System safety management: A new discipline

NASA Technical Reports Server (NTRS)

Pope, W. C.

1971-01-01

The systems theory is discussed in relation to safety management. It is suggested that systems safety management, as a new discipline, holds great promise for reducing operating errors, conserving labor resources, avoiding operating costs due to mistakes, and for improving managerial techniques. It is pointed out that managerial failures or system breakdowns are the basic reasons for human errors and condition defects. In this respect, a recommendation is made that safety engineers stop visualizing the problem only with the individual (supervisor or employee) and see the problem from the systems point of view.

Statistical Process Control Techniques for the Telecommunications Systems Manager

DTIC Science & Technology

1992-03-01

products that are out of 59 tolerance and bad designs. The third type of defect, mistakes, are remedied by Poka - Yoke methods that are 1 introduced later...based on total production costs plus quality costs. Once production is underway, interventions are determined by their impact on the QLF. F. POKA - YOKE ...Mistakes require process improvements called Poka Yoke or mistake proofing. Shiego Shingo developed Poka Yoke methods to incorporate 100% inspection at

Human error and the search for blame

NASA Technical Reports Server (NTRS)

Denning, Peter J.

1989-01-01

Human error is a frequent topic in discussions about risks in using computer systems. A rational analysis of human error leads through the consideration of mistakes to standards that designers use to avoid mistakes that lead to known breakdowns. The irrational side, however, is more interesting. It conditions people to think that breakdowns are inherently wrong and that there is ultimately someone who is responsible. This leads to a search for someone to blame which diverts attention from: learning from the mistakes; seeing the limitations of current engineering methodology; and improving the discourse of design.

The Buck Stops Here: Tying What Students Learn to What Educators Earn

ERIC Educational Resources Information Center

Slotnik, William J.

2010-01-01

Performance pay can be implemented in ways that are helpful to students and teachers, or it can repeat the mistakes of the past. To avoid these mistakes, initiatives must address the district factors that affect schools. There are six cornerstones for compensation reform: 1) Performance-based compensation is a systemic reform; 2) Compensation…

Grim Job Talks Are a Buzz Kill

ERIC Educational Resources Information Center

Shapiro, Dan

2012-01-01

This article takes a look at five mistakes that candidates should avoid making during their research presentations. These mistakes are the following: (1) they didn't do any research on the norms of the campus culture; (2) they presented a single, well-thought-out project that had no future; (3) they didn't use the opportunity to demonstrate their…

Using Risk Assessment Methodologies to Meet Management Objectives

NASA Technical Reports Server (NTRS)

DeMott, D. L.

2015-01-01

Corporate and program objectives focus on desired performance and results. ?Management decisions that affect how to meet these objectives now involve a complex mix of: technology, safety issues, operations, process considerations, employee considerations, regulatory requirements, financial concerns and legal issues. ?Risk Assessments are a tool for decision makers to understand potential consequences and be in a position to reduce, mitigate or eliminate costly mistakes or catastrophic failures. Using a risk assessment methodology is only a starting point. ?A risk assessment program provides management with important input in the decision making process. ?A pro-active organization looks to the future to avoid problems, a reactive organization can be blindsided by risks that could have been avoided. ?You get out what you put in, how useful your program is will be up to the individual organization.

Surgical errors and risks – the head and neck cancer patient

PubMed Central

Harréus, Ulrich

2013-01-01

Head and neck surgery is one of the basic principles of head and neck cancer therapy. Surgical errors and malpractice can have fatal consequences for the treated patients. It can lead to functional impairment and has impact in future chances for disease related survival. There are many risks for head and neck surgeons that can cause errors and malpractice. To avoid surgical mistakes, thorough preoperative management of patients is mandatory. As there are ensuring operability, cautious evaluation of preoperative diagnostics and operative planning. Moreover knowledge of anatomical structures of the head and neck, of the medical studies and data as well as qualification in modern surgical techniques and the surgeons ability for critical self assessment are basic and important prerequisites for head and neck surgeons in order to make out risks and to prevent from mistakes. Additionally it is important to have profound knowledge in nutrition management of cancer patients, wound healing and to realize and to be able to deal with complications, when they occur. Despite all precaution and surgical care, errors and mistakes cannot always be avoided. For that it is important to be able to deal with mistakes and to establish an appropriate and clear communication and management for such events. The manuscript comments on recognition and prevention of risks and mistakes in the preoperative, operative and postoperative phase of head and neck cancer surgery. PMID:24403972

Simulation software: engineer processes before reengineering.

PubMed

Lepley, C J

2001-01-01

People make decisions all the time using intuition. But what happens when you are asked: "Are you sure your predictions are accurate? How much will a mistake cost? What are the risks associated with this change?" Once a new process is engineered, it is difficult to analyze what would have been different if other options had been chosen. Simulating a process can help senior clinical officers solve complex patient flow problems and avoid wasted efforts. Simulation software can give you the data you need to make decisions. The author introduces concepts, methodologies, and applications of computer aided simulation to illustrate their use in making decisions to improve workflow design.

Ten Mistakes To Avoid When Injecting Botulinum Toxin.

PubMed

Ruiz-Rodriguez, R; Martin-Gorgojo, A

2015-01-01

Injection of botulinum toxin is currently the most common cosmetic procedure in the United States, and in recent years it has become-together with dermal fillers-the mainstay of therapy for the prevention and treatment of facial aging. However, in some cases the treatment may lead to a somewhat unnatural appearance, usually caused by loss of facial expression or other telltale signs. In the present article, we review the 10 mistakes that should be avoided when injecting botulinum toxin. We also reflect on how treatment with botulinum toxin influences us through our facial expressions, both in terms of how we feel and what others perceive. Copyright © 2015 Elsevier España, S.L.U. and AEDV. All rights reserved.

Make no mistake—errors can be controlled*

PubMed Central

Hinckley, C

2003-01-01



 Traditional quality control methods identify "variation" as the enemy. However, the control of variation by itself can never achieve the remarkably low non-conformance rates of world class quality leaders. Because the control of variation does not achieve the highest levels of quality, an inordinate focus on these techniques obscures key quality improvement opportunities and results in unnecessary pain and suffering for patients, and embarrassment, litigation, and loss of revenue for healthcare providers. Recent experience has shown that mistakes are the most common cause of problems in health care as well as in other industrial environments. Excessive product and process complexity contributes to both excessive variation and unnecessary mistakes. The best methods for controlling variation, mistakes, and complexity are each a form of mistake proofing. Using these mistake proofing techniques, virtually every mistake and non-conformance can be controlled at a fraction of the cost of traditional quality control methods. PMID:14532368

Overcoming barriers to electronic medical record (EMR) implementation in the US healthcare system: A comparative study.

PubMed

Kumar, Sameer; Aldrich, Krista

2010-12-01

An EMR system implementation would significantly reduce clinician workload and medical errors while saving the US healthcare system major expense. Yet, compared to other developed nations, the US lags behind. This article examines EMR system efforts, benefits, and barriers, as well as steps needed to move the US closer to a nationwide EMR system. The analysis includes a blueprint for implementation of EMR, industry comparisons to highlight the differences between successful and non-successful EMR ventures, references to costs and benefit information, and identification of root causes. 'Poka-yokes' (avoid (yokeru) mistakes (poka)) will be inserted to provide insight into how to systematically overcome challenges. Implementation will require upfront costs including patient privacy that must be addressed early in the development process. Government structure, incentives and mandates are required for nationwide EMR system in the US.

Personal Narratives: Cultural Differences and Clinical Implications

ERIC Educational Resources Information Center

Bliss, Lynn S.; McCabe, Allyssa

2008-01-01

A study was conducted to examine the misdiagnosis of cultural difference deficits and how mistaking deficits in narrative production for cultural differences can be avoided. Findings reveal the implications for intervention.

Mistakes in a stat laboratory: types and frequency.

PubMed

Plebani, M; Carraro, P

1997-08-01

Application of Total Quality Management concepts to laboratory testing requires that the total process, including preanalytical and postanalytical phases, be managed so as to reduce or, ideally, eliminate all defects within the process itself. Indeed a "mistake" can be defined as any defect during the entire testing process, from ordering tests to reporting results. We evaluated the frequency and types of mistakes found in the "stat" section of the Department of Laboratory Medicine of the University-Hospital of Padova by monitoring four different departments (internal medicine, nephrology, surgery, and intensive care unit) for 3 months. Among a total of 40490 analyses, we identified 189 laboratory mistakes, a relative frequency of 0.47%. The distribution of mistakes was: preanalytical 68.2%, analytical 13.3%, and postanalytical 18.5%. Most of the laboratory mistakes (74%) did not affect patients' outcome. However, in 37 patients (19%), laboratory mistakes were associated with further inappropriate investigations, thus resulting in an unjustifiable increase in costs. Moreover, in 12 patients (6.4%) laboratory mistakes were associated with inappropriate care or inappropriate modification of therapy. The promotion of quality control and continuous improvement of the total testing process, including pre- and postanalytical phases, seems to be a prerequisite for an effective laboratory service.

Seven common mistakes in population genetics and how to avoid them.

PubMed

Meirmans, Patrick G

2015-07-01

As the data resulting from modern genotyping tools are astoundingly complex, genotyping studies require great care in the sampling design, genotyping, data analysis and interpretation. Such care is necessary because, with data sets containing thousands of loci, small biases can easily become strongly significant patterns. Such biases may already be present in routine tasks that are present in almost every genotyping study. Here, I discuss seven common mistakes that can be frequently encountered in the genotyping literature: (i) giving more attention to genotyping than to sampling, (ii) failing to perform or report experimental randomization in the laboratory, (iii) equating geopolitical borders with biological borders, (iv) testing significance of clustering output, (v) misinterpreting Mantel's r statistic, (vi) only interpreting a single value of k and (vii) forgetting that only a small portion of the genome will be associated with climate. For every of those issues, I give some suggestions how to avoid the mistake. Overall, I argue that genotyping studies would benefit from establishing a more rigorous experimental design, involving proper sampling design, randomization and better distinction of a priori hypotheses and exploratory analyses. © 2015 John Wiley & Sons Ltd.

Defining the best quality-control systems by design and inspection.

PubMed

Hinckley, C M

1997-05-01

Not all of the many approaches to quality control are equally effective. Nonconformities in laboratory testing are caused basically by excessive process variation and mistakes. Statistical quality control can effectively control process variation, but it cannot detect or prevent most mistakes. Because mistakes or blunders are frequently the dominant source of nonconformities, we conclude that statistical quality control by itself is not effective. I explore the 100% inspection methods essential for controlling mistakes. Unlike the inspection techniques that Deming described as ineffective, the new "source" inspection methods can detect mistakes and enable corrections before nonconformities are generated, achieving the highest degree of quality at a fraction of the cost of traditional methods. Key relationships between task complexity and nonconformity rates are also described, along with cultural changes that are essential for implementing the best quality-control practices.

6 Tips to Avoid Medication Mistakes

MedlinePlus

... marketing the Electronic Medication Management Assistant (EMMA), a programmable device that stores and dispenses prescription medication for ... Of Your Health Care Team (article) Consumer Educational Materials: What You Need to Know to Use Medicine ...

AAA Foundation for Traffic Safety

MedlinePlus

... of Top Deadly Mistakes Made by Teen Drivers -- AAA AAA: Road debris causes avoidable crashes, deaths Save the ... and 500 deaths! Foundation News Stay Tuned New AAA Foundation for Traffic Safety website coming Fall 2017 ...

Driving safely into the future with applied technology

DOT National Transportation Integrated Search

1999-10-01

Driver error remains the leading cause of highway crashes. Through the Intelligent Vehicle Initiative (IVI), the Department of Transportation hopes to reduce crashes by helping drivers avoid hazardous mistakes. IVI aims to accelerate the development ...

Air quality impacts of intercity freight. Volume 1 : guidebook

DOT National Transportation Integrated Search

2000-01-01

Driver error remains the leading cause of highway crashes. Through the Intelligent Vehicle Initiative (IVI), the Department of Transportation hopes to reduce crashes by helping drivers avoid hazardous mistakes. IVI aims to accelerate the development ...

Computers Are for Kids: Designing Software Programs to Avoid Problems of Learning.

ERIC Educational Resources Information Center

Grimes, Lynn

1981-01-01

Procedures for programing computers to deal with handicapped students, problems in selective attention, visual discrimination, reaction time differences, short term memory, transfer and generalization, recognition of mistakes, and social skills are discussed. (CL)

Risks and injuries in laser and high-frequency applications

NASA Astrophysics Data System (ADS)

Giering, K.; Philipp, Carsten M.; Berlien, Hans-Peter

1995-01-01

An analysis of injuries and risks using high frequency (HF) and lasers in medicine based on a literature search with MEDLINE was performed. The cases reported in the literature were classified according to the following criteria: (1) Avoidable in an optimal operational procedure. These kind of injuries are caused by a chain of unfortunate incidents. They are in principle avoidable by the 'right action at the right time' which presupposes an appropriate training of the operating team, selection of the optimal parameters for procedure and consideration of all safety instructions. (2) Avoidable, caused by malfunction of the equipment and/or accessories. The injuries classified into this group are avoidable if all safety regulations were fulfilled. This includes a pre-operational check-up and the use of medical lasers and high frequency devices only which meet the international safety standards. (3) Avoidable, caused by misuse/mistake. Injuries of this group were caused by an inappropriate selection of the procedure, wrong medical indication or mistakes during application. (4) Unavoidable, fateful. These injuries can be caused by risks inherent to the type of energy used, malfunction of the equipment and/or accessories though a pre-operational check-up was done. Some risks and complications are common to high frequency and laser application. But whereas these risks can be excluded easily in laser surgery there is often a great expenditure necessary or they are not avoidable if high frequency if used. No unavoidable risks due to laser energy occur.

Contractor’s mistakes during tendering

NASA Astrophysics Data System (ADS)

Kamil, A. I. M.; Othman, N.; Adnan, H.; Zaki, ZA M.

2018-02-01

The occurrence of overrun in cost and time in a project that is usually caused by contractors, will generally make peopleput the blameonthem. This happensas a result of the lack of knowledge possessed by the contractors in determining the solution to be undertakendue totheir mistakes, especially when it comes to tendering process as what had happened in the cases that were reported in Supreme Court of Canada. This paper aims to identify the types of mistakes, factors that contribute to the mistakes and the responsiveness to the mistakes so that the contractor will be able to manage and control the mistakes, as well as the solution, along with preventing them from happening, and in making decision whether or notthey may withdraw from the bidding when the fault has been discovered or whether they should request for leniency from the client for a second chance in re-submitting the bid after the discovered inaccuracy. This research has been done based on cases that were related to the contractor’s mistakes during tendering which were collected from the Supreme Courts of Canada. The data have been analysed and interpreted by legal methodology, in which the result shows that the ability level of the contractors to respond to the mistake is unsatisfactory,and the fault is continuouslybeingmade. The findings are expected to educate and provide awareness to the contractors relating to the matters discussed.

The financial dimension of integrated behavioral/primary care.

PubMed

Cummings, Nicholas A; O'Donohue, William T; Cummings, Janet L

2009-03-01

There are two reasons why mental health, now more appropriately termed behavioral healthcare, is declining: (a) a lack of understanding among psychotherapists of healthcare economics, particularly the intricacies of medical cost offset, and (b) our failure as a profession to see the importance of behavioral interventions as an integral part of the healthcare system inasmuch as the nation pays for healthcare, not psychosocial care. This paper will briefly describe the rapid changes in the economics of healthcare during the past 75 years, including the post World War II enthusiastic espousal of psychotherapy by the American public which was followed by a precipitous decline as our outcomes research in behavioral care remained ignorant of financial outcomes, leaving it to the government and managed care to arbitrarily curtail escalating mental health costs. At the present time psychology is on the cusp of becoming part of the healthcare system through integrated behavioral/primary care, renewing the primacy of financial considerations such as return on investment (ROI) and medical cost offset, as well as an urgency that we avoid the mistakes that are emerging in some flawed implementations of integrated care.

Innovation: the classic traps.

PubMed

Kanter, Rosabeth Moss

2006-11-01

Never a fad, but always in or out of fashion, innovation gets rediscovered as a growth enabler every half dozen years. Too often, though, grand declarations about innovation are followed by mediocre execution that produces anemic results, and innovation groups are quietly disbanded in cost-cutting drives. Each managerial generation embarks on the same enthusiastic quest for the next new thing. And each generation faces the same vexing challenges- most of which stem from the tensions between protecting existing revenue streams critical to current success and supporting new concepts that may be crucial to future success. In this article, Harvard Business School professor Rosabeth Moss Kanter reflects on the four major waves of innovation enthusiasm she's observed over the past 25 years. She describes the classic mistakes companies make in innovation strategy, process, structure, and skills assessment, illustrating her points with a plethora of real-world examples--including AT&T Worldnet, Timberland, and Ocean Spray. A typical strategic blunder is when managers set their hurdles too high or limit the scope of their innovation efforts. Quaker Oats, for instance, was so busy in the 1990s making minor tweaks to its product formulas that it missed larger opportunities in distribution. A common process mistake is when managers strangle innovation efforts with the same rigid planning, budgeting, and reviewing approaches they use in their existing businesses--thereby discouraging people from adapting as circumstances warrant. Companies must be careful how they structure fledgling entities alongside existing ones, Kanter says, to avoid a clash of cultures and agendas--which Arrow Electronics experienced in its attempts to create an online venture. Finally, companies commonly undervalue and underinvest in the human side of innovation--for instance, promoting individuals out of innovation teams long before their efforts can pay off. Kanter offers practical advice for avoiding these traps.

[The characteristics of the notions used in forensic medicine and their logical basis].

PubMed

Kovalev, D; Shmarov, K; Ten'kov, D

2015-01-01

The authors briefly characterize the formerly poorly defined notions used by forensic medical experts for the completion of the conclusions based on the results of primary forensic medical examinations of the corpses. The main errors made in the use of these notions encountered in the materials of primary forensic medical expertises of the corpses, the recommendations to avoid these mistakes are proposed. The present paper continues the series of specialized articles dealing with the main types of logical fallacies encountered in the expert conclusions with a view to further publication of the results of the in-depth analysis of logical mistakes in these documents.

HSE inspector advises on 'common mistakes'.

PubMed

Baillie, Jonathan

2012-10-01

A recent IHEEM seminar on water hygiene and safety, 'The Invisible Threat', saw John Newbold, an HM specialist inspector at the Health and Safety Executive (HSE) with experience investigating Legionella cases and outbreaks, provide useful insight into how healthcare estates engineers and other 'responsible' personnel could ensure compliance with the law by properly 'managing and controlling' Legionella risk. He provided a first-hand view of what he dubbed 'some of the common mistakes' made by those responsible for managing water system safety, and gave useful advice and guidance on how to avoid them, and thus minimise the risk of falling foul of the HSE and other regulators. HEJ editor, Jonathan Baillie, reports.

Combined horizontal and vertical integration of care: a goal of practice-based commissioning.

PubMed

Thomas, Paul; Meads, Geoffrey; Moustafa, Ahmet; Nazareth, Irwin; Stange, Kurt C; Donnelly Hess, Gertrude

2008-01-01

Practice-based commissioning (PBC) in the UK is intended to improve both the vertical and horizontal integration of health care, in order to avoid escalating costs and enhance population health. Vertical integration involves patient pathways to treat named medical conditions that transcend organisational boundaries and connect community-based generalists with largely hospital-sited specialists, whereas horizontal integration involves peer-based and cross-sectoral collaboration to improve overall health. Effective mechanisms are now needed to permit ongoing dialogue between the vertical and horizontal dimensions to ensure that medical and nonmedical care are both used to their best advantage. This paper proposes three different models for combining vertical and horizontal integration - each is a hybrid of internationally recognised ideal types of primary care organisation. Leaders of PBC should consider a range of models and apply them in ways that are relevant to the local context. General practitioners, policy makers and others whose job it is to facilitate horizontal and vertical integration must learn to lead such combined approaches to integration if the UK is to avoid the mistakes of the USA in over-medicalising health issues.

Preparing for an EPA Inspection and Avoiding Common Mistakes.

ERIC Educational Resources Information Center

Manicone, Santo

2000-01-01

Discusses how a higher education facility can prepare for an Environmental Protection Agency inspection with some quick topics designed to smooth the process. Tips include determining if waste is hazardous, labeling waste properly, preventing pollution, improving housekeeping, and having good hazardous materials management practices. (GR)

Payoff non-linearity sways the effect of mistakes on the evolution of reciprocity.

PubMed

Kurokawa, Shun

2016-09-01

The existence of cooperation is considered to require explanation, and reciprocity is a potential explanatory mechanism. Animals sometimes fail to cooperate even when they attempt to do so, and a reciprocator has an Achilles' heel: it is vulnerable to error (the interaction between two reciprocators can lead to an endless vendetta.). However, the strategy favored by natural selection is determined also by its interaction with other strategies. The relationship between two reciprocators leading to a collapse of cooperation through error does not straightforwardly imply that mistakes make the conditions under which reciprocity evolves stringent. Hence, mistakes may facilitate the evolution of reciprocity. However, it has been shown through the analysis of the interaction between reciprocators and unconditional defectors that the existence of mistakes makes the conditions for reciprocators stable against invasion by an unconditional defector more stringent, which indicates that mistakes discourage the evolution of reciprocity. However, this result is based on the assumption that the effects of cooperation are additive (payoff is linear), while the game played by real animals does not always display this feature. In such cases, the result may be swayed. In this paper, we remove this assumption, reexamining whether mistakes disturb the evolution of reciprocity. Using the analysis of an evolutionarily stable strategy (ESS), we show that when extra fitness costs are present in cases where mutual cooperation is established, mistakes can facilitate the evolution of reciprocity; whereas, when the effect of cooperation is additive, mistakes always disturb the evolution of reciprocity, as has been shown previously. Copyright © 2016. Published by Elsevier Inc.

It's Hard To Keep Creativity Alive in Many Children.

ERIC Educational Resources Information Center

Winebrenner, Susan

2001-01-01

Suggestions are given to parents for encouraging creativity in children such as: respecting "wild and wacky" questions and responses, helping children understand the difference between making up tales and telling harmful lies, creating environments in which mistakes are not only valued but encouraged, and avoiding making comparisons in direct or…

The Roles of Assessment in Language Teaching

ERIC Educational Resources Information Center

Frank, Jerrold

2012-01-01

This piece makes a case for using assessment to understand and identify the needs of learners and introduces the three reprints that follow: "Twenty Common Testing Mistakes for EFL Teachers to Avoid," "Coming to Grips with Progress Testing: Some Guidelines for Its Design," and "Purposeful Language Assessment: Selecting the Right Alternative Test."

Ten common errors beginning substance abuse workers make in group treatment.

PubMed

Greif, G L

1996-01-01

Beginning therapists sometimes make mistakes when working with substance abusers in groups. This article discusses ten common errors that the author has observed. Five center on the therapist's approach and five center on the nuts and bolts of group leadership. Suggestions are offered for how to avoid them.

Seven Ways to Kill RTI

ERIC Educational Resources Information Center

Noll, Brandi

2013-01-01

The Response to Intervention initiative is in danger of failing and being thrown on the ash heaps of countless education reform initiatives, but not because it is poorly structured, rather on account of poor implementation. Among the implementation mistakes are seven that can be watched for and avoided. (Contains 3 tables.)

Jail Management. Book 6: Jail Planning.

ERIC Educational Resources Information Center

Blumer, Alice Howard

The course is for independent study by jail officers who must learn that, in addition to their rountine tasks, they must be prepared to be well-trained, responsible professionals, making important decisions and avoiding the mistakes and disproven beliefs of the past. The jail administrator must continually wrestle with the problems of conflicting…

Companies Can Apologize: Corporate Apologies and Legal Liability.

ERIC Educational Resources Information Center

Patel, Ameeta; Reinsch, Lamar

2003-01-01

Indicates that apologies generally do not constitute evidence of guilt and that, in fact, they sometimes have positive consequences for the apologist. Suggests that persons who practice (or teach) crisis communication should avoid the mistake of relying on an over-simplified and inaccurate understanding of the legal issues surrounding corporate…

Jail Management. Book 5: Legal Problems.

ERIC Educational Resources Information Center

Blumer, Alice Howard

The course is for independent study by jail officers who must learn that, in addition to their rountine tasks, they must be prepared to be well-trained, responsible professionals, making important decisions and avoiding the mistakes and disproven beliefs of the past. The jail administrator must continually wrestle with the problems of conflicting…

The Power of Peers

ERIC Educational Resources Information Center

Traver, Rob

2016-01-01

"Students are naturally inclined to watch one another, to make suggestions and support their peers, to avoid mistakes, to copy what works and modify what doesn't, and to learn from one another," writes Rob Traver in this article. To prove his point, Traver brings readers into three classrooms where teachers tap into students' intrinsic…

Lessons from chicken pluckers and others.

PubMed

Hammerle, R L

1988-04-01

The health-care industry is now bridging the gap between government regulation and a market-based system. Management skills are transferable, the author argues, and history can be a guide to avoiding mistakes. Health-care executives should look to strategies that worked in the airline, automobile and food-service industries.

Sexual regret: evidence for evolved sex differences.

PubMed

Galperin, Andrew; Haselton, Martie G; Frederick, David A; Poore, Joshua; von Hippel, William; Buss, David M; Gonzaga, Gian C

2013-10-01

Regret and anticipated regret enhance decision quality by helping people avoid making and repeating mistakes. Some of people's most intense regrets concern sexual decisions. We hypothesized evolved sex differences in women's and men's experiences of sexual regret. Because of women's higher obligatory costs of reproduction throughout evolutionary history, we hypothesized that sexual actions, particularly those involving casual sex, would be regretted more intensely by women than by men. In contrast, because missed sexual opportunities historically carried higher reproductive fitness costs for men than for women, we hypothesized that poorly chosen sexual inactions would be regretted more by men than by women. Across three studies (Ns = 200, 395, and 24,230), we tested these hypotheses using free responses, written scenarios, detailed checklists, and Internet sampling to achieve participant diversity, including diversity in sexual orientation. Across all data sources, results supported predicted psychological sex differences and these differences were localized in casual sex contexts. These findings are consistent with the notion that the psychology of sexual regret was shaped by recurrent sex differences in selection pressures operating over deep time.

Can Australia Avoid Repeating American and European Mistakes?

ERIC Educational Resources Information Center

Breen, Myles P.

In today's world, broad societal trends tend to originate in the center and migrate to the periphery. Europe and North America are in the center, and Australia is on the periphery. Of specific interest to communication scholars is the growth or ebbing of communication theories or techniques. One trend, the use of computers in communication…

Jail Management. Book 3. Jail and Community Corrections Programs.

ERIC Educational Resources Information Center

Blumer, Alice Howard

The course is for independent study by jail officers who must learn that, in addition to their routine tasks, they must be prepared to be well-trained, responsible professionals, making important decisions and avoiding the mistakes and disproven beliefs of the past. The jail administrator must continually wrestle with the problems of conflicting…

Mechanism problems

NASA Technical Reports Server (NTRS)

Riedel, J. K.

1972-01-01

It is pointed out that too frequently during the design and development of mechanisms, problems occur that could have been avoided if the right question had been asked before, rather than after, the fact. Several typical problems, drawn from actual experience, are discussed and analyzed. The lessons learned are used to generate various suggestions for minimizing mistakes in mechanism design.

Jail Management. Book 1: Administration of Jail Operations.

ERIC Educational Resources Information Center

Blumer, Alice Howard

The course is for independent study by jail officers who must learn that, in addition to their routine tasks, they must be prepared to be well-trained, responsible professionals, making important decisions and avoiding the mistakes and disproven beliefs of the past. The jail administrator must continually wrestle with the problems of conflicting…

Physician Practice Audit Targets Now Become Hospital and Health System Compliance Risks.

PubMed

Hirsch, Ronald L

2015-01-01

In 2013, 22% of the federal budget was spent on Medicare and Medicaid. The Medicare Trust Fund is forecast to be depleted in 2030. More than 12% of Medicare fee-for-service payments in 2014 were made in error. These factors have led Congress to apply more pressure to reduce improper payments. Although hospitals were the initial targets because of their higher reimbursement, recent efforts have shifted to physician billing. Hospitals and health systems continue to acquire physician practices, making them liable for the billing activities of physicians. And for physicians who remain independent, the cost and effort required to respond to audits and denials can be financially devastating, further demonstrating the importance of prevention. This article addresses some of the common audit targets and mistakes made by physicians and provides strategies for physician practices and health systems to respond to and, ultimately, avoid these denials.

Radiology Architecture Project Primer.

PubMed

Sze, Raymond W; Hogan, Laurie; Teshima, Satoshi; Davidson, Scott

2017-12-19

The rapid pace of technologic advancement and increasing expectations for patient- and family-friendly environments make it common for radiology leaders to be involved in imaging remodel and construction projects. Most radiologists and business directors lack formal training in architectural and construction processes but are expected to play significant and often leading roles in all phases of an imaging construction project. Avoidable mistakes can result in significant increased costs and scheduling delays; knowledgeable participation and communication can result in a final product that enhances staff workflow and morale and improves patient care and experience. This article presents practical guidelines for preparing for and leading a new imaging architectural and construction project. We share principles derived from the radiology and nonradiology literature and our own experience over the past decade completely remodeling a large pediatric radiology department and building a full-service outpatient imaging center. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Electronic health records: postadoption physician satisfaction and continued use.

PubMed

Wright, Edward; Marvel, Jon

2012-01-01

One goal of public-policy makers in general and health care managers in particular is the adoption and efficient utilization of electronic health record (EHR) systems throughout the health care industry. Consequently, this investigation focused on the effects of known antecedents of technology adoption on physician satisfaction with EHR technology and the continued use of such systems. The American Academy of Family Physicians provided support in the survey of 453 physicians regarding their satisfaction with their EHR use experience. A conceptual model merging technology adoption and computer user satisfaction models was tested using structural equation modeling. Results indicate that effort expectancy (ease of use) has the most substantive effect on physician satisfaction and the continued use of EHR systems. As such, health care managers should be especially sensitive to the user and computer interface of prospective EHR systems to avoid costly and disruptive system selection mistakes.

Evolution of direct reciprocity under uncertainty can explain human generosity in one-shot encounters

PubMed Central

Delton, Andrew W.; Krasnow, Max M.; Cosmides, Leda; Tooby, John

2011-01-01

Are humans too generous? The discovery that subjects choose to incur costs to allocate benefits to others in anonymous, one-shot economic games has posed an unsolved challenge to models of economic and evolutionary rationality. Using agent-based simulations, we show that such generosity is the necessary byproduct of selection on decision systems for regulating dyadic reciprocity under conditions of uncertainty. In deciding whether to engage in dyadic reciprocity, these systems must balance (i) the costs of mistaking a one-shot interaction for a repeated interaction (hence, risking a single chance of being exploited) with (ii) the far greater costs of mistaking a repeated interaction for a one-shot interaction (thereby precluding benefits from multiple future cooperative interactions). This asymmetry builds organisms naturally selected to cooperate even when exposed to cues that they are in one-shot interactions. PMID:21788489

Evolution of direct reciprocity under uncertainty can explain human generosity in one-shot encounters.

PubMed

Delton, Andrew W; Krasnow, Max M; Cosmides, Leda; Tooby, John

2011-08-09

Are humans too generous? The discovery that subjects choose to incur costs to allocate benefits to others in anonymous, one-shot economic games has posed an unsolved challenge to models of economic and evolutionary rationality. Using agent-based simulations, we show that such generosity is the necessary byproduct of selection on decision systems for regulating dyadic reciprocity under conditions of uncertainty. In deciding whether to engage in dyadic reciprocity, these systems must balance (i) the costs of mistaking a one-shot interaction for a repeated interaction (hence, risking a single chance of being exploited) with (ii) the far greater costs of mistaking a repeated interaction for a one-shot interaction (thereby precluding benefits from multiple future cooperative interactions). This asymmetry builds organisms naturally selected to cooperate even when exposed to cues that they are in one-shot interactions.

Mind the Comprehension Iceberg: Avoiding Titanic Mistakes with the CCSS

ERIC Educational Resources Information Center

Hollenbeck, Amy Feiker; Saternus, Kara

2013-01-01

As teachers and leaders move forward in implementing the Common Core State Standards within classrooms across 46 states, it is essential to consider the question of what knowledge is included in the English Language Arts Standards, and what knowledge is not present. The authors of the Common Core delineate an increasingly complex body of knowledge…

Control of Randomly Sampled Robotic Systems

DTIC Science & Technology

1989-05-01

task is so cumbersome and complicated that we would not be able to do without lots of mistakes. To avoid this formidable business , a Lisp program is...Artificial Inteligence Laboratory, 1972. PumA26O.c Ned Mar 8 17:51:04 1989 1 #include <rnath.h> #define real float #define mm 6 #define G 9.83. #define M6

On the Mark: Putting the Student Back in Student-Athlete.

ERIC Educational Resources Information Center

Lapchick, Richard E.; Malekoff, Robert

A self-help guide for junior and senior high school athletes is presented to help them choose colleges and avoid mistakes that may affect their lives as well as their athletic careers. Stories of the good/bad experiences of athletes are included. For the college-bound student, information is included on admissions, grades, college entrance tests,…

13 Reasons Colleges Are in This Mess

ERIC Educational Resources Information Center

Chronicle of Higher Education, 2009

2009-01-01

In some ways, higher education has been a victim of the recession--but not a defenseless victim. Smart moves clearly helped some colleges and universities avoid the worst of the downturn. Mistakes have left many others in the lurch. The downward spiral has brought layoffs, budget cuts, and anxiety to many campuses. With the cuts have come protests…

Direct Position Determination of Unknown Signals in the Presence of Multipath Propagation

PubMed Central

Yu, Hongyi

2018-01-01

A novel geolocation architecture, termed “Multiple Transponders and Multiple Receivers for Multiple Emitters Positioning System (MTRE)” is proposed in this paper. Existing Direct Position Determination (DPD) methods take advantage of a rather simple channel assumption (line of sight channels with complex path attenuations) and a simplified MUltiple SIgnal Classification (MUSIC) algorithm cost function to avoid the high dimension searching. We point out that the simplified assumption and cost function reduce the positioning accuracy because of the singularity of the array manifold in a multi-path environment. We present a DPD model for unknown signals in the presence of Multi-path Propagation (MP-DPD) in this paper. MP-DPD adds non-negative real path attenuation constraints to avoid the mistake caused by the singularity of the array manifold. The Multi-path Propagation MUSIC (MP-MUSIC) method and the Active Set Algorithm (ASA) are designed to reduce the dimension of searching. A Multi-path Propagation Maximum Likelihood (MP-ML) method is proposed in addition to overcome the limitation of MP-MUSIC in the sense of a time-sensitive application. An iterative algorithm and an approach of initial value setting are given to make the MP-ML time consumption acceptable. Numerical results validate the performances improvement of MP-MUSIC and MP-ML. A closed form of the Cramér–Rao Lower Bound (CRLB) is derived as a benchmark to evaluate the performances of MP-MUSIC and MP-ML. PMID:29562601

Direct Position Determination of Unknown Signals in the Presence of Multipath Propagation.

PubMed

Du, Jianping; Wang, Ding; Yu, Wanting; Yu, Hongyi

2018-03-17

A novel geolocation architecture, termed "Multiple Transponders and Multiple Receivers for Multiple Emitters Positioning System (MTRE)" is proposed in this paper. Existing Direct Position Determination (DPD) methods take advantage of a rather simple channel assumption (line of sight channels with complex path attenuations) and a simplified MUltiple SIgnal Classification (MUSIC) algorithm cost function to avoid the high dimension searching. We point out that the simplified assumption and cost function reduce the positioning accuracy because of the singularity of the array manifold in a multi-path environment. We present a DPD model for unknown signals in the presence of Multi-path Propagation (MP-DPD) in this paper. MP-DPD adds non-negative real path attenuation constraints to avoid the mistake caused by the singularity of the array manifold. The Multi-path Propagation MUSIC (MP-MUSIC) method and the Active Set Algorithm (ASA) are designed to reduce the dimension of searching. A Multi-path Propagation Maximum Likelihood (MP-ML) method is proposed in addition to overcome the limitation of MP-MUSIC in the sense of a time-sensitive application. An iterative algorithm and an approach of initial value setting are given to make the MP-ML time consumption acceptable. Numerical results validate the performances improvement of MP-MUSIC and MP-ML. A closed form of the Cramér-Rao Lower Bound (CRLB) is derived as a benchmark to evaluate the performances of MP-MUSIC and MP-ML.

Imperfect information facilitates the evolution of reciprocity.

PubMed

Kurokawa, Shun

2016-06-01

The existence of cooperation demands explanation since cooperation is costly to the actor. Reciprocity has long been regarded as a potential explanatory mechanism for the existence of cooperation. Reciprocity is a mechanism wherein a cooperator responds to an opponent's behavior by switching his/her own behavior. Hence, a possible problematic case relevant to the theory of reciprocity evolution arises when the mechanism is such that the information regarding an opponent's behavior is imperfect. Although it has been confirmed also by previous theoretical studies that imperfect information interferes with the evolution of reciprocity, this argument is based on the assumption that there are no mistakes in behavior. And, a previous study presumed that it might be expected that when such mistakes occur, reciprocity can more readily evolve in the case of imperfect information than in the case of perfect information. The reason why the previous study considers so is that in the former case, reciprocators can miss defections incurred by other reciprocators' mistakes due to imperfect information, allowing cooperation to persist when such reciprocators meet. However, contrary to this expectation, the previous study has shown that even when mistakes occur, imperfect information interferes with the evolution of reciprocity. Nevertheless, the previous study assumed that payoffs are linear (i.e., that the effect of behavior is additive and there are no synergetic effects). In this study, we revisited the same problem but removed the assumption that payoffs are linear. We used evolutionarily stable strategy analysis to compare the condition for reciprocity to evolve when mistakes occur and information is imperfect with the condition for reciprocity to evolve when mistakes occur and information is perfect. Our study revealed that when payoffs are not linear, imperfect information can facilitate the evolution of reciprocity when mistakes occur; while when payoffs are linear, imperfect information disturbs the evolution of reciprocity even when mistakes occur. Imperfect information can encourage the evolution of cooperation. Copyright © 2016 Elsevier Inc. All rights reserved.

