined the association of organizational culture and climate with attitudes toward adopting EBP. Participants were 301 public sector mental health service providers from 49 programs providing mental health services for youths and families. Correlation analyses and multilevel hierarchical regressions, controlling for effects of provider characteristics, showed that constructive culture was associated with more positive attitudes toward adoption of EBP and poor organizational climates with perceived divergence of usual practice and EBP. Behavioral health organizations may benefit from consideration of how culture and climate affect staff attitudes toward change in practice.

A rapid evidence-based service by librarians provided information to answer primary care clinical questions.

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McGowan, Jessie; Hogg, William; Rader, Tamara; Salzwedel, Doug; Worster, Danielle; Cogo, Elise; Rowan, Margo

2010-03-01

A librarian consultation service was offered to 88 primary care clinicians during office hours. This included a streamlined evidence-based process to answer questions in fewer than 20 min. This included a contact centre accessed through a Web-based platform and using hand-held devices and computers with Web access. Librarians were given technical training in evidence-based medicine, including how to summarise evidence. To describe the process and lessons learned from developing and operating a rapid response librarian consultation service for primary care clinicians. Evaluation included librarian interviews and a clinician exit satisfaction survey. Clinicians were positive about its impact on their clinical practice and decision making. The project revealed some important 'lessons learned' in the clinical use of hand-held devices, knowledge translation and training for clinicians and librarians. The Just-in-Time Librarian Consultation Service showed that it was possible to provide evidence-based answers to clinical questions in 15 min or less. The project overcame a number of barriers using innovative solutions. There are many opportunities to build on this experience for future joint projects of librarians and healthcare providers.

Does a ban on informal health providers save lives? Evidence from Malawi

Science.gov (United States)

Godlonton, Susan; Okeke, Edward N.

2015-01-01

Informal health providers ranging from drug vendors to traditional healers account for a large fraction of health care provision in developing countries. They are, however, largely unlicensed and unregulated leading to concern that they provide ineffective and, in some cases, even harmful care. A new and controversial policy tool that has been proposed to alter household health seeking behavior is an outright ban on these informal providers. The theoretical effects of such a ban are ambiguous. In this paper, we study the effect of a ban on informal (traditional) birth attendants imposed by the Malawi government in 2007. To measure the effect of the ban, we use a difference-in-difference strategy exploiting variation across time and space in the intensity of exposure to the ban. Our most conservative estimates suggest that the ban decreased use of traditional attendants by about 15 percentage points. Approximately three quarters of this decline can be attributed to an increase in use of the formal sector and the remainder is accounted for by an increase in relative/friend-attended births. Despite the rather large shift from the informal to the formal sector, we do not find any evidence of a statistically significant reduction in newborn mortality on average. The results are robust to a triple difference specification using young children as a control group. We examine several explanations for this result and find evidence consistent with quality of formal care acting as a constraint on improvements in newborn health. PMID:26681821

Skin pigmentation provides evidence of convergent melanism in extinct marine reptiles.

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Lindgren, Johan; Sjövall, Peter; Carney, Ryan M; Uvdal, Per; Gren, Johan A; Dyke, Gareth; Schultz, Bo Pagh; Shawkey, Matthew D; Barnes, Kenneth R; Polcyn, Michael J

2014-02-27

Throughout the animal kingdom, adaptive colouration serves critical functions ranging from inconspicuous camouflage to ostentatious sexual display, and can provide important information about the environment and biology of a particular organism. The most ubiquitous and abundant pigment, melanin, also has a diverse range of non-visual roles, including thermoregulation in ectotherms. However, little is known about the functional evolution of this important biochrome through deep time, owing to our limited ability to unambiguously identify traces of it in the fossil record. Here we present direct chemical evidence of pigmentation in fossilized skin, from three distantly related marine reptiles: a leatherback turtle, a mosasaur and an ichthyosaur. We demonstrate that dark traces of soft tissue in these fossils are dominated by molecularly preserved eumelanin, in intimate association with fossilized melanosomes. In addition, we suggest that contrary to the countershading of many pelagic animals, at least some ichthyosaurs were uniformly dark-coloured in life. Our analyses expand current knowledge of pigmentation in fossil integument beyond that of feathers, allowing for the reconstruction of colour over much greater ranges of extinct taxa and anatomy. In turn, our results provide evidence of convergent melanism in three disparate lineages of secondarily aquatic tetrapods. Based on extant marine analogues, we propose that the benefits of thermoregulation and/or crypsis are likely to have contributed to this melanisation, with the former having implications for the ability of each group to exploit cold environments.

Breaking Bad News: An Evidence-Based Review of Communication Models for Oncology Nurses.

Science.gov (United States)

Bumb, Meridith; Keefe, Joanna; Miller, Lindsay; Overcash, Janine

2017-10-01

A diagnosis of cancer is a stressful, difficult, and life-altering event. Breaking bad news is distressing to patients and families and is often uncomfortable for the nurse delivering it. Evidence-based communication models have been developed and adapted for use in clinical practice to assist nurses with breaking bad news.

. The purpose of this article is to provide an overview on breaking bad news and to review the utility of the SPIKES and PEWTER evidence-based communication models for oncology nurses.
. Perceptions of breaking bad news from the nurse and patient perspectives, as well as barriers and consequences to effective communication, will be presented. Clinical examples of possible situations of breaking bad news will demonstrate how to use the SPIKES and PEWTER models of communication when disclosing bad news to patients and their families.
. By using the evidence-based communication strategies depicted in this article, oncology nurses can support the delivery of bad news and maintain communication with their patients and their patients' families in an effective and productive manner.

Bio-Spectroscopic Imaging Provides Evidence of Hippocampal Zn Deficiency and Decreased Lipid Unsaturation in an Accelerated Ageing Mouse Model.

Science.gov (United States)

Fimognari, Nicholas; Hollings, Ashley; Lam, Virginie; Tidy, Rebecca J; Kewish, Cameron M; Albrecht, Matthew A; Takechi, Ryu; Mamo, John C L; Hackett, Mark J

2018-06-14

Western society is facing a health epidemic due to the increasing incidence of dementia in ageing populations, and there are still few effective diagnostic methods, minimal treatment options, and no cure. Ageing is the greatest risk factor for memory loss that occurs during the natural ageing process, as well as being the greatest risk factor for neurodegenerative disease such as Alzheimer's disease. Therefore, greater understanding of the biochemical pathways that drive a healthy ageing brain towards dementia (pathological ageing or Alzheimer's disease), is required to accelerate the development of improved diagnostics and therapies. Unfortunately, many animal models of dementia model chronic amyloid precursor protein over-expression, which although highly relevant to mechanisms of amyloidosis and familial Alzheimer's disease, does not model well dementia during the natural ageing process. A promising animal model reported to model mechanisms of accelerated natural ageing and memory impairments, is the senescence accelerated murine prone strain 8 (SAMP8), which has been adopted by many research group to study the biochemical transitions that occur during brain ageing. A limitation to traditional methods of biochemical characterisation is that many important biochemical and elemental markers (lipid saturation, lactate, transition metals) cannot be imaged at meso- or micro-spatial resolution. Therefore, in this investigation we report the first multi-modal biospectroscopic characterisation of the SAMP8 model, and have identified important biochemical and elemental alterations, and co-localisations, between 4 month old SAMP8 mice and the relevant control (SAMR1) mice. Specifically, we demonstrate direct evidence of altered metabolism and disturbed lipid homeostasis within corpus callosum white matter, in addition to localised hippocampal metal deficiencies, in the accelerated ageing phenotype. Such findings have important implication for future research aimed at

Coordinated vigilance provides evidence for direct reciprocity in coral reef fishes.

Science.gov (United States)

Brandl, Simon J; Bellwood, David R

2015-09-25

Reciprocity is frequently assumed to require complex cognitive abilities. Therefore, it has been argued that reciprocity may be restricted to animals that can meet these demands. Here, we provide evidence for the potential presence of direct reciprocity in teleost fishes. We demonstrate that in pairs of coral reef rabbitfishes (f. Siganidae), one fish frequently assumes an upright vigilance position in the water column, while the partner forages in small crevices in the reef substratum. Both behaviours are strongly coordinated and partners regularly alternate their positions, resulting in a balanced distribution of foraging activity. Compared to solitary individuals, fishes in pairs exhibit longer vigilance bouts, suggesting that the help provided to the partner is costly. In turn, fishes in pairs take more consecutive bites and penetrate deeper into crevices than solitary individuals, suggesting that the safety provided by a vigilant partner may outweigh initial costs by increasing foraging efficiency. Thus, the described system appears to meet all of the requirements for direct reciprocity. We argue that the nature of rabbitfish pairs provides favourable conditions for the establishment of direct reciprocity, as continuous interaction with the same partner, simultaneous needs, interdependence, and communication relax the cognitive demands of reciprocal cooperation.

Flipped classroom model for learning evidence-based medicine

Directory of Open Access Journals (Sweden)

Rucker SY

2017-08-01

Full Text Available Sydney Y Rucker,1 Zulfukar Ozdogan,1 Morhaf Al Achkar2 1School of Education, Indiana University, Bloomington, IN, 2Department of Family Medicine, School of Medicine, University of Washington, Seattle, WA, USA Abstract: Journal club (JC, as a pedagogical strategy, has long been used in graduate medical education (GME. As evidence-based medicine (EBM becomes a mainstay in GME, traditional models of JC present a number of insufficiencies and call for novel models of instruction. A flipped classroom model appears to be an ideal strategy to meet the demands to connect evidence to practice while creating engaged, culturally competent, and technologically literate physicians. In this article, we describe a novel model of flipped classroom in JC. We present the flow of learning activities during the online and face-to-face instruction, and then we highlight specific considerations for implementing a flipped classroom model. We show that implementing a flipped classroom model to teach EBM in a residency program not only is possible but also may constitute improved learning opportunity for residents. Follow-up work is needed to evaluate the effectiveness of this model on both learning and clinical practice. Keywords: evidence-based medicine, flipped classroom, residency education

Modeling Market Shares of Competing (e)Care Providers

Science.gov (United States)

van Ooteghem, Jan; Tesch, Tom; Verbrugge, Sofie; Ackaert, Ann; Colle, Didier; Pickavet, Mario; Demeester, Piet

In order to address the increasing costs of providing care to the growing group of elderly, efficiency gains through eCare solutions seem an obvious solution. Unfortunately not many techno-economic business models to evaluate the return of these investments are available. The construction of a business case for care for the elderly as they move through different levels of dependency and the effect of introducing an eCare service, is the intended application of the model. The simulation model presented in this paper allows for modeling evolution of market shares of competing care providers. Four tiers are defined, based on the dependency level of the elderly, for which the market shares are determined. The model takes into account available capacity of the different care providers, in- and outflow distribution between tiers and churn between providers within tiers.

A diffusion decision model analysis of evidence variability in the lexical decision task.

Science.gov (United States)

Tillman, Gabriel; Osth, Adam F; van Ravenzwaaij, Don; Heathcote, Andrew

2017-12-01

The lexical-decision task is among the most commonly used paradigms in psycholinguistics. In both the signal-detection theory and Diffusion Decision Model (DDM; Ratcliff, Gomez, & McKoon, Psychological Review, 111, 159-182, 2004) frameworks, lexical-decisions are based on a continuous source of word-likeness evidence for both words and non-words. The Retrieving Effectively from Memory model of Lexical-Decision (REM-LD; Wagenmakers et al., Cognitive Psychology, 48(3), 332-367, 2004) provides a comprehensive explanation of lexical-decision data and makes the prediction that word-likeness evidence is more variable for words than non-words and that higher frequency words are more variable than lower frequency words. To test these predictions, we analyzed five lexical-decision data sets with the DDM. For all data sets, drift-rate variability changed across word frequency and non-word conditions. For the most part, REM-LD's predictions about the ordering of evidence variability across stimuli in the lexical-decision task were confirmed.

Modeling patients' acceptance of provider-delivered e-health.

Science.gov (United States)

Wilson, E Vance; Lankton, Nancy K

2004-01-01

Health care providers are beginning to deliver a range of Internet-based services to patients; however, it is not clear which of these e-health services patients need or desire. The authors propose that patients' acceptance of provider-delivered e-health can be modeled in advance of application development by measuring the effects of several key antecedents to e-health use and applying models of acceptance developed in the information technology (IT) field. This study tested three theoretical models of IT acceptance among patients who had recently registered for access to provider-delivered e-health. An online questionnaire administered items measuring perceptual constructs from the IT acceptance models (intrinsic motivation, perceived ease of use, perceived usefulness/extrinsic motivation, and behavioral intention to use e-health) and five hypothesized antecedents (satisfaction with medical care, health care knowledge, Internet dependence, information-seeking preference, and health care need). Responses were collected and stored in a central database. All tested IT acceptance models performed well in predicting patients' behavioral intention to use e-health. Antecedent factors of satisfaction with provider, information-seeking preference, and Internet dependence uniquely predicted constructs in the models. Information technology acceptance models provide a means to understand which aspects of e-health are valued by patients and how this may affect future use. In addition, antecedents to the models can be used to predict e-health acceptance in advance of system development.

Do Cochrane reviews provide a good model for social science?

DEFF Research Database (Denmark)

Konnerup, Merete; Kongsted, Hans Christian

2012-01-01

Formalised research synthesis to underpin evidence-based policy and practice has become increasingly important in areas of public policy. In this paper we discuss whether the Cochrane standard for systematic reviews of healthcare interventions is appropriate for social research. We examine...... the formal criteria of the Cochrane Collaboration for including particular study designs and search the Cochrane Library to provide quantitative evidence on the de facto standard of actual Cochrane reviews. By identifying the sample of Cochrane reviews that consider observational designs, we are able...... to conclude that the majority of reviews appears limited to considering randomised controlled trials only. Because recent studies have delineated conditions for observational studies in social research to produce valid evidence, we argue that an inclusive approach is essential for truly evidence-based policy...

Team-Based Models for End-of-Life Care: An Evidence-Based Analysis

Science.gov (United States)

2014-01-01

the patient. A “comprehensive” model is one that provides continuity of service across inpatient and outpatient settings, e.g., in hospital and then at home. All teams consisted of a nurse and physician at minimum, at least one of whom had a specialty in end-of-life health care. More than 50% of the teams offered services that included symptom management, psychosocial care, development of patient care plans, end-of-life care planning, and coordination of care. We found moderate-quality evidence that the use of a comprehensive direct contact model initiated up to 9 months before death improved informal caregiver satisfaction and the odds of having a home death, and decreased the odds of dying in a nursing home. We found moderate-quality evidence that the use of a comprehensive, direct, and early (up to 24 months before death) contact model improved patient quality of life, symptom management, and patient satisfaction. We did not find that using a comprehensive team-based model had an impact on hospital admissions or length of stay. We found low-quality evidence that the use of a home team-based model increased the odds of having a home death. Limitations Heterogeneity in data reporting across studies limited the ability to complete a meta-analysis on many of the outcome measures. Missing data was not managed well within the studies. Conclusions Moderate-quality evidence shows that a comprehensive, direct-contact, team-based model of care provides the following benefits for end-of-life patients with an estimated survival of up to 9 months: it improves caregiver satisfaction and increases the odds of dying at home while decreasing the odds of dying in a nursing home. Moderate-quality evidence also shows that improvement in patient quality of life, symptom management, and patient satisfaction occur when end-of-life care via this model is provided early (up to 24 months before death). However, using this model to deliver end-of-life care does not impact hospital

Feedback to providers improves evidence-based implantable cardioverter-defibrillator programming and reduces shocks.

Science.gov (United States)

Silver, Marc T; Sterns, Laurence D; Piccini, Jonathan P; Joung, Boyoung; Ching, Chi-Keong; Pickett, Robert A; Rabinovich, Rafael; Liu, Shufeng; Peterson, Brett J; Lexcen, Daniel R

2015-03-01

Implantable cardioverter-defibrillator (ICD) shocks are associated with increased anxiety, health care utilization, and potentially mortality. The purpose of the Shock-Less Study was to determine if providing feedback reports to physicians on their adherence to evidence-based shock reduction programming could improve their programming behavior and reduce shocks. Shock-Less enrolled primary prevention (PP) and secondary prevention (SP) ICD patients between 2009 and 2012 at 118 study centers worldwide and followed patients longitudinally after their ICD implant. Center-specific therapy programming reports (TPRs) were delivered to each center 9 to 12 months after their first enrollment. The reports detailed adherence to evidence-based programming targets: number of intervals to detect ventricular fibrillation (VF NID), longest treatment interval (LTI), supraventricular tachycardia (SVT) discriminators (Wavelet, PR Logic), SVT limit, Lead Integrity Alert (LIA), and antitachycardia pacing (ATP). Clinicians programmed ICDs at their discretion. The primary outcome measure was the change in utilization of evidence-based shock reduction programming before (phase I, n = 2694 patients) and after initiation of the TPR (phase II, n = 1438 patients). Patients implanted after feedback reports (phase II) were up to 20% more likely to have their ICDs programmed in line with evidence-based shock reduction programming (eg, VF NID in PP patients 30/40 in 33.5% vs 18.6%, P programming feedback reports improves adherence to evidence-based shock reduction programming and is associated with lower risk of ICD shocks. Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

CULTURAL ADAPTATIONS OF EVIDENCE-BASED HOME-VISITATION MODELS IN TRIBAL COMMUNITIES.

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Hiratsuka, Vanessa Y; Parker, Myra E; Sanchez, Jenae; Riley, Rebecca; Heath, Debra; Chomo, Julianna C; Beltangady, Moushumi; Sarche, Michelle

2018-05-01

The Tribal Maternal, Infant, and Early Childhood Home Visiting (Tribal MIECHV) Program provides federal grants to tribes, tribal consortia, tribal organizations, and urban Indian organizations to implement evidence-based home-visiting services for American Indian and Alaska Native (AI/AN) families. To date, only one evidence-based home-visiting program has been developed for use in AI/AN communities. The purpose of this article is to describe the steps that four Tribal MIECHV Programs took to assess community needs, select a home-visiting model, and culturally adapt the model for use in AI/AN communities. In these four unique Tribal MIECHV Program settings, each program employed a rigorous needs-assessment process and developed cultural modifications in accordance with community strengths and needs. Adaptations occurred in consultation with model developers, with consideration of the conceptual rationale for the program, while grounding new content in indigenous cultures. Research is needed to improve measurement of home-visiting outcomes in tribal and urban AI/AN settings, develop culturally grounded home-visiting interventions, and assess the effectiveness of home visiting in AI/AN communities. © 2018 Michigan Association for Infant Mental Health.

Flipped classroom model for learning evidence-based medicine.

Science.gov (United States)

Rucker, Sydney Y; Ozdogan, Zulfukar; Al Achkar, Morhaf

2017-01-01

Journal club (JC), as a pedagogical strategy, has long been used in graduate medical education (GME). As evidence-based medicine (EBM) becomes a mainstay in GME, traditional models of JC present a number of insufficiencies and call for novel models of instruction. A flipped classroom model appears to be an ideal strategy to meet the demands to connect evidence to practice while creating engaged, culturally competent, and technologically literate physicians. In this article, we describe a novel model of flipped classroom in JC. We present the flow of learning activities during the online and face-to-face instruction, and then we highlight specific considerations for implementing a flipped classroom model. We show that implementing a flipped classroom model to teach EBM in a residency program not only is possible but also may constitute improved learning opportunity for residents. Follow-up work is needed to evaluate the effectiveness of this model on both learning and clinical practice.

Business models of micro businesses: Empirical evidence from creative industries

Directory of Open Access Journals (Sweden)

Pfeifer Sanja

2017-01-01

Full Text Available Business model describes how a business identifies and creates value for customers and how it organizes itself to capture some of this value in a profitable manner. Previous studies of business models in creative industries have only recently identified the unresolved issues in this field of research. The main objective of this article is to analyse the structure and diversity of business models and to deduce how these components interact or change in the context of micro and small businesses in creative services such as advertising, architecture and design. The article uses a qualitative approach. Case studies and semi-structured, in-depth interviews with six owners/managers of micro businesses in Croatia provide rich data. Structural coding in data analysis has been performed manually. The qualitative analysis has indicative relevance for the assessment and comparison of business models, however, it provides insights into which components of business models seem to be consolidated and which seem to contribute to the diversity of business models in creative industries. The article contributes to the advancement of empirical evidence and conceptual constructs that might lead to more advanced methodological approaches and proposition of the core typologies or classifications of business models in creative industries. In addition, a more detailed mapping of different choices available in managing value creation, value capturing or value networking might be a valuable help for owners/managers who want to change or cross-fertilize their business models.

Low level radiation: how does the linear without threshold model provide the safety of Canadian

International Nuclear Information System (INIS)

Anon.

2010-01-01

The linear without threshold model is a model of risk used worldwide by the most of health organisms of nuclear regulation in order to establish dose limits for workers and public. It is in the heart of the approach adopted by the Canadian commission of nuclear safety (C.C.S.N.) in matter of radiation protection. The linear without threshold model presumes reasonably it exists a direct link between radiation exposure and cancer rate. It does not exist scientific evidence that chronicle exposure to radiation doses under 100 milli sievert (mSv) leads harmful effects on health. Several scientific reports highlighted scientific evidences that seem indicate a low level of radiation is less harmful than the linear without threshold predicts. As the linear without threshold model presumes that any radiation exposure brings risks, the ALARA principle obliges the licensees to get the radiation exposure at the lowest reasonably achievable level, social and economical factors taken into account. ALARA principle constitutes a basic principle in the C.C.S.N. approach in matter of radiation protection; On the radiation protection plan, C.C.S.N. gets a careful approach that allows to provide health and safety of Canadian people and the protection of their environment. (N.C.)

Gene × Environment Interactions in Schizophrenia: Evidence from Genetic Mouse Models.

Science.gov (United States)

Moran, Paula; Stokes, Jennifer; Marr, Julia; Bock, Gavin; Desbonnet, Lieve; Waddington, John; O'Tuathaigh, Colm

2016-01-01

The study of gene × environment, as well as epistatic interactions in schizophrenia, has provided important insight into the complex etiopathologic basis of schizophrenia. It has also increased our understanding of the role of susceptibility genes in the disorder and is an important consideration as we seek to translate genetic advances into novel antipsychotic treatment targets. This review summarises data arising from research involving the modelling of gene × environment interactions in schizophrenia using preclinical genetic models. Evidence for synergistic effects on the expression of schizophrenia-relevant endophenotypes will be discussed. It is proposed that valid and multifactorial preclinical models are important tools for identifying critical areas, as well as underlying mechanisms, of convergence of genetic and environmental risk factors, and their interaction in schizophrenia.

Gene × Environment Interactions in Schizophrenia: Evidence from Genetic Mouse Models

Science.gov (United States)

Marr, Julia; Bock, Gavin; Desbonnet, Lieve; Waddington, John

2016-01-01

The study of gene × environment, as well as epistatic interactions in schizophrenia, has provided important insight into the complex etiopathologic basis of schizophrenia. It has also increased our understanding of the role of susceptibility genes in the disorder and is an important consideration as we seek to translate genetic advances into novel antipsychotic treatment targets. This review summarises data arising from research involving the modelling of gene × environment interactions in schizophrenia using preclinical genetic models. Evidence for synergistic effects on the expression of schizophrenia-relevant endophenotypes will be discussed. It is proposed that valid and multifactorial preclinical models are important tools for identifying critical areas, as well as underlying mechanisms, of convergence of genetic and environmental risk factors, and their interaction in schizophrenia. PMID:27725886

Pharmacists providing care in the outpatient setting through telemedicine models: a narrative review

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Littauer SL

2017-12-01

Full Text Available Telemedicine refers to the delivery of clinical services using technology that allows two-way, real time, interactive communication between the patient and the clinician at a distant site. Commonly, telemedicine is used to improve access to general and specialty care for patients in rural areas. This review aims to provide an overview of existing telemedicine models involving the delivery of care by pharmacists via telemedicine (including telemonitoring and video, but excluding follow-up telephone calls and to highlight the main areas of chronic-disease management where these models have been applied. Studies within the areas of hypertension, diabetes, asthma, anticoagulation and depression were identified, but only two randomized controlled trials with adequate sample size demonstrating the positive impact of telemonitoring combined with pharmacist care in hypertension were identified. The evidence for the impact of pharmacist-based telemedicine models is sparse and weak, with the studies conducted presenting serious threats to internal and external validity. Therefore, no definitive conclusions about the impact of pharmacist-led telemedicine models can be made at this time. In the Unites States, the increasing shortage of primary care providers and specialists represents an opportunity for pharmacists to assume a more prominent role managing patients with chronic disease in the ambulatory care setting. However, lack of reimbursement may pose a barrier to the provision of care by pharmacists using telemedicine.

Evidence-based practice beliefs and behaviors of nurses providing cancer pain management: a mixed-methods approach.

Science.gov (United States)

Eaton, Linda H; Meins, Alexa R; Mitchell, Pamela H; Voss, Joachim; Doorenbos, Ardith Z

2015-03-01

To describe evidence-based practice (EBP) beliefs and behaviors of nurses who provide cancer pain management. Descriptive, cross-sectional with a mixed-methods approach. Two inpatient oncology units in the Pacific Northwest. 40 RNs.
 Data collected by interviews and web-based surveys. EBP beliefs, EBP implementation, evidence-based pain management. Nurses agreed with the positive aspects of EBP and their implementation ability, although implementation level was low. They were satisfied with their pain management practices. Oncology nursing certification was associated with innovativeness, and innovativeness was associated with EBP beliefs. Themes identified were (a) limited definition of EBP, (b) varied evidence-based pain management decision making, (c) limited identification of evidence-based pain management practices, and (d) integration of nonpharmacologic interventions into patient care. Nurses' low level of EBP implementation in the context of pain management was explained by their trust that standards of care and medical orders were evidence-based. Nurses' EBP beliefs and behaviors should be considered when developing strategies for sustaining evidence-based pain management practices. Implementation of the EBP process by nurses may not be realistic in the inpatient setting; therefore, hospital pain management policies need to be evidence-based and reinforced with nurses.

Adoption of Evidence-Based Practices Among Substance Abuse Treatment Providers*

Science.gov (United States)

Haug, Nancy A.; Shopshire, Michael; Tajima, Barbara; Gruber, Valerie; Guydish, Joseph

2009-01-01

This research was conducted at a Substance Abuse Forum designed to address local community needs by focusing on Evidence-Based Practices (EBPs) in addiction treatment. The purpose of the study was to assess substance abuse treatment professionals’ readiness to adopt EBPs, experience with EBPs, and attitudes toward EBPs, as well as agency support for EBPs. A total of 119 addiction treatment providers completed pre-test measures, and 82% completed a post-test. Eighty-three percent of participants reported using some EBPs in the past year, and 75% reported currently using EBPs. Participants who were currently licensed or certified in addictions had less negative attitudes toward EBPs than those without credentials. While respondents reported agency support for EBPs, most expressed interest in further training. This study underscores the movement toward EBPs in addiction treatment and the need for effective dissemination and training in this area. PMID:18724657

Probing the Relationship Between Evidence-Based Practice Implementation Models and Critical Thinking in Applied Nursing Practice.

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Canada, Amanda N

2016-04-01

HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Probing the Relationship Between Evidence-Based Practice Implementation Models and Critical Thinking in Applied Nursing Practice," found on pages 161-168, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until March 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. • Describe the key components and characteristics related to evidence

An Empirical Investigation of the Black-Scholes Model: Evidence from the Australian Stock Exchange

Directory of Open Access Journals (Sweden)

Zaffar Subedar

2007-12-01

Full Text Available This paper evaluates the probability of an exchange traded European call option beingexercised on the ASX200 Options Index. Using single-parameter estimates of factors withinthe Black-Scholes model, this paper utilises qualitative regression and a maximum likelihoodapproach. Results indicate that the Black-Scholes model is statistically significant at the 1%level. The results also provide evidence that the use of implied volatility and a jump-diffusionapproach, which increases the tail properties of the underlying lognormal distribution,improves the statistical significance of the Black-Scholes model.

Gene × Environment Interactions in Schizophrenia: Evidence from Genetic Mouse Models

Directory of Open Access Journals (Sweden)

Paula Moran

2016-01-01

Full Text Available The study of gene × environment, as well as epistatic interactions in schizophrenia, has provided important insight into the complex etiopathologic basis of schizophrenia. It has also increased our understanding of the role of susceptibility genes in the disorder and is an important consideration as we seek to translate genetic advances into novel antipsychotic treatment targets. This review summarises data arising from research involving the modelling of gene × environment interactions in schizophrenia using preclinical genetic models. Evidence for synergistic effects on the expression of schizophrenia-relevant endophenotypes will be discussed. It is proposed that valid and multifactorial preclinical models are important tools for identifying critical areas, as well as underlying mechanisms, of convergence of genetic and environmental risk factors, and their interaction in schizophrenia.

A Practical Probabilistic Graphical Modeling Tool for Weighing Ecological Risk-Based Evidence

Science.gov (United States)

Past weight-of-evidence frameworks for adverse ecological effects have provided soft-scoring procedures for judgments based on the quality and measured attributes of evidence. Here, we provide a flexible probabilistic structure for weighing and integrating lines of evidence for e...

Modeling the Dynamics and Spillovers of the Health Labor Market: Evidence from China’s Provincial Panel Data

Directory of Open Access Journals (Sweden)

Bin Zhu

2018-01-01

Full Text Available Health workforce misdistribution is a major challenge faced by almost all countries. A more profound understanding of the dynamics of the health labor market provides evidence for policy makers to balance health workforce distribution with solid evidence. However, one major deficit of existing theoretical and empirical studies is that they often ignore the intra-regional spillovers of the health labor market. This study builds a theoretical “supply–demand–spillover” model that considers both intra-regional supply and demand-side factors, and inter-regional spillovers, hence providing a theoretical reference point for further in-depth studies. Using spatial econometric panel models, the effect of all determinants and spillovers were empirically measured based on a Chinese panel data set, shedding light on health workforce policies in China.

Operator models for delivering municipal solid waste management services in developing countries. Part A: The evidence base.

Science.gov (United States)

Wilson, David C; Kanjogera, Jennifer Bangirana; Soós, Reka; Briciu, Cosmin; Smith, Stephen R; Whiteman, Andrew D; Spies, Sandra; Oelz, Barbara

2017-08-01

This article presents the evidence base for 'operator models' - that is, how to deliver a sustainable service through the interaction of the 'client', 'revenue collector' and 'operator' functions - for municipal solid waste management in emerging and developing countries. The companion article addresses a selection of locally appropriate operator models. The evidence shows that no 'standard' operator model is effective in all developing countries and circumstances. Each city uses a mix of different operator models; 134 cases showed on average 2.5 models per city, each applying to different elements of municipal solid waste management - that is, street sweeping, primary collection, secondary collection, transfer, recycling, resource recovery and disposal or a combination. Operator models were analysed in detail for 28 case studies; the article summarises evidence across all elements and in more detail for waste collection. Operators fall into three main groups: The public sector, formal private sector, and micro-service providers including micro-, community-based and informal enterprises. Micro-service providers emerge as a common group; they are effective in expanding primary collection service coverage into poor- or peri-urban neighbourhoods and in delivering recycling. Both public and private sector operators can deliver effective services in the appropriate situation; what matters more is a strong client organisation responsible for municipal solid waste management within the municipality, with stable political and financial backing and capacity to manage service delivery. Revenue collection is also integral to operator models: Generally the municipality pays the operator from direct charges and/or indirect taxes, rather than the operator collecting fees directly from the service user.

Bayesian evidences for dark energy models in light of current observational data

Science.gov (United States)

Lonappan, Anto. I.; Kumar, Sumit; Ruchika; Dinda, Bikash R.; Sen, Anjan A.

2018-02-01

We do a comprehensive study of the Bayesian evidences for a large number of dark energy models using a combination of latest cosmological data from SNIa, CMB, BAO, strong lensing time delay, growth measurements, measurements of Hubble parameter at different redshifts and measurements of angular diameter distance by Megamaser Cosmology Project. We consider a variety of scalar field models with different potentials as well as different parametrizations for the dark energy equation of state. Among 21 models that we consider in our study, we do not find strong evidences in favor of any evolving dark energy model compared to Λ CDM . For the evolving dark energy models, we show that purely nonphantom models have much better evidences compared to those models that allow both phantom and nonphantom behaviors. Canonical scalar field with exponential and tachyon field with square potential have highest evidences among all the models considered in this work. We also show that a combination of low redshift measurements decisively favors an accelerating Λ CDM model compared to a nonaccelerating power law model.

Comprehensive Care For Joint Replacement Model - Provider Data

Data.gov (United States)

U.S. Department of Health & Human Services — Comprehensive Care for Joint Replacement Model - provider data. This data set includes provider data for two quality measures tracked during an episode of care:...

Computer models and the evidence of anthropogenic climate change: An epistemology of variety-of-evidence inferences and robustness analysis.

Science.gov (United States)

Vezér, Martin A

2016-04-01

To study climate change, scientists employ computer models, which approximate target systems with various levels of skill. Given the imperfection of climate models, how do scientists use simulations to generate knowledge about the causes of observed climate change? Addressing a similar question in the context of biological modelling, Levins (1966) proposed an account grounded in robustness analysis. Recent philosophical discussions dispute the confirmatory power of robustness, raising the question of how the results of computer modelling studies contribute to the body of evidence supporting hypotheses about climate change. Expanding on Staley's (2004) distinction between evidential strength and security, and Lloyd's (2015) argument connecting variety-of-evidence inferences and robustness analysis, I address this question with respect to recent challenges to the epistemology robustness analysis. Applying this epistemology to case studies of climate change, I argue that, despite imperfections in climate models, and epistemic constraints on variety-of-evidence reasoning and robustness analysis, this framework accounts for the strength and security of evidence supporting climatological inferences, including the finding that global warming is occurring and its primary causes are anthropogenic. Copyright © 2016 Elsevier Ltd. All rights reserved.

Long-term monitoring data provide evidence of declining species richness in a river valued for biodiversity conservation

Science.gov (United States)

Freeman, Mary C.; Hagler, Megan M.; Bumpers, Phillip M.; Wheeler, Kit; Wengerd, Seth J.; Freeman, Byron J.

2017-01-01

and observations identified contaminants, nutrient loading, or changes in benthic habitat as possible causes for fish species declines in the Conasauga River. Our analysis provides baseline information that could be used to assess effectiveness of future management actions in the Conasauga or Etowah rivers, and illustrates the use of dynamic occupancy models to evaluate evidence of faunal decline from time-series data.

Evidence-based management of otitis media: a 5S model approach.

Science.gov (United States)

Wasson, J D; Yung, M W

2015-02-01

The 5S model proposes five hierarchical levels (systems, summaries, synopses, syntheses and studies) of pre-appraised evidence to guide evidence-based practice. This review aimed to identify and summarise pre-appraised evidence at the highest available 5S level for the management of different subsets of otitis media: acute otitis media, otitis media with effusion, chronic suppurative otitis media and cholesteatoma in both adults and children. Data sources were pre-appraised evidence resources. Evidence freely available from sources at the highest available level of the 5S model were summarised for this review. System level evidence exists for acute otitis media and otitis media with effusion. Summary level evidence exists for recurrent acute otitis media and medical management of chronic suppurative otitis media. There is an absence of randomised controlled trials to prove the efficacy of surgical management of chronic suppurative otitis media and cholesteatoma. Until randomised controlled trial data are generated, consensus publications on the surgical management of chronic suppurative otitis media and cholesteatoma should be used to guide best practice.

Development of Model for Providing Feasible Scholarship

Directory of Open Access Journals (Sweden)

Harry Dhika

2016-05-01

Full Text Available The current work focuses on the development of a model to determine a feasible scholarship recipient on the basis of the naiv¨e Bayes’ method using very simple and limited attributes. Those attributes are the applicants academic year, represented by their semester, academic performance, represented by their GPa, socioeconomic ability, which represented the economic capability to attend a higher education institution, and their level of social involvement. To establish and evaluate the model performance, empirical data are collected, and the data of 100 students are divided into 80 student data for the model training and the remaining of 20 student data are for the model testing. The results suggest that the model is capable to provide recommendations for the potential scholarship recipient at the level of accuracy of 95%.

Evidence-based quantification of uncertainties induced via simulation-based modeling

International Nuclear Information System (INIS)

Riley, Matthew E.

2015-01-01

The quantification of uncertainties in simulation-based modeling traditionally focuses upon quantifying uncertainties in the parameters input into the model, referred to as parametric uncertainties. Often neglected in such an approach are the uncertainties induced by the modeling process itself. This deficiency is often due to a lack of information regarding the problem or the models considered, which could theoretically be reduced through the introduction of additional data. Because of the nature of this epistemic uncertainty, traditional probabilistic frameworks utilized for the quantification of uncertainties are not necessarily applicable to quantify the uncertainties induced in the modeling process itself. This work develops and utilizes a methodology – incorporating aspects of Dempster–Shafer Theory and Bayesian model averaging – to quantify uncertainties of all forms for simulation-based modeling problems. The approach expands upon classical parametric uncertainty approaches, allowing for the quantification of modeling-induced uncertainties as well, ultimately providing bounds on classical probability without the loss of epistemic generality. The approach is demonstrated on two different simulation-based modeling problems: the computation of the natural frequency of a simple two degree of freedom non-linear spring mass system and the calculation of the flutter velocity coefficient for the AGARD 445.6 wing given a subset of commercially available modeling choices. - Highlights: • Modeling-induced uncertainties are often mishandled or ignored in the literature. • Modeling-induced uncertainties are epistemic in nature. • Probabilistic representations of modeling-induced uncertainties are restrictive. • Evidence theory and Bayesian model averaging are integrated. • Developed approach is applicable for simulation-based modeling problems

Governance in Health – The Need for Exchange and Evidence; Comment on “Governance, Government, and the Search for New Provider Models”

Directory of Open Access Journals (Sweden)

Tata Chanturidze

2016-08-01

Full Text Available Governance in health is cited as one of the key factors in balancing the concerns of the government and public sector with the interests of civil society/private players, but often remains poorly described and operationalized. Richard Saltman and Antonio Duran look at two aspects in the search for new provider models in a context of health markets signalling liberalisation: (i the role of the government to balance public and private interests and responsibilities in delivering care through modernised governance arrangements, and (ii the finding that operational complexities may hinder well–designed provider governance models, unless governance reflects country-specific realities. This commentary builds on the discussion by Saltman and Duran, and argues that the concept of governance needs to be clearly defined and operationalized in order to be helpful for policy debate as well as for the development of an applicable framework for performance improvement. It provides a working definition of governance and includes a reflection on the prevailing cultural norms in an organization or society upon which any governance needs to be build. It proposes to explore whether the “evidence-based governance” concept can be introduced to generate knowledge about innovative and effective governance models, and concludes that studies similar to the one by Saltman and Duran can inform this debate.

AIC, BIC, Bayesian evidence against the interacting dark energy model

International Nuclear Information System (INIS)

Szydlowski, Marek; Krawiec, Adam; Kurek, Aleksandra; Kamionka, Michal

2015-01-01

Recent astronomical observations have indicated that the Universe is in a phase of accelerated expansion. While there are many cosmological models which try to explain this phenomenon, we focus on the interacting ΛCDM model where an interaction between the dark energy and dark matter sectors takes place. This model is compared to its simpler alternative - the ΛCDM model. To choose between these models the likelihood ratio test was applied as well as the model comparison methods (employing Occam's principle): the Akaike information criterion (AIC), the Bayesian information criterion (BIC) and the Bayesian evidence. Using the current astronomical data: type Ia supernova (Union2.1), h(z), baryon acoustic oscillation, the Alcock- Paczynski test, and the cosmic microwave background data, we evaluated both models. The analyses based on the AIC indicated that there is less support for the interacting ΛCDM model when compared to the ΛCDM model, while those based on the BIC indicated that there is strong evidence against it in favor of the ΛCDM model. Given the weak or almost non-existing support for the interacting ΛCDM model and bearing in mind Occam's razor we are inclined to reject this model. (orig.)

Dark energy observational evidence and theoretical models

CERN Document Server

Novosyadlyj, B; Shtanov, Yu; Zhuk, A

2013-01-01

The book elucidates the current state of the dark energy problem and presents the results of the authors, who work in this area. It describes the observational evidence for the existence of dark energy, the methods and results of constraining of its parameters, modeling of dark energy by scalar fields, the space-times with extra spatial dimensions, especially Kaluza---Klein models, the braneworld models with a single extra dimension as well as the problems of positive definition of gravitational energy in General Relativity, energy conditions and consequences of their violation in the presence of dark energy. This monograph is intended for science professionals, educators and graduate students, specializing in general relativity, cosmology, field theory and particle physics.

Magnetic resonance imaging provides evidence of glymphatic drainage from human brain to cervical lymph nodes.

Science.gov (United States)

Eide, Per Kristian; Vatnehol, Svein Are Sirirud; Emblem, Kyrre Eeg; Ringstad, Geir

2018-05-08

Pre-clinical research in rodents provides evidence that the central nervous system (CNS) has functional lymphatic vessels. In-vivo observations in humans, however, are not demonstrated. We here show data on CNS lymphatic drainage to cervical lymph nodes in-vivo by magnetic resonance imaging (MRI) enhanced with an intrathecal contrast agent as a cerebrospinal fluid (CSF) tracer. Standardized MRI of the intracranial compartment and the neck were acquired before and up to 24-48 hours following intrathecal contrast agent administration in 19 individuals. Contrast enhancement was radiologically confirmed by signal changes in CSF nearby inferior frontal gyrus, brain parenchyma of inferior frontal gyrus, parahippocampal gyrus, thalamus and pons, and parenchyma of cervical lymph node, and with sagittal sinus and neck muscle serving as reference tissue for cranial and neck MRI acquisitions, respectively. Time series of changes in signal intensity shows that contrast enhancement within CSF precedes glymphatic enhancement and peaks at 4-6 hours following intrathecal injection. Cervical lymph node enhancement coincides in time with peak glymphatic enhancement, with peak after 24 hours. Our findings provide in-vivo evidence of CSF tracer drainage to cervical lymph nodes in humans. The time course of lymph node enhancement coincided with brain glymphatic enhancement rather than with CSF enhancement.

Irrelevant sensory stimuli interfere with working memory storage: evidence from a computational model of prefrontal neurons.

Science.gov (United States)

Bancroft, Tyler D; Hockley, William E; Servos, Philip

2013-03-01

The encoding of irrelevant stimuli into the memory store has previously been suggested as a mechanism of interference in working memory (e.g., Lange & Oberauer, Memory, 13, 333-339, 2005; Nairne, Memory & Cognition, 18, 251-269, 1990). Recently, Bancroft and Servos (Experimental Brain Research, 208, 529-532, 2011) used a tactile working memory task to provide experimental evidence that irrelevant stimuli were, in fact, encoded into working memory. In the present study, we replicated Bancroft and Servos's experimental findings using a biologically based computational model of prefrontal neurons, providing a neurocomputational model of overwriting in working memory. Furthermore, our modeling results show that inhibition acts to protect the contents of working memory, and they suggest a need for further experimental research into the capacity of vibrotactile working memory.

The PERSIAN Cohort: Providing the Evidence Needed for Healthcare Reform.

Science.gov (United States)

Eghtesad, Sareh; Mohammadi, Zahra; Shayanrad, Amaneh; Faramarzi, Elnaz; Joukar, Farahnaz; Hamzeh, Behrooz; Farjam, Mojtaba; Zare Sakhvidi, Mohammad Javad; Miri-Monjar, Mohammadreza; Moosazadeh, Mahmood; Hakimi, Hamid; Rahimi Kazerooni, Salar; Cheraghian, Bahman; Ahmadi, Ali; Nejatizadeh, Azim; Mohebbi, Iraj; Pourfarzi, Farhad; Roozafzai, Farzin; Motamed-Gorji, Nazgol; Montazeri, Seyed Ali; Masoudi, Sahar; Amin-Esmaeili, Masoumeh; Danaie, Navid; Mirhafez, Seyed Reza; Hashemi, Hasan; Poustchi, Hossein; Malekzadeh, Reza

2017-11-01

In the past, communicable diseases caused the highest mortality in Iran. Improvements in socioeconomic status and living standards including access to safe drinking water, along with the inception of Health Houses in the 1980s, have changed disease patterns, decreasing the spread of and deaths from infectious and communicable diseases. The incidence and prevalence of non-communicable diseases (NCD), however, have now increased in Iran, accounting for nearly 80% of deaths and disabilities. Without interventions, NCD are predicted to impose a substantial human and economic burden in the next 2 decades. However, Iran's health system is not equipped with the necessary policies to combat this growth and must refocus and reform. Therefore, in the year 2013, the Ministry of Health and Medical Education funded a well-designed nationwide cohort study-Prospective Epidemiological Research Studies in IrAN (PERSIAN)-in order to assess the burden of NCD and investigate the risk factors associated with them in the different ethnicities and geographical areas of Iran. The PERSIAN Cohort, which aims to include 200000 participants, has 4 components: Adult (main), Birth, Youth and Elderly, which are being carried out in 22 different regions of Iran. Having an enormous dataset along with a biobank of blood, urine, hair and nail samples, the PERSIAN Cohort will serve as an important infrastructure for future implementation research and will provide the evidence needed for new healthcare policies in order to better control, manage and prevent NCD. Copyright © 2017 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

The implementation and evaluation of an evidence-based statewide prehospital pain management protocol developed using the national prehospital evidence-based guideline model process for emergency medical services.

Science.gov (United States)

Brown, Kathleen M; Hirshon, Jon Mark; Alcorta, Richard; Weik, Tasmeen S; Lawner, Ben; Ho, Shiu; Wright, Joseph L

2014-01-01

In 2008, the National Highway Traffic Safety Administration funded the development of a model process for the development and implementation of evidence-based guidelines (EBGs) for emergency medical services (EMS). We report on the implementation and evaluation of an evidence-based prehospital pain management protocol developed using this model process. An evidence-based protocol for prehospital management of pain resulting from injuries and burns was reviewed by the Protocol Review Committee (PRC) of the Maryland Institute for Emergency Medical Services Systems (MIEMSS). The PRC recommended revisions to the Maryland protocol that reflected recommendations in the EBG: weight-based dosing and repeat dosing of morphine. A training curriculum was developed and implemented using Maryland's online Learning Management System and successfully accessed by 3,941 paramedics and 15,969 BLS providers. Field providers submitted electronic patient care reports to the MIEMSS statewide prehospital database. Inclusion criteria were injured or burned patients transported by Maryland ambulances to Maryland hospitals whose electronic patient care records included data for level of EMS provider training during a 12-month preimplementation period and a 12-month postimplementation period from September 2010 through March 2012. We compared the percentage of patients receiving pain scale assessments and morphine, as well as the dose of morphine administered and the use of naloxone as a rescue medication for opiate use, before and after the protocol change. No differences were seen in the percentage of patients who had a pain score documented or the percent of patients receiving morphine before and after the protocol change, but there was a significant increase in the total dose and dose in mg/kg administered per patient. During the postintervention phase, patients received an 18% higher total morphine dose and a 14.9% greater mg/kg dose. We demonstrated that the implementation of a revised

AIC, BIC, Bayesian evidence against the interacting dark energy model

Energy Technology Data Exchange (ETDEWEB)

Szydlowski, Marek [Jagiellonian University, Astronomical Observatory, Krakow (Poland); Jagiellonian University, Mark Kac Complex Systems Research Centre, Krakow (Poland); Krawiec, Adam [Jagiellonian University, Institute of Economics, Finance and Management, Krakow (Poland); Jagiellonian University, Mark Kac Complex Systems Research Centre, Krakow (Poland); Kurek, Aleksandra [Jagiellonian University, Astronomical Observatory, Krakow (Poland); Kamionka, Michal [University of Wroclaw, Astronomical Institute, Wroclaw (Poland)

2015-01-01

Recent astronomical observations have indicated that the Universe is in a phase of accelerated expansion. While there are many cosmological models which try to explain this phenomenon, we focus on the interacting ΛCDM model where an interaction between the dark energy and dark matter sectors takes place. This model is compared to its simpler alternative - the ΛCDM model. To choose between these models the likelihood ratio test was applied as well as the model comparison methods (employing Occam's principle): the Akaike information criterion (AIC), the Bayesian information criterion (BIC) and the Bayesian evidence. Using the current astronomical data: type Ia supernova (Union2.1), h(z), baryon acoustic oscillation, the Alcock- Paczynski test, and the cosmic microwave background data, we evaluated both models. The analyses based on the AIC indicated that there is less support for the interacting ΛCDM model when compared to the ΛCDM model, while those based on the BIC indicated that there is strong evidence against it in favor of the ΛCDM model. Given the weak or almost non-existing support for the interacting ΛCDM model and bearing in mind Occam's razor we are inclined to reject this model. (orig.)

AIC, BIC, Bayesian evidence against the interacting dark energy model

Energy Technology Data Exchange (ETDEWEB)

Szydłowski, Marek, E-mail: marek.szydlowski@uj.edu.pl [Astronomical Observatory, Jagiellonian University, Orla 171, 30-244, Kraków (Poland); Mark Kac Complex Systems Research Centre, Jagiellonian University, Reymonta 4, 30-059, Kraków (Poland); Krawiec, Adam, E-mail: adam.krawiec@uj.edu.pl [Institute of Economics, Finance and Management, Jagiellonian University, Łojasiewicza 4, 30-348, Kraków (Poland); Mark Kac Complex Systems Research Centre, Jagiellonian University, Reymonta 4, 30-059, Kraków (Poland); Kurek, Aleksandra, E-mail: alex@oa.uj.edu.pl [Astronomical Observatory, Jagiellonian University, Orla 171, 30-244, Kraków (Poland); Kamionka, Michał, E-mail: kamionka@astro.uni.wroc.pl [Astronomical Institute, University of Wrocław, ul. Kopernika 11, 51-622, Wrocław (Poland)

2015-01-14

Recent astronomical observations have indicated that the Universe is in a phase of accelerated expansion. While there are many cosmological models which try to explain this phenomenon, we focus on the interacting ΛCDM model where an interaction between the dark energy and dark matter sectors takes place. This model is compared to its simpler alternative—the ΛCDM model. To choose between these models the likelihood ratio test was applied as well as the model comparison methods (employing Occam’s principle): the Akaike information criterion (AIC), the Bayesian information criterion (BIC) and the Bayesian evidence. Using the current astronomical data: type Ia supernova (Union2.1), h(z), baryon acoustic oscillation, the Alcock–Paczynski test, and the cosmic microwave background data, we evaluated both models. The analyses based on the AIC indicated that there is less support for the interacting ΛCDM model when compared to the ΛCDM model, while those based on the BIC indicated that there is strong evidence against it in favor of the ΛCDM model. Given the weak or almost non-existing support for the interacting ΛCDM model and bearing in mind Occam’s razor we are inclined to reject this model.

Flipped classroom model for learning evidence-based medicine

OpenAIRE

Rucker, Sydney Y; Ozdogan, Zulfukar; Al Achkar, Morhaf

2017-01-01

Sydney Y Rucker,1 Zulfukar Ozdogan,1 Morhaf Al Achkar2 1School of Education, Indiana University, Bloomington, IN, 2Department of Family Medicine, School of Medicine, University of Washington, Seattle, WA, USA Abstract: Journal club (JC), as a pedagogical strategy, has long been used in graduate medical education (GME). As evidence-based medicine (EBM) becomes a mainstay in GME, traditional models of JC present a number of insufficiencies and call for novel models of instruction. A flipped cla...

ProvenCare perinatal: a model for delivering evidence/ guideline-based care for perinatal populations.

Science.gov (United States)

Berry, Scott A; Laam, Leslie A; Wary, Andrea A; Mateer, Harry O; Cassagnol, Hans P; McKinley, Karen E; Nolan, Ruth A

2011-05-01

Geisinger Health System (GHS) has applied its ProvenCare model to demonstrate that a large integrated health care delivery system, enabled by an electronic health record (EHR), could reengineer a complicated clinical process, reduce unwarranted variation, and provide evidence-based care for patients with a specified clinical condition. In 2007 GHS began to apply the model to a more complicated, longer-term condition of "wellness"--perinatal care. ADAPTING PROVENCARE TO PERINATAL CARE: The ProvenCare Perinatal initiative was more complex than the five previous ProvenCare endeavors in terms of breadth, scope, and duration. Each of the 22 sites created a process flow map to depict the current, real-time process at each location. The local practice site providers-physicians and mid-level practitioners-reached consensus on 103 unique best practice measures (BPMs), which would be tracked for every patient. These maps were then used to create a single standardized pathway that included the BPMs but also preserved some unique care offerings that reflected the needs of the local context. A nine-phase methodology, expanded from the previous six-phase model, was implemented on schedule. Pre- to postimplementation improvement occurred for all seven BPMs or BPM bundles that were considered the most clinically relevant, with five statistically significant. In addition, the rate of primary cesarean sections decreased by 32%, and birth trauma remained unchanged as the number of vaginal births increased. Preliminary experience suggests that integrating evidence/guideline-based best practices into work flows in inpatient and outpatient settings can achieve improvements in daily patient care processes and outcomes.

Contracting with private providers for primary care services: evidence from urban China.

Science.gov (United States)

Wang, Yan; Eggleston, Karen; Yu, Zhenjie; Zhang, Qiong

2013-01-17

Controversy surrounds the role of the private sector in health service delivery, including primary care and population health services. China's recent health reforms call for non-discrimination against private providers and emphasize strengthening primary care, but formal contracting-out initiatives remain few, and the associated empirical evidence is very limited. This paper presents a case study of contracting with private providers for urban primary and preventive health services in Shandong Province, China. The case study draws on three primary sources of data: administrative records; a household survey of over 1600 community residents in Weifang and City Y; and a provider survey of over 1000 staff at community health stations (CHS) in both Weifang and City Y. We supplement the quantitative data with one-on-one, in-depth interviews with key informants, including local officials in charge of public health and government finance.We find significant differences in patient mix: Residents in the communities served by private community health stations are of lower socioeconomic status (more likely to be uninsured and to report poor health), compared to residents in communities served by a government-owned CHS. Analysis of a household survey of 1013 residents shows that they are more willing to do a routine health exam at their neighborhood CHS if they are of low socioeconomic status (as measured either by education or income). Government and private community health stations in Weifang did not statistically differ in their performance on contracted dimensions, after controlling for size and other CHS characteristics. In contrast, the comparison City Y had lower performance and a large gap between public and private providers. We discuss why these patterns arose and what policymakers and residents considered to be the main issues and concerns regarding primary care services.