Strategic Financial Management for Conferences, Workshops, and Meetings. Jossey-Bass Higher and Adult Education Series and Jossey-Bass Management Series.

ERIC Educational Resources Information Center

Simerly, Robert G.

This book shows how to design and implement a strategic financial management system for any organization that plans conferences, workshops, and meetings. It guides the reader through steps in the budgeting and strategic financial management process. Case studies, hints, and guidelines for avoiding the most common mistakes are given, and…

Developing the Pedagogical Culture of Parents by Means of Social Partnership with a Supplementary Education Institution

ERIC Educational Resources Information Center

Zakirova, Venera G.; Nikitina, Ekaterina L.

2016-01-01

The urgency of the research is due to the current requirements to develop the pedagogical culture of parents, which can help them to be successful parents, to effectively interact with their children avoiding family upbringing mistakes. In this respect, the article aims to identify the conditions for development of the pedagogical culture of…

Toward A Fail-Safe Air Force Culture: Creating a Resilient Future While Avoiding Past Mistakes

DTIC Science & Technology

2012-10-01

process often uses the “ Swiss cheese ” model to evaluate accidents. The image of holes in the protective cheese layers (proactive and reactive measures...minimize the number and size of holes in each slice of cheese . More importantly, however, a HRO’s 16 focus is on “the process of the slices lining up as

Some good C++ practices for using the art framework

DOE Office of Scientific and Technical Information (OSTI.GOV)

Paterno, Marc

2015-05-01

This document is intended for an audience that has some programming experience, at least beginning familiarity with C++, and at least beginning familiarity with the art2 framework. The intent of this document is to help the reader avoid some of the more common mistakes made by those with little experience in C++, or in use of the art framework, or both.

Case-Based Teaching of Fatal Incidents in Outdoor Education Teacher Preparation Courses

ERIC Educational Resources Information Center

North, Chris; Brookes, Andrew

2017-01-01

This article examines the use of case-based approaches to fatal incidents in outdoor education (OE) with a view to fatality prevention. Fatalities are rare in OE and therefore it is nearly impossible for teachers to learn how to avoid fatalities from their own past experiences. It is, however, possible to learn from the mistakes of others through…

Here's the Answer. Was There a Question? Avoiding the Top 10 Metrics Mistakes

ERIC Educational Resources Information Center

Vaillancourt, Allison

2007-01-01

It's no secret that all organizations wish to better themselves, and the best way to do so is to measure past successes and failures and apply these measurements to the future. In higher education, this means creating a metrics strategy that addresses the particular needs of your institution. There is no "one-size-fits-all" metrics program, but…

Trouble Spots in Online Direct-to-Consumer Prescription Drug Promotion: Teaching Drug Marketers How to Inform Better or Spin Better?

PubMed Central

Doran, Evan

2016-01-01

Hyosun Kim’s report "Trouble Spots in Online Direct to Consumer Prescription Drug Promotion: A content Analysis of FDA Warning Letters" aims to teach marketers how to avoid breaching current Food and Drug Administration (FDA) guidelines in their online drug promotion. While Kim hopes to minimise the potential for online promotion to misinform consumers and the study is carefully conducted, teaching drug marketers how to avoid the common mistakes in online drug promotion is more likely to make marketers more adept at spinning information than appropriately balancing it PMID:27239884

Apology and forgiveness evolve to resolve failures in cooperative agreements.

PubMed

Martinez-Vaquero, Luis A; Han, The Anh; Pereira, Luís Moniz; Lenaerts, Tom

2015-06-09

Making agreements on how to behave has been shown to be an evolutionarily viable strategy in one-shot social dilemmas. However, in many situations agreements aim to establish long-term mutually beneficial interactions. Our analytical and numerical results reveal for the first time under which conditions revenge, apology and forgiveness can evolve and deal with mistakes within ongoing agreements in the context of the Iterated Prisoners Dilemma. We show that, when the agreement fails, participants prefer to take revenge by defecting in the subsisting encounters. Incorporating costly apology and forgiveness reveals that, even when mistakes are frequent, there exists a sincerity threshold for which mistakes will not lead to the destruction of the agreement, inducing even higher levels of cooperation. In short, even when to err is human, revenge, apology and forgiveness are evolutionarily viable strategies which play an important role in inducing cooperation in repeated dilemmas.

Apology and forgiveness evolve to resolve failures in cooperative agreements

PubMed Central

Martinez-Vaquero, Luis A.; Han, The Anh; Pereira, Luís Moniz; Lenaerts, Tom

2015-01-01

Making agreements on how to behave has been shown to be an evolutionarily viable strategy in one-shot social dilemmas. However, in many situations agreements aim to establish long-term mutually beneficial interactions. Our analytical and numerical results reveal for the first time under which conditions revenge, apology and forgiveness can evolve and deal with mistakes within ongoing agreements in the context of the Iterated Prisoners Dilemma. We show that, when the agreement fails, participants prefer to take revenge by defecting in the subsisting encounters. Incorporating costly apology and forgiveness reveals that, even when mistakes are frequent, there exists a sincerity threshold for which mistakes will not lead to the destruction of the agreement, inducing even higher levels of cooperation. In short, even when to err is human, revenge, apology and forgiveness are evolutionarily viable strategies which play an important role in inducing cooperation in repeated dilemmas. PMID:26057819

Effects of Lean Six Sigma application in healthcare services: a literature review.

PubMed

Ahmed, Selim; Manaf, Noor H A; Islam, Rafikul

2013-01-01

The healthcare organization is the place where defects and mistakes cannot be tolerated. A simple mistake can cost a human life so defects or mistakes must be eliminated in healthcare service processes. A Lean Six Sigma (LSS) approach is the best option in a healthcare environment for dealing with a critical patient. The LSS methodology optimizes the average reduction of a desired process. The expected results can be reductions in several aspects of healthcare such as patient waiting time in emergency departments, lost charges for billing in patient financial services, delinquent medical records, diagnostic result turnaround times, accounts receivable days, patients' length of stay, or medication errors. This paper mainly discusses the effects of the LSS approach in different hospitals around the world according to the literature review. This review also discusses the relationship between LSS as well as their impacts on healthcare services based on literature review.

Social Media as an Informant.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Crawford, Justin

With today’s means of communication and the billions of people across the globe using social media, it is no surprise that law enforcement intelligence operations have turned to using social media as an information collection medium. Using social media to collect information on individuals offers many benefits to law enforcement agencies but also includes certain manageable risks. There are several oversight regulations that department administrators and officers alike should be aware of. While the regulations certainly do not prevent information collection, law enforcement officers may find the constraints somewhat burdensome. This paper seeks to help identify the more prevalent issuesmore » with using social media as a virtual informant and guide agencies in a way to avoid the more common mistakes. These mistakes can lead to civil rights infringements and government oversteps by state, local and tribal officials.« less

A systematic review of patient medication error on self-administering medication at home.

PubMed

Mira, José Joaquín; Lorenzo, Susana; Guilabert, Mercedes; Navarro, Isabel; Pérez-Jover, Virtudes

2015-06-01

Medication errors have been analyzed as a health professionals' responsibility (due to mistakes in prescription, preparation or dispensing). However, sometimes, patients themselves (or their caregivers) make mistakes in the administration of the medication. The epidemiology of patient medication errors (PEs) has been scarcely reviewed in spite of its impact on people, on therapeutic effectiveness and on incremental cost for the health systems. This study reviews and describes the methodological approaches and results of published studies on the frequency, causes and consequences of medication errors committed by patients at home. A review of research articles published between 1990 and 2014 was carried out using MEDLINE, Web-of-Knowledge, Scopus, Tripdatabase and Index Medicus. The frequency of PE was situated between 19 and 59%. The elderly and the preschooler population constituted a higher number of mistakes than others. The most common were: incorrect dosage, forgetting, mixing up medications, failing to recall indications and taking out-of-date or inappropriately stored drugs. The majority of these mistakes have no negative consequences. Health literacy, information and communication and complexity of use of dispensing devices were identified as causes of PEs. Apps and other new technologies offer several opportunities for improving drug safety.

Algorithm aversion: people erroneously avoid algorithms after seeing them err.

PubMed

Dietvorst, Berkeley J; Simmons, Joseph P; Massey, Cade

2015-02-01

Research shows that evidence-based algorithms more accurately predict the future than do human forecasters. Yet when forecasters are deciding whether to use a human forecaster or a statistical algorithm, they often choose the human forecaster. This phenomenon, which we call algorithm aversion, is costly, and it is important to understand its causes. We show that people are especially averse to algorithmic forecasters after seeing them perform, even when they see them outperform a human forecaster. This is because people more quickly lose confidence in algorithmic than human forecasters after seeing them make the same mistake. In 5 studies, participants either saw an algorithm make forecasts, a human make forecasts, both, or neither. They then decided whether to tie their incentives to the future predictions of the algorithm or the human. Participants who saw the algorithm perform were less confident in it, and less likely to choose it over an inferior human forecaster. This was true even among those who saw the algorithm outperform the human.

Environmental Pollution: An Under-recognized Threat to Children’s Health, Especially in Low- and Middle-Income Countries

PubMed Central

Suk, William A.; Ahanchian, Hamid; Asante, Kwadwo Ansong; Carpenter, David O.; Diaz-Barriga, Fernando; Ha, Eun-Hee; Huo, Xia; King, Malcolm; Ruchirawat, Mathuros; da Silva, Emerson R.; Sly, Leith; Sly, Peter D.; Stein, Renato T.; van den Berg, Martin; Zar, Heather; Landrigan, Philip J.

2016-01-01

Summary Exposures to environmental pollutants during windows of developmental vulnerability in early life can cause disease and death in infancy and childhood as well as chronic, non-communicable diseases that may manifest at any point across the life span. Patterns of pollution and pollution-related disease change as countries move through economic development. Environmental pollution is now recognized as a major cause of morbidity and mortality in low- and middle-income countries (LMICs). According to the World Health Organization, pollution is responsible for 8.9 million deaths around the world each year; of these, 94% (8.4 million) are in LMICs. Toxic chemical pollution is growing into a major threat to children’s health in LMICs. The disease and disability caused by environmental pollution have great economic costs, and these costs can undercut trajectories of national development. To combat pollution, improved programs of public health and environmental protection are needed in countries at every level of development. Pollution control strategies and technologies that have been developed in high-income countries must now be transferred to LMICs to assist these emerging economies to avoid the mistakes of the past. A new international clearinghouse is needed to define and track the health effects of pollution, quantify the economic costs of these effects, and direct much needed attention to environmental pollution as a risk factor for disease. PMID:26930243

Environmental Pollution: An Under-recognized Threat to Children's Health, Especially in Low- and Middle-Income Countries.

PubMed

Suk, William A; Ahanchian, Hamid; Asante, Kwadwo Ansong; Carpenter, David O; Diaz-Barriga, Fernando; Ha, Eun-Hee; Huo, Xia; King, Malcolm; Ruchirawat, Mathuros; da Silva, Emerson R; Sly, Leith; Sly, Peter D; Stein, Renato T; van den Berg, Martin; Zar, Heather; Landrigan, Philip J

2016-03-01

Exposures to environmental pollutants during windows of developmental vulnerability in early life can cause disease and death in infancy and childhood as well as chronic, non-communicable diseases that may manifest at any point across the life span. Patterns of pollution and pollution-related disease change as countries move through economic development. Environmental pollution is now recognized as a major cause of morbidity and mortality in low- and middle-income countries (LMICs). According to the World Health Organization, pollution is responsible for 8.9 million deaths around the world each year; of these, 94% (8.4 million) are in LMICs. Toxic chemical pollution is growing into a major threat to children's health in LMICs. The disease and disability caused by environmental pollution have great economic costs, and these costs can undercut trajectories of national development. To combat pollution, improved programs of public health and environmental protection are needed in countries at every level of development. Pollution control strategies and technologies that have been developed in high-income countries must now be transferred to LMICs to assist these emerging economies to avoid the mistakes of the past. A new international clearinghouse is needed to define and track the health effects of pollution, quantify the economic costs of these effects, and direct much needed attention to environmental pollution as a risk factor for disease.

The digital darkroom, part 3: digital presentations in plastic surgery.

PubMed

Galdino, G M; Chiaramonte, M; Klatsky, S A

2001-01-01

Digital technology is becoming an increasing popular format for societal and other presentations. Part 3 of The Digital Darkroom reviews the kinds of equipment available, the advantages and disadvantages of digital projection, and the most common pitfalls encountered in preparing and presenting material in digital presentations. It closes with a series of recommendations for optimizing your digital presentation and avoiding mistakes that might decrease its effectiveness.

[Analysis of women nutritional status during pregnancy--a survey].

PubMed

Selwet, Monika; Machura, Mariola; Sipiński, Adam; Kuna, Anna; Kazimierczak, Małgorzata

2004-01-01

The proper diet is one of the most important factor during pregnancy. The general knowledge about proper nourishment during pregnancy allows the women to avoid quantitative and qualitative nourishment mistakes. Because of this--the salubrious education in this aspect is very important. The aim of the study is to analyze the proper nourishment during pregnancy particularly in professionally active women and those who don't work during pregnancy.

Identity change and informed consent

PubMed Central

Witt, Karsten

2017-01-01

In this paper, I focus on a kind of medical intervention that is at the same time fascinating and disturbing: identity-changing interventions. My guiding question is how such interventions can be ethically justified within the bounds of contemporary bioethical mainstream that places great weight on the patient's informed consent. The answer that is standardly given today is that patients should be informed about the identity effects, thus suggesting that changes in identity can be treated like ‘normal’ side effects. In the paper, I argue that this approach is seriously lacking because it misses important complexities going along with decisions involving identity changes and consequently runs into mistakes. As a remedy I propose a new approach, the ‘perspective-sensitive account’, which avoids these mistakes and thus provides the conceptual resources to systematically reflect on and give a valid consent to identity-changing interventions. PMID:28320773

Six Common Mistakes in Conservation Priority Setting

PubMed Central

Game, Edward T; Kareiva, Peter; Possingham, Hugh P

2013-01-01

Abstract A vast number of prioritization schemes have been developed to help conservation navigate tough decisions about the allocation of finite resources. However, the application of quantitative approaches to setting priorities in conservation frequently includes mistakes that can undermine their authors’ intention to be more rigorous and scientific in the way priorities are established and resources allocated. Drawing on well-established principles of decision science, we highlight 6 mistakes commonly associated with setting priorities for conservation: not acknowledging conservation plans are prioritizations; trying to solve an ill-defined problem; not prioritizing actions; arbitrariness; hidden value judgments; and not acknowledging risk of failure. We explain these mistakes and offer a path to help conservation planners avoid making the same mistakes in future prioritizations. Seis Errores Comunes en la Definición de Prioridades de Conservación Resumen Se ha desarrollado un vasto número de esquemas de priorización para ayudar a que la conservación navegue entre decisiones difíciles en cuanto a la asignación de recursos finitos. Sin embargo, la aplicación de métodos cuantitativos para la definición de prioridades en la conservación frecuentemente incluye errores que pueden socavar la intención de sus autores de ser más rigurosos y científicos en la manera en que se establecen las prioridades y se asignan los recursos. Con base en los bien establecidos principios de la ciencia de la decisión, resaltamos seis errores comúnmente asociados con la definición de prioridades para la conservación: no reconocer que los planes de conservación son priorizaciones; tratar de resolver un problema mal definido; no priorizar acciones; arbitrariedad; juicios de valor ocultos y no reconocer el riesgo de fracasar. Explicamos estos errores y ofrecemos un camino para que planificadores de la conservación no cometan los mismos errores en priorizaciones futuras. PMID:23565990

Development of a Methodology to Optimally Allocate Visual Inspection Time

DTIC Science & Technology

1989-06-01

Model and then takes into account the costs of the errors. The purpose of the Alternative Model is to not make 104 costly mistakes while meeting the...James Buck, and Virgil Anderson, AIIE Transactions, Volume 11, No.4, December 1979. 26. "Inspection of Sheet Materials - Model and Data", Colin G. Drury ...worker error, the probability of inspector error, and the cost of system error. Paired comparisons of error phenomena from operational personnel are

Infections and their control: a historical perspective Swb Newsom Infections and their control: a historical perspective Sage/Infection Prevention Society £17.95 235pp 9781849204538 1849204535 [Formula: see text].

PubMed

2010-10-27

BILL NEWSOM, an eminent, but now retired, medical microbiologist, provides a personal but engaging review of infections and our attempts to control them. it is a fascinating social history of what has become an essential service, and Newsom highlights the need to be aware of past struggles and avoid repeating mistakes.

The Western Pacific Theater of Operations: A Brewing Showdown

DTIC Science & Technology

2016-06-01

jet designer avoids Americas mistakes,” From War is Boring, August, 2015. 33 China’s Cyber-Theft Jet Fighter, The Wall Street Journal, 12 November...AU/ACSC/2016 AIR COMMAND AND STAFF COLLEGE DISTANCE LEARNING AIR UNIVERSITY “THE WESTERN PACIFIC THEATER OF OPERATIONS: A BREWING SHOWDOWN...in the Asia Pacific. 2 The Nature of the Problem The US has lost a modicum of dominance in portions of the Western Pacific Theater of

Human Reliability and the Cost of Doing Business

NASA Technical Reports Server (NTRS)

DeMott, Diana

2014-01-01

Most businesses recognize that people will make mistakes and assume errors are just part of the cost of doing business, but does it need to be? Companies with high risk, or major consequences, should consider the effect of human error. In a variety of industries, Human Errors have caused costly failures and workplace injuries. These have included: airline mishaps, medical malpractice, administration of medication and major oil spills have all been blamed on human error. A technique to mitigate or even eliminate some of these costly human errors is the use of Human Reliability Analysis (HRA). Various methodologies are available to perform Human Reliability Assessments that range from identifying the most likely areas for concern to detailed assessments with human error failure probabilities calculated. Which methodology to use would be based on a variety of factors that would include: 1) how people react and act in different industries, and differing expectations based on industries standards, 2) factors that influence how the human errors could occur such as tasks, tools, environment, workplace, support, training and procedure, 3) type and availability of data and 4) how the industry views risk & reliability influences ( types of emergencies, contingencies and routine tasks versus cost based concerns). The Human Reliability Assessments should be the first step to reduce, mitigate or eliminate the costly mistakes or catastrophic failures. Using Human Reliability techniques to identify and classify human error risks allows a company more opportunities to mitigate or eliminate these risks and prevent costly failures.

Lessons learned in developing community mental health care in Latin American and Caribbean countries

PubMed Central

RAZZOUK, DENISE; GREGÓRIO, GUILHERME; ANTUNES, RENATO; MARI, JAIR DE JESUS

2012-01-01

This paper summarizes the findings for the Latin American and Caribbean countries of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Implementation of Community Mental Health Care. It presents an overview of the provision of mental health services in the region; describes key experiences in Argentina, Belize, Brazil, Chile, Cuba, Jamaica and Mexico; and discusses the lessons learned in developing community mental health care. PMID:23024680

Role of Human Factors and Engineering Psychology in Undergraduate and Graduate Engineering Curriculum

DOE Office of Scientific and Technical Information (OSTI.GOV)

Piyush Sabharwall; Jesse Rebol

The engineering discipline is a profession of acquiring and applying technical knowledge, and the focus of engineering psychology is to optimize the effectiveness and efficiency with which human activities are conducted. Having human factors and engineering psychology be a permanent part of the engineering curriculum will make students aware of them, so they can learn from past experiences and avoid making the same mistakes their peers made. (Should be close to 200 words)

The Implications of Nanotechnology for the Fire Service: Avoiding the Mistakes of the Past

DTIC Science & Technology

2017-12-01

Lauren Wollman Glen Woodbury THIS PAGE INTENTIONALLY LEFT BLANK i REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public reporting...ABSTRACT Unclassified 20. LIMITATION OF ABSTRACT UU NSN 7540-01-280-5500 Standard Form 298 (Rev. 2-89) Prescribed by ANSI Std. 239-18 ii THIS PAGE...rolled into cylinders to form the nanotubes.5 They can be manufactured or combustion generated and are detectable in exhaust from propane, natural gas

Contemporary Turkey: Avoiding the Mistakes of Post-WWII Vietnam

DTIC Science & Technology

2011-04-06

author and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the U.S. Government. U.S. Army... position between Europe, Russia, and Middle East and Turkey’s Ottoman Empire history have uniquely shaped Turkey’s secular government and Cold War and...expressed in this student academic research paper are those of the author and do not reflect the official policy or position of the Department of the

Moral Distress, Workplace Health, and Intrinsic Harm.

PubMed

Weber, Elijah

2016-05-01

Moral distress is now being recognized as a frequent experience for many health care providers, and there's good evidence that it has a negative impact on the health care work environment. However, contemporary discussions of moral distress have several problems. First, they tend to rely on inadequate characterizations of moral distress. As a result, subsequent investigations regarding the frequency and consequences of moral distress often proceed without a clear understanding of the phenomenon being discussed, and thereby risk substantially misrepresenting the nature, frequency, and possible consequences of moral distress. These discussions also minimize the intrinsically harmful aspects of moral distress. This is a serious omission. Moral distress doesn't just have a negative impact on the health care work environment; it also directly harms the one who experiences it. In this paper, I claim that these problems can be addressed by first clarifying our understanding of moral distress, and then identifying what makes moral distress intrinsically harmful. I begin by identifying three common mistakes that characterizations of moral distress tend to make, and explaining why these mistakes are problematic. Next, I offer an account of moral distress that avoids these mistakes. Then, I defend the claim that moral distress is intrinsically harmful to the subject who experiences it. I conclude by explaining how acknowledging this aspect of moral distress should reshape our discussions about how best to deal with this phenomenon. © 2015 John Wiley & Sons Ltd.

Trouble Spots in Online Direct-to-Consumer Prescription Drug Promotion: Teaching Drug Marketers How to Inform Better or Spin Better? Comment on "Trouble Spots in Online Direct-to-Consumer Prescription Drug Promotion: A Content Analysis of FDA Warning Letters".

PubMed

Doran, Evan

2016-02-21

Hyosun Kim's report "Trouble Spots in Online Direct to Consumer Prescription Drug Promotion: A content Analysis of FDA Warning Letters" aims to teach marketers how to avoid breaching current Food and Drug Administration (FDA) guidelines in their online drug promotion. While Kim hopes to minimise the potential for online promotion to misinform consumers and the study is carefully conducted, teaching drug marketers how to avoid the common mistakes in online drug promotion is more likely to make marketers more adept at spinning information than appropriately balancing it. © 2016 by Kerman University of Medical Sciences.

Towards a Fail-Safe Air Force Culture: Creating a Resilient Future While Avoiding Past Mistakes

DTIC Science & Technology

2011-02-16

for either preventing catastrophic failures or in the event they occur. The Air Force Safety process often uses the ― Swiss Cheese ‖ model to...evaluate accidents. The image of holes in the protective cheese layers (proactive and reactive measures) lining up in such a way as to allow an accident is... cheese . More importantly, however, a HRO‘s focus is on ―the process of the slices lining up as each moment where one hole aligns with another

An Analysis of the Concurrent Certification Program at Fleet Readiness Center Southwest

DTIC Science & Technology

2009-12-01

Mapping  5S Methodology  Kanban  Poka - yoke  A3 Problem Solving  Single Point Lesson Plans (SPLP)  Total Productive Maintenance (TPM) 54 What...the actual demand of the customers. Kanban is as a demand signal which immediately propagates through the supply chain. D. POKA - YOKE : A Japanese...term that means "fail-safing" or "mistake- proofing." Avoiding (yokeru) inadvertent errors ( poka ) is a behavior-shaping constraint, or a method of

Mucinous cystadenoma of the ovary with stromal luteinization and hilar cell hyperplasia during pregnancy.

PubMed

Pascal, R R; Grecco, L A

1988-02-01

A 32-year-old woman was delivered of a healthy, full-term infant by cesarean section, at which time a large ovarian cyst was removed. The cyst proved to be a mucinous cystadenoma with prominent luteinization of the stroma subtending the epithelium and with numerous foci of hyperplastic Leydig cells in the cyst wall and ovarian hilum. These hormonally induced changes must be recognized in order to avoid mistaking them for invasive epithelial components.

Consumer Handbook to Credit Protection Laws.

ERIC Educational Resources Information Center

Board of Governors of the Federal Reserve System, Washington, DC.

The five sections of this consumer handbook are The Cost of Credit, Applying for Credit, Credit Histories and Records, Correcting Credit Mistakes, and Complaining about Credit. Each section discusses relevant legislation: Truth in Lending, the Equal Credit Opportunity Act, and the Fair Credit Reporting Act. Topics discussed in section I include…

Mice learn to avoid regret.

PubMed

Sweis, Brian M; Thomas, Mark J; Redish, A David

2018-06-01

Regret can be defined as the subjective experience of recognizing that one has made a mistake and that a better alternative could have been selected. The experience of regret is thought to carry negative utility. This typically takes two distinct forms: augmenting immediate postregret valuations to make up for losses, and augmenting long-term changes in decision-making strategies to avoid future instances of regret altogether. While the short-term changes in valuation have been studied in human psychology, economics, neuroscience, and even recently in nonhuman-primate and rodent neurophysiology, the latter long-term process has received far less attention, with no reports of regret avoidance in nonhuman decision-making paradigms. We trained 31 mice in a novel variant of the Restaurant Row economic decision-making task, in which mice make decisions of whether to spend time from a limited budget to achieve food rewards of varying costs (delays). Importantly, we tested mice longitudinally for 70 consecutive days, during which the task provided their only source of food. Thus, decision strategies were interdependent across both trials and days. We separated principal commitment decisions from secondary reevaluation decisions across space and time and found evidence for regret-like behaviors following change-of-mind decisions that corrected prior economically disadvantageous choices. Immediately following change-of-mind events, subsequent decisions appeared to make up for lost effort by altering willingness to wait, decision speed, and pellet consumption speed, consistent with past reports of regret in rodents. As mice were exposed to an increasingly reward-scarce environment, we found they adapted and refined distinct economic decision-making strategies over the course of weeks to maximize reinforcement rate. However, we also found that even without changes in reinforcement rate, mice transitioned from an early strategy rooted in foraging to a strategy rooted in deliberation and planning that prevented future regret-inducing change-of-mind episodes from occurring. These data suggest that mice are learning to avoid future regret, independent of and separate from reinforcement rate maximization.

Distributed interactive virtual environments for collaborative experiential learning and training independent of distance over Internet2.

PubMed

Alverson, Dale C; Saiki, Stanley M; Jacobs, Joshua; Saland, Linda; Keep, Marcus F; Norenberg, Jeffrey; Baker, Rex; Nakatsu, Curtis; Kalishman, Summers; Lindberg, Marlene; Wax, Diane; Mowafi, Moad; Summers, Kenneth L; Holten, James R; Greenfield, John A; Aalseth, Edward; Nickles, David; Sherstyuk, Andrei; Haines, Karen; Caudell, Thomas P

2004-01-01

Medical knowledge and skills essential for tomorrow's healthcare professionals continue to change faster than ever before creating new demands in medical education. Project TOUCH (Telehealth Outreach for Unified Community Health) has been developing methods to enhance learning by coupling innovations in medical education with advanced technology in high performance computing and next generation Internet2 embedded in virtual reality environments (VRE), artificial intelligence and experiential active learning. Simulations have been used in education and training to allow learners to make mistakes safely in lieu of real-life situations, learn from those mistakes and ultimately improve performance by subsequent avoidance of those mistakes. Distributed virtual interactive environments are used over distance to enable learning and participation in dynamic, problem-based, clinical, artificial intelligence rules-based, virtual simulations. The virtual reality patient is programmed to dynamically change over time and respond to the manipulations by the learner. Participants are fully immersed within the VRE platform using a head-mounted display and tracker system. Navigation, locomotion and handling of objects are accomplished using a joy-wand. Distribution is managed via the Internet2 Access Grid using point-to-point or multi-casting connectivity through which the participants can interact. Medical students in Hawaii and New Mexico (NM) participated collaboratively in problem solving and managing of a simulated patient with a closed head injury in VRE; dividing tasks, handing off objects, and functioning as a team. Students stated that opportunities to make mistakes and repeat actions in the VRE were extremely helpful in learning specific principles. VRE created higher performance expectations and some anxiety among VRE users. VRE orientation was adequate but students needed time to adapt and practice in order to improve efficiency. This was also demonstrated successfully between Western Australia and UNM. We successfully demonstrated the ability to fully immerse participants in a distributed virtual environment independent of distance for collaborative team interaction in medical simulation designed for education and training. The ability to make mistakes in a safe environment is well received by students and has a positive impact on their understanding, as well as memory of the principles involved in correcting those mistakes. Bringing people together as virtual teams for interactive experiential learning and collaborative training, independent of distance, provides a platform for distributed "just-in-time" training, performance assessment and credentialing. Further validation is necessary to determine the potential value of the distributed VRE in knowledge transfer, improved future performance and should entail training participants to competence in using these tools.

The Connection between Employee Basic Skills & Productivity. Workforce & Workplace Literacy Series.

ERIC Educational Resources Information Center

BCEL Brief, 1993

1993-01-01

The experience of a number of specific local workplace programs indicates a definite connection between the provision of employee basic skills programs and increased worker productivity. One Tennessee company, for example, reports a 95 percent drop in costs resulting from worker mistakes and a doubling of worker productivity since the company…

"Grow" the College? Why Bigger May Be Far from Better. Discussion Paper.

ERIC Educational Resources Information Center

Winston, Gordon C.

This paper asks if the proposition that "growth is good" applies with equal force to private business and to private colleges and universities. An increasing appreciation of the fundamental differences in economic structure between business firms and academic institutions suggests that it is easy to make costly mistakes if those…

25+ Years of the Hubble Space Telescope and a Simple Error That Cost Millions

ERIC Educational Resources Information Center

Shakerin, Said

2016-01-01

A simple mistake in properly setting up a measuring device caused millions of dollars to be spent in correcting the initial optical failure of the Hubble Space Telescope (HST). This short article is intended as a lesson for a physics laboratory and discussion of errors in measurement.

The Sixteen Division Force: Anatomy of a Decision

DTIC Science & Technology

1975-06-06

blew up; there was the $500-million-plus MBr -70 tank--a "strategic mistake;" and Army experts paid $60 million for 60 atomic cannons, 57 of which...National Priorities and elsewhere" f-notably: Martin, Bink.n, Support Costs in the Defonse Budget: The Submerged One-Third (Wshingtonz 1rookings 7U.S

Scientific Progress or Regress in Sports Physiology?

PubMed

Böning, Dieter

2016-11-01

In modern societies there is strong belief in scientific progress, but, unfortunately, a parallel partial regress occurs because of often avoidable mistakes. Mistakes are mainly forgetting, erroneous theories, errors in experiments and manuscripts, prejudice, selected publication of "positive" results, and fraud. An example of forgetting is that methods introduced decades ago are used without knowing the underlying theories: Basic articles are no longer read or cited. This omission may cause incorrect interpretation of results. For instance, false use of actual base excess instead of standard base excess for calculation of the number of hydrogen ions leaving the muscles raised the idea that an unknown fixed acid is produced in addition to lactic acid during exercise. An erroneous theory led to the conclusion that lactate is not the anion of a strong acid but a buffer. Mistakes occur after incorrect application of a method, after exclusion of unwelcome values, during evaluation of measurements by false calculations, or during preparation of manuscripts. Co-authors, as well as reviewers, do not always carefully read papers before publication. Peer reviewers might be biased against a hypothesis or an author. A general problem is selected publication of positive results. An example of fraud in sports medicine is the presence of doped subjects in groups of investigated athletes. To reduce regress, it is important that investigators search both original and recent articles on a topic and conscientiously examine the data. All co-authors and reviewers should read the text thoroughly and inspect all tables and figures in a manuscript.

A principled approach to the stranded cost issue

DOE Office of Scientific and Technical Information (OSTI.GOV)

Maloney, M.T.; Sauer, R.D.

1998-04-01

The case against stranded cost recovery is a strong one, whether investments in generation were efficient ex ante or not. This is the unavoidable conclusion once the proper roles of the regulator, utilities, investors, and consumers in the regulatory system of the past century are clearly identified. It is improper and inefficient for government to sanction the mistakes of the private sector by taxing consumers in order to rescue producers. This is precisely what stranded cost recovery does. Denial of stranded cost recovery is consistent with the role of the regulator as a substitute for salutary market forces and, indeed,more » is required by it.« less

Preschoolers' Understanding of Lies and Innocent and Negligent Mistakes.

ERIC Educational Resources Information Center

Siegal, Michael; Peterson, Candida C.

1998-01-01

Examined preschoolers' ability to distinguish innocent and negligent mistakes from lies. Found that, when asked to identify a mistake or lie about a food's contact with contaminants and identify a bystander's reaction, children distinguished mistakes from lies; they could also discriminate between lies and both negligent mistakes that generate…

Disclosing medical mistakes: a communication management plan for physicians.

PubMed

Petronio, Sandra; Torke, Alexia; Bosslet, Gabriel; Isenberg, Steven; Wocial, Lucia; Helft, Paul R

2013-01-01

There is a growing consensus that disclosure of medical mistakes is ethically and legally appropriate, but such disclosures are made difficult by medical traditions of concern about medical malpractice suits and by physicians' own emotional reactions. Because the physician may have compelling reasons both to keep the information private and to disclose it to the patient or family, these situations can be conceptualized as privacy dilemmas. These dilemmas may create barriers to effectively addressing the mistake and its consequences. Although a number of interventions exist to address privacy dilemmas that physicians face, current evidence suggests that physicians tend to be slow to adopt the practice of disclosing medical mistakes. This discussion proposes a theoretically based, streamlined, two-step plan that physicians can use as an initial guide for conversations with patients about medical mistakes. The mistake disclosure management plan uses the communication privacy management theory. The steps are 1) physician preparation, such as talking about the physician's emotions and seeking information about the mistake, and 2) use of mistake disclosure strategies that protect the physician-patient relationship. These include the optimal timing, context of disclosure delivery, content of mistake messages, sequencing, and apology. A case study highlighted the disclosure process. This Mistake Disclosure Management Plan may help physicians in the early stages after mistake discovery to prepare for the initial disclosure of a medical mistakes. The next step is testing implementation of the procedures suggested.

[Building questions in forensic medicine and their logical basis].

PubMed

Kovalev, D; Shmarov, K; Ten'kov, D

2015-01-01

The authors characterize in brief the requirements to the correct formulation of the questions posed to forensic medical experts with special reference to the mistakes made in building the questions and the ways to avoid them. This article actually continues the series of publications of the authors concerned with the major logical errors encountered in expert conclusions. Further publications will be dedicated to the results of the in-depth analysis of the logical errors contained in the questions posed to forensic medical experts and encountered in the expert conclusions.

Solar elastosis in its papular form: uncommon, mistakable.

PubMed

Heng, Jun Khee; Aw, Derrick Chen Wee; Tan, Kong Bing

2014-01-01

Solar elastosis is a degenerative condition of elastic tissue in the dermis due to prolonged sun exposure. There are a variety of clinical manifestations of solar elastosis. In its most common form, solar elastosis manifests as yellow, thickened, coarsely wrinkled skin. We report two uncommon cases of severe solar elastosis with a papular morphology. Its presentation can closely mimic a host of cutaneous disorders and thus, although it is helpful to be cognizant of this entity, it is still crucial to biopsy these lesions to avoid missing a more sinister condition.

Teacher education professionals as partners in health science outreach.

PubMed

Houtz, Lynne E; Kosoko-Lasaki, Omofolasade; Zardetto-Smith, Andrea M; Mu, Keli; Royeen, Charlotte B

2004-01-01

Medical school and other health science outreach programs to educate and recruit precollege students always have relied on successful collaborative efforts. Creighton University shares the value, significance, and strategies of involving teacher education professionals in several of its current outreach programs, including HPPI, Brains Rule! Neuroscience Expositions, and HHMI Build a Human Project. The education department partner serves as an essential team member in the development, implementation, assessment, and dissemination of these projects to promote science and mathematics achievement and interest in medical careers. Specific examples and mistakes to avoid are included.

Disclosing Medical Mistakes: A Communication Management Plan for Physicians

PubMed Central

Petronio, Sandra; Torke, Alexia; Bosslet, Gabriel; Isenberg, Steven; Wocial, Lucia; Helft, Paul R

2013-01-01

Introduction: There is a growing consensus that disclosure of medical mistakes is ethically and legally appropriate, but such disclosures are made difficult by medical traditions of concern about medical malpractice suits and by physicians’ own emotional reactions. Because the physician may have compelling reasons both to keep the information private and to disclose it to the patient or family, these situations can be conceptualized as privacy dilemmas. These dilemmas may create barriers to effectively addressing the mistake and its consequences. Although a number of interventions exist to address privacy dilemmas that physicians face, current evidence suggests that physicians tend to be slow to adopt the practice of disclosing medical mistakes. Methods: This discussion proposes a theoretically based, streamlined, two-step plan that physicians can use as an initial guide for conversations with patients about medical mistakes. The mistake disclosure management plan uses the communication privacy management theory. Results: The steps are 1) physician preparation, such as talking about the physician’s emotions and seeking information about the mistake, and 2) use of mistake disclosure strategies that protect the physician-patient relationship. These include the optimal timing, context of disclosure delivery, content of mistake messages, sequencing, and apology. A case study highlighted the disclosure process. Conclusion: This Mistake Disclosure Management Plan may help physicians in the early stages after mistake discovery to prepare for the initial disclosure of a medical mistakes. The next step is testing implementation of the procedures suggested. PMID:23704848

Mistakes as Stepping Stones: Effects of Errors on Episodic Memory among Younger and Older Adults

ERIC Educational Resources Information Center

Cyr, Andrée-Ann; Anderson, Nicole D.

2015-01-01

The memorial costs and benefits of trial-and-error learning have clear pedagogical implications for students, and increasing evidence shows that generating errors during episodic learning can improve memory among younger adults. Conversely, the aging literature has found that errors impair memory among healthy older adults and has advocated for…

Planowanie strategiczne kluczowym czynnikiem rozwoju turystyki w regionie

NASA Astrophysics Data System (ADS)

Majewska, Iwona

2009-01-01

Elaborating strategic documents is being perceived as a basis for different initiatives and projects which on the other side stimulate regional and local development in various spheres. Tourism economy is one of the most efficient factor of the local and regional development thanks to its intersector links. It must be also stressed that the tourism economy will have the biggest influence on regional development the less nowadays the tourism potential is being explored. In such situation elaborating professional strategic documents like businessplans, tourism development strategies, tourism product development programmers, feasibility studies plays a key role. Documents containing clear action plans, being a scenario for the next years allow to avoid "ad hoc" actions and at the same time making mistakes that are sometimes very costly. Precisely identified and selected set of objectives and aims allows to concentrate resources on the most important, and, what is crucial, socially accepted actions. In tourism acceptance plays a key role because the whole community participates in tourism development and in image creation that influences directly on attractiveness, number of visitors and economic and social benefits. This is why the strategic planning plays a crucial role in the context of regional and local development.

Seven rules to avoid the tragedy of the commons.

PubMed

Murase, Yohsuke; Baek, Seung Ki

2018-07-14

Cooperation among self-interested players in a social dilemma is fragile and easily interrupted by mistakes. In this work, we study the repeated n-person public-goods game and search for a strategy that forms a cooperative Nash equilibrium in the presence of implementation error with a guarantee that the resulting payoff will be no less than any of the co-players'. By enumerating strategic possibilities for n=3, we show that such a strategy indeed exists when its memory length m equals three. It means that a deterministic strategy can be publicly employed to stabilize cooperation against error with avoiding the risk of being exploited. We furthermore show that, for general n-person public-goods game, m ≥ n is necessary to satisfy the above criteria. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Analysis of problems and failures in the measurement of soil-gas radon concentration.

PubMed

Neznal, Martin; Neznal, Matěj

2014-07-01

Long-term experience in the field of soil-gas radon concentration measurements allows to describe and explain the most frequent causes of failures, which can appear in practice when various types of measurement methods and soil-gas sampling techniques are used. The concept of minimal sampling depth, which depends on the volume of the soil-gas sample and on the soil properties, is shown in detail. Consideration of minimal sampling depth at the time of measurement planning allows to avoid the most common mistakes. The ways how to identify influencing parameters, how to avoid a dilution of soil-gas samples by the atmospheric air, as well as how to recognise inappropriate sampling methods are discussed. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

An automated rough mill for the production of interior furniture parts

Treesearch

Philip A. Araman; Edwin L. Lucas

1975-01-01

An automated rough mill layout has been designed for manufacturing interior furniture parts. Designed to reduce human decisions and mistakes that can be costly when converting lumber into parts, the mill is based on a manufacturing sequence in which lumber is first gangsaw-ripped into standard-width strips before being crosscut to remove defects and cut to specific...

A System for the Automatic Assembly of Test Questions Using a No-SQL Database

ERIC Educational Resources Information Center

Shin, Sanggyu; Hashimoto, Hiroshi

2014-01-01

We describe a system that automatically assembles test questions from a set of examples. Our system can create test questions appropriate for each user's level at low cost. In particular, when a user review their lesson, our system provides new test questions which are assembled based on their previous test results and past mistakes, rather than a…

Mind your errors: evidence for a neural mechanism linking growth mind-set to adaptive posterror adjustments.

PubMed

Moser, Jason S; Schroder, Hans S; Heeter, Carrie; Moran, Tim P; Lee, Yu-Hao

2011-12-01

How well people bounce back from mistakes depends on their beliefs about learning and intelligence. For individuals with a growth mind-set, who believe intelligence develops through effort, mistakes are seen as opportunities to learn and improve. For individuals with a fixed mind-set, who believe intelligence is a stable characteristic, mistakes indicate lack of ability. We examined performance-monitoring event-related potentials (ERPs) to probe the neural mechanisms underlying these different reactions to mistakes. Findings revealed that a growth mind-set was associated with enhancement of the error positivity component (Pe), which reflects awareness of and allocation of attention to mistakes. More growth-minded individuals also showed superior accuracy after mistakes compared with individuals endorsing a more fixed mind-set. It is critical to note that Pe amplitude mediated the relationship between mind-set and posterror accuracy. These results suggest that neural mechanisms indexing on-line awareness of and attention to mistakes are intimately involved in growth-minded individuals' ability to rebound from mistakes.

The hidden traps in decision making.

PubMed

Hammond, J S; Keeney, R L; Raiffa, H

1998-01-01

Bad decisions can often be traced back to the way the decisions were made--the alternatives were not clearly defined, the right information was not collected, the costs and benefits were not accurately weighted. But sometimes the fault lies not in the decision-making process but rather in the mind of the decision maker. The way the human brain works can sabotage the choices we make. John Hammond, Ralph Keeney, and Howard Raiffa examine eight psychological traps that are particularly likely to affect the way we make business decisions: The anchoring trap leads us to give disproportionate weight to the first information we receive. The statusquo trap biases us toward maintaining the current situation--even when better alternatives exist. The sunk-cost trap inclines us to perpetuate the mistakes of the past. The confirming-evidence trap leads us to seek out information supporting an existing predilection and to discount opposing information. The framing trap occurs when we misstate a problem, undermining the entire decision-making process. The overconfidence trap makes us overestimate the accuracy of our forecasts. The prudence trap leads us to be overcautious when we make estimates about uncertain events. And the recallability trap leads us to give undue weight to recent, dramatic events. The best way to avoid all the traps is awareness--forewarned is forearmed. But executives can also take other simple steps to protect themselves and their organizations from the various kinds of mental lapses. The authors show how to take action to ensure that important business decisions are sound and reliable.

Teaching and preschoolers' ability to infer knowledge from mistakes.

PubMed

Ronfard, Samuel; Corriveau, Kathleen H

2016-10-01

For instruction to be effective, teachers must adjust the way they teach to match what learners know. We asked whether children's ability to infer what someone knows based on his or her mistakes develops alongside their teaching-children's use of more explicit teaching strategies and their ability to tailor how much information to provide in response to their pupils' mistakes. Preschoolers (N=48) were taught a simple game and were then introduced to four puppets: one puppet who played the game perfectly, two puppets who each made one mistake, and one puppet who made two mistakes. After watching each puppet play individually, children were asked to rate the puppet's understanding of the game and then were invited to teach the puppet. Children's ability to monitor the relative accuracy of the puppets-the ability to make nuanced judgments about what each puppet understood based on each puppet's unique mistakes-improved with age. Moreover, older children were more explicit and more precise teachers than younger children. They more often contrasted the learners' mistakes with what should be done and more often provided instructions that directly addressed the puppets' unique mistakes. Thus, between 3 and 5 years of age, developments in children's ability to infer knowledge from mistakes parallel developments both in the strategies children use to teach and in the amount of information they teach in response to mistakes. Copyright © 2016 Elsevier Inc. All rights reserved.

Learning from Mistakes in History--A Thematic Instructional Unit.

ERIC Educational Resources Information Center

Richburg, Robert W.; Harward, Kathleen; Steinkamp, Kathy

2000-01-01

Describes a thematic unit for secondary education students that focuses on eight themes, with accompanying activities, on learning from mistakes, such as "mistakes are inevitable, and everyone makes them" and "making mistakes does not make you a faulty person." Provides a concluding activity on the Titanic. (CMK)

7 CFR 97.120 - Corrected certificate-office mistake.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Corrected certificate-office mistake. 97.120 Section... Corrected certificate—office mistake. When a certificate is incorrect because of a mistake in the Office... seal, without charge, to be issued to the owner and recorded in the records at the Office. ...

Strategic marketing, part 2: the 4 P's of marketing.

PubMed

Lexa, Frank James; Berlin, Jonathan

2006-04-01

Marketing and branding are critical business functions that are often ignored or misapplied in the health care sector. Radiology professionals are facing unprecedented competition, turf battles, and other pressures. One tool that can help in meeting this onslaught is to improve your marketing efforts. Some of the most expensive mistakes in marketing (medical and otherwise) are caused by not paying attention to the basics. These "rookie" errors can be avoided by a careful review of the 4 key principles of introductory marketing: product, price, placement, and promotion. This article reviews these concepts as they relate to medical marketing.

Sink or Swim

NASA Technical Reports Server (NTRS)

Little, Terry

2003-01-01

The traditional view of career development in the government goes something like this: Start your career as a functional apprentice. Become a functional expert over time by exhibiting technical leadership (whatever that means). Over time, seek out positions of increasingly greater responsibility with corresponding job titles. Make a gradual transition from a specialty focus to a managerial focus. Along the way submit to some vaccinations such as getting a Masters or PhD degree, attending some prestige courses, accepting a Headquarters assignment, and working at two or more field locations. Show some significant persistence and heaps of personal sacrifice. Avoid the big mistake. Burn no bridges.

Essentials of negotiating for employment in a changing environment.

PubMed

Satiani, Bhagwan; Nair, Deepak G; Starr, Jean E; Samson, Russell H

2014-07-01

Evolving changes in health care in the United States are causing new graduates and self-employed physicians to consider employment with large groups and health systems. Familiarity with the principles, proper conduct, and mechanics of negotiating an employment agreement will be important for vascular surgeons making such a decision. The various components of compensation packages and contract language need to be critically evaluated. To facilitate an understanding of the complexities involved in employment contracts, strategies to avoid making negotiating mistakes are discussed. Copyright © 2014 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

47 CFR 51.609 - Determination of avoided retail costs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 3 2013-10-01 2013-10-01 false Determination of avoided retail costs. 51.609... (CONTINUED) INTERCONNECTION Resale § 51.609 Determination of avoided retail costs. (a) Except as provided in § 51.611, the amount of avoided retail costs shall be determined on the basis of a cost study that...

47 CFR 51.609 - Determination of avoided retail costs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 3 2012-10-01 2012-10-01 false Determination of avoided retail costs. 51.609... (CONTINUED) INTERCONNECTION Resale § 51.609 Determination of avoided retail costs. (a) Except as provided in § 51.611, the amount of avoided retail costs shall be determined on the basis of a cost study that...

47 CFR 51.609 - Determination of avoided retail costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Determination of avoided retail costs. 51.609... (CONTINUED) INTERCONNECTION Resale § 51.609 Determination of avoided retail costs. (a) Except as provided in § 51.611, the amount of avoided retail costs shall be determined on the basis of a cost study that...

47 CFR 51.609 - Determination of avoided retail costs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 3 2014-10-01 2014-10-01 false Determination of avoided retail costs. 51.609... (CONTINUED) INTERCONNECTION Resale § 51.609 Determination of avoided retail costs. (a) Except as provided in § 51.611, the amount of avoided retail costs shall be determined on the basis of a cost study that...

47 CFR 51.609 - Determination of avoided retail costs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 3 2011-10-01 2011-10-01 false Determination of avoided retail costs. 51.609... (CONTINUED) INTERCONNECTION Resale § 51.609 Determination of avoided retail costs. (a) Except as provided in § 51.611, the amount of avoided retail costs shall be determined on the basis of a cost study that...

Do the Wrong Thing: How Toddlers Tell a Joke from a Mistake

ERIC Educational Resources Information Center

Hoicka, Elena; Gattis, Merideth

2008-01-01

We investigated whether 19-36-month-olds (1) differentiate mistakes from jokes, and (2) understand humorous intentions. The experimenter demonstrated unambiguous jokes accompanied by laughter, unambiguous mistakes accompanied by the experimenter saying, "Woops!", and ambiguous actions that could either be a mistake or a joke, accompanied by either…

Mathematical misconception in calculus 1: Identification and gender difference

NASA Astrophysics Data System (ADS)

Nassir, Asyura Abd; Abdullah, Nur Hidayah Masni; Ahmad, Salimah; Tarmuji, Nor Habibah; Idris, Aminatul Solehah

2017-08-01

A few years of experience of teaching mathematics make us notice that the same types of mistakes are done repeatedly by students. This paper presents an insight into categories of mistakes, how male and female students differ in terms of mistakes that are commonly done and the ability of the students to identify the mistakes. Sample of mistakes were taken from Calculus 1 final exam answer scripts, then it was listed and analyzed. Data analysis revealed that students' misconceptions fall into four categories. The first category is misunderstanding the meaning of brackets, followed by misconception of basic mathematics rules, misconception in notation and misconception in properties of trigonometry. A mistake identification test which consists of ten false mathematical statements was designed based on the mistake done by the previous batch of students that covered topics algebra, trigonometry, index, limit, differentiation and integration. Then, the test was given to students who enrolled in Calculus I course. Respondents of this study were randomly selected among two hundreds engineering students. Data obtained were analyzed using basic descriptive analysis and Chi Square test to capture gender differences in the mistake done for each category. Findings indicate that thirty five percent of the students have the ability to identify the mistakes and make a proper correction for at most two statements. Thirty one percent of the students are able to identify the mistakes but unable to make proper correction. Twenty five percent of the students failed to identify the mistakes in six out of ten false statements. Female students' misconception is more likely in basic mathematics rules compared to male. The findings of this study could serve as baseline information to be stressed in improving teaching and learning mathematics.

The Dangers of Parametrics

NASA Technical Reports Server (NTRS)

Prince, Frank A.

2017-01-01

Building a parametric cost model is hard work. The data is noisy and often does not behave like we want it to. We need statistics to give us an indication of the goodness of our models, but; statistics can be manipulated and mislead. On top of all of that, our own very human biases can lead us astray; causing us to see patterns in the noise and draw false conclusions from the data. Yet, it is the data itself that is the foundation for making better cost estimates and cost models. I believe the mistake we often make is we believe that our models are representative of the data; that our models summarize the experiences, the knowledge, and the stories contained in the data. However, it is the opposite that is true. Our models are but imitations of reality. They give us trends, but not truth. The experiences, the knowledge, and the stories that we need in order to make good cost estimates is bound up in the data. You cannot separate good cost estimating from a knowledge of the historical data. One final thought. It is our attempts to make sense out of the randomness that leads us astray. In order to make progress as cost modelers and cost estimators, we must accept that there are real limitations on our ability to model the past and predict the future. I do not believe we should throw up our hands and say this is the best we can do. Rather, to see real improvement we must first recognize these limitations, avoid the easy but misleading solutions, and seek to find ways to better model the world we live in. I don't have any simple solutions. Perhaps the answers lie in better data or in a totally different approach to simulating how the world works. All I know is that we must do our best to speak truth to ourselves and our customers. Misleading ourselves and our customers will, in the end, result in an inability to have a positive impact on those we serve.

Product Quality Improvement Using FMEA for Electric Parking Brake (EPB)

NASA Astrophysics Data System (ADS)

Dumitrescu, C. D.; Gruber, G. C.; Tişcă, I. A.

2016-08-01

One of the most frequently used methods to improve product quality is complex FMEA. (Failure Modes and Effects Analyses). In the literature various FMEA is known, depending on the mode and depending on the targets; we mention here some of these names: Failure Modes and Effects Analysis Process, or analysis Failure Mode and Effects Reported (FMECA). Whatever option is supported by the work team, the goal of the method is the same: optimize product design activities in research, design processes, implementation of manufacturing processes, optimization of mining product to beneficiaries. According to a market survey conducted on parts suppliers to vehicle manufacturers FMEA method is used in 75%. One purpose of the application is that after the research and product development is considered resolved, any errors which may be detected; another purpose of applying the method is initiating appropriate measures to avoid mistakes. Achieving these two goals leads to a high level distribution in applying, to avoid errors already in the design phase of the product, thereby avoiding the emergence and development of additional costs in later stages of product manufacturing. During application of FMEA method using standardized forms; with their help will establish the initial assemblies of product structure, in which all components will be viewed without error. The work is an application of the method FMEA quality components to optimize the structure of the electrical parking brake (Electric Parching Brake - E.P.B). This is a component attached to the roller system which ensures automotive replacement of conventional mechanical parking brake while ensuring its comfort, functionality, durability and saves space in the passenger compartment. The paper describes the levels at which they appealed in applying FMEA, working arrangements in the 4 distinct levels of analysis, and how to determine the number of risk (Risk Priority Number); the analysis of risk factors and established authors who have imposed measures to reduce / eliminate risk completely exploiting this complex product.

[Cognitive research about the use of virtual worlds among the students enrolled to the faculty of medicine and surgery "Campus Bio-Medico University" in Rome].

PubMed

Tambone, V; Alessi, A; Macchi, I; Milighetti, S; Muzii, L

2009-01-01

The main difference between a virtual reality and a generic representation is to be directly involved into the action you are performing. As a matter of fact, within the shift from real to virtual world, our biological physique does not mutate but is amplified and connected to the virtual world by technological interfaces. Training using a virtual reality simulator is an option to supplement (or replace) standard training. One of the two main goals of our study is to test, at first, how much students enrolled to the Faculty of Medicine at "University Campus Bio-Medico of Rome" are familiar with synthetic worlds, how long they have been using them and how they would like their Avatar to look like. Moreover, the second aim is to collect students' opinion about the use of virtual, interactive environments to enable learning and participation in dynamic, problem based, clinical, virtual simulations. Simulations might be used to allow learners to make mistakes safely in lieu of real life situations, learn from those mistakes and ultimately to improve performances by subsequent avoidance of those mistakes. The selected approach to the study is based on a semi-structured questionnaire made of 14 questions administered to all the medical students. Most of the students appear not to be very confident with virtual worlds mostly because of a lack of interest. However, a large majority of them are likely to use a virtual world for fun or escaping from reality. Students would select and customize their Avatar by giving her/him the same sexual identity, same figure, same social class but different employment. It is important to notice that a wide majority of the students is interested in practicing on a virtual world in order to manage new experiences and being able to face them; their willing is to get benefits from the ability to make mistakes in a safe environment as well as to record a positive impact on their understanding.

Preparation for workplace adversity: Student narratives as a stimulus for learning.

PubMed

Hanson, Julie; McAllister, Margaret

2017-07-01

Nursing students are not always well prepared for the kind of adverse events they may experience in the workplace and yet it seems apparent that future students could benefit from learning about such experiences so that they can be avoided, or their impact minimised. This research aimed to identify nursing students' experiences of adversity, collaborate with students to discern important lessons for future students in their experiences, and make recommendations for other educators on how to use these adversity stories as lessons. Seven Australian nursing students were interviewed using critical incident technique consisting of 7 questions. This paper focuses on the responses to the questions: "Does this story's message have a place in the curriculum?" and "How would you teach this lesson?" Data were analysed using critical discourse analysis. Four recurring discourses emerged including: power relationships are a two-way street; learn from mistakes to prevent mistakes; begin cultural consciousness-raising in first year, first semester; and become critically self-aware. Narratives derived from original stories of adversity may be a valuable source of learning about the realities of the workplace but to benefit fully, educators need to assist students to notice and analyse embedded messages. Copyright © 2017 Elsevier Ltd. All rights reserved.

Twilight reloaded: the peptide experience

PubMed Central

Weichenberger, Christian X.; Pozharski, Edwin; Rupp, Bernhard

2017-01-01

The de facto commoditization of biomolecular crystallography as a result of almost disruptive instrumentation automation and continuing improvement of software allows any sensibly trained structural biologist to conduct crystallo­graphic studies of biomolecules with reasonably valid outcomes: that is, models based on properly interpreted electron density. Robust validation has led to major mistakes in the protein part of structure models becoming rare, but some depositions of protein–peptide complex structure models, which generally carry significant interest to the scientific community, still contain erroneous models of the bound peptide ligand. Here, the protein small-molecule ligand validation tool Twilight is updated to include peptide ligands. (i) The primary technical reasons and potential human factors leading to problems in ligand structure models are presented; (ii) a new method used to score peptide-ligand models is presented; (iii) a few instructive and specific examples, including an electron-density-based analysis of peptide-ligand structures that do not contain any ligands, are discussed in detail; (iv) means to avoid such mistakes and the implications for database integrity are discussed and (v) some suggestions as to how journal editors could help to expunge errors from the Protein Data Bank are provided. PMID:28291756

Twilight reloaded: the peptide experience.

PubMed

Weichenberger, Christian X; Pozharski, Edwin; Rupp, Bernhard

2017-03-01

The de facto commoditization of biomolecular crystallography as a result of almost disruptive instrumentation automation and continuing improvement of software allows any sensibly trained structural biologist to conduct crystallographic studies of biomolecules with reasonably valid outcomes: that is, models based on properly interpreted electron density. Robust validation has led to major mistakes in the protein part of structure models becoming rare, but some depositions of protein-peptide complex structure models, which generally carry significant interest to the scientific community, still contain erroneous models of the bound peptide ligand. Here, the protein small-molecule ligand validation tool Twilight is updated to include peptide ligands. (i) The primary technical reasons and potential human factors leading to problems in ligand structure models are presented; (ii) a new method used to score peptide-ligand models is presented; (iii) a few instructive and specific examples, including an electron-density-based analysis of peptide-ligand structures that do not contain any ligands, are discussed in detail; (iv) means to avoid such mistakes and the implications for database integrity are discussed and (v) some suggestions as to how journal editors could help to expunge errors from the Protein Data Bank are provided.

"Was it a mistake to tell others that you are infected with HIV?": factors associated with regret following HIV disclosure among people living with HIV in five countries (Mali, Morocco, Democratic Republic of the Congo, Ecuador and Romania). Results from a community-based research.

PubMed

Henry, Emilie; Bernier, Adeline; Lazar, Florin; Matamba, Gaspard; Loukid, Mohamed; Bonifaz, Cesar; Diop, Samba; Otis, Joanne; Préau, Marie

2015-02-01

This study examined regret following HIV serostatus disclosure and associated factors in under-investigated contexts (Mali, Morocco, Democratic Republic of the Congo, Ecuador and Romania). A community-based cross-sectional study was implemented by a mixed consortium [researchers/community-based organizations (CBO)]. Trained CBO members interviewed 1,500 PLHIV in contact with CBOs using a 125-item questionnaire. A weighted multivariate logistic regression was performed. Among the 1,212 participants included in the analysis, 290 (23.9 %) declared that disclosure was a mistake. Female gender, percentage of PLHIV's network knowing about one's seropositivity from a third party, having suffered rejection after disclosure, having suffered HIV-based discrimination at work, perceived seriousness of infection score, daily loneliness, property index and self-esteem score were independently associated with regret. Discrimination, as well as individual characteristics and skills may affect the disclosure experience. Interventions aiming at improving PLHIV skills and reducing their social isolation may facilitate the disclosure process and avoid negative consequences.

Error Analysis of Indonesian Junior High School Student in Solving Space and Shape Content PISA Problem Using Newman Procedure

NASA Astrophysics Data System (ADS)

Sumule, U.; Amin, S. M.; Fuad, Y.

2018-01-01

This study aims to determine the types and causes of errors, as well as efforts being attempted to overcome the mistakes made by junior high school students in completing PISA content space and shape. Two subjects were selected based on the mathematical ability test results with the most error, yet they are able to communicate orally and in writing. Two selected subjects then worked on the PISA ability test question and the subjects were interviewed to find out the type and cause of the error and then given a scaffolding based on the type of mistake made.The results of this study obtained the type of error that students do are comprehension and transformation error. The reasons are students was not able to identify the keywords in the question, write down what is known or given, specify formulas or device a plan. To overcome this error, students were given scaffolding. Scaffolding that given to overcome misunderstandings were reviewing and restructuring. While to overcome the transformation error, scaffolding given were reviewing, restructuring, explaining and developing representational tools. Teachers are advised to use scaffolding to resolve errors so that the students are able to avoid these errors.

Higher threat avoidance costs reduce avoidance behaviour which in turn promotes fear extinction in humans.

PubMed

Rattel, Julina A; Miedl, Stephan F; Blechert, Jens; Wilhelm, Frank H

2017-09-01

Theoretical models specifying the underlying mechanisms of the development and maintenance of anxiety and related disorders state that fear responses acquired through classical Pavlovian conditioning are maintained by repeated avoidance behaviour; thus, it is assumed that avoidance prevents fear extinction. The present study investigated behavioural avoidance decisions as a function of avoidance costs in a naturalistic fear conditioning paradigm. Ecologically valid avoidance costs - manipulated between participant groups - were represented via time-delays during a detour in a gamified computer task. After differential acquisitions of shock-expectancy to a predictive conditioned stimulus (CS+), participants underwent extinction where they could either take a risky shortcut, while anticipating shock signaled by the CS+, or choose a costly avoidance option (lengthy detour); thus, they were faced with an approach-avoidance conflict. Groups with higher avoidance costs (longer detours) showed lower proportions of avoiders. Avoiders gave heightened shock-expectancy ratings post-extinction, demonstrating 'protecting from extinction', i.e. failure to extinguish. Moreover, there was an indirect effect of avoidance costs on protection from extinction through avoidance behaviour. No moderating role of trait-anxiety was found. Theoretical implications of avoidance behaviour are discussed, considering the involvement of instrumental learning in the maintenance of fear responses. Copyright © 2016 Elsevier Ltd. All rights reserved.

Economic benefits of sponsored clinical trials on pharmaceutical expenditures at a medical center in Taiwan.

PubMed

Shen, Li-Jiuan; Chou, Hua; Huang, Chih-Fen; Chou, Guann-Miaw; Chan, Wing Kai; Wu, Fe-Lin Lin

2011-07-01

Concerns exist regarding the additional cost of patient care when patients are enrolled in clinical trials at hospitals. To assess the avoidance of drug costs by conducting sponsored clinical trials, a retrospective analysis evaluating drug cost avoidance in all sponsored clinical trials was conducted in 2008 at the most prominent medical center in Taiwan. The National Health Insurance (NHI) reimbursement prices of either the investigated drugs or the standardized drug therapy for each specific disease were used to calculate the cost avoidance. Drug cost avoidance from sponsored clinical trials per year, per trial, per patient, in different therapeutic areas, and in different phases was analyzed. Three quarters of the cost avoidance in drug expenditures from 194 sponsored clinical trials were estimated. All cost values are in US Dollars. Around $11.2 million was avoided at the center in 2008. The average value of cost avoidance was $58,000/trial-year or $3,900/participant-year. The early-phase trials and phase III trials accounted for 25% and 56% of all trials, respectively, while they constituted 32% and 49% of the total costs avoided, respectively. The most frequently conducted and highest cost-avoiding trials were those for antineoplastic agents, especially targeted therapy which accounted for 85% of the total cost avoidance of anti-cancer trials. This study demonstrates the profoundly positive economic impact on the healthcare system in Taiwan by sponsored clinical trials. To understand the trend of economic benefits of the trials on pharmaceutical expenditure, it would be important to analyze the cost avoidance of trials regularly in an institution. Copyright © 2011 Elsevier Inc. All rights reserved.

Instructional design in mathematics for undergraduate students based on learning by mistakes approach utilizing scilab assistance

NASA Astrophysics Data System (ADS)

Kartika, H.

2018-03-01

The issue related to making mistake while learning such as negative emotion is found while students learn mathematics with the aid of a computer. When the computer output showed a mistake message, the students considered it as a computer software malfunction. Based on this issue, the writer designs an instructional model based on learning by mistake approach and which is Scilab assisted. The method used in this research is research design involving undergraduate students in matrix algebra courses. The data collected throught survey with questionnaire to gain feedback about the approach implemented. The data analyzed using quantitative descriptive. The instructional design proposed is the student act as a mistake corrector while the teacher acts as a mistake maker. Teacher deliberately makes mistakes with the help of Scilab software. On the other hand, students correct, analyze and explain errors resulting from Scilab software. The result of this research is an ICT based instructional design which is expected to be applicable as an alternative learning in directing students to think positively about mistakes in learning. Furthermore, students are also expected to improve their ability in understanding and thinking critically while solving problems and improving themselves in learning mathematics.

The failure-tolerant leader.

PubMed

Farson, Richard; Keyes, Ralph

2002-08-01

"The fastest way to succeed," IBM's Thomas Watson, Sr., once said, "is to double your failure rate." In recent years, more and more executives have embraced Watson's point of view, coming to understand what innovators have always known: Failure is a prerequisite to invention. But while companies may grasp the value of making mistakes at the level of corporate practices, they have a harder time accepting the idea at the personal level. People are afraid to fail, and corporate culture reinforces that fear. In this article, psychologist and former Harvard Business School professor Richard Farson and coauthor Ralph Keyes discuss how companies can reduce the fear of miscues. What's crucial is the presence of failure-tolerant leaders--executives who, through their words and actions, help employees overcome their anxieties about making mistakes and, in the process, create a culture of intelligent risk-taking that leads to sustained innovation. Such leaders don't just accept productive failure, they promote it. Drawing from their research in business, politics, sports, and science, the authors identify common practices among failure-tolerant leaders. These leaders break down the social and bureaucratic barriers that separate them from their followers. They engage at a personal level with the people they lead. They avoid giving either praise or criticism, preferring to take a nonjudgmental, analytical posture as they interact with staff. They openly admit their own mistakes rather than trying to cover them up or shifting the blame. And they try to root out the destructive competitiveness built into most organizations. Above all else, failure-tolerant leaders push people to see beyond traditional definitions of success and failure. They know that as long as a person views failure as the opposite of success, rather than its complement, he or she will never be able to take the risks necessary for innovation.

[Analysis of causes of incorrect use of dose aerosols].

PubMed

Petro, W; Gebert, P; Lauber, B

1994-03-01

Preparations administered by inhalation make relatively high demands on the skill and knowledge of the patient in handling this form of application, for the effectivity of the therapy is inseparably linked to its faultless application. The present article aims at analysing possible mistakes in handling and at finding the most effective way of avoiding them. Several groups of patients with different previous knowledge were analysed in respect of handling skill and the influence of training on an improvement of the same; the patients' self-assessment was analysed by questioning them. Most mistakes are committed by patients whose only information consists of the contents of the package circular. Written instructions alone cannot convey sufficient information especially on how to synchronize the release operations. Major mistakes are insufficient expiration before application in 85.6% of the patients and lack of synchronisation in 55.9%, while the lowest rate of errors in respect of handling was seen in patients who had undergone training and instruction. Training in application associated with demonstration and subsequent exercise reduces the error ratio to a tolerable level. Pulverizers free from propelling gas and preparations applied by means of a spacer are clearly superior to others in respect of a comparatively low error rate. 99.3% of all patients believe they are correctly following the instructions, but on going into the question more deeply it becomes apparent that 37.1% of them make incorrect statements. Hence, practical training in application should get top priority in the treatment of obstructive diseases of the airways. The individual steps of inhalation technique must be explained in detail and demonstrated by means of a placebo dosage aerosol.(ABSTRACT TRUNCATED AT 250 WORDS)

Artificial intelligence: Neural network model as the multidisciplinary team member in clinical decision support to avoid medical mistakes.

PubMed

Buzaev, Igor Vyacheslavovich; Plechev, Vladimir Vyacheslavovich; Nikolaeva, Irina Evgenievna; Galimova, Rezida Maratovna

2016-09-01

The continuous uninterrupted feedback system is the essential part of any well-organized system. We propose aLYNX concept that is a possibility to use an artificial intelligence algorithm or a neural network model in decision-making system so as to avoid possible mistakes and to remind the doctors to review tactics once more in selected cases. aLYNX system includes: registry with significant factors, decisions and results; machine learning process based on this registry data; the use of the machine learning results as the adviser. We show a possibility to build a computer adviser with a neural network model for making a choice between coronary aortic bypass surgery (CABG) and percutaneous coronary intervention (PCI) in order to achieve a higher 5-year survival rate in patients with angina based on the experience of 5107 patients. The neural network was trained by 4679 patients who achieved 5-year survival. Among them, 2390 patients underwent PCI and 2289 CABG. After training, the correlation coefficient ( r ) of the network was 0.74 for training, 0.67 for validation, 0.71 for test and 0.73 for total. Simulation of the neural network function has been performed after training in the two groups of patients with known 5-year outcome. The disagreement rate was significantly higher in the dead patient group than that in the survivor group between neural network model and heart team [16.8% (787/4679) vs. 20.3% (87/428), P  = 0.065)]. The study shows the possibility to build a computer adviser with a neural network model for making a choice between CABG and PCI in order to achieve a higher 5-year survival rate in patients with angina.

Urothelial cells in smears from cervix uteri

PubMed Central

Palaoro, Luis Alberto; Guerra, Fernando; Angeleri, Anabela; Palamas, Marta; Melba, Sardi-Segovia; Rocher, Adriana Esther

2012-01-01

Objectives: To establish the cytological criteria to identify the urothelial cells in cervical smears in order to avoid mistakes in the cytological diagnosis. Materials and Methods: Cervical smears from 34 post menopausal women with vesicovaginal fistulas, advanced bladder prolapse and genital erosive lichen planes (vulvar kraurosis) (Group 1) and transitional cell metaplasia of the cervix (TCM, Group 2) were stained with Papanicolaou technique. The cervical samples were taken during the routine annual examination for prevention of the uterine cancer. Results: The smears of cervix from Group 1 showed urothelial cells from the three layers of the transitional epithelium. The umbrella cells are the bigger ones with relatively large nuclei. Frequently, they are multinucleated with single or multiple nucleoli and a typical “frothy” cytoplasm (cytoplasmic vacuoles). The cells of the Group 2 showed nuclei with oval to spindled shapes, some tapered ends, less cytoplasm than squamous metaplastic cells, powdery chromatin, small nucleoli and nuclear grooves. Conclusions: The umbrella cells may be mistaken for dysplastic cells originating in low grade squamous intraepithelial lesions lesions (LSILs) due to their nuclear and cytoplasm sizes. Therefore, it is important to know the possibility of their appearance in the cervical smears, especially in post menopausal patients in order to avoid a false diagnosis of an intraepithelial lesion. It is unlikely that deeper cells of urothelium would be confused with high grade squamous intraepithelial lesion (HSIL) cells. However, their presence might be a reason of mistake in the diagnosis. TCM is an under-recognized metaplastic phenomenon of the cervix and vagina, which is a mimicker of high-grade squamous intraepithelial lesion. The differential characteristic between umbrella cells, cells from TCM and the deeper urothelial cells, and LSIL and HSIL are detailed in the present paper. PMID:22438615

Applications in Robotics and Controls

NASA Astrophysics Data System (ADS)

Youcef-Toumi, Kamal

2008-06-01

Recent industry trends have set new standards in business dealings and trades. Issues such as time to market, shoter market wondows, product performance, rapid increase of product complexity, costly mistakes, costly late introductions, and customer expectations have changed significantly. These trends have also influenced to a great extend the academic world. Some of these trends will be illustrated through examples which include automated systems, robotics, biotechnollogy, and nanotechnology. The examples will include concepts and prototypes of engineering systems in the macro, micro and nanodomains. The presentation also amphasizes the merging of the traditionally segregated disciplines into one multidisciplinary modeling, design, optimization and control approach.

Leave requirements under the Family and Medical Leave Act: a trap for the unwary.

PubMed

Mackarey, J A

1997-06-01

The old adage "ignorance of the law is no defense," is certainly true when dealing with the Family Medical leave Act. That is, lack of knowledge does not excuse the failure of the employer to properly designate the leave. Therefore, as an employer, one must be sure to know and follow the Family Medical Leave Act requirements. Not doing so may be a costly mistake.

Swimming and other activities: applied aspects of fish swimming performance

USGS Publications Warehouse

Castro-Santos, Theodore R.; Farrell, A.P.

2011-01-01

Human activities such as hydropower development, water withdrawals, and commercial fisheries often put fish species at risk. Engineered solutions designed to protect species or their life stages are frequently based on assumptions about swimming performance and behaviors. In many cases, however, the appropriate data to support these designs are either unavailable or misapplied. This article provides an overview of the state of knowledge of fish swimming performance – where the data come from and how they are applied – identifying both gaps in knowledge and common errors in application, with guidance on how to avoid repeating mistakes, as well as suggestions for further study.

[Forensic medical expertise of the injurious exposure].

PubMed

Shadymov, A B

2014-01-01

The objective of the present study was to develop the standardized approach to the evaluation of the character of injurious exposure with a view to objective interpretation of the conditions of injury formation and the properties of the traumatic agent. The main attention was given to such parameters of the injurious exposure as loading conditions (mass, speed, direction) and the surface properties of the traumatic agent (area, shape, hardness). It is expected that the use of the proposed system for the evaluation of the injurious exposure in the practical work of forensic medical experts will enhance the reliability of their conclusions and help to avoid mistakes.

Ten quick tips for machine learning in computational biology.

PubMed

Chicco, Davide

2017-01-01

Machine learning has become a pivotal tool for many projects in computational biology, bioinformatics, and health informatics. Nevertheless, beginners and biomedical researchers often do not have enough experience to run a data mining project effectively, and therefore can follow incorrect practices, that may lead to common mistakes or over-optimistic results. With this review, we present ten quick tips to take advantage of machine learning in any computational biology context, by avoiding some common errors that we observed hundreds of times in multiple bioinformatics projects. We believe our ten suggestions can strongly help any machine learning practitioner to carry on a successful project in computational biology and related sciences.

Putting politics first.

PubMed

Hacker, Jacob S

2008-01-01

The greatest lesson of the failure of comprehensive health reform in the early 1990s is that politics comes first. Even the best-laid policy plans are worthless if they lack the political support to pass. Putting politics first means avoiding the overarching mistake of the Clinton reformers: envisioning a grand policy compromise rather than hammering out a real political compromise. It also means addressing the inevitable fears of those who believe that they are well protected by our eroding employment-based system. And it means formulating political strategies that are premised on the contemporary realities of the hyperpolarized U.S. political environment, rather than wistfully recalled images of the bipartisan politics of old.