Contracting with private providers for primary care services: evidence from urban China

Science.gov (United States)

2013-01-01

Controversy surrounds the role of the private sector in health service delivery, including primary care and population health services. China’s recent health reforms call for non-discrimination against private providers and emphasize strengthening primary care, but formal contracting-out initiatives remain few, and the associated empirical evidence is very limited. This paper presents a case study of contracting with private providers for urban primary and preventive health services in Shandong Province, China. The case study draws on three primary sources of data: administrative records; a household survey of over 1600 community residents in Weifang and City Y; and a provider survey of over 1000 staff at community health stations (CHS) in both Weifang and City Y. We supplement the quantitative data with one-on-one, in-depth interviews with key informants, including local officials in charge of public health and government finance. We find significant differences in patient mix: Residents in the communities served by private community health stations are of lower socioeconomic status (more likely to be uninsured and to report poor health), compared to residents in communities served by a government-owned CHS. Analysis of a household survey of 1013 residents shows that they are more willing to do a routine health exam at their neighborhood CHS if they are of low socioeconomic status (as measured either by education or income). Government and private community health stations in Weifang did not statistically differ in their performance on contracted dimensions, after controlling for size and other CHS characteristics. In contrast, the comparison City Y had lower performance and a large gap between public and private providers. We discuss why these patterns arose and what policymakers and residents considered to be the main issues and concerns regarding primary care services. PMID:23327666

Providing reviews of evidence to COPD patients: controlled prospective 12-month trial.

Science.gov (United States)

Harris, M; Smith, B J; Veale, A J; Esterman, A; Frith, P A; Selim, P

2009-01-01

The aim of this study was to evaluate a novel patient-held manual designed to reduce the evidence-practice gap in chronic obstructive pulmonary disease (COPD). The intervention manual contained summaries of research evidence. It was developed using current best practice for patient information materials and designed to cause discussion of evidence between patient and doctor. A controlled before-and-after study was employed in two similar but geographically separate regions of metropolitan Adelaide, South Australia. Participants had moderate to severe COPD, with 249 included at baseline and 201 completing the study. Evidence-based COPD management was measured using an indicator with three components: rates of influenza vaccination, bone density testing, and pulmonary rehabilitation. A survey of behavioral steps leading to practice change was conducted with the trial. Analysis, by median split of socioeconomic disadvantage, showed significant difference between study arms for only one component of the indicator of evidence-based practice, enrollment in pulmonary rehabilitation and only for the most socioeconomically disadvantaged stratum. For both socioeconomic strata, more intervention participants than control participants reported remembering being given the information material, reading part or all, and finding it very or quite helpful. Other significant differences were restricted to the stratum of greatest socioeconomic disadvantage: reading all of the material, learning from it, referring back, and talking to a doctor about a topic from the material. Above 90% of all participants who received the manual reported reading from it, 42% reported discussing topics with a doctor, but only 10% reported treatment change attributable to the manual. We have found that people with COPD will read an evidence manual developed using current best practice. However, the study demonstrated improvement for only one of the three components of an indicator of evidence

Models for S&P500 Dynamics: Evidence from Realized Volatility, Daily Returns, and Option Prices

DEFF Research Database (Denmark)

Christoffersen, Peter; Jacobs, Kris; Mimouni, Karim

in the search for alternative specifications. We then estimate the models using maximum likelihood on S&P500 returns. Finally, we employ nonlinear least squares on a panel of option data. In comparison with earlier studies that explicitly solve the filtering problem, we analyze a more comprehensive option data......Most recent empirical option valuation studies build on the affine square root (SQR) stochastic volatility model. The SQR model is a convenient choice, because it yields closed-form solutions for option prices. However, relatively little is known about the resulting biases. We investigate...... alternatives to the SQR model, by comparing its empirical performance with that of five different but equally parsimonious stochastic volatility models. We provide empirical evidence from three different sources. We first use realized volatilities to assess the properties of the SQR model and to guide us...

Evidence-based hypnotherapy for depression.

Science.gov (United States)

Alladin, Assen

2010-04-01

Cognitive hypnotherapy (CH) is a comprehensive evidence-based hypnotherapy for clinical depression. This article describes the major components of CH, which integrate hypnosis with cognitive-behavior therapy as the latter provides an effective host theory for the assimilation of empirically supported treatment techniques derived from various theoretical models of psychotherapy and psychopathology. CH meets criteria for an assimilative model of psychotherapy, which is considered to be an efficacious model of psychotherapy integration. The major components of CH for depression are described in sufficient detail to allow replication, verification, and validation of the techniques delineated. CH for depression provides a template that clinicians and investigators can utilize to study the additive effects of hypnosis in the management of other psychological or medical disorders. Evidence-based hypnotherapy and research are encouraged; such a movement is necessary if clinical hypnosis is to integrate into mainstream psychotherapy.

Compositional models and conditional independence in evidence theory

Czech Academy of Sciences Publication Activity Database

Jiroušek, Radim; Vejnarová, Jiřina

2011-01-01

Roč. 52, č. 3 (2011), s. 316-334 ISSN 0888-613X Institutional research plan: CEZ:AV0Z10750506 Keywords : Evidence theory * Conditional independence * multidimensional models Subject RIV: BA - General Mathematics Impact factor: 1.948, year: 2011 http://library.utia.cas.cz/separaty/2012/MTR/jirousek-0370515.pdf

Wasted research when systematic reviews fail to provide a complete and up-to-date evidence synthesis: the example of lung cancer

OpenAIRE

Cr?quit, Perrine; Trinquart, Ludovic; Yavchitz, Am?lie; Ravaud, Philippe

2016-01-01

Background Multiple treatments are frequently available for a given condition, and clinicians and patients need a comprehensive, up-to-date synthesis of evidence for all competing treatments. We aimed to quantify the waste of research related to the failure of systematic reviews to provide a complete and up-to-date evidence synthesis over time. Methods We performed a series of systematic overviews and networks of randomized trials assessing the gap between evidence covered by systematic revie...

Hiring appropriate providers for different populations: acute care nurse practitioners.

Science.gov (United States)

Haut, Cathy; Madden, Maureen

2015-06-01

Acute care nurse practitioners, prepared as providers for a variety of populations of patients, continue to make substantial contributions to health care. Evidence indicates shorter stays, higher satisfaction among patients, increased work efficiency, and higher quality outcomes when acute care nurse practitioners are part of unit- or service-based provider teams. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education outlines detailed guidelines for matching nurse practitioners' education with certification and practice by using a population-focused algorithm. Despite national support for the model, nurse practitioners and employers continue to struggle with finding the right fit. Nurse practitioners often use their interest and previous nursing experience to apply for an available position, and hospitals may not understand preparation or regulations related to matching the appropriate provider to the work environment. Evidence and regulatory guidelines indicate appropriate providers for population-focused positions. This article presents history and recommendations for hiring acute care nurse practitioners as providers for different populations of patients. ©2015 American Association of Critical-Care Nurses.

Generalized role for the cerebellum in encoding internal models: evidence from semantic processing.

Science.gov (United States)

Moberget, Torgeir; Gullesen, Eva Hilland; Andersson, Stein; Ivry, Richard B; Endestad, Tor

2014-02-19

The striking homogeneity of cerebellar microanatomy is strongly suggestive of a corresponding uniformity of function. Consequently, theoretical models of the cerebellum's role in motor control should offer important clues regarding cerebellar contributions to cognition. One such influential theory holds that the cerebellum encodes internal models, neural representations of the context-specific dynamic properties of an object, to facilitate predictive control when manipulating the object. The present study examined whether this theoretical construct can shed light on the contribution of the cerebellum to language processing. We reasoned that the cerebellum might perform a similar coordinative function when the context provided by the initial part of a sentence can be highly predictive of the end of the sentence. Using functional MRI in humans we tested two predictions derived from this hypothesis, building on previous neuroimaging studies of internal models in motor control. First, focal cerebellar activation-reflecting the operation of acquired internal models-should be enhanced when the linguistic context leads terminal words to be predictable. Second, more widespread activation should be observed when such predictions are violated, reflecting the processing of error signals that can be used to update internal models. Both predictions were confirmed, with predictability and prediction violations associated with increased blood oxygenation level-dependent signal in the posterior cerebellum (Crus I/II). Our results provide further evidence for cerebellar involvement in predictive language processing and suggest that the notion of cerebellar internal models may be extended to the language domain.

Wasted research when systematic reviews fail to provide a complete and up-to-date evidence synthesis: the example of lung cancer.

Science.gov (United States)

Créquit, Perrine; Trinquart, Ludovic; Yavchitz, Amélie; Ravaud, Philippe

2016-01-20

Multiple treatments are frequently available for a given condition, and clinicians and patients need a comprehensive, up-to-date synthesis of evidence for all competing treatments. We aimed to quantify the waste of research related to the failure of systematic reviews to provide a complete and up-to-date evidence synthesis over time. We performed a series of systematic overviews and networks of randomized trials assessing the gap between evidence covered by systematic reviews and available trials of second-line treatments for advanced non-small cell lung cancer. We searched the Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, MEDLINE, EMBASE, and other resources sequentially by year from 2009 to March 2, 2015. We sequentially compared the amount of evidence missing from systematic reviews to the randomized evidence available for inclusion each year. We constructed cumulative networks of randomized evidence over time and evaluated the proportion of trials, patients, treatments, and treatment comparisons not covered by systematic reviews on December 31 each year from 2009 to 2015. We identified 77 trials (28,636 patients) assessing 47 treatments with 54 comparisons and 29 systematic reviews (13 published after 2013). From 2009 to 2015, the evidence covered by existing systematic reviews was consistently incomplete: 45 % to 70 % of trials; 30 % to 58 % of patients; 40 % to 66 % of treatments; and 38 % to 71 % of comparisons were missing. In the cumulative networks of randomized evidence, 10 % to 17 % of treatment comparisons were partially covered by systematic reviews and 55 % to 85 % were partially or not covered. We illustrate how systematic reviews of a given condition provide a fragmented, out-of-date panorama of the evidence for all treatments. This waste of research might be reduced by the development of live cumulative network meta-analyses.

Whole-Genome Scans Provide Evidence of Adaptive Evolution in Malawian Plasmodium falciparum Isolates

DEFF Research Database (Denmark)

Ocholla, Harold; Preston, Mark D; Mipando, Mwapatsa

2014-01-01

BACKGROUND:  Selection by host immunity and antimalarial drugs has driven extensive adaptive evolution in Plasmodium falciparum and continues to produce ever-changing landscapes of genetic variation. METHODS:  We performed whole-genome sequencing of 69 P. falciparum isolates from Malawi and used......, an area of high malaria transmission. Allele frequency-based tests provided evidence of recent population growth in Malawi and detected potential targets of host immunity and candidate vaccine antigens. Comparison of the sequence variation between isolates from Malawi and those from 5 geographically...... dispersed countries (Kenya, Burkina Faso, Mali, Cambodia, and Thailand) detected population genetic differences between Africa and Asia, within Southeast Asia, and within Africa. Haplotype-based tests of selection to sequence data from all 6 populations identified signals of directional selection at known...

No Evidence for Extensions to the Standard Cosmological Model

Science.gov (United States)

Heavens, Alan; Fantaye, Yabebal; Sellentin, Elena; Eggers, Hans; Hosenie, Zafiirah; Kroon, Steve; Mootoovaloo, Arrykrishna

2017-09-01

We compute the Bayesian evidence for models considered in the main analysis of Planck cosmic microwave background data. By utilizing carefully defined nearest-neighbor distances in parameter space, we reuse the Monte Carlo Markov chains already produced for parameter inference to compute Bayes factors B for many different model-data set combinations. The standard 6-parameter flat cold dark matter model with a cosmological constant (Λ CDM ) is favored over all other models considered, with curvature being mildly favored only when cosmic microwave background lensing is not included. Many alternative models are strongly disfavored by the data, including primordial correlated isocurvature models (ln B =-7.8 ), nonzero scalar-to-tensor ratio (ln B =-4.3 ), running of the spectral index (ln B =-4.7 ), curvature (ln B =-3.6 ), nonstandard numbers of neutrinos (ln B =-3.1 ), nonstandard neutrino masses (ln B =-3.2 ), nonstandard lensing potential (ln B =-4.6 ), evolving dark energy (ln B =-3.2 ), sterile neutrinos (ln B =-6.9 ), and extra sterile neutrinos with a nonzero scalar-to-tensor ratio (ln B =-10.8 ). Other models are less strongly disfavored with respect to flat Λ CDM . As with all analyses based on Bayesian evidence, the final numbers depend on the widths of the parameter priors. We adopt the priors used in the Planck analysis, while performing a prior sensitivity analysis. Our quantitative conclusion is that extensions beyond the standard cosmological model are disfavored by Planck data. Only when newer Hubble constant measurements are included does Λ CDM become disfavored, and only mildly, compared with a dynamical dark energy model (ln B ˜+2 ).

Evidence-based obstetrics in four hospitals in China: An observational study to explore clinical practice, women's preferences and provider's views

Directory of Open Access Journals (Sweden)

Liang Ji

2001-05-01

Full Text Available Abstract Background Evidence-based obstetric care is widely promoted in developing countries, but the success of implementation is not known. Using selected childbirth care procedures in four hospitals in Shanghai, we compared practice against evidence-based information, and explored user and provider views about each procedure. Methods Observational study. Using the Cochrane Library, we identified six procedures that should be avoided as routine and two that should be encouraged. Procedure rate determined by exit interviews with women, verified using hospital notes. Views of women and providers explored with in depth interviews. The study sites were three hospitals in Shanghai and one in neighbouring province of Jiangsu. 150 women at each centre for procedure rate, and 48 in-depth interviews with women and providers. Results Vaginal births were 50% (303/599 of the total. Of the six practices where evidence suggests they should be avoided as routine, three were performed with rates above 70%: pubic shaving (3 hospitals, rectal examination (3 hospitals, and episiotomy (3 hospitals. Most women delivered lying down, pain relief was rarely given, and only in the urban district hospital did women routinely have a companion. Most women wanted support or companionship during labour and to be given pain relief; but current practice is insufficient to meet women's needs. Conclusion Obstetric practice is not following best available evidence in the hospitals studied. There is a need to adjust hospital policy to support the use of interventions proven to be of benefit to women during childbirth, and develop approaches that ensure clinical practice changes.

Likelihood ratio model for classification of forensic evidence

Energy Technology Data Exchange (ETDEWEB)

Zadora, G., E-mail: gzadora@ies.krakow.pl [Institute of Forensic Research, Westerplatte 9, 31-033 Krakow (Poland); Neocleous, T., E-mail: tereza@stats.gla.ac.uk [University of Glasgow, Department of Statistics, 15 University Gardens, Glasgow G12 8QW (United Kingdom)

2009-05-29

One of the problems of analysis of forensic evidence such as glass fragments, is the determination of their use-type category, e.g. does a glass fragment originate from an unknown window or container? Very small glass fragments arise during various accidents and criminal offences, and could be carried on the clothes, shoes and hair of participants. It is therefore necessary to obtain information on their physicochemical composition in order to solve the classification problem. Scanning Electron Microscopy coupled with an Energy Dispersive X-ray Spectrometer and the Glass Refractive Index Measurement method are routinely used in many forensic institutes for the investigation of glass. A natural form of glass evidence evaluation for forensic purposes is the likelihood ratio-LR = p(E|H{sub 1})/p(E|H{sub 2}). The main aim of this paper was to study the performance of LR models for glass object classification which considered one or two sources of data variability, i.e. between-glass-object variability and(or) within-glass-object variability. Within the proposed model a multivariate kernel density approach was adopted for modelling the between-object distribution and a multivariate normal distribution was adopted for modelling within-object distributions. Moreover, a graphical method of estimating the dependence structure was employed to reduce the highly multivariate problem to several lower-dimensional problems. The performed analysis showed that the best likelihood model was the one which allows to include information about between and within-object variability, and with variables derived from elemental compositions measured by SEM-EDX, and refractive values determined before (RI{sub b}) and after (RI{sub a}) the annealing process, in the form of dRI = log{sub 10}|RI{sub a} - RI{sub b}|. This model gave better results than the model with only between-object variability considered. In addition, when dRI and variables derived from elemental compositions were used, this

Likelihood ratio model for classification of forensic evidence

International Nuclear Information System (INIS)

Zadora, G.; Neocleous, T.

2009-01-01

One of the problems of analysis of forensic evidence such as glass fragments, is the determination of their use-type category, e.g. does a glass fragment originate from an unknown window or container? Very small glass fragments arise during various accidents and criminal offences, and could be carried on the clothes, shoes and hair of participants. It is therefore necessary to obtain information on their physicochemical composition in order to solve the classification problem. Scanning Electron Microscopy coupled with an Energy Dispersive X-ray Spectrometer and the Glass Refractive Index Measurement method are routinely used in many forensic institutes for the investigation of glass. A natural form of glass evidence evaluation for forensic purposes is the likelihood ratio-LR = p(E|H 1 )/p(E|H 2 ). The main aim of this paper was to study the performance of LR models for glass object classification which considered one or two sources of data variability, i.e. between-glass-object variability and(or) within-glass-object variability. Within the proposed model a multivariate kernel density approach was adopted for modelling the between-object distribution and a multivariate normal distribution was adopted for modelling within-object distributions. Moreover, a graphical method of estimating the dependence structure was employed to reduce the highly multivariate problem to several lower-dimensional problems. The performed analysis showed that the best likelihood model was the one which allows to include information about between and within-object variability, and with variables derived from elemental compositions measured by SEM-EDX, and refractive values determined before (RI b ) and after (RI a ) the annealing process, in the form of dRI = log 10 |RI a - RI b |. This model gave better results than the model with only between-object variability considered. In addition, when dRI and variables derived from elemental compositions were used, this model outperformed two other

Is working memory stored along a logarithmic timeline? Converging evidence from neuroscience, behavior and models.

Science.gov (United States)

Singh, Inder; Tiganj, Zoran; Howard, Marc W

2018-04-23

A growing body of evidence suggests that short-term memory does not only store the identity of recently experienced stimuli, but also information about when they were presented. This representation of 'what' happened 'when' constitutes a neural timeline of recent past. Behavioral results suggest that people can sequentially access memories for the recent past, as if they were stored along a timeline to which attention is sequentially directed. In the short-term judgment of recency (JOR) task, the time to choose between two probe items depends on the recency of the more recent probe but not on the recency of the more remote probe. This pattern of results suggests a backward self-terminating search model. We review recent neural evidence from the macaque lateral prefrontal cortex (lPFC) (Tiganj, Cromer, Roy, Miller, & Howard, in press) and behavioral evidence from human JOR task (Singh & Howard, 2017) bearing on this question. Notably, both lines of evidence suggest that the timeline is logarithmically compressed as predicted by Weber-Fechner scaling. Taken together, these findings provide an integrative perspective on temporal organization and neural underpinnings of short-term memory. Copyright © 2018 Elsevier Inc. All rights reserved.

Are trans diagnostic models of eating disorders fit for purpose? A consideration of the evidence for food addiction.

Science.gov (United States)

Treasure, Janet; Leslie, Monica; Chami, Rayane; Fernández-Aranda, Fernando

2018-03-01

Explanatory models for eating disorders have changed over time to account for changing clinical presentations. The transdiagnostic model evolved from the maintenance model, which provided the framework for cognitive behavioural therapy for bulimia nervosa. However, for many individuals (especially those at the extreme ends of the weight spectrum), this account does not fully fit. New evidence generated from research framed within the food addiction hypothesis is synthesized here into a model that can explain recurrent binge eating behaviour. New interventions that target core maintenance elements identified within the model may be useful additions to a complex model of treatment for eating disorders. Copyright © 2018 John Wiley & Sons, Ltd and Eating Disorders Association.

Conceptual Models of the Individual Public Service Provider

DEFF Research Database (Denmark)

Andersen, Lotte Bøgh; Pedersen, Lene Holm; Bhatti, Yosef

are used to gain insight on the motivation of public service providers; namely principal-agent theory, self-determination theory and public service motivation theory. We situate the theoretical discussions in the context of public service providers being transferred to private organizations......Individual public service providers’ motivation can be conceptualized as either extrinsic, autonomous or prosocial, and the question is how we can best theoretically understand this complexity without losing too much coherence and parsimony. Drawing on Allison’s approach (1969), three perspectives...... theoretical – to develop a coherent model of individual public service providers – but the empirical illustration also contributes to our understanding of motivation in the context of public sector outsourcing....

A Model for Evidence Accumulation in the Lexical Decision Task

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Wagenmakers, Eric-Jan; Steyvers, Mark; Raaijmakers, Jeroen G. W.; Shiffrin, Richard M.; van Rijn, Hedderik; Zeelenberg, Rene

2004-01-01

We present a new model for lexical decision, REM-LD, that is based on REM theory (e.g., Shiffrin & Steyvers, 1997). REM-LD uses a principled (i.e., Bayes' rule) decision process that simultaneously considers the diagnosticity of the evidence for the 'WORD' response and the 'NONWORD' response. The model calculates the odds ratio that the presented…

An evidence-based approach to case management model selection for an acute care facility: is there really a preferred model?

Science.gov (United States)

Terra, Sandra M

2007-01-01

This research seeks to determine whether there is adequate evidence-based justification for selection of one acute care case management model over another. Acute Inpatient Hospital. This article presents a systematic review of published case management literature, resulting in classification specific to terms of level of evidence. This review examines the best available evidence in an effort to select an acute care case management model. Although no single case management model can be identified as preferred, it is clear that adequate evidence-based literature exists to acknowledge key factors driving the acute care model and to form a foundation for the efficacy of hospital case management practice. Although no single case management model can be identified as preferred, this systematic review demonstrates that adequate evidence-based literature exists to acknowledge key factors driving the acute care model and forming a foundation for the efficacy of hospital case management practice. Distinctive aspects of case management frameworks can be used to guide the development of an acute care case management model. The study illustrates: * The effectiveness of case management when there is direct patient contact by the case manager regardless of disease condition: not only does the quality of care increase but also length of stay (LOS) decreases, care is defragmented, and both patient and physician satisfaction can increase. * The preferred case management models result in measurable outcomes that can directly relate to, and demonstrate alignment with, organizational strategy. * Acute care management programs reduce cost and LOS, and improve outcomes. * An integrated case management program that includes social workers, as well as nursing, is the most effective acute care management model. * The successful case management model will recognize physicians, as well as patients, as valued customers with whom partnership can positively affect financial outcomes in terms of

Developing a nursing personnel policy to address body art using an evidence-based model.

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Dorwart, Shawna D; Kuntz, Sandra W; Armstrong, Myrna L

2010-12-01

An increase in the prevalence of body art as a form of self-expression has motivated health care organizations to develop policies addressing nursing personnel's body art. A systematic review of literature on body art was completed and a telephone survey of 15 hospitals was conducted to query existing policy statements addressing nursing personnel's body art. The literature established no prevalence of body art among nurses or effect of nurses' body art. Of the 13 hospitals (86%) that shared their policy on body art, none provided a rationale or references to support their existing policies. A lack of published evidence identifying the effect of body art among nurses shifts the burden of determining care outcomes to the leadership of individual hospitals. Further research on patients' perception of nursing personnel with visible body art, using an evidence-based model, is recommended. Copyright 2010, SLACK Incorporated.

Aural exostoses (surfer's ear) provide vital fossil evidence of an aquatic phase in Man's early evolution.

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Rhys Evans, P H; Cameron, M

2017-11-01

For over a century, otolaryngologists have recognised the condition of aural exostoses, but their significance and aetiology remains obscure, although they tend to be associated with frequent swimming and cold water immersion of the auditory canal. The fact that this condition is usually bilateral is predictable since both ears are immersed in water. However, why do exostoses only grow in swimmers and why do they grow in the deep bony meatus at two or three constant sites? Furthermore, from an evolutionary point of view, what is or was the purpose and function of these rather incongruous protrusions? In recent decades, paleoanthropological evidence has challenged ideas about early hominid evolution. In 1992 the senior author suggested that aural exostoses were evolved in early hominid Man for protection of the delicate tympanic membrane during swimming and diving by narrowing the ear canal in a similar fashion to other semiaquatic species. We now provide evidence for this theory and propose an aetiological explanation for the formation of exostoses.

An evidence-based patient-centered method makes the biopsychosocial model scientific.

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Smith, Robert C; Fortin, Auguste H; Dwamena, Francesca; Frankel, Richard M

2013-06-01

To review the scientific status of the biopsychosocial (BPS) model and to propose a way to improve it. Engel's BPS model added patients' psychological and social health concerns to the highly successful biomedical model. He proposed that the BPS model could make medicine more scientific, but its use in education, clinical care, and, especially, research remains minimal. Many aver correctly that the present model cannot be defined in a consistent way for the individual patient, making it untestable and non-scientific. This stems from not obtaining relevant BPS data systematically, where one interviewer obtains the same information another would. Recent research by two of the authors has produced similar patient-centered interviewing methods that are repeatable and elicit just the relevant patient information needed to define the model at each visit. We propose that the field adopt these evidence-based methods as the standard for identifying the BPS model. Identifying a scientific BPS model in each patient with an agreed-upon, evidence-based patient-centered interviewing method can produce a quantum leap ahead in both research and teaching. A scientific BPS model can give us more confidence in being humanistic. In research, we can conduct more rigorous studies to inform better practices. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Evidence used in model-based economic evaluations for evaluating pharmacogenetic and pharmacogenomic tests: a systematic review protocol.

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Peters, Jaime L; Cooper, Chris; Buchanan, James

2015-11-11

Decision models can be used to conduct economic evaluations of new pharmacogenetic and pharmacogenomic tests to ensure they offer value for money to healthcare systems. These models require a great deal of evidence, yet research suggests the evidence used is diverse and of uncertain quality. By conducting a systematic review, we aim to investigate the test-related evidence used to inform decision models developed for the economic evaluation of genetic tests. We will search electronic databases including MEDLINE, EMBASE and NHS EEDs to identify model-based economic evaluations of pharmacogenetic and pharmacogenomic tests. The search will not be limited by language or date. Title and abstract screening will be conducted independently by 2 reviewers, with screening of full texts and data extraction conducted by 1 reviewer, and checked by another. Characteristics of the decision problem, the decision model and the test evidence used to inform the model will be extracted. Specifically, we will identify the reported evidence sources for the test-related evidence used, describe the study design and how the evidence was identified. A checklist developed specifically for decision analytic models will be used to critically appraise the models described in these studies. Variations in the test evidence used in the decision models will be explored across the included studies, and we will identify gaps in the evidence in terms of both quantity and quality. The findings of this work will be disseminated via a peer-reviewed journal publication and at national and international conferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

fiReproxies: A computational model providing insight into heat-affected archaeological lithic assemblages.

Science.gov (United States)

Sorensen, Andrew C; Scherjon, Fulco

2018-01-01

Evidence for fire use becomes increasingly sparse the further back in time one looks. This is especially true for Palaeolithic assemblages. Primary evidence of fire use in the form of hearth features tends to give way to clusters or sparse scatters of more durable heated stone fragments. In the absence of intact fireplaces, these thermally altered lithic remains have been used as a proxy for discerning relative degrees of fire use between archaeological layers and deposits. While previous experimental studies have demonstrated the physical effects of heat on stony artefacts, the mechanisms influencing the proportion of fire proxy evidence within archaeological layers remain understudied. This fundamental study is the first to apply a computer-based model (fiReproxies) in an attempt to simulate and quantify the complex interplay of factors that ultimately determine when and in what proportions lithic artefacts are heated by (anthropogenic) fires. As an illustrative example, we apply our model to two hypothetical archaeological layers that reflect glacial and interglacial conditions during the late Middle Palaeolithic within a generic simulated cave site to demonstrate how different environmental, behavioural and depositional factors like site surface area, sedimentation rate, occupation frequency, and fire size and intensity can, independently or together, significantly influence the visibility of archaeological fire signals.

Evidence in the learning organization

Directory of Open Access Journals (Sweden)

Umscheid Craig A

2009-03-01

Full Text Available Abstract Background Organizational leaders in business and medicine have been experiencing a similar dilemma: how to ensure that their organizational members are adopting work innovations in a timely fashion. Organizational leaders in healthcare have attempted to resolve this dilemma by offering specific solutions, such as evidence-based medicine (EBM, but organizations are still not systematically adopting evidence-based practice innovations as rapidly as expected by policy-makers (the knowing-doing gap problem. Some business leaders have adopted a systems-based perspective, called the learning organization (LO, to address a similar dilemma. Three years ago, the Society of General Internal Medicine's Evidence-based Medicine Task Force began an inquiry to integrate the EBM and LO concepts into one model to address the knowing-doing gap problem. Methods During the model development process, the authors searched several databases for relevant LO frameworks and their related concepts by using a broad search strategy. To identify the key LO frameworks and consolidate them into one model, the authors used consensus-based decision-making and a narrative thematic synthesis guided by several qualitative criteria. The authors subjected the model to external, independent review and improved upon its design with this feedback. Results The authors found seven LO frameworks particularly relevant to evidence-based practice innovations in organizations. The authors describe their interpretations of these frameworks for healthcare organizations, the process they used to integrate the LO frameworks with EBM principles, and the resulting Evidence in the Learning Organization (ELO model. They also provide a health organization scenario to illustrate ELO concepts in application. Conclusion The authors intend, by sharing the LO frameworks and the ELO model, to help organizations identify their capacities to learn and share knowledge about evidence-based practice

New Provider Models for Sweden and Spain: Public, Private or Non-profit? Comment on "Governance, Government, and the Search for New Provider Models".

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Jeurissen, Patrick P T; Maarse, Hans

2016-06-29

Sweden and Spain experiment with different provider models to reform healthcare provision. Both models have in common that they extend the role of the for-profit sector in healthcare. As the analysis of Saltman and Duran demonstrates, privatisation is an ambiguous and contested strategy that is used for quite different purposes. In our comment, we emphasize that their analysis leaves questions open on the consequences of privatisation for the performance of healthcare and the role of the public sector in healthcare provision. Furthermore, we briefly address the absence of the option of healthcare provision by not-for-profit providers in the privatisation strategy of Sweden and Spain. © 2016 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cytoplasmic-genetic male sterility gene provides direct evidence for some hybrid rice recently evolving into weedy rice

Science.gov (United States)

Zhang, Jingxu; Lu, Zuomei; Dai, Weimin; Song, Xiaoling; Peng, Yufa; Valverde, Bernal E.; Qiang, Sheng

2015-01-01

Weedy rice infests paddy fields worldwide at an alarmingly increasing rate. There is substantial evidence indicating that many weedy rice forms originated from or are closely related to cultivated rice. There is suspicion that the outbreak of weedy rice in China may be related to widely grown hybrid rice due to its heterosis and the diversity of its progeny, but this notion remains unsupported by direct evidence. We screened weedy rice accessions by both genetic and molecular marker tests for the cytoplasmic male sterility (CMS) genes (Wild abortive, WA, and Boro type, BT) most widely used in the production of indica and japonica three-line hybrid rice as a diagnostic trait of direct parenthood. Sixteen weedy rice accessions of the 358 tested (4.5%) contained the CMS-WA gene; none contained the CMS-BT gene. These 16 accessions represent weedy rices recently evolved from maternal hybrid rice derivatives, given the primarily maternal inheritance of this trait. Our results provide key direct evidence that hybrid rice can be involved in the evolution of some weedy rice accessions, but is not a primary factor in the recent outbreak of weedy rice in China. PMID:26012494

Cytoplasmic-genetic male sterility gene provides direct evidence for some hybrid rice recently evolving into weedy rice.

Science.gov (United States)

Zhang, Jingxu; Lu, Zuomei; Dai, Weimin; Song, Xiaoling; Peng, Yufa; Valverde, Bernal E; Qiang, Sheng

2015-05-27

Weedy rice infests paddy fields worldwide at an alarmingly increasing rate. There is substantial evidence indicating that many weedy rice forms originated from or are closely related to cultivated rice. There is suspicion that the outbreak of weedy rice in China may be related to widely grown hybrid rice due to its heterosis and the diversity of its progeny, but this notion remains unsupported by direct evidence. We screened weedy rice accessions by both genetic and molecular marker tests for the cytoplasmic male sterility (CMS) genes (Wild abortive, WA, and Boro type, BT) most widely used in the production of indica and japonica three-line hybrid rice as a diagnostic trait of direct parenthood. Sixteen weedy rice accessions of the 358 tested (4.5%) contained the CMS-WA gene; none contained the CMS-BT gene. These 16 accessions represent weedy rices recently evolved from maternal hybrid rice derivatives, given the primarily maternal inheritance of this trait. Our results provide key direct evidence that hybrid rice can be involved in the evolution of some weedy rice accessions, but is not a primary factor in the recent outbreak of weedy rice in China.

Genetic data provide evidence for wind-mediated transmission of highly pathogenic avian influenza.

Science.gov (United States)

Ypma, Rolf J F; Jonges, Marcel; Bataille, Arnaud; Stegeman, Arjan; Koch, Guus; van Boven, Michiel; Koopmans, Marion; van Ballegooijen, W Marijn; Wallinga, Jacco

2013-03-01

Outbreaks of highly pathogenic avian influenza in poultry can cause severe economic damage and represent a public health threat. Development of efficient containment measures requires an understanding of how these influenza viruses are transmitted between farms. However, the actual mechanisms of interfarm transmission are largely unknown. Dispersal of infectious material by wind has been suggested, but never demonstrated, as a possible cause of transmission between farms. Here we provide statistical evidence that the direction of spread of avian influenza A(H7N7) is correlated with the direction of wind at date of infection. Using detailed genetic and epidemiological data, we found the direction of spread by reconstructing the transmission tree for a large outbreak in the Netherlands in 2003. We conservatively estimate the contribution of a possible wind-mediated mechanism to the total amount of spread during this outbreak to be around 18%.

Impact of an online medical internet site on knowledge and practice of health care providers: a mixed methods study of the Spinal Cord Injury Rehabilitation Evidence project.

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Eng, Janice J; Noonan, Vanessa K; Townson, Andrea F; Higgins, Caroline E; Rogers, Jess; Wolfe, Dalton L

2014-12-23

It is not known whether ongoing access to a broad-based Internet knowledge resource can influence the practice of health care providers. We undertook a study to evaluate the impact of a Web-based knowledge resource on increasing access to evidence and facilitating best practice of health care providers. The objective of this study was to evaluate (1) the impact of the Spinal Cord Injury Rehabilitation Evidence (SCIRE) project on access to information for health care providers and researchers and (2) how SCIRE influenced health care providers' management of clients. A 4-part mixed methods evaluation was undertaken: (1) monitoring website traffic and utilization using Google Analytics, (2) online survey of users who accessed the SCIRE website, (3) online survey of targeted end-users, that is, rehabilitation health care providers known to work with spinal cord injury (SCI) clients, as well as researchers, and (4) focus groups with health care providers who had previously accessed SCIRE. The online format allowed the content for a relatively specialized field to have far reach (eg, 26 countries and over 6500 users per month). The website survey and targeted end-user survey confirmed that health care providers, as well as researchers perceived that the website increased their access to SCI evidence. Access to SCIRE not only improved knowledge of SCI evidence but helped inform changes to the health providers' clinical practice and improved their confidence in treating SCI clients. The SCIRE information directly influenced the health providers' clinical decision making, in terms of choice of intervention, equipment needs, or assessment tool. A Web-based knowledge resource may be a relatively inexpensive method to increase access to evidence-based information, increase knowledge of the evidence, inform changes to the health providers' practice, and influence their clinical decision making.

Reconstruction of the feeding apparatus in Postgaardi mariagerensis provides evidence for character evolution within the Symbiontida (Euglenozoa).

Science.gov (United States)

Yubuki, Naoji; Simpson, Alastair G B; Leander, Brian S

2013-01-01

Microbial eukaryotes living in low oxygen environments often have novel physiological and morphological features that facilitate symbiotic relationships with bacteria and other means for acquiring nutrients. Comparative studies of these features provide evidence for phylogenetic relationships and evolutionary history. Postgaardi mariagerensis, for instance, is a euglenozoan that lives in low oxygen environments and is enveloped by episymbiotic bacteria. The general ultrastructure of P. mariagerensis was described more than a decade ago and no further studies have been carried out since, mainly because these cells are difficult to obtain. Postgaardi lacks the diagnostic features found in other major euglenozoan lineages (e.g., pellicle strips and kinetoplast-like mitochondrial inclusions) and no molecular data are available, so the phylogenetic position of this genus within the Euglenozoa remains unclear. We re-examined and reconstructed the ultrastructural organization of the feeding apparatus in Postgaardi by serial sectioning an existing block of resin-embedded cells. Postgaardi possesses distinctive finger-like projections within the feeding apparatus; this system has only been found in one other highly distinctive flagellate, namely the symbiontid Calkinsia. Detailed comparisons of the cytoskeleton in Postgaardi and in two symbiontids, Calkinsia and Bihospites, provided new evidence for phylogenetic relationships and character evolution in all three genera. Copyright © 2012 Elsevier GmbH. All rights reserved.

Biofuels and Land Use Change: Applying Recent Evidence to Model Estimates

Directory of Open Access Journals (Sweden)

Wallace E. Tyner

2013-01-01

Full Text Available Biofuels impact on global land use has been a controversial yet important topic. Up until recently, there has not been enough biofuels to have caused major land use change, so the evidence from actual global land use data has been scant. However, in the past decade, there have been 72 million hectares added to global crop cover. In this research we take advantage of this new data to calibrate the Global Trade Analysis Project (GTAP model and parameters. We make two major changes. First, we calibrate the land transformation parameters (called constant elasticity of transformation, CET to global regions so that the parameters better reflect the actual land cover change that has occurred. Second, we alter the land cover nesting structure. In the old GTAP model, cropland, pasture, and forest were all in the same nest suggesting, everything else being equal, that pasture or forest convert to cropland with equal ease and cost. However, we now take advantage of the fact that pasture converts to cropland at lower cost than forest. The paper provides the theoretical and empirical justification for these two model improvements. Then it re-evaluates the global land use impacts due to the USA ethanol program using the improved model tuned with actual observations. Finally, it shows that compared to the old model, the new model projects: (1 less expansion in global cropland due to ethanol expansion; (2 lower U.S. share in global cropland expansion; (3 and lower forest share in global cropland expansion.

Simulation model for transcervical laryngeal injection providing real-time feedback.

Science.gov (United States)

Ainsworth, Tiffiny A; Kobler, James B; Loan, Gregory J; Burns, James A

2014-12-01

This study aimed to develop and evaluate a model for teaching transcervical laryngeal injections. A 3-dimensional printer was used to create a laryngotracheal framework based on de-identified computed tomography images of a human larynx. The arytenoid cartilages and intrinsic laryngeal musculature were created in silicone from clay casts and thermoplastic molds. The thyroarytenoid (TA) muscle was created with electrically conductive silicone using metallic filaments embedded in silicone. Wires connected TA muscles to an electrical circuit incorporating a cell phone and speaker. A needle electrode completed the circuit when inserted in the TA during simulated injection, providing real-time feedback of successful needle placement by producing an audible sound. Face validation by the senior author confirmed appropriate tactile feedback and anatomical realism. Otolaryngologists pilot tested the model and completed presimulation and postsimulation questionnaires. The high-fidelity simulation model provided tactile and audio feedback during needle placement, simulating transcervical vocal fold injections. Otolaryngology residents demonstrated higher comfort levels with transcervical thyroarytenoid injection on postsimulation questionnaires. This is the first study to describe a simulator for developing transcervical vocal fold injection skills. The model provides real-time tactile and auditory feedback that aids in skill acquisition. Otolaryngologists reported increased confidence with transcervical injection after using the simulator. © The Author(s) 2014.

Model of Providing Assistive Technologies in Special Education Schools.

Science.gov (United States)

Lersilp, Suchitporn; Putthinoi, Supawadee; Chakpitak, Nopasit

2015-05-14

Most students diagnosed with disabilities in Thai special education schools received assistive technologies, but this did not guarantee the greatest benefits. The purpose of this study was to survey the provision, use and needs of assistive technologies, as well as the perspectives of key informants regarding a model of providing them in special education schools. The participants were selected by the purposive sampling method, and they comprised 120 students with visual, physical, hearing or intellectual disabilities from four special education schools in Chiang Mai, Thailand; and 24 key informants such as parents or caregivers, teachers, school principals and school therapists. The instruments consisted of an assistive technology checklist and a semi-structured interview. Results showed that a category of assistive technologies was provided for students with disabilities, with the highest being "services", followed by "media" and then "facilities". Furthermore, mostly students with physical disabilities were provided with assistive technologies, but those with visual disabilities needed it more. Finally, the model of providing assistive technologies was composed of 5 components: Collaboration; Holistic perspective; Independent management of schools; Learning systems and a production manual for users; and Development of an assistive technology center, driven by 3 major sources such as Government and Private organizations, and Schools.

Placoderm Assemblage from the Tetrapod-Bearing Locality of Strud (Belgium, Upper Famennian) Provides Evidence for a Fish Nursery

Science.gov (United States)

Clément, Gaël; Daeschler, Edward B.; Dupret, Vincent

2016-01-01

The placoderm fauna of the upper Famennian tetrapod-bearing locality of Strud, Belgium, includes the antiarch Grossilepis rikiki, the arthrodire groenlandaspidid Turrisaspis strudensis and the phyllolepidid Phyllolepis undulata. Based on morphological and morphometric evidence, the placoderm specimens from Strud are predominantly recognised as immature specimens and this locality as representing a placoderm nursery. The Strud depositional environment corresponds to a channel in an alluvial plain, and the presence of a nursery in such environment could have provided nutrients and protection to the placoderm offspring. This represents one of the earliest pieces of evidence for this sort of habitat partitioning in vertebrate history, with adults living more distantly from the nursery and using the nursery only to spawn or give live birth. PMID:27552196

The influence of system quality characteristics on health care providers' performance: Empirical evidence from Malaysia.

Science.gov (United States)

Mohd Salleh, Mohd Idzwan; Zakaria, Nasriah; Abdullah, Rosni

The Ministry of Health Malaysia initiated the total hospital information system (THIS) as the first national electronic health record system for use in selected public hospitals across the country. Since its implementation 15 years ago, there has been the critical requirement for a systematic evaluation to assess its effectiveness in coping with the current system, task complexity, and rapid technological changes. The study aims to assess system quality factors to predict the performance of electronic health in a single public hospital in Malaysia. Non-probability sampling was employed for data collection among selected providers in a single hospital for two months. Data cleaning and bias checking were performed before final analysis in partial least squares-structural equation modeling. Convergent and discriminant validity assessments were satisfied the required criterions in the reflective measurement model. The structural model output revealed that the proposed adequate infrastructure, system interoperability, security control, and system compatibility were the significant predictors, where system compatibility became the most critical characteristic to influence an individual health care provider's performance. The previous DeLone and McLean information system success models should be extended to incorporate these technological factors in the medical system research domain to examine the effectiveness of modern electronic health record systems. In this study, care providers' performance was expected when the system usage fits with patients' needs that eventually increased their productivity. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

The Zero Suicide Model: Applying Evidence-Based Suicide Prevention Practices to Clinical Care

Directory of Open Access Journals (Sweden)

Beth S. Brodsky

2018-02-01

Full Text Available Suicide is reaching epidemic proportions, with over 44,000 deaths by suicide in the US, and 800,000 worldwide in 2015. This, despite research and development of evidence-based interventions that target suicidal behavior directly. Suicide prevention efforts need a comprehensive approach, and research must lead to effective implementation across public and mental health systems. A 10-year systematic review of evidence-based findings in suicide prevention summarized the areas necessary for translating research into practice. These include risk assessment, means restriction, evidence-based treatments, population screening combined with chain of care, monitoring, and follow-up. In this article, we review how suicide prevention research informs implementation in clinical settings where those most at risk present for care. Evidence-based and best practices address the fluctuating nature of suicide risk, which requires ongoing risk assessment, direct intervention and monitoring. In the US, the National Action Alliance for Suicide Prevention has put forth the Zero Suicide (ZS Model, a framework to coordinate a multilevel approach to implementing evidence-based practices. We present the Assess, Intervene and Monitor for Suicide Prevention model (AIM-SP as a guide for implementation of ZS evidence-based and best practices in clinical settings. Ten basic steps for clinical management model will be described and illustrated through case vignette. These steps are designed to be easily incorporated into standard clinical practice to enhance suicide risk assessment, brief interventions to increase safety and teach coping strategies and to improve ongoing contact and monitoring of high-risk individuals during transitions in care and high risk periods.

Lay Health Worker Involvement in Evidence-Based Treatment Delivery: A Conceptual Model to Address Disparities in Care.

Science.gov (United States)

Barnett, Miya L; Lau, Anna S; Miranda, Jeanne

2018-05-07

Mobilizing lay health workers (LHWs) to deliver evidence-based treatments (EBTs) is a workforce strategy to address mental health disparities in underserved communities. LHWs can be leveraged to support access to EBTs in a variety of ways, from conducting outreach for EBTs delivered by professional providers to serving as the primary treatment providers. This critical review provides an overview of how LHW-supported or -delivered EBTs have been leveraged in low-, middle-, and high-income countries (HICs). We propose a conceptual model for LHWs to address drivers of service disparities, which relate to the overall supply of the EBTs provided and the demand for these treatments. The review provides illustrative case examples that demonstrate how LHWs have been leveraged globally and domestically to increase access to mental health services. It also discusses challenges and recommendations regarding implementing LHW-supported or -delivered EBTs.

Provider cost analysis supports results-based contracting out of maternal and newborn health services: an evidence-based policy perspective.

Science.gov (United States)

Hatcher, Peter; Shaikh, Shiraz; Fazli, Hassan; Zaidi, Shehla; Riaz, Atif

2014-11-13

There is dearth of evidence on provider cost of contracted out services particularly for Maternal and Newborn Health (MNH). The evidence base is weak for policy makers to estimate resources required for scaling up contracting. This paper ascertains provider unit costs and expenditure distribution at contracted out government primary health centers to inform the development of optimal resource envelopes for contracting out MNH services. This is a case study of provider costs of MNH services at two government Rural Health Centers (RHCs) contracted out to a non-governmental organization in Pakistan. It reports on four selected Basic Emergency Obstetrical and Newborn Care (BEmONC) services provided in one RHC and six Comprehensive Emergency Obstetrical and Newborn Care (CEmONC) services in the other. Data were collected using staff interviews and record review to compile resource inputs and service volumes, and analyzed using the CORE Plus tool. Unit costs are based on actual costs of MNH services and are calculated for actual volumes in 2011 and for volumes projected to meet need with optimal resource inputs. The unit costs per service for actual 2011 volumes at the BEmONC RHC were antenatal care (ANC) visit USD$ 18.78, normal delivery US$ 84.61, newborn care US$ 16.86 and a postnatal care (PNC) visit US$ 13.86; and at the CEmONC RHC were ANC visit US$ 45.50, Normal Delivery US$ 148.43, assisted delivery US$ 167.43, C-section US$ 183.34, Newborn Care US$ 41.07, and PNC visit US$ 27.34. The unit costs for the projected volumes needed were lower due to optimal utilization of resources. The percentage distribution of expenditures at both RHCs was largest for salaries of technical staff, followed by salaries of administrative staff, and then operating costs, medicines, medical and diagnostic supplies. The unit costs of MNH services at the two contracted out government rural facilities remain higher than is optimal, primarily due to underutilization. Provider cost analysis

Cost Calculation Model for Logistics Service Providers

Directory of Open Access Journals (Sweden)

Zoltán Bokor

2012-11-01

Full Text Available The exact calculation of logistics costs has become a real challenge in logistics and supply chain management. It is essential to gain reliable and accurate costing information to attain efficient resource allocation within the logistics service provider companies. Traditional costing approaches, however, may not be sufficient to reach this aim in case of complex and heterogeneous logistics service structures. So this paper intends to explore the ways of improving the cost calculation regimes of logistics service providers and show how to adopt the multi-level full cost allocation technique in logistics practice. After determining the methodological framework, a sample cost calculation scheme is developed and tested by using estimated input data. Based on the theoretical findings and the experiences of the pilot project it can be concluded that the improved costing model contributes to making logistics costing more accurate and transparent. Moreover, the relations between costs and performances also become more visible, which enhances the effectiveness of logistics planning and controlling significantly

The effectiveness and feasibility of videoconferencing technology to provide evidence-based treatment to rural domestic violence and sexual assault populations.

Science.gov (United States)

Hassija, Christina; Gray, Matt J

2011-05-01

Although evidence-based treatments for post-traumatic stress disorder (PTSD) have been available for some time, many treatment-seeking trauma survivors are unable to access such services. This is especially the case in remote and rural areas where access to specialists is an exception rather than a rule. Advances in videoconferencing-based technologies are improving rural residents' access to specialized psychological services. However, at present, little is known about the viability and efficacy of providing psychological interventions via distal technologies to individuals who present at rural domestic violence and rape crisis centers. The present study attempts to partially address this void by evaluating, in the context of an uncontrolled trial, the effectiveness and feasibility of providing evidence-based, trauma-focused treatment via videoconferencing to rural survivors of domestic violence and sexual assault. Participants in the present study were clients referred to the Wyoming Trauma Telehealth Treatment Clinic (WTTTC) for psychological services via videoconferencing from distal domestic violence and rape crisis centers located in the state of Wyoming. Fifteen female victims of assaultive violence who received at least four sessions of trauma-focused treatment via videoconferencing-based technology at distal rape and domestic violence crisis centers were included in the present study. Participants completed measures of PTSD and depression symptom severity and client satisfaction. Participants evidenced large reductions on measures of PTSD (d = 1.17) and depression (d = 1.24) symptom severity following treatment via videoconferencing. Additionally, participants reported a high degree of satisfaction with videoconferencing-administered services. Results provide evidence in support of videoconferencing as an effective means to provide psychological services to rural domestic violence and sexual assault populations. Clinical implications and avenues

Neuropsychologists as primary care providers of cognitive health: A novel comprehensive cognitive wellness service delivery model.

Science.gov (United States)

Pimental, Patricia A; O'Hara, John B; Jandak, Jessica L

2018-01-01

By virtue of their extensive knowledge base and specialized training in brain-behavior relationships, neuropsychologists are especially poised to execute a unique broad-based approach to overall cognitive wellness and should be viewed as primary care providers of cognitive health. This article will describe a novel comprehensive cognitive wellness service delivery model including cognitive health, anti-aging, lifelong wellness, and longevity-oriented practices. These practice areas include brain-based cognitive wellness, emotional and spiritually centric exploration, and related multimodality health interventions. As experts in mind-body connections, neuropsychologists can provide a variety of evidence-based treatment options, empowering patients with a sense of value and purpose. Multiple areas of clinical therapy skill-based learning, tailor-made to fit individual needs, will be discussed including: brain stimulating activities, restorative techniques, automatic negative thoughts and maladaptive thinking reduction, inflammation and pain management techniques, nutrition and culinary focused cognitive wellness, spirituality based practices and mindfulness, movement and exercise, alternative/complimentary therapies, relationship restoration/social engagement, and trauma healing/meaning. Cognitive health rests upon the foundation of counteracting mind-body connection disruptions from multiple etiologies including inflammation, chronic stress, metabolic issues, cardiac conditions, autoimmune disease, neurological disorders, infectious diseases, and allergy spectrum disorders. Superimposed on these issues are lifestyle patterns and negative health behaviors that develop as ill-fated compensatory mechanisms used to cope with life stressors and aging. The brain and body are electrical systems that can "short circuit." The therapy practices inherent in the proposed cognitive wellness service delivery model can provide preventative insulation and circuit breaking against

THE B/C AND SUB-IRON/IRON COSMIC RAY RATIOS—FURTHER EVIDENCE IN FAVOR OF THE SPIRAL-ARM DIFFUSION MODEL

International Nuclear Information System (INIS)

Benyamin, David; Piran, Tsvi; Shaviv, Nir J.; Nakar, Ehud

2016-01-01

The boron to carbon (B/C) and sub-Fe/Fe ratios provide an important clue on cosmic ray (CR) propagation within the Galaxy. These ratios estimate the grammage that the CRs traverse as they propagate from their sources to Earth. Attempts to explain these ratios within the standard CR propagation models require ad hoc modifications and even with those these models necessitate inconsistent grammages to explain both ratios. As an alternative, physically motivated model, we have proposed that CRs originate preferably within the galactic spiral arms. CR propagation from dynamic spiral arms has important imprints on various secondary to primary ratios, such as the B/C ratio and the positron fraction. We use our spiral-arm diffusion model with the spallation network extended up to nickel to calculate the sub-Fe/Fe ratio. We show that without any additional parameters the spiral-arm model consistently explains both ratios with the same grammage, providing further evidence in favor of this model.

THE B/C AND SUB-IRON/IRON COSMIC RAY RATIOS—FURTHER EVIDENCE IN FAVOR OF THE SPIRAL-ARM DIFFUSION MODEL

Energy Technology Data Exchange (ETDEWEB)

Benyamin, David; Piran, Tsvi; Shaviv, Nir J. [The Racah Institute of Physics, The Hebrew University of Jerusalem, Jerusalem 91904 (Israel); Nakar, Ehud [Raymond and Beverly Sackler School of Physics and Astronomy, Tel Aviv University, Tel Aviv 69978 (Israel)

2016-07-20

The boron to carbon (B/C) and sub-Fe/Fe ratios provide an important clue on cosmic ray (CR) propagation within the Galaxy. These ratios estimate the grammage that the CRs traverse as they propagate from their sources to Earth. Attempts to explain these ratios within the standard CR propagation models require ad hoc modifications and even with those these models necessitate inconsistent grammages to explain both ratios. As an alternative, physically motivated model, we have proposed that CRs originate preferably within the galactic spiral arms. CR propagation from dynamic spiral arms has important imprints on various secondary to primary ratios, such as the B/C ratio and the positron fraction. We use our spiral-arm diffusion model with the spallation network extended up to nickel to calculate the sub-Fe/Fe ratio. We show that without any additional parameters the spiral-arm model consistently explains both ratios with the same grammage, providing further evidence in favor of this model.

Using decision-analytic modelling to transfer international evidence from health technology assessment to the context of the German health care system

Directory of Open Access Journals (Sweden)

Siebert, Uwe

2005-11-01

Full Text Available The objective of this Health Technology Assessment (HTA methods report was to examine and to assess decision analysis (DA as a method to transfer and adapt international scientific evidence in HTA to the German health care context. Furthermore, we sought to develop a systematic framework to facilitate the selection, transfer, adaptation, and synthesis of these data in German HTA projects. In this report, we review and summarise the concepts and methods of DA; present potential areas of applications, and provide a basis for the critical assessment of decision-analytic studies. The two main methods of DA, decision trees and Markov models, as well as various approaches to sensitivity analyses are described. Examples of typical situations for the use of DA in scientific evidence transfer are described, and a list of main health care domains and parameters in evidence transfer is presented. Finally, we developed a framework to transfer and apply international evidence to the national health care context. The strengths and limitations of the decision-analytic approach are critically examined. In summary, this HTA report describes different situations, in which decision-analytic models can be useful, and demonstrates the utility of DA in transferring and applying international evidence to the national health care context. We developed a systematic instrument to transfer international evidence to the context of other countries and successfully applied this instrument in two German HTA projects. The use of this instrument is recommended in further HTA projects dealing with the application of international evidence to the German health care context. The use of decision-analytic models to transfer international evidence is endorsed. However, the limitations of DA should be clearly stated discussed transparently in all HTA reports.