APPLICATION OF THE 3D MODEL OF RAILWAY VIADUCTS TO COST ESTIMATION AND CONSTRUCTION

NASA Astrophysics Data System (ADS)

Fujisawa, Yasuo; Yabuki, Nobuyoshi; Igarashi, Zenichi; Yoshino, Hiroyuki

Three dimensional models of civil engineering structures are only partially used in either design or construction but not both. Research on integration of design, cost estimation and construction by 3Dmodels has not been heard in civil engineering domain yet. Using continuously a 3D product model of a structure from design to construction through estimation should improve the efficiency and decrease the occurrence of mistakes, hence enhancing the quality. In this research, we investigated the current practices of flow from design to construction, particularly focusing on cost estimation. Then, we identified advantages and issues on utilization of 3D design models to estimation and construction by applying 3D models to an actual railway construction project.

Evolution of precopulatory and post-copulatory strategies of inbreeding avoidance and associated polyandry.

PubMed

Duthie, A B; Bocedi, G; Germain, R R; Reid, J M

2018-01-01

Inbreeding depression is widely hypothesized to drive adaptive evolution of precopulatory and post-copulatory mechanisms of inbreeding avoidance, which in turn are hypothesized to affect evolution of polyandry (i.e. female multiple mating). However, surprisingly little theory or modelling critically examines selection for precopulatory or post-copulatory inbreeding avoidance, or both strategies, given evolutionary constraints and direct costs, or examines how evolution of inbreeding avoidance strategies might feed back to affect evolution of polyandry. Selection for post-copulatory inbreeding avoidance, but not for precopulatory inbreeding avoidance, requires polyandry, whereas interactions between precopulatory and post-copulatory inbreeding avoidance might cause functional redundancy (i.e. 'degeneracy') potentially generating complex evolutionary dynamics among inbreeding strategies and polyandry. We used individual-based modelling to quantify evolution of interacting precopulatory and post-copulatory inbreeding avoidance and associated polyandry given strong inbreeding depression and different evolutionary constraints and direct costs. We found that evolution of post-copulatory inbreeding avoidance increased selection for initially rare polyandry and that evolution of a costly inbreeding avoidance strategy became negligible over time given a lower-cost alternative strategy. Further, fixed precopulatory inbreeding avoidance often completely precluded evolution of polyandry and hence post-copulatory inbreeding avoidance, but fixed post-copulatory inbreeding avoidance did not preclude evolution of precopulatory inbreeding avoidance. Evolution of inbreeding avoidance phenotypes and associated polyandry is therefore affected by evolutionary feedbacks and degeneracy. All else being equal, evolution of precopulatory inbreeding avoidance and resulting low polyandry is more likely when post-copulatory inbreeding avoidance is precluded or costly, and evolution of post-copulatory inbreeding avoidance greatly facilitates evolution of costly polyandry. © The Authors. Journal of Evolutionary Biology published by John Wiley & Sons Ltd on behalf of European Society for Evolutionary Biology.

Communication Avoiding and Overlapping for Numerical Linear Algebra

DTIC Science & Technology

2012-05-08

future exascale systems, communication cost must be avoided or overlapped. Communication-avoiding 2.5D algorithms improve scalability by reducing...linear algebra problems to future exascale systems, communication cost must be avoided or overlapped. Communication-avoiding 2.5D algorithms improve...will continue to grow relative to the cost of computation. With exascale computing as the long-term goal, the community needs to develop techniques

Using total quality management approach to improve patient safety by preventing medication error incidences*.

PubMed

Yousef, Nadin; Yousef, Farah

2017-09-04

Whereas one of the predominant causes of medication errors is a drug administration error, a previous study related to our investigations and reviews estimated that the incidences of medication errors constituted 6.7 out of 100 administrated medication doses. Therefore, we aimed by using six sigma approach to propose a way that reduces these errors to become less than 1 out of 100 administrated medication doses by improving healthcare professional education and clearer handwritten prescriptions. The study was held in a General Government Hospital. First, we systematically studied the current medication use process. Second, we used six sigma approach by utilizing the five-step DMAIC process (Define, Measure, Analyze, Implement, Control) to find out the real reasons behind such errors. This was to figure out a useful solution to avoid medication error incidences in daily healthcare professional practice. Data sheet was used in Data tool and Pareto diagrams were used in Analyzing tool. In our investigation, we reached out the real cause behind administrated medication errors. As Pareto diagrams used in our study showed that the fault percentage in administrated phase was 24.8%, while the percentage of errors related to prescribing phase was 42.8%, 1.7 folds. This means that the mistakes in prescribing phase, especially because of the poor handwritten prescriptions whose percentage in this phase was 17.6%, are responsible for the consequent) mistakes in this treatment process later on. Therefore, we proposed in this study an effective low cost strategy based on the behavior of healthcare workers as Guideline Recommendations to be followed by the physicians. This method can be a prior caution to decrease errors in prescribing phase which may lead to decrease the administrated medication error incidences to less than 1%. This improvement way of behavior can be efficient to improve hand written prescriptions and decrease the consequent errors related to administrated medication doses to less than the global standard; as a result, it enhances patient safety. However, we hope other studies will be made later in hospitals to practically evaluate how much effective our proposed systematic strategy really is in comparison with other suggested remedies in this field.

Methodology for Determining the Avoidable and Fully Allocated Costs of Amtrak Routes : Volume II, Appendix A

DOT National Transportation Integrated Search

2009-08-01

The Federal Railroad Administration tasked the Volpe Center with developing a methodology for determining the avoidable and fully allocated costs of Amtrak routes. Avoidable costs are costs that would not be incurred if an Amtrak route were discontin...

Methodology for Determining the Avoidable and Fully Allocated Costs of Amtrak Routes : Volume III, Appendix B-H

DOT National Transportation Integrated Search

2009-08-01

The Federal Railroad Administration tasked the Volpe Center with developing a methodology for determining the avoidable and fully allocated costs of Amtrak routes. Avoidable costs are costs that would not be incurred if an Amtrak route were discontin...

Methodology for determining the avoidable and fully allocated costs of Amtrak routes, volume 1 : main report

DOT National Transportation Integrated Search

2009-08-01

The Federal Railroad Administration tasked the Volpe Center with developing a methodology for determining the avoidable and fully allocated costs of Amtrak routes. Avoidable costs are costs that would not be incurred if an Amtrak route were discontin...

Quality improvement in hospitals: how much does it reduce healthcare costs?

PubMed

Jones, S B

1995-01-01

The philosophy of W.E. Deming suggests that continuous quality improvement efforts, when properly applied, ultimately will lead to financial dividends and will help ensure business longevity. Reducing hospital charges can be exciting for the participants and can provide an impetus for expanding quality improvement efforts. Americans, however, tend to demand almost instant gratification and have limited patience for longer-term results. This factor, coupled with minimal knowledge of actual operational costs and inaccurate charge accounting systems, may lead hospital managers to misinterpret the potential net long-term effects of their quality improvement efforts. In the approaching environment of capitated reimbursement, such mistakes may have serious consequences.

Contact lenses fitting teaching: learning improvement with monitor visualization of webcam video recordings

NASA Astrophysics Data System (ADS)

Gargallo, Ana; Arines, Justo

2014-08-01

We have adapted low cost webcams to the slit lamps objectives with the aim of improving contact lens fitting practice. With this solution we obtain good quality pictures and videos, we also recorded videos of eye examination, evaluation routines of contact lens fitting, and the final practice exam of our students. In addition, the video system increases the interactions between students because they could see what their colleagues are doing and take conscious of their mistakes, helping and correcting each others. We think that the proposed system is a low cost solution for supporting the training in contact lens fitting practice.

Hiring: take your time but not too much

NASA Astrophysics Data System (ADS)

Usher, Linda

2010-08-01

People are any company's greatest asset. Without a great team no company would be able to conceive of a product or service. It would not be able to design or develop a product or service. It could not possibly market or sell that product or service. How a company goes about hiring its talent is one of the most critical components to developing a great team, to having low attrition, and to having a high level of employee faith in management. Far too often I have seen companies when tasked with filling requisitions not take the time to consider, or layout and execute their priorities in hiring. It's a pretty safe assumption that if one doesn't feel they have enough time to be careful and thorough in their hiring approach in order to get the right person the first time - they probably won't have enough time to replace someone they would not have hired had they done it right in the first place! The flip side of this is the problem of letting too much time pass in the process and therefore losing opportunities to hire great people. This paper will point out many mistakes I have seen made in hiring approaches so that hopefully, different strategies can be adopted to avoid those mistakes in the future.

Febuxostat in the management of gout: a cost-effectiveness analysis.

PubMed

Smolen, Lee J; Gahn, James C; Mitri, Ghaith; Shiozawa, Aki

2016-01-01

To determine the cost-effectiveness of febuxostat vs allopurinol for the management of gout. A stochastic microsimulation cost-effectiveness model with a US private-payer perspective and 5-year time horizon was developed. Model flow based on guideline and real-world treatment paradigms incorporated gout flare, serum uric acid (sUA) testing, treatment titration, discontinuation, and adverse events, chronic kidney disease (CKD) incidence and progression, and type 2 diabetes mellitus (T2DM) incidence. Outcomes were estimated for the general gout population and for gout patients with CKD stages 3/4. Modeled treatment interventions were daily oral febuxostat 40-80 mg and allopurinol 100-300 mg. Baseline patient characteristics were taken from epidemiologic studies, efficacy data from randomized controlled trials, adverse event rates from package inserts, and costs from the literature, government sources, and expert opinion. Eight clinically-relevant incremental cost-effectiveness ratios were estimated: per patient reaching target sUA, per flare avoided, per CKD incidence, progression, stages 3/4 progression, and stage 5 progression avoided, per incident T2DM avoided, and per death avoided. Five-year incremental cost-effectiveness ratios for the general gout population were $5377 per patient reaching target sUA, $1773 per flare avoided, $221,795 per incident CKD avoided, $29,063 per CKD progression avoided, $36,018 per progression to CKD 3/4 avoided, $71,426 per progression to CKD 5 avoided, $214,277 per incident T2DM avoided, and $217,971 per death avoided. In patients with CKD 3/4, febuxostat dominated allopurinol for all cost-effectiveness outcome measures. Febuxostat may be a cost-effective alternative to allopurinol, especially for patients with CKD stages 3 or 4.

Avoidance of nonhost plants by a bark beetle, Pityogenes bidentatus, in a forest of odors

NASA Astrophysics Data System (ADS)

Byers, John A.; Zhang, Qing-He; Birgersson, Göran

The bark beetle, Pityogenes bidentatus (Coleoptera: Scolytidae), searches in mixed conifer and deciduous forests of northern Europe for suitable branches of its host, Scots pine (Pinus sylvestris). We tested whether odors from several diverse nonhost trees and plants common in the habitat (e.g., mountain ash, Sorbus aucuparia; oak, Quercus robur; alder buckthorn, Frangula alnus; blueberry, Vaccinium myrtillus; raspberry, Rubus idaeus; and grass, Deschampsia flexuosa) would reduce the attraction of the bark beetle to traps releasing its aggregation pheromone components in the field. Volatiles from the leaves or bark of each of these plants significantly reduced the attraction of the beetles to their pheromone. Odors collected from these nonhosts and analyzed by GC/MS contained monoterpenes, sesquiterpenes, and ``green-leaf'' alcohols, several of which (e.g., 1-octene-3-ol and β-caryophyllene) reduced the attraction to pheromone in the field and elicited electroantennographic responses. In the laboratory, reproduction by the beetle was marginal in nonhost Norway spruce, Picea abies, and was absent in the other nonhost trees. Olfactory avoidance of unsuitable nonhosts may have evolved due to advantages in avoiding mistakes during host selection.

Solar Avoided Cost Solution SunShot 6 Final Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tucker, John; Danziger, Eric

2014-01-29

The core objectives of this project were two separate but integrated products, collectively providing game-changing Avoided Cost capabilities. The first was a kit of avoided cost tools and data that any solar provider can use a-lacarte or as a whole. It’s open and easily accessible nature allows the rapid and accurate calculation of avoided cost in whatever context and software that make sense (“Typical and Avoided Cost Tools”). This kit includes a dataset of typical energy rates, costs and usage that can be used for solar prospecting, lead generation and any situation where data about an opportunity is missing ormore » imperfect. The second is a web application and related APIs specifically built for solar providers to radically streamline their lead-to-sale process (“Solar Provider Module”). The typical and Avoided Cost tools are built directly into this, and allow for solar providers to track their opportunities, collaborate with their installers and financiers, and close more sales faster.« less

48 CFR 2014.407 - Mistakes in bids.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Mistakes in bids. 2014.407 Section 2014.407 Federal Acquisition Regulations System NUCLEAR REGULATORY COMMISSION CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and Award of Contract 2014.407 Mistakes in bids. ...

An Analysis of Students' Mistakes on Routine Slope Tasks

ERIC Educational Resources Information Center

Cho, Peter; Nagle, Courtney

2017-01-01

This study extends past research on students' understanding of slope by analyzing college students' mistakes on routine tasks involving slope. We conduct quantitative and qualitative analysis of students' mistakes to extract information regarding slope conceptualizations described in prior research. Results delineate procedural proficiencies and…

48 CFR 3414.406 - Mistakes in bids.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Mistakes in bids. 3414.406 Section 3414.406 Federal Acquisition Regulations System DEPARTMENT OF EDUCATION ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and Award of Contract 3414.406 Mistakes...

Two spatiotemporally distinct value systems shape reward-based learning in the human brain.

PubMed

Fouragnan, Elsa; Retzler, Chris; Mullinger, Karen; Philiastides, Marios G

2015-09-08

Avoiding repeated mistakes and learning to reinforce rewarding decisions is critical for human survival and adaptive actions. Yet, the neural underpinnings of the value systems that encode different decision-outcomes remain elusive. Here coupling single-trial electroencephalography with simultaneously acquired functional magnetic resonance imaging, we uncover the spatiotemporal dynamics of two separate but interacting value systems encoding decision-outcomes. Consistent with a role in regulating alertness and switching behaviours, an early system is activated only by negative outcomes and engages arousal-related and motor-preparatory brain structures. Consistent with a role in reward-based learning, a later system differentially suppresses or activates regions of the human reward network in response to negative and positive outcomes, respectively. Following negative outcomes, the early system interacts and downregulates the late system, through a thalamic interaction with the ventral striatum. Critically, the strength of this coupling predicts participants' switching behaviour and avoidance learning, directly implicating the thalamostriatal pathway in reward-based learning.

Incorporation of Tropical Cyclone Avoidance Into Automated Ship Scheduling

DTIC Science & Technology

2014-06-01

damage and even sink ships. Avoiding TCs adds to fuel costs and causes delays. In the private sector, commercial shipping uses automated routing...improvements in forecasting have enabled ships to avoid TC-impacted areas altogether. Avoiding TCs does not come without a cost . Delaying departure or...steaming around a TC results in more fuel being burned at a high cost , plus the cost due to the delay in arrival at the destination, and the associated

48 CFR 314.407-4 - Mistakes after award.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Mistakes after award. 314.407-4 Section 314.407-4 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES CONTRACTING... administrative determinations in connection with mistakes in bid alleged after award. (d) OGC-GLD shall concur in...

48 CFR 314.407-4 - Mistakes after award.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Mistakes after award. 314.407-4 Section 314.407-4 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES CONTRACTING... administrative determinations in connection with mistakes in bid alleged after award. (d) OGC-GLD shall concur in...

Eighteen- and 24-Month-Old Infants Correct Others in Anticipation of Action Mistakes

ERIC Educational Resources Information Center

Knudsen, Birgit; Liszkowski, Ulf

2012-01-01

Much of human communication and collaboration is predicated on making predictions about others' actions. Humans frequently use predictions about others' action mistakes to correct others and spare them mistakes. Such anticipatory correcting reveals a social motivation for unsolicited helping. Cognitively, it requires forward inferences about…

Framework programmable platform for the advanced software development workstation. Integration mechanism design document

NASA Technical Reports Server (NTRS)

Mayer, Richard J.; Blinn, Thomas M.; Mayer, Paula S. D.; Reddy, Uday; Ackley, Keith; Futrell, Mike

1991-01-01

The Framework Programmable Software Development Platform (FPP) is a project aimed at combining effective tool and data integration mechanisms with a model of the software development process in an intelligent integrated software development environment. Guided by this model, this system development framework will take advantage of an integrated operating environment to automate effectively the management of the software development process so that costly mistakes during the development phase can be eliminated.

Performance assurance of the re-applying project documentation

NASA Astrophysics Data System (ADS)

Kozlova, Olga

2017-10-01

Usage of the re-applying project documentation is cost effective measure. Saving of budgetary funds for purchases for development of new project documentation occurs by means of it. It also becomes possible to consider better decisions and prevent the repetition of mistakes. Nowadays, state authorities in construction management are forming separate institute for re-applying project documentation. The article shows the main tasks of such events and the issues to be solved for achievement of a high positive result.

Routine operation of an Elliott 903 computer in a clinical chemistry laboratory

PubMed Central

Whitby, L. G.; Simpson, D.

1973-01-01

Experience gained in the last four years concerning the capabilities and limitations of an 8K Elliott 903 (18-bit word) computer with magnetic tape backing store in the routine operation of a clinical chemistry laboratory is described. Designed as a total system, routine operation has latterly had to be confined to data acquisition and process control functions, due primarily to limitations imposed by the choice of hardware early in the project. In this final report of a partially successful experiment the opportunity is taken to review mistakes made, especially at the start of the project, to warn potential computer users of pitfalls to be avoided. PMID:4580240

Process modeling of a HLA research lab

NASA Astrophysics Data System (ADS)

Ribeiro, Bruna G. C.; Sena, Alexandre C.; Silva, Dilson; Marzulo, Leandro A. J.

2017-11-01

Bioinformatics has provided tremendous breakthroughs in the field of molecular biology. All this evolution has generated a large volume of biological data that increasingly require the use of computing for analysis and storage of this information. The identification of the human leukocyte antigen (HLA) genotypes is critical to the success of organ transplants in humans. HLA typing involves not only laboratory tests but also DNA sequencing, with the participation of several professionals responsible for different stages of the process. Thus, the objective of this paper is to map the main steps in HLA typing in a laboratory specialized in performing such procedures, analyzing each process and proposing solutions to speed up the these steps, avoiding mistakes.

A Proposal of Operational Risk Management Method Using FMEA for Drug Manufacturing Computerized System

NASA Astrophysics Data System (ADS)

Takahashi, Masakazu; Nanba, Reiji; Fukue, Yoshinori

This paper proposes operational Risk Management (RM) method using Failure Mode and Effects Analysis (FMEA) for drug manufacturing computerlized system (DMCS). The quality of drug must not be influenced by failures and operational mistakes of DMCS. To avoid such situation, DMCS has to be conducted enough risk assessment and taken precautions. We propose operational RM method using FMEA for DMCS. To propose the method, we gathered and compared the FMEA results of DMCS, and develop a list that contains failure modes, failures and countermeasures. To apply this list, we can conduct RM in design phase, find failures, and conduct countermeasures efficiently. Additionally, we can find some failures that have not been found yet.

Mathematics Self-Efficacy and Mistake-Handling Learning as Predictors of Mathematics Anxiety

ERIC Educational Resources Information Center

Aksu, Zeki; Ozkaya, Merve; Gedik, Solmaz Damla; Konyalioglu, Alper Cihan

2016-01-01

This study aims to analyze the relationship between secondary school seventh grade students' perception of mathematical self-efficacy, mistake-handling learning awareness, and mathematical anxiety; and to define the power of mistake-handling learning and self-efficacy in predicting mathematical anxiety. In this study, relational model was used and…

48 CFR 14.407-4 - Mistakes after award.

Code of Federal Regulations, 2014 CFR

2014-10-01

... CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and Award of Contract 14.407-4 Mistakes...) To rescind a contract; (2) To reform a contract (i) to delete the items involved in the mistake or.... (vi) A written request by the contractor to reform or rescind the contract, and copies of all other...

48 CFR 14.407-4 - Mistakes after award.

Code of Federal Regulations, 2012 CFR

2012-10-01

... CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and Award of Contract 14.407-4 Mistakes...) To rescind a contract; (2) To reform a contract (i) to delete the items involved in the mistake or.... (vi) A written request by the contractor to reform or rescind the contract, and copies of all other...

48 CFR 14.407-4 - Mistakes after award.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and Award of Contract 14.407-4 Mistakes...) To rescind a contract; (2) To reform a contract (i) to delete the items involved in the mistake or.... (vi) A written request by the contractor to reform or rescind the contract, and copies of all other...

48 CFR 14.407-4 - Mistakes after award.

Code of Federal Regulations, 2013 CFR

2013-10-01

... CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and Award of Contract 14.407-4 Mistakes...) To rescind a contract; (2) To reform a contract (i) to delete the items involved in the mistake or.... (vi) A written request by the contractor to reform or rescind the contract, and copies of all other...

48 CFR 14.407-4 - Mistakes after award.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and Award of Contract 14.407-4 Mistakes...) To rescind a contract; (2) To reform a contract (i) to delete the items involved in the mistake or.... (vi) A written request by the contractor to reform or rescind the contract, and copies of all other...

The Mistakes We Make and How We Correct Them: What I've Learned as a Consultant

ERIC Educational Resources Information Center

Boylan, Hunter R.

2009-01-01

This manuscript describes five of the most common mistakes made in developmental education programs based on the author's experiences, which include consulting at over 200 community colleges. These mistakes include failing to create a seamless transition, failing to train adjunct instructors, failing to coordinate developmental programs, failing…

48 CFR 6101.29 - Clerical mistakes; harmless error [Rule 29].

Code of Federal Regulations, 2010 CFR

2010-10-01

...; harmless error [Rule 29]. 6101.29 Section 6101.29 Federal Acquisition Regulations System CIVILIAN BOARD OF...; harmless error [Rule 29]. (a) Clerical mistakes. Clerical mistakes in decisions, orders, or other parts of... error in anything done or not done by the Board will be a ground for granting a new hearing or for...

Faith community nursing demonstrates good stewardship of community benefit dollars through cost savings and cost avoidance.

PubMed

Brown, Ameldia R; Coppola, Patricia; Giacona, Marian; Petriches, Anne; Stockwell, Mary Ann

2009-01-01

Health systems seeking responsible stewardship of community benefit dollars supporting Faith Community Nursing Networks require demonstration of positive measurable health outcomes. Faith Community Nurses (FCNs) answer the call for measurable outcomes by documenting cost savings and cost avoidances to families, communities, and health systems associated with their interventions. Using a spreadsheet tool based on Medicare reimbursements and diagnostic-related groupings, 3 networks of FCNs have together shown more than 600 000 (for calendar year 2008) healthcare dollars saved by avoidance of unnecessary acute care visits and extended care placements. The cost-benefit ratio of support dollars to cost savings and cost avoidance demonstrates that support of FCNs is good stewardship of community benefit dollars.

The neural basis of financial risk taking.

PubMed

Kuhnen, Camelia M; Knutson, Brian

2005-09-01

Investors systematically deviate from rationality when making financial decisions, yet the mechanisms responsible for these deviations have not been identified. Using event-related fMRI, we examined whether anticipatory neural activity would predict optimal and suboptimal choices in a financial decision-making task. We characterized two types of deviations from the optimal investment strategy of a rational risk-neutral agent as risk-seeking mistakes and risk-aversion mistakes. Nucleus accumbens activation preceded risky choices as well as risk-seeking mistakes, while anterior insula activation preceded riskless choices as well as risk-aversion mistakes. These findings suggest that distinct neural circuits linked to anticipatory affect promote different types of financial choices and indicate that excessive activation of these circuits may lead to investing mistakes. Thus, consideration of anticipatory neural mechanisms may add predictive power to the rational actor model of economic decision making.

Why Does the Law of One Price Fail? An Experiment on Index Mutual Funds*

PubMed Central

Choi, James J.; Laibson, David; Madrian, Brigitte C.

2009-01-01

We conduct an experiment to evaluate why individuals invest in high-fee index funds. In our experiments, subjects allocate $10,000 across four S&P 500 index funds and are rewarded for their portfolio’s subsequent return. Subjects overwhelmingly fail to minimize fees. We can reject the hypothesis that subjects buy high-fee index funds because of bundled non-portfolio services. Search costs for fees matter, but even when we eliminate these costs, fees are not minimized. Instead, subjects place high weight on annualized returns since inception. Fees paid decrease with financial literacy. Interestingly, subjects who choose high-fee funds sense they are making a mistake. PMID:20495662

Protocols for Robust Herbicide Resistance Testing in Different Weed Species.

PubMed

Panozzo, Silvia; Scarabel, Laura; Collavo, Alberto; Sattin, Maurizio

2015-07-02

Robust protocols to test putative herbicide resistant weed populations at whole plant level are essential to confirm the resistance status. The presented protocols, based on whole-plant bioassays performed in a greenhouse, can be readily adapted to a wide range of weed species and herbicides through appropriate variants. Seed samples from plants that survived a field herbicide treatment are collected and stored dry at low temperature until used. Germination methods differ according to weed species and seed dormancy type. Seedlings at similar growth stage are transplanted and maintained in the greenhouse under appropriate conditions until plants have reached the right growth stage for herbicide treatment. Accuracy is required to prepare the herbicide solution to avoid unverifiable mistakes. Other critical steps such as the application volume and spray speed are also evaluated. The advantages of this protocol, compared to others based on whole plant bioassays using one herbicide dose, are related to the higher reliability and the possibility of inferring the resistance level. Quicker and less expensive in vivo or in vitro diagnostic screening tests have been proposed (Petri dish bioassays, spectrophotometric tests), but they provide only qualitative information and their widespread use is hindered by the laborious set-up that some species may require. For routine resistance testing, the proposed whole plant bioassay can be applied at only one herbicide dose, so reducing the costs.

Assessing the value of information for long-term structural health monitoring

NASA Astrophysics Data System (ADS)

Pozzi, Matteo; Der Kiureghian, Armen

2011-04-01

In the field of Structural Health Monitoring, tests and sensing systems are intended as tools providing diagnoses, which allow the operator of the facility to develop an efficient maintenance plan or to require extraordinary measures on a structure. The effectiveness of these systems depends directly on their capability to guide towards the most optimal decision for the prevailing circumstances, avoiding mistakes and wastes of resources. Though this is well known, most studies only address the accuracy of the information gained from sensors without discussing economic criteria. Other studies evaluate these criteria separately, with only marginal or heuristic connection with the outcomes of the monitoring system. The concept of "Value of Information" (VoI) provides a rational basis to rank measuring systems according to a utility-based metric, which fully includes the decision-making process affected by the monitoring campaign. This framework allows, for example, an explicit assessment of the economical justifiability of adopting a sensor depending on its precision. In this paper we outline the framework for assessing the VoI, as applicable to the ranking of competitive measuring systems. We present the basic concepts involved, highlight issues related to monitoring of civil structures, address the problem of non-linearity of the cost-to-utility mapping, and introduce an approximate Monte Carlo approach suitable for the implementation of time-consuming predictive models.

[Psychosocial disintegration].

PubMed

Köhler, S

1994-08-01

Among the patients referred for rehabilitation in the latter half of their working life, many are notable due to considerable discrepancies between their objectively ascertainable performance and its subjectively perceived decline. In these cases, the "substantial threat to earning capacity" cannot be explained by measurable organ deficiencies. Similarly, treatment efforts focussed solely at improved somatic functioning remain inefficient in terms of stabilization of earning capacity, because they do not bring about changes in the cause of subjective performance deterioration. The author in these circumstances assumes the presence of an independent syndrome, called "psychosocial disintegration". He describes the full picture of this disease entity, and suggests causal mechanisms as well as potential for remedial intervention. On account of the considerable social dimension of the disorder outlined, early identification of these gradually developing changes as well as qualified care of the insurants are indispensable. All those involved in treatment and care of the patients or working in some branch of the social security system should be familiar with this psychosocial disintegration syndrome in order to avoid the guidance and counselling mistakes that are frequently the case. As rehabilitation is impossible in case of inhibiting personal attitudes of an insurant, it is advisable to verify the individual's readiness for rehabilitation and/or to strengthen it by appropriate measures before engaging in costly in-patient service provision. If the needed motivation is to be achieved during participation in a rehabilitation measure, extended service provision will invariably be required.

A Category Mistake: Why Contemporary Australian Religious Education in Catholic Schools May Be Doomed to Failure

ERIC Educational Resources Information Center

Hyde, Brendan

2013-01-01

Assuming religious education to be the same as other subject areas of a Catholic school's curriculum by, for example, applying the outcomes based philosophy and language of other subject areas to religious education renders a category mistake. A prominent notion in the work of metaphysical philosopher Gilbert Ryle, a category mistake arises when…

Mistake of Criminal Law and Its Influence on the Classification of Crime

ERIC Educational Resources Information Center

Veresha, Roman V.

2016-01-01

The paper examines the characteristics of a mistake of the commitment of crime as an optional feature of the mental state of the crime. The analysis conducted offers an opportunity to state that in international criminal law, a mistake of law, although taken into account, does not generally affect the classification of crime. We uncovered and…

A First-Year Teacher's Top 10 Mistakes

ERIC Educational Resources Information Center

Nourie, Meredith C.

2011-01-01

In June the author completed her first full year of high school teaching. In this article, she shares her top 10 mistakes for several reasons: (1) so that other beginners will know what to expect; (2) so that teacher educators will share with candidates for licensure; (3) so that she won't make the same mistakes again; (4) so that veteran teachers…

Cost-effectiveness of natalizumab vs fingolimod for the treatment of relapsing-remitting multiple sclerosis: analyses in Sweden.

PubMed

O'Day, Ken; Meyer, Kellie; Stafkey-Mailey, Dana; Watson, Crystal

2015-04-01

To assess the cost-effectiveness of natalizumab vs fingolimod over 2 years in relapsing-remitting multiple sclerosis (RRMS) patients and patients with rapidly evolving severe disease in Sweden. A decision analytic model was developed to estimate the incremental cost per relapse avoided of natalizumab and fingolimod from the perspective of the Swedish healthcare system. Modeled 2-year costs in Swedish kronor of treating RRMS patients included drug acquisition costs, administration and monitoring costs, and costs of treating MS relapses. Effectiveness was measured in terms of MS relapses avoided using data from the AFFIRM and FREEDOMS trials for all patients with RRMS and from post-hoc sub-group analyses for patients with rapidly evolving severe disease. Probabilistic sensitivity analyses were conducted to assess uncertainty. The analysis showed that, in all patients with MS, treatment with fingolimod costs less (440,463 Kr vs 444,324 Kr), but treatment with natalizumab results in more relapses avoided (0.74 vs 0.59), resulting in an incremental cost-effectiveness ratio (ICER) of 25,448 Kr per relapse avoided. In patients with rapidly evolving severe disease, natalizumab dominated fingolimod. Results of the sensitivity analysis demonstrate the robustness of the model results. At a willingness-to-pay (WTP) threshold of 500,000 Kr per relapse avoided, natalizumab is cost-effective in >80% of simulations in both patient populations. Limitations include absence of data from direct head-to-head studies comparing natalizumab and fingolimod, use of relapse rate reduction rather than sustained disability progression as the primary model outcome, assumption of 100% adherence to MS treatment, and exclusion of adverse event costs in the model. Natalizumab remains a cost-effective treatment option for patients with MS in Sweden. In the RRMS patient population, the incremental cost per relapse avoided is well below a 500,000 Kr WTP threshold per relapse avoided. In the rapidly evolving severe disease patient population, natalizumab dominates fingolimod.

Mistakes Made by Freshman Students of Science Teaching and Their Reasons during the Proving Process

ERIC Educational Resources Information Center

Gökkurt, Burçin; Erdem, Emrullah; Basibüyük, Kani; Sahin, Ömer; Soylu, Yasin

2017-01-01

The aim of this study was to examine the mistakes made by freshman students of science teaching during the process of proving and the reasons for these mistakes. To this aim, the study, which was conducted via the case study method, was performed with 52 freshman students who were studying at the department of science teaching in a state…

How Stereotype Threat Affects Healthy Older Adults’ Performance on Clinical Assessments of Cognitive Decline: The Key Role of Regulatory Fit

PubMed Central

Mather, Mara; Gatz, Margaret

2015-01-01

Objectives. Stereotype threat can impair older adults’ performance on clinical assessments for cognitive decline. We examined why this occurs. Based upon the regulatory focus account of stereotype threat, we predicted that the effects of stereotype threat should depend upon the assessments’ reward structure. Stereotype threat should be associated with poor performance when the assessment emphasizes gaining correct answers, but not when it emphasizes avoiding mistakes. Method. Healthy older adults completed a series of mental status examinations. Half of the participants completed these examinations under stereotype threat about their cognitive abilities. Monetary incentives were also manipulated. For half of the participants correct responding led to gains. For the remaining participants incorrect responding/forgetting led to losses. Results. Consistent with the regulatory focus account, stereotype threat was associated with poor performance when the mental status examinations had a gains-based structure, but not when they had a losses-based structure. Discussion. Older adults respond to stereotype threat by becoming vigilant to avoid the losses that will make them their worst. Researchers and clinicians can capitalize on this motivational change to combat stereotype threat’s negative effects. By using a loss-avoidance frame, stereotype threat’s negative effects can be attenuated or even eliminated. PMID:25752896

Mistake proofing: changing designs to reduce error

PubMed Central

Grout, J R

2006-01-01

Mistake proofing uses changes in the physical design of processes to reduce human error. It can be used to change designs in ways that prevent errors from occurring, to detect errors after they occur but before harm occurs, to allow processes to fail safely, or to alter the work environment to reduce the chance of errors. Effective mistake proofing design changes should initially be effective in reducing harm, be inexpensive, and easily implemented. Over time these design changes should make life easier and speed up the process. Ideally, the design changes should increase patients' and visitors' understanding of the process. These designs should themselves be mistake proofed and follow the good design practices of other disciplines. PMID:17142609

Persistent problems with the Munchausen syndrome by proxy label.

PubMed

Pankratz, Loren

2006-01-01

After nearly 30 years of clinical and legal experience, the definition of Munchausen syndrome by proxy remains controversial. As a result, mothers who present the problems of their children in ways perceived as unusual or problematic have become entangled in legal battles that should have been resolved clinically. Re-labeling the disorder as Pediatric Condition Falsification misdirects the focus onto mistakes and misunderstandings while avoiding the more crucial issue of intentions. Experts have enflamed the fears of harm by confusing warning signs with diagnostic signs and by citing retrospective studies instead of the more optimistic outcome studies. Accused mothers need the support of multidisciplinary teams but are often forced into contentious struggles with legal professionals and child protection services.

ADDME – Avoiding Drug Development Mistakes Early: central nervous system drug discovery perspective

PubMed Central

Tsaioun, Katya; Bottlaender, Michel; Mabondzo, Aloise

2009-01-01

The advent of early absorption, distribution, metabolism, excretion, and toxicity (ADMET) screening has increased the attrition rate of weak drug candidates early in the drug-discovery process, and decreased the proportion of compounds failing in clinical trials for ADMET reasons. This paper reviews the history of ADMET screening and its place in pharmaceutical development, and central nervous system drug discovery in particular. Assays that have been developed in response to specific needs and improvements in technology that result in higher throughput and greater accuracy of prediction of human mechanisms of absorption and toxicity are discussed. The paper concludes with the authors' forecast of new models that will better predict human efficacy and toxicity. PMID:19534730

Intracerebral Bleeding and Massive Pericardial Effusion as Presenting Symptoms of Myxedema Crisis

PubMed Central

Rimpau, C.; Nickel, C. H.; Baier, P.

2017-01-01

The endocrinological emergency of a fully blown myxedema crisis can present as a multicolored clinical picture. This can obscure the underlying pathology and easily lead to mistakes in clinical diagnosis, work-up, and treatment. We present a case of an unconscious 39-year-old patient with a medical history of weakness, lethargy, and findings of hyponatremia, intracerebral bleeding, and massive pericardial effusion. Finally, myxedema crisis was diagnosed as underlying cause. Replacement therapy of thyroid hormone and conservative management of the intracerebral bleeding resulted in patient's survival without significant neurological impairment. However, diagnostic pericardiocentesis resulted in life-threatening pericardial tamponade. It is of tremendous importance to diagnose myxoedema crisis early to avoid adverse health outcomes. PMID:28255471

A case report of pseudo grey platelet syndrome with citrate-induced pseudothrombocytopenia: those artifacts may interfere in the platelet numeration and lead to critical misdiagnosis.

PubMed

Herb, Agathe; Maurer, Maxime; Alamome, Isabelle; Bihl, Pierre-Adrien; Ghiura, Cosmina; Hurstel, Rémy

2017-08-01

The pseudo grey platelet syndrome is a rare artifact due to the degranulation of platelets caused, in vitro, by EDTA. This phenomenon is likely to disturb the platelet numeration and it is essential not to mistake it for a grey syndrome platelet, which is a constitutional thrombopathy with macrothrombopenia, in order to avoid specialized tests, or even misdiagnosis. Indeed, these two entities are cytologically alike, as grey platelets are found on the blood smear of a sample collected on EDTA in both cases. We here describe the case of a patient admitted in Colmar's Hospital for a chronic thrombocytopenia, associating both a pseudothrombocytopenia and a pseudo grey platelet syndrome.

[Giving medico-legal opinions in cases with suspicion of medical mistake. part 2. Expert evidence in cases with suspicion of medical mistake - expectations, possibilities, threats…].

PubMed

Chowaniec, Czesław; Chowaniec, Małgorzata; Wilk, Mateusz

Problems of medical mistake and therapeutic failure are inextricably linked with realization of medical services. In recent years, mostly by the media and increasing demanding attitude, a rapid increase of initiated cases opened by judicial body in conjunction with medical mistake made by medical staff is observed. Making medico-legal opinions is not easy task and often face many difficulties. These consist of lacks in medical documentation, time rigor, formal tightening and need to create team that consist of both forensic medicine specialist and clinicians, who together shall write complex medico-legal opinion. This article touches the essence of the opinion-making problem in the aspect of medical mistake. It shows specifics of the role of forensic medicine specialist, his challenges and difficulties in creating opinions. The article confronts real possibilities of court experts with expectations of judicial body, outlining new challenges and dangers which court experts have to face.

The social benefits of private infectious disease-risk mitigation.

PubMed

Morin, Benjamin R; Perrings, Charles; Kinzig, Ann; Levin, Simon

2015-11-01

Does society benefit from private measures to mitigate infectious disease risks? Since mitigation reduces both peak prevalence and the number of people who fall ill, the answer might appear to be yes. But mitigation also prolongs epidemics and therefore the time susceptible people engage in activities to avoid infection. These avoidance activities come at a cost-in lost production or consumption, for example. Whether private mitigation yields net social benefits depends on the social weight given to the costs of illness and illness avoidance, now and into the future. We show that, for a large class of infectious diseases, private risk mitigation is socially beneficial. However, in cases where society discounts the future at either very low or very high rates relative to private individuals, or where it places a low weight on the private cost of illness, the social cost of illness under proportionate mixing (doing nothing) may be lower than the social cost of illness under preferential mixing (avoiding infectious individuals). That is, under some circumstances, society would prefer shorter, more intense epidemics without avoidance costs over longer, less intense epidemics with avoidance costs. A sobering (although not surprising) implication of this is that poorer societies should be expected to promote less private disease-risk mitigation than richer societies.

Intelligent Tutoring Systems: Past, Present, and Future.

DTIC Science & Technology

1994-05-01

prevent fnmration. 10 Our working definition of computer-tutor intelligence is that the system must behave intelligMtly, not actually be intelligent...e.g., Reiser, Ramey, Lovett & Kimberg, 1989), the student is not only prevented from following these mistakes to their logical conclusion (and getting...hopelessly confused) but also prevented from obtaining an insight into the mistake (i.e., that the mistake is obvious). These ae some of the best

Unexpected Results are Usually Wrong, but Often Interesting

NASA Astrophysics Data System (ADS)

Huber, M.

2014-12-01

In climate modeling, an unexpected result is usually wrong, arising from some sort of mistake. Despite the fact that we all bemoan uncertainty in climate, the field is underlain by a robust, successful body of theory and any properly conducted modeling experiment is posed and conducted within that context. Consequently, if results from a complex climate model disagree with theory or from expectations from simpler models, much skepticism is in order. But, this exposes the fundamental tension of using complex, sophisticated models. If simple models and theory were perfect there would be no reason for complex models--the entire point of sophisticated models is to see if unexpected phenomena arise as emergent properties of the system. In this talk, I will step through some paleoclimate examples, drawn from my own work, of unexpected results that emerge from complex climate models arising from mistakes of two kinds. The first kind of mistake, is what I call a 'smart mistake'; it is an intentional incorporation of assumptions, boundary conditions, or physics that is in violation of theoretical or observational constraints. The second mistake, a 'dumb mistake', is just that, an unintentional violation. Analysis of such mistaken simulations provides some potentially novel and certainly interesting insights into what is possible and right in paleoclimate modeling by forcing the reexamination of well-held assumptions and theories.

Mistakes and inconsistencies regarding adsorption of contaminants from aqueous solutions: A critical review.

PubMed

Tran, Hai Nguyen; You, Sheng-Jie; Hosseini-Bandegharaei, Ahmad; Chao, Huan-Ping

2017-09-01

In recent years, adsorption science and technology for water and wastewater treatment has attracted substantial attention from the scientific community. However, the number of publications containing inconsistent concepts is increasing. Many publications either reiterate previously discussed mistakes or create new mistakes. The inconsistencies are reflected by the increasing publication of certain types of article in this field, including "short communications", "discussions", "critical reviews", "comments", "letters to the editor", and "correspondence (comment/rebuttal)". This article aims to discuss (1) the inaccurate use of technical terms, (2) the problem associated with quantities for measuring adsorption performance, (3) the important roles of the adsorbate and adsorbent pK a , (4) mistakes related to the study of adsorption kinetics, isotherms, and thermodynamics, (5) several problems related to adsorption mechanisms, (6) inconsistent data points in experimental data and model fitting, (7) mistakes in measuring the specific surface area of an adsorbent, and (8) other mistakes found in the literature. Furthermore, correct expressions and original citations of the relevant models (i.e., adsorption kinetics and isotherms) are provided. The authors hope that this work will be helpful for readers, researchers, reviewers, and editors who are interested in the field of adsorption studies. Copyright © 2017 Elsevier Ltd. All rights reserved.

Management of Dropped Skull Flaps.

PubMed

Abdelfatah, Mohamed AbdelRahman

2017-01-01

Dropping a skull flap on the floor is an uncommon and avoidable mistake in the neurosurgical operating theater. This study retrospectively reviewed all incidents of dropped skull flaps in Ain-Shams University hospitals during a 10-year period to show how to manage this problem and its outcome. Thirty-one incidents of dropped skull flaps occurred from January 2004 to January 2014 out of more than 10,000 craniotomies. Follow-up period varied from 20 to 44 months. The bone flap was dropped while elevating the bone (n = 16), while drilling the bone on the operating table (n = 5), and during insertion of the bone flap (n = 10). Treatment included re-insertion of the skull flap after soaking it in povidone iodine and antibiotic solution (n = 17) or after autoclaving (n = 11), or discarding the skull flap and replacing it with a mesh cranioplasty in the same operation (n = 3). No bone or wound infection was noted during the follow-up period. Management of dropped skull flap is its prevention. Replacement of the skull flap, after decontamination, is an option that avoids the expense and time of cranioplasty.

The Six Cs of Managing Federal Projects: How to Avoid Cost Disallowances.

ERIC Educational Resources Information Center

Goeres, Ernest R.; Mancini, Cesidio G.

1995-01-01

To avoid embarrassment and financial cost of incurring cost disallowances on federally-sponsored projects, college and university administrators must pay particular attention to these management areas: compensation (release time, overload, and others); costs (allowable, attributable, transfers, and others); consulting; certification of time and…

Satellite-instrument system engineering best practices and lessons

NASA Astrophysics Data System (ADS)

Schueler, Carl F.

2009-08-01

This paper focuses on system engineering development issues driving satellite remote sensing instrumentation cost and schedule. A key best practice is early assessment of mission and instrumentation requirements priorities driving performance trades among major instrumentation measurements: Radiometry, spatial field of view and image quality, and spectral performance. Key lessons include attention to technology availability and applicability to prioritized requirements, care in applying heritage, approaching fixed-price and cost-plus contracts with appropriate attention to risk, and assessing design options with attention to customer preference as well as design performance, and development cost and schedule. A key element of success either in contract competition or execution is team experience. Perhaps the most crucial aspect of success, however, is thorough requirements analysis and flowdown to specifications driving design performance with sufficient parameter margin to allow for mistakes or oversights - the province of system engineering from design inception to development, test and delivery.

ICRP publication 112. A report of preventing accidental exposures from new external beam radiation therapy technologies.

PubMed

Ortiz López, P; Cosset, J M; Dunscombe, P; Holmberg, O; Rosenwald, J C; Pinillos Ashton, L; Vilaragut Llanes, J J; Vatnitsky, S

2009-08-01

Disseminating the knowledge and lessons learned from accidental exposures is crucial in preventing re-occurrence. This is particularly important in radiation therapy; the only application of radiation in which very high radiation doses are deliberately given to patients to achieve cure or palliation of disease. Lessons from accidental exposures are, therefore, an invaluable resource for revealing vulnerable aspects of the practice of radiotherapy, and for providing guidance for the prevention of future occurrences. These lessons have successfully been applied to avoid catastrophic events with conventional technologies and techniques. Recommendations, for example, include the independent verification of beam calibration and independent calculation of the treatment times and monitor units for external beam radiotherapy, and the monitoring of patients and their clothes immediately after brachytherapy. New technologies are meant to bring substantial improvement to radiation therapy. However, this is often achieved with a considerable increase in complexity, which in turn brings opportunities for new types of human error and problems with equipment. Dissemination of information on these errors or mistakes as soon as it becomes available is crucial in radiation therapy with new technologies. In addition, information on circumstances that almost resulted in serious consequences (near-misses) is also important, as the same type of events may occur elsewhere. Sharing information about near-misses is thus a complementary important aspect of prevention. Lessons from retrospective information are provided in Sections 2 and 4 of this report. Disseminating lessons learned for serious incidents is necessary but not sufficient when dealing with new technologies. It is of utmost importance to be proactive and continually strive to answer questions such as 'What else can go wrong', 'How likely is it?' and 'What kind of cost-effective choices do I have for prevention?'. These questions are addressed in Sections 3 and 5 of this report. Section 6 contains the conclusions and recommendations. This report is expected to be a valuable resource for radiation oncologists, hospital administrators, medical physicists, technologists, dosimetrists, maintenance engineers, radiation safety specialists, and regulators. While the report applies specifically to new external beam therapies, the general principles for prevention are applicable to the broad range of radiotherapy practices where mistakes could result in serious consequences for the patient and practitioner.

Framework Programmable Platform for the advanced software development workstation: Framework processor design document

NASA Technical Reports Server (NTRS)

Mayer, Richard J.; Blinn, Thomas M.; Mayer, Paula S. D.; Ackley, Keith A.; Crump, Wes; Sanders, Les

1991-01-01

The design of the Framework Processor (FP) component of the Framework Programmable Software Development Platform (FFP) is described. The FFP is a project aimed at combining effective tool and data integration mechanisms with a model of the software development process in an intelligent integrated software development environment. Guided by the model, this Framework Processor will take advantage of an integrated operating environment to provide automated support for the management and control of the software development process so that costly mistakes during the development phase can be eliminated.

The social benefits of private infectious disease-risk mitigation

PubMed Central

Perrings, Charles; Kinzig, Ann; Levin, Simon

2015-01-01

Does society benefit from private measures to mitigate infectious disease risks? Since mitigation reduces both peak prevalence and the number of people who fall ill, the answer might appear to be yes. But mitigation also prolongs epidemics and therefore the time susceptible people engage in activities to avoid infection. These avoidance activities come at a cost—in lost production or consumption, for example. Whether private mitigation yields net social benefits depends on the social weight given to the costs of illness and illness avoidance, now and into the future. We show that, for a large class of infectious diseases, private risk mitigation is socially beneficial. However, in cases where society discounts the future at either very low or very high rates relative to private individuals, or where it places a low weight on the private cost of illness, the social cost of illness under proportionate mixing (doing nothing) may be lower than the social cost of illness under preferential mixing (avoiding infectious individuals). That is, under some circumstances, society would prefer shorter, more intense epidemics without avoidance costs over longer, less intense epidemics with avoidance costs. A sobering (although not surprising) implication of this is that poorer societies should be expected to promote less private disease-risk mitigation than richer societies. PMID:26858777

Cost-Effectiveness Analysis of an Automated Medication System Implemented in a Danish Hospital Setting.

PubMed

Risør, Bettina Wulff; Lisby, Marianne; Sørensen, Jan

To evaluate the cost-effectiveness of an automated medication system (AMS) implemented in a Danish hospital setting. An economic evaluation was performed alongside a controlled before-and-after effectiveness study with one control ward and one intervention ward. The primary outcome measure was the number of errors in the medication administration process observed prospectively before and after implementation. To determine the difference in proportion of errors after implementation of the AMS, logistic regression was applied with the presence of error(s) as the dependent variable. Time, group, and interaction between time and group were the independent variables. The cost analysis used the hospital perspective with a short-term incremental costing approach. The total 6-month costs with and without the AMS were calculated as well as the incremental costs. The number of avoided administration errors was related to the incremental costs to obtain the cost-effectiveness ratio expressed as the cost per avoided administration error. The AMS resulted in a statistically significant reduction in the proportion of errors in the intervention ward compared with the control ward. The cost analysis showed that the AMS increased the ward's 6-month cost by €16,843. The cost-effectiveness ratio was estimated at €2.01 per avoided administration error, €2.91 per avoided procedural error, and €19.38 per avoided clinical error. The AMS was effective in reducing errors in the medication administration process at a higher overall cost. The cost-effectiveness analysis showed that the AMS was associated with affordable cost-effectiveness rates. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Mistakes and Molecular Evolution.

ERIC Educational Resources Information Center

Trevors, J. T.

1998-01-01

Examines the role mistakes play in the molecular evolution of bacteria. Discusses the interacting physical, chemical, and biological factors that cause changes in DNA and play a role in prokaryotic evolution. (DDR)

Health and life insurance as an alternative to malpractice tort law

PubMed Central

2010-01-01

Background Tort law has legitimate social purposes of deterrence, punishment and compensation, but medical tort law does none of these well. Tort law could be counterproductive in medicine, encouraging costly defensive practices that harm some patients, restricting access to care in some settings and discouraging innovation. Discussion Patients might be better served by purchasing combined health and life insurance policies and waiving their right to pursue malpractice claims. The combined policy should encourage the insurer to profit by inexpensively delaying policyholders' deaths. A health and life insurer would attempt to minimize mortal risks to policyholders from any cause, including medical mistakes and could therefore pursue systematic quality improvement efforts. If policyholders trust the insurer to seek, develop and reward genuinely effective care; identify, deter and remediate poor care; and compensate survivors through the no-fault process of paying life insurance benefits, then tort law is largely redundant and the right to sue may be waived. If expensive defensive medicine can be avoided, that savings alone could pay for fairly large life insurance policies. Summary Insurers are maligned largely because of their logical response to incentives that are misaligned with the interests of patients and physicians in the United States. Patient, provider and insurer incentives could be realigned by combining health and life insurance, allowing the insurer to use its considerable information access and analytic power to improve patient care. This arrangement would address the social goals of malpractice torts, so that policyholders could rationally waive their right to sue. PMID:20525190

Health and life insurance as an alternative to malpractice tort law.

PubMed

Sumner, Walton

2010-06-02

Tort law has legitimate social purposes of deterrence, punishment and compensation, but medical tort law does none of these well. Tort law could be counterproductive in medicine, encouraging costly defensive practices that harm some patients, restricting access to care in some settings and discouraging innovation. Patients might be better served by purchasing combined health and life insurance policies and waiving their right to pursue malpractice claims. The combined policy should encourage the insurer to profit by inexpensively delaying policyholders' deaths. A health and life insurer would attempt to minimize mortal risks to policyholders from any cause, including medical mistakes and could therefore pursue systematic quality improvement efforts. If policyholders trust the insurer to seek, develop and reward genuinely effective care; identify, deter and remediate poor care; and compensate survivors through the no-fault process of paying life insurance benefits, then tort law is largely redundant and the right to sue may be waived. If expensive defensive medicine can be avoided, that savings alone could pay for fairly large life insurance policies. Insurers are maligned largely because of their logical response to incentives that are misaligned with the interests of patients and physicians in the United States. Patient, provider and insurer incentives could be realigned by combining health and life insurance, allowing the insurer to use its considerable information access and analytic power to improve patient care. This arrangement would address the social goals of malpractice torts, so that policyholders could rationally waive their right to sue.

What can health care marketing learn from bank marketing?

PubMed

Mindak, W A

1988-01-01

A useful technique in assessing opportunities for international marketers is called "lead lag" analysis. It suggests that one can predict developments, such as demand patterns, in one country by looking at an analogous country. Applying such a technique to the domestic scene, what could we predict about the development and application of marketing to the health care sector if we looked at an analogous service such as banking? Many experts believe that health care is following in the footsteps of banking and point to environmental similarities such as changes in government regulation, new forms of nontraditional competition, increased concern about retail sectors, and pressures on scarce resources. Are there lessons that health care marketers can learn from bankers that might help them avoid some false starts or expensive mistakes?

Governance of nanotechnology and nanomaterials: principles, regulation, and renegotiating the social contract.

PubMed

Kimbrell, George A

2009-01-01

Good governance for nanotechnology and nanomaterials is predicated on principles of general good governance. This paper discusses on what lessons we can learn from the oversight of past emerging technologies in formulating these principles. Nanotechnology provides us a valuable opportunity to apply these lessons and a duty to avoid repeating past mistakes. To do that will require mandatory regulation, grounded in precaution, that takes into account the uniqueness of nanomaterials. Moreover, this policy dialogue is not taking place in a vacuum. In applying the lessons of the past, nanotechnology provides a window to renegotiate our public's social contract on chemicals, health, the environment, and risks. Emerging technologies illuminate structural weaknesses, providing a crucial chance to ameliorate lingering regulatory inadequacies and provide much needed updates of existing laws.

Reporting Research: A Biologist's Guide to Articles, Talks, and Posters

NASA Astrophysics Data System (ADS)

Clymo, R. S.

2014-12-01

Want to learn how to present your research successfully? This practical guide for students and postdoctoral scholars offers a unique step-by-step approach to help you avoid the worst, yet most common, mistakes in biology communication. Covering irritants such as sins of ambiguity, circumlocution, inconsistency, vagueness and verbosity, misuse of words and quantitative matters, it also provides guidance to design your next piece of work effectively. Learn how to write scientific articles and get them published, prepare posters and talks that will capture your audience and develop a critical attitude towards your own work as well as that of your colleagues. With numerous practical examples, comparisons among disciplines, valuable tips and real-life anecdotes, this must-read guide will be a valuable resource to both new graduate students and their supervisors.

Composite correlation filter for O-ring detection in stationary colored noise

NASA Astrophysics Data System (ADS)

Hassebrook, Laurence G.

2009-04-01

O-rings are regularly replaced in aircraft and if they are not replaced or if they are installed improperly, they can result in catastrophic failure of the aircraft. It is critical that the o-rings be packaged correctly to avoid mistakes made by technicians during routine maintenance. For this reason, fines may be imposed on the o-ring manufacturer if the o-rings are packaged incorrectly. That is, a single o-ring must be packaged and labeled properly. No o-rings or more than one o-ring per package is not acceptable. We present an industrial inspection system based on real-time composite correlation filtering that has successfully solved this problem in spite of opaque paper o-ring packages. We present the system design including the composite filter design.

Managing change isn't good enough.

PubMed

South, S F

1999-01-01

One lesson learned from past reengineering is that to be successful in the next decade, organizations will need to create and lead transformation, not just manage the process. Two critical aspects of transformation are that it is a process and that it requires leadership. The "five Cs" of transformation are imperative: create the vision, create the plan, communicate the vision and the plan, cultivate motivated and empowered stakeholders, and cement change in the organization's culture. Business skills, the ability to lead others, and the ability to forge and maintain relationships are needed for effective leadership. For successful transformation, businesses must avoid the mistakes made in the past decade, including too much complacency, too little and/or inappropriate communication, and underestimating the importance of vision and leadership to the transformation effort.

Curation, Spacecraft Recovery and Preliminary Examination for the Stardust Mission: A Perspective from the Curatorial Facility

NASA Technical Reports Server (NTRS)

Zolensky, Michael; Nakamura-Messenger, Keiko; Fletcher, Lisa; See, Thomas

2008-01-01

We briefly describe some of the challenges to the Stardust mission, curation and sample preliminary analysis, from the perspective of the Curation Office at the Johnson Space Center. Our goal is to inform persons planning future sample returns, so that they may learn from both our successes and challenges (and avoid some of our mistakes). The Curation office played a role in the mission from its inception, most critically assisting in the design and implementation of the spacecraft contamination control plan, and in planning and documenting the recovery of the spacecraft reentry capsule in Utah. A unique class 100 cleanroom was built to maintain the returned comet and interstellar samples in clean comfort, and to permit dissection and allocation of samples for analysis.

The Expert Project Management System (EPMS)

NASA Technical Reports Server (NTRS)

Silverman, Barry G.; Diakite, Coty

1986-01-01

Successful project managers (PMs) have been shown to rely on 'intuition,' experience, and analogical reasoning heuristics. For new PMs to be trained and experienced PMs to avoid repeating others' mistakes, it is necessary to make the knowledge and heuristics of successful PMs more widely available. The preparers have evolved a model of PM thought processes over the last decade that is now ready to be implemented as a generic PM aid. This aid consists of a series of 'specialist' expert systems (CRITIC, LIBRARIAN, IDEA MAN, CRAFTSMAN, and WRITER) that communicate with each other via a 'blackboard' architecture. The various specialist expert systems are driven to support PM training and problem solving since any 'answers' they pass to the blackboard are subjected to conflict identification (AGENDA FORMULATOR) and GOAL SETTER inference engines.

[Evidence-based medicine: modern scientific methods for determining usefulness].

PubMed

Schmidt, J G

1999-01-01

For quite some time, clinical epidemiology has introduced the art of critical appraisal of evidence as well as the methods of how to design sound clinical studies and trials. Almost unnoticed by most medical institutions a new hierarchy of evidence has emerged which puts well thought out trials, able to document unbiased treatment benefit in terms of patient suffering, above pathophysiological theory. Many controlled trials have shown, in the meantime, that the control of laboratory or other kind of pathologies and the correction of anatomical abnormalities do not necessarily mean a benefit for the patient. Concepts relating to this dissection of evidence include: Surrogate fallacy ("cosmetics" of laboratory results or ligament or cartilage "cosmetics" in surgery), confounding (spurious causal relationships), selection bias (comparison with selected groups) as well as lead-time bias (mistaking earlier diagnosis as increase of survival), length bias (overlooking differences in the aggressiveness of diseases as determinants of disease stage distributions) and overdiagnosis bias (mistaking the increasing detection of clinically silent pathologies as improvement of prognosis). Moreover, absolute instead of relative risk reduction needs to be used to measure patient benefit. The incorporation of decision-analysis and of the concepts or clinical epidemiology will improve the efficiency and quality of medicine much more effectively than the sole focus on technical medical performance. Evidence based medicine is the systematic and critical appraisal of medical interventions, based on the understanding how to avoid the fallacies and biases mentioned.

Evaluating the cost of one telehealth application connecting an acute and long-term care setting.

PubMed

Specht, J K; Wakefield, B; Flanagan, J

2001-01-01

This article describes a study of the costs of a pilot telemedicine chronic wound consultation clinic. Cost minimization analysis is the technique used to examine the costs of the clinic. The components of cost analysis include the fixed costs of personnel and equipment and the indirect costs of circuit and line charges. Cost avoidance is also examined. Cost avoidance evaluates what costs were avoided by the use of the telemedicine clinic. Additionally, the cost perspectives of the consulting agency, the referring agency, and the patient are examined. The average cost of a chronic wound consultation was $136.16 (acute care perspective). Costs of a traditional face-to-face consultation, if the residents were transported to the acute care facility would be $246.28. Fifteen telehealth consultations per month were used to determine per consultation costs for line charges and depreciation/maintenance costs. In this pilot study, a cost savings was realized and patients benefited. Increased volume will help to offset the cost of the equipment depreciation and maintenance and make telehealth chronic wound consultations more cost effective.

Development of a low cost pupillometer-eyetracker and applications

NASA Astrophysics Data System (ADS)

Bianchetti, Arturo; Perez, Liliana I.; Comastri, Silvia A.

2013-11-01

The determination of ocular pupil diameter and gaze direction is important in various psychophysical and cognitive tests and can be accomplished using commercial, academic or open-source devices. In this work we develop a table-top pupillometer eyetracker termed Blick, the hardware costs 50 dollars and the software is open source (https://github.com/abianchetti/blick). The hardware is mounted in a portable holder and comprises an illumination system (two infrared LEDs generating 0.13 W/m2 at 22 cm) and a detection system (containing an USB camera, an infrared filter and a 16mm lens system) The software, programmed in C++ using OpenCV and cvblob libraries, processes eye images in real time and supplies plots and tables of pupil diameter and gaze direction and a video of the eye. As applications, capturing the right eye of six young emmetropes and after performing the pixel-mm and homographic calibrations (required to determine diameter in mm and gaze direction), we conduct three tests. The corresponding tasks are to detect mistakes in three series of four poker cards, to recognize letters F between distractors and to write a sentence via eye movements using Blick as eye tracker and the tool Dasher (MacKayśs Cambridge Group). We obtain that Blicḱs performance is satisfactory (errors being 0.05 mm in pupil diameter and 1 degree in gaze direction); that there are slight pupil dilations when subjects used to playing cards find mistakes and when some subjects find targets and, finally, that Blick can be employed as eyetracker to allow communication of disabled persons.

Proactive Security Testing and Fuzzing

NASA Astrophysics Data System (ADS)

Takanen, Ari

Software is bound to have security critical flaws, and no testing or code auditing can ensure that software is flaw-less. But software security testing requirements have improved radically during the past years, largely due to criticism from security conscious consumers and Enterprise customers. Whereas in the past, security flaws were taken for granted (and patches were quietly and humbly installed), they now are probably one of the most common reasons why people switch vendors or software providers. The maintenance costs from security updates often add to become one of the biggest cost items to large Enterprise users. Fortunately test automation techniques have also improved. Techniques like model-based testing (MBT) enable efficient generation of security tests that reach good confidence levels in discovering zero-day mistakes in software. This technique is called fuzzing.

How Stereotype Threat Affects Healthy Older Adults' Performance on Clinical Assessments of Cognitive Decline: The Key Role of Regulatory Fit.

PubMed

Barber, Sarah J; Mather, Mara; Gatz, Margaret

2015-11-01

Stereotype threat can impair older adults' performance on clinical assessments for cognitive decline. We examined why this occurs. Based upon the regulatory focus account of stereotype threat, we predicted that the effects of stereotype threat should depend upon the assessments' reward structure. Stereotype threat should be associated with poor performance when the assessment emphasizes gaining correct answers, but not when it emphasizes avoiding mistakes. Healthy older adults completed a series of mental status examinations. Half of the participants completed these examinations under stereotype threat about their cognitive abilities. Monetary incentives were also manipulated. For half of the participants correct responding led to gains. For the remaining participants incorrect responding/forgetting led to losses. Consistent with the regulatory focus account, stereotype threat was associated with poor performance when the mental status examinations had a gains-based structure, but not when they had a losses-based structure. Older adults respond to stereotype threat by becoming vigilant to avoid the losses that will make them their worst. Researchers and clinicians can capitalize on this motivational change to combat stereotype threat's negative effects. By using a loss-avoidance frame, stereotype threat's negative effects can be attenuated or even eliminated. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cost effectiveness and budget impact of natalizumab in patients with relapsing multiple sclerosis.

PubMed

Chiao, Evelyn; Meyer, Kellie

2009-06-01

Disease-modifying therapy (DMT) is the largest single-cost item that contributes to the total per-patient cost of multiple sclerosis (MS), a disabling disorder of the central nervous system. Natalizumab is the most recent DMT to be approved for the treatment of relapsing MS and may be an attractive alternative to interferon beta and glatiramer acetate (GA). To determine from the perspective of a United States payer (1) the incremental cost effectiveness of natalizumab compared with other DMTs and (2) the budgetary impact of utilization of natalizumab for the treatment of relapsing MS. A combined cost effectiveness and budget impact model was developed. Model inputs were drug acquisition costs (wholesale acquisition cost), costs of drug administration and monitoring, costs of treating relapses, anticipated reduction in relapse rates after 2 years of therapy, and estimated market utilization of natalizumab. Outcomes included total 2-year costs of therapy per patient, costs per relapse avoided for each treatment, and overall 2-year costs to the health plan and per member per month (PMPM) costs. Drug acquisition costs are in 2008 US dollars, and all other costs were inflated to 2008 US dollars when necessary. Univariate sensitivity analyses were performed to determine the model inputs with the greatest influence on the cost per relapse avoided for natalizumab. The overall 2-year cost of therapy per patient was $72,120 for natalizumab, $56,790 for intramuscular (IM) interferon beta-1a (IFNbeta-1a), $56,773 for IFNbeta-1b, $57,180 for GA, and $58,538 for subcutaneous (SC) IFNbeta-1a. The cost per relapse avoided was lowest for natalizumab at $56,594, followed by $87,791 for IFNbeta-1b, $93,306 for IM IFNbeta-1a, $96,178 for SC IFNbeta-1a, and $103,665 for GA. The incremental cost-effectiveness ratios of natalizumab relative to IM IFNbeta-1a, IFNbeta-1b, GA, and SC IFNbeta-1a were $23,029, $24,452, $20,671, and $20,403 per additional relapse avoided, respectively. An increase in natalizumab utilization to 9% resulted in an increase of approximately $61 760 in total 2-year costs to a hypothetical health plan of 1 million members, or a $0.003 PMPM incremental cost. Univariate sensitivity analyses indicated that the model inputs with the most influence on cost per relapse avoided for natalizumab were the weighted average number of relapses before treatment and the anticipated relative relapse rate reduction. Natalizumab was the most cost-effective therapy as measured by total cost per relapse avoided, not withstanding a higher drug acquisition cost versus other DMTs. Entry of natalizumab to the market is likely to result in a minimal increase in health-plan costs on a PMPM basis. Limitations of the study include the use of a surrogate measure, relapse avoided, as an outcome measure; also, adverse events were not included in the model.

Neural Mechanisms for Adaptive Learned Avoidance of Mental Effort.

PubMed

Mitsuto Nagase, Asako; Onoda, Keiichi; Clifford Foo, Jerome; Haji, Tomoki; Akaishi, Rei; Yamaguchi, Shuhei; Sakai, Katsuyuki; Morita, Kenji

2018-02-05

Humans tend to avoid mental effort. Previous studies have demonstrated this tendency using various demand-selection tasks; participants generally avoid options associated with higher cognitive demand. However, it remains unclear whether humans avoid mental effort adaptively in uncertain and non-stationary environments, and if so, what neural mechanisms underlie this learned avoidance and whether they remain the same irrespective of cognitive-demand types. We addressed these issues by developing novel demand-selection tasks where associations between choice options and cognitive-demand levels change over time, with two variations using mental arithmetic and spatial reasoning problems (29:4 and 18:2 males:females). Most participants showed avoidance, and their choices depended on the demand experienced on multiple preceding trials. We assumed that participants updated the expected cost of mental effort through experience, and fitted their choices by reinforcement learning models, comparing several possibilities. Model-based fMRI analyses revealed that activity in the dorsomedial and lateral frontal cortices was positively correlated with the trial-by-trial expected cost for the chosen option commonly across the different types of cognitive demand, and also revealed a trend of negative correlation in the ventromedial prefrontal cortex. We further identified correlates of cost-prediction-error at time of problem-presentation or answering the problem, the latter of which partially overlapped with or were proximal to the correlates of expected cost at time of choice-cue in the dorsomedial frontal cortex. These results suggest that humans adaptively learn to avoid mental effort, having neural mechanisms to represent expected cost and cost-prediction-error, and the same mechanisms operate for various types of cognitive demand. SIGNIFICANCE STATEMENT In daily life, humans encounter various cognitive demands, and tend to avoid high-demand options. However, it remains unclear whether humans avoid mental effort adaptively under dynamically changing environments, and if so, what are the underlying neural mechanisms and whether they operate irrespective of cognitive-demand types. To address these issues, we developed novel tasks, where participants could learn to avoid high-demand options under uncertain and non-stationary environments. Through model-based fMRI analyses, we found regions whose activity was correlated with the expected mental effort cost, or cost-prediction-error, regardless of demand-type, with overlap or adjacence in the dorsomedial frontal cortex. This finding contributes to clarifying the mechanisms for cognitive-demand avoidance, and provides empirical building blocks for the emerging computational theory of mental effort. Copyright © 2018 the authors.

Prospective multi-center study for quantification of chemotherapies and CTX-related direct medication costs avoided by use of biomarkers uPA and PAI-1 in primary breast cancer.

PubMed

Jacobs, Volker R; Augustin, Doris; Wischnik, Arthur; Kiechle, Marion; Höss, Cornelia; Steinkohl, Oliver; Rack, Brigitte; Kapitza, Thomas; Krase, Peter

2013-08-01

Biomarkers uPA/PAI-1 as recommended by ASCO and AGO are used in primary breast cancer to avoid unnecessary CTX in medium risk-recurrence patients. This study verified how many CTX cycles and CTX-related direct medication costs can be avoided by uPA/PAI-1 testing. A prospective, non-interventional, multi-center study was performed among six Certified Breast Centers to analyze application of uPA/PAI-1 and consecutive decision-making. CTX avoided were identified and direct costs for CTX, CTX-related concomitant medication and febrile neutropenia (FN) prophylaxis with G-CSF calculated. In n = 93 breast cancers n = 35 CTX (37.6%) with 210 CTX cycles were avoided according to uPA/PAI-1 test result. uPA/PAI-1 testing saved direct medication costs for CTX of 177,453 €, CTX-related concomitant medication of 27,482 € and FN prophylaxis of 20,599 €, overall 225,534 €. At test costs at 287.50 € uPA/PAI-1 testing resulted in additional costs of 26,737.50 €. uPA/PAI-1 has proven to be cost-effective at a return-on-investment ratio of 8.4:1. Indirect cost savings further increase this ROI. These results support decision-making for cost-effective diagnostics and therapy in breast cancer. Copyright © 2013 Elsevier Ltd. All rights reserved.

Risk management: correct patient and specimen identification in a surgical pathology laboratory. The experience of Infermi Hospital, Rimini, Italy.

PubMed

Fabbretti, G

2010-06-01

Because of its complex nature, surgical pathology practice is prone to error. In this report, we describe our methods for reducing error as much as possible during the pre-analytical and analytical phases. This was achieved by revising procedures, and by using computer technology and automation. Most mistakes are the result of human error in the identification and matching of patient and samples. To avoid faulty data interpretation, we employed a new comprehensive computer system that acquires all patient ID information directly from the hospital's database with a remote order entry; it also provides label and request forms via-Web where clinical information is required before sending the sample. Both patient and sample are identified directly and immediately at the site where the surgical procedures are performed. Barcode technology is used to input information at every step and automation is used for sample blocks and slides to avoid errors that occur when information is recorded or transferred by hand. Quality control checks occur at every step of the process to ensure that none of the steps are left to chance and that no phase is dependent on a single operator. The system also provides statistical analysis of errors so that new strategies can be implemented to avoid repetition. In addition, the staff receives frequent training on avoiding errors and new developments. The results have been shown promising results with a very low error rate (0.27%). None of these compromised patient health and all errors were detected before the release of the diagnosis report.

Cost-outcome description of clinical pharmacist interventions in a university teaching hospital.

PubMed

Gallagher, James; Byrne, Stephen; Woods, Noel; Lynch, Deirdre; McCarthy, Suzanne

2014-04-17

Pharmacist interventions are one of the pivotal parts of a clinical pharmacy service within a hospital. This study estimates the cost avoidance generated by pharmacist interventions due to the prevention of adverse drug events (ADE). The types of interventions identified are also analysed. Interventions recorded by a team of hospital pharmacists over a one year time period were included in the study. Interventions were assigned a rating score, determined by the probability that an ADE would have occurred in the absence of an intervention. These scores were then used to calculate cost avoidance. Net cost benefit and cost benefit ratio were the primary outcomes. Categories of interventions were also analysed. A total cost avoidance of €708,221 was generated. Input costs were calculated at €81,942. This resulted in a net cost benefit of €626,279 and a cost benefit ratio of 8.64: 1. The most common type of intervention was the identification of medication omissions, followed by dosage adjustments and requests to review therapies. This study provides further evidence that pharmacist interventions provide substantial cost avoidance to the healthcare payer. There is a serious issue of patient's regular medication being omitted on transfer to an inpatient setting in Irish hospitals.

The costs of avoiding environmental impacts from shale-gas surface infrastructure.

PubMed

Milt, Austin W; Gagnolet, Tamara D; Armsworth, Paul R

2016-12-01

Growing energy demand has increased the need to manage conflicts between energy production and the environment. As an example, shale-gas extraction requires substantial surface infrastructure, which fragments habitats, erodes soils, degrades freshwater systems, and displaces rare species. Strategic planning of shale-gas infrastructure can reduce trade-offs between economic and environmental objectives, but the specific nature of these trade-offs is not known. We estimated the cost of avoiding impacts from land-use change on forests, wetlands, rare species, and streams from shale-energy development within leaseholds. We created software for optimally siting shale-gas surface infrastructure to minimize its environmental impacts at reasonable construction cost. We visually assessed sites before infrastructure optimization to test whether such inspection could be used to predict whether impacts could be avoided at the site. On average, up to 38% of aggregate environmental impacts of infrastructure could be avoided for 20% greater development costs by spatially optimizing infrastructure. However, we found trade-offs between environmental impacts and costs among sites. In visual inspections, we often distinguished between sites that could be developed to avoid impacts at relatively low cost (29%) and those that could not (20%). Reductions in a metric of aggregate environmental impact could be largely attributed to potential displacement of rare species, sedimentation, and forest fragmentation. Planners and regulators can estimate and use heterogeneous trade-offs among development sites to create industry-wide improvements in environmental performance and do so at reasonable costs by, for example, leveraging low-cost avoidance of impacts at some sites to offset others. This could require substantial effort, but the results and software we provide can facilitate the process. © 2016 Society for Conservation Biology.

Popper's Epistemology as a Pedagogic and Didactic Principle, or: Let Them Make More "Mistakes."

ERIC Educational Resources Information Center

Derkse, W.

1981-01-01

Describes the relationship of Popper's theory of knowledge to chemistry instruction. Suggests that students be allowed to learn from their mistakes and presents five experiments with an implicit falsification purpose. (JN)

What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation

PubMed Central

Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin

2016-01-01

Objective This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Design Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Setting Champlain health region in Eastern Ontario, Canada. Population Primary care providers and specialists registered to use the eConsult service. Main outcome measures Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. Results A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Conclusions Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. PMID:27338880

Breakdown Cause and Effect Analysis. Case Study

NASA Astrophysics Data System (ADS)

Biały, Witold; Ružbarský, Juraj

2018-06-01

Every company must ensure that the production process proceeds without interferences. Within this article, the author uses the term "interferences" in reference to unplanned stoppages caused by breakdowns. Unfortunately, usually due to machine operators' mistakes, machines break, which causes stoppages thus generating additional costs for the company. This article shows a cause and effect analysis of a breakdown in a production process. The FMEA as well as quality management tools: the Ishikawa diagram and Pareto chart were used for the analysis. Correction measures were presented which allowed for a significant reduction in the number of stoppages caused by breakdowns.