The application of Dempster-Shafer theory demonstrated with justification provided by legal evidence

Directory of Open Access Journals (Sweden)

Shawn P. Curley

2007-10-01

Full Text Available In forecasting and decision making, people can and often do represent a degree of belief in some proposition. At least two separate constructs capture such degrees of belief: likelihoods capturing evidential balance and support capturing evidential weight. This paper explores the weight or justification that evidence affords propositions, with subjects communicating using a belief function in hypothetical legal situations, where justification is a relevant goal. Subjects evaluated the impact of sets of 1--3 pieces of evidence, varying in complexity, within a hypothetical legal situation. The study demonstrates the potential usefulness of this evidential weight measure as an alternative or complement to the more-studied probability measure. Subjects' responses indicated that weight and likelihood were distinguished; that subjects' evidential weight tended toward single elements in a targeted fashion; and, that there were identifiable individual differences in reactions to conflicting evidence. Specifically, most subjects reacted to conflicting evidence that supported disjoint sets of suspects with continued support in the implicated sets, although an identifiable minority reacted by pulling back their support, expressing indecisiveness. Such individuals would likely require a greater amount of evidence than the others to counteract this tendency in support. Thus, the study identifies the value of understanding evidential weight as distinct from likelihood, informs our understanding of the psychology of individuals' judgments of evidential weight, and furthers the application and meaningfulness of belief functions as a communication language.

Numerical evidence of liquid crystalline mesophases of a lollipop shaped model in two dimensions

Science.gov (United States)

Pérez-Lemus, G. R.; Armas-Pérez, J. C.; Chapela, G. A.; Quintana-H., J.

2017-12-01

Small alterations in the molecular details may produce noticeable changes in the symmetry of the resulting phase behavior. It is possible to produce morphologies having different n-fold symmetries by manipulating molecular features such as chirality, polarity or anisotropy. In this paper, a two dimensional hard molecular model is introduced to study the formation of liquid crystalline phases in low dimensionality. The model is similar to that reported by Julio C. Armas-Pérez and Jacqueline Quintana-H., Phys. Rev. E 83, 051709 (2011). The main difference is the lack of chirality in the model proposed, although they share some characteristics like the geometrical polarity. Our model is called a lollipop model, because its shape is constructed by a rounded section attached to the end of a stick. Contrary to what happens in three dimensions where chiral nematogens produce interesting and complex phases such as blue phases, the lack of molecular chirality of our model generates a richer phase diagram compared to the chiral system. We show numerical and some geometrical evidences that the lack of laterality of the non chiral model seems to provide more routes of molecular self-assembly, producing triatic, a random cluster and possibly a tetratic phase behavior which were not presented in the previous work. We support our conclusions using results obtained from isobaric and isochoric Monte Carlo simulations. Properties as the n-fold order parameters such as the nematic, tetratic and triatic as well as their correlation functions were used to characterize the phases. We also provide the Fourier transform of equilibrium configurations to analyze the n-fold symmetry characteristic of each phase.

Putting research in place: an innovative approach to providing contextualized evidence synthesis for decision makers

Directory of Open Access Journals (Sweden)

Stephen Bornstein

2017-11-01

Full Text Available Abstract Background The Contextualized Health Research Synthesis Program (CHRSP, developed in 2007 by the Newfoundland and Labrador Centre for Applied Health Research, produces contextualized knowledge syntheses for health-system decision makers. The program provides timely, relevant, and easy-to-understand scientific evidence; optimizes evidence uptake; and, most importantly, attunes research questions and evidence to the specific context in which knowledge users must apply the findings. Methods As an integrated knowledge translation (KT method, CHRSP: Involves intensive partnerships with senior healthcare decision makers who propose priority research topics and participate on research teams; Considers local context both in framing the research question and in reporting the findings; Makes economical use of resources by utilizing a limited number of staff; Uses a combination of external and local experts; and Works quickly by synthesizing high-level systematic review evidence rather than primary studies. Although it was developed in the Canadian province of Newfoundland and Labrador, the CHRSP methodology is adaptable to a variety of settings with distinctive features, such as those in rural, remote, and small-town locations. Results CHRSP has published 25 syntheses on priority topics chosen by the provincial healthcare system, including: Clinical and cost-effectiveness: telehealth, rural renal dialysis, point-of-care testing; Community-based health services: helping seniors age in place, supporting seniors with dementia, residential treatment centers for at-risk youth; Healthcare organization/service delivery: reducing acute-care length of stay, promoting flu vaccination among health workers, safe patient handling, age-friendly acute care; and Health promotion: diabetes prevention, promoting healthy dietary habits. These studies have been used by decision makers to inform local policy and practice decisions. Conclusions By asking the health

Adaptation and validation of the Evidence-Based Practice Belief and Implementation scales for French-speaking Swiss nurses and allied healthcare providers.

Science.gov (United States)

Verloo, Henk; Desmedt, Mario; Morin, Diane

2017-09-01

To evaluate two psychometric properties of the French versions of the Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales, namely their internal consistency and construct validity. The Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales developed by Melnyk et al. are recognised as valid, reliable instruments in English. However, no psychometric validation for their French versions existed. Secondary analysis of a cross sectional survey. Source data came from a cross-sectional descriptive study sample of 382 nurses and other allied healthcare providers. Cronbach's alpha was used to evaluate internal consistency, and principal axis factor analysis and varimax rotation were computed to determine construct validity. The French Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales showed excellent reliability, with Cronbach's alphas close to the scores established by Melnyk et al.'s original versions. Principal axis factor analysis showed medium-to-high factor loading scores without obtaining collinearity. Principal axis factor analysis with varimax rotation of the 16-item Evidence-Based Practice Beliefs scale resulted in a four-factor loading structure. Principal axis factor analysis with varimax rotation of the 17-item Evidence-Based Practice Implementation scale revealed a two-factor loading structure. Further research should attempt to understand why the French Evidence-Based Practice Implementation scale showed a two-factor loading structure but Melnyk et al.'s original has only one. The French versions of the Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales can both be considered valid and reliable instruments for measuring Evidence-Based Practice beliefs and implementation. The results suggest that the French Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales are valid and reliable and can therefore be used to

Translating research into practice: the role of provider-based research networks in the diffusion of an evidence-based colon cancer treatment innovation.

Science.gov (United States)

Carpenter, William R; Meyer, Anne-Marie; Wu, Yang; Qaqish, Bahjat; Sanoff, Hanna K; Goldberg, Richard M; Weiner, Bryan J

2012-08-01

Provider-based research networks (PBRNs)--collaborative research partnerships between academic centers and community-based practitioners--are a promising model for accelerating the translation of research into practice; however, empirical evidence of accelerated translation is limited. Oxaliplatin in adjuvant combination chemotherapy is an innovation with clinical trial-proven survival benefit compared with prior therapies. The goal of this study is to examine the diffusion of oxaliplatin into community practice, and whether affiliation with the National Cancer Institute's (NCI's) Community Clinical Oncology Program (CCOP)--a nationwide cancer-focused PBRN--is associated with accelerated innovation adoption. This retrospective observational study used linked Surveillance, Epidemiology, and End Results-Medicare and NCI CCOP data to examine Medicare participants with stage III colon cancer initiating treatment in 2003 through 2006, the years surrounding oxaliplatin's Food and Drug Administration approval. A fixed-effects analysis examined chemotherapy use among patients treated outside academic centers at CCOP-affiliated practices compared with non-CCOP practices. Two-group modeling controlled for multiple levels of clustering, year of chemotherapy initiation, tumor characteristics, patient age, race, comorbidity, Medicaid dual-eligibility status, and education. Of 4055 community patients, 35% received 5-fluoruracil, 20% received oxaliplatin, 7% received another chemotherapy, and 38% received no chemotherapy. Twenty-five percent of CCOP patients received oxaliplatin, compared with 19% of non-CCOP patients. In multivariable analysis, CCOP exposure was associated with higher odds of receiving guideline-concordant treatment in general, and oxaliplatin specifically. These findings contribute to a growing set of evidence linking PBRNs with a greater probability of receiving treatment innovations and high-quality cancer care, with implications for clinical and research

An improved mixing model providing joint statistics of scalar and scalar dissipation

Energy Technology Data Exchange (ETDEWEB)

Meyer, Daniel W. [Department of Energy Resources Engineering, Stanford University, Stanford, CA (United States); Jenny, Patrick [Institute of Fluid Dynamics, ETH Zurich (Switzerland)

2008-11-15

For the calculation of nonpremixed turbulent flames with thin reaction zones the joint probability density function (PDF) of the mixture fraction and its dissipation rate plays an important role. The corresponding PDF transport equation involves a mixing model for the closure of the molecular mixing term. Here, the parameterized scalar profile (PSP) mixing model is extended to provide the required joint statistics. Model predictions are validated using direct numerical simulation (DNS) data of a passive scalar mixing in a statistically homogeneous turbulent flow. Comparisons between the DNS and the model predictions are provided, which involve different initial scalar-field lengthscales. (author)

Diabetes Mellitus Induces Alzheimer’s Disease Pathology: Histopathological Evidence from Animal Models

Directory of Open Access Journals (Sweden)

Nobuyuki Kimura

2016-04-01

Full Text Available Alzheimer’s disease (AD is the major causative disease of dementia and is characterized pathologically by the accumulation of senile plaques (SPs and neurofibrillary tangles (NFTs in the brain. Although genetic studies show that β-amyloid protein (Aβ, the major component of SPs, is the key factor underlying AD pathogenesis, it remains unclear why advanced age often leads to AD. Interestingly, several epidemiological and clinical studies show that type II diabetes mellitus (DM patients are more likely to exhibit increased susceptibility to AD. Moreover, growing evidence suggests that there are several connections between the neuropathology that underlies AD and DM, and there is evidence that the experimental induction of DM can cause cognitive dysfunction, even in rodent animal models. This mini-review summarizes histopathological evidence that DM induces AD pathology in animal models and discusses the possibility that aberrant insulin signaling is a key factor in the induction of AD pathology.

Mixed methods for implementation research: application to evidence-based practice implementation and staff turnover in community-based organizations providing child welfare services.

Science.gov (United States)

Aarons, Gregory A; Fettes, Danielle L; Sommerfeld, David H; Palinkas, Lawrence A

2012-02-01

Many public sector service systems and provider organizations are in some phase of learning about or implementing evidence-based interventions. Child welfare service systems represent a context where implementation spans system, management, and organizational concerns. Research utilizing mixed methods that combine qualitative and quantitative design, data collection, and analytic approaches are particularly well suited to understanding both the process and outcomes of dissemination and implementation efforts in child welfare systems. This article describes the process of using mixed methods in implementation research and provides an applied example of an examination of factors impacting staff retention during an evidence-based intervention implementation in a statewide child welfare system. The authors integrate qualitative data with previously published quantitative analyses of job autonomy and staff turnover during this statewide implementation project in order to illustrate the utility of mixed method approaches in providing a more comprehensive understanding of opportunities and challenges in implementation research.

[The Bellagio Model: an evidence-informed, international framework for population-oriented primary care. First experiences].

Science.gov (United States)

Schlette, Sophia; Lisac, Melanie; Wagner, Ed; Gensichen, Jochen

2009-01-01

The Bellagio Model for Population-oriented Primary Care is an evidence-informed framework to assess accessible care for sick, vulnerable, and healthy people. The model was developed in spring 2008 by a multidisciplinary group of 24 experts from nine countries. The purpose of their gathering was to determine success factors for effective 21st century primary care based on state-of-the-art research findings, models, and empirical experience, and to assist with its implementation in practice, management, and health policy. Against the backdrop of "partialization", fragmentation in open health care systems, and the growing numbers of chronically ill or fragile people or those in need of any other kind of care, today's health care systems do not provide the much needed anchor point for continuing coordination and assistance prior, during and following an episode of illness. The Bellagio Model consists of ten key elements, which can make a substantial contribution to identify and overcome current gaps in primary care by using a synergetic approach. These elements are Shared Leadership, Public Trust, Horizontal and Vertical Integration, Networking of Professionals, Standardized Measurement, Research and Development, Payment Mix, Infrastructure, Programmes for Practice Improvement, and Population-oriented Management. All of these elements, which have been identified as being equally necessary, are also alike in that they involve all those responsible for health care: providers, managers, and policymakers.

Models accounting for intention-behavior discordance in the physical activity domain: a user's guide, content overview, and review of current evidence.

Science.gov (United States)

Rhodes, Ryan E; Yao, Christopher A

2015-02-07

There is a growing concern among researchers with the limited effectiveness and yet subsequent stagnation of theories applied to physical activity (PA). One of the most highlighted areas of concern is the established gap between intention and PA, yet the considerable use of models that assume intention is the proximal antecedent of PA. The objective of this review was to: 1) provide a guide and thematic analysis of the available models that include constructs that address intention-behavior discordance and 2) highlight the evidence for these structures in the PA domain. A literature search was conducted among 13 major databases to locate relevant models and PA studies published before August 2014. Sixteen models were identified and nine overall themes for post-intentional constructs were created. Of the 16 models, eight were applied to 36 PA studies. Early evidence supported maintenance self-efficacy, behavioral regulation strategies, affective judgments, perceived control/opportunity, habit, and extraversion as reliable predictors of post-intention PA. Several intention-behavior discordance models exist within the literature, but are not used frequently. Further efforts are needed to test these models, preferably with experimental designs.

Unconscious perception: a model-based approach to method and evidence.

Science.gov (United States)

Snodgrass, Michael; Bernat, Edward; Shevrin, Howard

2004-07-01

Unconscious perceptual effects remain controversial because it is hard to rule out alternative conscious perception explanations for them. We present a novel methodological framework, stressing the centrality of specifying the single-process conscious perception model (i.e., the null hypothesis). Various considerations, including those of SDT (Macmillan & Creelman, 1991), suggest that conscious perception functions hierarchically, in such a way that higher level effects (e.g., semantic priming) should not be possible without lower level discrimination (i.e., detection and identification). Relatedly, alternative conscious perception accounts (as well as the exhaustiveness, null sensitivity, and exclusiveness problems-Reingold & Merikle, 1988, 1990) predict positive relationships between direct and indirect measures. Contrariwise, our review suggests that negative and/or nonmonotonic relationships are found, providing strong evidence for unconscious perception and further suggesting that conscious and unconscious perceptual influences are functionally exclusive (cf. Jones, 1987), in such a way that the former typically override the latter when both are present. Consequently, unconscious perceptual effects manifest reliably only when conscious perception is completely absent, which occurs at the objective detection (but not identification) threshold.

A social marketing approach to implementing evidence-based practice in VHA QUERI: the TIDES depression collaborative care model.

Science.gov (United States)

Luck, Jeff; Hagigi, Fred; Parker, Louise E; Yano, Elizabeth M; Rubenstein, Lisa V; Kirchner, JoAnn E

2009-09-28

Collaborative care models for depression in primary care are effective and cost-effective, but difficult to spread to new sites. Translating Initiatives for Depression into Effective Solutions (TIDES) is an initiative to promote evidence-based collaborative care in the U.S. Veterans Health Administration (VHA). Social marketing applies marketing techniques to promote positive behavior change. Described in this paper, TIDES used a social marketing approach to foster national spread of collaborative care models. The approach relied on a sequential model of behavior change and explicit attention to audience segmentation. Segments included VHA national leadership, Veterans Integrated Service Network (VISN) regional leadership, facility managers, frontline providers, and veterans. TIDES communications, materials and messages targeted each segment, guided by an overall marketing plan. Depression collaborative care based on the TIDES model was adopted by VHA as part of the new Primary Care Mental Health Initiative and associated policies. It is currently in use in more than 50 primary care practices across the United States, and continues to spread, suggesting success for its social marketing-based dissemination strategy. Development, execution and evaluation of the TIDES marketing effort shows that social marketing is a promising approach for promoting implementation of evidence-based interventions in integrated healthcare systems.

A social marketing approach to implementing evidence-based practice in VHA QUERI: the TIDES depression collaborative care model

Science.gov (United States)

2009-01-01

Abstract Collaborative care models for depression in primary care are effective and cost-effective, but difficult to spread to new sites. Translating Initiatives for Depression into Effective Solutions (TIDES) is an initiative to promote evidence-based collaborative care in the U.S. Veterans Health Administration (VHA). Social marketing applies marketing techniques to promote positive behavior change. Described in this paper, TIDES used a social marketing approach to foster national spread of collaborative care models. TIDES social marketing approach The approach relied on a sequential model of behavior change and explicit attention to audience segmentation. Segments included VHA national leadership, Veterans Integrated Service Network (VISN) regional leadership, facility managers, frontline providers, and veterans. TIDES communications, materials and messages targeted each segment, guided by an overall marketing plan. Results Depression collaborative care based on the TIDES model was adopted by VHA as part of the new Primary Care Mental Health Initiative and associated policies. It is currently in use in more than 50 primary care practices across the United States, and continues to spread, suggesting success for its social marketing-based dissemination strategy. Discussion and conclusion Development, execution and evaluation of the TIDES marketing effort shows that social marketing is a promising approach for promoting implementation of evidence-based interventions in integrated healthcare systems. PMID:19785754

Embedding inflation into the Standard Model — More evidence for classical scale invariance

International Nuclear Information System (INIS)

Kannike, Kristjan; Racioppi, Antonio; Raidal, Martti

2014-01-01

If cosmological inflation is due to a slowly rolling single inflation field taking trans-Planckian values as suggested by the BICEP2 measurement of primordial tensor modes in CMB, embedding inflation into the Standard Model challenges standard paradigm of effective field theories. Together with an apparent absence of Planck scale contributions to the Higgs mass and to the cosmological constant, BICEP2 provides further experimental evidence for the absence of large M_P induced operators. We show that classical scale invariance — the paradigm that all fundamental scales in Nature are induced by quantum effects — solves the problem and allows for a remarkably simple scale-free Standard Model extension with inflaton without extending the gauge group. Due to trans-Planckian inflaton values and vevs, a dynamically induced Coleman-Weinberg-type inflaton potential of the model can predict tensor-to-scalar ratio r in a large range, converging around the prediction of chaotic m"2ϕ"2 inflation for a large trans-Planckian value of the inflaton vev. Precise determination of r in future experiments will single out a unique scale-free inflation potential, allowing to test the proposed field-theoretic framework.

Evidence logics with relational evidence

DEFF Research Database (Denmark)

Baltag, Alexandru; Occhipinti, Andrés

2017-01-01

We introduce a family of logics for reasoning about relational evidence: evidence that involves an ordering of states in terms of their relative plausibility. We provide sound and complete axiomatizations for the logics. We also present several evidential actions and prove soundness...

Bring Your Own Device - Providing Reliable Model of Data Access

Directory of Open Access Journals (Sweden)

Stąpór Paweł

2016-10-01

Full Text Available The article presents a model of Bring Your Own Device (BYOD as a model network, which provides the user reliable access to network resources. BYOD is a model dynamically developing, which can be applied in many areas. Research network has been launched in order to carry out the test, in which as a service of BYOD model Work Folders service was used. This service allows the user to synchronize files between the device and the server. An access to the network is completed through the wireless communication by the 802.11n standard. Obtained results are shown and analyzed in this article.

GARCH Option Valuation: Theory and Evidence

DEFF Research Database (Denmark)

Christoffersen, Peter; Jacobs, Kris; Ornthanalai, Chayawat

We survey the theory and empirical evidence on GARCH option valuation models. Our treatment includes the range of functional forms available for the volatility dynamic, multifactor models, nonnormal shock distributions as well as style of pricing kernels typically used. Various strategies...... for empirical implementation are laid out and we also discuss the links between GARCH and stochastic volatility models. In the appendix we provide Matlab computer code for option pricing via Monte Carlo simulation for nonaffine models as well as Fourier inversion for affine models....

Evidence-based models of care for people with epilepsy.

LENUS (Irish Health Repository)

Fitzsimons, Mary

2012-02-01

Advances in medical science and technology, together with improved medical and nursing care, are continuously improving health outcomes in chronic illness, including epilepsy. The consequent increasing diagnostic and therapeutic complexity is placing a burgeoning strain on health care systems. In response, an international move to transform chronic disease management (CDM) aims to optimize the quality and safety of care while containing health care costs. CDM models recommend: integration of care across organizational boundaries that is supported with information and communication technology; patient self-management; and guideline implementation to promote standardized care. Evidence of the effectiveness of CDM models in epilepsy care is presented in this review article.

Mangroves can provide protection against wind damage during storms

Science.gov (United States)

Das, Saudamini; Crépin, Anne-Sophie

2013-12-01

Research has established that mangroves can protect lives and property from storms by buffering the impacts of storm surges. However, their effects in attenuating wind velocity and providing protection from wind damage during storms are not known. This study examined whether mangroves attenuate damage from cyclonic winds and found that they provide substantial protection to properties, even relatively far away from mangroves and the coast. We devised a theoretical model of wind protection by mangroves and calibrated and applied this model using data from the 1999 cyclone in the Odisha region of India. The model predicted and quantified the actual level of damage reasonably accurately and showed that mangroves reduced wind damage to houses. The wind protection value of mangroves in reducing house damage amounted to approximately US$177 per hectare at 1999 prices. This provides additional evidence of the storm protection ecosystem services that mangroves supply in the region and an additional reason to invest in mangrove ecosystems to provide better adaptability to coastal disasters such as storms.

Mixed Methods for Implementation Research: Application to Evidence-Based Practice Implementation and Staff Turnover in Community Based Organizations Providing Child Welfare Services

Science.gov (United States)

Aarons, Gregory A.; Fettes, Danielle L.; Sommerfeld, David H.; Palinkas, Lawrence

2013-01-01

Many public sector services systems and provider organizations are in some phase of learning about or implementing evidence-based interventions. Child welfare service systems represent a context where implementation spans system, management, and organizational concerns. Research utilizing mixed methods that combine qualitative and quantitative design, data collection, and analytic approaches are particularly well-suited to understanding both the process and outcomes of dissemination and implementation efforts in child welfare systems. This paper describes the process of using mixed methods in implementation research and provides an applied example of an examination of factors impacting staff retention during an evidence-based intervention implementation in a statewide child welfare system. We integrate qualitative data with previously published quantitative analyses of job autonomy and staff turnover during this statewide implementation project in order to illustrate the utility of mixed method approaches in providing a more comprehensive understanding of opportunities and challenges in implementation research. PMID:22146861

Resequencing data provide no evidence for a human bottleneck in Africa during the penultimate glacial period.

Science.gov (United States)

Sjödin, Per; E Sjöstrand, Agnès; Jakobsson, Mattias; Blum, Michael G B

2012-07-01

Based on the accumulation of genetic, climatic, and fossil evidence, a central theory in paleoanthropology stipulates that a demographic bottleneck coincided with the origin of our species Homo Sapiens. This theory proposes that anatomically modern humans--which were only present in Africa at the time--experienced a drastic bottleneck during the penultimate glacial age (130-190 kya) when a cold and dry climate prevailed. Two scenarios have been proposed to describe the bottleneck, which involve either a fragmentation of the range occupied by humans or the survival of one small group of humans. Here, we analyze DNA sequence data from 61 nuclear loci sequenced in three African populations using Approximate Bayesian Computation and numerical simulations. In contrast to the bottleneck theory, we show that a simple model without any bottleneck during the penultimate ice age has the greatest statistical support compared with bottleneck models. Although the proposed bottleneck is ancient, occurring at least 130 kya, we can discard the possibility that it did not leave detectable footprints in the DNA sequence data except if the bottleneck involves a less than a 3-fold reduction in population size. Finally, we confirm that a simple model without a bottleneck is able to reproduce the main features of the observed patterns of genetic variation. We conclude that models of Pleistocene refugium for modern human origins now require substantial revision.

A new immuno- dystrophin-deficient model, the NSG-mdx4Cv mouse, provides evidence for functional improvement following allogeneic satellite cell transplantation

Science.gov (United States)

Arpke, Robert W.; Darabi, Radbod; Mader, Tara L.; Zhang, Yu; Toyama, Akira; Lonetree, Cara-lin; Nash, Nardina; Lowe, Dawn A.; Perlingeiro, Rita C.R.; Kyba, Michael

2013-01-01

Transplantation of a myogenic cell population into an immunodeficient recipient is an excellent way of assessing the in vivo muscle-generating capacity of that cell population. To facilitate both allogeneic and xenogeneic transplantations of muscle-forming cells in mice we have developed a novel immunodeficient muscular dystrophy model, the NSG-mdx4Cv mouse. The IL2Rg mutation, which is linked to the Dmd gene on the X chromosome, simultaneously depletes NK cells and suppresses thymic lymphomas, issues that limit the utility of the SCID/mdx model. The NSG-mdx4Cv mouse presents a muscular dystrophy of similar severity to the conventional mdx mouse. We show that this animal supports robust engraftment of both pig and dog muscle mononuclear cells. The question of whether satellite cells prospectively isolated by flow cytometry can confer a functional benefit upon transplantation has been controversial. Using allogeneic Pax7-ZsGreen donors and NSG-mdx4Cv recipients, we demonstrate definitively that as few as 900 FACS-isolated satellite cells can provide functional regeneration in vivo, in the form of an increased mean maximal force-generation capacity in cell-transplanted muscles, compared to a sham-injected control group. These studies highlight the potency of satellite cells to improve muscle function, and the utility of the NSG-mdx4Cv model for studies on muscle regeneration and Duchenne muscular dystrophy therapy. PMID:23606600

Relationship of Evidence-Based Practice and Treatments: A Survey of Community Mental Health Providers

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DiMeo, Michelle A.; Moore, G. Kurt; Lichtenstein, Carolyn

2012-01-01

Evidence-based treatments (EBTs) are "interventions" that have been proven effective through rigorous research methodologies. Evidence-based practice (EBP), however, refers to a "decision-making process" that integrates the best available research, clinician expertise, and client characteristics. This study examined community mental health service…

Psychosocial interventions in opiate substitution treatment services: does the evidence provide a case for optimism or nihilism?

Science.gov (United States)

Day, Ed; Mitcheson, Luke

2017-08-01

Clinical guidelines from around the world recommend the delivery of psychosocial interventions as part of routine care in opiate substitution treatment (OST) programmes. However, although individual studies demonstrate benefit for structured psychosocial interventions, meta-analytical reviews find no benefit for manual-based treatments beyond 'routine counselling'. We consider the question of whether OST medication alone is sufficient to produce the required outcomes, or whether greater efforts should be made to provide high-quality psychosocial treatment alongside medication. In so doing, we consider the nuances and limitations of the evidence and the organizational barriers to transferring it into routine practice. The evidence base for psychosocial interventions in opiate substitution treatment (OST) services can be interpreted both positively and negatively. Steering a path between overly optimistic or nihilistic interpretations of the value of psychosocial treatment in OST programmes is the most pragmatic approach. Greater attention should be paid to elements common to all psychological treatments (such as therapeutic alliance), but also to the sequencing and packaging of psychosocial elements and their linkage to peer-led interventions. © 2017 Society for the Study of Addiction.

Protecting Digital Evidence Integrity by Using Smart Cards

Science.gov (United States)

Saleem, Shahzad; Popov, Oliver

RFC 3227 provides general guidelines for digital evidence collection and archiving, while the International Organization on Computer Evidence offers guidelines for best practice in the digital forensic examination. In the light of these guidelines we will analyze integrity protection mechanism provided by EnCase and FTK which is mainly based on Message Digest Codes (MDCs). MDCs for integrity protection are not tamper proof, hence they can be forged. With the proposed model for protecting digital evidence integrity by using smart cards (PIDESC) that establishes a secure platform for digitally signing the MDC (in general for a whole range of cryptographic services) in combination with Public Key Cryptography (PKC), one can show that this weakness might be overcome.

Discriminating evidence accumulation from urgency signals in speeded decision making.

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Hawkins, Guy E; Wagenmakers, Eric-Jan; Ratcliff, Roger; Brown, Scott D

2015-07-01

The dominant theoretical paradigm in explaining decision making throughout both neuroscience and cognitive science is known as “evidence accumulation”--The core idea being that decisions are reached by a gradual accumulation of noisy information. Although this notion has been supported by hundreds of experiments over decades of study, a recent theory proposes that the fundamental assumption of evidence accumulation requires revision. The "urgency gating" model assumes decisions are made without accumulating evidence, using only moment-by-moment information. Under this assumption, the successful history of evidence accumulation models is explained by asserting that the two models are mathematically identical in standard experimental procedures. We demonstrate that this proof of equivalence is incorrect, and that the models are not identical, even when both models are augmented with realistic extra assumptions. We also demonstrate that the two models can be perfectly distinguished in realistic simulated experimental designs, and in two real data sets; the evidence accumulation model provided the best account for one data set, and the urgency gating model for the other. A positive outcome is that the opposing modeling approaches can be fruitfully investigated without wholesale change to the standard experimental paradigms. We conclude that future research must establish whether the urgency gating model enjoys the same empirical support in the standard experimental paradigms that evidence accumulation models have gathered over decades of study. Copyright © 2015 the American Physiological Society.

A stochastic multicriteria model for evidence-based decision making in drug benefit-risk analysis

NARCIS (Netherlands)

Tervonen, Tommi; van Valkenhoef, Gert; Buskens, Erik; Hillege, Hans L.; Postmus, Douwe

2011-01-01

Drug benefit-risk (BR) analysis is based on firm clinical evidence regarding various safety and efficacy outcomes. In this paper, we propose a new and more formal approach for constructing a supporting multicriteria model that fully takes into account the evidence on efficacy and adverse drug

Modeling determinants of growth: evidence for a community-based target in height?

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Aßmann, Christian; Hermanussen, Michael

2013-07-01

Human growth is traditionally envisaged as a target-seeking process regulated by genes, nutrition, health, and the state of an individual's social and economic environment; it is believed that under optimal physical conditions, an individual will achieve his or her full genetic potential. Using a panel data set on individual height increments, we suggest a statistical modeling approach that characterizes growth as first-order trend stationary and allows for controlling individual growth tempo via observable measures of individual maturity. A Bayesian framework and corresponding Markov-chain Monte Carlo techniques allowing for a conceptually stringent treatment of missing values are adapted for parameter estimation. The model provides evidence for the adjustment of the individual growth rate toward average height of the population. The increase in adult body height during the past 150 y has been explained by the steady improvement of living conditions that are now being considered to have reached an optimum in Western societies. The current investigation questions the notion that the traditional concept in the understanding of this target-seeking process is sufficient. We consider an additional regulator that possibly points at community-based target seeking in growth.

Investigation of training and support needs in rural and remote disability and mainstream service providers: implications for an online training model.

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Johnsson, Genevieve; Kerslake, Rachel; Crook, Sarah; Cribb, Corinne

2017-12-01

Objectives It is known that there are difficulties in recruiting and retaining practitioners in rural and remote communities and that access to support and professional development can be key in breaking this cycle. Technology provides a possible solution not only for increasing access to these opportunities, but also in building community capacity to support children with autism. The aim of the present study was to investigate the current learning and support needs within rural and remote professionals prior to setting up a model of support. Methods An online survey was used to gather information from service providers in rural and remote communities on their demographics, current skills and confidence in working with clients on the autism spectrum, current supervision and professional development, identified learning and support needs, and the availability and uptake of technology for accessing professional development. Results Respondents reported below average levels of perceived confidence and skills when working with children with autism, most notably children with challenging behaviour. Half the respondents do not currently attend supervision sessions, with only 15% receiving regular supervision (fortnightly or more often), and 66% of respondents had travelled more than 3h to access professional development workshops. The majority of participants had access to technology and over half had already used this for online training. Conclusion Overall, service providers in rural and remote areas are generally not currently meeting their needs in terms of frequency of supervision and professional development. The present needs analysis identifies key areas for learning, the ideal frequency of support and the acceptability of using technology to deliver this support. This information will guide future researchers in the development of an evidence-based model that will be accessible and meaningful to its participants. What is known about the topic? It is known that

Value-added strategy models to provide quality services in senior health business.

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Yang, Ya-Ting; Lin, Neng-Pai; Su, Shyi; Chen, Ya-Mei; Chang, Yao-Mao; Handa, Yujiro; Khan, Hafsah Arshed Ali; Elsa Hsu, Yi-Hsin

2017-06-20

The rapid population aging is now a global issue. The increase in the elderly population will impact the health care industry and health enterprises; various senior needs will promote the growth of the senior health industry. Most senior health studies are focused on the demand side and scarcely on supply. Our study selected quality enterprises focused on aging health and analyzed different strategies to provide excellent quality services to senior health enterprises. We selected 33 quality senior health enterprises in Taiwan and investigated their excellent quality services strategies by face-to-face semi-structured in-depth interviews with CEO and managers of each enterprise in 2013. A total of 33 senior health enterprises in Taiwan. Overall, 65 CEOs and managers of 33 enterprises were interviewed individually. None. Core values and vision, organization structure, quality services provided, strategies for quality services. This study's results indicated four type of value-added strategy models adopted by senior enterprises to offer quality services: (i) residential care and co-residence model, (ii) home care and living in place model, (iii) community e-business experience model and (iv) virtual and physical portable device model. The common part in these four strategy models is that the services provided are elderly centered. These models offer virtual and physical integrations, and also offer total solutions for the elderly and their caregivers. Through investigation of successful strategy models for providing quality services to seniors, we identified opportunities to develop innovative service models and successful characteristics, also policy implications were summarized. The observations from this study will serve as a primary evidenced base for enterprises developing their senior market and, also for promoting the value co-creation possibility through dialogue between customers and those that deliver service. © The Author 2017. Published by Oxford

Modelling catchment areas for secondary care providers: a case study.

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Jones, Simon; Wardlaw, Jessica; Crouch, Susan; Carolan, Michelle

2011-09-01

Hospitals need to understand patient flows in an increasingly competitive health economy. New initiatives like Patient Choice and the Darzi Review further increase this demand. Essential to understanding patient flows are demographic and geographic profiles of health care service providers, known as 'catchment areas' and 'catchment populations'. This information helps Primary Care Trusts (PCTs) to review how their populations are accessing services, measure inequalities and commission services; likewise it assists Secondary Care Providers (SCPs) to measure and assess potential gains in market share, redesign services, evaluate admission thresholds and plan financial budgets. Unlike PCTs, SCPs do not operate within fixed geographic boundaries. Traditionally, SCPs have used administrative boundaries or arbitrary drive times to model catchment areas. Neither approach satisfactorily represents current patient flows. Furthermore, these techniques are time-consuming and can be challenging for healthcare managers to exploit. This paper presents three different approaches to define catchment areas, each more detailed than the previous method. The first approach 'First Past the Post' defines catchment areas by allocating a dominant SCP to each Census Output Area (OA). The SCP with the highest proportion of activity within each OA is considered the dominant SCP. The second approach 'Proportional Flow' allocates activity proportionally to each OA. This approach allows for cross-boundary flows to be captured in a catchment area. The third and final approach uses a gravity model to define a catchment area, which incorporates drive or travel time into the analysis. Comparing approaches helps healthcare providers to understand whether using more traditional and simplistic approaches to define catchment areas and populations achieves the same or similar results as complex mathematical modelling. This paper has demonstrated, using a case study of Manchester, that when estimating

Why choose Random Forest to predict rare species distribution with few samples in large undersampled areas? Three Asian crane species models provide supporting evidence

Directory of Open Access Journals (Sweden)

Chunrong Mi

2017-01-01

Full Text Available Species distribution models (SDMs have become an essential tool in ecology, biogeography, evolution and, more recently, in conservation biology. How to generalize species distributions in large undersampled areas, especially with few samples, is a fundamental issue of SDMs. In order to explore this issue, we used the best available presence records for the Hooded Crane (Grus monacha, n = 33, White-naped Crane (Grus vipio, n = 40, and Black-necked Crane (Grus nigricollis, n = 75 in China as three case studies, employing four powerful and commonly used machine learning algorithms to map the breeding distributions of the three species: TreeNet (Stochastic Gradient Boosting, Boosted Regression Tree Model, Random Forest, CART (Classification and Regression Tree and Maxent (Maximum Entropy Models. In addition, we developed an ensemble forecast by averaging predicted probability of the above four models results. Commonly used model performance metrics (Area under ROC (AUC and true skill statistic (TSS were employed to evaluate model accuracy. The latest satellite tracking data and compiled literature data were used as two independent testing datasets to confront model predictions. We found Random Forest demonstrated the best performance for the most assessment method, provided a better model fit to the testing data, and achieved better species range maps for each crane species in undersampled areas. Random Forest has been generally available for more than 20 years and has been known to perform extremely well in ecological predictions. However, while increasingly on the rise, its potential is still widely underused in conservation, (spatial ecological applications and for inference. Our results show that it informs ecological and biogeographical theories as well as being suitable for conservation applications, specifically when the study area is undersampled. This method helps to save model-selection time and effort, and allows robust and rapid

Why choose Random Forest to predict rare species distribution with few samples in large undersampled areas? Three Asian crane species models provide supporting evidence.

Science.gov (United States)

Mi, Chunrong; Huettmann, Falk; Guo, Yumin; Han, Xuesong; Wen, Lijia

2017-01-01

Species distribution models (SDMs) have become an essential tool in ecology, biogeography, evolution and, more recently, in conservation biology. How to generalize species distributions in large undersampled areas, especially with few samples, is a fundamental issue of SDMs. In order to explore this issue, we used the best available presence records for the Hooded Crane ( Grus monacha , n  = 33), White-naped Crane ( Grus vipio , n  = 40), and Black-necked Crane ( Grus nigricollis , n  = 75) in China as three case studies, employing four powerful and commonly used machine learning algorithms to map the breeding distributions of the three species: TreeNet (Stochastic Gradient Boosting, Boosted Regression Tree Model), Random Forest, CART (Classification and Regression Tree) and Maxent (Maximum Entropy Models). In addition, we developed an ensemble forecast by averaging predicted probability of the above four models results. Commonly used model performance metrics (Area under ROC (AUC) and true skill statistic (TSS)) were employed to evaluate model accuracy. The latest satellite tracking data and compiled literature data were used as two independent testing datasets to confront model predictions. We found Random Forest demonstrated the best performance for the most assessment method, provided a better model fit to the testing data, and achieved better species range maps for each crane species in undersampled areas. Random Forest has been generally available for more than 20 years and has been known to perform extremely well in ecological predictions. However, while increasingly on the rise, its potential is still widely underused in conservation, (spatial) ecological applications and for inference. Our results show that it informs ecological and biogeographical theories as well as being suitable for conservation applications, specifically when the study area is undersampled. This method helps to save model-selection time and effort, and allows robust and rapid

Are Private Providers more Productive and Efficient than Public Providers of International Education? Evidence from New Zealand

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Dayal TALUKDER

2011-10-01

Full Text Available This study has investigated the productivity growth and efficiency of private and public providers of international education in New Zealand. It has used secondary data to calculate the DEA-based Malmquist productivity index for measuring Total Factor Productivity (TFP-growth and efficiency of both public and private providers of international education during 1999-2010. The study has found that private providers experienced a larger TFP-growth than that of public providers during 1999-2004. However, they experienced a sharp decline in TFP-growth since 2005 through to 2010 and experienced a much smaller TFP-growth than that of public providers during this period. Conversely, public providers experienced a positive TFP-growth during 1999-2004 but they experienced a negative TFP-growth since 2005 through to 2010. Considering efficiency, both private and public providers experienced almost a constant Technical Efficiency Change (TEC having a same level of efficiency of one. Both private and public providers exhibited a constant return to scale during 1999-2010. This study argues that on an average, private providers are more productive than public providers of international education. However, they are not more efficient than public providers as both types of providers exhibited a constant return to scale during 1999-2010. This study also argues that TFP-growth of New Zealand’s international education was determined by Technological Change (TC, not by TEC during this period.

Health decision making: lynchpin of evidence-based practice.

Science.gov (United States)

Spring, Bonnie

2008-01-01

Health decision making is both the lynchpin and the least developed aspect of evidence-based practice. The evidence-based practice process requires integrating the evidence with consideration of practical resources and patient preferences and doing so via a process that is genuinely collaborative. Yet, the literature is largely silent about how to accomplish integrative, shared decision making. for evidence-based practice are discussed for 2 theories of clinician decision making (expected utility and fuzzy trace) and 2 theories of patient health decision making (transtheoretical model and reasoned action). Three suggestions are offered. First, it would be advantageous to have theory-based algorithms that weight and integrate the 3 data strands (evidence, resources, preferences) in different decisional contexts. Second, patients, not providers, make the decisions of greatest impact on public health, and those decisions are behavioral. Consequently, theory explicating how provider-patient collaboration can influence patient lifestyle decisions made miles from the provider's office is greatly needed. Third, although the preponderance of data on complex decisions supports a computational approach, such an approach to evidence-based practice is too impractical to be widely applied at present. More troublesomely, until patients come to trust decisions made computationally more than they trust their providers' intuitions, patient adherence will remain problematic. A good theory of integrative, collaborative health decision making remains needed.

Evidence-Based Toxicology.

Science.gov (United States)

Hoffmann, Sebastian; Hartung, Thomas; Stephens, Martin

Evidence-based toxicology (EBT) was introduced independently by two groups in 2005, in the context of toxicological risk assessment and causation as well as based on parallels between the evaluation of test methods in toxicology and evidence-based assessment of diagnostics tests in medicine. The role model of evidence-based medicine (EBM) motivated both proposals and guided the evolution of EBT, whereas especially systematic reviews and evidence quality assessment attract considerable attention in toxicology.Regarding test assessment, in the search of solutions for various problems related to validation, such as the imperfectness of the reference standard or the challenge to comprehensively evaluate tests, the field of Diagnostic Test Assessment (DTA) was identified as a potential resource. DTA being an EBM discipline, test method assessment/validation therefore became one of the main drivers spurring the development of EBT.In the context of pathway-based toxicology, EBT approaches, given their objectivity, transparency and consistency, have been proposed to be used for carrying out a (retrospective) mechanistic validation.In summary, implementation of more evidence-based approaches may provide the tools necessary to adapt the assessment/validation of toxicological test methods and testing strategies to face the challenges of toxicology in the twenty first century.

Evidence accumulation in decision making: unifying the "take the best" and the "rational" models.

Science.gov (United States)

Lee, Michael D; Cummins, Tarrant D R

2004-04-01

An evidence accumulation model of forced-choice decision making is proposed to unify the fast and frugal take the best (TTB) model and the alternative rational (RAT) model with which it is usually contrasted. The basic idea is to treat the TTB model as a sequential-sampling process that terminates as soon as any evidence in favor of a decision is found and the rational approach as a sequential-sampling process that terminates only when all available information has been assessed. The unified TTB and RAT models were tested in an experiment in which participants learned to make correct judgments for a set of real-world stimuli on the basis of feedback, and were then asked to make additional judgments without feedback for cases in which the TTB and the rational models made different predictions. The results show that, in both experiments, there was strong intraparticipant consistency in the use of either the TTB or the rational model but large interparticipant differences in which model was used. The unified model is shown to be able to capture the differences in decision making across participants in an interpretable way and is preferred by the minimum description length model selection criterion.

What kind of evidence is it that Evidence-Based Medicine advocates want health care providers and consumers to pay attention to?

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Haynes R Brian

2002-03-01

Full Text Available Abstract Background In 1992, Evidence-Based Medicine advocates proclaimed a "new paradigm", in which evidence from health care research is the best basis for decisions for individual patients and health systems. Hailed in New York Times Magazine in 2001 as one of the most influential ideas of the year, this approach was initially and provocatively pitted against the traditional teaching of medicine, in which the key elements of knowing for clinical purposes are understanding of basic pathophysiologic mechanisms of disease coupled with clinical experience. This paper reviews the origins, aspirations, philosophical limitations, and practical challenges of evidence-based medicine. Discussion EBM has long since evolved beyond its initial (misconception, that EBM might replace traditional medicine. EBM is now attempting to augment rather than replace individual clinical experience and understanding of basic disease mechanisms. EBM must continue to evolve, however, to address a number of issues including scientific underpinnings, moral stance and consequences, and practical matters of dissemination and application. For example, accelerating the transfer of research findings into clinical practice is often based on incomplete evidence from selected groups of people, who experience a marginal benefit from an expensive technology, raising issues of the generalizability of the findings, and increasing problems with how many and who can afford the new innovations in care. Summary Advocates of evidence-based medicine want clinicians and consumers to pay attention to the best findings from health care research that are both valid and ready for clinical application. Much remains to be done to reach this goal.

New horned dinosaurs from Utah provide evidence for intracontinental dinosaur endemism.

Science.gov (United States)

Sampson, Scott D; Loewen, Mark A; Farke, Andrew A; Roberts, Eric M; Forster, Catherine A; Smith, Joshua A; Titus, Alan L

2010-09-22

During much of the Late Cretaceous, a shallow, epeiric sea divided North America into eastern and western landmasses. The western landmass, known as Laramidia, although diminutive in size, witnessed a major evolutionary radiation of dinosaurs. Other than hadrosaurs (duck-billed dinosaurs), the most common dinosaurs were ceratopsids (large-bodied horned dinosaurs), currently known only from Laramidia and Asia. Remarkably, previous studies have postulated the occurrence of latitudinally arrayed dinosaur "provinces," or "biomes," on Laramidia. Yet this hypothesis has been challenged on multiple fronts and has remained poorly tested. Here we describe two new, co-occurring ceratopsids from the Upper Cretaceous Kaiparowits Formation of Utah that provide the strongest support to date for the dinosaur provincialism hypothesis. Both pertain to the clade of ceratopsids known as Chasmosaurinae, dramatically increasing representation of this group from the southern portion of the Western Interior Basin of North America. Utahceratops gettyi gen. et sp. nov.-characterized by short, rounded, laterally projecting supraorbital horncores and an elongate frill with a deep median embayment-is recovered as the sister taxon to Pentaceratops sternbergii from the late Campanian of New Mexico. Kosmoceratops richardsoni gen. et sp. nov.-characterized by elongate, laterally projecting supraorbital horncores and a short, broad frill adorned with ten well developed hooks-has the most ornate skull of any known dinosaur and is closely allied to Chasmosaurus irvinensis from the late Campanian of Alberta. Considered in unison, the phylogenetic, stratigraphic, and biogeographic evidence documents distinct, co-occurring chasmosaurine taxa north and south on the diminutive landmass of Laramidia. The famous Triceratops and all other, more nested chasmosaurines are postulated as descendants of forms previously restricted to the southern portion of Laramidia. Results further suggest the presence of

Experimental evidence and modelling of drought induced alternative stable soil moisture states

Science.gov (United States)

Robinson, David; Jones, Scott; Lebron, Inma; Reinsch, Sabine; Dominguez, Maria; Smith, Andrew; Marshal, Miles; Emmett, Bridget

2017-04-01

The theory of alternative stable states in ecosystems is well established in ecology; however, evidence from manipulation experiments supporting the theory is limited. Developing the evidence base is important because it has profound implications for ecosystem management. Here we show evidence of the existence of alternative stable soil moisture states induced by drought in an upland wet heath. We used a long-term (15 yrs) climate change manipulation experiment with moderate sustained drought, which reduced the ability of the soil to retain soil moisture by degrading the soil structure, reducing moisture retention. Moreover, natural intense droughts superimposed themselves on the experiment, causing an unexpected additional alternative soil moisture state to develop, both for the drought manipulation and control plots; this impaired the soil from rewetting in winter. Our results show the coexistence of three stable states. Using modelling with the Hydrus 1D software package we are able to show the circumstances under which shifts in soil moisture states are likely to occur. Given the new understanding it presents a challenge of how to incorporate feedbacks, particularly related to soil structure, into soil flow and transport models?

Providing free autopoweroff plugs

DEFF Research Database (Denmark)

Jensen, Carsten Lynge; Hansen, Lars Gårn; Fjordbak, Troels

2012-01-01

Experimental evidence of the effect of providing households with cheap energy saving technology is sparse. We present results from a field experiment in which autopoweroff plugs were provided free of charge to randomly selected households. We use propensity score matching to find treatment effects...

Proposal of a Holistic Model to Support Local-Level Evidence-Based Practice

Directory of Open Access Journals (Sweden)

Said Shahtahmasebi

2010-01-01

Full Text Available In response to a central drive for evidence-based practice, there have been many research support schemes, setups, and other practices concentrating on facilitating access to external research, such as the Centre for Evidence Based Healthcare Aotearoa, the Cochrane Collaboration, and the York Centre for Reviews and Dissemination. Very little attention has been paid to supporting internal research in terms of local evidence and internal research capabilities. The whole evidence-based practice movement has alienated internal decision makers and, thus, very little progress has been made in the context of evidence informing local policy formation. Health and social policies are made centrally based on dubious claims and often evidence is sought after implementation. For example, on record, most health care practitioners appear to agree with the causal link between depression and mental illness (sometimes qualified with other social factors with suicide; off the record, even some psychiatrists doubt that such a link is applicable to the population as a whole. Therefore, be it through misplaced loyalty or a lack of support for internal researchers/decision makers, local evidence informing local decision making may have been ignored in favour of external evidence. In this paper, we present a practical holistic model to support local evidence-based decision making. This approach is more relevant in light of a new approach to primary health care of “local knowledge” complementing external evidence. One possible outcome would be to network with other regional programmes around the world to share information and identify “best” practices, such as the “Stop Youth Suicide Campaign”(www.stopyouthsuicide.com.

Integration of Evidence Base into a Probabilistic Risk Assessment

Science.gov (United States)

Saile, Lyn; Lopez, Vilma; Bickham, Grandin; Kerstman, Eric; FreiredeCarvalho, Mary; Byrne, Vicky; Butler, Douglas; Myers, Jerry; Walton, Marlei

2011-01-01

INTRODUCTION: A probabilistic decision support model such as the Integrated Medical Model (IMM) utilizes an immense amount of input data that necessitates a systematic, integrated approach for data collection, and management. As a result of this approach, IMM is able to forecasts medical events, resource utilization and crew health during space flight. METHODS: Inflight data is the most desirable input for the Integrated Medical Model. Non-attributable inflight data is collected from the Lifetime Surveillance for Astronaut Health study as well as the engineers, flight surgeons, and astronauts themselves. When inflight data is unavailable cohort studies, other models and Bayesian analyses are used, in addition to subject matters experts input on occasion. To determine the quality of evidence of a medical condition, the data source is categorized and assigned a level of evidence from 1-5; the highest level is one. The collected data reside and are managed in a relational SQL database with a web-based interface for data entry and review. The database is also capable of interfacing with outside applications which expands capabilities within the database itself. Via the public interface, customers can access a formatted Clinical Findings Form (CLiFF) that outlines the model input and evidence base for each medical condition. Changes to the database are tracked using a documented Configuration Management process. DISSCUSSION: This strategic approach provides a comprehensive data management plan for IMM. The IMM Database s structure and architecture has proven to support additional usages. As seen by the resources utilization across medical conditions analysis. In addition, the IMM Database s web-based interface provides a user-friendly format for customers to browse and download the clinical information for medical conditions. It is this type of functionality that will provide Exploratory Medicine Capabilities the evidence base for their medical condition list

Phylogenomics provides strong evidence for relationships of butterflies and moths.

Science.gov (United States)

Kawahara, Akito Y; Breinholt, Jesse W

2014-08-07

Butterflies and moths constitute some of the most popular and charismatic insects. Lepidoptera include approximately 160 000 described species, many of which are important model organisms. Previous studies on the evolution of Lepidoptera did not confidently place butterflies, and many relationships among superfamilies in the megadiverse clade Ditrysia remain largely uncertain. We generated a molecular dataset with 46 taxa, combining 33 new transcriptomes with 13 available genomes, transcriptomes and expressed sequence tags (ESTs). Using HaMStR with a Lepidoptera-specific core-orthologue set of single copy loci, we identified 2696 genes for inclusion into the phylogenomic analysis. Nucleotides and amino acids of the all-gene, all-taxon dataset yielded nearly identical, well-supported trees. Monophyly of butterflies (Papilionoidea) was strongly supported, and the group included skippers (Hesperiidae) and the enigmatic butterfly-moths (Hedylidae). Butterflies were placed sister to the remaining obtectomeran Lepidoptera, and the latter was grouped with greater than or equal to 87% bootstrap support. Establishing confident relationships among the four most diverse macroheteroceran superfamilies was previously challenging, but we recovered 100% bootstrap support for the following relationships: ((Geometroidea, Noctuoidea), (Bombycoidea, Lasiocampoidea)). We present the first robust, transcriptome-based tree of Lepidoptera that strongly contradicts historical placement of butterflies, and provide an evolutionary framework for genomic, developmental and ecological studies on this diverse insect order. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

Theory- and Evidence- Based Intervention: Practice-Based Evidence--Integrating Positive Psychology into a Clinical Psychological Assessment and Intervention Model and How to Measure Outcome

Science.gov (United States)

Nissen, Poul

2011-01-01

In this paper, a model for assessment and intervention is presented. This model explains how to perform theory- and evidence- based as well as practice-based assessment and intervention. The assessment model applies a holistic approach to treatment planning, which includes recognition of the influence of community, school, peers, family and the…

Experimental Evidence on Transfer Pricing

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Tran Quoc H.

2016-06-01

Full Text Available We use incentivized economics experiments to test both the point predictions and comparative static predictions of optimal transfer pricing models, comparing behavior under varying conditions, including wholly versus partially-owned subsidiaries and different tariff and tax rates. As predicted, we find that transfer prices are responsive to relative tax and tariff rates as well as ownership proportions. Additionally, we examine convergence and learning in this setting. While individuals do not choose optimal transfer prices, their choices converge to optimal levels with experience. This paper thus makes two important contributions. First, by comparing behavior with theoretical predictions it provides evidence of whether (and when individuals set transfer prices optimally. Second, by comparing behavior under conditions of full and partial ownership it provides evidence on the impact of policy interventions (like regulating ownership proportions by MNEs on tax revenues.

Video Modeling Training Effects on Types of Attention Delivered by Educational Care-Providers.

Science.gov (United States)

Taber, Traci A; Lambright, Nathan; Luiselli, James K

2017-06-01

We evaluated the effects of abbreviated (i.e., one-session) video modeling on delivery of student-preferred attention by educational care-providers. The video depicted a novel care-provider interacting with and delivering attention to the student. Within a concurrent multiple baseline design, video modeling increased delivery of the targeted attention for all participants as well as their delivery of another type of attention that was not trained although these effects were variable within and between care-providers. We discuss the clinical and training implications from these findings.

Social models provide a norm of appropriate food intake for young women.

Directory of Open Access Journals (Sweden)

Lenny R Vartanian

Full Text Available It is often assumed that social models influence people's eating behavior by providing a norm of appropriate food intake, but this hypothesis has not been directly tested. In three experiments, female participants were exposed to a low-intake model, a high-intake model, or no model (control condition. Experiments 1 and 2 used a remote-confederate manipulation and were conducted in the context of a cookie taste test. Experiment 3 used a live confederate and was conducted in the context of a task during which participants were given incidental access to food. Participants also rated the extent to which their food intake was influenced by a variety of factors (e.g., hunger, taste, how much others ate. In all three experiments, participants in the low-intake conditions ate less than did participants in the high-intake conditions, and also reported a lower perceived norm of appropriate intake. Furthermore, perceived norms of appropriate intake mediated the effects of the social model on participants' food intake. Despite the observed effects of the social models, participants were much more likely to indicate that their food intake was influenced by taste and hunger than by the behavior of the social models. Thus, social models appear to influence food intake by providing a norm of appropriate eating behavior, but people may be unaware of the influence of a social model on their behavior.

Breastfeeding knowledge, attitudes, and practices among providers in a medical home.

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Szucs, Kinga A; Miracle, Donna J; Rosenman, Marc B

2009-03-01

Breastfeeding offers numerous health advantages to children, mothers, and society. From obstetrics to pediatrics, breastfeeding dyads come in contact with a wide range of healthcare providers. The American Academy of Pediatrics (AAP) calls for pediatricians to support breastfeeding enthusiastically and for all children to have a medical home. We studied an inner-city healthcare system with a Dyson Community Pediatrics Training Initiative Model Medical Home clinic, to explore how a breastfeeding/baby-friendly medical home might be built upon this framework. We describe breastfeeding knowledge, attitudes, and practices among a full range of providers and healthcare system-level barriers to effective and coordinated breastfeeding services. We conducted eight focus groups using semistructured interviews: (1) pediatricians; (2) obstetricians; (3) pediatric nurses and allied health professionals; (4) obstetric nurses and allied health professionals; (5) 24-hour telephone triage answering service nurses; (6) public health nurses; (7) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) personnel; and (8) lactation consultants and peer counselors. We identified gaps in providers' breastfeeding knowledge, counseling skills, and professional education and training. Providers' cultures and attitudes affect breastfeeding promotion and support. Providers used their own breastfeeding experiences to replace evidence-based knowledge and AAP policy statement recommendations for breastfeeding dyads. There were communication disconnects between provider groups. Providers underestimated their own, and overestimated others', influence on breastfeeding. The system lacked a coordinated breastfeeding mission. This study illuminated key disconnectedness challenges (and, hence, opportunities) for a model medical home in fostering continuous, comprehensive, coordinated, culturally effective, and evidence-based breastfeeding promotion and support.

Providing Family Planning Services at Primary Care Organizations after the Exclusion of Planned Parenthood from Publicly Funded Programs in Texas: Early Qualitative Evidence.

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White, Kari; Hopkins, Kristine; Grossman, Daniel; Potter, Joseph E

2017-10-20

To explore organizations' experiences providing family planning during the first year of an expanded primary care program in Texas. Between November 2014 and February 2015, in-depth interviews were conducted with program administrators at 30 organizations: 7 women's health organizations, 13 established primary care contractors (e.g., community health centers, public health departments), and 10 new primary care contractors. Interviews addressed organizational capacities to expand family planning and integrate services with primary care. Interview transcripts were analyzed using a theme-based approach. Themes were compared across the three types of organizations. Established and new primary care contractors identified several challenges expanding family planning services, which were uncommon among women's health organizations. Clinicians often lacked training to provide intrauterine devices and contraceptive implants. Organizations often recruited existing clients into family planning services, rather than expanding their patient base, and new contractors found family planning difficult to integrate because of clients' other health needs. Primary care contractors frequently described contraceptive provision protocols that were not evidence-based. Many primary care organizations in Texas initially lacked the capacity to provide evidence-based family planning services that women's health organizations already provided. © Health Research and Educational Trust.

Disentangling the Role of Domain-Specific Knowledge in Student Modeling

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Ruppert, John; Duncan, Ravit Golan; Chinn, Clark A.

2017-08-01

This study explores the role of domain-specific knowledge in students' modeling practice and how this knowledge interacts with two domain-general modeling strategies: use of evidence and developing a causal mechanism. We analyzed models made by middle school students who had a year of intensive model-based instruction. These models were made to explain a familiar but unstudied biological phenomenon: late onset muscle pain. Students were provided with three pieces of evidence related to this phenomenon and asked to construct a model to account for this evidence. Findings indicate that domain-specific resources play a significant role in the extent to which the models accounted for provided evidence. On the other hand, familiarity with the situation appeared to contribute to the mechanistic character of models. Our results indicate that modeling strategies alone are insufficient for the development of a mechanistic model that accounts for provided evidence and that, while learners can develop a tentative model with a basic familiarity of the situation, scaffolding certain domain-specific knowledge is necessary to assist students with incorporating evidence in modeling tasks.

Evidence-based management of ambulatory electronic health record system implementation: an assessment of conceptual support and qualitative evidence.

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McAlearney, Ann Scheck; Hefner, Jennifer L; Sieck, Cynthia; Rizer, Milisa; Huerta, Timothy R

2014-07-01

While electronic health record (EHR) systems have potential to drive improvements in healthcare, a majority of EHR implementations fall short of expectations. Shortcomings in implementations are often due to organizational issues around the implementation process rather than technological problems. Evidence from both the information technology and healthcare management literature can be applied to improve the likelihood of implementation success, but the translation of this evidence into practice has not been widespread. Our objective was to comprehensively study and synthesize best practices for managing ambulatory EHR system implementation in healthcare organizations, highlighting applicable management theories and successful strategies. We held 45 interviews with key informants in six U.S. healthcare organizations purposively selected based on reported success with ambulatory EHR implementation. We also conducted six focus groups comprised of 37 physicians. Interview and focus group transcripts were analyzed using both deductive and inductive methods to answer research questions and explore emergent themes. We suggest that successful management of ambulatory EHR implementation can be guided by the Plan-Do-Study-Act (PDSA) quality improvement (QI) model. While participants did not acknowledge nor emphasize use of this model, we found evidence that successful implementation practices could be framed using the PDSA model. Additionally, successful sites had three strategies in common: 1) use of evidence from published health information technology (HIT) literature emphasizing implementation facilitators; 2) focusing on workflow; and 3) incorporating critical management factors that facilitate implementation. Organizations seeking to improve ambulatory EHR implementation processes can use frameworks such as the PDSA QI model to guide efforts and provide a means to formally accommodate new evidence over time. Implementing formal management strategies and incorporating

The Healthcare Improvement Scotland evidence note rapid review process: providing timely, reliable evidence to inform imperative decisions on healthcare.

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McIntosh, Heather M; Calvert, Julie; Macpherson, Karen J; Thompson, Lorna

2016-06-01

Rapid review has become widely adopted by health technology assessment agencies in response to demand for evidence-based information to support imperative decisions. Concern about the credibility of rapid reviews and the reliability of their findings has prompted a call for wider publication of their methods. In publishing this overview of the accredited rapid review process developed by Healthcare Improvement Scotland, we aim to raise awareness of our methods and advance the discourse on best practice. Healthcare Improvement Scotland produces rapid reviews called evidence notes using a process that has achieved external accreditation through the National Institute for Health and Care Excellence. Key components include a structured approach to topic selection, initial scoping, considered stakeholder involvement, streamlined systematic review, internal quality assurance, external peer review and updating. The process was introduced in 2010 and continues to be refined over time in response to user feedback and operational experience. Decision-makers value the responsiveness of the process and perceive it as being a credible source of unbiased evidence-based information supporting advice for NHSScotland. Many agencies undertaking rapid reviews are striving to balance efficiency with methodological rigour. We agree that there is a need for methodological guidance and that it should be informed by better understanding of current approaches and the consequences of different approaches to streamlining systematic review methods. Greater transparency in the reporting of rapid review methods is essential to enable that to happen.

Calibration of complex models through Bayesian evidence synthesis: a demonstration and tutorial

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Jackson, Christopher; Jit, Mark; Sharples, Linda; DeAngelis, Daniela

2016-01-01

Summary Decision-analytic models must often be informed using data which are only indirectly related to the main model parameters. The authors outline how to implement a Bayesian synthesis of diverse sources of evidence to calibrate the parameters of a complex model. A graphical model is built to represent how observed data are generated from statistical models with unknown parameters, and how those parameters are related to quantities of interest for decision-making. This forms the basis of an algorithm to estimate a posterior probability distribution, which represents the updated state of evidence for all unknowns given all data and prior beliefs. This process calibrates the quantities of interest against data, and at the same time, propagates all parameter uncertainties to the results used for decision-making. To illustrate these methods, the authors demonstrate how a previously-developed Markov model for the progression of human papillomavirus (HPV16) infection was rebuilt in a Bayesian framework. Transition probabilities between states of disease severity are inferred indirectly from cross-sectional observations of prevalence of HPV16 and HPV16-related disease by age, cervical cancer incidence, and other published information. Previously, a discrete collection of plausible scenarios was identified, but with no further indication of which of these are more plausible. Instead, the authors derive a Bayesian posterior distribution, in which scenarios are implicitly weighted according to how well they are supported by the data. In particular, we emphasise the appropriate choice of prior distributions and checking and comparison of fitted models. PMID:23886677

Human toddlers' attempts to match two simple behaviors provide no evidence for an inherited, dedicated imitation mechanism.

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Susan S Jones

Full Text Available Influential theories of imitation have proposed that humans inherit a neural mechanism - an "active intermodal matching " (AIM mechanism or a mirror neuron system - that functions from birth to automatically match sensory input from others' actions to motor programs for performing those same actions, and thus produces imitation. To test these proposals, 160 1- to 2½-year-old toddlers were asked to imitate two simple movements- bending the arm to make an elbow, and moving the bent elbow laterally. Both behaviors were almost certain to be in each child's repertoire, and the lateral movement was goal-directed (used to hit a plastic cup. Thus, one or both behaviors should have been imitable by toddlers with a functioning AIM or mirror neuron system. Each child saw the two behaviors repeated 18 times, and was encouraged to imitate. Children were also asked to locate their own elbows. Almost no children below age 2 imitated either behavior. Instead, younger children gave clear evidence of a developmental progression, from reproducing only the outcome of the models' movements (hitting the object, through trying (but failing to reproduce the model's arm posture and/or the arm-cup relations they had seen, to accurate imitation of arm bending by age 2 and of both movements by age 2½. Across age levels, almost all children who knew the word 'elbow' imitated both behaviors: very few who did not know the word imitated either behavior. The evidence is most consistent with a view of early imitation as the product of a complex system of language, cognitive, social, and motor competencies that develop in infancy. The findings do not rule out a role for an inherited neural mechanism, but they suggest that such a system would not by itself be sufficient to explain imitation at any age.

Provider report of the existence of detection and care of perinatal depression: quantitative evidence from public obstetric units in Mexico.

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Castro, Filipa de; Place, Jean Marie; Allen-Leigh, Betania; Rivera-Rivera, Leonor; Billings, Deborah

2016-08-01

To provide evidence on perinatal mental healthcare in Mexico. Descriptive and bivariate analyses of data from a cross-sectional probabilistic survey of 211 public obstetric units. Over half (64.0%) of units offer mental healthcare; fewer offer perinatal depression (PND) detection (37.1%) and care (40.3%). More units had protocols/guidelines for PND detection and for care, respectively, in Mexico City-Mexico state (76.7%; 78.1%) than in Southern (26.5%; 36.4%), Northern (27.3%; 28.1%) and Central Mexico (50.0%; 52.7%). Protocols and provider training in PND, implementation of brief screening tools and psychosocial interventions delivered by non-clinical personnel are needed.

Hybrid wildebeest (Artiodactyla: Bovidae provide further evidence for shared signatures of admixture in mammalian crania

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Bonita de Klerk

2010-10-01

Full Text Available The genus Connochaetes, Lichtenstein, 1814, contains two extant species, the blue wildebeest (C. taurinus, Burchell, 1823 and the black wildebeest (C. gnou, Zimmermann, 1780. In recent years, forced sympatry in confined areas within South Africa has led to interbreeding between these taxa and to fertile hybrid offspring. Here we report on a series of cranial characteristics of a hybrid wildebeest population culled at Spioenkop Dam Nature Reserve, KwaZulu-Natal, South Africa. Dental, sutural and horn morphological anomalies occur at high frequency within these animals. Similar cranial morphological anomalies have been shown in other mammalian hybrids and this study provides further evidence that such anomalies may characterise hybridisation more broadly across phylogenetically divergent mammalian groups, although the anomalies appear to differ in their expression across taxa. An increased ability to identify hybrids may also have important applications in the conservation of the endemic black wildebeest.

Sicily statement on evidence-based practice

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Hopayian Kevork

2005-01-01

Full Text Available Abstract Background A variety of definitions of evidence-based practice (EBP exist. However, definitions are in themselves insufficient to explain the underlying processes of EBP and to differentiate between an evidence-based process and evidence-based outcome. There is a need for a clear statement of what Evidence-Based Practice (EBP means, a description of the skills required to practise in an evidence-based manner and a curriculum that outlines the minimum requirements for training health professionals in EBP. This consensus statement is based on current literature and incorporating the experience of delegates attending the 2003 Conference of Evidence-Based Health Care Teachers and Developers ("Signposting the future of EBHC". Discussion Evidence-Based Practice has evolved in both scope and definition. Evidence-Based Practice (EBP requires that decisions about health care are based on the best available, current, valid and relevant evidence. These decisions should be made by those receiving care, informed by the tacit and explicit knowledge of those providing care, within the context of available resources. Health care professionals must be able to gain, assess, apply and integrate new knowledge and have the ability to adapt to changing circumstances throughout their professional life. Curricula to deliver these aptitudes need to be grounded in the five-step model of EBP, and informed by ongoing research. Core assessment tools for each of the steps should continue to be developed, validated, and made freely available. Summary All health care professionals need to understand the principles of EBP, recognise EBP in action, implement evidence-based policies, and have a critical attitude to their own practice and to evidence. Without these skills, professionals and organisations will find it difficult to provide 'best practice'.

Testing the Monetary Model for Exchange Rate Determination in South Africa: Evidence from 101 Years of Data

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Riané de Bruyn

2013-03-01

Full Text Available Evidence in favor of the monetary model of exchange rate determination for the South African Rand is, at best, mixed. A co-integrating relationship between the nominal exchange rate and monetary fundamentals forms the basis of the monetary model. With the econometric literature suggesting that the span of the data, not the frequency, determines the power of the co-integration tests and the studies on South Africa primarily using short-span data from the post-Bretton Woods era, we decided to test the long-run monetary model of exchange rate determination for the South African Rand relative to the US Dollar using annual data from 1910 – 2010. The results provide some support for the monetary model in that long-run co-integration is found between the nominal exchange rate and the output and money supply deviations. However, the theoretical restrictions required by the monetary model are rejected. A vector error-correction model identifies both the nominal exchange rate and the monetary fundamentals as the channel for the adjustment process of deviations from the long-run equilibrium exchange rate. A subsequent comparison of nominal exchange rate forecasts based on the monetary model with those of the random walk model suggests that the forecasting performance of the monetary model is superior.

A Model for the Growth of Network Service Providers

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2011-12-01

Service Provider O-D Origin-Destination POP Point of Presence UCG Unilateral Connection Game xiv THIS PAGE INTENTIONALLY LEFT BLANK xv EXECUTIVE...xvi We make use of the Abilene dataset as input to the network provisioning model and assume that the NSP is new to the market and is building an...has to decide on the connections to build and the markets to serve in order to maximize its profits. The NSP makes these decisions based on the market

The anti-human trafficking collaboration model and serving victims: Providers' perspectives on the impact and experience.

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Kim, Hea-Won; Park, Taekyung; Quiring, Stephanie; Barrett, Diana

2018-01-01

A coalition model is often used to serve victims of human trafficking but little is known about whether the model is adequately meeting the needs of the victims. The purpose of this study was to examine anti-human trafficking collaboration model in terms of its impact and the collaborative experience, including challenges and lessons learned from the service providers' perspective. Mixed methods study was conducted to evaluate the impact of a citywide anti-trafficking coalition model from the providers' perspectives. Web-based survey was administered with service providers (n = 32) and focus groups were conducted with Core Group members (n = 10). Providers reported the coalition model has made important impacts in the community by increasing coordination among the key agencies, law enforcement, and service providers and improving quality of service provision. Providers identified the improved and expanded partnerships among coalition members as the key contributing factor to the success of the coalition model. Several key strategies were suggested to improve the coalition model: improved referral tracking, key partner and protocol development, and information sharing.

National Water Model: Providing the Nation with Actionable Water Intelligence

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Aggett, G. R.; Bates, B.

2017-12-01

The National Water Model (NWM) provides national, street-level detail of water movement through time and space. Operating hourly, this flood of information offers enormous benefits in the form of water resource management, natural disaster preparedness, and the protection of life and property. The Geo-Intelligence Division at the NOAA National Water Center supplies forecasters and decision-makers with timely, actionable water intelligence through the processing of billions of NWM data points every hour. These datasets include current streamflow estimates, short and medium range streamflow forecasts, and many other ancillary datasets. The sheer amount of NWM data produced yields a dataset too large to allow for direct human comprehension. As such, it is necessary to undergo model data post-processing, filtering, and data ingestion by visualization web apps that make use of cartographic techniques to bring attention to the areas of highest urgency. This poster illustrates NWM output post-processing and cartographic visualization techniques being developed and employed by the Geo-Intelligence Division at the NOAA National Water Center to provide national actionable water intelligence.

Molecular Evidence for Differential Long-term Outcomes of Early Life Severe Acute Malnutrition

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Allan Sheppard

2017-04-01

Implications of All the Available Evidence: These data are compatible with the different clinical responses to SAM arising from developmentally-induced epigenetic changes laid down largely before birth and provide evidence for the predictive adaptive response model operating in human development.

The ASM-NSF Biology Scholars Program: An Evidence-Based Model for Faculty Development

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Amy L. Chang

2016-05-01

Full Text Available The American Society for Microbiology (ASM established its ASM-NSF (National Science Foundation Biology Scholars Program (BSP to promote undergraduate education reform by 1 supporting biologists to implement evidence-based teaching practices, 2 engaging life science professional societies to facilitate biologists’ leadership in scholarly teaching within the discipline, and 3 participating in a teaching community that fosters disciplinary-level science, technology, engineering, and mathematics (STEM reform. Since 2005, the program has utilized year-long residency training to provide a continuum of learning and practice centered on principles from the scholarship of teaching and learning (SoTL to more than 270 participants (“scholars” from biology and multiple other disciplines. Additionally, the program has recruited 11 life science professional societies to support faculty development in SoTL and discipline-based education research (DBER. To identify the BSP’s long-term outcomes and impacts, ASM engaged an external evaluator to conduct a study of the program’s 2010­–2014 scholars (n = 127 and society partners. The study methods included online surveys, focus groups, participant observation, and analysis of various documents. Study participants indicate that the program achieved its proposed goals relative to scholarship, professional society impact, leadership, community, and faculty professional development. Although participants also identified barriers that hindered elements of their BSP participation, findings suggest that the program was essential to their development as faculty and provides evidence of the BSP as a model for other societies seeking to advance undergraduate science education reform. The BSP is the longest-standing faculty development program sponsored by a collective group of life science societies. This collaboration promotes success across a fragmented system of more than 80 societies representing the life

The ASM-NSF Biology Scholars Program: An Evidence-Based Model for Faculty Development.

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Chang, Amy L; Pribbenow, Christine M

2016-05-01

The American Society for Microbiology (ASM) established its ASM-NSF (National Science Foundation) Biology Scholars Program (BSP) to promote undergraduate education reform by 1) supporting biologists to implement evidence-based teaching practices, 2) engaging life science professional societies to facilitate biologists' leadership in scholarly teaching within the discipline, and 3) participating in a teaching community that fosters disciplinary-level science, technology, engineering, and mathematics (STEM) reform. Since 2005, the program has utilized year-long residency training to provide a continuum of learning and practice centered on principles from the scholarship of teaching and learning (SoTL) to more than 270 participants ("scholars") from biology and multiple other disciplines. Additionally, the program has recruited 11 life science professional societies to support faculty development in SoTL and discipline-based education research (DBER). To identify the BSP's long-term outcomes and impacts, ASM engaged an external evaluator to conduct a study of the program's 2010-2014 scholars (n = 127) and society partners. The study methods included online surveys, focus groups, participant observation, and analysis of various documents. Study participants indicate that the program achieved its proposed goals relative to scholarship, professional society impact, leadership, community, and faculty professional development. Although participants also identified barriers that hindered elements of their BSP participation, findings suggest that the program was essential to their development as faculty and provides evidence of the BSP as a model for other societies seeking to advance undergraduate science education reform. The BSP is the longest-standing faculty development program sponsored by a collective group of life science societies. This collaboration promotes success across a fragmented system of more than 80 societies representing the life sciences and helps

New Horned Dinosaurs from Utah Provide Evidence for Intracontinental Dinosaur Endemism

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Sampson, Scott D.; Loewen, Mark A.; Farke, Andrew A.; Roberts, Eric M.; Forster, Catherine A.; Smith, Joshua A.; Titus, Alan L.

2010-01-01

Background During much of the Late Cretaceous, a shallow, epeiric sea divided North America into eastern and western landmasses. The western landmass, known as Laramidia, although diminutive in size, witnessed a major evolutionary radiation of dinosaurs. Other than hadrosaurs (duck-billed dinosaurs), the most common dinosaurs were ceratopsids (large-bodied horned dinosaurs), currently known only from Laramidia and Asia. Remarkably, previous studies have postulated the occurrence of latitudinally arrayed dinosaur “provinces,” or “biomes,” on Laramidia. Yet this hypothesis has been challenged on multiple fronts and has remained poorly tested. Methodology/Principal Findings Here we describe two new, co-occurring ceratopsids from the Upper Cretaceous Kaiparowits Formation of Utah that provide the strongest support to date for the dinosaur provincialism hypothesis. Both pertain to the clade of ceratopsids known as Chasmosaurinae, dramatically increasing representation of this group from the southern portion of the Western Interior Basin of North America. Utahceratops gettyi gen. et sp. nov.—characterized by short, rounded, laterally projecting supraorbital horncores and an elongate frill with a deep median embayment—is recovered as the sister taxon to Pentaceratops sternbergii from the late Campanian of New Mexico. Kosmoceratops richardsoni gen. et sp. nov.—characterized by elongate, laterally projecting supraorbital horncores and a short, broad frill adorned with ten well developed hooks—has the most ornate skull of any known dinosaur and is closely allied to Chasmosaurus irvinensis from the late Campanian of Alberta. Conclusions/Significance Considered in unison, the phylogenetic, stratigraphic, and biogeographic evidence documents distinct, co-occurring chasmosaurine taxa north and south on the diminutive landmass of Laramidia. The famous Triceratops and all other, more nested chasmosaurines are postulated as descendants of forms previously restricted

New horned dinosaurs from Utah provide evidence for intracontinental dinosaur endemism.

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Scott D Sampson

Full Text Available BACKGROUND: During much of the Late Cretaceous, a shallow, epeiric sea divided North America into eastern and western landmasses. The western landmass, known as Laramidia, although diminutive in size, witnessed a major evolutionary radiation of dinosaurs. Other than hadrosaurs (duck-billed dinosaurs, the most common dinosaurs were ceratopsids (large-bodied horned dinosaurs, currently known only from Laramidia and Asia. Remarkably, previous studies have postulated the occurrence of latitudinally arrayed dinosaur "provinces," or "biomes," on Laramidia. Yet this hypothesis has been challenged on multiple fronts and has remained poorly tested. METHODOLOGY/PRINCIPAL FINDINGS: Here we describe two new, co-occurring ceratopsids from the Upper Cretaceous Kaiparowits Formation of Utah that provide the strongest support to date for the dinosaur provincialism hypothesis. Both pertain to the clade of ceratopsids known as Chasmosaurinae, dramatically increasing representation of this group from the southern portion of the Western Interior Basin of North America. Utahceratops gettyi gen. et sp. nov.-characterized by short, rounded, laterally projecting supraorbital horncores and an elongate frill with a deep median embayment-is recovered as the sister taxon to Pentaceratops sternbergii from the late Campanian of New Mexico. Kosmoceratops richardsoni gen. et sp. nov.-characterized by elongate, laterally projecting supraorbital horncores and a short, broad frill adorned with ten well developed hooks-has the most ornate skull of any known dinosaur and is closely allied to Chasmosaurus irvinensis from the late Campanian of Alberta. CONCLUSIONS/SIGNIFICANCE: Considered in unison, the phylogenetic, stratigraphic, and biogeographic evidence documents distinct, co-occurring chasmosaurine taxa north and south on the diminutive landmass of Laramidia. The famous Triceratops and all other, more nested chasmosaurines are postulated as descendants of forms previously

Identifying an evidence-based model of therapy for the pre-hospital emergency management of supraventricular tachycardia

OpenAIRE

Smith, Gavin

2017-01-01

This thesis provides a comprehensive reporting of the work undertaken to identify evidence supporting pre-hospital management of supraventricular tachycardia (SVT), delivering an evidence base for paramedic treatment of these patients. The literature search identified absences in evidence supporting therapies used within existing clinical guidelines. The vagal manoeuvres, the simplest and least invasive therapy to employ in the stable patient, were insufficiently evidenced regarding technique...

An Organizational Model for Excellence in Healthcare Delivery: Evidence From Winners of the Baldrige Quality Award.

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Griffith, John R

Winners of the Baldrige National Quality Award in healthcare have documented top quartile clinical outcomes and patient satisfaction across a variety of American communities and a full spectrum of care. Their results also show high levels of satisfaction among physicians, nurses, and other workers, as well as effective financial performance. The managerial methods they use-collectively, the Baldrige model-are consistent with organizational theory literature and are found across all winners. The winners have sustained excellence after winning and expanded it by acquisition of other healthcare organizations.The model differs substantially from traditional management approaches in healthcare delivery. It is a comprehensive program that emphasizes a shared focus on excellence, systematically responsive management, evidence-based medicine, multidimensional measures and negotiated goals, improvement of work processes, thorough training, and extensive rewards. The model could be expanded on a much larger scale. Doing so successfully would substantially improve the quality and cost of healthcare, as well as the satisfaction and commitment of care providers and other staff. The opportunity deserves further study and trial by large healthcare delivery systems, insurers, and consulting companies.

Models of Investor Forecasting Behavior — Experimental Evidence

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Federico Bonetto

2017-12-01

Full Text Available Different forecasting behaviors affect investors’ trading decisions and lead to qualitatively different asset price trajectories. It has been shown in the literature that the weights that investors place on observed asset price changes when forecasting future price changes, and the nature of their confidence when price changes are forecast, determine whether price bubbles, price crashes, and unpredictable price cycles occur. In this paper, we report the results of behavioral experiments involving multiple investors who participated in a market for a virtual asset. Our goal is to study investors’ forecast formation. We conducted three experimental sessions with different participants in each session. We fit different models of forecast formation to the observed data. There is strong evidence that the investors forecast future prices by extrapolating past price changes, even when they know the fundamental value of the asset exactly and the extrapolated forecasts differ significantly from the fundamental value. The rational expectations hypothesis seems inconsistent with the observed forecasts. The forecasting models of all participants that best fit the observed forecasting data were of the type that cause price bubbles and cycles in dynamical systems models, and price bubbles and cycles ended up occurring in all three sessions.

Evidence of a fractional quantum Hall nematic phase in a microscopic model

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Regnault, N.; Maciejko, J.; Kivelson, S. A.; Sondhi, S. L.

2017-07-01

At small momenta, the Girvin-MacDonald-Platzman (GMP) mode in the fractional quantum Hall (FQH) effect can be identified with gapped nematic fluctuations in the isotropic FQH liquid. This correspondence would be exact as the GMP mode softens upon approach to the putative point of a quantum phase transition to a FQH nematic. Motivated by these considerations as well as by suggestive evidence of an FQH nematic in tilted field experiments, we have sought evidence of such a nematic FQHE in a microscopic model of interacting electrons in the lowest Landau level at filling factor 1/3. Using a family of anisotropic Laughlin states as trial wave functions, we find a continuous quantum phase transition between the isotropic Laughlin liquid and the FQH nematic. Results of numerical exact diagonalization also suggest that rotational symmetry is spontaneously broken, and that the phase diagram of the model contains both a nematic and a stripe phase.

Interventions to increase recommendation and delivery of screening for breast, cervical, and colorectal cancers by healthcare providers systematic reviews of provider assessment and feedback and provider incentives.

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Sabatino, Susan A; Habarta, Nancy; Baron, Roy C; Coates, Ralph J; Rimer, Barbara K; Kerner, Jon; Coughlin, Steven S; Kalra, Geetika P; Chattopadhyay, Sajal

2008-07-01

Most major medical organizations recommend routine screening for breast, cervical, and colorectal cancers. Screening can lead to early detection of these cancers, resulting in reduced mortality. Yet not all people who should be screened are screened, either regularly or, in some cases, ever. This report presents results of systematic reviews of effectiveness, applicability, economic efficiency, barriers to implementation, and other harms or benefits of two provider-directed intervention approaches to increase screening for breast, cervical, and colorectal cancers. These approaches, provider assessment and feedback, and provider incentives encourage providers to deliver screening services at appropriate intervals. Evidence in these reviews indicates that provider assessment and feedback interventions can effectively increase screening by mammography, Pap test, and fecal occult blood test. Health plans, healthcare systems, and cancer control coalitions should consider such evidence-based findings when implementing interventions to increase screening use. Evidence was insufficient to determine the effectiveness of provider incentives in increasing use of any of these tests. Specific areas for further research are suggested in this report, including the need for additional research to determine whether provider incentives are effective in increasing use of any of these screening tests, and whether assessment and feedback interventions are effective in increasing other tests for colorectal cancer (i.e., flexible sigmoidoscopy, colonoscopy, or double-contrast barium enema).

From Theory to Practice: One Agency's Experience with Implementing an Evidence-Based Model.

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Murray, Maureen; Culver, Tom; Farmer, Betsy; Jackson, Leslie Ann; Rixon, Brian

2014-07-01

As evidence-based practice is becoming integrated into children's mental health services as a means of improving outcomes for children and youth with severe behavioral and emotional problems, therapeutic foster care (TFC) which is a specialized treatment program for such youth, is one of few community-based programs considered to be evidence-based. "Together Facing the Challenge" (TFTC) which was developed as a component of a randomized trial of TFC has been identified as an evidence-based model. We describe the experiences reported by one of the agencies that participated in our study and how they have incorporated TFTC into their on-going practice. They highlight key implementation strategies, challenges faced, and lessons learned as they moved forward towards full implementation of TFTC throughout their agency.

Understanding the roles of faith-based health-care providers in Africa: review of the evidence with a focus on magnitude, reach, cost, and satisfaction.

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Olivier, Jill; Tsimpo, Clarence; Gemignani, Regina; Shojo, Mari; Coulombe, Harold; Dimmock, Frank; Nguyen, Minh Cong; Hines, Harrison; Mills, Edward J; Dieleman, Joseph L; Haakenstad, Annie; Wodon, Quentin

2015-10-31

At a time when many countries might not achieve the health targets of the Millennium Development Goals and the post-2015 agenda for sustainable development is being negotiated, the contribution of faith-based health-care providers is potentially crucial. For better partnership to be achieved and for health systems to be strengthened by the alignment of faith-based health-providers with national systems and priorities, improved information is needed at all levels. Comparisons of basic factors (such as magnitude, reach to poor people, cost to patients, modes of financing, and satisfaction of patients with the services received) within faith-based health-providers and national systems show some differences. As the first report in the Series on faith-based health care, we review a broad body of published work and introduce some empirical evidence on the role of faith-based health-care providers, with a focus on Christian faith-based health providers in sub-Saharan Africa (on which the most detailed documentation has been gathered). The restricted and diverse evidence reported supports the idea that faith-based health providers continue to play a part in health provision, especially in fragile health systems, and the subsequent reports in this Series review controversies in faith-based health care and recommendations for how public and faith sectors might collaborate more effectively. Copyright © 2015 Elsevier Ltd. All rights reserved.

Blood-brain barrier alterations provide evidence of subacute diaschisis in an ischemic stroke rat model.

Directory of Open Access Journals (Sweden)

Svitlana Garbuzova-Davis

Full Text Available Comprehensive stroke studies reveal diaschisis, a loss of function due to pathological deficits in brain areas remote from initial ischemic lesion. However, blood-brain barrier (BBB competence in subacute diaschisis is uncertain. The present study investigated subacute diaschisis in a focal ischemic stroke rat model. Specific focuses were BBB integrity and related pathogenic processes in contralateral brain areas.In ipsilateral hemisphere 7 days after transient middle cerebral artery occlusion (tMCAO, significant BBB alterations characterized by large Evans Blue (EB parenchymal extravasation, autophagosome accumulation, increased reactive astrocytes and activated microglia, demyelinization, and neuronal damage were detected in the striatum, motor and somatosensory cortices. Vascular damage identified by ultrastuctural and immunohistochemical analyses also occurred in the contralateral hemisphere. In contralateral striatum and motor cortex, major ultrastructural BBB changes included: swollen and vacuolated endothelial cells containing numerous autophagosomes, pericyte degeneration, and perivascular edema. Additionally, prominent EB extravasation, increased endothelial autophagosome formation, rampant astrogliosis, activated microglia, widespread neuronal pyknosis and decreased myelin were observed in contralateral striatum, and motor and somatosensory cortices.These results demonstrate focal ischemic stroke-induced pathological disturbances in ipsilateral, as well as in contralateral brain areas, which were shown to be closely associated with BBB breakdown in remote brain microvessels and endothelial autophagosome accumulation. This microvascular damage in subacute phase likely revealed ischemic diaschisis and should be considered in development of treatment strategies for stroke.

An evidence-based health workforce model for primary and community care

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Leach Matthew J

2011-08-01

Full Text Available Abstract Background The delivery of best practice care can markedly improve clinical outcomes in patients with chronic disease. While the provision of a skilled, multidisciplinary team is pivotal to the delivery of best practice care, the occupational or skill mix required to deliver this care is unclear; it is also uncertain whether such a team would have the capacity to adequately address the complex needs of the clinic population. This is the role of needs-based health workforce planning. The objective of this article is to describe the development of an evidence-informed, needs-based health workforce model to support the delivery of best-practice interdisciplinary chronic disease management in the primary and community care setting using diabetes as a case exemplar. Discussion Development of the workforce model was informed by a strategic review of the literature, critical appraisal of clinical practice guidelines, and a consensus elicitation technique using expert multidisciplinary clinical panels. Twenty-four distinct patient attributes that require unique clinical competencies for the management of diabetes in the primary care setting were identified. Patient attributes were grouped into four major themes and developed into a conceptual model: the Workforce Evidence-Based (WEB planning model. The four levels of the WEB model are (1 promotion, prevention, and screening of the general or high-risk population; (2 type or stage of disease; (3 complications; and (4 threats to self-care capacity. Given the number of potential combinations of attributes, the model can account for literally millions of individual patient types, each with a distinct clinical team need, which can be used to estimate the total health workforce requirement. Summary The WEB model was developed in a way that is not only reflective of the diversity in the community and clinic populations but also parsimonious and clear to present and operationalize. A key feature of the

Modelling distribution of archaeological settlement evidence based on heterogeneous spatial and temporal data

Czech Academy of Sciences Publication Activity Database

Demján, P.; Dreslerová, Dagmar

2016-01-01

Roč. 69, May (2016), s. 100-109 ISSN 0305-4403 Institutional support: RVO:67985912 Keywords : settlement density * evidence density estimation * predictive modelling * prehistory * large datasets Subject RIV: AC - Archeology, Anthropology, Ethnology Impact factor: 2.602, year: 2016

MODEL OF PROVIDING WITH DEVELOPMENT STRATEGY FOR INFORMATION TECHNOLOGIES IN AN ORGANIZATION

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A. A. Kuzkin

2015-03-01

Full Text Available Subject of research. The paper presents research and instructional tools for assessment of providing with the development strategy for information technologies in an organization. Method. The corresponding assessment model is developed which takes into consideration IT-processes equilibrium according to selected efficiency factors of information technologies application. Basic results. The model peculiarity resides in applying neuro-fuzzy approximators where the conclusion is drawn upon fuzzy logic, and membership functions are adjusted through the use of neural networks. For the adequacy testing of the suggested model, due diligence result analysis has been carried out for the IT-strategy executed in the “Navigator” group of companies at the stage of implementation and support of new technologies and production methods. Data visualization with a circle diagram is applied for the comparative evaluation of the analysis results. The chosen model adequacy is proved by the agreement between predictive assessments for IT-strategy performance targets derived by means of the fuzzy cognitive model over 12 months planning horizon and the real values of these targets upon the expiry of the given planning term. Practical significance. The developed model application gives the possibility to solve the problem of sustainability assessment for the process of providing the required IT-strategy realization level based upon the fuzzy cognitive map analysis and to reveal IT-objectives changing tendencies for an organization over the stated planning interval.

A stochastic multicriteria model for evidence-based decision making in drug benefit-risk analysis.

Science.gov (United States)

Tervonen, Tommi; van Valkenhoef, Gert; Buskens, Erik; Hillege, Hans L; Postmus, Douwe

2011-05-30

Drug benefit-risk (BR) analysis is based on firm clinical evidence regarding various safety and efficacy outcomes. In this paper, we propose a new and more formal approach for constructing a supporting multi-criteria model that fully takes into account the evidence on efficacy and adverse drug reactions. Our approach is based on the stochastic multi-criteria acceptability analysis methodology, which allows us to compute the typical value judgments that support a decision, to quantify decision uncertainty, and to compute a comprehensive BR profile. We construct a multi-criteria model for the therapeutic group of second-generation antidepressants. We assess fluoxetine and venlafaxine together with placebo according to incidence of treatment response and three common adverse drug reactions by using data from a published study. Our model shows that there are clear trade-offs among the treatment alternatives. Copyright © 2011 John Wiley & Sons, Ltd.

Reliability constrained decision model for energy service provider incorporating demand response programs

International Nuclear Information System (INIS)

Mahboubi-Moghaddam, Esmaeil; Nayeripour, Majid; Aghaei, Jamshid

2016-01-01

Highlights: • The operation of Energy Service Providers (ESPs) in electricity markets is modeled. • Demand response as the cost-effective solution is used for energy service provider. • The market price uncertainty is modeled using the robust optimization technique. • The reliability of the distribution network is embedded into the framework. • The simulation results demonstrate the benefits of robust framework for ESPs. - Abstract: Demand response (DR) programs are becoming a critical concept for the efficiency of current electric power industries. Therefore, its various capabilities and barriers have to be investigated. In this paper, an effective decision model is presented for the strategic behavior of energy service providers (ESPs) to demonstrate how to participate in the day-ahead electricity market and how to allocate demand in the smart distribution network. Since market price affects DR and vice versa, a new two-step sequential framework is proposed, in which unit commitment problem (UC) is solved to forecast the expected locational marginal prices (LMPs), and successively DR program is applied to optimize the total cost of providing energy for the distribution network customers. This total cost includes the cost of purchased power from the market and distributed generation (DG) units, incentive cost paid to the customers, and compensation cost of power interruptions. To obtain compensation cost, the reliability evaluation of the distribution network is embedded into the framework using some innovative constraints. Furthermore, to consider the unexpected behaviors of the other market participants, the LMP prices are modeled as the uncertainty parameters using the robust optimization technique, which is more practical compared to the conventional stochastic approach. The simulation results demonstrate the significant benefits of the presented framework for the strategic performance of ESPs.

Forensic Evidence Identification and Modeling for Attacks against a Simulated Online Business Information System

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Manghui Tu

2012-12-01

Full Text Available Forensic readiness can support future forensics investigation or auditing on external/internal attacks, internal sabotage and espionage, and business frauds. To establish forensics readiness, it is essential for an organization to identify what evidences are relevant and where they can be found, to determine whether they are logged in a forensic sound way and whether all the needed evidences are available to reconstruct the events successfully.  Our goal of this research is to ensure evidence availability. First, both external and internal attacks are molded as augmented attack trees/graphs based on the system vulnerabilities. Second, modeled attacks are conducted against a honeynet simulating an online business information system, and each honeypot's hard drive is forensic sound imaged for each individual attack. Third, an evidence tree/graph will be built after forensics examination on the disk images for each attack. The evidence trees/graphs are expected to be used for automatic crime scene reconstruction and automatic attack/fraud detection in the future.

Novel mitochondrial extensions provide evidence for a link between microtubule-directed movement and mitochondrial fission

International Nuclear Information System (INIS)

Bowes, Timothy; Gupta, Radhey S.

2008-01-01

Mitochondrial dynamics play an important role in a large number of cellular processes. Previously, we reported that treatment of mammalian cells with the cysteine-alkylators, N-ethylmaleimide and ethacrynic acid, induced rapid mitochondrial fusion forming a large reticulum approximately 30 min after treatment. Here, we further investigated this phenomenon using a number of techniques including live-cell confocal microscopy. In live cells, drug-induced fusion coincided with a cessation of fast mitochondrial movement which was dependent on microtubules. During this loss of movement, thin mitochondrial tubules extending from mitochondria were also observed, which we refer to as 'mitochondrial extensions'. The formation of these mitochondrial extensions, which were not observed in untreated cells, depended on microtubules and was abolished by pretreatment with nocodazole. In this study, we provide evidence that these extensions result from of a block in mitochondrial fission combined with continued application of motile force by microtubule-dependent motor complexes. Our observations strongly suggest the existence of a link between microtubule-based mitochondrial trafficking and mitochondrial fission

Research utilization among children's mental health providers

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Ferguson H Bruce

2008-04-01

Full Text Available Abstract Background Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP relies, in part, on the research utilization practices of mental health care providers. This study reports on a survey of research utilization practices among 80 children's mental health (CMH service provider organizations in Ontario, Canada. Methods A web-based survey was distributed to 80 CMH service provider organizations, to which 51 executive directors and 483 children's mental health practitioners responded. Research utilization was assessed using questions with Likert-type responses based on the Canadian Health Services Research Foundation's Four-A's approach: access, assess, adapt, apply. Results There was general agreement among executive directors and practitioners regarding the capacity of their organizations to use – access, assess, adapt, and apply – research evidence. Overall, both groups rated their organizations as using research information 'somewhat well.' The low response rate to the practitioner survey should be noted. Conclusion These findings provide a useful benchmark from which changes in reported research utilization in the Ontario CMH sector can be tracked over time, as a function of EBP training and implementation initiatives, for instance. The need to improve access to research evidence should be addressed because it relates to the eventual implementation and uptake of evidence-based practices. Communities of practice are recommended as a strategy that would enable practitioners to build capacity in their adaptation and application of research evidence.

Research utilization among children's mental health providers.

Science.gov (United States)

Barwick, Melanie A; Boydell, Katherine M; Stasiulis, Elaine; Ferguson, H Bruce; Blase, Karen; Fixsen, Dean

2008-04-09

Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP) relies, in part, on the research utilization practices of mental health care providers. This study reports on a survey of research utilization practices among 80 children's mental health (CMH) service provider organizations in Ontario, Canada. A web-based survey was distributed to 80 CMH service provider organizations, to which 51 executive directors and 483 children's mental health practitioners responded. Research utilization was assessed using questions with Likert-type responses based on the Canadian Health Services Research Foundation's Four-A's approach: access, assess, adapt, apply. There was general agreement among executive directors and practitioners regarding the capacity of their organizations to use - access, assess, adapt, and apply - research evidence. Overall, both groups rated their organizations as using research information 'somewhat well.' The low response rate to the practitioner survey should be noted. These findings provide a useful benchmark from which changes in reported research utilization in the Ontario CMH sector can be tracked over time, as a function of EBP training and implementation initiatives, for instance. The need to improve access to research evidence should be addressed because it relates to the eventual implementation and uptake of evidence-based practices. Communities of practice are recommended as a strategy that would enable practitioners to build capacity in their adaptation and application of research evidence.

The Market for Television Advertising: Model and Evidence

OpenAIRE

Robert Kieschnick; B. McCullough; Steven Wildman

2001-01-01

We provide a model of television advertising based on an explicit characterization of an advertisement's contribution to an advertiser's profits that suggests that each program faces a downward sloping demand for its ad time. Hence Fournier and Martin's (1983) "law of one price" does not hold in our model. We study these contrasting arguments about television advertising by examining the pricing of broadcast network advertising. In conducting this empirical examination we encounter and solve ...

Microtubules provide directional information for core PCP function

Science.gov (United States)

Matis, Maja; Russler-Germain, David A; Hu, Qie; Tomlin, Claire J; Axelrod, Jeffrey D

2014-01-01

Planar cell polarity (PCP) signaling controls the polarization of cells within the plane of an epithelium. Two molecular modules composed of Fat(Ft)/Dachsous(Ds)/Four-jointed(Fj) and a ‘PCP-core’ including Frizzled(Fz) and Dishevelled(Dsh) contribute to polarization of individual cells. How polarity is globally coordinated with tissue axes is unresolved. Consistent with previous results, we find that the Ft/Ds/Fj-module has an effect on a MT-cytoskeleton. Here, we provide evidence for the model that the Ft/Ds/Fj-module provides directional information to the core-module through this MT organizing function. We show Ft/Ds/Fj-dependent initial polarization of the apical MT-cytoskeleton prior to global alignment of the core-module, reveal that the anchoring of apical non-centrosomal MTs at apical junctions is polarized, observe that directional trafficking of vesicles containing Dsh depends on Ft, and demonstrate the feasibility of this model by mathematical simulation. Together, these results support the hypothesis that Ft/Ds/Fj provides a signal to orient core PCP function via MT polarization. DOI: http://dx.doi.org/10.7554/eLife.02893.001 PMID:25124458

Bank Bailouts and Moral Hazard : Evidence from Germany

NARCIS (Netherlands)

Dam, L.; Koetter, M.

We use a structural econometric model to provide empirical evidence that safety nets in the banking industry lead to additional risk taking. To identify the moral hazard effect of bailout expectations on bank risk, we exploit the fact that regional political factors explain bank bailouts but not

Guide to Working with Model Providers.

Science.gov (United States)

Walter, Katie; Hassel, Bryan C.

Often a central feature of a school's improvement efforts is the adoption of a Comprehensive School Reform (CSR) model, an externally developed research-based design for school improvement. Adopting a model is only the first step in CSR. Another important step is forging partnerships with developers of CSR models. This guide aims to help schools…

A Practical Probabilistic Graphical Modeling Tool for Weighing ...

Science.gov (United States)

Past weight-of-evidence frameworks for adverse ecological effects have provided soft-scoring procedures for judgments based on the quality and measured attributes of evidence. Here, we provide a flexible probabilistic structure for weighing and integrating lines of evidence for ecological risk determinations. Probabilistic approaches can provide both a quantitative weighing of lines of evidence and methods for evaluating risk and uncertainty. The current modeling structure wasdeveloped for propagating uncertainties in measured endpoints and their influence on the plausibility of adverse effects. To illustrate the approach, we apply the model framework to the sediment quality triad using example lines of evidence for sediment chemistry measurements, bioassay results, and in situ infauna diversity of benthic communities using a simplified hypothetical case study. We then combine the three lines evidence and evaluate sensitivity to the input parameters, and show how uncertainties are propagated and how additional information can be incorporated to rapidly update the probability of impacts. The developed network model can be expanded to accommodate additional lines of evidence, variables and states of importance, and different types of uncertainties in the lines of evidence including spatial and temporal as well as measurement errors. We provide a flexible Bayesian network structure for weighing and integrating lines of evidence for ecological risk determinations

Supporting patients in obtaining and oncologists in providing evidence-based health-related quality of life information prior to and after esophageal cancer surgery

NARCIS (Netherlands)

Jacobs, M.

2015-01-01

The overall aim of this thesis was to support patients in obtaining and oncologists in providing evidence-based HRQL data prior to and following esophageal cancer surgery. This thesis is divided in two parts. In Part I, we addressed the information needs of esophageal cancer patients prior to and

EPR: Evidence and fallacy.

Science.gov (United States)

Nichols, Joseph W; Bae, You Han

2014-09-28

The enhanced permeability and retention (EPR) of nanoparticles in tumors has long stood as one of the fundamental principles of cancer drug delivery, holding the promise of safe, simple and effective therapy. By allowing particles preferential access to tumors by virtue of size and longevity in circulation, EPR provided a neat rationale for the trend toward nano-sized drug carriers. Following the discovery of the phenomenon by Maeda in the mid-1980s, this rationale appeared to be well justified by the flood of evidence from preclinical studies and by the clinical success of Doxil. Clinical outcomes from nano-sized drug delivery systems, however, have indicated that EPR is not as reliable as previously thought. Drug carriers generally fail to provide superior efficacy to free drug systems when tested in clinical trials. A closer look reveals that EPR-dependent drug delivery is complicated by high tumor interstitial fluid pressure (IFP), irregular vascular distribution, and poor blood flow inside tumors. Furthermore, the animal tumor models used to study EPR differ from clinical tumors in several key aspects that seem to make EPR more pronounced than in human patients. On the basis of this evidence, we believe that EPR should only be invoked on a case-by-case basis, when clinical evidence suggests the tumor type is susceptible. Copyright © 2014 Elsevier B.V. All rights reserved.

Metacognition and evidence analysis instruction: an educational framework and practical experience.

Science.gov (United States)

Parrott, J Scott; Rubinstein, Matthew L

2015-08-21

The role of metacognitive skills in the evidence analysis process has received little attention in the research literature. While the steps of the evidence analysis process are well defined, the role of higher-level cognitive operations (metacognitive strategies) in integrating the steps of the process is not well understood. In part, this is because it is not clear where and how metacognition is implicated in the evidence analysis process nor how these skills might be taught. The purposes of this paper are to (a) suggest a model for identifying critical thinking and metacognitive skills in evidence analysis instruction grounded in current educational theory and research and (b) demonstrate how freely available systematic review/meta-analysis tools can be used to focus on higher-order metacognitive skills, while providing a framework for addressing common student weaknesses. The final goal of this paper is to provide an instructional framework that can generate critique and elaboration while providing the conceptual basis and rationale for future research agendas on this topic.

Reconstructing an f(R) model from holographic dark energy: using the observational evidence

International Nuclear Information System (INIS)

Saaidi, Kh; Aghamohammadi, A

2012-01-01

We investigate the correspondence relation between f(R) gravity and an interacting holographic dark energy (HDE). By obtaining the conditions needed for some observational evidence such as positive acceleration expansion of the Universe, crossing the phantom divide line and validity of the thermodynamics second law in an interacting HDE model and corresponding it with the f(R) model of gravity, we find a viable f(R) model that can explain the present Universe. We also obtain the explicit evolutionary forms of the corresponding scalar field, potential and scale factor of the Universe. (paper)

runjags: An R Package Providing Interface Utilities, Model Templates, Parallel Computing Methods and Additional Distributions for MCMC Models in JAGS

Directory of Open Access Journals (Sweden)

Matthew J. Denwood

2016-07-01

Full Text Available The runjags package provides a set of interface functions to facilitate running Markov chain Monte Carlo models in JAGS from within R. Automated calculation of appropriate convergence and sample length diagnostics, user-friendly access to commonly used graphical outputs and summary statistics, and parallelized methods of running JAGS are provided. Template model specifications can be generated using a standard lme4-style formula interface to assist users less familiar with the BUGS syntax. Automated simulation study functions are implemented to facilitate model performance assessment, as well as drop-k type cross-validation studies, using high performance computing clusters such as those provided by parallel. A module extension for JAGS is also included within runjags, providing the Pareto family of distributions and a series of minimally-informative priors including the DuMouchel and half-Cauchy priors. This paper outlines the primary functions of this package, and gives an illustration of a simulation study to assess the sensitivity of two equivalent model formulations to different prior distributions.

Implementing three evidence-based program models: early lessons from the Teen Pregnancy Prevention Replication Study.

Science.gov (United States)

Kelsey, Meredith; Layzer, Jean

2014-03-01

This article describes some of the early implementation challenges faced by nine grantees participating in the Teen Pregnancy Prevention Replication Study and their response to them. The article draws on information collected as part of a comprehensive implementation study. Sources include site and program documents; program officer reports; notes from site investigation, selection and negotiation; ongoing communications with grantees as part of putting the study into place; and semi-structured interviews with program staff. The issues faced by grantees in implementing evidence-based programs designed to prevent teen pregnancy varied by program model. Grantees implementing a classroom-based curriculum faced challenges in delivering the curriculum within the constraints of school schedules and calendars (program length and size of class). Grantees implementing a culturally tailored curriculum faced a series of challenges, including implementing the intervention as part of the regular school curriculum in schools with diverse populations; low attendance when delivered as an after-school program; and resistance on the part of schools to specific curriculum content. The third set of grantees, implementing a program in clinics, faced challenges in identifying and recruiting young women into the program and in retaining young women once they were in the program. The experiences of these grantees reflect some of the complexities that should be carefully considered when choosing to replicate evidence-based programs. The Teen Pregnancy Prevention replication study will provide important context for assessing the effectiveness of some of the more widely replicated evidence-based programs. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Using Toxicological Evidence from QSAR Models in Practice

Science.gov (United States)

The new generation of QSAR models provides supporting documentation in addition to the predicted toxicological value. Such information enables the toxicologist to explore the properties of chemical substances and to review and increase the reliability of toxicity predictions. Thi...

Evidence-based librarianship: searching for the needed EBL evidence.

Science.gov (United States)

Eldredge, J D

2000-01-01

This paper discusses the challenges of finding evidence needed to implement Evidence-Based Librarianship (EBL). Focusing first on database coverage for three health sciences librarianship journals, the article examines the information contents of different databases. Strategies are needed to search for relevant evidence in the library literature via these databases, and the problems associated with searching the grey literature of librarianship. Database coverage, plausible search strategies, and the grey literature of library science all pose challenges to finding the needed research evidence for practicing EBL. Health sciences librarians need to ensure that systems are designed that can track and provide access to needed research evidence to support Evidence-Based Librarianship (EBL).

Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence.