Recruitment versus retention: why working to keep good employees is worth the effort.

PubMed

Van, Allen

2008-01-01

The tight demand for medical professionals has many organizations lowering hiring standards in desperate hopes of filling long-vacant positions, but one physician recruiter cautions practice managers against making that mistake. Instead, maintaining high standards and working from the outset with a strategic plan to retain valued employees is the best long-term solution. Breaking down the time and cost investment, and looking at the consequences of both good and bad hires, there's no doubt that waiting longer for the right candidate beats settling for the next warm body that walks through the door.

Operation Noble Eagle and the Use of Combat Air Patrols for Homeland Defense

DTIC Science & Technology

2008-12-01

aviation security , together with the absence of terrorist attacks on the homeland and of no actionable intelligence indicating an imminent air threat in America. The following sub-areas were researched to help evaluate and recommend changes to the current ONE CAP policy: the history of air defense in America; U.S. air defense mistakes on 9/11 and the evolution of ONE; improvements in the intelligence community and aviation security since 9/11; specific threats to aviation and the risk of another 9/11-style attack in the United States; and the cost and

Avoid costly litigation: ten steps to implementing lawful hiring practices.

PubMed

Holmes, Judith H

2004-01-01

A malpractice claim or suit can have a devastating effect on a physician's practice and personal life. What is often overlooked is that an employment-related suit or EEOC charge also can extract a heavy toll, personally, professionally, and financially. The number of employment-related suits and claims has risen dramatically in the last few years. According to recent enforcement and litigation statistics released by the U.S. Equal Employment Opportunity Commission (EEOC) (1), the total discrimination charges filed by individuals against their employers increased last year to 80,840--the highest level since the mid-1990's. According to the EEOC data, in 2001, employers paid $248 million in connection with charges of discrimination filed with the EEOC by job applicants, employees, and former employees. Employers paid an additional $47 million to the EEOC in connection with lawsuits filed against employers by the EEOC (2). This does not include the millions of dollars employers were forced to pay in settlements, judgments, costs, and attorney's fees incurred in connection with employment-related lawsuits filed in state and federal courts during the same period of time. Employment-related litigation is on the rise, and the healthcare industry is not immune. Physicians as employers can be a target for a wide range of employment-related claims and suits, such as breach of contract, invasion of privacy, sex, race, age, religious and age discrimination, and negligent hiring, just to name a few. The number of jury verdicts rendered against employers is increasing and the verdict awards are often staggering. In addition, defending these suits can be as expensive as defending a complicated malpractice suit. Even worse, employment discrimination suits and charges are generally not covered by malpractice, D & O, or general liability insurance policies, leaving the physician to cope with the financial burden of judgments, settlements, attorney's fees and litigation costs. Most employment-related disputes that lead to costly litigation would never have arisen if the employer had implemented more effective employment practices. Hiring mistakes in particular cause many costly legal battles. This article identifies legal issues that precipitate litigation and suggests ten steps physicians can take to implement lawful hiring practices that will reduce the risk of costly employment suits while improving office efficiency, morale, and productivity. NOTE: This article is intended as an overview of lawful hiring strategies, and is not a substitute for legal advice from experienced employment counsel. Applicable laws vary from state to state and appropriate procedures may depend on specific factual situations. This article is not, and should not be construed as, legal advice.

Self-Compassion and Relationship Maintenance: The Moderating Roles of Conscientiousness and Gender

PubMed Central

Baker, Levi; McNulty, James K.

2010-01-01

Should intimates respond to their interpersonal mistakes with self-criticism or with self-compassion? Although it is reasonable to expect self-compassion to benefit relationships by promoting self-esteem, it is also reasonable to expect self-compassion to hurt relationships by removing intimates’ motivation to correct their interpersonal mistakes. Two correlational studies, 1 experiment, and 1 longitudinal study demonstrated that whether self-compassion helps or hurts relationships depends on the presence versus absence of dispositional sources of the motivation to correct interpersonal mistakes. Among men, the implications of self-compassion were moderated by conscientiousness. Among men high in conscientiousness, self-compassion was associated with greater motivation to correct interpersonal mistakes (Studies 1 and 3), observations of more-constructive problem-solving behaviors (Study 2), reports of more accommodation (Study 3), and fewer declines in marital satisfaction that were mediated by decreases in interpersonal problem severity (Study 4); among men low in conscientiousness, self-compassion was associated with these outcomes in the opposite direction. Among women, in contrast, likely because women are inherently more motivated than men to preserve their relationships for cultural and/or biological reasons, self-compassion was never harmful to the relationship. Instead, women’s self-compassion was positively associated with the motivation to correct their interpersonal mistakes (Study 1) and changes in relationship satisfaction (Study 4), regardless of conscientiousness. Accordingly, theoretical descriptions of the implications of self-promoting thoughts for relationships may be most complete to the extent that they consider the presence versus absence of other sources of the motivation to correct interpersonal mistakes. PMID:21280964

Self-compassion and relationship maintenance: the moderating roles of conscientiousness and gender.

PubMed

Baker, Levi R; McNulty, James K

2011-05-01

Should intimates respond to their interpersonal mistakes with self-criticism or with self-compassion? Although it is reasonable to expect self-compassion to benefit relationships by promoting self-esteem, it is also reasonable to expect self-compassion to hurt relationships by removing intimates' motivation to correct their interpersonal mistakes. Two correlational studies, 1 experiment, and 1 longitudinal study demonstrated that whether self-compassion helps or hurts relationships depends on the presence versus absence of dispositional sources of the motivation to correct interpersonal mistakes. Among men, the implications of self-compassion were moderated by conscientiousness. Among men high in conscientiousness, self-compassion was associated with greater motivation to correct interpersonal mistakes (Studies 1 and 3), observations of more constructive problem-solving behaviors (Study 2), reports of more accommodation (Study 3), and fewer declines in marital satisfaction that were mediated by decreases in interpersonal problem severity (Study 4); among men low in conscientiousness, self-compassion was associated with these outcomes in the opposite direction. Among women, in contrast, likely because women are inherently more motivated than men to preserve their relationships for cultural and/or biological reasons, self-compassion was never harmful to the relationship. Instead, women's self-compassion was positively associated with the motivation to correct their interpersonal mistakes (Study 1) and changes in relationship satisfaction (Study 4), regardless of conscientiousness. Accordingly, theoretical descriptions of the implications of self-promoting thoughts for relationships may be most complete to the extent that they consider the presence versus absence of other sources of the motivation to correct interpersonal mistakes. (c) 2011 APA, all rights reserved.

PURPA 210 avoided cost rates: Economic and implementation issues

DOE Office of Scientific and Technical Information (OSTI.GOV)

Devine, M.D.; Chartock, M.A.; Gunn, E.M.

The purpose of Section 210 of the Public Utilities Regulatory Policies Act (PURPA) was to promote the utilization of waste and renewable fuels and cogeneration processes for increasing electric power supplies. It represents a radical change in policy by allowing financially unregulated parties to generate power in ''qualifying facilities'' and by requiring utilities to purchase this power at the utilities' marginal (or ''avoided'') cost. PURPA 210 has clearly had a major impact as measured by the actual and proposed number of new qualifying facilities; however, implementation has been difficult due to the adversarial nature of the process for negotiating ormore » setting the avoided cost rates. This paper reviews the pertinent PURPA rules and regulations, analyzes the status of current avoided cost rates that have been established, and discusses implementation issues and options for resolving those issues.« less

48 CFR 750.7106-3 - Mistakes.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Mistakes. 750.7106-3 Section 750.7106-3 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT CONTRACT MANAGEMENT EXTRAORDINARY CONTRACTUAL ACTIONS Extraordinary Contractual Actions To Protect Foreign Policy...

Learning from Our Mistakes.

ERIC Educational Resources Information Center

Perkinson, Henry J.

1979-01-01

Discusses the theories of leading educational theorists of the twentieth century, including John Dewey, Jean Piaget, B. F. Skinner, Maria Montessori, Carl Rogers, and A. S. Neill, to show that they have shared a common theory--that of "learning from our mistakes." (GT)

Managing medical mistakes: ideology, insularity and accountability among internists-in-training.

PubMed

Mizrahi, T

1984-01-01

By the end of graduate medical training, novice internists (collectively known as the housestaff) were initiated into the experience of either having done something to a patient which had a deleterious consequence or else having witnessed colleagues do the same. When these events occurred, the housestaff engaged in social-psychological processes, utilizing a variety of coping mechanisms and in-group practices to manage these mishaps. Three major mechanisms were utilized by the housestaff for defining and defending the various mishaps which frequently occurred: denial, discounting and distancing. Denial consisted of three components: the negation of the concept of error by defining the practice of medicine as an art with 'gray areas', the repression of actual mistakes by forgetting them and the redefinition of mistakes to non-mistakes. Discounting included those defenses which externalized the blame; namely mistakes which were due to circumstances beyond their control. These included: blaming the bureaucratic system outside of medicine; blaming superiors or subordinates within internal medicine; blaming the disease and blaming the patient. When they could not longer deny or discount a mistake because of its magnitude, they utilized distancing techniques. Not withstanding this shared elaborate repertoire of denial, discounting and distancing, it was found that profound doubts and even guilt remained for many housestaff. These troublesome feelings neither easily nor automatically resolved themselves. Interspersed among their defenses were fundamental questions of culpability and responsibility as they vacillated between self and other blame. For many 'the case was never closed', even as they terminated formal training, a point neglected in the medical and sociological literature. Little in their 3 year graduate program allowed them to work through the attendant vulnerability and ambiguity accompanying the managing of mistakes. Hence, there were maladaptive aspects of the collectively acquired defense mechanisms. The whole system of accountability during graduate medical specialty training was found to be a variable, and at times, contradictory process. The housestaff ultimately sees itself as the sole arbiter of mistakes and their adjudication. Housestaffers come to feel that nobody can judge them or their decisions, least of all their patients. As they progress through training even internal accountability cohorts--the Department of Medicine, teaching faculty and peers--are discounted to varying degrees. They have developed a strong ideology justifying their jealously guarded autonomy.(ABSTRACT TRUNCATED AT 400 WORDS)

Evaluating the ability of dental technician students and graduate dentists to match tooth color.

PubMed

Sinmazisik, Gulden; Trakyali, Goksu; Tarcin, Bilge

2014-12-01

The ability of dental technician students to match tooth shade with the Vita 3D-Master shade guide and Toothguide Training Box has not been investigated. The purpose of this study was to evaluate and compare the shade-matching ability of dental technician students and graduate dentists using the Vita 3D-Master shade guide. Twenty-nine dental technician students (DTS group) and 30 graduate dentists (GD group) participated in this study. The Toothguide Training Box (TTB) was used to train the participants and test their shade-matching abilities. Shade-matching ability was evaluated with 3 exercises and a final test, all of which are components of the TTB. The number of mistakes for each participant for value (L), chroma (c), and hue (h) were recorded during the exercises and the final test, and the mistake ratios were calculated. Color difference (ΔE) values for each shade were calculated from the L*, a*, and b* values of the Vita 3D-Master shade guide for each participant in both groups. The Mann-Whitney U test was used to determine statistically significant differences between the L, c, and h mistake ratios of the 2 groups, and the Student t test was used to determine statistically significant differences between the final test scores and the ΔE values of the groups (α=.05). The mistake ratio for L in the GD group was significantly higher than that of the DTS group (P<.05), whereas the mistake ratio for h in the DTS group was higher (P<.001). No significant differences were observed between the groups regarding the mistake ratios for c (P>.05). With regard to the final test scores and the ΔE values, no significant differences were found between the groups (P<.001), and the DTS group received higher scores than the GD group (912 and 851). The mean ΔE values for the DTS and GD groups were 1.72 and 2.92. DTSs made more mistakes in the h parameter than GDs, and GDs made more mistakes in the L parameter than DTSs. With regard to the final test scores and the ΔE values, DTSs were more successful in shade matching than GDs. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

The malpractice liability of radiology reports: minimizing the risk.

PubMed

Srinivasa Babu, Aparna; Brooks, Michael L

2015-01-01

The art and science of interpreting radiologic examinations, an ability that is acquired over years of training, is on display in every radiology report. It is vital that these reports be crafted so as to both reflect the radiologist's expertise and capability and eliminate any factors that might result in unintended harm to the patient. Unfortunately, a deficient report may result in legal action against the radiologist; thus, a thorough understanding of the litigious potential of the language used in radiology reports is crucial. It is important that ambiguous vocabulary, undefined modifiers, double negatives, and generalizations be avoided. Errors in radiology reports may result from inappropriate terminology, transcription mistakes, or deficient or inadequately documented communication. Critical findings that may have an immediate impact on patient management must be promptly communicated to the referring physician and such communication fully documented. A meticulous and well-written report is the best way for radiologists to care for their patients. In addition, a well-worded report can be the deciding factor in a successful defense against a malpractice claim. Understanding the legal implications of radiology reports will enable radiologists to develop strategies for avoiding malpractice suits. (©)RSNA, 2015.

A role for the striatum in regret-related choice repetition

PubMed Central

Nicolle, Antoinette; Bach, Dominik R.; Driver, Jon; Dolan, Raymond J.

2011-01-01

‘Regret aversion’ is proposed to explain a tendency to avoid future choices that have induced past regret. However, regret might also motivate us to repeat previous regret-related choices to make up for their previous selection, a behavior resembling ‘chasing’ in the context of gambling. In the current experiment we acquired fMRI brain data while participants placed monetary bets on repeated gambles. Behaviorally, participants showed a tendency to repeat previously regret-related choices (operationalized as those leading to an outcome worse than what might have been), an effect restricted to early runs of the task. At gamble outcome, we show a reduction in ventral striatal activity for regret-related, relative to relief-related, outcomes. Critically, this modulation was only seen when subjects were responsible for the bet choice. Activity in dorsal striatum was associated with an influence of previous regret on participants’ subsequent choices, evident in increased activity when regret-related choices were repeated, relative to avoided, on the next trial. Our findings indicate that regret can lead to choice repetition as if seeking to make up for our mistakes and in so doing may lead to subsequent chasing behavior. PMID:20433245

[Risk management in health care systems: the new legislative orientations in medical civil responsibility].

PubMed

Tomassini, A; Signorelli, C; Colzani, E

2004-01-01

The recent radical change in the relationships between physicians and patients has increased the frequency of malpractice. Consequently, on one hand, many physicians got used to avoiding any possible risk of denunciation by applying the so called "defensive medicine", while on the other hand, the insurance companies raised the prices of their premiums for policies concerning civil responsibility of health operators. In order to avoid this "vicious circle", some health structures created Units for the Risk Management related to malpractice, while others took advantage of the collaboration of Associations for Patients' Rights to create database about the most frequent medical mistakes. The need for a legislative change has been accepted by the Parliament which expects with the proposal n.108 (approved in spring 2002 by the Commission for Hygiene and Health of the Senate) to attribute the civil responsibility of the physicians to the hospitals (both private and public) for which they work, to constitute a Register of experts and to accelerate the legal disputes. The problem is complex and still to be solved, but it seems that time for a strong intervention in order to improve the situation has to come.

Current and future avoidable cost of smoking--estimates for Sweden 2007.

PubMed

Bolin, Kristian; Borgman, Benny; Gip, Christina; Wilson, Koo

2011-11-01

To estimate current and future avoidable smoking-attributable costs in Sweden for the year 2007. Disease specific smoking-attributable proportions were calculated for Swedish smoking patterns and applied to estimate costs for smoking-related diseases based on data from public registers. Avoidable future effects of smoking were calculated employing a Markov simulation model. The estimated total cost in 2007 was USD 1.6 billion, or USD 181 per capita. Healthcare (direct) cost accounted for 30% of the total cost. The number of deaths was 97 per 100,000 inhabitants (79 in 2001); the number of years of potential life lost 1,227 per 100,000 inhabitants (1012 in 2001); and the number of years of potential productive life lost 226 (185 in 2001) per 100,000 inhabitants. Avoidable future lifetime costs, per 100,000 inhabitants, amounted to USD 19 million (healthcare), 14,000 years of potential life lost, corresponding to a present value of USD 158 million. Total avoidable cost of current smoking amounted to USD 16 billion. In spite of declining smoking-prevalence rates during the last 30 years, smoking-attributable deaths increased between 2001 and 2007. The number of life years lost per death decreased somewhat, indicating that the age distribution of those dying shifted further towards older age. Simulations indicate that smoking-cessation among young smokers yields considerable more benefits each year than smoking-cessation among older smokers. The health benefits that accrued in 2007, as a result of declining smoking prevalence since 1980, correspond to more than the total cost of smoking in that year. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Cost-effectiveness of Increasing Access to Contraception during the Zika Virus Outbreak, Puerto Rico, 2016.

PubMed

Li, Rui; Simmons, Katharine B; Bertolli, Jeanne; Rivera-Garcia, Brenda; Cox, Shanna; Romero, Lisa; Koonin, Lisa M; Valencia-Prado, Miguel; Bracero, Nabal; Jamieson, Denise J; Barfield, Wanda; Moore, Cynthia A; Mai, Cara T; Korhonen, Lauren C; Frey, Meghan T; Perez-Padilla, Janice; Torres-Muñoz, Ricardo; Grosse, Scott D

2017-01-01

We modeled the potential cost-effectiveness of increasing access to contraception in Puerto Rico during a Zika virus outbreak. The intervention is projected to cost an additional $33.5 million in family planning services and is likely to be cost-saving for the healthcare system overall. It could reduce Zika virus-related costs by $65.2 million ($2.8 million from less Zika virus testing and monitoring and $62.3 million from avoided costs of Zika virus-associated microcephaly [ZAM]). The estimates are influenced by the contraception methods used, the frequency of ZAM, and the lifetime incremental cost of ZAM. Accounting for unwanted pregnancies that are prevented, irrespective of Zika virus infection, an additional $40.4 million in medical costs would be avoided through the intervention. Increasing contraceptive access for women who want to delay or avoid pregnancy in Puerto Rico during a Zika virus outbreak can substantially reduce the number of cases of ZAM and healthcare costs.

Cost-effectiveness of Increasing Access to Contraception during the Zika Virus Outbreak, Puerto Rico, 2016

PubMed Central

Simmons, Katharine B.; Bertolli, Jeanne; Rivera-Garcia, Brenda; Cox, Shanna; Romero, Lisa; Koonin, Lisa M.; Valencia-Prado, Miguel; Bracero, Nabal; Jamieson, Denise J.; Barfield, Wanda; Moore, Cynthia A.; Mai, Cara T.; Korhonen, Lauren C.; Frey, Meghan T.; Perez-Padilla, Janice; Torres-Muñoz, Ricardo; Grosse, Scott D.

2017-01-01

We modeled the potential cost-effectiveness of increasing access to contraception in Puerto Rico during a Zika virus outbreak. The intervention is projected to cost an additional $33.5 million in family planning services and is likely to be cost-saving for the healthcare system overall. It could reduce Zika virus–related costs by $65.2 million ($2.8 million from less Zika virus testing and monitoring and $62.3 million from avoided costs of Zika virus–associated microcephaly [ZAM]). The estimates are influenced by the contraception methods used, the frequency of ZAM, and the lifetime incremental cost of ZAM. Accounting for unwanted pregnancies that are prevented, irrespective of Zika virus infection, an additional $40.4 million in medical costs would be avoided through the intervention. Increasing contraceptive access for women who want to delay or avoid pregnancy in Puerto Rico during a Zika virus outbreak can substantially reduce the number of cases of ZAM and healthcare costs. PMID:27805547

Optimizing emissions targets for residential recycling programmes: Why 'more' is not necessarily better with respect to diversion.

PubMed

Lakhan, Calvin

2016-11-01

This study highlights the economic and environmental challenges of recycling in Ontario, specifically examining the effect of attempting to increase the emissions target for the province's household recycling programme. The findings from the cost model analysis found that Ontario's Blue Box programme reduces overall carbon emissions by approximately 1.8 million tonnes every year. This study also found that targeting specific materials for recovery could result in a scenario where the province could improve both overall diversion and emissions offsets while reducing material management costs. Under our modelled scenario, as the tonnes of greenhouse gases (GHGs) avoided increases, the system cost per tonne of GHG avoided initial declines. However, after avoiding 2.05 million tonnes of GHGs, the system cost/tonne GHG avoided increases. To achieve an emissions target in excess of 2.05 million tonnes, the province will have to start recycling higher cost non-core materials (composite materials, other plastics, etc.). © The Author(s) 2016.

48 CFR 2014.407-4 - Mistakes after award.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Mistakes after award. 2014.407-4 Section 2014.407-4 Federal Acquisition Regulations System NUCLEAR REGULATORY COMMISSION... concurred in by legal counsel prior to notification of the contractor. ...

Cost as a barrier to accessing dental care: findings from a Canadian population-based study.

PubMed

Thompson, Brandy; Cooney, Peter; Lawrence, Herenia; Ravaghi, Vahid; Quiñonez, Carlos

2014-01-01

The aim of this study is to determine the demographic and socioeconomic characteristics of Canadians who report cost barriers to dental care. An analysis of data collected from the 2007/09 Canadian Health Measures Survey was undertaken from a sample of 5,586 Canadian participants aged 6-79. Cost barriers to dental care were operationalized through two questions: "In the past 12 months, have you avoided going to a dental professional because of the cost of dental care?" and "In the past 12 months, have you avoided having all the dental treatment that was recommended because of the cost?" Logistic regressions were conducted to identify relationships between covariates and positive responses to these questions. Approximately 17.3 percent of respondents had avoided a dental professional because of cost within the previous year, and 16.5 percent had declined recommended dental treatment because of cost. Adjusted estimates demonstrate that respondents with lower incomes and without dental insurance were over four times more likely to avoid a dental professional because of cost and approximately two and a half times more likely to decline recommended dental treatment because of cost. Nearly one out of five Canadians surveyed reported cost barriers to dental care. This study provides valuable baseline information for future studies to assess whether financial barriers to dental care are getting better or worse for Canadians. © 2014 American Association of Public Health Dentistry.

Physician recruitment success: how to acquire top physician talent.

PubMed

Rosman, Judy

2011-01-01

This article provides step-by-step instructions on how to complete the strategic planning needed to ensure success in physician recruitment efforts, outlines how to build a successful recruitment team, and provides helpful advice to avoid common recruiting mistakes that can sabotage the recruitment efforts of even the best practices. This article discusses the role of the in-house hospital recruiter in the recruitment process, how to evaluate independent search firms, how to make use of the physicians in your group to ensure success during a site visit, and how to ensure that your new hire will be able to successfully develop a practice. The article also discusses how to find and use benchmarking data to ensure that your compensation package is competitive, and provides advice on how to help your new physician hit the ground running.

Network systems security analysis

NASA Astrophysics Data System (ADS)

Yilmaz, Ä.°smail

2015-05-01

Network Systems Security Analysis has utmost importance in today's world. Many companies, like banks which give priority to data management, test their own data security systems with "Penetration Tests" by time to time. In this context, companies must also test their own network/server systems and take precautions, as the data security draws attention. Based on this idea, the study cyber-attacks are researched throughoutly and Penetration Test technics are examined. With these information on, classification is made for the cyber-attacks and later network systems' security is tested systematically. After the testing period, all data is reported and filed for future reference. Consequently, it is found out that human beings are the weakest circle of the chain and simple mistakes may unintentionally cause huge problems. Thus, it is clear that some precautions must be taken to avoid such threats like updating the security software.

Highlighting inconsistencies regarding metal biosorption.

PubMed

Robalds, Artis; Naja, Ghinwa Melodie; Klavins, Maris

2016-03-05

Thousands of articles have been devoted to examine different types of biosorbents and their use in cleaning polluted waters. An important objective of some studies has been the identification of the biosorption mechanisms. This type of investigation is not always performed, as it can only be done if scientists are aware of all mechanisms that, at least theoretically, control the removal of the target substances. Mistakes are often made, even in highly cited review articles, where biosorption mechanisms are named and/or grouped. The aim of this article is to highlight errors and inaccuracies as well as to discuss different classification systems of the biosorption mechanisms. This article serves as a guide, as well as a platform for discussion among researchers involved in the investigation of biosorbents, in an effort to avoid reproducing errors in subsequent articles. Copyright © 2015 Elsevier B.V. All rights reserved.

Self-compassion increases self-improvement motivation.

PubMed

Breines, Juliana G; Chen, Serena

2012-09-01

Can treating oneself with compassion after making a mistake increase self-improvement motivation? In four experiments, the authors examined the hypothesis that self-compassion motivates people to improve personal weaknesses, moral transgressions, and test performance. Participants in a self-compassion condition, compared to a self-esteem control condition and either no intervention or a positive distraction control condition, expressed greater incremental beliefs about a personal weakness (Experiment 1); reported greater motivation to make amends and avoid repeating a recent moral transgression (Experiment 2); spent more time studying for a difficult test following an initial failure (Experiment 3); exhibited a preference for upward social comparison after reflecting on a personal weakness (Experiment 4); and reported greater motivation to change the weakness (Experiment 4). These findings suggest that, somewhat paradoxically, taking an accepting approach to personal failure may make people more motivated to improve themselves.

The analysis and resolution of ethical dilemmas.

PubMed

Macauley, Robert C

2013-01-01

Perhaps no other field of medicine illustrates the ethical dilemmas occasioned by the explosion of technology more than neurology. Many dilemmas which at first appear to be ethical, however, are actually biotechnical, informational, or interpersonal in nature. For those which are, indeed, ethical, a review of existing information and acquisition of additional data can often serve to identify the proper response. When the optimal course of action remains unclear, the comprehensive, structured approach described in this chapter is both philosophically rigorous and clinically relevant. It takes into account a variety of critical considerations - including rights, duties, consequences, virtues, and similar cases - while utilizing both inductive and deductive methods. The end result is the "least bad" of available options, or, at the very least, a practical response which preserves future options and avoids crucial mistakes. © 2013 Elsevier B.V. All rights reserved.

BEHAVIORAL HAZARD IN HEALTH INSURANCE*

PubMed Central

Baicker, Katherine; Mullainathan, Sendhil; Schwartzstein, Joshua

2015-01-01

A fundamental implication of standard moral hazard models is overuse of low-value medical care because copays are lower than costs. In these models, the demand curve alone can be used to make welfare statements, a fact relied on by much empirical work. There is ample evidence, though, that people misuse care for a different reason: mistakes, or “behavioral hazard.” Much high-value care is underused even when patient costs are low, and some useless care is bought even when patients face the full cost. In the presence of behavioral hazard, welfare calculations using only the demand curve can be off by orders of magnitude or even be the wrong sign. We derive optimal copay formulas that incorporate both moral and behavioral hazard, providing a theoretical foundation for value-based insurance design and a way to interpret behavioral “nudges.” Once behavioral hazard is taken into account, health insurance can do more than just provide financial protection—it can also improve health care efficiency. PMID:23930294

48 CFR 2014.407-3 - Other mistakes disclosed before award.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Other mistakes disclosed before award. 2014.407-3 Section 2014.407-3 Federal Acquisition Regulations System NUCLEAR REGULATORY... by legal counsel prior to notification of the bidder. ...

JPRS Report, East Europe.

DTIC Science & Technology

1988-03-02

months, an additional refrigeration storage plant with a freezer tun- nel. Using credit from the Swiss firm TRADAX, a horticultural combine in...it is not its therapeutic value, but rather that many mistakes have become clearer. The first mistake is that its proponents believed that the

Mr. Stardust's Wild Ride

NASA Technical Reports Server (NTRS)

Atkins, Kenneth L.

2003-01-01

Effective budget planning considers not only how much money a project requires, but also when the money is needed. Many times, project success isn t the result of not making mistakes; it s the result of having the courage to face mistakes head on and take action.

The mouse that trolled: the long and tortuous history of a gene mutation patent that became an expensive impediment to Alzheimer's research

PubMed Central

Bubela, Tania; Vishnubhakat, Saurabh; Cook-Deegan, Robert

2015-01-01

This case study presents the tale of the academic discovery of a rare mutation for early-onset Alzheimer's disease that was patented by a sole inventor and licensed to a non-practicing entity (NPE), the Alzheimer's Institute of America (AIA). Our aims are (1) to relate this story about patents, research tools, and impediments to medical progress, and (2) to inform ongoing debates about how patents affect research, disposition of university inventions, and the distribution of benefits from publicly funded research. We present an account of the hunt for Alzheimer's genes, their patenting, assignment, and enforcement based on literature, litigation records and judicial decisions. While AIA's litigation eventually failed, its suits against 18 defendants, including one university, one foundation, and three non-profit organizations were costly in court years, legal fees, and expert time. Reasons for the failure included non-disclosure of co-inventors, State laws on ownership and assignment of university inventions, and enablement. We discuss the policy implications of the litigation, questioning the value of patents in the research ecosystem and the role of NPEs (“patent trolls”) in biotechnological innovation. The case illustrates tactics that may be deployed against NPEs, including, avenues to invalidate patent claims, Authorization and Consent, legislative reforms specifically targeting NPEs, reforms in the America Invents Act, and judicial action and rules for judicial proceedings. In the highly competitive research environment of Alzheimer's genetics in the 1990s, patents played a minor, subordinate role in spurring innovation. The case produces a mixed message about the patent system. It illustrates many mistakes in how patents were obtained, administered, and enforced, but, eventually, the legal system rectified these mistakes, albeit slowly, laboriously, and at great cost. PMID:26594384

Avoidable costs of comprehensive case management.

PubMed

Issel, L M; Anderson, R A

1999-01-01

Comprehensive case management has become an industry standard and its pervasiveness raises questions about the ubiquitous need for this service. Analyzed from the perspective of transaction cost analysis and access, we argue that in some cases comprehensive case management is an avoidable cost incurred because of system problems that limit access to otherwise eligible clients. Implications are discussed.

Clinical and economic consequences of vancomycin and fidaxomicin for the treatment of Clostridium difficile infection in Canada.

PubMed

Wagner, Monika; Lavoie, Louis; Goetghebeur, Mireille

2014-03-01

Clostridium difficile infection (CDI) represents a public health problem with increasing incidence and severity. To evaluate the clinical and economic consequences of vancomycin compared with fidaxomicin in the treatment of CDI from the Canadian health care system perspective. A decision-tree model was developed to compare vancomycin and fidaxomicin for the treatment of severe CDI. The model assumed identical initial cure rates and included first recurrent episodes of CDI (base case). Treatment of patients presenting with recurrent CDI was examined as an alternative analysis. Costs included were for study medication, physician services and hospitalization. Cost effectiveness was measured as incremental cost per recurrence avoided. Sensitivity analyses of key input parameters were performed. In a cohort of 1000 patients with an initial episode of severe CDI, treatment with fidaxomicin led to 137 fewer recurrences at an incremental cost of $1.81 million, resulting in an incremental cost of $13,202 per recurrence avoided. Among 1000 patients with recurrent CDI, 113 second recurrences were avoided at an incremental cost of $18,190 per second recurrence avoided. Incremental costs per recurrence avoided increased with increasing proportion of cases caused by the NAP1/B1/027 strain. Results were sensitive to variations in recurrence rates and treatment duration but were robust to variations in other parameters. The use of fidaxomicin is associated with a cost increase for the Canadian health care system. Clinical benefits of fidaxomicin compared with vancomycin depend on the proportion of cases caused by the NAP1/B1/027 strain in patients with severe CDI.

Uncalculating cooperation is used to signal trustworthiness.

PubMed

Jordan, Jillian J; Hoffman, Moshe; Nowak, Martin A; Rand, David G

2016-07-20

Humans frequently cooperate without carefully weighing the costs and benefits. As a result, people may wind up cooperating when it is not worthwhile to do so. Why risk making costly mistakes? Here, we present experimental evidence that reputation concerns provide an answer: people cooperate in an uncalculating way to signal their trustworthiness to observers. We present two economic game experiments in which uncalculating versus calculating decision-making is operationalized by either a subject's choice of whether to reveal the precise costs of cooperating (Exp. 1) or the time a subject spends considering these costs (Exp. 2). In both experiments, we find that participants are more likely to engage in uncalculating cooperation when their decision-making process is observable to others. Furthermore, we confirm that people who engage in uncalculating cooperation are perceived as, and actually are, more trustworthy than people who cooperate in a calculating way. Taken together, these data provide the first empirical evidence, to our knowledge, that uncalculating cooperation is used to signal trustworthiness, and is not merely an efficient decision-making strategy that reduces cognitive costs. Our results thus help to explain a range of puzzling behaviors, such as extreme altruism, the use of ethical principles, and romantic love.

Uncalculating cooperation is used to signal trustworthiness

PubMed Central

Jordan, Jillian J.; Hoffman, Moshe; Nowak, Martin A.; Rand, David G.

2016-01-01

Humans frequently cooperate without carefully weighing the costs and benefits. As a result, people may wind up cooperating when it is not worthwhile to do so. Why risk making costly mistakes? Here, we present experimental evidence that reputation concerns provide an answer: people cooperate in an uncalculating way to signal their trustworthiness to observers. We present two economic game experiments in which uncalculating versus calculating decision-making is operationalized by either a subject’s choice of whether to reveal the precise costs of cooperating (Exp. 1) or the time a subject spends considering these costs (Exp. 2). In both experiments, we find that participants are more likely to engage in uncalculating cooperation when their decision-making process is observable to others. Furthermore, we confirm that people who engage in uncalculating cooperation are perceived as, and actually are, more trustworthy than people who cooperate in a calculating way. Taken together, these data provide the first empirical evidence, to our knowledge, that uncalculating cooperation is used to signal trustworthiness, and is not merely an efficient decision-making strategy that reduces cognitive costs. Our results thus help to explain a range of puzzling behaviors, such as extreme altruism, the use of ethical principles, and romantic love. PMID:27439873

Barriers to implementation of workplace health interventions: an economic perspective.

PubMed

Cherniack, Martin; Lahiri, Supriya

2010-09-01

To identify insurance related, structural, and workplace cultural barriers to the implementation of effective preventive and upstream clinical interventions in the working age adult population. Analysis of avoided costs from perspective of health economics theory and from empiric observations from large studies; presentation of data from our own cost-plus model on integrating health promotion and ergonomics. We identify key avoided costs issues as a misalignment of interests between employers, insurers, service institutions, and government. Conceptual limitations of neoclassical economics are attributable to work culture and supply-driven nature of health care. Effective valuation of avoided costs is a necessary condition for redirecting allocations and incentives. Key content for valuation models is discussed.

Goal-Directed Fluid Therapy Guided by Cardiac Monitoring During High-Risk Abdominal Surgery in Adult Patients: Cost-Effectiveness Analysis of Esophageal Doppler and Arterial Pulse Pressure Waveform Analysis.

PubMed

Legrand, Guillaume; Ruscio, Laura; Benhamou, Dan; Pelletier-Fleury, Nathalie

2015-07-01

Several minimally invasive techniques for cardiac output monitoring such as the esophageal Doppler (ED) and arterial pulse pressure waveform analysis (APPWA) have been shown to improve surgical outcomes compared with conventional clinical assessment (CCA). To evaluate the cost-effectiveness of these techniques in high-risk abdominal surgery from the perspective of the French public health insurance fund. An analytical decision model was constructed to compare the cost-effectiveness of ED, APPWA, and CCA. Effectiveness data were defined from meta-analyses of randomized clinical trials. The clinical end points were avoidance of hospital mortality and avoidance of major complications. Hospital costs were estimated by the cost of corresponding diagnosis-related groups. Both goal-directed therapy strategies evaluated were more effective and less costly than CCA. Perioperative mortality and the rate of major complications were reduced by the use of ED and APPWA. Cost reduction was mainly due to the decrease in the rate of major complications. APPWA was dominant compared with ED in 71.6% and 27.6% and dominated in 23.8% and 20.8% of the cases when the end point considered was "major complications avoided" and "death avoided," respectively. Regarding cost per death avoided, APPWA was more likely to be cost-effective than ED in a wide range of willingness to pay. Cardiac output monitoring during high-risk abdominal surgery is cost-effective and is associated with a reduced rate of hospital mortality and major complications, whatever the device used. The two devices evaluated had negligible costs compared with the observed reduction in hospital costs. Our comparative studies suggest a larger effect with APPWA that needs to be confirmed by further studies. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Organizational climate determinants of resident safety culture in nursing homes.

PubMed

Arnetz, Judith E; Zhdanova, Ludmila S; Elsouhag, Dalia; Lichtenberg, Peter; Luborsky, Mark R; Arnetz, Bengt B

2011-12-01

In recent years, there has been an increasing focus on the role of safety culture in preventing costly adverse events, such as medication errors and falls, among nursing home residents. However, little is known regarding critical organizational determinants of a positive safety culture in nursing homes. The aim of this study was to identify organizational climate predictors of specific aspects of the staff-rated resident safety culture (RSC) in a sample of nursing homes. Staff at 4 Michigan nursing homes responded to a self-administered questionnaire measuring organizational climate and RSC. Multiple regression analyses were used to identify organizational climate factors that predicted the safety culture dimensions nonpunitive response to mistakes, communication about incidents, and compliance with procedures.  The organizational climate factors efficiency and work climate predicted nonpunitive response to mistakes (p < .001 for both scales) and compliance with procedures (p < .05 and p < .001 respectively). Work stress was an inverse predictor of compliance with procedures (p < .05). Goal clarity was the only significant predictor of communication about incidents (p < .05). Efficiency, work climate, work stress, and goal clarity are all malleable organizational factors that could feasibly be the focus of interventions to improve RSC. Future studies will examine whether these results can be replicated with larger samples.

[Research advances in the relationships between biodiversity and invasiveness within plant communities].