Science.gov (United States)

Javadi, D; Feldhaus, I; Mancuso, A; Ghaffar, A

2017-01-01

This paper seeks to review the available evidence to determine whether a systems approach is employed in the implementation and evaluation of task shifting for mental health using lay providers in low- and middle-income countries, and to highlight system-wide effects of task-shifting strategies in order to better inform efforts to strength community mental health systems. Pubmed, CINAHL, and Cochrane Library databases were searched. Articles were screened by two independent reviewers with a third reviewer resolving discrepancies. Two stages of screens were done to ensure sensitivity. Studies were analysed using the World Health Organization's building blocks framework with the addition of a community building block, and systems thinking characteristics to determine the extent to which system-wide effects had been considered. Thirty studies were included. Almost all studies displayed positive findings on mental health using task shifting. One study showed no effect. No studies explicitly employed systems thinking tools, but some demonstrated systems thinking characteristics, such as exploring various stakeholder perspectives, capturing unintended consequences, and looking across sectors for system-wide impact. Twenty-five of the 30 studies captured elements other than the most directly relevant building blocks of service delivery and health workforce. There is a lack of systematic approaches to exploring complexity in the evaluation of task-shifting interventions. Systems thinking tools should support evidence-informed decision making for a more complete understanding of community-based systems strengthening interventions for mental health.

An Ensemble Deep Convolutional Neural Network Model with Improved D-S Evidence Fusion for Bearing Fault Diagnosis.

Science.gov (United States)

Li, Shaobo; Liu, Guokai; Tang, Xianghong; Lu, Jianguang; Hu, Jianjun

2017-07-28

Intelligent machine health monitoring and fault diagnosis are becoming increasingly important for modern manufacturing industries. Current fault diagnosis approaches mostly depend on expert-designed features for building prediction models. In this paper, we proposed IDSCNN, a novel bearing fault diagnosis algorithm based on ensemble deep convolutional neural networks and an improved Dempster-Shafer theory based evidence fusion. The convolutional neural networks take the root mean square (RMS) maps from the FFT (Fast Fourier Transformation) features of the vibration signals from two sensors as inputs. The improved D-S evidence theory is implemented via distance matrix from evidences and modified Gini Index. Extensive evaluations of the IDSCNN on the Case Western Reserve Dataset showed that our IDSCNN algorithm can achieve better fault diagnosis performance than existing machine learning methods by fusing complementary or conflicting evidences from different models and sensors and adapting to different load conditions.

The Leadville Mine Drainage Tunnel Catastrophe: A Case Study of How Isotope Geochemistry Provided Forensic Evidence to Inform Policy Decisions

Science.gov (United States)

Williams, M. W.; Wireman, M.; Liu, F.; Gertson, J.

2008-12-01

A state of emergency was declared in February 2008 because of fears that a blocked drainage tunnel in the Leadville mining district of Colorado could cause a catastrophic flood. An estimated 1 billion gallons of metals-laden water poses an eminent threat to the city of Leadville and the headwaters of the Arkansas river. Within days of the declaration of a state of emergency, Governor Ritter and Senator Salazer of Colorado, along with a host of other local and statewide politicians, visited the site and emphasized the need to develop a fast yet safe mitigation plan. Here we provide information from a case study that illustrates how a suite of isotopic and hydrologic tools enables identification of critical, site-specific variables essential in developing a science plan to guide targeted remediation of the Leadville drainage tunnel. The isotopic tools, including both stable and radiogenic isotopes, provided clear and compelling evidence of water sources and flowpaths in an area that has undergone extensive perturbations, including the drilling of more than 2,000 mine shafts. This forensic evidence was the key information in developing a plan to plug the drainage tunnel several hundred feet underground, divert a major source of polluted water from reaching the collapsed tunnel and piping it to an existing treatment plant, and guidance on where to place pumps in additional mine shafts, and the drilling of new wells to pump water in case the plugging of the tunnel caused water to pool up and raise the water table to dangerous heights. This particular case of forensic hydrology using isotopic tools not only provides the scientific basis for an operational plan to defuse a life- and property-threatening situation, it also provides the basis for decommissioning an existing water treatment plant, which will result in savings of over 1 million annually in operational costs. Decommissioning the existing water treatment plant will pay for the tunnel mitigation within several

Recognising Informal Elearning with Digital Badging: Evidence for a Sustainable Business Model

Science.gov (United States)

Law, Patrina

2015-01-01

Digital badging as a trend in education is now recognised. It offers a way to reward and motivate, providing evidence of skills and achievements. Badged Open Courses (BOCs) were piloted by The Open University (OU) in 2013. The project built on research into the motivations and profiles of learners using free educational resources which the OU…

Beliefs and implementation of evidence-based practice among nurses and allied healthcare providers in the Valais hospital, Switzerland.

Science.gov (United States)

Verloo, Henk; Desmedt, Mario; Morin, Diane

2017-02-01

Evidence-based practice (EBP) is upheld as a means for patients to receive the most efficient care in a given context. Despite the available evidence and positive beliefs about it, implementing EBP as standard daily practice still faces many obstacles. This study investigated the beliefs about and implementation of EBP among nurses and allied healthcare providers (AHP) in 9 acute care hospitals in the canton of Valais, Switzerland. A cross-sectional descriptive survey was conducted. The target population was composed of 1899 nurses and 126 AHPs. Beliefs about and implementation of EBP were measured using EBP-Beliefs and EBP-Implementation scales of Melnyk et al. The initial sample consisted in 491 participants (overall response rate 24.2%): 421 nurses (22.4% response rate) and 78 AHPs (61.9% response rate). The final sample, composed only of those who declared previous exposure to EBP, included 391 participants (329 nurses and 62 AHPs). Overall, participants had positive attitudes towards EBP and were willing to increase their knowledge to guide practice. However, they acknowledged poor implementation of EBP in daily practice. A significantly higher level of EBP implementation was declared by those formally trained in it (P = 0.006) and by those occupying more senior professional functions (P = 0.004). EBP-Belief scores predicted 13% of the variance in the EBP-Implementation scores (R 2  = 0.13). EBP is poorly implemented despite positive beliefs about it. Continuing education and support on EBP would help to ensure that patients receive the best available care based on high-quality evidence, patient needs, clinical expertise, and a fair distribution of healthcare resources. This study's results will be used to guide institutional strategy to increase the use of EBP in daily practice. © 2016 John Wiley & Sons, Ltd.

Provider report of the existence of detection and care of perinatal depression: quantitative evidence from public obstetric units in Mexico

Directory of Open Access Journals (Sweden)

Filipa de Castro

2016-07-01

Full Text Available Objective. To provide evidence on perinatal mental healthcare in Mexico. Materials and methods. Descriptive and bivariate analyses of data from a cross-sectional probabilistic survey of 211 public obstetric units. Results. Over half (64.0% of units offer mental healthcare; fewer offer perinatal depression (PND detection (37.1% and care (40.3%. More units had protocols/guidelines for PND detection and for care, respectively, in Mexico City-Mexico state (76.7%; 78.1% than in Southern (26.5%; 36.4%, Northern (27.3%; 28.1% and Central Mexico (50.0%; 52.7%. Conclusion. Protocols and provider training in PND, implementation of brief screening tools and psychosocial interventions delivered by non-clinical personnel are needed.      DOI: http://dx.doi.org/10.21149/spm.v58i4.8028

The Quest for Evidence for Proton Therapy: Model-Based Approach and Precision Medicine

Energy Technology Data Exchange (ETDEWEB)

Widder, Joachim, E-mail: j.widder@umcg.nl [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Schaaf, Arjen van der [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Lambin, Philippe [Department of Radiation Oncology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht (Netherlands); Marijnen, Corrie A.M. [Department of Radiation Oncology, Leiden University Medical Center, Leiden (Netherlands); Pignol, Jean-Philippe [Department of Radiation Oncology, Erasmus Medical Center Cancer Institute, Rotterdam (Netherlands); Rasch, Coen R. [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands); Slotman, Ben J. [Department of Radiation Oncology, VU Medical Center, Amsterdam (Netherlands); Verheij, Marcel [Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam (Netherlands); Langendijk, Johannes A. [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands)

2016-05-01

Purpose: Reducing dose to normal tissues is the advantage of protons versus photons. We aimed to describe a method for translating this reduction into a clinically relevant benefit. Methods and Materials: Dutch scientific and health care governance bodies have recently issued landmark reports regarding generation of relevant evidence for new technologies in health care including proton therapy. An approach based on normal tissue complication probability (NTCP) models has been adopted to select patients who are most likely to experience fewer (serious) adverse events achievable by state-of-the-art proton treatment. Results: By analogy with biologically targeted therapies, the technology needs to be tested in enriched cohorts of patients exhibiting the decisive predictive marker: difference in normal tissue dosimetric signatures between proton and photon treatment plans. Expected clinical benefit is then estimated by virtue of multifactorial NTCP models. In this sense, high-tech radiation therapy falls under precision medicine. As a consequence, randomizing nonenriched populations between photons and protons is predictably inefficient and likely to produce confusing results. Conclusions: Validating NTCP models in appropriately composed cohorts treated with protons should be the primary research agenda leading to urgently needed evidence for proton therapy.

Experimental evidence for an optical interference model for vibrational sum frequency generation on multilayer organic thin film systems. I. Electric dipole approximation

International Nuclear Information System (INIS)

O’Brien, Daniel B.; Massari, Aaron M.

2015-01-01

In the field of vibrational sum frequency generation spectroscopy (VSFG) applied to organic thin film systems, a significant challenge to data analysis is in the accurate description of optical interference effects. Herein, we provide experimental evidence that a model recently developed in our lab provides an accurate description of this phenomenon. We studied the organic small molecule N,N′-dioctyl-3,4,9,10-perylenedicarboximide vapor deposited as a thickness gradient on silicon wafer substrates with two oxide thicknesses and two surface preps. VSFG data were obtained using the ssp and the sps polarization combinations in the imide carbonyl stretching region as a function of organic thickness. In this first of two reports, the data are modeled and interpreted within the ubiquitous electric dipole approximation for VSFG. The intrinsic sample responses are parameterized during the fitting routines while optical interference effects are simply calculated from the model using known refractive indices, thin film thicknesses, and beam angles. The results indicate that the thin film model provides a good description of optical interferences, indicating that interfacial terms are significant. Inconsistencies between the fitting results within the bounds of the electric dipole response motivate deliberation for additional effects to be considered in the second report

Experimental evidence for an optical interference model for vibrational sum frequency generation on multilayer organic thin film systems. I. Electric dipole approximation.

Science.gov (United States)

O'Brien, Daniel B; Massari, Aaron M

2015-01-14

In the field of vibrational sum frequency generation spectroscopy (VSFG) applied to organic thin film systems, a significant challenge to data analysis is in the accurate description of optical interference effects. Herein, we provide experimental evidence that a model recently developed in our lab provides an accurate description of this phenomenon. We studied the organic small molecule N,N'-dioctyl-3,4,9,10-perylenedicarboximide vapor deposited as a thickness gradient on silicon wafer substrates with two oxide thicknesses and two surface preps. VSFG data were obtained using the ssp and the sps polarization combinations in the imide carbonyl stretching region as a function of organic thickness. In this first of two reports, the data are modeled and interpreted within the ubiquitous electric dipole approximation for VSFG. The intrinsic sample responses are parameterized during the fitting routines while optical interference effects are simply calculated from the model using known refractive indices, thin film thicknesses, and beam angles. The results indicate that the thin film model provides a good description of optical interferences, indicating that interfacial terms are significant. Inconsistencies between the fitting results within the bounds of the electric dipole response motivate deliberation for additional effects to be considered in the second report.

Experimental evidence for an optical interference model for vibrational sum frequency generation on multilayer organic thin film systems. I. Electric dipole approximation

Energy Technology Data Exchange (ETDEWEB)

O’Brien, Daniel B.; Massari, Aaron M., E-mail: massari@umn.edu [Department of Chemistry, University of Minnesota—Twin Cities, 207 Pleasant Street SE, Minneapolis, Minnesota 55455 (United States)

2015-01-14

In the field of vibrational sum frequency generation spectroscopy (VSFG) applied to organic thin film systems, a significant challenge to data analysis is in the accurate description of optical interference effects. Herein, we provide experimental evidence that a model recently developed in our lab provides an accurate description of this phenomenon. We studied the organic small molecule N,N′-dioctyl-3,4,9,10-perylenedicarboximide vapor deposited as a thickness gradient on silicon wafer substrates with two oxide thicknesses and two surface preps. VSFG data were obtained using the ssp and the sps polarization combinations in the imide carbonyl stretching region as a function of organic thickness. In this first of two reports, the data are modeled and interpreted within the ubiquitous electric dipole approximation for VSFG. The intrinsic sample responses are parameterized during the fitting routines while optical interference effects are simply calculated from the model using known refractive indices, thin film thicknesses, and beam angles. The results indicate that the thin film model provides a good description of optical interferences, indicating that interfacial terms are significant. Inconsistencies between the fitting results within the bounds of the electric dipole response motivate deliberation for additional effects to be considered in the second report.

A critical examination of the youth foyer model for alleviating homelessness: Strengthening a promising evidence base

Directory of Open Access Journals (Sweden)

Iris Levin

2015-12-01

Full Text Available This article assesses the quality of 15 primary studies that examined the effectiveness of youth foyer or foyer-like programs on the lives of young homeless people. The youth foyer model provides an integrated approach to tackling youth homelessness, connecting affordable accommodation to training and employment. In Australia, there is growing support from government for the development and funding of foyer programs. However to date, there has been very limited development and investment in the evidence base on the effectiveness of this model in Australia or internationally. Following an extensive literature search, we argue that there is a need to lift the standard of the evidence base of youth foyer effectiveness. We discuss two main issues: the difficulty studies had validating claims of foyer effectiveness, and limitations of research design and methodology. The implications of the lack of rigour in the research reviewed are three-fold. Firstly, youth foyer evaluation study quality could be improved by: clearer methodological and model documentation; post intervention follow-up design; comparison of data to non-randomised comparison groups; and a pre-publication peer-review process. This would be supported with clearer expectations from the research community regarding the production and assessment of grey literature. Secondly, while the standard of reporting needs to be raised, the ‘gold standard’ (i.e. randomised controlled trials of research design in the scientific community is not a relevant benchmark in the field of homelessness research. This is due to the complexity of homelessness interventions and the inadequate funding of the homelessness research field. Greater investment in robust research and evaluation should accompany the substantial investment in youth foyer programs in order to accurately appraise the effectiveness of the youth foyer model. Thirdly, the lack of rigour in the studies reviewed suggests gaps in the service

Governance, Government, and the Search for New Provider Models

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Richard B. Saltman

2016-01-01

Full Text Available A central problem in designing effective models of provider governance in health systems has been to ensure an appropriate balance between the concerns of public sector and/or government decision-makers, on the one hand, and of non-governmental health services actors in civil society and private life, on the other. In tax-funded European health systems up to the 1980s, the state and other public sector decision-makers played a dominant role over health service provision, typically operating hospitals through national or regional governments on a command-and-control basis. In a number of countries, however, this state role has started to change, with governments first stepping out of direct service provision and now de facto pushed to focus more on steering provider organizations rather than on direct public management. In this new approach to provider governance, the state has pulled back into a regulatory role that introduces market-like incentives and management structures, which then apply to both public and private sector providers alike. This article examines some of the main operational complexities in implementing this new governance reality/strategy, specifically from a service provision (as opposed to mostly a financing or even regulatory perspective. After briefly reviewing some of the key theoretical dilemmas, the paper presents two case studies where this new approach was put into practice: primary care in Sweden and hospitals in Spain. The article concludes that good governance today needs to reflect practical operational realities if it is to have the desired effect on health sector reform outcome.

Governance, Government, and the Search for New Provider Models.

Science.gov (United States)

Saltman, Richard B; Duran, Antonio

2015-11-03

A central problem in designing effective models of provider governance in health systems has been to ensure an appropriate balance between the concerns of public sector and/or government decision-makers, on the one hand, and of non-governmental health services actors in civil society and private life, on the other. In tax-funded European health systems up to the 1980s, the state and other public sector decision-makers played a dominant role over health service provision, typically operating hospitals through national or regional governments on a command-and-control basis. In a number of countries, however, this state role has started to change, with governments first stepping out of direct service provision and now de facto pushed to focus more on steering provider organizations rather than on direct public management. In this new approach to provider governance, the state has pulled back into a regulatory role that introduces market-like incentives and management structures, which then apply to both public and private sector providers alike. This article examines some of the main operational complexities in implementing this new governance reality/strategy, specifically from a service provision (as opposed to mostly a financing or even regulatory) perspective. After briefly reviewing some of the key theoretical dilemmas, the paper presents two case studies where this new approach was put into practice: primary care in Sweden and hospitals in Spain. The article concludes that good governance today needs to reflect practical operational realities if it is to have the desired effect on health sector reform outcome. © 2016 by Kerman University of Medical Sciences.

Evidence-Based Adequacy Model for School Funding: Success Rates in Illinois Schools that Meet Targets

Science.gov (United States)

Murphy, Gregory J.

2012-01-01

This quantitative study explores the 2010 recommendation of the Educational Funding Advisory Board to consider the Evidence-Based Adequacy model of school funding in Illinois. This school funding model identifies and costs research based practices necessary in a prototypical school and sets funding levels based upon those practices. This study…

Neimark-Sacker bifurcations and evidence of chaos in a discrete dynamical model of walkers

International Nuclear Information System (INIS)

Rahman, Aminur; Blackmore, Denis

2016-01-01

Bouncing droplets on a vibrating fluid bath can exhibit wave-particle behavior, such as being propelled by interacting with its own wave field. These droplets seem to walk across the bath, and thus are dubbed walkers. Experiments have shown that walkers can exhibit exotic dynamical behavior indicative of chaos. While the integro-differential models developed for these systems agree well with the experiments, they are difficult to analyze mathematically. In recent years, simpler discrete dynamical models have been derived and studied numerically. The numerical simulations of these models show evidence of exotic dynamics such as period doubling bifurcations, Neimark–Sacker (N–S) bifurcations, and even chaos. For example, in [1], based on simulations Gilet conjectured the existence of a supercritical N-S bifurcation as the damping factor in his one- dimensional path model. We prove Gilet’s conjecture and more; in fact, both supercritical and subcritical (N-S) bifurcations are produced by separately varying the damping factor and wave-particle coupling for all eigenmode shapes. Then we compare our theoretical results with some previous and new numerical simulations, and find complete qualitative agreement. Furthermore, evidence of chaos is shown by numerically studying a global bifurcation.

Preparing for fieldwork: Students' perceptions of their readiness to provide evidence-based practice.

Science.gov (United States)

Evenson, Mary E

2013-01-01

The purpose of this study was to explore students' perceptions of their confidence to use research evidence to complete a client case analysis assignment in preparation for participation in fieldwork and future practice. A convenience sample of 42 entry-level occupational therapy Masters students, included 41 females and one male, ages 24 to 35. A quasi-experimental pretest-posttest design was used. Students participated in a problem-based learning approach supported by educational technology. Measures included a pre- and post-semester confidence survey, a post-semester satisfaction survey, and an assignment rubric. Based on paired t-tests and Wilcoxin Signed Ranks Tests, statistically significant differences in pre- and post-test scores were noted for all 18 items on the confidence survey (plearning methods were significantly associated with students' perceptions of their confidence to use research evidence to analyze a client case. These results cannot necessarily be generalized due to the limitations of using non-standardized measures with a convenience sample, without a control group, within the context of a single course as part of one academic program curriculum.

The Presence of the Chromosphere: Evidence for a Liquid Model of the Sun

Science.gov (United States)

Robitaille, Pierre-Marie

2006-04-01

Critical Opalescence occurs at the critical point. It is that point in the phase diagram where the transition between liquid and gas is no longer discernable. In the laboratory, critical opalescence occurs as the meniscus disappears. There is often strong scattering of light and a transparent solution becomes cloudy. In approaching the critical point gases slowly begin to gain order as they prepare to enter the condensed state. In this presentation, it will be advanced that the Chromosphere of the Sun represents matter at the critical point. As such, the Chromosphere experiences a unique combination of temperature, pressure and gravity wherein the gaseous matter in the corona is preparing to condense onto a liquid photosphere. It is consequently stated that the very existence of the Chromosphere, constitutes a powerful piece of evidence in favor of condensed models of the Sun (http://www.arxiv.org/html/astro-ph/0410075 [1]). Additional evidence for a liquid plasma model of the Sun will also be presented.

Cutting Edge PBPK Models and Analyses: Providing the Basis for Future Modeling Efforts and Bridges to Emerging Toxicology Paradigms

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Jane C. Caldwell

2012-01-01

Full Text Available Physiologically based Pharmacokinetic (PBPK models are used for predictions of internal or target dose from environmental and pharmacologic chemical exposures. Their use in human risk assessment is dependent on the nature of databases (animal or human used to develop and test them, and includes extrapolations across species, experimental paradigms, and determination of variability of response within human populations. Integration of state-of-the science PBPK modeling with emerging computational toxicology models is critical for extrapolation between in vitro exposures, in vivo physiologic exposure, whole organism responses, and long-term health outcomes. This special issue contains papers that can provide the basis for future modeling efforts and provide bridges to emerging toxicology paradigms. In this overview paper, we present an overview of the field and introduction for these papers that includes discussions of model development, best practices, risk-assessment applications of PBPK models, and limitations and bridges of modeling approaches for future applications. Specifically, issues addressed include: (a increased understanding of human variability of pharmacokinetics and pharmacodynamics in the population, (b exploration of mode of action hypotheses (MOA, (c application of biological modeling in the risk assessment of individual chemicals and chemical mixtures, and (d identification and discussion of uncertainties in the modeling process.

An agent-based simulation model of patient choice of health care providers in accountable care organizations.

Science.gov (United States)

Alibrahim, Abdullah; Wu, Shinyi

2018-03-01

Accountable care organizations (ACO) in the United States show promise in controlling health care costs while preserving patients' choice of providers. Understanding the effects of patient choice is critical in novel payment and delivery models like ACO that depend on continuity of care and accountability. The financial, utilization, and behavioral implications associated with a patient's decision to forego local health care providers for more distant ones to access higher quality care remain unknown. To study this question, we used an agent-based simulation model of a health care market composed of providers able to form ACO serving patients and embedded it in a conditional logit decision model to examine patients capable of choosing their care providers. This simulation focuses on Medicare beneficiaries and their congestive heart failure (CHF) outcomes. We place the patient agents in an ACO delivery system model in which provider agents decide if they remain in an ACO and perform a quality improving CHF disease management intervention. Illustrative results show that allowing patients to choose their providers reduces the yearly payment per CHF patient by $320, reduces mortality rates by 0.12 percentage points and hospitalization rates by 0.44 percentage points, and marginally increases provider participation in ACO. This study demonstrates a model capable of quantifying the effects of patient choice in a theoretical ACO system and provides a potential tool for policymakers to understand implications of patient choice and assess potential policy controls.

Ecological plant epigenetics: Evidence from model and non-model species, and the way forward.

Science.gov (United States)

Richards, Christina L; Alonso, Conchita; Becker, Claude; Bossdorf, Oliver; Bucher, Etienne; Colomé-Tatché, Maria; Durka, Walter; Engelhardt, Jan; Gaspar, Bence; Gogol-Döring, Andreas; Grosse, Ivo; van Gurp, Thomas P; Heer, Katrin; Kronholm, Ilkka; Lampei, Christian; Latzel, Vít; Mirouze, Marie; Opgenoorth, Lars; Paun, Ovidiu; Prohaska, Sonja J; Rensing, Stefan A; Stadler, Peter F; Trucchi, Emiliano; Ullrich, Kristian; Verhoeven, Koen J F

2017-12-01

Growing evidence shows that epigenetic mechanisms contribute to complex traits, with implications across many fields of biology. In plant ecology, recent studies have attempted to merge ecological experiments with epigenetic analyses to elucidate the contribution of epigenetics to plant phenotypes, stress responses, adaptation to habitat, and range distributions. While there has been some progress in revealing the role of epigenetics in ecological processes, studies with non-model species have so far been limited to describing broad patterns based on anonymous markers of DNA methylation. In contrast, studies with model species have benefited from powerful genomic resources, which contribute to a more mechanistic understanding but have limited ecological realism. Understanding the significance of epigenetics for plant ecology requires increased transfer of knowledge and methods from model species research to genomes of evolutionarily divergent species, and examination of responses to complex natural environments at a more mechanistic level. This requires transforming genomics tools specifically for studying non-model species, which is challenging given the large and often polyploid genomes of plants. Collaboration among molecular geneticists, ecologists and bioinformaticians promises to enhance our understanding of the mutual links between genome function and ecological processes. © 2017 The Authors. Ecology Letters published by CNRS and John Wiley & Sons Ltd.

Ignorance- versus evidence-based decision making: a decision time analysis of the recognition heuristic.

Science.gov (United States)

Hilbig, Benjamin E; Pohl, Rüdiger F

2009-09-01

According to part of the adaptive toolbox notion of decision making known as the recognition heuristic (RH), the decision process in comparative judgments-and its duration-is determined by whether recognition discriminates between objects. By contrast, some recently proposed alternative models predict that choices largely depend on the amount of evidence speaking for each of the objects and that decision times thus depend on the evidential difference between objects, or the degree of conflict between options. This article presents 3 experiments that tested predictions derived from the RH against those from alternative models. All experiments used naturally recognized objects without teaching participants any information and thus provided optimal conditions for application of the RH. However, results supported the alternative, evidence-based models and often conflicted with the RH. Recognition was not the key determinant of decision times, whereas differences between objects with respect to (both positive and negative) evidence predicted effects well. In sum, alternative models that allow for the integration of different pieces of information may well provide a better account of comparative judgments. (c) 2009 APA, all rights reserved.

Automated Eukaryotic Gene Structure Annotation Using EVidenceModeler and the Program to Assemble Spliced Alignments

Energy Technology Data Exchange (ETDEWEB)

Haas, B J; Salzberg, S L; Zhu, W; Pertea, M; Allen, J E; Orvis, J; White, O; Buell, C R; Wortman, J R

2007-12-10

EVidenceModeler (EVM) is presented as an automated eukaryotic gene structure annotation tool that reports eukaryotic gene structures as a weighted consensus of all available evidence. EVM, when combined with the Program to Assemble Spliced Alignments (PASA), yields a comprehensive, configurable annotation system that predicts protein-coding genes and alternatively spliced isoforms. Our experiments on both rice and human genome sequences demonstrate that EVM produces automated gene structure annotation approaching the quality of manual curation.

Capital productivity in industrialised economies: Evidence from error-correction model and lagrange multiplier tests

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Trofimov Ivan D.

2017-01-01

Full Text Available The paper re-examines the “stylized facts” of the balanced growth in developed economies, looking specifically at capital productivity variable. The economic data is obtained from European Commission AMECO database, spanning 1961-2014 period. For a sample of 22 OECD economies, the paper applies univariate LM unit root tests with one or two structural breaks, and estimates error-correction and linear trend models with breaks. It is shown that diverse statistical patterns were present across economies and overall mixed evidence is provided as to the stability of capital productivity and balanced growth in general. Specifically, both upward and downward trends in capital productivity were present, while in several economies mean reversion and random walk patterns were observed. The data and results were largely in line with major theoretical explanations pertaining to capital productivity. With regard to determinants of the capital productivity movements, the structure of capital stock and the prices of capital goods were likely most salient.

Low-grade inflammation decreases emotion recognition - Evidence from the vaccination model of inflammation.

Science.gov (United States)

Balter, Leonie J T; Hulsken, Sasha; Aldred, Sarah; Drayson, Mark T; Higgs, Suzanne; Veldhuijzen van Zanten, Jet J C S; Raymond, Jane E; Bosch, Jos A

2018-05-06

The ability to adequately interpret the mental state of another person is key to complex human social interaction. Recent evidence suggests that this ability, considered a hallmark of 'theory of mind' (ToM), becomes impaired by inflammation. However, extant supportive empirical evidence is based on experiments that induce not only inflammation but also induce discomfort and sickness, factors that could also account for temporary social impairment. Hence, an experimental inflammation manipulation was applied that avoided this confound, isolating effects of inflammation and social interaction. Forty healthy male participants (mean age = 25, SD = 5 years) participated in this double-blind placebo-controlled crossover trial. Inflammation was induced using Salmonella Typhi vaccination (0.025 mg; Typhim Vi, Sanofi Pasteur, UK); saline-injection was used as a control. About 6 h 30 m after injection in each condition, participants completed the Reading the Mind in the Eyes Test (RMET), a validated test for assessing how well the mental states of others can be inferred through observation of the eyes region of the face. Vaccination induced systemic inflammation, elevating IL-6 by +419% (p  .21). Importantly, compared to placebo, vaccination significantly reduced RMET accuracy (p valence (positive, negative, neutral) provided no evidence of a selective impact of treatment. By utilizing an inflammation-induction procedure that avoided concurrent sicknesses or symptoms in a double-blinded design, the present study provides further support for the hypothesis that immune activation impairs ToM. Such impairment may provide a mechanistic link explaining social-cognitive deficits in psychopathologies that exhibit low-grade inflammation, such as major depression. Copyright © 2018 Elsevier Inc. All rights reserved.

Do public nursing home care providers deliver higher quality than private providers? Evidence from Sweden.

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Winblad, Ulrika; Blomqvist, Paula; Karlsson, Andreas

2017-07-14

Swedish nursing home care has undergone a transformation, where the previous virtual public monopoly on providing such services has been replaced by a system of mixed provision. This has led to a rapidly growing share of private actors, the majority of which are large, for-profit firms. In the wake of this development, concerns have been voiced regarding the implications for care quality. In this article, we investigate the relationship between ownership and care quality in nursing homes for the elderly by comparing quality levels between public, for-profit, and non-profit nursing home care providers. We also look at a special category of for-profit providers; private equity companies. The source of data is a national survey conducted by the Swedish National Board of Health and Welfare in 2011 at 2710 nursing homes. Data from 14 quality indicators are analyzed, including structure and process measures such as staff levels, staff competence, resident participation, and screening for pressure ulcers, nutrition status, and risk of falling. The main statistical method employed is multiple OLS regression analysis. We differentiate in the analysis between structural and processual quality measures. The results indicate that public nursing homes have higher quality than privately operated homes with regard to two structural quality measures: staffing levels and individual accommodation. Privately operated nursing homes, on the other hand, tend to score higher on process-based quality indicators such as medication review and screening for falls and malnutrition. No significant differences were found between different ownership categories of privately operated nursing homes. Ownership does appear to be related to quality outcomes in Swedish nursing home care, but the results are mixed and inconclusive. That staffing levels, which has been regarded as a key quality indicator in previous research, are higher in publicly operated homes than private is consistent with earlier

Evidence for criticality in financial data

Science.gov (United States)

Ruiz, G.; de Marcos, A. F.

2018-01-01

We provide evidence that cumulative distributions of absolute normalized returns for the 100 American companies with the highest market capitalization, uncover a critical behavior for different time scales Δt. Such cumulative distributions, in accordance with a variety of complex - and financial - systems, can be modeled by the cumulative distribution functions of q-Gaussians, the distribution function that, in the context of nonextensive statistical mechanics, maximizes a non-Boltzmannian entropy. These q-Gaussians are characterized by two parameters, namely ( q, β), that are uniquely defined by Δt. From these dependencies, we find a monotonic relationship between q and β, which can be seen as evidence of criticality. We numerically determine the various exponents which characterize this criticality.

Evidence & Gap Maps: A tool for promoting evidence informed policy and strategic research agendas.

Science.gov (United States)

Snilstveit, Birte; Vojtkova, Martina; Bhavsar, Ami; Stevenson, Jennifer; Gaarder, Marie

2016-11-01

A range of organizations are engaged in the production of evidence on the effects of health, social, and economic development programs on human welfare outcomes. However, evidence is often scattered around different databases, web sites, and the gray literature and is often presented in inaccessible formats. Lack of overview of the evidence in a specific field can be a barrier to the use of existing research and prevent efficient use of limited resources for new research. Evidence & Gap Maps (EGMs) aim to address these issues and complement existing synthesis and mapping approaches. EGMs are a new addition to the tools available to support evidence-informed policymaking. To provide an accessible resource for researchers, commissioners, and decision makers, EGMs provide thematic collections of evidence structured around a framework which schematically represents the types of interventions and outcomes of relevance to a particular sector. By mapping the existing evidence using this framework, EGMs provide a visual overview of what we know and do not know about the effects of different programs. They make existing evidence available, and by providing links to user-friendly summaries of relevant studies, EGMs can facilitate the use of existing evidence for decision making. They identify key "gaps" where little or no evidence from impact evaluations and systematic reviews is available and can be a valuable resource to inform a strategic approach to building the evidence base in a particular sector. The article will introduce readers to the concept and methods of EGMs and present a demonstration of the EGM tool using existing examples. Copyright © 2016 Elsevier Inc. All rights reserved.

Provider Monitoring and Pay-for-Performance When Multiple Providers Affect Outcomes: An Application to Renal Dialysis

Science.gov (United States)

Hirth, Richard A; Turenne, Marc N; Wheeler, John RC; Pan, Qing; Ma, Yu; Messana, Joseph M

2009-01-01

Objective To characterize the influence of dialysis facilities and nephrologists on resource use and patient outcomes in the dialysis population and to illustrate how such information can be used to inform payment system design. Data Sources Medicare claims for all hemodialysis patients for whom Medicare was the primary payer in 2004, combined with the Medicare Enrollment Database and the CMS Medical Evidence Form (CMS Form 2728), which is completed at onset of renal replacement therapy. Study Design Resource use (mainly drugs and laboratory tests) per dialysis session and two clinical outcomes (achieving targets for anemia management and dose of dialysis) were modeled at the patient level with random effects for nephrologist and dialysis facility, controlling for patient characteristics. Results For each measure, both the physician and the facility had significant effects. However, facilities were more influential than physicians, as measured by the standard deviation of the random effects. Conclusions The success of tools such as P4P and provider profiling relies upon the identification of providers most able to enhance efficiency and quality. This paper demonstrates a method for determining the extent to which variation in health care costs and quality of care can be attributed to physicians and institutional providers. Because variation in quality and cost attributable to facilities is consistently larger than that attributable to physicians, if provider profiling or financial incentives are targeted to only one type of provider, the facility appears to be the appropriate locus. PMID:19555398

A Hybrid Artificial Reputation Model Involving Interaction Trust, Witness Information and the Trust Model to Calculate the Trust Value of Service Providers

Directory of Open Access Journals (Sweden)

Gurdeep Singh Ransi

2014-02-01

Full Text Available Agent interaction in a community, such as the online buyer-seller scenario, is often uncertain, as when an agent comes in contact with other agents they initially know nothing about each other. Currently, many reputation models are developed that help service consumers select better service providers. Reputation models also help agents to make a decision on who they should trust and transact with in the future. These reputation models are either built on interaction trust that involves direct experience as a source of information or they are built upon witness information also known as word-of-mouth that involves the reports provided by others. Neither the interaction trust nor the witness information models alone succeed in such uncertain interactions. In this paper we propose a hybrid reputation model involving both interaction trust and witness information to address the shortcomings of existing reputation models when taken separately. A sample simulation is built to setup buyer-seller services and uncertain interactions. Experiments reveal that the hybrid approach leads to better selection of trustworthy agents where consumers select more reputable service providers, eventually helping consumers obtain more gains. Furthermore, the trust model developed is used in calculating trust values of service providers.

Evidence synthesis to inform model-based cost-effectiveness evaluations of diagnostic tests: a methodological review of health technology assessments

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Bethany Shinkins

2017-04-01

Full Text Available Abstract Background Evaluations of diagnostic tests are challenging because of the indirect nature of their impact on patient outcomes. Model-based health economic evaluations of tests allow different types of evidence from various sources to be incorporated and enable cost-effectiveness estimates to be made beyond the duration of available study data. To parameterize a health-economic model fully, all the ways a test impacts on patient health must be quantified, including but not limited to diagnostic test accuracy. Methods We assessed all UK NIHR HTA reports published May 2009-July 2015. Reports were included if they evaluated a diagnostic test, included a model-based health economic evaluation and included a systematic review and meta-analysis of test accuracy. From each eligible report we extracted information on the following topics: 1 what evidence aside from test accuracy was searched for and synthesised, 2 which methods were used to synthesise test accuracy evidence and how did the results inform the economic model, 3 how/whether threshold effects were explored, 4 how the potential dependency between multiple tests in a pathway was accounted for, and 5 for evaluations of tests targeted at the primary care setting, how evidence from differing healthcare settings was incorporated. Results The bivariate or HSROC model was implemented in 20/22 reports that met all inclusion criteria. Test accuracy data for health economic modelling was obtained from meta-analyses completely in four reports, partially in fourteen reports and not at all in four reports. Only 2/7 reports that used a quantitative test gave clear threshold recommendations. All 22 reports explored the effect of uncertainty in accuracy parameters but most of those that used multiple tests did not allow for dependence between test results. 7/22 tests were potentially suitable for primary care but the majority found limited evidence on test accuracy in primary care settings

Brain circuits underlying visual stability across eye movements - converging evidence for a neuro-computational model of area LIP

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Arnold eZiesche

2014-03-01

Full Text Available The understanding of the subjective experience of a visually stable world despite the occurrence of an observer's eye movements has been the focus of extensive research for over 20 years. These studies have revealed fundamental mechanisms such as anticipatory receptive field shifts and the saccadic suppression of stimulus displacements, yet there currently exists no single explanatory framework for these observations. We show that a previously presented neuro-computational model of peri-saccadic mislocalization accounts for the phenomenon of predictive remapping and for the observation of saccadic suppression of displacement (SSD. This converging evidence allows us to identify the potential ingredients of perceptual stability that generalize beyond different data sets in a formal physiology-based model. In particular we propose that predictive remapping stabilizes the visual world across saccades by introducing a feedback loop and, as an emergent result, small displacements of stimuli are not noticed by the visual system. The model provides a link from neural dynamics, to neural mechanism and finally to behavior, and thus offers a testable comprehensive framework of visual stability.

A generalized preferential attachment model for business firms growth rates. I. Empirical evidence

Science.gov (United States)

Pammolli, F.; Fu, D.; Buldyrev, S. V.; Riccaboni, M.; Matia, K.; Yamasaki, K.; Stanley, H. E.

2007-05-01

We introduce a model of proportional growth to explain the distribution P(g) of business firm growth rates. The model predicts that P(g) is Laplace in the central part and depicts an asymptotic power-law behavior in the tails with an exponent ζ = 3. Because of data limitations, previous studies in this field have been focusing exclusively on the Laplace shape of the body of the distribution. We test the model at different levels of aggregation in the economy, from products, to firms, to countries, and we find that the predictions are in good agreement with empirical evidence on both growth distributions and size-variance relationships.

Institutions, culture and migrants' preference for state-provided welfare

DEFF Research Database (Denmark)

Schmidt-Catran, Alexander; Careja, Romana

2017-01-01

Using the difference-in-differences estimator and data provided by the German Socio-Economic Panel, this article explores migrants’ preferences for state-provided welfare. The study finds evidence that over time, the preferences of immigrants and natives become more similar. We interpret this fin......Using the difference-in-differences estimator and data provided by the German Socio-Economic Panel, this article explores migrants’ preferences for state-provided welfare. The study finds evidence that over time, the preferences of immigrants and natives become more similar. We interpret...... this finding as evidence that the culture of home countries does not have a time-invariant effect, and that immigrants’ welfare preferences are subject to a socializing effect of the host countries’ welfare regime....

Heavy Metal Exposure and Metabolic Syndrome: Evidence from Human and Model System Studies.

Science.gov (United States)

Planchart, Antonio; Green, Adrian; Hoyo, Cathrine; Mattingly, Carolyn J

2018-03-01

Metabolic syndrome (MS) describes the co-occurrence of conditions that increase one's risk for heart disease and other disorders such as diabetes and stroke. The worldwide increase in the prevalence of MS cannot be fully explained by lifestyle factors such as sedentary behavior and caloric intake alone. Environmental exposures, such as heavy metals, have been implicated, but results are conflicting and possible mechanisms remain unclear. To assess recent progress in determining a possible role between heavy metal exposure and MS, we reviewed epidemiological and model system data for cadmium (Cd), lead (Pb), and mercury (Hg) from the last decade. Data from 36 epidemiological studies involving 17 unique countries/regions and 13 studies leveraging model systems are included in this review. Epidemiological and model system studies support a possible association between heavy metal exposure and MS or comorbid conditions; however, results remain conflicting. Epidemiological studies were predominantly cross-sectional and collectively, they highlight a global interest in this question and reveal evidence of differential susceptibility by sex and age to heavy metal exposures. In vivo studies in rats and mice and in vitro cell-based assays provide insights into potential mechanisms of action relevant to MS including altered regulation of lipid and glucose homeostasis, adipogenesis, and oxidative stress. Heavy metal exposure may contribute to MS or comorbid conditions; however, available data are conflicting. Causal inference remains challenging as epidemiological data are largely cross-sectional; and variation in study design, including samples used for heavy metal measurements, age of subjects at which MS outcomes are measured; the scope and treatment of confounding factors; and the population demographics vary widely. Prospective studies, standardization or increased consistency across study designs and reporting, and consideration of molecular mechanisms informed by model

Biological Model Development as an Opportunity to Provide Content Auditing for the Foundational Model of Anatomy Ontology.

Science.gov (United States)

Wang, Lucy L; Grunblatt, Eli; Jung, Hyunggu; Kalet, Ira J; Whipple, Mark E

2015-01-01

Constructing a biological model using an established ontology provides a unique opportunity to perform content auditing on the ontology. We built a Markov chain model to study tumor metastasis in the regional lymphatics of patients with head and neck squamous cell carcinoma (HNSCC). The model attempts to determine regions with high likelihood for metastasis, which guides surgeons and radiation oncologists in selecting the boundaries of treatment. To achieve consistent anatomical relationships, the nodes in our model are populated using lymphatic objects extracted from the Foundational Model of Anatomy (FMA) ontology. During this process, we discovered several classes of inconsistencies in the lymphatic representations within the FMA. We were able to use this model building opportunity to audit the entities and connections in this region of interest (ROI). We found five subclasses of errors that are computationally detectable and resolvable, one subclass of errors that is computationally detectable but unresolvable, requiring the assistance of a content expert, and also errors of content, which cannot be detected through computational means. Mathematical descriptions of detectable errors along with expert review were used to discover inconsistencies and suggest concepts for addition and removal. Out of 106 organ and organ parts in the ROI, 8 unique entities were affected, leading to the suggestion of 30 concepts for addition and 4 for removal. Out of 27 lymphatic chain instances, 23 were found to have errors, with a total of 32 concepts suggested for addition and 15 concepts for removal. These content corrections are necessary for the accurate functioning of the FMA and provide benefits for future research and educational uses.

Development and implementation of the Ontario Stroke System: the use of evidence

Directory of Open Access Journals (Sweden)

Jill I. Cameron

2007-08-01

Full Text Available Introduction The Ontario Stroke System was developed to enhance the quality and continuity of stroke care provided across the care continuum. Research Objective To identify the role evidence played in the development and implementation of the Ontario Stroke System. Methods This study employed a qualitative case study design. In-depth interviews were conducted with six members of the Ontario Stroke System provincial steering committee. Nine focus groups were conducted with: Regional Program Managers, Regional Education Coordinators, and seven acute care teams. To supplement these findings interviews were conducted with eight individuals knowledgeable about national and international models of integrated service delivery. Results Our analyses identified six themes. The first four themes highlight the use of evidence to support the process of system development and implementation including: 1 informing system development; 2 mobilizing governmental support; 3 getting the system up and running; and 4 integrating services across the continuum of care. The final two themes describe the foundation required to support this process: 1 human capacity and 2 mechanisms to share evidence. Conclusion This study provides guidance to support the development and implementation of evidence-based models of integrated service delivery.

A constructive Indian country response to the evidence-based program mandate.

Science.gov (United States)

Walker, R Dale; Bigelow, Douglas A

2011-01-01

Over the last 20 years governmental mandates for preferentially funding evidence-based "model" practices and programs has become doctrine in some legislative bodies, federal agencies, and state agencies. It was assumed that what works in small sample, controlled settings would work in all community settings, substantially improving safety, effectiveness, and value-for-money. The evidence-based "model" programs mandate has imposed immutable "core components," fidelity testing, alien programming and program developers, loss of familiar programs, and resource capacity requirements upon tribes, while infringing upon their tribal sovereignty and consultation rights. Tribal response in one state (Oregon) went through three phases: shock and rejection; proposing an alternative approach using criteria of cultural appropriateness, aspiring to evaluability; and adopting logic modeling. The state heard and accepted the argument that the tribal way of knowing is different and valid. Currently, a state-authorized tribal logic model and a review panel process are used to approve tribal best practices for state funding. This constructive response to the evidence-based program mandate elevates tribal practices in the funding and regulatory world, facilitates continuing quality improvement and evaluation, while ensuring that practices and programs remain based on local community context and culture. This article provides details of a model that could well serve tribes facing evidence-based model program mandates throughout the country.

Improving the representation of river-groundwater interactions in land surface modeling at the regional scale: Observational evidence and parameterization applied in the Community Land Model

KAUST Repository

Zampieri, Matteo

2012-02-01

Groundwater is an important component of the hydrological cycle, included in many land surface models to provide a lower boundary condition for soil moisture, which in turn plays a key role in the land-vegetation-atmosphere interactions and the ecosystem dynamics. In regional-scale climate applications land surface models (LSMs) are commonly coupled to atmospheric models to close the surface energy, mass and carbon balance. LSMs in these applications are used to resolve the momentum, heat, water and carbon vertical fluxes, accounting for the effect of vegetation, soil type and other surface parameters, while lack of adequate resolution prevents using them to resolve horizontal sub-grid processes. Specifically, LSMs resolve the large-scale runoff production associated with infiltration excess and sub-grid groundwater convergence, but they neglect the effect from loosing streams to groundwater. Through the analysis of observed data of soil moisture obtained from the Oklahoma Mesoscale Network stations and land surface temperature derived from MODIS we provide evidence that the regional scale soil moisture and surface temperature patterns are affected by the rivers. This is demonstrated on the basis of simulations from a land surface model (i.e., Community Land Model - CLM, version 3.5). We show that the model cannot reproduce the features of the observed soil moisture and temperature spatial patterns that are related to the underlying mechanism of reinfiltration of river water to groundwater. Therefore, we implement a simple parameterization of this process in CLM showing the ability to reproduce the soil moisture and surface temperature spatial variabilities that relate to the river distribution at regional scale. The CLM with this new parameterization is used to evaluate impacts of the improved representation of river-groundwater interactions on the simulated water cycle parameters and the surface energy budget at the regional scale. © 2011 Elsevier B.V.

Comparing consumer-directed and agency models for providing supportive services at home.

Science.gov (United States)

Benjamin, A E; Matthias, R; Franke, T M

2000-04-01

To examine the service experiences and outcomes of low-income Medicaid beneficiaries with disabilities under two different models for organizing home-based personal assistance services: agency-directed and consumer-directed. A survey of a random sample of 1,095 clients, age 18 and over, who receive services in California's In-Home Supportive Services (IHSS) program funded primarily by Medicaid. Other data were obtained from the California Management and Payrolling System (CMIPS). The sample was stratified by service model (agency-directed or consumer-directed), client age (over or under age 65), and severity. Data were collected on client demographics, condition/functional status, and supportive service experience. Outcome measures were developed in three areas: safety, unmet need, and service satisfaction. Factor analysis was used to reduce multiple outcome measures to nine dimensions. Multiple regression analysis was used to assess the effect of service model on each outcome dimension, taking into account the client-provider relationship, client demographics, and case mix. Recipients of IHSS services as of mid-1996 were interviewed by telephone. The survey was conducted in late 1996 and early 1997. On various outcomes, recipients in the consumer-directed model report more positive outcomes than those in the agency model, or they report no difference. Statistically significant differences emerge on recipient safety, unmet needs, and service satisfaction. A family member present as a paid provider is also associated with more positive reported outcomes within the consumer-directed model, but model differences persist even when this is taken into account. Although both models have strengths and weaknesses, from a recipient perspective the consumer-directed model is associated with more positive outcomes. Although health professionals have expressed concerns about the capacity of consumer direction to assure quality, particularly with respect to safety, meeting unmet

Applying Evidence-Based Medicine in Telehealth: An Interactive Pattern Recognition Approximation

Directory of Open Access Journals (Sweden)

Carlos Fernández-Llatas

2013-10-01

Full Text Available Born in the early nineteen nineties, evidence-based medicine (EBM is a paradigm intended to promote the integration of biomedical evidence into the physicians daily practice. This paradigm requires the continuous study of diseases to provide the best scientific knowledge for supporting physicians in their diagnosis and treatments in a close way. Within this paradigm, usually, health experts create and publish clinical guidelines, which provide holistic guidance for the care for a certain disease. The creation of these clinical guidelines requires hard iterative processes in which each iteration supposes scientific progress in the knowledge of the disease. To perform this guidance through telehealth, the use of formal clinical guidelines will allow the building of care processes that can be interpreted and executed directly by computers. In addition, the formalization of clinical guidelines allows for the possibility to build automatic methods, using pattern recognition techniques, to estimate the proper models, as well as the mathematical models for optimizing the iterative cycle for the continuous improvement of the guidelines. However, to ensure the efficiency of the system, it is necessary to build a probabilistic model of the problem. In this paper, an interactive pattern recognition approach to support professionals in evidence-based medicine is formalized.

Wind farms providing secondary frequency regulation: evaluating the performance of model-based receding horizon control

Directory of Open Access Journals (Sweden)

C. R. Shapiro

2018-01-01

Full Text Available This paper is an extended version of our paper presented at the 2016 TORQUE conference (Shapiro et al., 2016. We investigate the use of wind farms to provide secondary frequency regulation for a power grid using a model-based receding horizon control framework. In order to enable real-time implementation, the control actions are computed based on a time-varying one-dimensional wake model. This model describes wake advection and wake interactions, both of which play an important role in wind farm power production. In order to test the control strategy, it is implemented in a large-eddy simulation (LES model of an 84-turbine wind farm using the actuator disk turbine representation. Rotor-averaged velocity measurements at each turbine are used to provide feedback for error correction. The importance of including the dynamics of wake advection in the underlying wake model is tested by comparing the performance of this dynamic-model control approach to a comparable static-model control approach that relies on a modified Jensen model. We compare the performance of both control approaches using two types of regulation signals, RegA and RegD, which are used by PJM, an independent system operator in the eastern United States. The poor performance of the static-model control relative to the dynamic-model control demonstrates that modeling the dynamics of wake advection is key to providing the proposed type of model-based coordinated control of large wind farms. We further explore the performance of the dynamic-model control via composite performance scores used by PJM to qualify plants for regulation services or markets. Our results demonstrate that the dynamic-model-controlled wind farm consistently performs well, passing the qualification threshold for all fast-acting RegD signals. For the RegA signal, which changes over slower timescales, the dynamic-model control leads to average performance that surpasses the qualification threshold, but further

The climate4impact platform: Providing, tailoring and facilitating climate model data access

Science.gov (United States)

Pagé, Christian; Pagani, Andrea; Plieger, Maarten; Som de Cerff, Wim; Mihajlovski, Andrej; de Vreede, Ernst; Spinuso, Alessandro; Hutjes, Ronald; de Jong, Fokke; Bärring, Lars; Vega, Manuel; Cofiño, Antonio; d'Anca, Alessandro; Fiore, Sandro; Kolax, Michael

2017-04-01

One of the main objectives of climate4impact is to provide standardized web services and tools that are reusable in other portals. These services include web processing services, web coverage services and web mapping services (WPS, WCS and WMS). Tailored portals can be targeted to specific communities and/or countries/regions while making use of those services. Easier access to climate data is very important for the climate change impact communities. To fulfill this objective, the climate4impact (http://climate4impact.eu/) web portal and services has been developed, targeting climate change impact modellers, impact and adaptation consultants, as well as other experts using climate change data. It provides to users harmonized access to climate model data through tailored services. It features static and dynamic documentation, Use Cases and best practice examples, an advanced search interface, an integrated authentication and authorization system with the Earth System Grid Federation (ESGF), a visualization interface with ADAGUC web mapping tools. In the latest version, statistical downscaling services, provided by the Santander Meteorology Group Downscaling Portal, were integrated. An innovative interface to integrate statistical downscaling services will be released in the upcoming version. The latter will be a big step in bridging the gap between climate scientists and the climate change impact communities. The climate4impact portal builds on the infrastructure of an international distributed database that has been set to disseminate the results from the global climate model results of the Coupled Model Intercomparison project Phase 5 (CMIP5). This database, the ESGF, is an international collaboration that develops, deploys and maintains software infrastructure for the management, dissemination, and analysis of climate model data. The European FP7 project IS-ENES, Infrastructure for the European Network for Earth System modelling, supports the European

Providers of antenatal care services in Ghana: evidence from Ghana demographic and health surveys 1988-2014.

Science.gov (United States)

Dickson, Kwamena Sekyi; Darteh, Eugene Kofuor Maafo; Kumi-Kyereme, Akwasi

2017-03-14

Antenatal care is one of the three most essential care - antenatal, delivery and post-natal, given to women during pregnancy and has the potential to contribute towards the achievement of the Sustainable Development Goal (SDG) target 3.1- reducing the global maternal mortality ratio to less than 70 per 100,000 and target 3.8 - achieve universal health coverage. The main objective is to examine the contribution of the various providers of antenatal care services in Ghana from 1988 to 2014. The study uses data from all the six rounds of the Ghana Demographic and Health Survey (GDHS). Binary logistic regression models were applied to examine the association between background characteristics of respondents and providers of antenatal care services. The results show that majority of antenatal care services were provided by nurses over the period under review. The proportion of women who received antenatal care services from nurses improved over the period from 55% in 1988 to 89.5% in 2014. Moreover, there was a decline in antenatal care services provided by traditional birth attendants and women who did not receive antenatal care services from any service provider over the years under review. It was observed that women from rural areas were more likely to utilise antenatal care services provided by traditional birth attendants, whilst those from urban areas were more likely to utilise antenatal care from doctors and nurses. To further improve access to and utilisation of antenatal care services provided by nurses and doctors it is recommended that the Ghana Health Service and the Ministry of Health should put in place systems aimed at improving on the quality of care given such as regular training workshops for health personnel and assessment of patient's satisfaction with services provided. Also, they should encourage women in rural areas especially those from the savannah zone to utilise antenatal care services from skilled providers through social and behaviour

No evidence of chaos but some evidence of dependence in the US stock market

International Nuclear Information System (INIS)

Serletis, Apostolos; Shintani, Mototsugu

2003-01-01

This paper uses recent advances in the field of applied econometrics and tools from dynamical systems theory to test for random walks and chaos in the US stock market, using daily observations on the Dow Jones Industrial Average (from January 3, 1928 to October 18, 2000 - a total of 18,490 observations). In doing so, we follow the recent contribution by Whang and Linton [J Econometr 91 (1999) 1] and construct the standard error for the Nychka et al. [J Roy Statist Soc B 54 (1992) 399] dominant Lyapunov exponent, thereby providing a statistical test of chaos. We find statistically significant evidence against low-dimensional chaos and point to the use of stochastic models and statistical inference in the modeling of asset markets

No evidence of chaos but some evidence of dependence in the US stock market

Energy Technology Data Exchange (ETDEWEB)

Serletis, Apostolos E-mail: serletis@ucalgary.ca; Shintani, Mototsugu E-mail: mototsugu.shintani@vanderbilt.edu

2003-07-01

This paper uses recent advances in the field of applied econometrics and tools from dynamical systems theory to test for random walks and chaos in the US stock market, using daily observations on the Dow Jones Industrial Average (from January 3, 1928 to October 18, 2000 - a total of 18,490 observations). In doing so, we follow the recent contribution by Whang and Linton [J Econometr 91 (1999) 1] and construct the standard error for the Nychka et al. [J Roy Statist Soc B 54 (1992) 399] dominant Lyapunov exponent, thereby providing a statistical test of chaos. We find statistically significant evidence against low-dimensional chaos and point to the use of stochastic models and statistical inference in the modeling of asset markets.