PubMed

Zheng, Jingming; Ma, Keping

2006-07-01

This paper reviewed the theoretical, observational, and experimental studies on the relationships between biodiversity and invasiveness within plant communities. The contradictory conclusions made from these studies were summarized and analyzed, and suggestions were put forward to improve future researches. In theoretical studies, models were highly simplified and depended on unrealistic assumptions, e. g., single mechanism of biodiversity formation, balance between communities status, and similar characters of alien and native species, which limited the credibility of research conclusions. Most of the observational studies were not directly exploring the relationships between biodiversity and invasiveness, but inferring from invasion patterns occurred in nature. Different research scales always resulted in contradictory conclusions. In small-scale research where some biotic factors dominated species interaction, the relationships between biodiversity and invasiveness might be negative, while in larger-scale research, other co-varying extrinsic factors might override those biotic factors in small-scale research, and the relationships between biodiversity and invasiveness might be positive. Although most experimental studies were conducted in small scale and extrinsic influences were ruled out, some mistakes might still happen when constructing biodiversity gradients in the experimental communities. Among these mistakes, sampling effect was the most common one, and the others included building communities with same species abundance but varying richness and density. Some suggestions were put forward on improving the study of the relationships between biodiversity and invasiveness in plant communities. In future researches, we should integrate observational study with experimental study, pay more attention to research scale, avoid sampling effect, and couple model with experimental design.

What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation.

PubMed

Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin

2016-06-23

This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Champlain health region in Eastern Ontario, Canada. Primary care providers and specialists registered to use the eConsult service. Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. 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/

The most common mistakes on dermatoscopy of melanocytic lesions

PubMed Central

Kamińska-Winciorek, Grażyna

2015-01-01

Dermatoscopy is a method of in vivo evaluation of the structures within the epidermis and dermis. Currently, it may be the most precise pre-surgical method of diagnosing melanocytic lesions. Diagnostic errors may result in unnecessary removal of benign lesions or what is even worse, they can cause early and very early melanomas to be overlooked. Errors in assessment of dermatoscopy can be divided into those arising from failure to maintain proper test procedures (procedural and technical errors) and knowledge based mistakes related to the lack of sufficient familiarity and experience in dermatoscopy. The article discusses the most common mistakes made by beginner or inexperienced dermatoscopists. PMID:25821425

48 CFR 2414.407-4 - Mistakes after award.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Mistakes after award. 2414.407-4 Section 2414.407-4 Federal Acquisition Regulations System DEPARTMENT OF HOUSING AND URBAN... Contracting Activity will obtain the concurrence of legal counsel before notification to the Contractor. The...

48 CFR 2814.407-4 - Mistakes after award.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Mistakes after award. 2814.407-4 Section 2814.407-4 Federal Acquisition Regulations System DEPARTMENT OF JUSTICE Contracting... award. Proposed determinations under FAR 14.407 shall be coordinated with legal counsel in accordance...

48 CFR 3414.406-3 - Other mistakes disclosed before award.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Other mistakes disclosed before award. 3414.406-3 Section 3414.406-3 Federal Acquisition Regulations System DEPARTMENT OF EDUCATION ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and...

Interpreting ground conditions from geologic maps

USGS Publications Warehouse

,

1949-01-01

Intelligent planning for heavy construction, water supply, or other land utilization requires advance knowledge of ground conditions in the area. It is essential to know:the topography, that is, the configuration of the land surface;the geology and soils, that is, the deposits that compose the land and its weathered surface; andthe hydrology, that is, the occurrence of water whether under or on the ground.These elements usually are considered in planning land developments that involve much investment; detailed surveys generally are made of the topography, geology, soils, and hydrology at the site selected for development. Such detailed surveys are essential, but equally essential and often overlooked is the need for general surveys prior to site selection.Only if the general surveys have been made is it possible to know that a particular site is most suitable for the purpose and that no situations in the tributary areas that might affect the project have been overlooked. Moreover, the general regional relations must be known in order to properly interpret the geology, soils, and hydrology at a particular locality. In brief, both the general and the specific are needed in order to avoid costly mistakes either during or after development.The accompanying maps illustrate how a general geologic map can be used for interpreting grc .d conditions during a planning stage prior to site selection. The topographic and geologic maps, which provide the basic data, have been simplified from some existing ones. The interpretive sheets are intended to provide some examples of the kinds of information that trained persons can read from such basic maps.

Avoidable cost of alcohol abuse in Canada.

PubMed

Rehm, Jürgen; Patra, Jayadeep; Gnam, William H; Sarnocinska-Hart, Anna; Popova, Svetlana

2011-01-01

To estimate avoidable burden and avoidable costs of alcohol abuse in Canada for the year 2002. A policy effectiveness approach was used. The impact of six effective and cost-effective alcohol policy interventions aimed to reduce alcohol consumption was modeled. In addition, the effect of privatized alcohol sales that would increase alcohol consumption and alcohol-attributable costs was also modeled. The effects of these interventions were compared with the baseline (aggregate) costs obtained from the second Canadian Study of Social Costs Attributable to Substance Abuse. It was estimated that by implementing six cost-effective policies from about 900 million to two billion Canadian dollars per year could be saved in Canada. The greatest savings due to the implementation of these interventions would be achieved in the lowering of productivity losses, followed by health care, and criminality. Substantial increases in burden and cost would occur if Canadian provinces were to privatize alcohol sales. The implementation of proven effective population-based interventions would reduce alcohol-attributable burden and its costs in Canada to a considerable degree. Copyright © 2010 S. Karger AG, Basel.

Social Appearance Anxiety and Dietary Restraint as Mediators between Perfectionism and Binge Eating: A Six Month Three Wave Longitudinal Study

PubMed Central

Brosof, Leigh C.; Levinson, Cheri A.

2016-01-01

Binge eating is related to perfectionism and restrained eating. However, the mechanisms underlying these relationships are not well understood. It is possible that social anxiety, specifically social appearance anxiety (i.e., the fear of overall appearance evaluation), influences the relationship between binge eating, perfectionism, and dietary restraint. In the current study (N = 300 women), we tested the relationship between dietary restraint, social appearance anxiety, concern over mistakes (a component of perfectionism), and binge eating in prospective data (three time points: at baseline, at two month, and at six month follow up). We found that social appearance anxiety, dietary restraint, and concern over mistakes each predicted binge eating at baseline. Only social appearance anxiety prospectively predicted binge eating when accounting for all variables. Further, in the tested model, social appearance anxiety mediated the relationship between concern over mistakes and binge eating across six months. On the contrary, dietary restraint did not mediate the relationship between concern over mistakes and binge eating in the tested model. The finding that social appearance anxiety served as a mediator between concern over mistakes and binge eating, but that dietary restraint did not, implies that social appearance anxiety may be a more salient prospective predictor of binge eating than dietary restraint. Intervening on social appearance anxiety may be important in the treatment and prevention of binge eating. PMID:27742237

Air pollution, avoidance behaviour and children's respiratory health: evidence from England.

PubMed

Janke, Katharina

2014-12-01

Despite progress in air pollution control, concerns remain over the health impact of poor air quality. Governments increasingly issue air quality information to enable vulnerable groups to avoid exposure. Avoidance behaviour potentially biases estimates of the health effects of air pollutants. But avoidance behaviour imposes a cost on individuals and therefore may not be taken in all circumstances. This paper exploits panel data at the English local authority level to estimate the relationship between children's daily hospital emergency admissions for respiratory diseases and common air pollutants, while allowing for avoidance behaviour in response to air pollution warnings. A 1% increase in nitrogen dioxide or ozone concentrations increases hospital admissions by 0.1%. For the subset of asthma admissions - where avoidance is less costly - there is evidence of avoidance behaviour. Ignoring avoidance behaviour, however, does not result in statistically significant underestimation of the health effect of air pollution. Copyright © 2014 Elsevier B.V. All rights reserved.

Applying economic evaluation to public health interventions: the case of interventions to promote physical activity.

PubMed

Trueman, Paul; Anokye, Nana Kwame

2013-03-01

This paper explores the application of alternative approaches to economic evaluation of public health interventions, using a worked example of exercise referral schemes (ERSs). Cost-utility (CUA) and cost-consequence analyses (CCA) were used to assess the cost-effectiveness of ERSs. For the CUA, evidence was synthesized using a decision analytic model that adopts a lifetime horizon and NHS/Personal Social Services perspective. Outcomes were expressed as incremental cost per quality-adjusted life-year (QALY). CCA was conducted from a partial-societal perspective, including health and non-healthcare costs and benefits. Outcomes were reported in natural units, such as cases of strokes or CHD avoided. Compared with usual care, the incremental cost per QALY of ERS is £20 876. Based on a cohort of 100 000 individuals, CCA estimates cost of ERS at £22 million to the healthcare provider and £12 million to participants. The benefits of ERS include additional 3900 people becoming physically active, 51 cases of CHD avoided, 16 cases of stroke avoided, 86 cases of diabetes avoided and a gain of ∼800 QALYs. CCA might provide greater transparency than CUA in reporting the outcomes of public health interventions and have greater resonance with stakeholders involved in commissioning these interventions.

The relationships of physician practice characteristics to quality of care and costs.

PubMed

Kralewski, John; Dowd, Bryan; Knutson, David; Tong, Junliang; Savage, Megan

2015-06-01

Medical group practices are central to many of the proposals for health care reform, but little is known about the relationship between practice-level characteristics and the quality and cost of care. Practice characteristics from a 2009 national survey of 211 group practices were linked to Medicare claims data for beneficiaries attributed to the practices. Multivariate regression was used to examine the relationship between practice characteristics and claims-computable measures of screening and monitoring, avoidable utilization, risk-adjusted per-beneficiary per-year (PBPY) costs, and the practice's net revenue. Several characteristics of group practices are predictive of screening and monitoring measures. Those measures, in turn, are predictive of lower values of avoidable utilization measures that contribute to higher PBPY costs. The effects of group practice characteristics on avoidable utilization, cost, and practice net revenue appear to work primarily through improved screening and monitoring. Practice characteristics influence costs indirectly through a set of statistically significant relationships among screening and monitoring measures and avoidable utilization. However, these relationships are not the only pathways connecting practice characteristics to cost and those additional pathways contain substantial "noise" adding uncertainty to the estimated direct effects. Some of the attributes thought to be important characteristics of accountable care organizations and medical homes appear to be associated with lower quality and no improvement in cost. © Health Research and Educational Trust.

A mediation skills model to manage disclosure of errors and adverse events to patients.

PubMed

Liebman, Carol B; Hyman, Chris Stern

2004-01-01

In 2002 Pennsylvania became the first state to impose on hospitals a statutory duty to notify patients in writing of a serious event. If the disclosure conversations are carefully planned, properly executed, and responsive to patients' needs, this new requirement creates possible benefits for both patient safety and litigation risk management. This paper describes a model for accomplishing these goals that encourages health care providers to communicate more effectively with patients following an adverse event or medical error, learn from mistakes, respond to the concerns of patients and families after an adverse event, and arrive at a fair and cost-effective resolution of valid claims.

Error Prevention Aid

NASA Technical Reports Server (NTRS)

1987-01-01

In a complex computer environment there is ample opportunity for error, a mistake by a programmer, or a software-induced undesirable side effect. In insurance, errors can cost a company heavily, so protection against inadvertent change is a must for the efficient firm. The data processing center at Transport Life Insurance Company has taken a step to guard against accidental changes by adopting a software package called EQNINT (Equations Interpreter Program). EQNINT cross checks the basic formulas in a program against the formulas that make up the major production system. EQNINT assures that formulas are coded correctly and helps catch errors before they affect the customer service or its profitability.

Framework Programmable Platform for the Advanced Software Development Workstation (FPP/ASDW). Demonstration framework document. Volume 1: Concepts and activity descriptions

NASA Technical Reports Server (NTRS)

Mayer, Richard J.; Blinn, Thomas M.; Dewitte, Paul S.; Crump, John W.; Ackley, Keith A.

1992-01-01

The Framework Programmable Software Development Platform (FPP) is a project aimed at effectively combining tool and data integration mechanisms with a model of the software development process to provide an intelligent integrated software development environment. Guided by the model, this system development framework will take advantage of an integrated operating environment to automate effectively the management of the software development process so that costly mistakes during the development phase can be eliminated. The Advanced Software Development Workstation (ASDW) program is conducting research into development of advanced technologies for Computer Aided Software Engineering (CASE).

Learning from Failures.

ERIC Educational Resources Information Center

Saffran, Murray

1991-01-01

Describes mistakes made in trying to change the Nutrition and Digestion section of a medical biochemistry course. Author tried to make the section student taught and reports nine mistakes including the following: ignoring active opposition of colleagues, failure to assess the receptivity of the class to a new form of teaching, and overestimating…

Does Online Education Rest on a Mistake?

ERIC Educational Resources Information Center

Verene, Donald Phillip

2013-01-01

This article presents the author's view that online education mistakes information for education and training for teaching. He presents a historical look at "distance learning" as the original correspondence courses offered through the mail, and he observes that the past and present technologies were missing the main piece of…

Juggling with Language Learning Theories. [Videotape

ERIC Educational Resources Information Center

Murphey, Tim

2005-01-01

Learning to juggle has become popular among corporate training programs because it shows participants how to appreciate mistakes and use "Intelligent Fast Failure" (learning quickly by daring to make a lot of simple mistakes at the beginning of a process). Big business also likes the way juggling can get executives "out of the…

Lean Six Sigma Implementation for Military Logistics to Improve Readiness

DTIC Science & Technology

2007-04-30

mistake-proofing ( poka - yoke ). Lean, as a management philosophy, is also very focused on creating a better workplace through the Toyota principle...Techniques • Pull System • Visual Control • Mistake proofing ( poka yoke ) • Equipment Changeover 37 Pull System • Issuance of an RFI engine would “trigger

48 CFR 14.407-2 - Apparent clerical mistakes.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and Award of Contract 14.407-2 Apparent... contracting officer before award. The contracting officer first shall obtain from the bidder a verification of the bid intended. Examples of apparent mistakes are— (1) Obvious misplacement of a decimal point; (2...

48 CFR 14.407-2 - Apparent clerical mistakes.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and Award of Contract 14.407-2 Apparent... contracting officer before award. The contracting officer first shall obtain from the bidder a verification of the bid intended. Examples of apparent mistakes are— (1) Obvious misplacement of a decimal point; (2...

Math Mistakes That Make the News

ERIC Educational Resources Information Center

Lewis, Heather A.

2015-01-01

Teachers often promote care in doing calculations, but for most students a single mistake rarely has major consequences. This article presents several real-life events in which relatively minor mathematical errors led to situations that ranged from public embarrassment to the loss of millions of dollars' worth of equipment. The stories here…

48 CFR 714.406-4 - Disclosure of mistakes after award.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Disclosure of mistakes after award. 714.406-4 Section 714.406-4 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and Award of Contract 714...

48 CFR 714.406-3 - Other mistakes disclosed before award.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Other mistakes disclosed before award. 714.406-3 Section 714.406-3 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and Award of Contract 714...

48 CFR 714.406-3 - Other mistakes disclosed before award.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Other mistakes disclosed before award. 714.406-3 Section 714.406-3 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and Award of Contract 714...

48 CFR 714.406-4 - Disclosure of mistakes after award.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Disclosure of mistakes after award. 714.406-4 Section 714.406-4 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and Award of Contract 714...

Making Mistakes: Emotional Adaptation and Classroom Learning

ERIC Educational Resources Information Center

McCaslin, Mary; Vriesema, Christine C.; Burggraf, Susan

2016-01-01

Background: We studied how students in Grades 4-6 participate in and emotionally adapt to the give-and-take of learning in classrooms, particularly when making mistakes. Our approach is consistent with researchers who (a) include cognitive appraisals in the study of emotional experiences, (b) consider how personal concerns might mediate…

Net Survey: "Top Ten Mistakes" in Academic Web Design.

ERIC Educational Resources Information Center

Petrik, Paula

2000-01-01

Highlights the top ten mistakes in academic Web design: (1) bloated graphics; (2) scaling images; (3) dense text; (4) lack of contrast; (5) font size; (6) looping animations; (7) courseware authoring software; (8) scrolling/long pages; (9) excessive download; and (10) the nothing site. Includes resources. (CMK)

Error-Eliciting Problems: Fostering Understanding and Thinking

ERIC Educational Resources Information Center

Lim, Kien H.

2014-01-01

Student errors are springboards for analyzing, reasoning, and justifying. The mathematics education community recognizes the value of student errors, noting that "mistakes are seen not as dead ends but rather as potential avenues for learning." To induce specific errors and help students learn, choose tasks that might produce mistakes.…

National economic impact of tirofiban for unstable angina and myocardial infarction without ST elevation; example from the United Kingdom.

PubMed

Bakhai, Ameet; Flather, Marcus D; Collinson, Julian R; Stevens, Warren; Normand, Charles; Alemao, Evo; Itzler, Robbin; Ben-Joseph, Rami

2003-10-01

Acute coronary syndromes without ST elevation are a major health and economic burden. Treatments such as glycoprotein IIb/IIIa antagonists like tirofiban reduce the risk of complications but the cost impact of these agents including cost offsets of avoiding complications are needed particularly in Europe. We used treatment patterns from the Prospective Registry of Acute Ischemic Syndromes in the UK, risk reductions derived from the PRISM-PLUS trial and cost estimates from the CHKS database to estimate the impact of tirofiban on PRAIS-UK patients with and without complications and subgroups at higher risk of complications. These subgroups (and proportions) were patients: (1) aged 60 or over with abnormal electrocardiograms (58%), (2) with ST depression or bundle branch block on admission (30%) and (3) with ST depression, bundle branch block or MI on admission (37%). Total cost of care in the UK at 6 months for the estimated 87339 acute coronary syndromes admissions annually was pound 213 million, which would increase by pound 33 million (15.7%) if tirofiban were given to all patients, avoiding 2422 complications at a mean cost per event avoided of pound 13388. Among the subgroups, the mean cost per event avoided ranges from pound 10856 for subgroup 1 to pound 5953 for subgroup 3. Treating the latter subgroup, would avoid 1977 events at a cost of pound 12 million (5.5%). The use of tirofiban in the UK to treat acute coronary syndromes patients without ST elevation provides an important therapeutic advantage at modest proportional increase in cost, particularly if targeted to higher risk subgroups as recommended in the European guidelines.

Selling Complementary Patents: Experimental Investigation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bjornstad, David J; Santore, Rudy; McKee, Michael

2010-02-01

Production requiring licensing groups of complementary patents implements a coordination game among patent holders, who can price patents by choosing among combinations of fixed and royalty fees. Summed across patents, these fees become the total producer cost of the package of patents. Royalties, because they function as excise taxes, add to marginal costs, resulting in higher prices and reduced quantities of the downstream product and lower payoffs to the patent holders. Using fixed fees eliminates this inefficiency but yields a more complex coordination game in which there are multiple equilibria, which are very fragile in that small mistakes can leadmore » the downstream firm to not license the technology, resulting in inefficient outcomes. We report on a laboratory market investigation of the efficiency effects of coordinated pricing of patents in a patent pool. We find that pool-like pricing agreements can yield fewer coordination failures in the pricing of complementary patents.« less

Using Lean Process Improvement to Enhance Safety and Value in Orthopaedic Surgery: The Case of Spine Surgery.

PubMed

Sethi, Rajiv; Yanamadala, Vijay; Burton, Douglas C; Bess, Robert Shay

2017-11-01

Lean methodology was developed in the manufacturing industry to increase output and decrease costs. These labor organization methods have become the mainstay of major manufacturing companies worldwide. Lean methods involve continuous process improvement through the systematic elimination of waste, prevention of mistakes, and empowerment of workers to make changes. Because of the profit and productivity gains made in the manufacturing arena using lean methods, several healthcare organizations have adopted lean methodologies for patient care. Lean methods have now been implemented in many areas of health care. In orthopaedic surgery, lean methods have been applied to reduce complication rates and create a culture of continuous improvement. A step-by-step guide based on our experience can help surgeons use lean methods in practice. Surgeons and hospital centers well versed in lean methodology will be poised to reduce complications, improve patient outcomes, and optimize cost/benefit ratios for patient care.

Cost avoidance associated with optimal stroke care in Canada.

PubMed

Krueger, Hans; Lindsay, Patrice; Cote, Robert; Kapral, Moira K; Kaczorowski, Janusz; Hill, Michael D

2012-08-01

Evidence-based stroke care has been shown to improve patient outcomes and may reduce health system costs. Cost savings, however, are poorly quantified. This study assesses 4 aspects of stroke management (rapid assessment and treatment services, thrombolytic therapy, organized stroke units, and early home-supported discharge) and estimates the potential for cost avoidance in Canada if these services were provided in a comprehensive fashion. Several independent data sources, including the Canadian Institute of Health Information Discharge Abstract Database, the 2008-2009 National Stroke Audit, and the Acute Cerebrovascular Syndrome Registry in the province of British Columbia, were used to assess the current status of stroke care in Canada. Evidence from the literature was used to estimate the effect of providing optimal stroke care on rates of acute care hospitalization, length of stay in hospital, discharge disposition (including death), changes in quality of life, and costs avoided. Comprehensive and optimal stroke care in Canada would decrease the number of annual hospital episodes by 1062 (3.3%), the number of acute care days by 166 000 (25.9%), and the number of residential care days by 573 000 (12.8%). The number of deaths in the hospital would be reduced by 1061 (14.9%). Total avoidance of costs was estimated at $682 million annually ($307.4 million in direct costs, $374.3 million in indirect costs). The costs of stroke care in Canada can be substantially reduced, at the same time as improving patient outcomes, with the greater use of known effective treatment modalities.

The Hayes principles: learning from the national pilot of information technology and core generalisable theory in informatics.

PubMed

de Lusignan, Simon; Krause, Paul

2010-01-01

There has been much criticism of the NHS national programme for information technology (IT); it has been an expensive programme and some elements appear to have achieved little. The Hayes report was written as an independent review of health and social care IT in England. To identify key principles for health IT implementation which may have relevance beyond the critique of NHS IT. We elicit ten principles from the Hayes report, which if followed may result in more effective IT implementation in health care. They divide into patient-centred, subsidiarity and strategic principles. The patient-centred principles are: 1) the patient must be at the centre of all information systems; 2) the provision of patient-level operational data should form the foundation - avoid the dataset mentality; 3) store health data as close to the patient as possible; 4) enable the patient to take a more active role with their health data within a trusted doctor-patient relationship. The subsidiarity principles set out to balance the local and health-system-wide needs: 5) standardise centrally - patients must be able to benefit from interoperability; 6) provide a standard procurement package and an approved process that ensures safety standards and provision of interoperable systems; 7) authorise a range of local suppliers so that health providers can select the system best meeting local needs; 8) allow local migration from legacy systems, as and when improved functionality for patients is available. And finally the strategic principles: 9) evaluate health IT systems in terms of measureable benefits to patients; 10) strategic planning of systems should reflect strategic goals for the health of patients/the population. Had the Hayes principles been embedded within our approach to health IT, and in particular to medical record implementation, we might have avoided many of the costly mistakes with the UK national programme. However, these principles need application within the modern IT environment. Closeness to the patient must not be interpreted as physical but instead as a virtual patient-centred space; data will be secure within the cloud and we should dump the vault and infrastructure mentality. Health IT should be developed as an adaptive ecosystem.

From Science to Finance-A Tool for Deriving Economic Implications from the Results of Dietary Supplement Clinical Studies.

PubMed

Shanahan, Christopher J; de Lorimier, Robert

2016-01-01

This article examines evidence showing that the use of key dietary supplements can reduce overall disease treatment-related hospital utilization costs associated with coronary heart disease (CHD) in the United States among those at a high risk of experiencing a costly, disease-related event. Results show that the potential avoided hospital utilization costs related to the use of omega-3 supplements at preventive intake levels among the target population can be as much as $2.06 billion on average per year from 2013 to 2020. The potential net savings in avoided CHD-related hospital utilization costs after accounting for the cost of omega-3 dietary supplements at preventive daily intake levels would be more than $3.88 billion in cumulative health care cost savings from 2013 to 2020. Furthermore, the use of folic acid, B6, and B12 among the target population at preventive intake levels could yield avoided CHD-related hospital utilization costs savings of an average savings of $1.52 billion per year from 2013 to 2020. The potential net savings in avoided CHD-related health care costs after accounting for the cost of folic acid, B6, and B12 utilization at preventive daily intake levels would be more than $5.23 billion in cumulative health care cost net savings during the same period. Thus, targeted dietary supplement regimens are recommended as a means to help control rising societal health care costs, and as a means for high-risk individuals to minimize the chance of having to deal with potentially costly events and to invest in increased quality of life.

How Much of Language Acquisition Does Operant Conditioning Explain?

PubMed

Sturdy, Christopher B; Nicoladis, Elena

2017-01-01

Since the 1950s, when Chomsky argued that Skinner's arguments could not explain syntactic acquisition, psychologists have generally avoided explicitly invoking operant or instrumental conditioning as a learning mechanism for language among human children. In this article, we argue that this is a mistake. We focus on research that has been done on language learning in human infants and toddlers in order to illustrate our points. Researchers have ended up inventing learning mechanisms that, in actual practice, not only resemble but also in fact are examples of operant conditioning (OC) by any other name they select. We argue that language acquisition researchers should proceed by first ruling out OC before invoking alternative learning mechanisms. While it is possible that OC cannot explain all of the language acquisition, simple learning mechanisms that work across species may have some explanatory power in children's language learning.

Tactile Architectural Models as Universal ‘Urban Furniture’

NASA Astrophysics Data System (ADS)

Kłopotowska, Agnieszka

2017-10-01

Tactile architectural models and maquettes have been built in the external public spaces of Polish cities since the latter half of the 00s of the 21st century. These objects are designed for the blind, but also other people - tourists, children, and those who arrive in wheelchairs. This collection has got currently more than 70 implements, which places Poland in the group of European leaders. Unfortunately, this “furniture”, is not always “convenient” and safe for all recipients. Studies, which have been conducted together with Maciej Kłopotowski since 2016 across the country, show a number of serious design and executive mistakes or examples of misuse. The purpose of this article is drawing attention to these issues and pointing out ways how they can be avoided. These objects may become completely valuable, universal tool for learning and a great way of studying architecture in an alternative way.

Applications of Ontology Design Patterns in Biomedical Ontologies

PubMed Central

Mortensen, Jonathan M.; Horridge, Matthew; Musen, Mark A.; Noy, Natalya F.

2012-01-01

Ontology design patterns (ODPs) are a proposed solution to facilitate ontology development, and to help users avoid some of the most frequent modeling mistakes. ODPs originate from similar approaches in software engineering, where software design patterns have become a critical aspect of software development. There is little empirical evidence for ODP prevalence or effectiveness thus far. In this work, we determine the use and applicability of ODPs in a case study of biomedical ontologies. We encoded ontology design patterns from two ODP catalogs. We then searched for these patterns in a set of eight ontologies. We found five patterns of the 69 patterns. Two of the eight ontologies contained these patterns. While ontology design patterns provide a vehicle for capturing formally reoccurring models and best practices in ontology design, we show that today their use in a case study of widely used biomedical ontologies is limited. PMID:23304337

Using Weather Data and Climate Model Output in Economic Analyses of Climate Change

DOE Office of Scientific and Technical Information (OSTI.GOV)

Auffhammer, M.; Hsiang, S. M.; Schlenker, W.

2013-06-28

Economists are increasingly using weather data and climate model output in analyses of the economic impacts of climate change. This article introduces a set of weather data sets and climate models that are frequently used, discusses the most common mistakes economists make in using these products, and identifies ways to avoid these pitfalls. We first provide an introduction to weather data, including a summary of the types of datasets available, and then discuss five common pitfalls that empirical researchers should be aware of when using historical weather data as explanatory variables in econometric applications. We then provide a brief overviewmore » of climate models and discuss two common and significant errors often made by economists when climate model output is used to simulate the future impacts of climate change on an economic outcome of interest.« less

Paediatric acid-base disorders: A case-based review of procedures and pitfalls

PubMed Central

Carmody, J Bryan; Norwood, Victoria F

2013-01-01

Acid-base disorders occur frequently in paediatric patients. Despite the perception that their analysis is complex and difficult, a straightforward set of rules is sufficient to interpret even the most complex disorders – provided certain pitfalls are avoided. Using a case-based approach, the present article reviews the fundamental concepts of acid-base analysis and highlights common mistakes and oversights. Specific topics include the proper identification of the primary disorder; distinguishing compensatory changes from additional primary disorders; use of the albumin-corrected anion gap to generate a differential diagnosis for patients with metabolic acidosis; screening for mixed disorders with the delta-delta formula; recognizing the limits of compensation; use of the anion gap to identify ‘hidden’ acidosis; and the importance of using information from the history and physical examination to identify the specific cause of a patient’s acid-base disturbance. PMID:24381489

How Much of Language Acquisition Does Operant Conditioning Explain?

PubMed Central

Sturdy, Christopher B.; Nicoladis, Elena

2017-01-01

Since the 1950s, when Chomsky argued that Skinner’s arguments could not explain syntactic acquisition, psychologists have generally avoided explicitly invoking operant or instrumental conditioning as a learning mechanism for language among human children. In this article, we argue that this is a mistake. We focus on research that has been done on language learning in human infants and toddlers in order to illustrate our points. Researchers have ended up inventing learning mechanisms that, in actual practice, not only resemble but also in fact are examples of operant conditioning (OC) by any other name they select. We argue that language acquisition researchers should proceed by first ruling out OC before invoking alternative learning mechanisms. While it is possible that OC cannot explain all of the language acquisition, simple learning mechanisms that work across species may have some explanatory power in children’s language learning. PMID:29163295

Delivering a lifelong integrated electronic health record based on a service oriented architecture.

PubMed

Katehakis, Dimitrios G; Sfakianakis, Stelios G; Kavlentakis, Georgios; Anthoulakis, Dimitrios N; Tsiknakis, Manolis

2007-11-01

Efficient access to a citizen's Integrated Electronic Health Record (I-EHR) is considered to be the cornerstone for the support of continuity of care, the reduction of avoidable mistakes, and the provision of tools and methods to support evidence-based medicine. For the past several years, a number of applications and services (including a lifelong I-EHR) have been installed, and enterprise and regional infrastructure has been developed, in HYGEIAnet, the Regional Health Information Network (RHIN) of the island of Crete, Greece. Through this paper, the technological effort toward the delivery of a lifelong I-EHR by means of World Wide Web Consortium (W3C) technologies, on top of a service-oriented architecture that reuses already existing middleware components is presented and critical issues are discussed. Certain design and development decisions are exposed and explained, laying this way the ground for coordinated, dynamic navigation to personalized healthcare delivery.

Clinical relevance of about-yearly changes in blood pressure and the environment

NASA Astrophysics Data System (ADS)

Halberg, Franz; Cornélissen, Germaine; Haus, Erhard; Northrup, Gordon; Portela, Ana; Wendt, Hans; Otsuka, Kuniaki; Kumagai, Yuji; Watanabe, Yoshihiko; Zaslavskaya, Rina

1996-12-01

Changes identified by inferential statistics from summer to winter of high to low arterial blood pressures (BP) have been quantified as a large predictable about-yearly BP swing. This condition of a large annual BP amplitude (LABPA) raises concern about hypotension as well as hypertension and raises new questions regarding appropriate guidelines for diagnosis and treatment. Recommendations made in the fall on the basis of data collected in the summer may be totally inadequate in dealing with the patient's condition in the winter. In order to avoid such mistakes, it is imperative to implement a systematic surveillance of BP in the light of current chronobiological limits. Patients with a large circannual BP amplitude are particularly suited for a study of the underlying hormonal mechanisms. The longitudinal monitoring of their BP is also amenable to the study of environmental influences from near and far.

Multiple Versus Single Set Validation of Multivariate Models to Avoid Mistakes.

PubMed

Harrington, Peter de Boves

2018-01-02

Validation of multivariate models is of current importance for a wide range of chemical applications. Although important, it is neglected. The common practice is to use a single external validation set for evaluation. This approach is deficient and may mislead investigators with results that are specific to the single validation set of data. In addition, no statistics are available regarding the precision of a derived figure of merit (FOM). A statistical approach using bootstrapped Latin partitions is advocated. This validation method makes an efficient use of the data because each object is used once for validation. It was reviewed a decade earlier but primarily for the optimization of chemometric models this review presents the reasons it should be used for generalized statistical validation. Average FOMs with confidence intervals are reported and powerful, matched-sample statistics may be applied for comparing models and methods. Examples demonstrate the problems with single validation sets.

Synergi and E&P forum HSE management system helps companies improve HSE performance and reduce losses

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grundt, H.J.

1996-12-31

This paper discusses the use of information on accidents and near-misses to improve HSE performance and reduce losses in Exploration and Production activities. Incidents are considered a result of management system failure. To avoid incidents and recurrence of incidents, companies should adopt an integrated HSE Management System and software especially designed for recording, analyzing and following up events. The E&P Forum has issued guidelines to support current company HSE Management systems and practices. Concurrently, the Synergi Project has been established to facilitate experience transfer and effective handling of incidents as part of an integrated HSE Management System. The paper describesmore » how important it is to learn from past mistakes, to have a management system which facilitates the implementation of the required corrective action, and that tools for improved loss control are available.« less

Telehealth for paediatric burn patients in rural areas: a retrospective audit of activity and cost savings.

PubMed

McWilliams, Tania; Hendricks, Joyce; Twigg, Di; Wood, Fiona; Giles, Margaret

2016-11-01

Since 2005, the Western Australian paediatric burn unit has provided a state-wide clinical consultancy and support service for the assessment and management of acute and rehabilitative burn patients via its telehealth service. Since then, the use of this telehealth service has steadily increased as it has become imbedded in the model of care for paediatric burn patients. Primarily, the service involves acute and long term patient reviews conducted by the metropolitan-located burn unit in contact with health practitioners, advising patients and their families who reside outside the metropolitan area thereby avoiding unnecessary transfers and inpatient bed days. A further benefit of the paediatric burn service using telehealth is more efficient use of tertiary level burn unit beds, with only those patients meeting clinical criteria for admission being transferred. To conduct a retrospective audit of avoided transfers and bed days in 2005/06-2012/13 as a result of the use of the paediatric Burns Telehealth Service and estimate their cost savings in 2012/13. A retrospective chart audit identified activity, avoided unnecessary acute and scar review patient transfers, inpatient bed days and their associated avoided costs to the tertiary burn unit and patient travel funding. Over the period 2005/06-2012/13 the audit identified 4,905 avoided inpatient bed days, 364 avoided acute patient transfers and 1,763 avoided follow up review transfers for a total of 1,312 paediatric burn patients as a result of this telehealth service. This paper presents the derivation of these outcomes and an estimation of their cost savings in 2012/13 of AUD 1.89million. This study demonstrates avoided patient transfers, inpatient bed days and associated costs as the result of an integrated burns telehealth service. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Reconsidering English Grammar Teaching for Improving Non-English Majors' English Writing Ability

ERIC Educational Resources Information Center

Shen, Yuru

2012-01-01

With the globalization of world economy, English learners' writing ability has been attached less and less importance. As a result, many college students in China, especially the non-English majors, cannot express themselves effectively in written English. They make various kinds of mistakes, mostly grammar mistakes, such as writing sentence…

The Culture of Learning from Mistakes: How Employees Handle Mistakes in Everyday Work

ERIC Educational Resources Information Center

Harteis, Christian; Bauer, Johannes; Gruber, Hans

2008-01-01

Workplace learning circumscribes processes leading to the development of competencies and skills through daily work. It is of increasing importance for many modern enterprises, which consider themselves as being learning organisations, to make use of the potential of their employees in order to be competitive within global markets. Dealing with…

The Power of Proverbs: Dissonance Reduction through Common Sayings

ERIC Educational Resources Information Center

Stalder, Daniel R.

2010-01-01

After reading a detailed account of a serious mistake in which a similar-age other went against personal values or a prior commitment, undergraduates rated their feelings of dissonance (regret, hypocrisy, and stupidity) had they been in the actor's place. Relative to a control condition, reading relevant proverbs such as "everybody makes mistakes"…

The Most Common Mistakes of Teacher Trainees' Former Teachers

ERIC Educational Resources Information Center

Özer, Bayram; Gelen, Ismail; Alkan, Sinem Hizli; Çinar, Gonca; Duran, Volkan

2016-01-01

The fundamental parts of the educational processes are teachers and students. The study aims to determine the common mistakes done by teachers in the classrooms. The research was conducted to 278 third year students in the departments of English Language Teaching, Turkish Language Teaching, and Fine Arts Teaching in 2012-2013 academic year. The…

Learning by Identification of Mistakes in Workings in Engineering Modules

ERIC Educational Resources Information Center

Chian, S. C.

2018-01-01

Conventional graded assignments are commonly structured in a format where students attempt a prescribed question and are graded based on the completeness of their workings rather than the understanding of concepts. An alternative assignment format was proposed which requires students to identify and explain mistakes in a given set of workings…

Errors and Their Corrections

ERIC Educational Resources Information Center

Joosten, Albert Max

2016-01-01

"Our primary concern is not that the child learns to do something without mistakes. Our real concern is that the child does what he needs, with interest." The reaction of so many adults to the mistakes of children is to correct, immediately and directly, says Joosten. To truly aid the child in development, we must learn to control our…

Maximizing Peak Running on Race Day

ERIC Educational Resources Information Center

Consolo, Kitty

2008-01-01

Distance runners spend many hours training assiduously for competition, yet on race day they can often make mistakes that sabotage their performance. This article addresses five common race-day mistakes: (1) failure to bring proper equipment to the race; (2) failure to eat an appropriate race-day meal; (3) failure to hydrate properly; (4) failure…

Effects of the Design of Written Music on the Readability for Children with Dyslexia

ERIC Educational Resources Information Center

Flach, Nanke; Timmermans, Anneke; Korpershoek, Hanke

2016-01-01

This study investigates the relationship between the design of written music and the number of mistakes dyslexic and non-dyslexic children make in reading music is investigated in this study. Previous research shows that children with dyslexia experience difficulties with reading music, especially discerning pitch. Common mistakes of dyslexic…

Learning in Public: Faculty and Student Opinions about Social Media in the Classroom

ERIC Educational Resources Information Center

Hickerson, Andrea; Kothari, Ammina

2017-01-01

For communication instructors charged with safely and constructively educating students, incorporating social media in communication coursework presents a variety of problems. Among them are how to grade social media and how to respond to students' social media mistakes, knowing these mistakes and corrections could follow students into their…

Martin Gardner's Mistake

ERIC Educational Resources Information Center

Khovanova, Tanya

2012-01-01

When Martin Gardner first presented the Two-Children problem, he made a mistake in its solution. Later he corrected the error, but unfortunately the incorrect solution is more widely known than his correction. In fact, a Tuesday-Child variation of this problem went viral in 2010, and the same flaw keeps reappearing in proposed solutions of that…

Finding a needle in the haystack: the costs and cost-effectiveness of syphilis diagnosis and treatment during pregnancy to prevent congenital syphilis in Kalomo District of Zambia.