Private sector, for-profit health providers in low and middle income countries: can they reach the poor at scale?

Science.gov (United States)

Tung, Elizabeth; Bennett, Sara

2014-06-24

The bottom of the pyramid concept suggests that profit can be made in providing goods and services to poor people, when high volume is combined with low margins. To-date there has been very limited empirical evidence from the health sector concerning the scope and potential for such bottom of the pyramid models. This paper analyzes private for-profit (PFP) providers currently offering services to the poor on a large scale, and assesses the future prospects of bottom of the pyramid models in health. We searched published and grey literature and databases to identify PFP companies that provided more than 40,000 outpatient visits per year, or who covered 15% or more of a particular type of service in their country. For each included provider, we searched for additional information on location, target market, business model and performance, including quality of care. Only 10 large scale PFP providers were identified. The majority of these were in South Asia and most provided specialized services such as eye care. The characteristics of the business models of these firms were found to be similar to non-profit providers studied by other analysts (such as Bhattacharya 2010). They pursued social rather than traditional marketing, partnerships with government, low cost/high volume services and cross-subsidization between different market segments. There was a lack of reliable data concerning these providers. There is very limited evidence to support the notion that large scale bottom of the pyramid models in health offer good prospects for extending services to the poor in the future. In order to be successful PFP providers often require partnerships with government or support from social health insurance schemes. Nonetheless, more reliable and independent data on such schemes is needed.

Providing surgical care in Somalia: A model of task shifting.

Science.gov (United States)

Chu, Kathryn M; Ford, Nathan P; Trelles, Miguel

2011-07-15

Somalia is one of the most political unstable countries in the world. Ongoing insecurity has forced an inconsistent medical response by the international community, with little data collection. This paper describes the "remote" model of surgical care by Medecins Sans Frontieres, in Guri-El, Somalia. The challenges of providing the necessary prerequisites for safe surgery are discussed as well as the successes and limitations of task shifting in this resource-limited context. In January 2006, MSF opened a project in Guri-El located between Mogadishu and Galcayo. The objectives were to reduce mortality due to complications of pregnancy and childbirth and from violent and non-violent trauma. At the start of the program, expatriate surgeons and anesthesiologists established safe surgical practices and performed surgical procedures. After January 2008, expatriates were evacuated due to insecurity and surgical care has been provided by local Somalian doctors and nurses with periodic supervisory visits from expatriate staff. Between October 2006 and December 2009, 2086 operations were performed on 1602 patients. The majority (1049, 65%) were male and the median age was 22 (interquartile range, 17-30). 1460 (70%) of interventions were emergent. Trauma accounted for 76% (1585) of all surgical pathology; gunshot wounds accounted for 89% (584) of violent injuries. Operative mortality (0.5% of all surgical interventions) was not higher when Somalian staff provided care compared to when expatriate surgeons and anesthesiologists. The delivery of surgical care in any conflict-settings is difficult, but in situations where international support is limited, the challenges are more extreme. In this model, task shifting, or the provision of services by less trained cadres, was utilized and peri-operative mortality remained low demonstrating that safe surgical practices can be accomplished even without the presence of fully trained surgeon and anesthesiologists. If security improves

Fatigue crack propagation: Probabilistic models and experimental evidence

International Nuclear Information System (INIS)

Lucia, A.C.; Jovanovic, A.

1987-01-01

The central aim of the LWR Primary Circuit Component Life Prediction Project, going on at JRC-Ispra, is to develop and check a 'procedure' (encompassing monitoring and inspection, data collection and analysis, prediction) allowing the quantitatives estimation of the accumulation of structural damage and of the residual lifetime. The ongoing activity matches theoretical development and experimentation, the latter being at present essentially based on a test-rig for room-temperature fatigue cycling of 1:5 scaled models of pressure vessels. During Phase I of fatigue testing of vessel R2, different pieces of information coming from material characterization, non-destructive inspection, continuous monitoring, stress analysis, have been merged and used to infere the future behaviour of the structure. The prediction of residual lifetime (cycles to failure), based on the outcomes of the ultrasonic continuous monitoring and made by means of the COVASTOL code, was in quite good agreement with experimental evidence. (orig./HP)

Using Evidence Credibility Decay Model for dependence assessment in human reliability analysis

International Nuclear Information System (INIS)

Guo, Xingfeng; Zhou, Yanhui; Qian, Jin; Deng, Yong

2017-01-01

Highlights: • A new computational model is proposed for dependence assessment in HRA. • We combined three factors of “CT”, “TR” and “SP” within Dempster–Shafer theory. • The BBA of “SP” is reconstructed by discounting rate based on the ECDM. • Simulation experiments are illustrated to show the efficiency of the proposed method. - Abstract: Dependence assessment among human errors plays an important role in human reliability analysis. When dependence between two sequent tasks exists in human reliability analysis, if the preceding task fails, the failure probability of the following task is higher than success. Typically, three major factors are considered: “Closeness in Time” (CT), “Task Relatedness” (TR) and “Similarity of Performers” (SP). Assume TR is not changed, both SP and CT influence the degree of dependence level and SP is discounted by the time as the result of combine two factors in this paper. In this paper, a new computational model is proposed based on the Dempster–Shafer Evidence Theory (DSET) and Evidence Credibility Decay Model (ECDM) to assess the dependence between tasks in human reliability analysis. First, the influenced factors among human tasks are identified and the basic belief assignments (BBAs) of each factor are constructed based on expert evaluation. Then, the BBA of SP is discounted as the result of combining two factors and reconstructed by using the ECDM, the factors are integrated into a fused BBA. Finally, the dependence level is calculated based on fused BBA. Experimental results demonstrate that the proposed model not only quantitatively describe the fact that the input factors influence the dependence level, but also exactly show how the dependence level regular changes with different situations of input factors.

Comparisons of aerosol optical depth provided by seviri satellite observations and CAMx air quality modelling

Science.gov (United States)

Fernandes, A.; Riffler, M.; Ferreira, J.; Wunderle, S.; Borrego, C.; Tchepel, O.

2015-04-01

Satellite data provide high spatial coverage and characterization of atmospheric components for vertical column. Additionally, the use of air pollution modelling in combination with satellite data opens the challenging perspective to analyse the contribution of different pollution sources and transport processes. The main objective of this work is to study the AOD over Portugal using satellite observations in combination with air pollution modelling. For this purpose, satellite data provided by Spinning Enhanced Visible and Infra-Red Imager (SEVIRI) on-board the geostationary Meteosat-9 satellite on AOD at 550 nm and modelling results from the Chemical Transport Model (CAMx - Comprehensive Air quality Model) were analysed. The study period was May 2011 and the aim was to analyse the spatial variations of AOD over Portugal. In this study, a multi-temporal technique to retrieve AOD over land from SEVIRI was used. The proposed method takes advantage of SEVIRI's high temporal resolution of 15 minutes and high spatial resolution. CAMx provides the size distribution of each aerosol constituent among a number of fixed size sections. For post processing, CAMx output species per size bin have been grouped into total particulate sulphate (PSO4), total primary and secondary organic aerosols (POA + SOA), total primary elemental carbon (PEC) and primary inert material per size bin (CRST1 to CRST_4) to be used in AOD quantification. The AOD was calculated by integration of aerosol extinction coefficient (Qext) on the vertical column. The results were analysed in terms of temporal and spatial variations. The analysis points out that the implemented methodology provides a good spatial agreement between modelling results and satellite observation for dust outbreak studied (10th -17th of May 2011). A correlation coefficient of r=0.79 was found between the two datasets. This work provides relevant background to start the integration of these two different types of the data in order

Persistent Modelling

DEFF Research Database (Denmark)

2012-01-01

The relationship between representation and the represented is examined here through the notion of persistent modelling. This notion is not novel to the activity of architectural design if it is considered as describing a continued active and iterative engagement with design concerns – an evident....... It also provides critical insight into the use of contemporary modelling tools and methods, together with an examination of the implications their use has within the territories of architectural design, realisation and experience....... on this subject, this book makes essential reading for anyone considering new ways of thinking about architecture. In drawing upon both historical and contemporary perspectives this book provides evidence of the ways in which relations between representation and the represented continue to be reconsidered...

Persistent Modelling

DEFF Research Database (Denmark)

The relationship between representation and the represented is examined here through the notion of persistent modelling. This notion is not novel to the activity of architectural design if it is considered as describing a continued active and iterative engagement with design concerns – an evident....... It also provides critical insight into the use of contemporary modelling tools and methods, together with an examination of the implications their use has within the territories of architectural design, realisation and experience....... on this subject, this book makes essential reading for anyone considering new ways of thinking about architecture. In drawing upon both historical and contemporary perspectives this book provides evidence of the ways in which relations between representation and the represented continue to be reconsidered...

Toward an evidence-based patient-provider communication in rehabilitation: linking communication elements to better rehabilitation outcomes.

Science.gov (United States)

Jesus, Tiago Silva; Silva, Isabel Lopes

2016-04-01

There is a growing interest in linking aspects of patient-provider communication to rehabilitation outcomes. However, the field lacks a conceptual understanding on: (a) 'how' rehabilitation outcomes can be improved by communication; and (b) through 'which' elements in particular. This article elaborates on the conceptual developments toward informing further practice and research. Existing models of communication in healthcare were adapted to rehabilitation, and its outcomes through a comprehensive literature review. After depicting mediating mechanisms and variables (e.g. therapeutic engagement, adjustment toward disability), this article presents the '4 Rehab Communication Elements' deemed likely to underpin rehabilitation outcomes. The four elements are: (a) knowing the person and building a supportive relationship; (b) effective information exchange and education; (c) shared goal-setting and action planning; and (d) fostering a more positive, yet realistic, cognitive and self-reframing. This article describes an unprecedented, outcomes-oriented approach toward the design of rehabilitation communication, which has resulted in the development of a new intervention model: the '4 Rehab Communication Elements'. Further trials are needed to evaluate the impact of this whole intervention model on rehabilitation outcomes. © The Author(s) 2015.

Ghost supernova remnants : evidence for pulsar reactivation in dusty molecular clouds

International Nuclear Information System (INIS)

Heintzmann, H.; Novello, M.

1983-01-01

An evidence in favour of a new model for pulsar evolution is discussed, according to which pulsars may only function as regularly pulsed emitters if an accretion disc provides a sufficiently continuous return-current to the radio pulsar (neutron star). (L.C.) [pt

What's in a setting?: Influence of organizational culture on provider adherence to clinical guidelines for treating tobacco use.

Science.gov (United States)

Hung, Dorothy Y; Leidig, Robynn; Shelley, Donna R

2014-01-01

Organizational culture is an important but underinvestigated feature of the work environment that can impact provider behavior, including adherence to clinical practice guidelines. There is substantial evidence that physician assistance to smokers can produce significant reductions in tobacco use. However, this evidence has not been well translated into practice, as only a small proportion of smokers receive recommended treatment during medical visits. This study examines organizational culture as a contextual feature of primary care clinics and its impact on adherence to evidence-based guidelines for treating tobacco use. Cross-sectional survey data were collected from 500 primary care providers in 60 community clinics located in New York City. Relationships between provider adherence to "5A" clinical guidelines, as recommended by the U.S. Public Health Service, and both provider and organizational covariates were described. We used hierarchical linear modeling to examine the associations between clinic culture and provider treatment patterns. Providers in clinics with stronger "group/clan," "hierarchical," and "rational" culture types, as compared with a "developmental" culture, reported greater adherence to 5A guidelines (p organizational culture can influence provider adherence to cessation treatment guidelines, even when controlling for other factors known to affect practice patterns. Specifically, cultures that emphasize human resources and performance standards are conducive to integrating 5A guidelines into routine practice. Understanding the role of organizational culture enables healthcare managers and practitioners to be strategic when implementing, and also sustaining, use of evidence-based guidelines.

A Global Remote Laboratory Experimentation Network and the Experiment Service Provider Business Model and Plans

Directory of Open Access Journals (Sweden)

Tor Ivar Eikaas

2003-07-01

Full Text Available This paper presents results from the IST KAII Trial project ReLAX - Remote LAboratory eXperimentation trial (IST 1999-20827, and contributes with a framework for a global remote laboratory experimentation network supported by a new business model. The paper presents this new Experiment Service Provider business model that aims at bringing physical experimentation back into the learning arena, where remotely operable laboratory experiments used in advanced education and training schemes are made available to a global education and training market in industry and academia. The business model is based on an approach where individual experiment owners offer remote access to their high-quality laboratory facilities to users around the world. The usage can be for research, education, on-the-job training etc. The access to these facilities is offered via an independent operating company - the Experiment Service Provider. The Experiment Service Provider offers eCommerce services like booking, access control, invoicing, dispute resolution, quality control, customer evaluation services and a unified Lab Portal.

[Evidence and Evidence Gaps - an Introduction].

Science.gov (United States)

Dreier, G; Löhler, J

2016-04-01

Treating patients requires the inclusion of existing evidence in any health care decision, to be able to choose the best diagnosis or treatment measure or to make valid prognosis statements for a particular patient in consideration of the physician's own expertise.The basis are clinical trials, the results of which are ideally gathered in systematic reviews, rated, summarized and published. In addition to the GCP (Good Clinical Practice)-compliant planning, conducting and analysis of clinical studies it is essential, that all study results are made publicly available, in order to avoid publication bias. This includes the public registration of planned and discontinued trials. In the last 25 years, the evidence-based medicine (EbM) has increasingly found its way into clinical practice and research. Here EbM is closely associated with the names Archibald Cochrane and David Sackett. In Germany, both the German Cochrane Centre (DCZ) and the network of evidence-based medicine (DNEbM) were established approximately 15 years ago. In the international Cochrane Collaboration clinicians and other scientists like statisticians interdisciplinary work side by side to develop the methods of evidence-based medicine and to address the topics of evidence generation and processing as well as the transfer of knowledge. Challenge: Existing evidence primarily serves doctors to support their decision-making, but is also the basis for providing scientific proof for a health care intervention's benefit to patients and ultimately payers/health insurances. The closure of existing evidence gaps requires substantial human and financial resources, a complex organizational structure and can only succeed with the involvement of clinical and methodological expertise and specific knowledge in the field of clinical research. In addition, the knowledge must be transferred into practice, using journals, guidelines, conferences, databases, information portals with processed evidence and not least the

Evidence of leopard predation on bonobos (Pan paniscus).

Science.gov (United States)

D'Amour, Danielle E; Hohmann, Gottfried; Fruth, Barbara

2006-01-01

Current models of social organization assume that predation is one of the major forces that promotes group living in diurnal primates. As large body size renders some protection against predators, gregariousness of great apes and other large primate species is usually related to other parameters. The low frequency of observed cases of nonhuman predation on great apes seems to support this assumption. However, recent efforts to study potential predator species have increasingly accumulated direct and indirect evidence of predation by leopards (Panthera pardus) on chimpanzees and gorillas. The following report provides the first evidence of predation by a leopard on bonobos (Pan paniscus). Copyright 2006 S. Karger AG, Basel.

Nutrition and dementia care: developing an evidence-based model for nutritional care in nursing homes.

Science.gov (United States)

Murphy, Jane L; Holmes, Joanne; Brooks, Cindy

2017-02-14

There is a growing volume of research to offer improvements in nutritional care for people with dementia living in nursing homes. Whilst a number of interventions have been identified to support food and drink intake, there has been no systematic research to understand the factors for improving nutritional care from the perspectives of all those delivering care in nursing homes. The aim of this study was to develop a research informed model for understanding the complex nutritional problems associated with eating and drinking for people with dementia. We conducted nine focus groups and five semi-structured interviews with those involved or who have a level of responsibility for providing food and drink and nutritional care in nursing homes (nurses, care workers, catering assistants, dietitians, speech and language therapists) and family carers. The resulting conceptual model was developed by eliciting care-related processes, thus supporting credibility from the perspective of the end-users. The seven identified domain areas were person-centred nutritional care (the overarching theme); availability of food and drink; tools, resources and environment; relationship to others when eating and drinking; participation in activities; consistency of care and provision of information. This collaboratively developed, person-centred model can support the design of new education and training tools and be readily translated into existing programmes. Further research is needed to evaluate whether these evidence-informed approaches have been implemented successfully and adopted into practice and policy contexts and can demonstrate effectiveness for people living with dementia.

Providing the meta-model of development of competency using the meta-ethnography approach: Part 2. Synthesis of the available competency development models

Directory of Open Access Journals (Sweden)

Shahram Yazdani

2016-12-01

Full Text Available Background and Purpose: ConsideringBackground and Purpose: Considering the importance and necessity of competency-based education at a global level and with respect to globalization and the requirement of minimum competencies in medical fields, medical education communities and organizations worldwide have tried to determine the competencies, present frameworks and education models to respond to be sure of the ability of all graduates. In the literature, we observed numerous competency development models that refer to the same issues with different terminologies. It seems that evaluation and synthesis of all these models can finally result in designing a comprehensive meta-model for competency development.Methods: Meta-ethnography is a useful method for synthesis of qualitative research that is used to develop models that interpret the results in several studies. Considering that the aim of this study is to ultimately provide a competency development meta-model, in the previous section of the study, the literature review was conducted to achieve competency development models. Models obtained through the search were studied in details, and the key concepts of the models and overarching concepts were extracted in this section, models’ concepts were reciprocally translated and the available competency development models were synthesized.Results: A presentation of the competency development meta-model and providing a redefinition of the Dreyfus brothers model.Conclusions: Given the importance of competency-based education at a global level and the need to review curricula and competency-based curriculum design, it is required to provide competency development as well as meta-model to be the basis for curriculum development. As there are a variety of competency development models available, in this study, it was tried to develop the curriculum using them.Keywords: Meta-ethnography, Competency development, Meta-model, Qualitative synthesis

Infant feeding and analgesia in labour: the evidence is accumulating

Directory of Open Access Journals (Sweden)

Jordan Sue

2006-12-01

Full Text Available Abstract The interesting and important paper by Torvaldsen and colleagues provides further circumstantial evidence of a positive association between intrapartum analgesia and feeding infant formula. Not all research supports this association. Before 'failure to breastfeed' can be adjudged an adverse effect of intrapartum analgesia, the research evidence needs to be considered in detail. Examination of the existing evidence against the Bradford-Hill criteria indicates that the evidence is not yet conclusive. However, the difficulties of obtaining funding and undertaking large trials to explore putative adverse drug reactions in pregnant women may mean that we shall never have conclusive evidence of harm. Therefore, reports of large cohort studies with regression models, as in the paper published today, assume a greater importance than in other areas of investigation. Meanwhile, women and their clinicians may feel that sufficient evidence has accumulated to justify offering extra support to establish breastfeeding if women have received high doses of analgesics in labour.

Depression Care for the Elderly: Reducing Barriers to Evidence Based Practice

OpenAIRE

Ell, Kathleen

2006-01-01

This paper provides an overview of five key bodies of evidence identifying: 1) Characteristics of depression among older adults - its prevalence, risk factors and illness course, and impact on functional status, mortality, use of health services, and health care costs; 2) Effective Interventions, including pharmacologic, psychotherapies, care management, and combined intervention models; 3) Known Barriers to depression care including patient, provider and service system barriers; 4) Effective...

Fracture flow modelling. Proof of evidence

International Nuclear Information System (INIS)

Hencher, S.R.

1996-01-01

Proof of Evidence by an expert witness is presented in support of the case by Friends of the Earth (FOE) against the proposed construction by UK Nirex Ltd of an underground Rock Characterisation Facility (RCF) at a site in the Sellafield area. The RCF is part of an investigation by Nirex into a suitable site for an underground repository for the disposal of radioactive waste. The objections were raised at a Planning Inquiry in 1995. The evidence points out that current understanding of the factors which control flow through a network of interconnecting fractures, such as that at the Sellafield site, is at a very early stage of development. Neither are the methods of investigation and analysis required for a post-closure performance assessment (PCPA) for a repository well developed. These issues are being investigated in international underground research laboratories but the proposed RCF is intended to be confirmatory rather than experimental. (23 references). (UK)

What is Evidence? (editorial

Directory of Open Access Journals (Sweden)

Denise Koufogiannakis

2011-06-01

Full Text Available Lately, I have been pondering what we really mean when we say “evidence based practice”? In LIS, we all know the definitions that have been proposed (Booth 2000, Eldredge 2000, Crumley and Koufogiannakis 2002, and which have not ever really been challenged. But have we ever said explicitly what qualifies as evidence in this model? The underlying assumption seems to be that evidence is research, hence, we are really talking about research-based practice, but we don’t actually use that term.Higgs and Jones (2000 note that evidence is “knowledge derived from a variety of sources that has been subjected to testing and has found to be credible.” The Oxford English Dictionary states that evidence is “something serving as a proof” (OED, 2011. Neither of these definitions of evidence notes that evidence equals research; research is only one form of evidence. It certainly isn’t the only form of evidence – so what, then, constitutes evidence?Rycroff-Malone et al. (2004 state that that in order for evidence based practice to create a broader evidence base in nursing, “the external, scientific and the internal, intuitive” need to be brought together. The external, scientific is what evidence based practice has been focused on, in the form of scientific research, but Rycroff-Malone et al. note that other elements such as clinical experience, patient experience, and information from the local context also need to be considered.In library and information practice, what are the other forms of evidence we need to consider? I propose that while research evidence is of high importance to our profession and knowledge, LIS practitioners need to first of all consider local evidence. Local evidence is found in our working environment and specific to the context in which we carry out our work. It includes such things as our experiences with patrons in particular contexts, and what we observe to work in such situations, assessment of programs

Modeling a historical mountain pine beetle outbreak using Landsat MSS and multiple lines of evidence

Science.gov (United States)

Assal, Timothy J.; Sibold, Jason; Reich, Robin M.

2014-01-01

Mountain pine beetles are significant forest disturbance agents, capable of inducing widespread mortality in coniferous forests in western North America. Various remote sensing approaches have assessed the impacts of beetle outbreaks over the last two decades. However, few studies have addressed the impacts of historical mountain pine beetle outbreaks, including the 1970s event that impacted Glacier National Park. The lack of spatially explicit data on this disturbance represents both a major data gap and a critical research challenge in that wildfire has removed some of the evidence from the landscape. We utilized multiple lines of evidence to model forest canopy mortality as a proxy for outbreak severity. We incorporate historical aerial and landscape photos, aerial detection survey data, a nine-year collection of satellite imagery and abiotic data. This study presents a remote sensing based framework to (1) relate measurements of canopy mortality from fine-scale aerial photography to coarse-scale multispectral imagery and (2) classify the severity of mountain pine beetle affected areas using a temporal sequence of Landsat data and other landscape variables. We sampled canopy mortality in 261 plots from aerial photos and found that insect effects on mortality were evident in changes to the Normalized Difference Vegetation Index (NDVI) over time. We tested multiple spectral indices and found that a combination of NDVI and the green band resulted in the strongest model. We report a two-step process where we utilize a generalized least squares model to account for the large-scale variability in the data and a binary regression tree to describe the small-scale variability. The final model had a root mean square error estimate of 9.8% canopy mortality, a mean absolute error of 7.6% and an R2 of 0.82. The results demonstrate that a model of percent canopy mortality as a continuous variable can be developed to identify a gradient of mountain pine beetle severity on the

TRANSIT: model for providing generic transportation input for preliminary siting analysis

International Nuclear Information System (INIS)

McNair, G.W.; Cashwell, J.W.

1985-02-01

To assist the US Department of Energy's efforts in potential facility site screening in the nuclear waste management program, a computerized model, TRANSIT, is being developed. Utilizing existing data on the location and inventory characteristics of spent nuclear fuel at reactor sites, TRANSIT derives isopleths of transportation mileage, costs, risks and fleet requirements for shipments to storage sites and/or repository sites. This technique provides a graphic, first-order method for use by the Department in future site screening efforts. 2 refs

Endothelin: Visualization of mRNAs by in situ hybridization provides evidence for local action

International Nuclear Information System (INIS)

MacCumber, M.W.; Ross, C.A.; Glaser, B.M.; Snyder, S.H.

1989-01-01

Endothelin (ET) is a recently identified vasoactive peptide with three isoforms for which three genes have been cloned. The cellular sites of synthesis of this peptide have not yet been identified in vivo. Using Northern blot analysis, we have detected two forms of ET mRNA in rat tissues: a 3.7-kilobase form in the kidney, eye, and brain, a 2.5-kilobase form in the intestine, and both forms in the lung. We have localized these forms of ET mRNA in several rat tissues using in situ hybridization. In the 19-day rat fetus, ET mRNA is highest in the lung, intestine, and meninges. At high resolution, ET mRNA is localized in the lung to respiratory epithelial cells of bronchioles and apparently in blood vessels. In adult tissues, ET mRNA is present throughout the lung, in the renal medulla vasa recta, and in the iris of the eye. ET mRNA is synthesized in close proximity to ET binding sites in many organs (e.g., lung, kidney, intestine, and eye), suggesting a local action of this peptide. However, in other areas (e.g., heart and renal cortex), ET binding sites are present in the absence of ET mRNA, suggesting an action of ET from the bloodstream or from neurons. Northern blot analysis of ET mRNA in microvascular endothelial cells in culture indicates that ET is synthesized in small blood vessels and regulated similarly to its regulation in large vessels. Our results provide evidence that ET, like other regulatory peptides, may serve in several tissues as a neuromodulator or local hormone

Centromeric DNA characterization in the model grass Brachypodium distachyon provides insights on the evolution of the genus.

Science.gov (United States)

Li, Yinjia; Zuo, Sheng; Zhang, Zhiliang; Li, Zhanjie; Han, Jinlei; Chu, Zhaoqing; Hasterok, Robert; Wang, Kai

2018-03-01

Brachypodium distachyon is a well-established model monocot plant, and its small and compact genome has been used as an accurate reference for the much larger and often polyploid genomes of cereals such as Avena sativa (oats), Hordeum vulgare (barley) and Triticum aestivum (wheat). Centromeres are indispensable functional units of chromosomes and they play a core role in genome polyploidization events during evolution. As the Brachypodium genus contains about 20 species that differ significantly in terms of their basic chromosome numbers, genome size, ploidy levels and life strategies, studying their centromeres may provide important insight into the structure and evolution of the genome in this interesting and important genus. In this study, we isolated the centromeric DNA of the B. distachyon reference line Bd21 and characterized its composition via the chromatin immunoprecipitation of the nucleosomes that contain the centromere-specific histone CENH3. We revealed that the centromeres of Bd21 have the features of typical multicellular eukaryotic centromeres. Strikingly, these centromeres contain relatively few centromeric satellite DNAs; in particular, the centromere of chromosome 5 (Bd5) consists of only ~40 kb. Moreover, the centromeric retrotransposons in B. distachyon (CRBds) are evolutionarily young. These transposable elements are located both within and adjacent to the CENH3 binding domains, and have similar compositions. Moreover, based on the presence of CRBds in the centromeres, the species in this study can be grouped into two distinct lineages. This may provide new evidence regarding the phylogenetic relationships within the Brachypodium genus. © 2018 The Authors The Plant Journal © 2018 John Wiley & Sons Ltd.

Neural evidence of motivational conflict between social values.

Science.gov (United States)

Leszkowicz, Emilia; Linden, David E J; Maio, Gregory R; Ihssen, Niklas

2017-10-01

Motivational interdependence is an organizing principle in Schwartz's circumplex model of social values, which has received abundant cross-cultural support. We used fMRI to test whether motivational relations between social values predict different brain responses in a situation of choice between values. We hypothesized that differences in brain responses would become evident when the more important value had to be selected in pairs of congruent (e.g., wealth and success) as opposed to incongruent (e.g., curiosity and stability) values as they are described in Schwartz's model, because the former serve mutually facilitating motives, whereas the latter serve mutually inhibiting motives. Consistent with the model, choosing between congruent values led to longer response times and more activation in conflict-related brain regions (e.g., the supplementary motor area, dorsolateral prefrontal cortex) than selecting between incongruent values. These results provide novel neural evidence supporting the circumplex model's predictions about motivational interdependence between social values. In particular, our results show that the neural networks underlying social values are organized in a way that allows activation patterns related to motivational similarity between congruent values to be dissociated from those related to incongruent values.

An Evidence-Based Practitioner's Model for Adolescent Leadership Development

Science.gov (United States)

Rehm, Christopher J.

2014-01-01

This paper proposes a model for youth leadership education based on adolescent development and leadership research in an effort to provide practitioners with a practical blueprint to aid their creation and implementation of high school leadership programs. By focusing on student leader development areas which school level educators can affect,…

Supporting patients in obtaining and oncologists in providing evidence-based health-related quality of life information prior to and after esophageal cancer surgery

OpenAIRE

Jacobs, M.

2015-01-01

The overall aim of this thesis was to support patients in obtaining and oncologists in providing evidence-based HRQL data prior to and following esophageal cancer surgery. This thesis is divided in two parts. In Part I, we addressed the information needs of esophageal cancer patients prior to and following esophageal surgery, the barriers and facilitators patients experienced when discussing their information needs with their oncologist, and the development of a web-based question prompt shee...

Model validation and the role of the proposed Rock Characterisation Facility at Sellafield. Proof of evidence

International Nuclear Information System (INIS)

Wallace, H.

1996-01-01

Proof of Evidence is given by an expert witness on behalf of Greenpeace Ltd as part of their submission to a Planning Inquiry in 1995 hearing the application of UK Nirex Ltd for permission to construct an underground Rock Characterisation Facility (RCF) at a site near Sellafield. The RCF is part of an investigation by Nirex into a suitable site for the disposal of radioactive waste. An examination of the groundwater flow models used by Nirex and the procedure for their validation have led to the following conclusions: no evidence has been presented by Nirex to show that the construction of the RCF will improve the confidence they claim to have in the site; the prospects are slim for validating the models of present groundwater flow so that they satisfy the criteria to meet the risk target; it is extremely unlikely that results from the RCF will increase confidence in a safety assessment of this site; all the evidence available to date suggests that the risk assessment is not, and will not become, robust to variations in flux through the repository. (1 figure; 8 references). (UK)

Micro worlds versus boundary objects in group model building; evidence from the literature on problem definition and model conceptulization

Energy Technology Data Exchange (ETDEWEB)

Zagonel, Aldo A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Systems Engineering & Analysis; Andersen, David F. [University in Albany, NY (United States). The Rockefeller College of Public Affairs & Policy

2007-03-01

Based upon participant observation in group model building and content analysis of the system dynamics literature, we postulate that modeling efforts have a dual nature. On one hand, the modeling process aims to create a useful representation of a real-world system. This must be done, however, while aligning the clients’ mental models around a shared view of the system. There is significant overlap and confusion between these two goals and how they play out on a practical level. This research clarifies these distinctions by establishing an ideal-type dichotomy. To highlight the differences, we created two straw men: “micro world” characterizes a model that represents reality and “boundary object” represents a socially negotiated model. Using this framework, the literature was examined, revealing evidence for several competing views on problem definition and model conceptualization. The results are summarized in the text of this article, substantiated with strikingly polarized citations, often from the same authors. We also introduce hypotheses for the duality across the remaining phases of the modeling process. Finally, understanding and appreciation of the differences between these ideal types can promote constructive debate on their balance in system dynamics theory and practice.

Early atmospheric metal pollution provides evidence for Chalcolithic/Bronze Age mining and metallurgy in Southwestern Europe.

Science.gov (United States)

Martínez Cortizas, Antonio; López-Merino, Lourdes; Bindler, Richard; Mighall, Tim; Kylander, Malin E

2016-03-01

Although archaeological research suggests that mining/metallurgy already started in the Chalcolithic (3rd millennium BC), the earliest atmospheric metal pollution in SW Europe has thus far been dated to ~3500-3200 cal.yr. BP in paleo-environmental archives. A low intensity, non-extensive mining/metallurgy and the lack of appropriately located archives may be responsible for this mismatch. We have analysed the older section (>2100 cal.yr. BP) of a peat record from La Molina (Asturias, Spain), a mire located in the proximity (35-100 km) of mines which were exploited in the Chalcolithic/Bronze Age, with the aim of assessing evidence of this early mining/metallurgy. Analyses included the determination of C as a proxy for organic matter content, lithogenic elements (Si, Al, Ti) as markers of mineral matter, and trace metals (Cr, Cu, Zn, Pb) and stable Pb isotopes as tracers of atmospheric metal pollution. From ~8000 to ~4980 cal.yr. BP the Pb composition is similar to that of the underlying sediments (Pb 15 ± 4 μg g(-1); (206)Pb/(207)Pb 1.204 ± 0.002). A sustained period of low (206)Pb/(207)Pb ratios occurred from ~4980 to ~2470 cal.yr. BP, which can be divided into four phases: Chalcolithic (~4980-3700 cal.yr. BP), (206)Pb/(207)Pb ratios decline to 1.175 and Pb/Al ratios increase; Early Bronze Age (~3700-3500 cal.yr. BP), (206)Pb/(207)Pb increase to 1.192 and metal/Al ratios remain stable; Late Bronze Age (~3500-2800 cal.yr. BP), (206)Pb/(207)Pb decline to their lowest values (1.167) while Pb/Al and Zn/Al increase; and Early Iron Age (~2800-2470 cal.yr. BP), (206)Pb/(207)Pb increase to 1.186, most metal/Al ratios decrease but Zn/Al shows a peak. At the beginning of the Late Iron Age, (206)Pb/(207)Pb ratios and metal enrichments show a rapid return to pre-anthropogenic values. These results provide evidence of regional/local atmospheric metal pollution triggered by the earliest phases of mining/metallurgy in the area, and reconcile paleo-environmental and

Evidence-based policy: implications for nursing and policy involvement.

Science.gov (United States)

Hewison, Alistair

2008-11-01

Evidence-based policy making is espoused as a central feature of government in the United Kingdom. However, an expectation that this will improve the quality of policy produced and provide a path to increased involvement of nurses in the policy process is misplaced. The purpose of this article is to demonstrate that the emphasis on evidence-based policy is problematic and cannot be regarded as a "new model" of policy making. Also, it could deflect attention from more practical approaches to policy involvement on the part of nurses. Policy development activities, acquisition of skills in policy analysis, and other forms of involvement are needed if nurses are to move along the continuum from policy literacy, through policy acumen, to policy competence. This involves taking a critical stance on the notion of evidence-based policy.

9: ADAPTATION OF PREGNANCY RISK ASSESSMENT MONITORING SYSTEM (PRAMS) AND PROVIDE A MODEL ON IT

Science.gov (United States)

Kharaghani, Roghieh; Shariati, Mohammad; Keramat, Afsaneh; Yunesian, Masud; Moghisi, Alireza

2017-01-01

Background and aims A surveillance system helps to detect epidemics and the pattern of the problems incidence in the community and it is essential part of evidence based decision making process. This study aimed to adapt of PRAMS and provide a model on it. Methods This study was performed in 7 steps as follows: Surveillance systems in pregnancy were reviewed and appropriate system was selected for Iran by nominal group technique. Two comparative studies were conducted to determine the similarities and differences between Iran and the selected community. PRAMS method and system were adapted based on the results of the comparative studies and experts opinions. The study tool was adapted. A field trial was conducted to assess adapted PRAMS feasibility based on TELOS (technical, economic, legal, operational, and schedule) model in the city of Shahriar, located in the west of Tehran, and to compare data collection methods. Then, based on the results and consultation with related executive managers, the final model of PRAMS was suggested for Iranian health system. Results Review of the surveillance systems in pregnancy, identified six models. The results of the nominal group technique showed that, the appropriate model for Iran is PRAMS. Based on the comparative studies and expert opinions, the appropriate system and method for program was as follows: the sampling frame was composed of data in thyroid screening forms and hospital records, the sampling method was systematic, data collection methods were home and phone based surveys, and participants were women within 2 to 6 months postpartum who had a live or still birth. The study tool was adapted. Thirty-seven health volunteers collected the data in this study (technical feasibility). Any home based completed questionnaire cost 2.45 and a phone cost 1.89 USD. Many indices were achieved from the study, which were worth much more than the expenses (economic feasibility). The project was consistent with legal requirements

College quality and hourly wages: evidence from the self-revelation model, sibling models and instrumental variables.

Science.gov (United States)

Borgen, Nicolai T

2014-11-01

This paper addresses the recent discussion on confounding in the returns to college quality literature using the Norwegian case. The main advantage of studying Norway is the quality of the data. Norwegian administrative data provide information on college applications, family relations and a rich set of control variables for all Norwegian citizens applying to college between 1997 and 2004 (N = 141,319) and their succeeding wages between 2003 and 2010 (676,079 person-year observations). With these data, this paper uses a subset of the models that have rendered mixed findings in the literature in order to investigate to what extent confounding biases the returns to college quality. I compare estimates obtained using standard regression models to estimates obtained using the self-revelation model of Dale and Krueger (2002), a sibling fixed effects model and the instrumental variable model used by Long (2008). Using these methods, I consistently find increasing returns to college quality over the course of students' work careers, with positive returns only later in students' work careers. I conclude that the standard regression estimate provides a reasonable estimate of the returns to college quality. Copyright © 2014 Elsevier Inc. All rights reserved.

A Novel Stackelberg-Bertrand Game Model for Pricing Content Provider

Directory of Open Access Journals (Sweden)

Cheng Zhang

2015-11-01

Full Text Available With the popularity of smart devices such as smartphone, tablet, contents that traditionally be viewed on a personal computer, can also be viewed on these smart devices. The demand for contents thus is increasing year by year, which makes the content providers (CPs get great revenue from either users’ subscription or advertisement. On the other hand, Internet service providers (ISPs, who keep investing in the network technology or capacity capacity to support the huge traffic generated by contents, do not benefit directly from the content traffic. One choice for ISPs is to charge CPs to share the revenue from the huge content traffic. Then ISPs have enough incentives to invest in network infrastructure to improve quality of services (QoS, which eventually benefit CPs and users. This paper presents a novel economic model called Stackelberg-Bertrand game to capture the interaction and competitions among ISPs, CPs and users when ISPs charge CPs. A generic user demand function is assumed to capture the sensitivity of demand to prices of ISPs and CPs. The numerical results show that the price elasticity of ISP and CP plays an important part on the payoff of the ISP and CP.

Provide a model to improve the performance of intrusion detection systems in the cloud

OpenAIRE

Foroogh Sedighi

2016-01-01

High availability of tools and service providers in cloud computing and the fact that cloud computing services are provided by internet and deal with public, have caused important challenges for new computing model. Cloud computing faces problems and challenges such as user privacy, data security, data ownership, availability of services, and recovery after breaking down, performance, scalability, programmability. So far, many different methods are presented for detection of intrusion in clou...

The emotional and professional wellbeing of Australian midwives: A comparison between those providing continuity of midwifery care and those not providing continuity.

Science.gov (United States)

Fenwick, Jennifer; Sidebotham, Mary; Gamble, Jenny; Creedy, Debra K

2018-02-01

Continuity of midwifery care contributes to significant positive outcomes for women and babies. There is a perception that providing continuity of care may negatively impact on the wellbeing and professional lives of midwives. To compare the emotional and professional wellbeing as well as satisfaction with time off and work-life balance of midwives providing continuity of care with midwives not providing continuity. Online survey. Measures included; Copenhagen Burnout Inventory (CBI); Depression, Anxiety and Stress Scale-21; and Perceptions of Empowerment in Midwifery Scale (PEMS-Revised). The sample (n=862) was divided into two groups; midwives working in continuity (n=214) and those not working in continuity (n=648). Mann Whitney U tests were used to compare the groups. The continuity group had significantly lower scores on each of the burnout subscales (CBI Personal p=.002; CBI Work pwork-life balance. Our results indicate that providing continuity of midwifery care is also beneficial for midwives. Conversely, midwives working in shift-based models providing fragmented care are at greater risk of psychological distress. Maternity service managers should feel confident that re-orientating care to align with the evidence is likely to improve workforce wellbeing and is a sustainable way forward. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Temperate marine protected area provides recruitment subsidies to local fisheries.

Science.gov (United States)

Le Port, A; Montgomery, J C; Smith, A N H; Croucher, A E; McLeod, I M; Lavery, S D

2017-10-25

The utility of marine protected areas (MPAs) as a means of protecting exploited species and conserving biodiversity within MPA boundaries is supported by strong empirical evidence. However, the potential contribution of MPAs to fished populations beyond their boundaries is still highly controversial; empirical measures are scarce and modelling studies have produced a range of predictions, including both positive and negative effects. Using a combination of genetic parentage and relatedness analysis, we measured larval subsidies to local fisheries replenishment for Australasian snapper ( Chrysophrys auratus : Sparidae) from a small (5.2 km 2 ), well-established, temperate, coastal MPA in northern New Zealand. Adult snapper within the MPA contributed an estimated 10.6% (95% CI: 5.5-18.1%) of newly settled juveniles to surrounding areas (approx. 400 km 2 ), with no decreasing trend in contributions up to 40 km away. Biophysical modelling of larval dispersal matched experimental data, showing larvae produced inside the MPA dispersed over a comparable distance. These results demonstrate that temperate MPAs have the potential to provide recruitment subsidies at magnitudes and spatial scales relevant to fisheries management. The validated biophysical model provides a cost-efficient opportunity to generalize these findings to other locations and climate conditions, and potentially informs the design of MPA networks for enhancing fisheries management. © 2017 The Author(s).

Modeling fMRI signals can provide insights into neural processing in the cerebral cortex.

Science.gov (United States)

Vanni, Simo; Sharifian, Fariba; Heikkinen, Hanna; Vigário, Ricardo

2015-08-01

Every stimulus or task activates multiple areas in the mammalian cortex. These distributed activations can be measured with functional magnetic resonance imaging (fMRI), which has the best spatial resolution among the noninvasive brain imaging methods. Unfortunately, the relationship between the fMRI activations and distributed cortical processing has remained unclear, both because the coupling between neural and fMRI activations has remained poorly understood and because fMRI voxels are too large to directly sense the local neural events. To get an idea of the local processing given the macroscopic data, we need models to simulate the neural activity and to provide output that can be compared with fMRI data. Such models can describe neural mechanisms as mathematical functions between input and output in a specific system, with little correspondence to physiological mechanisms. Alternatively, models can be biomimetic, including biological details with straightforward correspondence to experimental data. After careful balancing between complexity, computational efficiency, and realism, a biomimetic simulation should be able to provide insight into how biological structures or functions contribute to actual data processing as well as to promote theory-driven neuroscience experiments. This review analyzes the requirements for validating system-level computational models with fMRI. In particular, we study mesoscopic biomimetic models, which include a limited set of details from real-life networks and enable system-level simulations of neural mass action. In addition, we discuss how recent developments in neurophysiology and biophysics may significantly advance the modelling of fMRI signals. Copyright © 2015 the American Physiological Society.

The magmatic model for the origin of Archean Au-quartz vein ore systems: an assessment of the evidence

International Nuclear Information System (INIS)

Spooner, E.T.C.

1991-01-01

The magmatic model for the origin of Archean Au-quartz vein ore systems suggests that Au was derived by partition between silicate (± sulphide) melts of certain compositions and H 2 O-CO 2 -NaCl magmatic fluids. Supporting evidence includes partial/structural geological relationships, timing relationships, H and C isotope geochemistry, probable primary Au enrichment in the Lamaque stocks, and fluid inclusion volatile geochemistry. Evidence is currently negative with respect to various within- and sub-greenstone belt metamorphic/deep crustal fluid models for primary Au mineralization; however a U-Pb age for vein stage 3 sphene from the Camflo deposit, Quebec which is ∼ 55-60 Ma younger than the host stock at 2685-2680 Ma indicates dissolution/reprecipitation of Au by late, (?) upper crustal saline fluids. Evidence is accumulating that epithermal-meso thermal Au-Ag mineralization in island arc and cordilleran settings may also have been magmatically derived ± high level fluid mixing from calc-alkaline, shoshonitic and other igneous compositions. (author)

Conceptualising a model to guide nursing and midwifery in the community guided by an evidence review.

Science.gov (United States)

Leahy-Warren, Patricia; Mulcahy, Helen; Benefield, Lazelle; Bradley, Colin; Coffey, Alice; Donohoe, Ann; Fitzgerald, Serena; Frawley, Tim; Healy, Elizabeth; Healy, Maria; Kelly, Marcella; McCarthy, Bernard; McLoughlin, Kathleen; Meagher, Catherine; O'Connell, Rhona; O'Mahony, Aoife; Paul, Gillian; Phelan, Amanda; Stokes, Diarmuid; Walsh, Jessica; Savage, Eileen

2017-01-01

Successful models of nursing and midwifery in the community delivering healthcare throughout the lifespan and across a health and illness continuum are limited, yet necessary to guide global health services. Primary and community health services are the typical points of access for most people and the location where most care is delivered. The scope of primary healthcare is complex and multifaceted and therefore requires a practice framework with sound conceptual and theoretical underpinnings. The aim of this paper is to present a conceptual model informed by a scoping evidence review of the literature. A scoping evidence review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Databases included CINAHL, MEDLINE, PsycINFO and SocINDEX using the EBSCO platform and the Cochrane Library using the keywords: model, nursing, midwifery, community, primary care. Grey literature for selected countries was searched using the Google 'advanced' search interface. Data extraction and quality appraisal for both empirical and grey literature were conducted independently by two reviewers. From 127 empirical and 24 non-empirical papers, data extraction parameters, in addition to the usual methodological features, included: the nature of nursing and midwifery; the population group; interventions and main outcomes; components of effective nursing and midwifery outcomes. The evidence was categorised into six broad areas and subsequently synthesised into four themes. These were not mutually exclusive: (1) Integrated and Collaborative Care; (2) Organisation and Delivery of Nursing and Midwifery Care in the Community; (3) Adjuncts to Nursing Care and (4) Overarching Conceptual Model. It is the latter theme that is the focus of this paper. In essence, the model depicts a person/client on a lifespan and preventative-curative trajectory. The health related needs of the client, commensurate with their point

A Novel Evaluation Model for Hybrid Power System Based on Vague Set and Dempster-Shafer Evidence Theory

Directory of Open Access Journals (Sweden)

Dongxiao Niu

2012-01-01

Full Text Available Because clean energy and traditional energy have different advantages and disadvantages, it is of great significance to evaluate comprehensive benefits for hybrid power systems. Based on thorough analysis of important characters on hybrid power systems, an index system including security, economic benefit, environmental benefit, and social benefit is established in this paper. Due to advantages of processing abundant uncertain and fuzzy information, vague set is used to determine the decision matrix. Convert vague decision matrix to real one by vague combination ruleand determine uncertain degrees of different indexes by grey incidence analysis, then the mass functions of different comment set in different indexes are obtained. Information can be fused in accordance with Dempster-Shafer (D-S combination rule and the evaluation result is got by vague set and D-S evidence theory. A simulation of hybrid power system including thermal power, wind power, and photovoltaic power in China is provided to demonstrate the effectiveness and potential of the proposed design scheme. It can be clearly seen that the uncertainties in decision making can be dramatically decreased compared with existing methods in the literature. The actual implementation results illustrate that the proposed index system and evaluation model based on vague set and D-S evidence theory are effective and practical to evaluate comprehensive benefit of hybrid power system.

Identification of Evidence for Key Parameters in Decision-Analytic Models of Cost Effectiveness: A Description of Sources and a Recommended Minimum Search Requirement.

Science.gov (United States)

Paisley, Suzy

2016-06-01

This paper proposes recommendations for a minimum level of searching for data for key parameters in decision-analytic models of cost effectiveness and describes sources of evidence relevant to each parameter type. Key parameters are defined as treatment effects, adverse effects, costs, resource use, health state utility values (HSUVs) and baseline risk of events. The recommended minimum requirement for treatment effects is comprehensive searching according to available methodological guidance. For other parameter types, the minimum is the searching of one bibliographic database plus, where appropriate, specialist sources and non-research-based and non-standard format sources. The recommendations draw on the search methods literature and on existing analyses of how evidence is used to support decision-analytic models. They take account of the range of research and non-research-based sources of evidence used in cost-effectiveness models and of the need for efficient searching. Consideration is given to what constitutes best evidence for the different parameter types in terms of design and scientific quality and to making transparent the judgments that underpin the selection of evidence from the options available. Methodological issues are discussed, including the differences between decision-analytic models of cost effectiveness and systematic reviews when searching and selecting evidence and comprehensive versus sufficient searching. Areas are highlighted where further methodological research is required.

Twelve evidence-based principles for implementing self-management support in primary care.

Science.gov (United States)

Battersby, Malcolm; Von Korff, Michael; Schaefer, Judith; Davis, Connie; Ludman, Evette; Greene, Sarah M; Parkerton, Melissa; Wagner, Edward H

2010-12-01

Recommendations to improve self-management support and health outcomes for people with chronic conditions in primary care settings are provided on the basis of expert opinion supported by evidence for practices and processes. Practices and processes that could improve self-management support in primary care were identified through a nominal group process. In a targeted search strategy, reviews and meta-analyses were then identifed using terms from a wide range of chronic conditions and behavioral risk factors in combination with Self-Care, Self-Management, and Primary Care. On the basis of these reviews, evidence-based principles for self-management support were developed. The evidence is organized within the framework of the Chronic Care Model. Evidence-based principles in 12 areas were associated with improved patient self-management and/or health outcomes: (1) brief targeted assessment, (2) evidence-based information to guide shared decision-making, (3) use of a nonjudgmental approach, (4) collaborative priority and goal setting, (5) collaborative problem solving, (6) self-management support by diverse providers, (7) self-management interventions delivered by diverse formats, (8) patient self-efficacy, (9) active followup, (10) guideline-based case management for selected patients, (11) linkages to evidence-based community programs, and (12) multifaceted interventions. A framework is provided for implementing these principles in three phases of the primary care visit: enhanced previsit assessment, a focused clinical encounter, and expanded postvisit options. There is a growing evidence base for how self-management support for chronic conditions can be integrated into routine health care.

Rectal cancer: An evidence-based update for primary care providers

Science.gov (United States)

Gaertner, Wolfgang B; Kwaan, Mary R; Madoff, Robert D; Melton, Genevieve B

2015-01-01

Rectal adenocarcinoma is an important cause of cancer-related deaths worldwide, and key anatomic differences between the rectum and the colon have significant implications for management of rectal cancer. Many advances have been made in the diagnosis and management of rectal cancer. These include clinical staging with imaging studies such as endorectal ultrasound and pelvic magnetic resonance imaging, operative approaches such as transanal endoscopic microsurgery and laparoscopic and robotic assisted proctectomy, as well as refined neoadjuvant and adjuvant therapies. For stage II and III rectal cancers, combined chemoradiotherapy offers the lowest rates of local and distant relapse, and is delivered neoadjuvantly to improve tolerability and optimize surgical outcomes, particularly when sphincter-sparing surgery is an endpoint. The goal in rectal cancer treatment is to optimize disease-free and overall survival while minimizing the risk of local recurrence and toxicity from both radiation and systemic therapy. Optimal patient outcomes depend on multidisciplinary involvement for tailored therapy. The successful management of rectal cancer requires a multidisciplinary approach, with the involvement of enterostomal nurses, gastroenterologists, medical and radiation oncologists, radiologists, pathologists and surgeons. The identification of patients who are candidates for combined modality treatment is particularly useful to optimize outcomes. This article provides an overview of the diagnosis, staging and multimodal therapy of patients with rectal cancer for primary care providers. PMID:26167068

Neutrino masses and mixing: evidence and implications

International Nuclear Information System (INIS)

Gonzalez-Garcia, M.C.; Nir, Yosef

2003-01-01

Measurements of various features of the fluxes of atmospheric and solar neutrinos have provided evidence for neutrino oscillations and therefore for neutrino masses and mixing. The authors review the phenomenology of neutrino oscillations in vacuum and in matter. They present the existing evidence from solar and atmospheric neutrinos as well as the results from laboratory searches, including the final status of the Liquid Scintillator Neutrino Detector (LSND) experiment. The theoretical inputs that are used to interpret the experimental results are described in terms of neutrino oscillations. The allowed ranges for the mass and mixing parameters are derived in two frameworks: First, each set of observations is analyzed separately in a two-neutrino framework; Second, the data from solar and atmospheric neutrinos are analyzed in a three-active-neutrino framework. The theoretical implications of these results are then discussed, including the existence of new physics, the estimate of the scale of this new physics, and the lessons for grand unified theories, for models of extra dimensions and singlet fermions in the bulk, and for flavor models

Translating sickle cell guidelines into practice for primary care providers with Project ECHO

Directory of Open Access Journals (Sweden)

Lisa M. Shook

2016-11-01

Full Text Available Background: Approximately 100,000 persons with sickle cell disease (SCD live in the United States, including 15,000 in the Midwest. Unfortunately, many patients experience poor health outcomes due to limited access to primary care providers (PCPs who are prepared to deliver evidence-based SCD care. Sickle Treatment and Outcomes Research in the Midwest (STORM is a regional network established to improve care and outcomes for individuals with SCD living in Indiana, Illinois, Michigan, Minnesota, Ohio, and Wisconsin. Methods: STORM investigators hypothesized that Project ECHO® methodology could be replicated to create a low-cost, high-impact intervention to train PCPs in evidence-based care for pediatric and young adult patients with SCD in the Midwest, called STORM TeleECHO. This approach utilizes video technology for monthly telementoring clinics consisting of didactic and case-based presentations focused on the National Heart, Lung and Blood Institute (NHLBI evidence-based guidelines for SCD. Results: Network leads in each of the STORM states assisted with developing the curriculum and are recruiting providers for monthly clinics. To assess STORM TeleECHO feasibility and acceptability, monthly attendance and satisfaction data are collected. Changes in self-reported knowledge, comfort, and practice patterns will be compared with pre-participation, and 6 and 12 months after participation. Conclusions: STORM TeleECHO has the potential to increase implementation of the NHLBI evidence-based guidelines, especially increased use of hydroxyurea, resulting in improvements in the quality of care and outcomes for children and young adults with SCD. This model could be replicated in other pediatric chronic illness conditions to improve PCP knowledge and confidence in delivering evidence-based care.

LTDNA evidence on trial

OpenAIRE

Roberts, Paul

2016-01-01

Adopting the interpretative/hermeneutical method typical of much legal scholarship, this article considers two sets of issues pertaining to LTDNA profiles as evidence in criminal proceedings. The section titled Expert Evidence as Forensic Epistemic Warrant addresses some rather large questions about the epistemic status and probative value of expert testimony in general. It sketches a theoretical model of expert evidence, highlighting five essential criteria: (1) expert competence; (2) discip...

Using the Dynamic Model to develop an evidence-based and theory-driven approach to school improvement

NARCIS (Netherlands)

Creemers, B.P.M.; Kyriakides, L.

2010-01-01

This paper refers to a dynamic perspective of educational effectiveness and improvement stressing the importance of using an evidence-based and theory-driven approach. Specifically, an approach to school improvement based on the dynamic model of educational effectiveness is offered. The recommended

Providers' perspectives of factors influencing implementation of evidence-based treatments in a community mental health setting: A qualitative investigation of the training-practice gap.

Science.gov (United States)

Marques, Luana; Dixon, Louise; Valentine, Sarah E; Borba, Christina P C; Simon, Naomi M; Wiltsey Stirman, Shannon

2016-08-01

This study aims to elucidate relations between provider perceptions of aspects of the consolidated framework for implementation research (Damschroder et al., 2009) and provider attitudes toward the implementation of evidence-based treatments (EBTs) in an ethnically diverse community health setting. Guided by directed content analysis, we analyzed 28 semistructured interviews that were conducted with providers during the pre-implementation phase of a larger implementation study for cognitive processing therapy for posttraumatic stress disorder (Resick et al., 2008). Our findings extend the existing literature by also presenting provider-identified client-level factors that contribute to providers' positive and negative attitudes toward EBTs. Provider-identified client-level factors include the following: client motivation to engage in treatment, client openness to EBTs, support networks of family and friends, client use of community and government resources, the connection and relationship with their therapist, client treatment adherence, client immediate needs or crises, low literacy or illiteracy, low levels of education, client cognitive limitations, and misconceptions about therapy. These results highlight the relations between provider perceptions of their clients, provider engagement in EBT training, and subsequent adoption of EBTs. We present suggestions for future implementation research in this area. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Hydrological regulation drives regime shifts: evidence from paleolimnology and ecosystem modeling of a large shallow Chinese lake.

Science.gov (United States)

Kong, Xiangzhen; He, Qishuang; Yang, Bin; He, Wei; Xu, Fuliu; Janssen, Annette B G; Kuiper, Jan J; van Gerven, Luuk P A; Qin, Ning; Jiang, Yujiao; Liu, Wenxiu; Yang, Chen; Bai, Zelin; Zhang, Min; Kong, Fanxiang; Janse, Jan H; Mooij, Wolf M

2017-02-01

Quantitative evidence of sudden shifts in ecological structure and function in large shallow lakes is rare, even though they provide essential benefits to society. Such 'regime shifts' can be driven by human activities which degrade ecological stability including water level control (WLC) and nutrient loading. Interactions between WLC and nutrient loading on the long-term dynamics of shallow lake ecosystems are, however, often overlooked and largely underestimated, which has hampered the effectiveness of lake management. Here, we focus on a large shallow lake (Lake Chaohu) located in one of the most densely populated areas in China, the lower Yangtze River floodplain, which has undergone both WLC and increasing nutrient loading over the last several decades. We applied a novel methodology that combines consistent evidence from both paleolimnological records and ecosystem modeling to overcome the hurdle of data insufficiency and to unravel the drivers and underlying mechanisms in ecosystem dynamics. We identified the occurrence of two regime shifts: one in 1963, characterized by the abrupt disappearance of submerged vegetation, and another around 1980, with strong algal blooms being observed thereafter. Using model scenarios, we further disentangled the roles of WLC and nutrient loading, showing that the 1963 shift was predominantly triggered by WLC, whereas the shift ca. 1980 was attributed to aggravated nutrient loading. Our analysis also shows interactions between these two stressors. Compared to the dynamics driven by nutrient loading alone, WLC reduced the critical P loading and resulted in earlier disappearance of submerged vegetation and emergence of algal blooms by approximately 26 and 10 years, respectively. Overall, our study reveals the significant role of hydrological regulation in driving shallow lake ecosystem dynamics, and it highlights the urgency of using multi-objective management criteria that includes ecological sustainability perspectives when

The eSourcing Capability Model for Service Providers: Knowledge Manage-ment across the Sourcing Life-cycle

OpenAIRE

Laaksonen, Pekka

2011-01-01

Laaksonen, Pekka The eSourcing Capability Model for Service Providers: Knowledge Manage-ment across the Sourcing Life-cycle Jyväskylä: Jyväskylän yliopisto, 2011, 42 s. Tietojärjestelmätiede, kandidaatintutkielma Ohjaaja(t): Käkölä, Timo Tässä kandidaatintutkielmassa selvitettiin sitä, miten the eSourcing Capability Model for Service Providers-mallin käytännöt (practices) ovat liittyneet tietä-myksenhallinnan neljään prosessiin: tiedon luominen, varastointi/noutaminen, jakamine...

Exploring the Symbiodinium rare biosphere provides evidence for symbiont switching in reef-building corals.

Science.gov (United States)

Boulotte, Nadine M; Dalton, Steven J; Carroll, Andrew G; Harrison, Peter L; Putnam, Hollie M; Peplow, Lesa M; van Oppen, Madeleine Jh

2016-11-01

Reef-building corals possess a range of acclimatisation and adaptation mechanisms to respond to seawater temperature increases. In some corals, thermal tolerance increases through community composition changes of their dinoflagellate endosymbionts (Symbiodinium spp.), but this mechanism is believed to be limited to the Symbiodinium types already present in the coral tissue acquired during early life stages. Compelling evidence for symbiont switching, that is, the acquisition of novel Symbiodinium types from the environment, by adult coral colonies, is currently lacking. Using deep sequencing analysis of Symbiodinium rDNA internal transcribed spacer 2 (ITS2) PCR amplicons from two pocilloporid coral species, we show evidence consistent with de novo acquisition of Symbiodinium types from the environment by adult corals following two consecutive bleaching events. Most of these newly detected symbionts remained in the rare biosphere (background types occurring below 1% relative abundance), but one novel type reached a relative abundance of ~33%. Two de novo acquired Symbiodinium types belong to the thermally resistant clade D, suggesting that this switching may have been driven by consecutive thermal bleaching events. Our results are particularly important given the maternal mode of Symbiodinium transmission in the study species, which generally results in high symbiont specificity. These findings will cause a paradigm shift in our understanding of coral-Symbiodinium symbiosis flexibility and mechanisms of environmental acclimatisation in corals.

Modelling intentions to provide smoking cessation support among mental health professionals in the Netherlands.

Science.gov (United States)

Blankers, Matthijs; Buisman, Renate; Hopman, Petra; van Gool, Ronald; van Laar, Margriet

2016-01-01

Tobacco use prevalence is elevated among people with mental illnesses, leading to elevated rates of premature smoking-related mortality. Opportunities to encourage smoking cessation among them are currently underused by mental health professionals. In this paper, we aim to explore mechanisms to invigorate professionals' intentions to help patients stop smoking. Data stem from a recent staff survey on the provision of smoking cessation support to patients with mental illnesses in the Netherlands. Items and underlying constructs were based on the theory of planned behaviour and literature on habitual behaviour. Data were weighted and only data from staff members with regular patient contact (n = 506) were included. Descriptive statistics of the survey items are presented and in a second step using structural equation modelling (SEM), we regressed the latent variables attitudes, subjective norms (SN), perceived behavioural control (PBC), past cessation support behaviour (PB) and current smoking behaviour on intentions to provide support. In optimisation steps, models comprising a subset of this initial model were evaluated. A sample of 506 mental health workers who had direct contact with patients completed the survey. The majority of them were females (70.0 %), respondents had an average age of 42.5 years (SD = 12.0). Seventy-five percent had at least a BSc educational background. Of the respondents, 76 % indicated that patients should be encouraged more to quit smoking. Respondents were supportive to train their direct colleagues to provide cessation support more often (71 %) and also supported the involvement of mental health care facilities in providing cessation support to patients (69 %). The majority of the respondents feels capable to provide cessation support (66 %). Two thirds of the respondents wants to provide support, however only a minority (35 %) intends to actually do so during the coming year. Next, using SEM an acceptable fit was

Providing comprehensive and consistent access to astronomical observatory archive data: the NASA archive model

Science.gov (United States)

McGlynn, Thomas; Fabbiano, Giuseppina; Accomazzi, Alberto; Smale, Alan; White, Richard L.; Donaldson, Thomas; Aloisi, Alessandra; Dower, Theresa; Mazzerella, Joseph M.; Ebert, Rick; Pevunova, Olga; Imel, David; Berriman, Graham B.; Teplitz, Harry I.; Groom, Steve L.; Desai, Vandana R.; Landry, Walter

2016-07-01

Since the turn of the millennium a constant concern of astronomical archives have begun providing data to the public through standardized protocols unifying data from disparate physical sources and wavebands across the electromagnetic spectrum into an astronomical virtual observatory (VO). In October 2014, NASA began support for the NASA Astronomical Virtual Observatories (NAVO) program to coordinate the efforts of NASA astronomy archives in providing data to users through implementation of protocols agreed within the International Virtual Observatory Alliance (IVOA). A major goal of the NAVO collaboration has been to step back from a piecemeal implementation of IVOA standards and define what the appropriate presence for the US and NASA astronomy archives in the VO should be. This includes evaluating what optional capabilities in the standards need to be supported, the specific versions of standards that should be used, and returning feedback to the IVOA, to support modifications as needed. We discuss a standard archive model developed by the NAVO for data archive presence in the virtual observatory built upon a consistent framework of standards defined by the IVOA. Our standard model provides for discovery of resources through the VO registries, access to observation and object data, downloads of image and spectral data and general access to archival datasets. It defines specific protocol versions, minimum capabilities, and all dependencies. The model will evolve as the capabilities of the virtual observatory and needs of the community change.

Using a matrix-analytical approach to synthesizing evidence solved incompatibility problem in the hierarchy of evidence.

Science.gov (United States)

Walach, Harald; Loef, Martin

2015-11-01

The hierarchy of evidence presupposes linearity and additivity of effects, as well as commutativity of knowledge structures. It thereby implicitly assumes a classical theoretical model. This is an argumentative article that uses theoretical analysis based on pertinent literature and known facts to examine the standard view of methodology. We show that the assumptions of the hierarchical model are wrong. The knowledge structures gained by various types of studies are not sequentially indifferent, that is, do not commute. External validity and internal validity are at least partially incompatible concepts. Therefore, one needs a different theoretical structure, typical of quantum-type theories, to model this situation. The consequence of this situation is that the implicit assumptions of the hierarchical model are wrong, if generalized to the concept of evidence in total. The problem can be solved by using a matrix-analytical approach to synthesizing evidence. Here, research methods that produce different types of evidence that complement each other are synthesized to yield the full knowledge. We show by an example how this might work. We conclude that the hierarchical model should be complemented by a broader reasoning in methodology. Copyright © 2015 Elsevier Inc. All rights reserved.

[The dual process model of addiction. Towards an integrated model?].

Science.gov (United States)

Vandermeeren, R; Hebbrecht, M

2012-01-01

Neurobiology and cognitive psychology have provided us with a dual process model of addiction. According to this model, behavior is considered to be the dynamic result of a combination of automatic and controlling processes. In cases of addiction the balance between these two processes is severely disturbed. Automated processes will continue to produce impulses that ensure the continuance of addictive behavior. Weak, reflective or controlling processes are both the reason for and the result of the inability to forgo addiction. To identify features that are common to current neurocognitive insights into addiction and psychodynamic views on addiction. The picture that emerges from research is not clear. There is some evidence that attentional bias has a causal effect on addiction. There is no evidence that automatic associations have a causal effect, but there is some evidence that automatic action-tendencies do have a causal effect. Current neurocognitive views on the dual process model of addiction can be integrated with an evidence-based approach to addiction and with psychodynamic views on addiction.

SEE: structured representation of scientific evidence in the biomedical domain using Semantic Web techniques.

Science.gov (United States)

Bölling, Christian; Weidlich, Michael; Holzhütter, Hermann-Georg

2014-01-01

Accounts of evidence are vital to evaluate and reproduce scientific findings and integrate data on an informed basis. Currently, such accounts are often inadequate, unstandardized and inaccessible for computational knowledge engineering even though computational technologies, among them those of the semantic web, are ever more employed to represent, disseminate and integrate biomedical data and knowledge. We present SEE (Semantic EvidencE), an RDF/OWL based approach for detailed representation of evidence in terms of the argumentative structure of the supporting background for claims even in complex settings. We derive design principles and identify minimal components for the representation of evidence. We specify the Reasoning and Discourse Ontology (RDO), an OWL representation of the model of scientific claims, their subjects, their provenance and their argumentative relations underlying the SEE approach. We demonstrate the application of SEE and illustrate its design patterns in a case study by providing an expressive account of the evidence for certain claims regarding the isolation of the enzyme glutamine synthetase. SEE is suited to provide coherent and computationally accessible representations of evidence-related information such as the materials, methods, assumptions, reasoning and information sources used to establish a scientific finding by adopting a consistently claim-based perspective on scientific results and their evidence. SEE allows for extensible evidence representations, in which the level of detail can be adjusted and which can be extended as needed. It supports representation of arbitrary many consecutive layers of interpretation and attribution and different evaluations of the same data. SEE and its underlying model could be a valuable component in a variety of use cases that require careful representation or examination of evidence for data presented on the semantic web or in other formats.

6 CFR 13.34 - Evidence.

Science.gov (United States)

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Evidence. 13.34 Section 13.34 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.34 Evidence. (a) The ALJ will determine the admissibility of evidence. (b) Except as provided in this part, the ALJ...

How value-glamour investors use financial information: UK evidence of investor's confirmation bias

OpenAIRE

Doung, C.; Pescetto, G.; Santamaria, D.

2014-01-01

The paper investigates investor’s behaviour in the context of value–glamour investing and fundamental analysis, and provides a direct test of the confirmation bias by bringing together the evidence from several strands of literature into a well-defined framework of investor behaviour. The empirical evidence presented is in line with a model of\\ud investor’s asymmetric reaction to good and bad news due to confirmation bias. Pessimistic value investors typically under-react to good financial in...

An Evidence-Based Framework for Evidence-Based Management in ...

African Journals Online (AJOL)

2018-05-01

May 1, 2018 ... BACKGROUND: Evidence-based management (EBMgt) is a growing literature ... organization and management, especially in the last decade (1-6). One of these models is ..... Organizational Behavior. 2017;4(1):235-61.

Modeling Sensor Reliability in Fault Diagnosis Based on Evidence Theory

Directory of Open Access Journals (Sweden)

Kaijuan Yuan

2016-01-01

Full Text Available Sensor data fusion plays an important role in fault diagnosis. Dempster–Shafer (D-R evidence theory is widely used in fault diagnosis, since it is efficient to combine evidence from different sensors. However, under the situation where the evidence highly conflicts, it may obtain a counterintuitive result. To address the issue, a new method is proposed in this paper. Not only the statistic sensor reliability, but also the dynamic sensor reliability are taken into consideration. The evidence distance function and the belief entropy are combined to obtain the dynamic reliability of each sensor report. A weighted averaging method is adopted to modify the conflict evidence by assigning different weights to evidence according to sensor reliability. The proposed method has better performance in conflict management and fault diagnosis due to the fact that the information volume of each sensor report is taken into consideration. An application in fault diagnosis based on sensor fusion is illustrated to show the efficiency of the proposed method. The results show that the proposed method improves the accuracy of fault diagnosis from 81.19% to 89.48% compared to the existing methods.

Radiation inactivation method provides evidence that membrane-bound mitochondrial creatine kinase is an oligomer

International Nuclear Information System (INIS)

Quemeneur, E.; Eichenberger, D.; Goldschmidt, D.; Vial, C.; Beauregard, G.; Potier, M.

1988-01-01

Lyophilized suspensions of rabbit heart mitochondria have been irradiated with varying doses of gamma rays. Mitochondrial creatine kinase activity was inactivated exponentially with a radiation inactivation size of 352 or 377 kDa depending upon the initial medium. These values are in good agreement with the molecular mass previously deduced from by permeation experiments: 357 kDa. This is the first direct evidence showing that the native form of mitochondrial creatine kinase is associated to the inner membrane as an oligomer, very likely an octamer

Early atmospheric metal pollution provides evidence for Chalcolithic/Bronze Age mining and metallurgy in Southwestern Europe

Energy Technology Data Exchange (ETDEWEB)

Martínez Cortizas, Antonio, E-mail: antonio.martinez.cortizas@usc.es [Departamento de Edafoloxía e Química Agrícola, Facultade de Bioloxía, Universidade de Santiago de Compostela, Campus Sur s/n, Santiago de Compostela (Spain); López-Merino, Lourdes, E-mail: lourdes.lopez-merino@brunel.ac.uk [Institute of Environment, Health and Societies, Brunel University London, UB8 3PH Uxbridge (United Kingdom); Bindler, Richard, E-mail: richard.bindler@umu.se [Department of Ecology and Environmental Science, Umeå University, Umeå (Sweden); Mighall, Tim, E-mail: t.mighall@abdn.ac.uk [Department of Geography & Environment, School of Geosciences, University of Aberdeen, Elphinstone Road, Aberdeen AB24 3UF (United Kingdom); Kylander, Malin E., E-mail: malin.kylander@geo.su.se [Department of Geological Sciences and the Bolin Centre for Climate Research, Stockholm University, SE-10691, Stockholm (Sweden)

2016-03-01

Although archaeological research suggests that mining/metallurgy already started in the Chalcolithic (3rd millennium BC), the earliest atmospheric metal pollution in SW Europe has thus far been dated to ~ 3500–3200 cal. yr. BP in paleo-environmental archives. A low intensity, non-extensive mining/metallurgy and the lack of appropriately located archives may be responsible for this mismatch. We have analysed the older section (> 2100 cal. yr. BP) of a peat record from La Molina (Asturias, Spain), a mire located in the proximity (35–100 km) of mines which were exploited in the Chalcolithic/Bronze Age, with the aim of assessing evidence of this early mining/metallurgy. Analyses included the determination of C as a proxy for organic matter content, lithogenic elements (Si, Al, Ti) as markers of mineral matter, and trace metals (Cr, Cu, Zn, Pb) and stable Pb isotopes as tracers of atmospheric metal pollution. From ~ 8000 to ~ 4980 cal. yr. BP the Pb composition is similar to that of the underlying sediments (Pb 15 ± 4 μg g{sup −1}; {sup 206}Pb/{sup 207}Pb 1.204 ± 0.002). A sustained period of low {sup 206}Pb/{sup 207}Pb ratios occurred from ~ 4980 to ~ 2470 cal. yr. BP, which can be divided into four phases: Chalcolithic (~ 4980–3700 cal. yr. BP), {sup 206}Pb/{sup 207}Pb ratios decline to 1.175 and Pb/Al ratios increase; Early Bronze Age (~ 3700–3500 cal. yr. BP), {sup 206}Pb/{sup 207}Pb increase to 1.192 and metal/Al ratios remain stable; Late Bronze Age (~ 3500–2800 cal. yr. BP), {sup 206}Pb/{sup 207}Pb decline to their lowest values (1.167) while Pb/Al and Zn/Al increase; and Early Iron Age (~ 2800–2470 cal. yr. BP), {sup 206}Pb/{sup 207}Pb increase to 1.186, most metal/Al ratios decrease but Zn/Al shows a peak. At the beginning of the Late Iron Age, {sup 206}Pb/{sup 207}Pb ratios and metal enrichments show a rapid return to pre-anthropogenic values. These results provide evidence of regional/local atmospheric metal pollution triggered by the

Basing care reforms on evidence: the Kenya health sector costing model.

Science.gov (United States)

Flessa, Steffen; Moeller, Michael; Ensor, Tim; Hornetz, Klaus

2011-05-27

The Government of the Republic of Kenya is in the process of implementing health care reforms. However, poor knowledge about costs of health care services is perceived as a major obstacle towards evidence-based, effective and efficient health care reforms. Against this background, the Ministry of Health of Kenya in cooperation with its development partners conducted a comprehensive costing exercise and subsequently developed the Kenya Health Sector Costing Model in order to fill this data gap. Based on standard methodology of costing of health care services in developing countries, standard questionnaires and analyses were employed in 207 health care facilities representing different trustees (e.g. Government, Faith Based/Nongovernmental, private-for-profit organisations), levels of care and regions (urban, rural). In addition, a total of 1369 patients were randomly selected and asked about their demand-sided costs. A standard step-down costing methodology was applied to calculate the costs per service unit and per diagnosis of the financial year 2006/2007. The total costs of essential health care services in Kenya were calculated as 690 million Euros or 18.65 Euro per capita. 54% were incurred by public sector facilities, 17% by Faith Based and other Nongovernmental facilities and 23% in the private sector. Some 6% of the total cost is due to the overall administration provided directly by the Ministry and its decentralised organs. Around 37% of this cost is absorbed by salaries and 22% by drugs and medical supplies. Generally, costs of lower levels of care are lower than of higher levels, but health centres are an exemption. They have higher costs per service unit than district hospitals. The results of this study signify that the costs of health care services are quite high compared with the Kenyan domestic product, but a major share are fixed costs so that an increasing coverage does not necessarily increase the health care costs proportionally. Instead

Basing care reforms on evidence: The Kenya health sector costing model

Science.gov (United States)

2011-01-01

Background The Government of the Republic of Kenya is in the process of implementing health care reforms. However, poor knowledge about costs of health care services is perceived as a major obstacle towards evidence-based, effective and efficient health care reforms. Against this background, the Ministry of Health of Kenya in cooperation with its development partners conducted a comprehensive costing exercise and subsequently developed the Kenya Health Sector Costing Model in order to fill this data gap. Methods Based on standard methodology of costing of health care services in developing countries, standard questionnaires and analyses were employed in 207 health care facilities representing different trustees (e.g. Government, Faith Based/Nongovernmental, private-for-profit organisations), levels of care and regions (urban, rural). In addition, a total of 1369 patients were randomly selected and asked about their demand-sided costs. A standard step-down costing methodology was applied to calculate the costs per service unit and per diagnosis of the financial year 2006/2007. Results The total costs of essential health care services in Kenya were calculated as 690 million Euros or 18.65 Euro per capita. 54% were incurred by public sector facilities, 17% by Faith Based and other Nongovernmental facilities and 23% in the private sector. Some 6% of the total cost is due to the overall administration provided directly by the Ministry and its decentralised organs. Around 37% of this cost is absorbed by salaries and 22% by drugs and medical supplies. Generally, costs of lower levels of care are lower than of higher levels, but health centres are an exemption. They have higher costs per service unit than district hospitals. Conclusions The results of this study signify that the costs of health care services are quite high compared with the Kenyan domestic product, but a major share are fixed costs so that an increasing coverage does not necessarily increase the health

Beyond ROC Curvature: Strength Effects and Response Time Data Support Continuous-Evidence Models of Recognition Memory

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Dube, Chad; Starns, Jeffrey J.; Rotello, Caren M.; Ratcliff, Roger

2012-01-01

A classic question in the recognition memory literature is whether retrieval is best described as a continuous-evidence process consistent with signal detection theory (SDT), or a threshold process consistent with many multinomial processing tree (MPT) models. Because receiver operating characteristics (ROCs) based on confidence ratings are…

The dynamic information architecture system : a simulation framework to provide interoperability for process models

International Nuclear Information System (INIS)

Hummel, J. R.; Christiansen, J. H.

2002-01-01

As modeling and simulation becomes a more important part of the day-to-day activities in industry and government, organizations are being faced with the vexing problem of how to integrate a growing suite of heterogeneous models both within their own organizations and between organizations. The Argonne National Laboratory, which is operated by the University of Chicago for the United States Department of Energy, has developed the Dynamic Information Architecture System (DIAS) to address such problems. DIAS is an object-oriented, subject domain independent framework that is used to integrate legacy or custom-built models and applications. In this paper we will give an overview of the features of DIAS and give examples of how it has been used to integrate models in a number of applications. We shall also describe some of the key supporting DIAS tools that provide seamless interoperability between models and applications

Rainfall induced landslide susceptibility mapping using weight-of-evidence, linear and quadratic discriminant and logistic model tree method

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Hong, H.; Zhu, A. X.

2017-12-01

Climate change is a common phenomenon and it is very serious all over the world. The intensification of rainfall extremes with climate change is of key importance to society and then it may induce a large impact through landslides. This paper presents GIS-based new ensemble data mining techniques that weight-of-evidence, logistic model tree, linear and quadratic discriminant for landslide spatial modelling. This research was applied in Anfu County, which is a landslide-prone area in Jiangxi Province, China. According to a literature review and research the study area, we select the landslide influencing factor and their maps were digitized in a GIS environment. These landslide influencing factors are the altitude, plan curvature, profile curvature, slope degree, slope aspect, topographic wetness index (TWI), Stream Power Index (SPI), Topographic Wetness Index (SPI), distance to faults, distance to rivers, distance to roads, soil, lithology, normalized difference vegetation index and land use. According to historical information of individual landslide events, interpretation of the aerial photographs, and field surveys supported by the government of Jiangxi Meteorological Bureau of China, 367 landslides were identified in the study area. The landslide locations were divided into two subsets, namely, training and validating (70/30), based on a random selection scheme. In this research, Pearson's correlation was used for the evaluation of the relationship between the landslides and influencing factors. In the next step, three data mining techniques combined with the weight-of-evidence, logistic model tree, linear and quadratic discriminant, were used for the landslide spatial modelling and its zonation. Finally, the landslide susceptibility maps produced by the mentioned models were evaluated by the ROC curve. The results showed that the area under the curve (AUC) of all of the models was > 0.80. At the same time, the highest AUC value was for the linear and quadratic

FIA: An Open Forensic Integration Architecture for Composing Digital Evidence

Science.gov (United States)

Raghavan, Sriram; Clark, Andrew; Mohay, George

The analysis and value of digital evidence in an investigation has been the domain of discourse in the digital forensic community for several years. While many works have considered different approaches to model digital evidence, a comprehensive understanding of the process of merging different evidence items recovered during a forensic analysis is still a distant dream. With the advent of modern technologies, pro-active measures are integral to keeping abreast of all forms of cyber crimes and attacks. This paper motivates the need to formalize the process of analyzing digital evidence from multiple sources simultaneously. In this paper, we present the forensic integration architecture (FIA) which provides a framework for abstracting the evidence source and storage format information from digital evidence and explores the concept of integrating evidence information from multiple sources. The FIA architecture identifies evidence information from multiple sources that enables an investigator to build theories to reconstruct the past. FIA is hierarchically composed of multiple layers and adopts a technology independent approach. FIA is also open and extensible making it simple to adapt to technological changes. We present a case study using a hypothetical car theft case to demonstrate the concepts and illustrate the value it brings into the field.

Priming Contour-Deleted Images: Evidence for Immediate Representations in Visual Object Recognition.

Science.gov (United States)

Biederman, Irving; Cooper, Eric E.

1991-01-01

Speed and accuracy of identification of pictures of objects are facilitated by prior viewing. Contributions of image features, convex or concave components, and object models in a repetition priming task were explored in 2 studies involving 96 college students. Results provide evidence of intermediate representations in visual object recognition.…

Funding issues and options for pharmacists providing sessional services to rural hospitals in Australia.

Science.gov (United States)

Tan, Amy Cw; Emmerton, Lynne M; Hattingh, H Laetitia; La Caze, Adam

2015-06-01

Many of Australia' s rural hospitals operate without an on-site pharmacist. In some, community pharmacists have sessional contracts to provide medication management services to inpatients. This paper discusses the funding arrangements of identified sessional employment models to raise awareness of options for other rural hospitals. Semistructured one-on-one interviews were conducted with rural pharmacists with experience in a sessional employment role (n =8) or who were seeking sessional arrangements (n = 4). Participants were identified via publicity and referrals. Interviews were conducted via telephone or Skype for ~40-55 min each, recorded and analysed descriptively. A shortage of state funding and reliance on federal funding was reported. Pharmacists accredited to provide medication reviews claimed remuneration via these federal schemes; however, restrictive criteria limited their scope of services. Funds pooling to subsidise remuneration for the pharmacists was evident and arrangements with local community pharmacies provided business frameworks to support sessional services. Participants were unaware of each other's models of practice, highlighting the need to share information and these findings. Several similarities existed, namely, pooling funds and use of federal medication review remuneration. Findings highlighted the need for a stable remuneration pathway and business model to enable wider implementation of sessional pharmacist models.

Creating a market: an economic analysis of the purchaser-provider model.

Science.gov (United States)

Shackley, P; Healey, A

1993-09-01

The focus of this paper is the extent to which the purchaser-provider split and the creation of a market in the provision of health care can be expected to bring about greater efficiency within the new NHS. The starting point is a theoretical discussion of markets and competition. In particular, emphasis is placed upon the economic model of perfect competition. It is argued that because of the existence of externalities, uncertainty and a lack of perfect information, an unregulated market in health care will almost certainly fail. In view of this, the imperfect provider markets of monopoly and contestable markets, which are of particular relevance to health care, are discussed. A description of the new health care market and the principal actors within it is followed by an evaluation of the new health care market. It is argued that in view of the restrictions to competition that exist between providers, some form of price regulation will be necessary to prevent monopolistic behaviour in the hospital sector. Regulation of purchasers is also suggested as a means of improving efficiency. It is concluded that competition may be a necessary condition for increased efficiency in health care provision, but is not sufficient in itself. Other incentives in the hospital sector are necessary to assist the market process and to enhance its impact on efficiency.

Do cratons preserve evidence of stagnant lid tectonics?

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Derek Wyman

2018-01-01

Full Text Available Evidence for episodic crustal growth extending back to the Hadean has recently prompted a number of numerically based geodynamic models that incorporate cyclic changes from stagnant lid to mobile lid tectonics. A large part of the geologic record is missing for the times at which several of these cycles are inferred to have taken place. The cratons, however, are likely to retain important clues relating to similar cycles developed in the Mesoarchean and Neoarchean. Widespread acceptance of a form of plate tectonics by ∼3.2 Ga is not at odds with the sporadic occurrence of stagnant lid tectonics after this time. The concept of scale as applied to cratons, mantle plumes and Neoarchean volcanic arcs are likely to provide important constraints on future models of Earth's geodynamic evolution. The Superior Province will provide some of the most concrete evidence in this regard given that its constituent blocks may have been locked into a stagnant lid relatively soon after their formation and then assembled in the next global plate tectonic interval. Perceived complexities associated with inferred mantle plume – volcanic arc associations in the Superior Province and other cratons may be related to an over estimation of plume size. A possible stagnant lid episode between ∼2.9 Ga and ∼2.8 Ga is identified by previously unexplained lapses in volcanism on cratons, including the Kaapvaal, Yilgarn and Superior Province cratons. If real, then mantle dynamics associated with this episode likely eliminated any contemporaneous mantle plume incubation sites, which has important implications for widespread plumes developed at ∼2.7 Ga and favours a shallow mantle source in the transition zone. The Superior Province provides a uniquely preserved local proxy for this global event and could serve as the basis for detailed numerical models in the future.

Personality and Depression: Explanatory Models and Review of the Evidence

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Klein, Daniel N.; Kotov, Roman; Bufferd, Sara J.

2012-01-01

Understanding the association between personality and depression has implications for elucidating etiology and comorbidity, identifying at-risk individuals, and tailoring treatment. We discuss seven major models that have been proposed to explain the relation between personality and depression, and we review key methodological issues, including study design, the heterogeneity of mood disorders, and the assessment of personality. We then selectively review the extensive empirical literature on the role of personality traits in depression in adults and children. Current evidence suggests that depression is linked to traits such as neuroticism/negative emotionality, extraversion/positive emotionality, and conscientiousness. Moreover, personality characteristics appear to contribute to the onset and course of depression through a variety of pathways. Implications for prevention and prediction of treatment response are discussed, as well as specific considerations to guide future research on the relation between personality and depression. PMID:21166535

Provider accountability as a driving force towards physician–hospital integration: a systematic review

Directory of Open Access Journals (Sweden)

Jeroen Trybou

2015-04-01

Full Text Available Background: Hospitals and physicians lie at the heart of our health care delivery system. In general, physicians provide medical care and hospitals the resources to deliver health care. In the past two decades many countries have adopted reforms in which provider financial risk bearing is increased. By making providers financially accountable for the delivered care integrated care delivery is stimulated.Purpose: To assess the evidence base supporting the relationship between provider financial risk bearing and physician–hospital integration and to identify the different types of methods used to measure physician–hospital integration to evaluate the functional value of these integrative models.Results: Nine studies met the inclusion criteria. The evidence base is mixed and inconclusive. Our methodological analysis of previous research shows that previous studies have largely focused on the formal structures of physician–hospital arrangements as an indicator of physician–hospital integration.Conclusion: The link between provider financial risk bearing and physician–hospital integration can at this time be supported merely on the basis of theoretical insights of agency theory rather than empirical research. Physician–hospital integration measurement has concentrated on the prevalence of contracting vehicles that enables joint bargaining in a managed care environment but without realizing integration and cooperation between hospital and physicians. Therefore, we argue that these studies fail to shed light on the impact of risk shifting on the hospital–physician relationship accurately.

Provider accountability as a driving force towards physician–hospital integration: a systematic review

Directory of Open Access Journals (Sweden)

Jeroen Trybou

2015-04-01

Full Text Available Background: Hospitals and physicians lie at the heart of our health care delivery system. In general, physicians provide medical care and hospitals the resources to deliver health care. In the past two decades many countries have adopted reforms in which provider financial risk bearing is increased. By making providers financially accountable for the delivered care integrated care delivery is stimulated. Purpose: To assess the evidence base supporting the relationship between provider financial risk bearing and physician–hospital integration and to identify the different types of methods used to measure physician–hospital integration to evaluate the functional value of these integrative models. Results: Nine studies met the inclusion criteria. The evidence base is mixed and inconclusive. Our methodological analysis of previous research shows that previous studies have largely focused on the formal structures of physician–hospital arrangements as an indicator of physician–hospital integration. Conclusion: The link between provider financial risk bearing and physician–hospital integration can at this time be supported merely on the basis of theoretical insights of agency theory rather than empirical research. Physician–hospital integration measurement has concentrated on the prevalence of contracting vehicles that enables joint bargaining in a managed care environment but without realizing integration and cooperation between hospital and physicians. Therefore, we argue that these studies fail to shed light on the impact of risk shifting on the hospital–physician relationship accurately.

The Evidence-Based Practice of Applied Behavior Analysis.

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Slocum, Timothy A; Detrich, Ronnie; Wilczynski, Susan M; Spencer, Trina D; Lewis, Teri; Wolfe, Katie

2014-05-01

Evidence-based practice (EBP) is a model of professional decision-making in which practitioners integrate the best available evidence with client values/context and clinical expertise in order to provide services for their clients. This framework provides behavior analysts with a structure for pervasive use of the best available evidence in the complex settings in which they work. This structure recognizes the need for clear and explicit understanding of the strength of evidence supporting intervention options, the important contextual factors including client values that contribute to decision making, and the key role of clinical expertise in the conceptualization, intervention, and evaluation of cases. Opening the discussion of EBP in this journal, Smith (The Behavior Analyst, 36, 7-33, 2013) raised several key issues related to EBP and applied behavior analysis (ABA). The purpose of this paper is to respond to Smith's arguments and extend the discussion of the relevant issues. Although we support many of Smith's (The Behavior Analyst, 36, 7-33, 2013) points, we contend that Smith's definition of EBP is significantly narrower than definitions that are used in professions with long histories of EBP and that this narrowness conflicts with the principles that drive applied behavior analytic practice. We offer a definition and framework for EBP that aligns with the foundations of ABA and is consistent with well-established definitions of EBP in medicine, psychology, and other professions. In addition to supporting the systematic use of research evidence in behavior analytic decision making, this definition can promote clear communication about treatment decisions across disciplines and with important outside institutions such as insurance companies and granting agencies.

A Randomized Controlled Trial Provides Evidence to Support Aromatherapy to Minimize Anxiety in Women Undergoing Breast Biopsy.

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Trambert, Renee; Kowalski, Mildred Ortu; Wu, Betty; Mehta, Nimisha; Friedman, Paul

2017-10-01

Aromatherapy has been used to reduce anxiety in a variety of settings, but usefulness associated with breast biopsies has not been documented. This study was conducted in women undergoing image-guided breast biopsy. We explored the use of two different aromatherapy scents, compared to placebo, aimed at reducing anxiety with the intent of generating new knowledge. This was a randomized, placebo-controlled study of two different types of external aromatherapy tabs (lavender-sandalwood and orange-peppermint) compared with a matched placebo-control delivery system. Anxiety was self-reported before and after undergoing a breast biopsy using the Spielberger State Anxiety Inventory Scale. Eighty-seven women participated in this study. There was a statistically significant reduction in self-reported anxiety with the use of the lavender-sandalwood aromatherapy tab compared with the placebo group (p = .032). Aromatherapy tabs reduced anxiety during image-guided breast biopsy. The completion of the biopsy provided some relief from anxiety in all groups. The use of aromatherapy tabs offers an evidence-based nursing intervention to improve adaptation and reduce anxiety for women undergoing breast biopsy. Lavender-sandalwood aromatherapy reduced anxiety and promoted adaptation more than orange-peppermint aromatherapy or placebo. © 2017 Sigma Theta Tau International.

Understanding juror perceptions of forensic evidence: investigating the impact of case context on perceptions of forensic evidence strength.

Science.gov (United States)

Smith, Lisa L; Bull, Ray; Holliday, Robyn

2011-03-01

The most widely accepted model of juror decision making acknowledges the importance of both the case-specific information presented in the courtroom, as well as the prior general knowledge and beliefs held by each juror. The studies presented in this paper investigated whether mock jurors could differentiate between evidence of varying strengths in the absence of case information and then followed on to determine the influence that case context (and therefore the story model) has on judgments made about the strength of forensic DNA evidence. The results illustrated that mock jurors correctly identified various strengths of evidence when it was not presented with case information; however, the perceived strength of evidence was significantly inflated when presented in the context of a criminal case, particularly when the evidence was of a weak or ambiguous standard. These findings are discussed in relation to the story model, and the potential implications for real juries. © 2011 American Academy of Forensic Sciences.

Blood donor deferral: time for change? An evidence-based analysis

Directory of Open Access Journals (Sweden)

Borra V

2016-05-01

Full Text Available Vere Borra,1 Giovani Vandewalle,1 Hans Van Remoortel,1 Veerle Compernolle,1,2 Emmy De Buck,1 Philippe Vandekerckhove1–31Belgian Red Cross-Flanders, Mechelen, 2Faculty of Medicine, University of Ghent, Ghent, 3Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, BelgiumAbstract: Donor selection remains an important part in the safety of the blood supply all over the world. Yet, donor deferral criteria seem to be strongly based on the precautionary principle protecting safety and quality, and on supply and expense considerations. This review therefore provides an overview of the available evidence on donor exclusion criteria, as well as on their cost-effectiveness, for the most frequent reasons of donor deferral in our region. PubMed was queried to retrieve primary research studies, systematic reviews, and health technology assessments (HTAs concerning donor exclusion criteria. With a similar approach, HTAs about the different blood-banking safety interventions were included. Reasons for donor deferral were recorded via the blood bank information system of the Belgian Red Cross-Flanders. Seven systematic reviews were identified: four on donor safety (hypotension, hypertension/type 2 diabetes, epilepsy, and higher age and three on recipient safety (hemochromatosis, men who have sex with men, and endoscopy. Forty-three low-quality observational studies were included, as well as 16 HTAs: three about donor exclusion criteria and 13 cost-utility analyses about blood-banking safety interventions. In general, the available evidence for deferral reasons was of low quality, and for 60% of the top 30 reasons for excluding donors, no evidence was found. Blood banking shows its unique position as many safety measures far exceed the normally accepted cost of €50,000/quality-adjusted life-years. The historical model based on the precautionary principle and on supply and expense considerations provides adequate supplies of

Using evidence to make decisions

Science.gov (United States)

Jenkins, Charles

2014-12-01

Bayesian evidence ratios give a very attractive way of comparing models, and being able to quote the odds on a particular model seems a very clear motivation for making a choice. Jeffreys' scale of evidence is often used in the interpretation of evidence ratios. A natural question is, how often will you get it right when you choose on the basis of some threshold value of the evidence ratio? The evidence ratio will be different in different realizations of the data, and its utility can be examined in a Neyman-Pearson like way to see what the trade-offs are between statistical power (the chance of "getting it right") versus the false alarm rate, picking the alternative hypothesis when the null is actually true. I will show some simple examples which show that there can be a surprisingly large range for an evidence ratio under different realizations of the data. It seems best not to simply rely on Jeffrey's scale when decisions have to be taken, but also to examine the probability of taking the "wrong" decision if some evidence ratio is taken to be decisive. Interestingly, Turing knew this and applied it during WWII, although (like much else) he did not publish it.

The phenology of Rubus fruticosus in Ireland: herbarium specimens provide evidence for the response of phenophases to temperature, with implications for climate warming

Science.gov (United States)

Diskin, E.; Proctor, H.; Jebb, M.; Sparks, T.; Donnelly, A.

2012-11-01

To date, phenological research has provided evidence that climate warming is impacting both animals and plants, evidenced by the altered timing of phenophases. Much of the evidence supporting these findings has been provided by analysis of historic records and present-day fieldwork; herbaria have been identified recently as an alternative source of phenological data. Here, we used Rubus specimens to evaluate herbaria as potential sources of phenological data for use in climate change research and to develop the methodology for using herbaria specimens in phenological studies. Data relevant to phenology (collection date) were recorded from the information cards of over 600 herbarium specimens at Ireland's National Herbarium in Dublin. Each specimen was assigned a score (0-5) corresponding to its phenophase. Temperature data for the study period (1852 - 2007) were obtained from the University of East Anglia's Climate Research Unit (CRU); relationships between temperature and the dates of first flower, full flower, first fruit and full fruit were assessed using weighted linear regression. Of the five species of Rubus examined in this study, specimens of only one ( R. fruticosus) were sufficiently abundant to yield statistically significant relationships with temperature. The results revealed a trend towards earlier dates of first flower, full flower and first fruit phenophases with increasing temperature. Through its multi-phenophase approach, this research serves to extend the most recent work—which validated the use of herbaria through use of a single phenophase—to confirm herbarium-based research as a robust methodology for use in future phenological studies.

Incorporation of a health economic modelling tool into public health commissioning: Evidence use in a politicised context.

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Sanders, Tom; Grove, Amy; Salway, Sarah; Hampshaw, Susan; Goyder, Elizabeth

2017-08-01

This paper explores how commissioners working in an English local government authority (LA) viewed a health economic decision tool for planning services in relation to diabetes. We conducted 15 interviews and 2 focus groups between July 2015 and February 2016, with commissioners (including public health managers, data analysts and council members). Two overlapping themes were identified explaining the obstacles and enablers of using such a tool in commissioning: a) evidence cultures, and b) system interdependency. The former highlighted the diverse evidence cultures present in the LA with politicians influenced by the 'soft' social care agendas affecting their local population and treating local opinion as evidence, whilst public health managers prioritised the scientific view of evidence informed by research. System interdependency further complicated the decision making process by recognizing interlinking with departments and other disease groups. To achieve legitimacy within the commissioning arena health economic modelling needs to function effectively in a highly politicised environment where decisions are made not only on the basis of research evidence, but on grounds of 'soft' data, personal opinion and intelligence. In this context decisions become politicised, with multiple opinions seeking a voice. The way that such decisions are negotiated and which ones establish authority is of importance. We analyse the data using Larson's (1990) discursive field concept to show how the tool becomes an object of research push and pull likely to be used instrumentally by stakeholders to advance specific agendas, not a means of informing complex decisions. In conclusion, LA decision making is underpinned by a transactional business ethic which is a further potential 'pull' mechanism for the incorporation of health economic modelling in local commissioning. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

The Heart of the Matter of Opinion and Evidence: The Value of Evidence-Based Medicine

OpenAIRE

Masvidal, Daniel; Lavie, Carl J.

2012-01-01

Evidence-based medicine is an important aspect of continuing medical education. This article reviews previous and current examples of conflicting topics that evidence-based medicine has clarified to allow us to provide the best possible patient care.

Provider-Independent Use of the Cloud

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Harmer, Terence; Wright, Peter; Cunningham, Christina; Perrott, Ron

Utility computing offers researchers and businesses the potential of significant cost-savings, making it possible for them to match the cost of their computing and storage to their demand for such resources. A utility compute provider enables the purchase of compute infrastructures on-demand; when a user requires computing resources a provider will provision a resource for them and charge them only for their period of use of that resource. There has been a significant growth in the number of cloud computing resource providers and each has a different resource usage model, application process and application programming interface (API)-developing generic multi-resource provider applications is thus difficult and time consuming. We have developed an abstraction layer that provides a single resource usage model, user authentication model and API for compute providers that enables cloud-provider neutral applications to be developed. In this paper we outline the issues in using external resource providers, give examples of using a number of the most popular cloud providers and provide examples of developing provider neutral applications. In addition, we discuss the development of the API to create a generic provisioning model based on a common architecture for cloud computing providers.

Development of the IMB Model and an Evidence-Based Diabetes Self-management Mobile Application.

Science.gov (United States)

Jeon, Eunjoo; Park, Hyeoun-Ae

2018-04-01

This study developed a diabetes self-management mobile application based on the information-motivation-behavioral skills (IMB) model, evidence extracted from clinical practice guidelines, and requirements identified through focus group interviews (FGIs) with diabetes patients. We developed a diabetes self-management (DSM) app in accordance with the following four stages of the system development life cycle. The functional and knowledge requirements of the users were extracted through FGIs with 19 diabetes patients. A system diagram, data models, a database, an algorithm, screens, and menus were designed. An Android app and server with an SSL protocol were developed. The DSM app algorithm and heuristics, as well as the usability of the DSM app were evaluated, and then the DSM app was modified based on heuristics and usability evaluation. A total of 11 requirement themes were identified through the FGIs. Sixteen functions and 49 knowledge rules were extracted. The system diagram consisted of a client part and server part, 78 data models, a database with 10 tables, an algorithm, and a menu structure with 6 main menus, and 40 user screens were developed. The DSM app was Android version 4.4 or higher for Bluetooth connectivity. The proficiency and efficiency scores of the algorithm were 90.96% and 92.39%, respectively. Fifteen issues were revealed through the heuristic evaluation, and the app was modified to address three of these issues. It was also modified to address five comments received by the researchers through the usability evaluation. The DSM app was developed based on behavioral change theory through IMB models. It was designed to be evidence-based, user-centered, and effective. It remains necessary to fully evaluate the effect of the DSM app on the DSM behavior changes of diabetes patients.

How evidence-based are the recommendations in evidence-based guidelines?

Directory of Open Access Journals (Sweden)

Finlay A McAlister

2007-08-01

Full Text Available BACKGROUND: Treatment recommendations for the same condition from different guideline bodies often disagree, even when the same randomized controlled trial (RCT evidence is cited. Guideline appraisal tools focus on methodology and quality of reporting, but not on the nature of the supporting evidence. This study was done to evaluate the quality of the evidence (based on consideration of its internal validity, clinical relevance, and applicability underlying therapy recommendations in evidence-based clinical practice guidelines. METHODS AND FINDINGS: A cross-sectional analysis of cardiovascular risk management recommendations was performed for three different conditions (diabetes mellitus, dyslipidemia, and hypertension from three pan-national guideline panels (from the United States, Canada, and Europe. Of the 338 treatment recommendations in these nine guidelines, 231 (68% cited RCT evidence but only 105 (45% of these RCT-based recommendations were based on high-quality evidence. RCT-based evidence was downgraded most often because of reservations about the applicability of the RCT to the populations specified in the guideline recommendation (64/126 cases, 51% or because the RCT reported surrogate outcomes (59/126 cases, 47%. CONCLUSIONS: The results of internally valid RCTs may not be applicable to the populations, interventions, or outcomes specified in a guideline recommendation and therefore should not always be assumed to provide high-quality evidence for therapy recommendations.

A simple simulation model as a tool to assess alternative health care provider payment reform options in Vietnam.

Science.gov (United States)

Cashin, Cheryl; Phuong, Nguyen Khanh; Shain, Ryan; Oanh, Tran Thi Mai; Thuy, Nguyen Thi

2015-01-01

Vietnam is currently considering a revision of its 2008 Health Insurance Law, including the regulation of provider payment methods. This study uses a simple spreadsheet-based, micro-simulation model to analyse the potential impacts of different provider payment reform scenarios on resource allocation across health care providers in three provinces in Vietnam, as well as on the total expenditure of the provincial branches of the public health insurance agency (Provincial Social Security [PSS]). The results show that currently more than 50% of PSS spending is concentrated at the provincial level with less than half at the district level. There is also a high degree of financial risk on district hospitals with the current fund-holding arrangement. Results of the simulation model show that several alternative scenarios for provider payment reform could improve the current payment system by reducing the high financial risk currently borne by district hospitals without dramatically shifting the current level and distribution of PSS expenditure. The results of the simulation analysis provided an empirical basis for health policy-makers in Vietnam to assess different provider payment reform options and make decisions about new models to support health system objectives.

Extending an evidence hierarchy to include topics other than treatment: revising the Australian 'levels of evidence'

Science.gov (United States)

2009-01-01

Background In 1999 a four-level hierarchy of evidence was promoted by the National Health and Medical Research Council in Australia. The primary purpose of this hierarchy was to assist with clinical practice guideline development, although it was co-opted for use in systematic literature reviews and health technology assessments. In this hierarchy interventional study designs were ranked according to the likelihood that bias had been eliminated and thus it was not ideal to assess studies that addressed other types of clinical questions. This paper reports on the revision and extension of this evidence hierarchy to enable broader use within existing evidence assessment systems. Methods A working party identified and assessed empirical evidence, and used a commissioned review of existing evidence assessment schema, to support decision-making regarding revision of the hierarchy. The aim was to retain the existing evidence levels I-IV but increase their relevance for assessing the quality of individual diagnostic accuracy, prognostic, aetiologic and screening studies. Comprehensive public consultation was undertaken and the revised hierarchy was piloted by individual health technology assessment agencies and clinical practice guideline developers. After two and a half years, the hierarchy was again revised and commenced a further 18 month pilot period. Results A suitable framework was identified upon which to model the revision. Consistency was maintained in the hierarchy of "levels of evidence" across all types of clinical questions; empirical evidence was used to support the relationship between study design and ranking in the hierarchy wherever possible; and systematic reviews of lower level studies were themselves ascribed a ranking. The impact of ethics on the hierarchy of study designs was acknowledged in the framework, along with a consideration of how harms should be assessed. Conclusion The revised evidence hierarchy is now widely used and provides a common

Extending an evidence hierarchy to include topics other than treatment: revising the Australian 'levels of evidence'

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Merlin Tracy

2009-06-01

Full Text Available Abstract Background In 1999 a four-level hierarchy of evidence was promoted by the National Health and Medical Research Council in Australia. The primary purpose of this hierarchy was to assist with clinical practice guideline development, although it was co-opted for use in systematic literature reviews and health technology assessments. In this hierarchy interventional study designs were ranked according to the likelihood that bias had been eliminated and thus it was not ideal to assess studies that addressed other types of clinical questions. This paper reports on the revision and extension of this evidence hierarchy to enable broader use within existing evidence assessment systems. Methods A working party identified and assessed empirical evidence, and used a commissioned review of existing evidence assessment schema, to support decision-making regarding revision of the hierarchy. The aim was to retain the existing evidence levels I-IV but increase their relevance for assessing the quality of individual diagnostic accuracy, prognostic, aetiologic and screening studies. Comprehensive public consultation was undertaken and the revised hierarchy was piloted by individual health technology assessment agencies and clinical practice guideline developers. After two and a half years, the hierarchy was again revised and commenced a further 18 month pilot period. Results A suitable framework was identified upon which to model the revision. Consistency was maintained in the hierarchy of "levels of evidence" across all types of clinical questions; empirical evidence was used to support the relationship between study design and ranking in the hierarchy wherever possible; and systematic reviews of lower level studies were themselves ascribed a ranking. The impact of ethics on the hierarchy of study designs was acknowledged in the framework, along with a consideration of how harms should be assessed. Conclusion The revised evidence hierarchy is now widely

Hydrogeochemical evidence supporting models for groundwater flow around Sellafield, U.K

International Nuclear Information System (INIS)

Metcalfe, R.; Milodowski, A.E.; Noy, D.J.

1999-01-01

Recently, United Kingdom Nirex Limited has investigated a site near Sellafield, north-west England to assess its suitability as the potential location for a deep underground repository for the disposal of intermediate- level, and some low-level, solid radioactive waste. Groundwater flow at the site was simulated using a variety of computer codes, based upon conceptual models of the hydrogeological system. Chemical data for groundwaters aided the development of these conceptual models, and also provided a check upon the computer models' validity. Mineralogical information can be accommodated within the conceptual and theoretical framework. The results of the investigation are presented. (author)

Sex determination in the haplodiploid wasp Nasonia vitripennis (Hymenoptera Chalcidoidea) : A critical consideration of models and evidence

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Beukeboom, Leo W.; Kamping, Albert; van de Zande, Louis

Sex determining mechanisms are highly diverse. Like all Hymenoptera, the parasitic wasp Nasonia vitripennis reproduces by haplodiploidy: males are haploid and females are diploid. Sex in Nasonia is not determined by complementary alleles at sex loci. Evidence for several alternative models is

The Heart of the Matter of Opinion and Evidence: The Value of Evidence-Based Medicine

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Masvidal, Daniel; Lavie, Carl J.

2012-01-01

Evidence-based medicine is an important aspect of continuing medical education. This article reviews previous and current examples of conflicting topics that evidence-based medicine has clarified to allow us to provide the best possible patient care. PMID:22438783

Agent-based organizational modelling for analysis of safety culture at an air navigation service provider

International Nuclear Information System (INIS)

Stroeve, Sybert H.; Sharpanskykh, Alexei; Kirwan, Barry

2011-01-01

Assessment of safety culture is done predominantly by questionnaire-based studies, which tend to reveal attitudes on immaterial characteristics (values, beliefs, norms). There is a need for a better understanding of the implications of the material aspects of an organization (structures, processes, etc.) for safety culture and their interactions with the immaterial characteristics. This paper presents a new agent-based organizational modelling approach for integrated and systematic evaluation of material and immaterial characteristics of socio-technical organizations in safety culture analysis. It uniquely considers both the formal organization and the value- and belief-driven behaviour of individuals in the organization. Results are presented of a model for safety occurrence reporting at an air navigation service provider. Model predictions consistent with questionnaire-based results are achieved. A sensitivity analysis provides insight in organizational factors that strongly influence safety culture indicators. The modelling approach can be used in combination with attitude-focused safety culture research, towards an integrated evaluation of material and immaterial characteristics of socio-technical organizations. By using this approach an organization is able to gain a deeper understanding of causes of diverse problems and inefficiencies both in the formal organization and in the behaviour of organizational agents, and to systematically identify and evaluate improvement options.

Cameroon mid-level providers offer a promising public health dentistry model

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Achembong Leo

2012-11-01

Full Text Available Background Oral health services are inadequate and unevenly distributed in many developing countries, particularly those in sub-Saharan Africa. Rural areas in these countries and poorer sections of the population in urban areas often do not have access to oral health services mainly because of a significant shortage of dentists and the high costs of care. We reviewed Cameroon’s experience with deploying a mid-level cadre of oral health professionals and the feasibility of establishing a more formal and predictable role for these health workers. We anticipate that a task-shifting approach in the provision of dental care will significantly improve the uneven distribution of oral health services particularly in the rural areas of Cameroon, which is currently served by only 3% of the total number of dentists. Methods The setting of this study was the Cameroon Baptist Convention Health Board (BCHB, which has four dentists and 42 mid-level providers. De-identified data were collected manually from the registries of 10 Baptist Convention clinics located in six of Cameroon’s 10 regions and then entered into an Excel format before importing into STATA. A retrospective abstraction of all entries for patient visits starting October 2010, and going back in time until 1500 visits were extracted from each clinic. Results This study showed that mid-level providers in BCHB clinics are offering a full scope of dental work across the 10 clinics, with the exception of treatment for major facial injuries. Mid-level providers alone performed 93.5% of all extractions, 87.5% of all fillings, 96.5% of all root canals, 97.5% of all cleanings, and 98.1% of all dentures. The dentists also typically played a teaching role in training the mid-level providers. Conclusions The Ministry of Health in Cameroon has an opportunity to learn from the BCHB model to expand access to oral health care across the country. This study shows the benefits of using a simple, workable, low

A Clinical Translation of the Article Titled "Evidence for the Implementation of the Early Start Denver Model for Young Children With Autism Spectrum Disorder".

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Shannon, Robin Adair

2015-01-01

The purpose of this article is to offer a clinical translation of a literature review titled "Evidence for the Implementation of the Early Start Denver Model for Young Children With Autism Spectrum Disorder" by Ryberg (2015). The literature review was conducted to determine the strength of the research evidence regarding the effectiveness of the Early Start Denver Model in improving cognitive, language, and behavioral functioning of children with autism spectrum disorder. In an effort to narrow the gap between evidence and practice, this clinical translation will discuss the components of the literature review in terms of its rationale for and objectives, methods, results, and implications for evidence-based nursing practice. © The Author(s) 2015.

An X chromosome association scan of the Norfolk Island genetic isolate provides evidence for a novel migraine susceptibility locus at Xq12.

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Bridget H Maher

Full Text Available Migraine is a common and debilitating neurovascular disorder with a complex envirogenomic aetiology. Numerous studies have demonstrated a preponderance of women affected with migraine and previous pedigree linkage studies in our laboratory have identified susceptibility loci on chromosome Xq24-Xq28. In this study we have used the genetic isolate of Norfolk Island to further analyse the X chromosome for migraine susceptibility loci.An association approach was employed to analyse 14,124 SNPs spanning the entire X chromosome. Genotype data from 288 individuals comprising a large core-pedigree, of which 76 were affected with migraine, were analysed. Although no SNP reached chromosome-wide significance (empirical α = 1 × 10(-5 ranking by P-value revealed two primary clusters of SNPs in the top 25. A 10 SNP cluster represents a novel migraine susceptibility locus at Xq12 whilst a 11 SNP cluster represents a previously identified migraine susceptibility locus at Xq27. The strongest association at Xq12 was seen for rs599958 (OR = 1.75, P = 8.92 × 10(-4, whilst at Xq27 the strongest association was for rs6525667 (OR = 1.53, P = 1.65 × 10(-4. Further analysis of SNPs at these loci was performed in 5,122 migraineurs from the Women's Genome Health Study and provided additional evidence for association at the novel Xq12 locus (P<0.05.Overall, this study provides evidence for a novel migraine susceptibility locus on Xq12. The strongest effect SNP (rs102834, joint P = 1.63 × 10(-5 is located within the 5'UTR of the HEPH gene, which is involved in iron homeostasis in the brain and may represent a novel pathway for involvement in migraine pathogenesis.

Recognising Informal Elearning with Digital Badging: Evidence for a Sustainable Business Model

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Patrina Law

2015-11-01

Full Text Available Digital badging as a trend in education is now recognised. It offers a way to reward and motivate, providing evidence of skills and achievements. Badged Open Courses (BOCs were piloted by The Open University (OU in 2013. The project built on research into the motivations and profiles of learners using free educational resources which the OU makes available through its OpenLearn platform (Law, Perryman & Law, 2013. This research found that an increasing proportion of learners are keen to have their informal learning achievements recognised (Law & Law, 2014. Based on these data, a suite of free BOCs, assessed through the deployment of Moodle quizzes, was launched. This paper reports on evaluation of the BOCs and what we now know of the strategic importance of informal learning recognition. The initiative aligns with University strategies to provide accessible routes into formal learning for those who might not otherwise have the opportunity.

Emergent Writing in Preschoolers: Preliminary Evidence for a Theoretical Framework

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Puranik, Cynthia S.; Lonigan, Christopher J.

2014-01-01

Researchers and educators use the term emergent literacy to refer to a broad set of skills and attitudes that serve as foundational skills for acquiring success in later reading and writing; however, models of emergent literacy have generally focused on reading and reading-related behaviors. Hence, the primary aim of this study was to articulate and evaluate a theoretical model of the components of emergent writing. Alternative models of the structure of individual and developmental differences of emergent writing and writing-related skills were examined in 372 preschool children who ranged in age from 3- to 5-years using confirmatory factor analysis. Results from a confirmatory factor analysis provide evidence that these emergent writing skills are best described by three correlated but distinct factors, (a) Conceptual Knowledge, (b) Procedural Knowledge, and (c) Generative Knowledge. Evidence that these three emergent writing factors show different patterns of relations to emergent literacy constructs is presented. Implications for understanding the development of writing and assessment of early writing skills are discussed. PMID:25316955

Evidence that non-dreamers do dream: a REM sleep behaviour disorder model.

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Herlin, Bastien; Leu-Semenescu, Smaranda; Chaumereuil, Charlotte; Arnulf, Isabelle

2015-12-01

To determine whether non-dreamers do not produce dreams or do not recall them, subjects were identified with no dream recall with dreamlike behaviours during rapid eye movement sleep behaviour disorder, which is typically characterised by dream-enacting behaviours congruent with sleep mentation. All consecutive patients with idiopathic rapid eye movement sleep behaviour disorder or rapid eye movement sleep behaviour disorder associated with Parkinson's disease who underwent a video-polysomnography were interviewed regarding the presence or absence of dream recall, retrospectively or upon spontaneous arousals. The patients with no dream recall for at least 10 years, and never-ever recallers were compared with dream recallers with rapid eye movement sleep behaviour disorder regarding their clinical, cognitive and sleep features. Of the 289 patients with rapid eye movement sleep behaviour disorder, eight (2.8%) patients had no dream recall, including four (1.4%) patients who had never ever recalled dreams, and four patients who had no dream recall for 10-56 years. All non-recallers exhibited, daily or almost nightly, several complex, scenic and dreamlike behaviours and speeches, which were also observed during rapid eye movement sleep on video-polysomnography (arguing, fighting and speaking). They did not recall a dream following sudden awakenings from rapid eye movement sleep. These eight non-recallers with rapid eye movement sleep behaviour disorder did not differ in terms of cognition, clinical, treatment or sleep measures from the 17 dreamers with rapid eye movement sleep behaviour disorder matched for age, sex and disease. The scenic dreamlike behaviours reported and observed during rapid eye movement sleep in the rare non-recallers with rapid eye movement sleep behaviour disorder (even in the never-ever recallers) provide strong evidence that non-recallers produce dreams, but do not recall them. Rapid eye movement sleep behaviour disorder provides a new model to

Leading change: evidence-based transition.

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Lewis, Brennan; Allen, Stephanie

2015-01-01

The purpose of this article was to provide a framework for evidence-based transition of patient populations within an acute care pediatric institution. Transition within a hospital is foreseeable, given the ever-changing needs of the patients within an evolving healthcare system. These changes include moving patient populations because of expansion, renovation, or cohorting similar patient diagnoses to provide care across a continuum. Over the past 1 to 2 years, Children's Health Children's Medical Center Dallas has experienced a wide variety of transition. To provide a smooth transition for patients and families into new care areas resulting in a healthy work environment for all team members. The planning phase for patient population moves, and transition should address key aspects to include physical location and care flow, supplies and equipment, staffing model and human resources (HR), education and orientation, change process and integrating teams, and family preparation. It is imperative to consider these aspects in order for transitions within a healthcare system to be successful. During a time of such transitions, the clinical nurse specialist (CNS) is a highly valuable team member offering a unique perspective and methodological approach, which is central to the new initiative's overall success. The themes addressed in this article on evidence-based transition are organized according to the CNS spheres of influence: system/organization, patient/family, and nursing. An evidence-based transition plan was developed and implemented successfully with the support from the CNS for 3 patient populations. Organizational leadership gained an increased awareness of the CNS role at the conclusion of each successful transition. The CNS plays a pivotal role as clinical experts and proponents of evidence-based practice and effects change in the system/organization, nursing, and patient/family spheres of influence. While transitions can be a source of stress for leaders

Providing education on evidence-based practice improved knowledge but did not change behaviour: a before and after study

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Lovarini Meryl

2005-12-01

Full Text Available Abstract Background Many health professionals lack the skills to find and appraise published research. This lack of skills and associated knowledge needs to be addressed, and practice habits need to change, for evidence-based practice to occur. The aim of this before and after study was to evaluate the effect of a multifaceted intervention on the knowledge, skills, attitudes and behaviour of allied health professionals. Methods 114 self-selected occupational therapists were recruited. The intervention included a 2-day workshop combined with outreach support for eight months. Support involved email and telephone contact and a workplace visit. Measures were collected at baseline, post-workshop, and eight months later. The primary outcome was knowledge, measured using the Adapted Fresno Test of Evidence-Based Practice (total score 0 to 156. Secondary outcomes were attitude to evidence-based practice (% reporting improved skills and confidence; % reporting barriers, and behaviour measured using an activity diary (% engaging/not engaging in search and appraisal activities, and assignment completion. Results Post-workshop, there were significant gains in knowledge which were maintained at follow-up. The mean difference in the Adapted Fresno Test total score was 20.6 points (95% CI, 15.6 to 25.5. The change from post-workshop to follow-up was small and non-significant (mean difference 1.2 points, 95% CI, -6.0 to 8.5. Fewer participants reported lack of searching and appraisal skills as barriers to evidence-based practice over time (searching = 61%, 53%, 24%; appraisal 60%, 65%, 41%. These differences were statistically significant (p = 0.0001 and 0.010 respectively. Behaviour changed little. Pre-workshop, 6% engaged in critical appraisal increasing to 18% post-workshop and 18% at follow-up. Nearly two thirds (60% were not reading any research literature at follow-up. Twenty-three participants (20.2% completed their assignment. Conclusion Evidence

Osteosarcoma models : understanding complex disease

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Mohseny, Alexander Behzad

2012-01-01

A mesenchymal stem cell (MSC) based osteosarcoma model was established. The model provided evidence for a MSC origin of osteosarcoma. Normal MSCs transformed spontaneously to osteosarcoma-like cells which was always accompanied by genomic instability and loss of the Cdkn2a locus. Accordingly loss of

Understanding the role of speech production in reading: Evidence for a print-to-speech neural network using graphical analysis.

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Cummine, Jacqueline; Cribben, Ivor; Luu, Connie; Kim, Esther; Bahktiari, Reyhaneh; Georgiou, George; Boliek, Carol A

2016-05-01

The neural circuitry associated with language processing is complex and dynamic. Graphical models are useful for studying complex neural networks as this method provides information about unique connectivity between regions within the context of the entire network of interest. Here, the authors explored the neural networks during covert reading to determine the role of feedforward and feedback loops in covert speech production. Brain activity of skilled adult readers was assessed in real word and pseudoword reading tasks with functional MRI (fMRI). The authors provide evidence for activity coherence in the feedforward system (inferior frontal gyrus-supplementary motor area) during real word reading and in the feedback system (supramarginal gyrus-precentral gyrus) during pseudoword reading. Graphical models provided evidence of an extensive, highly connected, neural network when individuals read real words that relied on coordination of the feedforward system. In contrast, when individuals read pseudowords the authors found a limited/restricted network that relied on coordination of the feedback system. Together, these results underscore the importance of considering multiple pathways and articulatory loops during language tasks and provide evidence for a print-to-speech neural network. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Estimating error rates for firearm evidence identifications in forensic science

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Song, John; Vorburger, Theodore V.; Chu, Wei; Yen, James; Soons, Johannes A.; Ott, Daniel B.; Zhang, Nien Fan

2018-01-01

Estimating error rates for firearm evidence identification is a fundamental challenge in forensic science. This paper describes the recently developed congruent matching cells (CMC) method for image comparisons, its application to firearm evidence identification, and its usage and initial tests for error rate estimation. The CMC method divides compared topography images into correlation cells. Four identification parameters are defined for quantifying both the topography similarity of the correlated cell pairs and the pattern congruency of the registered cell locations. A declared match requires a significant number of CMCs, i.e., cell pairs that meet all similarity and congruency requirements. Initial testing on breech face impressions of a set of 40 cartridge cases fired with consecutively manufactured pistol slides showed wide separation between the distributions of CMC numbers observed for known matching and known non-matching image pairs. Another test on 95 cartridge cases from a different set of slides manufactured by the same process also yielded widely separated distributions. The test results were used to develop two statistical models for the probability mass function of CMC correlation scores. The models were applied to develop a framework for estimating cumulative false positive and false negative error rates and individual error rates of declared matches and non-matches for this population of breech face impressions. The prospect for applying the models to large populations and realistic case work is also discussed. The CMC method can provide a statistical foundation for estimating error rates in firearm evidence identifications, thus emulating methods used for forensic identification of DNA evidence. PMID:29331680

Mechanical Properties of Nanoporous Au: From Empirical Evidence to Phenomenological Modeling

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Giorgio Pia

2015-09-01

Full Text Available The present work focuses on the development of a theoretical model aimed at relating the mechanical properties of nanoporous metals to the bending response of thick ligaments. The model describes the structure of nanoporous metal foams in terms of an idealized regular lattice of massive cubic nodes and thick ligaments with square cross-sections. Following a general introduction to the subject, model predictions are compared with Young’s modulus and the yield strength of nanoporous Au foams determined experimentally and available in literature. It is shown that the model provides a quantitative description of the elastic and plastic deformation behavior of nanoporous metals, reproducing to a satisfactory extent the experimental Young’s modulus and yield strength values of nanoporous Au.

Evidence synthesis and decision modelling to support complex decisions: stockpiling neuraminidase inhibitors for pandemic influenza usage [version 2; referees: 2 approved

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Samuel I. Watson

2017-03-01

Full Text Available Objectives: The stockpiling of neuraminidase inhibitor (NAI antivirals as a defence against pandemic influenza is a significant public health policy decision that must be made despite a lack of conclusive evidence from randomised controlled trials regarding the effectiveness of NAIs on important clinical end points such as mortality. The objective of this study was to determine whether NAIs should be stockpiled for treatment of pandemic influenza on the basis of current evidence. Methods: A decision model for stockpiling was designed. Data on previous pandemic influenza epidemiology was combined with data on the effectiveness of NAIs in reducing mortality obtained from a recent individual participant meta-analysis using observational data. Evidence synthesis techniques and a bias modelling method for observational data were used to incorporate the evidence into the model. The stockpiling decision was modelled for adults (≥16 years old and the United Kingdom was used as an example. The main outcome was the expected net benefits of stockpiling in monetary terms. Health benefits were estimated from deaths averted through stockpiling. Results: After adjusting for biases in the estimated effectiveness of NAIs, the expected net benefit of stockpiling in the baseline analysis was £444 million, assuming a willingness to pay of £20,000/QALY ($31,000/QALY. The decision would therefore be to stockpile NAIs. There was a greater probability that the stockpile would not be utilised than utilised. However, the rare but catastrophic losses from a severe pandemic justified the decision to stockpile. Conclusions: Taking into account the available epidemiological data and evidence of effectiveness of NAIs in reducing mortality, including potential biases, a decision maker should stockpile anti-influenza medication in keeping with the postulated decision rule.

Quantitative Hydraulic Models Of Early Land Plants Provide Insight Into Middle Paleozoic Terrestrial Paleoenvironmental Conditions

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Wilson, J. P.; Fischer, W. W.

2010-12-01

Fossil plants provide useful proxies of Earth’s climate because plants are closely connected, through physiology and morphology, to the environments in which they lived. Recent advances in quantitative hydraulic models of plant water transport provide new insight into the history of climate by allowing fossils to speak directly to environmental conditions based on preserved internal anatomy. We report results of a quantitative hydraulic model applied to one of the earliest terrestrial plants preserved in three dimensions, the ~396 million-year-old vascular plant Asteroxylon mackei. This model combines equations describing the rate of fluid flow through plant tissues with detailed observations of plant anatomy; this allows quantitative estimates of two critical aspects of plant function. First and foremost, results from these models quantify the supply of water to evaporative surfaces; second, results describe the ability of plant vascular systems to resist tensile damage from extreme environmental events, such as drought or frost. This approach permits quantitative comparisons of functional aspects of Asteroxylon with other extinct and extant plants, informs the quality of plant-based environmental proxies, and provides concrete data that can be input into climate models. Results indicate that despite their small size, water transport cells in Asteroxylon could supply a large volume of water to the plant's leaves--even greater than cells from some later-evolved seed plants. The smallest Asteroxylon tracheids have conductivities exceeding 0.015 m^2 / MPa * s, whereas Paleozoic conifer tracheids do not reach this threshold until they are three times wider. However, this increase in conductivity came at the cost of little to no adaptations for transport safety, placing the plant’s vegetative organs in jeopardy during drought events. Analysis of the thickness-to-span ratio of Asteroxylon’s tracheids suggests that environmental conditions of reduced relative

Evidence for dynamic behavior of O2 in oxy-heme model compounds

International Nuclear Information System (INIS)

Montiel-Montoya, R.; Bill, E.; Trautwein, A.X.; Winkler, H.

1986-01-01

The authors have performed Moessbauer studies on several oxy-heme model compounds, and for two of them they have also derived the three dimensional structure from X-ray studies. The X-ray structure analysis of these model compounds provides the information that O 2 occupies three different sites in one and only two sites in the other. (Auth.)

Provider self-disclosure during contraceptive counseling.

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McLean, Merritt; Steinauer, Jody; Schmittdiel, Julie; Chan, Pamela; Dehlendorf, Christine

2017-02-01

Provider self-disclosure (PSD) - defined as providers making statements regarding personal information to patients - has not been well characterized in the context of contraceptive counseling. In this study, we describe the incidence, content and context of contraceptive PSD. This mixed methods analysis used data from the Provider-Patient Contraceptive Counseling study, for which 349 family planning patients were recruited from 2009 to 2012 from six clinics in the San Francisco Bay Area. Audio-recordings from their visits were analyzed for the presence or absence of PSD, and those visits with evidence of PSD were analyzed using qualitative methods. The associations of patient and provider demographics and patient satisfaction measures, obtained from survey data, with PSD were analyzed using bivariable and multivariable analyses. Thirty-seven percent of providers showed evidence of PSD during at least one visit, and PSD occurred in 9% of clinic visits. Fifty-four percent of PSD statements were about intrauterine devices. About half of PSD statements occurred prior to the final selection of the contraceptive method and appeared to influence the choice of method. In post-visit surveys, all patients who reported receiving PSD considered it to be appropriate, and patient-reported PSD was not statistically associated with measures of patient satisfaction. This study provides some support for the appropriateness of PSD during family planning encounters, at least as practiced during the sampled visits. Further research could explore whether this counseling strategy has an impact on patients' ability to identify the best contraceptive methods for them. In this study, PSD did not have a demonstrated negative effect on the provider-patient relationship. In almost half of visits, PSD appeared to influence patients' choice of a method; whether this influence is beneficial needs further research. Copyright © 2017 Elsevier Inc. All rights reserved.

The effect of narrow provider networks on health care use.

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Atwood, Alicia; Lo Sasso, Anthony T

2016-12-01

Network design is an often overlooked aspect of health insurance contracts. Recent policy factors have resulted in narrower provider networks. We provide plausibly causal evidence on the effect of narrow network plans offered by a large national health insurance carrier in a major metropolitan market. Our econometric design exploits the fact that some firms offer a narrow network plan to their employees and some do not. Our results show that narrow network health plans lead to reductions in health care utilization and spending. We find evidence that narrow networks save money by selecting lower cost providers into the network. Copyright © 2016 Elsevier B.V. All rights reserved.

A Dual-Process Model of the Alcohol-Behavior Link for Social Drinking

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Moss, Antony C.; Albery, Ian P.

2009-01-01

A dual-process model of the alcohol-behavior link is presented, synthesizing 2 of the major social-cognitive approaches: expectancy and myopia theories. Substantial evidence has accrued to support both of these models, and recent neurocognitive models of the effects of alcohol on thought and behavior have provided evidence to support both as well.…

Complex interventions required to comprehensively educate allied health practitioners on evidence-based practice

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Dizon JM

2011-05-01

Full Text Available Janine Margarita Dizon1,2, Karen Grimmer-Somers11International Centre for Allied Health Evidence, University of South Australia, Adelaide, SA, Australia; 2University of Santo Tomas, Manila, PhilippinesAbstract: There is currently no strong evidence regarding the most effective training approach for allied health professionals that will support them to consistently apply the best research evidence in daily practice. Current evidence-based practice training tends to be 'one size fits all', and is unlikely to be appropriate for all allied health disciplines because of the variability in their tasks and scope of practice. The scant body of evidence regarding the effectiveness of evidence-based practice training for allied health practitioners provides some support for improving knowledge and skills, but equivocal evidence about influencing behaviors and attitudes. We propose a new model of evidence-based practice training, based on the concept of complex interventions reported in the literature. We believe that by offering training in evidence-based practice based on complex interventions relevant to the needs of the attendees, using fixed and variable components, there may be greater success in significantly influencing knowledge skills, attitudes, and behaviors.Keywords: complex interventions, evidence-based practice training, allied health

Historical perspectives on evidence-based nursing.

Science.gov (United States)

Beyea, Suzanne C; Slattery, Mary Jo

2013-04-01

The authors of this article offer a review and historical perspective on research utilization and evidence-based practice in nursing. They present the evolution of research utilization to the more contemporary framework of evidence-based nursing practice. The authors address the role of qualitative research in the context of evidence-based practice. Finally, some approaches and resources for learning more about the fundamentals of evidence-based healthcare are provided.

Approaches to the mechanisms of song memorization and singing provide evidence for a procedural memory

OpenAIRE

Hultsch,Henrike; Todt,Dietmar

2004-01-01

There is growing evidence that, during song learning, birds do not only acquire 'what to sing' (the inventory of behavior), but also 'how to sing' (the singing program), including order-features of song sequencing. Common Nightingales Luscinia megarhynchos acquire such serial information by segmenting long strings of heard songs into smaller subsets or packages, by a process reminiscent of the chunking of information as a coding mechanism in short term memory. Here we report three tutoring ex...

Lexical prediction via forward models: N400 evidence from German Sign Language.

Science.gov (United States)

Hosemann, Jana; Herrmann, Annika; Steinbach, Markus; Bornkessel-Schlesewsky, Ina; Schlesewsky, Matthias

2013-09-01

Models of language processing in the human brain often emphasize the prediction of upcoming input-for example in order to explain the rapidity of language understanding. However, the precise mechanisms of prediction are still poorly understood. Forward models, which draw upon the language production system to set up expectations during comprehension, provide a promising approach in this regard. Here, we present an event-related potential (ERP) study on German Sign Language (DGS) which tested the hypotheses of a forward model perspective on prediction. Sign languages involve relatively long transition phases between one sign and the next, which should be anticipated as part of a forward model-based prediction even though they are semantically empty. Native speakers of DGS watched videos of naturally signed DGS sentences which either ended with an expected or a (semantically) unexpected sign. Unexpected signs engendered a biphasic N400-late positivity pattern. Crucially, N400 onset preceded critical sign onset and was thus clearly elicited by properties of the transition phase. The comprehension system thereby clearly anticipated modality-specific information about the realization of the predicted semantic item. These results provide strong converging support for the application of forward models in language comprehension. © 2013 Elsevier Ltd. All rights reserved.

Testing Capital Asset Pricing Model: Empirical Evidences from Indian Equity Market

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Kapil CHOUDHARY

2010-11-01

Full Text Available The present study examines the Capital Asset Pricing Model (CAPM for the Indian stock market using monthly stock returns from 278 companies of BSE 500 Index listed on the Bombay stock exchange for the period of January 1996 to December 2009. The findings of this study are not substantiating the theory’s basic result that higher risk (beta is associated with higher levels of return. The model does explain, however, excess returns and thus lends support to the linear structure of the CAPM equation. The theory’s prediction for the intercept is that it should equal zero and the slope should equal the excess returns on the market portfolio. The results of the study lead to negate the above hypotheses and offer evidence against the CAPM. The tests conducted to examine the nonlinearity of the relationship between return and betas bolster the hypothesis that the expected return-beta relationship is linear. Additionally, this study investigates whether the CAPM adequately captures all-important determinants of returns including the residual variance of stocks. The results exhibit that residual risk has no effect on the expected returns of portfolios.

Structural equation modelling of determinants of customer satisfaction of mobile network providers: Case of Kolkata, India

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Shibashish Chakraborty

2014-12-01

Full Text Available The Indian market of mobile network providers is growing rapidly. India is the second largest market of mobile network providers in the world and there is intense competition among existing players. In such a competitive market, customer satisfaction becomes a key issue. The objective of this paper is to develop a customer satisfaction model of mobile network providers in Kolkata. The results indicate that generic requirements (an aggregation of output quality and perceived value, flexibility, and price are the determinants of customer satisfaction. This study offers insights for mobile network providers to understand the determinants of customer satisfaction.

The BDNF Val66Met Polymorphism Interacts with Maternal Parenting Influencing Adolescent Depressive Symptoms: Evidence of Differential Susceptibility Model.

Science.gov (United States)

Zhang, Leilei; Li, Zhi; Chen, Jie; Li, Xinying; Zhang, Jianxin; Belsky, Jay

2016-03-01

Although depressive symptoms are common during adolescence, little research has examined gene-environment interaction on youth depression. This study chose the brain-derived neurotrophic factor (BDNF) gene, tested the interaction between a functional polymorphism resulting amino acid substitution of valine (Val) to methionine (Met) in the proBDNF protein at codon 66 (Val66Met), and maternal parenting on youth depressive symptoms in a sample of 780 community adolescents of Chinese Han ethnicity (aged 11-17, M = 13.6, 51.3 % females). Participants reported their depressive symptoms and perceived maternal parenting. Results indicated the BDNF Val66Met polymorphism significantly moderated the influence of maternal warmth-reasoning, but not harshness-hostility, on youth depressive symptoms. Confirmatory model evaluation indicated that the interaction effect involving warmth-reasoning conformed to the differential-susceptibility rather than diathesis-stress model of person-X-environment interaction. Thus, Val carriers experienced less depressive symptoms than Met homozygotes when mothering was more positive but more symptoms when mothering was less positive. The findings provided evidence in support of the differential susceptibility hypothesis of youth depressive symptoms and shed light on the importance of examining the gene-environment interaction from a developmental perspective.

Evidence Aid: Using Systematic Reviews to Improve Access to Evidence for Humanitarian Emergencies

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Mike Clarke

2017-10-01

Full Text Available Evidence Aid is an international initiative to improve access to reliable evidence that will help people and organisations make well-informed decisions about interventions, actions and strategies in the disaster setting. It focuses on systematic reviews as the most reliable source of research evidence, maximising the power of existing research, avoiding undue emphasis on single studies and reducing the waste associated with research that is ignored or not accessible to decision makers. Evidence Aid is knowledge champion for influencers of the humanitarian sector, including funders, policy makers, NGOs, and humanitarian professionals. Evidence Aid was established by members of the Cochrane Collaboration after the Indian Ocean tsunami of December 2004. It provides access to information relevant to disaster risk reduction, planning, response, recovery, resilience and rehabilitation. This presentation will discuss the need for Evidence Aid, and describes its activities.Find out more about Mike.

Evidence-based guidelines for wise use of electronic games by children.

Science.gov (United States)

Straker, Leon; Abbott, Rebecca; Collins, Rachel; Campbell, Amity

2014-01-01

Electronic games (e-games) are widely used by children, often for substantial durations, yet to date there are no evidence-based guidelines regarding their use. The aim of this paper is to present guidelines for the wise use of e-games by children based on a narrative review of the research. This paper proposes a model of factors that influence child-e-games interaction. It summarises the evidence on positive and negative effects of use of e-games on physical activity and sedentary behaviour, cardio-metabolic health, musculoskeletal health, motor coordination, vision, cognitive development and psychosocial health. Available guidelines and the role of guidelines are discussed. Finally, this information is compiled into a clear set of evidence-based guidelines, about wise use of e-games by children, targeting children, parents, professionals and the e-game industry. These guidelines provide an accessible synthesis of available knowledge and pragmatic guidelines based on e-game specific evidence and related research.

Early Prostate Cancer: Hedonic Prices Model of Provider-Patient Interactions and Decisions

International Nuclear Information System (INIS)

Jani, Ashesh B.; Hellman, Samuel

2008-01-01

Purpose: To determine the relative influence of treatment features and treatment availabilities on final treatment decisions in early prostate cancer. Methods and Materials: We describe and apply a model, based on hedonic prices, to understand provider-patient interactions in prostate cancer. This model included four treatments (observation, external beam radiotherapy, brachytherapy, and prostatectomy) and five treatment features (one efficacy and four treatment complication features). We performed a literature search to estimate (1) the intersections of the 'bid' functions and 'offer' functions with the price function along different treatment feature axes, and (2) the treatments actually rendered in different patient subgroups based on age. We performed regressions to determine the relative weight of each feature in the overall interaction and the relative availability of each treatment modality to explain differences between observed vs. predicted use of different modalities in different patient subpopulations. Results: Treatment efficacy and potency preservation are the major factors influencing decisions for young patients, whereas preservation of urinary and rectal function is much more important for very elderly patients. Referral patterns seem to be responsible for most of the deviations of observed use of different treatments from those predicted by idealized provider-patient interactions. Specifically, prostatectomy is used far more commonly in young patients and radiotherapy and observation used far more commonly in elderly patients than predicted by a uniform referral pattern. Conclusions: The hedonic prices approach facilitated identifying the relative importance of treatment features and quantification of the impact of the prevailing referral pattern on prostate cancer treatment decisions

Impact of Changes in Accounting Standards in Debt Ratios of Firms: Evidence in Brazil

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André Aroldo Freitas de Moura

2016-01-01

Full Text Available ABSTRACT This research investigates the impact of changes in debt ratios of Brazilian firms due to the IFRS adoption. We make a comparison between the forecast of the time-series of debt ratios accounted until 2007 for the span from 2008 to the first quarter of 2015 with those effectively accounted from 2008 to the first quarter of 2015 derived from the new accounting standard. The research utilizes SARIMAX model and Chow’s (1960 structural break forecast test, controlling for changes originating from the macroeconomic environment as well. We find evidence of significant changes in the debt ratio towards both higher and lower debt with predominance of greater ratios. This result is consistent with past literature in Europe, Australia and New Zealand. Nevertheless, we do not find evidence of a structural break in the Financial Dependency ratio. Moreover, there is no evidence of any distinct effects across different industries. The research provides new evidence confirming the informational effects of IFRS by utilizing a robust time-series model with macroeconomic controls in an innovative approach towards the accounting environment.

Learning From Others About Research Evidence (editorial

Directory of Open Access Journals (Sweden)

Alison Brettle

2012-06-01

've attended forthe last few years (don’t ask!. Each time, I've been struck by both the similarities and differences between counselling and LIS research in the UK. Counselling research is conducted by a relatively small number of individuals and, as in LIS, the vast majority of practitioners don’t engage in writing any research up for publication (Clapton, 2010. Particular types of research dominate in counselling, but most are highly qualitative in manner, e.g. using biographical approaches. I can’t immediately see how these could become widely used in LIS, but I do find it fascinating to hear about different approaches and the evidence this provides. Like many of the things that LIS professionals do, counselling and psychotherapy is a complex intervention and it is not always immediately apparent what has caused an effect. It may well be that the counsellor is only one of a number of elements that has led to a positive outcome or a change in effect. This makes it difficult to generate evidence about the effectiveness of counselling, similar, for example, to trying to generate evidence regarding the effectiveness of information literacy.Due to political drivers there is an increasing interest (and resistance to a more evidence based approach in counselling and psychotherapy. One of the main areas of resistance towards evidence based practice (EBP in counselling is that the medical model or paradigm of EBP and the view that the randomized controlled trial (RCT is the method of choice for providing high quality evidence on the effectiveness of services doesn't fit with the way counsellors provide services to their clients. Each client is seen as an individual and therapy is provided according to a client’s particular needs at that time rather than following a set manual or course. This makes it impossible to assess in a "randomized controlled" manner, before even beginning to worry about the ethical and practical implications of conducting an experimental study

The Distribution of Crystalline Hematite on Mars from the Thermal Emission Spectrometer: Evidence for Liquid Water

Science.gov (United States)

Christensen, P. R.; Malin, M.; Morris, D.; Bandfield, J.; Lane, M.; Edgett, K.

2000-01-01

Crystalline hematite on Mars has been mapped using the MGS TES. Two major, and several minor areas of significant accumulation are identified. We favor precipitation models involving Fe-rich water, providing direct mineralogic evidence for large-scale water interactions.

Bi-national cross-validation of an evidence-based conduct problem prevention model.

Science.gov (United States)

Porta, Carolyn M; Bloomquist, Michael L; Garcia-Huidobro, Diego; Gutiérrez, Rafael; Vega, Leticia; Balch, Rosita; Yu, Xiaohui; Cooper, Daniel K

2018-04-01

To (a) explore the preferences of Mexican parents and Spanish-speaking professionals working with migrant Latino families in Minnesota regarding the Mexican-adapted brief model versus the original conduct problems intervention and (b) identifying the potential challenges, and preferred solutions, to implementation of a conduct problems preventive intervention. The core practice elements of a conduct problems prevention program originating in the United States were adapted for prevention efforts in Mexico. Three focus groups were conducted in the United States, with Latino parents (n = 24; 2 focus groups) and professionals serving Latino families (n = 9; 1 focus group), to compare and discuss the Mexican-adapted model and the original conduct problems prevention program. Thematic analysis was conducted on the verbatim focus group transcripts in the original language spoken. Participants preferred the Mexican-adapted model. The following key areas were identified for cultural adaptation when delivering a conduct problems prevention program with Latino families: recruitment/enrollment strategies, program delivery format, and program content (i.e., child skills training, parent skills training, child-parent activities, and child-parent support). For both models, strengths, concerns, barriers, and strategies for overcoming concerns and barriers were identified. We summarize recommendations offered by participants to strengthen the effective implementation of a conduct problems prevention model with Latino families in the United States. This project demonstrates the strength in binational collaboration to critically examine cultural adaptations of evidence-based prevention programs that could be useful to diverse communities, families, and youth in other settings. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Evidence in Support of the Independent Channel Model Describing the Sensorimotor Control of Human Stance Using a Humanoid Robot.

Science.gov (United States)

Pasma, Jantsje H; Assländer, Lorenz; van Kordelaar, Joost; de Kam, Digna; Mergner, Thomas; Schouten, Alfred C

2018-01-01

provides further evidence that the IC model is a valid description of human balance control.

Evidence in Support of the Independent Channel Model Describing the Sensorimotor Control of Human Stance Using a Humanoid Robot

Directory of Open Access Journals (Sweden)

Jantsje H. Pasma

2018-03-01

humanoid robot. This provides further evidence that the IC model is a valid description of human balance control.

The parasitic model of L2 and L3 vocabulary acquisition: evidence from naturalistic and experimental studies

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Peter Ecke

2014-09-01

Full Text Available This paper reviews evidence for the Parasitic Model of Vocabulary Acquisition for second and third language learners/developing multilinguals. It first describes the model’s predictions about default processes based on the detection and use of similarity at the three stages involved in the development of individual lexical items: (1 the establishing of a form representation, (2 the building of connections to syntactic frame and concept representations, and (3 the strengthening and automatization of representations and access routes. The paper then summarizes both naturalistic and experimental evidence for processes involved at these three stages. Finally it discusses open issues and potential areas for future investigation.

The Electronic Evidence in Trial Proceedings

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Monica Pocora

2015-05-01

Full Text Available This paper will consider theoretical and practical issues which arise in trial proceedings, throughout the virtual presence of persons involved. The EU Convention of 2000 provide the legal base for the use of video conference. In most jurisdictions, all forms of evidence is admissible, subject to rules relating to the exclusion of evidence because of improper actions or because the inclusion of the evidence would be unfair to the defendant. There is a difference between the admissibility of the evidence and laying the correct foundations before the evidence can be admitted.

Modeling the impact of transport energy consumption on CO2 emission in Pakistan: Evidence from ARDL approach.

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Danish; Baloch, Muhammad Awais; Suad, Shah

2018-04-01

The objective of this research is to examine the relationship between transport energy consumption, economic growth, and carbon dioxide emission (CO 2 ) from transport sector incorporating foreign direct investment and urbanization. This study is carried out in Pakistan by applying autoregressive distributive lag (ARDL) and vector error correction model (VECM) over 1990-2015. The empirical results indicate a strong significant impact of transport energy consumption on CO 2 emissions from the transportation sector. Furthermore, foreign direct investment also contributes to CO 2 emission. Interestingly, the impact of economic growth and urbanization on transport CO 2 emission is statistically insignificant. Overall, transport energy consumption and foreign direct investment are not environmentally friendly. The new empirical evidence from this study provides a complete picture of the determinants of emissions from the transport sector and these novel findings not only help to advance the existing literature but also can be of special interest to the country's policymakers. So, we urge that government needs to focus on promoting the energy efficient means of transportation to improve environmental quality with less adverse influence on economic growth.

Taurine Provides Neuroprotection against Retinal Ganglion Cell Degeneration

Science.gov (United States)

Froger, Nicolas; Cadetti, Lucia; Lorach, Henri; Martins, Joao; Bemelmans, Alexis-Pierre; Dubus, Elisabeth; Degardin, Julie; Pain, Dorothée; Forster, Valérie; Chicaud, Laurent; Ivkovic, Ivana; Simonutti, Manuel; Fouquet, Stéphane; Jammoul, Firas; Léveillard, Thierry; Benosman, Ryad; Sahel, José-Alain; Picaud, Serge

2012-01-01

Retinal ganglion cell (RGC) degeneration occurs in numerous retinal diseases leading to blindness, either as a primary process like in glaucoma, or secondary to photoreceptor loss. However, no commercial drug is yet directly targeting RGCs for their neuroprotection. In the 70s, taurine, a small sulfonic acid provided by nutrition, was found to be essential for the survival of photoreceptors, but this dependence was not related to any retinal disease. More recently, taurine deprivation was incriminated in the retinal toxicity of an antiepileptic drug. We demonstrate here that taurine can improve RGC survival in culture or in different animal models of RGC degeneration. Taurine effect on RGC survival was assessed in vitro on primary pure RCG cultures under serum-deprivation conditions, and on NMDA-treated retinal explants from adult rats. In vivo, taurine was administered through the drinking water in two glaucomatous animal models (DBA/2J mice and rats with vein occlusion) and in a model of Retinitis pigmentosa with secondary RGC degeneration (P23H rats). After a 6-day incubation, 1 mM taurine significantly enhanced RGCs survival (+68%), whereas control RGCs were cultured in a taurine-free medium, containing all natural amino-acids. This effect was found to rely on taurine-uptake by RGCs. Furthermore taurine (1 mM) partly prevented NMDA-induced RGC excitotoxicity. Finally, taurine supplementation increased RGC densities both in DBA/2J mice, in rats with vein occlusion and in P23H rats by contrast to controls drinking taurine-free water. This study indicates that enriched taurine nutrition can directly promote RGC survival through RGC intracellular pathways. It provides evidence that taurine can positively interfere with retinal degenerative diseases. PMID:23115615

20 CFR 410.240 - Evidence.

Science.gov (United States)

2010-04-01

... evidence may be submitted as part of a prescribed application form if the form provides for its inclusion... disability or death due to pneumoconiosis. For evidence requirements to support allegations of total disability or death due to pneumoconiosis; for the effect of the failure or refusal of an individual to...

From evidence-based to evidence-reflected practice

DEFF Research Database (Denmark)

Lystbæk, Christian Tang

“Knowledge” is of the utmost significance for professional practice and learning. Today, though, the established knowledge base is changing in all areas of the labour market (Alvesson, 2004). Work and society are dominated by commitment to demands for high levels of demonstrable accountability......, cost-efficiency and measurable quality. Thus, today, evidence-based practice has become an expectation and fashion, often used to emphasize the grounding of practice in research based knowledge that provides measurable evidence for best practice. But at the same time, there is a growing distrust...... of the supremacy of this kind of knowledge, and traditional monopolies of knowledge are challenged (Gabbay & May, 2010). In the literature, there is an on-going debate about professional knowledge enacted in diverse settings. This debate presents a wide range of epistemological terminologies and typologies, which...

Self-esteem Is Mostly Stable Across Young Adulthood: Evidence from Latent STARTS Models.

Science.gov (United States)

Wagner, Jenny; Lüdtke, Oliver; Trautwein, Ulrich

2016-08-01

How stable is self-esteem? This long-standing debate has led to different conclusions across different areas of psychology. Longitudinal data and up-to-date statistical models have recently indicated that self-esteem has stable and autoregressive trait-like components and state-like components. We applied latent STARTS models with the goal of replicating previous findings in a longitudinal sample of young adults (N = 4,532; Mage  = 19.60, SD = 0.85; 55% female). In addition, we applied multigroup models to extend previous findings on different patterns of stability for men versus women and for people with high versus low levels of depressive symptoms. We found evidence for the general pattern of a major proportion of stable and autoregressive trait variance and a smaller yet substantial amount of state variance in self-esteem across 10 years. Furthermore, multigroup models suggested substantial differences in the variance components: Females showed more state variability than males. Individuals with higher levels of depressive symptoms showed more state and less autoregressive trait variance in self-esteem. Results are discussed with respect to the ongoing trait-state debate and possible implications of the group differences that we found in the stability of self-esteem. © 2015 Wiley Periodicals, Inc.

Close but no cigar: Spatial precision deficits following medial temporal lobe lesions provide novel insight into theoretical models of navigation and memory.

Science.gov (United States)

Kolarik, Branden S; Baer, Trevor; Shahlaie, Kiarash; Yonelinas, Andrew P; Ekstrom, Arne D

2018-01-01

Increasing evidence suggests that the human hippocampus contributes to a range of different behaviors, including episodic memory, language, short-term memory, and navigation. A novel theoretical framework, the Precision and Binding Model, accounts for these phenomenon by describing a role for the hippocampus in high-resolution, complex binding. Other theories like Cognitive Map Theory, in contrast, predict a specific role for the hippocampus in allocentric navigation, while Declarative Memory Theory predicts a specific role in delay-dependent conscious memory. Navigation provides a unique venue for testing these predictions, with past results from research with humans providing inconsistent findings regarding the role of the human hippocampus in spatial navigation. Here, we tested five patients with lesions primarily restricted to the hippocampus and those extending out into the surrounding medial temporal lobe cortex on a virtual water maze task. Consistent with the Precision and Binding Model, we found partially intact allocentric memory in all patients, with impairments in the spatial precision of their searches for a hidden target. We found similar impairments at both immediate and delayed testing. Our findings are consistent with the Precision and Binding Model of hippocampal function, arguing for its role across domains in high-resolution, complex binding. Remembering goal locations in one's environment is a critical skill for survival. How this information is represented in the brain is still not fully understood, but is believed to rely in some capacity on structures in the medial temporal lobe. Contradictory findings from studies of both humans and animals have been difficult to reconcile with regard to the role of the MTL, specifically the hippocampus. By assessing impairments observed during navigation to a goal in patients with medial temporal lobe damage we can better understand the role these structures play in such behavior. Utilizing virtual reality

PUBLIC AND PRIVATE HIGHER EDUCATION INSTITUTIONS IN MALAYSIA: COMPETING, COMPLEMENTARY OR CROSSBREEDS AS EDUCATION PROVIDERS

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Wan Chang Da

2007-01-01

Full Text Available Delivery of higher education used to be exclusive to the public sector in Malaysia. However, legislative changes made in 1996 led to the coexistence of public and private higher education institutions. In 2007, there were 20 public universities compared to more than 500 private institutions, of which 30 are currently categorised as universities or university colleges. Looking at their respective roles as higher education providers, public and private institutions display characteristics of being substitutes while at the same time serving complementary roles to one another. This dichotomy between public and private higher education institutions can, in fact, be seen as inclining towards a hybrid model that allows both to operate within a single system of higher education provision in the country. Such a hybrid model is evident in how the clientele is being divided between public and private higher institutions. It is also evident in the different roles played by the respective faculty members as well as in the programmes being made available in either type of institutions.

Early Start Denver Model. Un modello Evidence Based per l’intervento educativo precoce nei Disturbi dello Spettro Autistico

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Saverio Fontani

2016-07-01

Full Text Available The Autism Spectrum Disorders represents one of the most complex developmental disabilities for the massive deficit of communication competences. The social disability related to disorders is the main objective of the intervention of the Early Start Denver Model – ESDM (Rogers & Dawson, 2010, which can be considered as one of the most advanced models for early educational intervention according the perspective of Evidence Based Education. In this paper the theoretical foundations of the model are presented and its implications for a modern inclusive education are discussed..

Short-run Exchange-Rate Dynamics: Theory and Evidence

DEFF Research Database (Denmark)

Carlson, John A.; Dahl, Christian Møller; Osler, Carol L.

Recent research has revealed a wealth of information about the microeconomics of currency markets and thus the determination of exchange rates at short horizons. This information is valuable to us as scientists since, like evidence of macroeconomic regularities, it can provide critical guidance...... of currency markets, it accurately reflects the constraints and objectives faced by the major participants, and it fits key stylized facts concerning returns and order flow. With respect to macroeconomics, the model is consistent with most of the major puzzles that have emerged under floating rates....

Chemical elemental distribution and soil DNA fingerprints provide the critical evidence in murder case investigation.

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Giuseppe Concheri

Full Text Available BACKGROUND: The scientific contribution to the solution of crime cases, or throughout the consequent forensic trials, is a crucial aspect of the justice system. The possibility to extract meaningful information from trace amounts of samples, and to match and validate evidences with robust and unambiguous statistical tests, are the key points of such process. The present report is the authorized disclosure of an investigation, carried out by Attorney General appointment, on a murder case in northern Italy, which yielded the critical supporting evidence for the judicial trial. METHODOLOGY/PRINCIPAL FINDINGS: The proportional distribution of 54 chemical elements and the bacterial community DNA fingerprints were used as signature markers to prove the similarity of two soil samples. The first soil was collected on the crime scene, along a corn field, while the second was found in trace amounts on the carpet of a car impounded from the main suspect in a distant location. The matching similarity of the two soils was proven by crossing the results of two independent techniques: a elemental analysis via inductively coupled plasma mass spectrometry (ICP-MS and optical emission spectrometry (ICP-OES approaches, and b amplified ribosomal DNA restriction analysis by gel electrophoresis (ARDRA. CONCLUSIONS: Besides introducing the novel application of these methods to forensic disciplines, the highly accurate level of resolution observed, opens new possibilities also in the fields of soil typing and tracking, historical analyses, geochemical surveys and global land mapping.

LTDNA Evidence on Trial

Science.gov (United States)

Roberts, Paul

2016-01-01

Adopting the interpretative/hermeneutical method typical of much legal scholarship, this article considers two sets of issues pertaining to LTDNA profiles as evidence in criminal proceedings. The section titled Expert Evidence as Forensic Epistemic Warrant addresses some rather large questions about the epistemic status and probative value of expert testimony in general. It sketches a theoretical model of expert evidence, highlighting five essential criteria: (1) expert competence; (2) disciplinary domain; (3) methodological validity; (4) materiality; and (5) legal admissibility. This generic model of expert authority, highlighting law's fundamentally normative character, applies to all modern forms of criminal adjudication, across Europe and farther afield. The section titled LTDNA Evidence in UK Criminal Trials then examines English and Northern Irish courts' attempts to get to grips with LTDNA evidence in recent cases. Better appreciating the ways in which UK courts have addressed the challenges of LTDNA evidence may offer some insights into parallel developments in other legal systems. Appellate court rulings follow a predictable judicial logic, which might usefully be studied and reflected upon by any forensic scientist or statistician seeking to operate effectively in criminal proceedings. Whilst each legal jurisdiction has its own unique blend of jurisprudence, institutions, cultures and historical traditions, there is considerable scope for comparative analysis and cross-jurisdictional borrowing and instruction. In the spirit of promoting more nuanced and sophisticated international interdisciplinary dialogue, this article examines UK judicial approaches to LTDNA evidence and begins to elucidate their underlying institutional logic. Legal argument and broader policy debates are not confined to considerations of scientific validity, contamination risks and evidential integrity, or associated judgments of legal admissibility or exclusion. They also crucially

LTDNA Evidence on Trial.

Science.gov (United States)

Roberts, Paul

2016-01-01

Adopting the interpretative/hermeneutical method typical of much legal scholarship, this article considers two sets of issues pertaining to LTDNA profiles as evidence in criminal proceedings. The section titled Expert Evidence as Forensic Epistemic Warrant addresses some rather large questions about the epistemic status and probative value of expert testimony in general. It sketches a theoretical model of expert evidence, highlighting five essential criteria: (1) expert competence; (2) disciplinary domain; (3) methodological validity; (4) materiality; and (5) legal admissibility. This generic model of expert authority, highlighting law's fundamentally normative character, applies to all modern forms of criminal adjudication, across Europe and farther afield. The section titled LTDNA Evidence in UK Criminal Trials then examines English and Northern Irish courts' attempts to get to grips with LTDNA evidence in recent cases. Better appreciating the ways in which UK courts have addressed the challenges of LTDNA evidence may offer some insights into parallel developments in other legal systems. Appellate court rulings follow a predictable judicial logic, which might usefully be studied and reflected upon by any forensic scientist or statistician seeking to operate effectively in criminal proceedings. Whilst each legal jurisdiction has its own unique blend of jurisprudence, institutions, cultures and historical traditions, there is considerable scope for comparative analysis and cross-jurisdictional borrowing and instruction. In the spirit of promoting more nuanced and sophisticated international interdisciplinary dialogue, this article examines UK judicial approaches to LTDNA evidence and begins to elucidate their underlying institutional logic. Legal argument and broader policy debates are not confined to considerations of scientific validity, contamination risks and evidential integrity, or associated judgments of legal admissibility or exclusion. They also crucially

Stress and strain provide positional and directional cues in development.

Directory of Open Access Journals (Sweden)

Behruz Bozorg

2014-01-01

Full Text Available The morphogenesis of organs necessarily involves mechanical interactions and changes in mechanical properties of a tissue. A long standing question is how such changes are directed on a cellular scale while being coordinated at a tissular scale. Growing evidence suggests that mechanical cues are participating in the control of growth and morphogenesis during development. We introduce a mechanical model that represents the deposition of cellulose fibers in primary plant walls. In the model both the degree of material anisotropy and the anisotropy direction are regulated by stress anisotropy. We show that the finite element shell model and the simpler triangular biquadratic springs approach provide equally adequate descriptions of cell mechanics in tissue pressure simulations of the epidermis. In a growing organ, where circumferentially organized fibers act as a main controller of longitudinal growth, we show that the fiber direction can be correlated with both the maximal stress direction and the direction orthogonal to the maximal strain direction. However, when dynamic updates of the fiber direction are introduced, the mechanical stress provides a robust directional cue for the circumferential organization of the fibers, whereas the orthogonal to maximal strain model leads to an unstable situation where the fibers reorient longitudinally. Our investigation of the more complex shape and growth patterns in the shoot apical meristem where new organs are initiated shows that a stress based feedback on fiber directions is capable of reproducing the main features of in vivo cellulose fiber directions, deformations and material properties in different regions of the shoot. In particular, we show that this purely mechanical model can create radially distinct regions such that cells expand slowly and isotropically in the central zone while cells at the periphery expand more quickly and in the radial direction, which is a well established growth pattern

Stress and strain provide positional and directional cues in development.

Science.gov (United States)

Bozorg, Behruz; Krupinski, Pawel; Jönsson, Henrik

2014-01-01

The morphogenesis of organs necessarily involves mechanical interactions and changes in mechanical properties of a tissue. A long standing question is how such changes are directed on a cellular scale while being coordinated at a tissular scale. Growing evidence suggests that mechanical cues are participating in the control of growth and morphogenesis during development. We introduce a mechanical model that represents the deposition of cellulose fibers in primary plant walls. In the model both the degree of material anisotropy and the anisotropy direction are regulated by stress anisotropy. We show that the finite element shell model and the simpler triangular biquadratic springs approach provide equally adequate descriptions of cell mechanics in tissue pressure simulations of the epidermis. In a growing organ, where circumferentially organized fibers act as a main controller of longitudinal growth, we show that the fiber direction can be correlated with both the maximal stress direction and the direction orthogonal to the maximal strain direction. However, when dynamic updates of the fiber direction are introduced, the mechanical stress provides a robust directional cue for the circumferential organization of the fibers, whereas the orthogonal to maximal strain model leads to an unstable situation where the fibers reorient longitudinally. Our investigation of the more complex shape and growth patterns in the shoot apical meristem where new organs are initiated shows that a stress based feedback on fiber directions is capable of reproducing the main features of in vivo cellulose fiber directions, deformations and material properties in different regions of the shoot. In particular, we show that this purely mechanical model can create radially distinct regions such that cells expand slowly and isotropically in the central zone while cells at the periphery expand more quickly and in the radial direction, which is a well established growth pattern in the meristem.