PubMed

Larson, Bruce A; Lembela-Bwalya, Deophine; Bonawitz, Rachael; Hammond, Emily E; Thea, Donald M; Herlihy, Julie

2014-01-01

In March 2012, The Elizabeth Glaser Pediatric AIDS Foundation trained maternal and child health workers in Southern Province of Zambia to use a new rapid syphilis test (RST) during routine antenatal care. A recent study by Bonawitz et al. (2014) evaluated the impact of this roll out in Kalomo District. This paper estimates the costs and cost-effectiveness from the provider's perspective under the actual conditions observed during the first year of the RST roll out. Information on materials used and costs were extracted from program records. A decision-analytic model was used to evaluate the costs (2012 USD) and cost-effectiveness. Basic parameters needed for the model were based on the results from the evaluation study. During the evaluation study, 62% of patients received a RST, and 2.8% of patients tested were positive (and 10.4% of these were treated). Even with very high RST sensitivity and specificity (98%), true prevalence of active syphilis would be substantially less (estimated at <0.7%). For 1,000 new ANC patients, costs of screening and treatment were estimated at $2,136, and the cost per avoided disability-adjusted-life year lost (DALY) was estimated at $628. Costs change little if all positives are treated (because prevalence is low and treatment costs are small), but the cost-per-DALY avoided falls to just $66. With full adherence to guidelines, costs increase to $3,174 per 1,000 patients and the cost-per-DALY avoided falls to $60. Screening for syphilis is only useful for reducing adverse birth outcomes if patients testing positive are actually treated. Even with very low prevalence of syphilis (a needle in the haystack), cost effectiveness improves dramatically if those found positive are treated; additional treatment costs little but DALYs avoided are substantial. Without treatment, the needle is essentially found and thrown back into the haystack.

Designing PURPA (Public Utilities Regulatory Act) power purchase auctions: Theory and practice. [Cogenerated electricity purchasing model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rothkopf, M.H.; Kahn, E.P.; Teisberg, T.J.

The Public Utilities Regulatory Act (PURPA) requires there to be procedures for electric utilities to buy electric power from qualifying cogenerators and small power producers (QFs) at rates up to ''avoided cost.'' This has led to price-posting procedures at prices calculated as the utility's marginal cost. Unexpectedly large sales at these prices and slow adjustment to falling energy cost are partially responsible for payments to QFs in excess of the utility's true avoided cost. Using competitive bidding instead of posted prices has been proposed as a way to avoid this outcome. This report reviews bidding theory and explores four issuesmore » that arise in deisigning auction systems for the purchase of power from QFs under PURPA. 77 refs., 6 figs., 15 tabs.« less

Designing PURPA (Public Utilities Regulatory Policies Act) power purchase auctions: Theory and practice. [Buys from cogenerators and small power generators

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

The Public Utilities Regulatory Act (PURPA) requires there to be procedures for electric utilities to buy electric power from qualifying cogenerators and small power producers (QFs) at rates up to ''avoided cost''. This has led to price-posting procedures at prices calculated as the utility's marginal cost. Unexpectedly large sales at these prices and slow adjustment to falling energy cost are partially responsible for payments to QFs in excess of the utility's true avoided cost. Using competitive bidding instead of posted prices has been proposed as a way to avoid this outcome. This report reviews bidding theory and explores four issuesmore » that arise in designing auction systems for the purchase of power from QFs under PURPA.« less

Attentional Flexibility During Approach and Avoidance Motivational States: The Role of Context in Shifts of Attentional Breadth

PubMed Central

Calcott, Rebecca D.; Berkman, Elliot T.

2014-01-01

In the present studies, we aimed to understand how approach and avoidance states affect attentional flexibility by examining attentional shifts on a trial-by-trial basis. We also examined how a novel construct in this area, task context, might interact with motivation to influence attentional flexibility. Participants completed a modified composite letter task in which the ratio of global to local targets was varied by block, making different levels of attentional focus beneficial to performance on different blocks. Study 1 demonstrated that, in the absence of a motivation manipulation, switch costs were lowest on blocks with an even ratio of global and local trials and were higher on blocks with an uneven ratio. Other participants completed the task while viewing pictures (Studies 2 and 3) and assuming arm positions (Studies 2 and 4) to induce approach, avoidance, and neutral motivational states. Avoidance motivation reduced switch costs in evenly proportioned contexts, whereas approach motivation reduced switch costs in mostly global contexts. Additionally, approach motivation imparted a similar switch cost magnitude across different contexts, whereas avoidance and neutral states led to variable switch costs depending on the context. Subsequent analyses revealed that these effects were driven largely by faster switching to local targets on mostly global blocks in the approach condition. These findings suggest that avoidance facilitates attentional shifts when switches are frequent, whereas approach facilitates responding to rare or unexpected local stimuli. The main implication of these results is that motivation has different effects on attentional shifts depending on the context. PMID:24294866

Social appearance anxiety and dietary restraint as mediators between perfectionism and binge eating: A six month three wave longitudinal study.

PubMed

Brosof, Leigh C; Levinson, Cheri A

2017-01-01

Binge eating is related to perfectionism and restrained eating. However, the mechanisms underlying these relationships are not well understood. It is possible that social anxiety, specifically social appearance anxiety (i.e., the fear of overall appearance evaluation), influences the relationship between binge eating, perfectionism, and dietary restraint. In the current study (N = 300 women), we tested the relationship between dietary restraint, social appearance anxiety, concern over mistakes (a component of perfectionism), and binge eating in prospective data (three time points: at baseline, at two month, and at six month follow up). We found that social appearance anxiety, dietary restraint, and concern over mistakes each predicted binge eating at baseline. Only social appearance anxiety prospectively predicted binge eating when accounting for all variables. Further, in the tested model, social appearance anxiety mediated the relationship between concern over mistakes and binge eating across six months. On the contrary, dietary restraint did not mediate the relationship between concern over mistakes and binge eating in the tested model. The finding that social appearance anxiety served as a mediator between concern over mistakes and binge eating, but that dietary restraint did not, implies that social appearance anxiety may be a more salient prospective predictor of binge eating than dietary restraint. Intervening on social appearance anxiety may be important in the treatment and prevention of binge eating. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effect of implementing instructional videos in a physical examination course: an alternative paradigm for chiropractic physical examination teaching.

PubMed

Zhang, Niu; Chawla, Sudeep

2012-01-01

This study examined the effect of implementing instructional video in ophthalmic physical examination teaching on chiropractic students' laboratory physical examination skills and written test results. Instructional video clips of ophthalmic physical examination, consisting of both standard procedures and common mistakes, were created and used for laboratory teaching. The video clips were also available for student review after class. Students' laboratory skills and written test results were analyzed and compared using one-way analysis of variance (ANOVA) and post hoc multiple comparison tests among three study cohorts: the comparison cohort who did not utilize the instructional videos as a tool, the standard video cohort who viewed only the standard procedure of video clips, and the mistake-referenced video cohort who viewed video clips containing both standard procedure and common mistakes. One-way ANOVA suggested a significant difference of lab results among the three cohorts. Post hoc multiple comparisons further revealed that the mean scores of both video cohorts were significantly higher than that of the comparison cohort (p < .001). There was, however, no significant difference of the mean scores between the two video cohorts (p > .05). However, the percentage of students having a perfect score was the highest in the mistake-referenced video cohort. There was no significant difference of written test scores among all three cohorts (p > .05). The instructional video of the standard procedure improves chiropractic students' ophthalmic physical examination skills, which may be further enhanced by implementing a mistake-referenced instructional video.

Avoiding genetic genocide: understanding good intentions and eugenics in the complex dialogue between the medical and disability communities.

PubMed

Miller, Paul Steven; Levine, Rebecca Leah

2013-02-01

The relationship between the medical and disability communities is complex and is influenced by historical, social, and cultural factors. Although clinicians, health-care researchers, and people with disabilities all work from the standpoint of the best interest of disabled individuals, the notion of what actually is "best" is often understood quite differently among these constituencies. Eugenics campaigns, legal restrictions on reproductive and other freedoms, and prenatal testing recommendations predicated on the lesser worth of persons with disabilities have all contributed toward the historic trauma experienced by the disability community, particularly with respect to medical genetics. One premise of personalized medicine is that different individuals require different solutions. Disabled persons' experiences are a reminder that these solutions can be best realized by maintaining awareness and sensitivity in a complex ethical and moral terrain. Geneticists should recognize that their research may have implications for those with disabilities; they should recognize the impact of the historical trauma of the eugenics movement, and seek to involve people with disabilities in discussions about policies that affect them. Dialogue can be messy and uncomfortable, but it is the only way to avoid the mistakes of the past and to ensure a more equitable, and healthful, future.

Data Science Careers: A Sampling of Successful Strategies, Pitfalls, and Persistent Challenges

NASA Astrophysics Data System (ADS)

Stocks, K. I.; Duerr, R.; Wyborn, L. A.; Yarmey, L.

2015-12-01

Data Scientists do not have a single career trajectory or preparatory pathway. Successful data scientists have come from domain sciences, computer science, library science, and other diverse fields. They have worked up from entry-level staff positions, have started as academics with doctoral degrees, and have established themselves as management professionals. They have positions in government, industry, academia, and NGO's, and their responsibilities range from highly specialized, to generalists, to high-level leadership. This presents a potentially confusing landscape for students interested in the field: how to decide among the varied options to have the best chance at fulfilling employment? What are the mistakes to avoid? Many established data scientist, both old-timers and early career professionals, expressed interest in presenting in this session but were unable to justify using their one AGU abstract for something other than their funded projects. As the session chairs we interviewed them, plus our extended network of colleagues, to ask for their best advice on what was most critical to their success in their current position, what pitfalls to avoid, what ongoing challenges they see, and what advice they would give themselves, if they could do it all over again starting now. Here we consolidate those interviews with our own perspectives to present some of the common themes and standout advice.

Legal & ethical compliance when sharing biospecimen.

PubMed

Klingstrom, Tomas; Bongcam-Rudloff, Erik; Reichel, Jane

2018-01-01

When obtaining samples from biobanks, resolving ethical and legal concerns is a time-consuming task where researchers need to balance the needs of privacy, trust and scientific progress. The Biobanking and Biomolecular Resources Research Infrastructure-Large Prospective Cohorts project has resolved numerous such issues through intense communication between involved researchers and experts in its mission to unite large prospective study sets in Europe. To facilitate efficient communication, it is useful for nonexperts to have an at least basic understanding of the regulatory system for managing biological samples.Laws regulating research oversight are based on national law and normally share core principles founded on international charters. In interview studies among donors, chief concerns are privacy, efficient sample utilization and access to information generated from their samples. Despite a lack of clear evidence regarding which concern takes precedence, scientific as well as public discourse has largely focused on privacy concerns and the right of donors to control the usage of their samples.It is therefore important to proactively deal with ethical and legal issues to avoid complications that delay or prevent samples from being accessed. To help biobank professionals avoid making unnecessary mistakes, we have developed this basic primer covering the relationship between ethics and law, the concept of informed consent and considerations for returning findings to donors. © The Author 2017. Published by Oxford University Press.

Avoiding genetic genocide: understanding good intentions and eugenics in the complex dialogue between the medical and disability communities

PubMed Central

Miller, Paul Steven; Levine, Rebecca Leah

2013-01-01

The relationship between the medical and disability communities is complex and is influenced by historical, social, and cultural factors. Although clinicians, health-care researchers, and people with disabilities all work from the standpoint of the best interest of disabled individuals, the notion of what actually is “best” is often understood quite differently among these constituencies. Eugenics campaigns, legal restrictions on reproductive and other freedoms, and prenatal testing recommendations predicated on the lesser worth of persons with disabilities have all contributed toward the historic trauma experienced by the disability community, particularly with respect to medical genetics. One premise of personalized medicine is that different individuals require different solutions. Disabled persons’ experiences are a reminder that these solutions can be best realized by maintaining awareness and sensitivity in a complex ethical and moral terrain. Geneticists should recognize that their research may have implications for those with disabilities; they should recognize the impact of the historical trauma of the eugenics movement, and seek to involve people with disabilities in discussions about policies that affect them. Dialogue can be messy and uncomfortable, but it is the only way to avoid the mistakes of the past and to ensure a more equitable, and healthful, future. PMID:22899092

Legal & ethical compliance when sharing biospecimen

PubMed Central

Klingstrom, Tomas; Bongcam-Rudloff, Erik; Reichel, Jane

2018-01-01

Abstract When obtaining samples from biobanks, resolving ethical and legal concerns is a time-consuming task where researchers need to balance the needs of privacy, trust and scientific progress. The Biobanking and Biomolecular Resources Research Infrastructure-Large Prospective Cohorts project has resolved numerous such issues through intense communication between involved researchers and experts in its mission to unite large prospective study sets in Europe. To facilitate efficient communication, it is useful for nonexperts to have an at least basic understanding of the regulatory system for managing biological samples. Laws regulating research oversight are based on national law and normally share core principles founded on international charters. In interview studies among donors, chief concerns are privacy, efficient sample utilization and access to information generated from their samples. Despite a lack of clear evidence regarding which concern takes precedence, scientific as well as public discourse has largely focused on privacy concerns and the right of donors to control the usage of their samples. It is therefore important to proactively deal with ethical and legal issues to avoid complications that delay or prevent samples from being accessed. To help biobank professionals avoid making unnecessary mistakes, we have developed this basic primer covering the relationship between ethics and law, the concept of informed consent and considerations for returning findings to donors. PMID:28460118

Health economic evaluation of vaccination strategies for the prevention of herpes zoster and postherpetic neuralgia in Germany.

PubMed

Ultsch, Bernhard; Weidemann, Felix; Reinhold, Thomas; Siedler, Anette; Krause, Gérard; Wichmann, Ole

2013-09-26

Herpes zoster (HZ) is a self-limiting painful skin rash affecting mostly individuals from 50 years of age. The main complication is postherpetic neuralgia (PHN), a long-lasting pain after rash has resolved. A HZ-vaccine has recently been licensed in Europe for individuals older than 50 years. To support an informed decision-making for a potential vaccination recommendation, we conducted a health economic evaluation to identify the most cost-effective vaccination strategy. We developed a static Markov-cohort model, which compared a vaccine-scenario with no vaccination. The cohort entering the model was 50 years of age, vaccinated at age 60, and stayed over life-time in the model. Transition probabilities were based on HZ/PHN-epidemiology and demographic data from Germany, as well as vaccine efficacy (VE) data from clinical trials. Costs for vaccination and HZ/PHN-treatment (in Euros; 2010), as well as outcomes were discounted equally with 3% p.a. We accounted results from both, payer and societal perspective. We calculated benefit-cost-ratio (BCR), number-needed-to-vaccinate (NNV), and incremental cost-effectiveness ratios (ICERs) for costs per HZ-case avoided, per PHN-case avoided, and per quality-adjusted life-year (QALY) gained. Different target age-groups were compared to identify the most cost-effective vaccination strategy. Base-case-analysis as well as structural, descriptive-, and probabilistic-sensitivity-analyses (DSA, PSA) were performed. When vaccinating 20% of a cohort of 1 million 50 year old individuals at the age of 60 years, approximately 20,000 HZ-cases will be avoided over life-time. The NNV to avoid one HZ (PHN)-case was 10 (144). However, with a BCR of 0.34 this vaccination-strategy did not save costs. The base-case-analysis yielded an ICER of 1,419 (20,809) Euros per avoided HZ (PHN)-case and 28,146 Euros per QALY gained. Vaccination at the age of 60 was identified in most (sensitivity) analyses to be the most cost-effective vaccination strategy. In DSA, vaccine price and VE were shown to be the most critical input-data. According to our evaluation, HZ-vaccination is expected to avoid HZ/PHN-cases and gain QALYs to higher costs. However, the vaccine price had the highest impact on the ICERs. Among different scenarios, targeting individuals aged 60 years seems to represent the most cost-effective vaccination-strategy.

Differential Cost Avoidance and Successful Criminal Careers: Random or Rational?

ERIC Educational Resources Information Center

Kazemian, Lila; Le Blanc, Marc

2007-01-01

Using a sample of adjudicated French Canadian males from the Montreal Two Samples Longitudinal Study, this article investigates individual and social characteristics associated with differential cost avoidance. The main objective of this study is to determine whether such traits are randomly distributed across differential degrees of cost…

Estimating the avoided fuel-reatment costs of wildfire

Treesearch

Geoffrey H. Donovan; Thomas C. Brown

2008-01-01

Although the importance of wildfire to fire-adapted ecosystems is widely recognized, wildfire management has historically placed less emphasis on the beneficial effects of wildfire. We estimate the avoided fuel treatment cost for 10 ponderosa pine (Pinus ponderosa) stands on the Umatilla National Forest in the Pacific Northwest. Results show that...

Chemistry Practical Lessons: Altering Traditions for Students' Emancipation

ERIC Educational Resources Information Center

Nhalevilo, Emilia Afonso

2012-01-01

This paper is a response to Maria Andree's paper. Andree tells in the paper how mistakes in practical lessons may be critical events to change students' attitudes in regard science. While traditionally mistakes in practical lessons could obligate students to repeat the experiment in order to get the "right result" in the paper we have a good…

Communicative Acts in Coach-Athlete Interactions: When Losing Competitions and when Making Mistakes in Training

ERIC Educational Resources Information Center

Sagar, Sam S.; Jowett, Sophia

2012-01-01

Athletes' perceptions of coaches' communicative acts of interaction in two key interpersonal situations were examined, and their impact on the athletes: (a) when athletes lose competitions; and, (b) when athletes make mistakes in training. Athletes (N = 324, M age = 20.11) completed an open-ended survey. Data were deductively and inductively…

The Top 10 Mistakes in Early Intervention in Natural Environments--And the Solutions

ERIC Educational Resources Information Center

McWilliam, R. A.

2011-01-01

Early intervention for infants and toddlers with disabilities and their families has strayed from its conceptual roots and the intent of the original legislation. The author describes the top 10 mistakes commonly made in early intervention, including what happens at intake, assessment, plan development, and delivery of services. He proposes five…

Using Correction Codes to Enhance Understanding of 4-Parts Harmony

ERIC Educational Resources Information Center

Engür, Doruk

2018-01-01

The effective ways of error correction in teaching musical harmony have been neglected. Making students realize their mistakes and have them think over them are assumed to be helpful in harmony teaching. In this sense, correction code technique is thought to be beneficial for students to realize their mistakes and solve them on their own. Forty…

Policies that Clarify Student Rights & Responsibilities. School Board Policy Development Kit.

ERIC Educational Resources Information Center

National School Boards Association, Waterford, CT. Educational Policies Service.

This kit discusses written policies basic to student rights and responsibilities, including those based on the constitution and those not. Specific policies should be based on three broad, basic premises: (1) recognition that freedom implies the right to make mistakes as long as these mistakes do not endanger life and property or are not seriously…

Data storage: Retrospective and prospective

NASA Technical Reports Server (NTRS)

Speliotis, Dennis E.

1993-01-01

We study history to learn from its lessons so we don't repeat the mistakes. Ironically, however, sometimes it seems that the lessons we learn from history is how to repeat the mistakes more precisely. A brief discussion about the history of magnetic recording is presented, and the lessons of the past are used to look into the future.

Erratum: I-Love-Q relations for gravastars and the approach to the black-hole limit [Phys. Rev. D 92, 124030 (2015)

NASA Astrophysics Data System (ADS)

Pani, Paolo

2017-02-01

We point out two mistakes which affect the computation of the moment of inertia and of the tidal Love number in the original paper. Both mistakes have been corrected in Ref. [1] and the correct tidal Love number agrees with the recent computation of Ref. [2].

Prospective Mathematics Teachers' Ability to Identify Mistakes Related to Angle Concept of Sixth Grade Students

ERIC Educational Resources Information Center

Arslan, Cigdem; Erbay, Hatice Nur; Guner, Pinar

2017-01-01

In the present study we try to highlight prospective mathematics teachers' ability to identify mistakes of sixth grade students related to angle concept. And also we examined prospective mathematics teachers' knowledge of angle concept. Study was carried out with 30 sixth-grade students and 38 prospective mathematics teachers. Sixth grade students…

Achievement Is a Relation, Not a Trait: The Gravity of the Situation

ERIC Educational Resources Information Center

Corrado, Gail

2012-01-01

Ability and achievement are not traits: they are relations. Mistaking traits for relations has a history even in science (our understanding of gravity). This mistake is possibly responsible for the lackluster performance of the results of our educational research when we have tried to use it to inform policy. It is particularly troublesome for…

Development of a Drug Rehabilitation Center or Mistakes We Have Made.

ERIC Educational Resources Information Center

Fox, Twilah A.; And Others

The authors discuss their first efforts at providing a contact point where young people could come for information crisis intervention and talk. Major mistakes, such as too exclusive reliance on ex-users, are elaborated. Clients' demographic and psychiatric data receive brief mention, as does the initial screening procedure. The bulk of the paper…

Low-Cost Avoidance Behaviors are Resistant to Fear Extinction in Humans

PubMed Central

Vervliet, Bram; Indekeu, Ellen

2015-01-01

Elevated levels of fear and avoidance are core symptoms across the anxiety disorders. It has long been known that fear serves to motivate avoidance. Consequently, fear extinction has been the primary focus in pre-clinical anxiety research for decades, under the implicit assumption that removing the motivator of avoidance (fear) would automatically mitigate the avoidance behaviors as well. Although this assumption has intuitive appeal, it has received little scientific scrutiny. The scarce evidence from animal studies is mixed, while the assumption remains untested in humans. The current study applied an avoidance conditioning protocol in humans to investigate the effects of fear extinction on the persistence of low-cost avoidance. Online danger-safety ratings and skin conductance responses documented the dynamics of conditioned fear across avoidance and extinction phases. Anxiety- and avoidance-related questionnaires explored individual differences in rates of avoidance. Participants first learned to click a button during a predictive danger signal, in order to cancel an upcoming aversive electrical shock (avoidance conditioning). Next, fear extinction was induced by presenting the signal in the absence of shocks while button-clicks were prevented (by removing the button in Experiment 1, or by instructing not to click the button in Experiment 2). Most importantly, post-extinction availability of the button caused a significant return of avoidant button-clicks. In addition, trait-anxiety levels correlated positively with rates of avoidance during a predictive safety signal, and with the rate of pre- to post-extinction decrease during this signal. Fear measures gradually decreased during avoidance conditioning, as participants learned that button-clicks effectively canceled the shock. Preventing button-clicks elicited a sharp increase in fear, which subsequently extinguished. Fear remained low during avoidance testing, but danger-safety ratings increased again when button-clicks were subsequently prevented. Together, these results show that low-cost avoidance behaviors can persist following fear extinction and induce increased threat appraisal. On the other hand, fear extinction did reduce augmented rates of unnecessary avoidance during safety in trait-anxious individuals, and instruction-based response prevention was more effective than removal of response cues. More research is needed to characterize the conditions under which fear extinction might mitigate avoidance. PMID:26733837

Assessing the economic value of avoiding hospital admissions by shifting the management of gram+ acute bacterial skin and skin-structure infections to an outpatient care setting.

PubMed

Ektare, V; Khachatryan, A; Xue, M; Dunne, M; Johnson, K; Stephens, J

2015-01-01

To estimate, from a US payer perspective, the cost offsets of treating gram positive acute bacterial skin and skin-structure infections (ABSSSI) with varied hospital length of stay (LOS) followed by outpatient care, as well as the cost implications of avoiding hospital admission. Economic drivers of care were estimated using a literature-based economic model incorporating inpatient and outpatient components. The model incorporated equal efficacy, adverse events (AE), resource use, and costs from literature. Costs of once- and twice-daily outpatient infusions to achieve a 14-day treatment were analyzed. Sensitivity analyses were performed. Costs were adjusted to 2015 US$. Total non-drug medical cost for treatment of ABSSSI entirely in the outpatient setting to avoid hospital admission was the lowest among all scenarios and ranged from $4039-$4924. Total non-drug cost for ABSSSI treated in the inpatient setting ranged from $9813 (3 days LOS) to $18,014 (7 days LOS). Inpatient vs outpatient cost breakdown was: 3 days inpatient ($6657)/11 days outpatient ($3156-$3877); 7 days inpatient ($15,017)/7 days outpatient ($2495-$2997). Sensitivity analyses revealed a key outpatient cost driver to be peripherally inserted central catheter (PICC) costs (average per patient cost of $873 for placement and $205 for complications). Drug and indirect costs were excluded and resource use was not differentiated by ABSSSI type. It was assumed that successful ABSSSI treatment takes up to 14 days per the product labels, and that once-daily and twice-daily antibiotics have equal efficacy. Shifting ABSSSI care to outpatient settings may result in medical cost savings greater than 53%. Typical outpatient scenarios represent 14-37% of total medical cost, with PICC accounting for 28-43% of the outpatient burden. The value of new ABSSSI therapies will be driven by eliminating the need for PICC line, reducing length of stay and the ability to completely avoid a hospital stay.

Through the minefield: teaching climate change in a misinformation-rich environment

NASA Astrophysics Data System (ADS)

Bedford, D. P.; Cook, J.; Schuenemann, K. C.; Mandia, S. A.; Cowtan, K.; Nuccitelli, D.

2016-12-01

It is now widely accepted that students enter science classrooms with their own, often erroneous, pre-existing models of basic scientific concepts. These misconceptions can interfere with student learning. However, the science of climate change is perhaps distinctive in that a deliberate effort has been undertaken by a variety of individuals and institutions to promulgate and perpetuate misconceptions. Both formal and informal efforts to communicate the science of climate change must therefore contend with the effects of these misconceptions, which may be passionately held and in strong opposition to the findings of peer-reviewed research. This presentation reports on the current state of research on misinformation and misconceptions; identifies common mistakes made in attempting to address misconceptions; and details a model which can help to avoid making most, if not all, of these common mistakes. In sum, research in cognitive psychology has shown that misconceptions are extraordinarily difficult to remove, with individuals commonly rejecting information that does not fit with their existing mental models. Attempts to address misconceptions directly can backfire if too much emphasis is placed on the misconception (i.e. leading with the myth) or by reinforcing the misconception at the expense of more accurate explanations (the familiarity backfire effect). Thus, a preferred approach involves a "myth sandwich" of facts followed by myth, followed by an explanation of how the myth distorts the facts. The misconception is therefore sandwiched between facts. This approach has been tested in a widely subscribed MOOC (Denial 101X, by Cook et al., 2015), and a textbook (Bedford and Cook, 2016). This presentation provides fundamental background on effective climate change myth debunking, and will include preliminary data regarding the efficacy of the "myth sandwich" approach.

Presenteeism--unhealthy extra presence in the workplace.

PubMed

Zakrzewska, Karolina

2014-01-01

Modifications of working conditions and difficult labour market situation have an influence on employee's health status. Consequently, new psychological phenomena can be observed in the workplace. One of them is presenteeism (sickness presence), i.e. situation when sick employee is present at work. It is associated with the decrease of productivity. The symptoms have an effect on work, its quality and amount by decreasing the productivity, generating the possibilities to make mistakes and distracting the employee from work. In case of the infectious diseases, there is a risk of disease transmission to colleagues and close contacts. Presenteeism can be defined as 'unhealthy officiousness'. It may frequently result from uncertainty, decreased possibilities for finding new work, activities aimed at reducing the absenteeism (especially sickness absenteeism) and associated costs. From the studies transpires that hidden costs of presenteeism exceed the costs of treatment, absenteeism and disability. The chronic presenteeism results in decreasing employee's productivity and potential disability. Initial pilot studies confirm that presenteeism is also observed in Poland. Thus, there is a necessity to conduct further studies on presence of sick employees in the workplace.

Marine EM: The Past, The Present, and The Future

NASA Astrophysics Data System (ADS)

Constable, S.

2016-12-01

The high cost of deepwater exploration motivated the development of commercial marine magnetotelluric (MT) exploration in 1995, but it wasn't until marine controlled-source electromagnetic (CSEM) methods burst upon the industry scene with the formation of three new contractors in 2002 that things got really exciting. Now the bubble has burst and the excitement has diminished, but marine EM remains an important tool for offshore exploration. Early mistakes were made as a result of poor instrumentation and a lack of good interpretation tools - unlike seismics, EM relies heavily on inversion to produce useful results - but both equipment and inversion codes have improved significantly. Still, there are mistakes that can be made. Rock anisotropy and seawater conductivity have to be handled appropriately. A strong galvanic response means that there is a resistivity/thickness ambiguity when imaging reservoirs, but the inductive nature of the data means that multi-frequency inversions are very much better than using single frequencies. Resolution will never be as good as for seismic methods, but is much better than for potential field methods and conductivity may often be a more diagnostic property than acoustic impedance. EM images resistivity, not hydrocarbon content, and false positives occasionally occur, but false negatives are rare. That is, without a CSEM signature there is little chance of discovering economical hydrocarbons. This should bode well for the future of the method.

32 CFR Appendix to Part 162 - Reporting Procedures

Code of Federal Regulations, 2014 CFR

2014-07-01

... generated. e. Projected Life-Cycle Savings. For each PIF project provide the estimated amount of savings the project is projected to earn over the project's economic life. f. Projected Life-Cycle Cost Avoidance. For... Projected Life-Cycle Savings. e. Total Projected Life-Cycle Cost Avoidance. 3. CSI. Each DoD Component that...

Tobacco, taxation, and fairness

PubMed Central

McLachlan, H

2002-01-01

The author defends himself against an attack by Smith and Bopp on his views on smoking and taxation. The theory that, on the grounds of equity and/or fairness, smokers should pay via taxation on tobacco for the health care costs of treating smoking-related medical conditions is discussed and shown to be defective. It is argued that the fundamental mistake that Smith and Bopp make is to confuse and conflate the separate issues of whether particular taxes are fair and whether they are justifiable. The conclusion is reached that an excise duty on tobacco is a good tax. It is a non-fair or even an unfair tax but it is justified on grounds other than fairness. PMID:12468659

Are visual cues helpful for virtual spatial navigation and spatial memory in patients with mild cognitive impairment or Alzheimer's disease?

PubMed

Cogné, Mélanie; Auriacombe, Sophie; Vasa, Louise; Tison, François; Klinger, Evelyne; Sauzéon, Hélène; Joseph, Pierre-Alain; N Kaoua, Bernard

2018-05-01

To evaluate whether visual cues are helpful for virtual spatial navigation and memory in Alzheimer's disease (AD) and patients with mild cognitive impairment (MCI). 20 patients with AD, 18 patients with MCI and 20 age-matched healthy controls (HC) were included. Participants had to actively reproduce a path that included 5 intersections with one landmark at each intersection that they had seen previously during a learning phase. Three cueing conditions for navigation were offered: salient landmarks, directional arrows and a map. A path without additional visual stimuli served as control condition. Navigation time and number of trajectory mistakes were recorded. With the presence of directional arrows, no significant difference was found between groups concerning the number of trajectory mistakes and navigation time. The number of trajectory mistakes did not differ significantly between patients with AD and patients with MCI on the path with arrows, the path with salient landmarks and the path with a map. There were significant correlations between the number of trajectory mistakes under the arrow condition and executive tests, and between the number of trajectory mistakes under the salient landmark condition and memory tests. Visual cueing such as directional arrows and salient landmarks appears helpful for spatial navigation and memory tasks in patients with AD and patients with MCI. This study opens new research avenues for neuro-rehabilitation, such as the use of augmented reality in real-life settings to support the navigational capabilities of patients with MCI and patients with AD. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Mediants Make (Number) Sense of Fraction Foibles

ERIC Educational Resources Information Center

McDowell, Eric L.

2016-01-01

By the time they reach middle school, all students have been taught to add fractions. However, not all have "learned" to add fractions. The common mistake in adding fractions is to report that a/b + c/d is equal to (a + c)/(b + d). It is certainly necessary to correct this mistake when a student makes it. However, this occasion also…

Finding and Fixing Mistakes: Do Checklists Work for Clinicians with Different Levels of Experience?

ERIC Educational Resources Information Center

Sibbald, Matthew; De Bruin, Anique B. H.; van Merrienboer, Jeroen J. G.

2014-01-01

Checklists that focus attention on key variables might allow clinicians to find and fix their mistakes. However, whether this approach can be applied to clinicians of varying degrees of expertise is unclear. Novice and expert clinicians vary in their predominant reasoning processes and in the types of errors they commit. We studied 44 clinicians…

What is Radical Behaviorism? A Review of Jay Moore's Conceptual Foundations of Radical Behaviorism

PubMed Central

Baum, William M

2011-01-01

B. F. Skinner founded both radical behaviorism and behavior analysis. His founding innovations included: a versatile preparation for studying behavior; explicating the generic nature of stimulus and response; a pragmatic criterion for defining behavioral units; response rate as a datum; the concept of stimulus control; the concept of verbal behavior; and explicating the explanatory power of contingencies. Besides these achievements, however, Skinner also made some mistakes. Subsequent developments in radical behaviorist thought have attempted to remedy these mistakes. Moore's book presents a “party line” version of radical behaviorism. It focuses narrowly on a few of Skinner's concepts (mostly mentalism and verbal behavior) and contains no criticism of his mistakes. In fact, Moore adds a few mistakes of his own manufacture; for example, he insists that the mental realm does not exist—an unprovable and distracting assertion. The book's portrayal of behavior analysis would have been current around 1960; it mentions almost none of the developments since then. It also includes almost no developments in radical behaviorism since Skinner. Moore's book would give an unwary reader a highly distorted picture of contemporary behavior analysis and radical behaviorism.

Electrophysiological correlates of oxytocin-induced enhancement of social performance monitoring.

PubMed

de Bruijn, Ellen R A; Ruissen, Margit I; Radke, Sina

2017-10-01

Altered performance monitoring has been demonstrated after administration of different pharmacological compounds and in various clinical populations, such as excessive neurophysiological responses to mistakes in anxiety disorders. Here, a novel social pharmacological approach was applied to investigate whether oxytocin administration (24 IU) enhances performance monitoring for errors that have negative consequences for another individual, so-called social mistakes. Healthy male volunteers (N = 24) participated in a placebo-controlled crossover design. EEG measures were obtained while pairs of participants performed a speeded choice reaction-time task in an individual and social context. Following oxytocin administration, error-related negativity amplitudes were increased for social compared with individual mistakes. This increase was not found in the placebo condition. No effects of oxytocin were present in the individual context. The current study shows that oxytocin enhances performance monitoring specifically for social mistakes. This outcome is in line with a presumed role for oxytocin in salience attribution to social cues and underlines its context-dependency. Combining these processes may thus open up new research avenues and advance our understanding of individual differences in performance monitoring and oxytocin responses from a social neurocognitive, pharmacological and clinical perspective. © The Author (2017). Published by Oxford University Press.

Five-year cost-effectiveness of the Patient Empowerment Programme (PEP) for type 2 diabetes mellitus in primary care.

PubMed

Lian, Jinxiao; McGhee, Sarah M; So, Ching; Chau, June; Wong, Carlos K H; Wong, William C W; Lam, Cindy L K

2017-09-01

This study evaluated the short-term cost-effectiveness of the Patient Empowerment Programme (PEP) for diabetes mellitus (DM) in Hong Kong. Propensity score matching was used to select a matched group of PEP and non-PEP subjects. A societal perspective was adopted to estimate the cost of PEP. Outcome measures were the cumulative incidence of all-cause mortality and diabetic complication over a 5-year follow-up period and the number needed to treat (NNT) to avoid 1 event. The incremental cost-effectiveness ratio (ICER) of cost per event avoided was calculated using the PEP cost per subject multiplied by the NNT. The PEP cost per subject from the societal perspective was US$247. There was a significantly lower cumulative incidence of all-cause mortality (2.9% vs 4.6%, P < .001), any DM complication (9.5% vs 10.8%, P = .001) and CVD events (6.8% vs 7.6%, P = .018), in the PEP group. The costs per death from any cause, DM complication or case of CVD avoided were US$14 465, US$19 617 and US$30 796, respectively. The extra amount allocated to managing PEP was small and it appears cost-effective in the short-term as an addition to RAMP. © 2017 John Wiley & Sons Ltd.

Barriers to movement: Modelling energetic costs of avoiding marine wind farms amongst breeding seabirds.

PubMed

Masden, Elizabeth A; Haydon, Daniel T; Fox, Anthony D; Furness, Robert W

2010-07-01

Proposals for wind farms in areas of known importance for breeding seabirds highlight the need to understand the impacts of these structures. Using an energetic modelling approach, we examine the effects of wind farms as barriers to movement on seabirds of differing morphology. Additional costs, expressed in relation to typical daily energetic expenditures, were highest per unit flight for seabirds with high wing loadings, such as cormorants. Taking species-specific differences into account, costs were relatively higher in terns, due to the high daily frequency of foraging flights. For all species, costs of extra flight to avoid a wind farm appear much less than those imposed by low food abundance or adverse weather, although such costs will be additive to these. We conclude that adopting a species-specific approach is essential when assessing the impacts of wind farms on breeding seabird populations, to fully anticipate the effects of avoidance flights. Copyright 2010 Elsevier Ltd. All rights reserved.

The costs (or benefits) associated with attended objects do little to influence inattentional blindness.

PubMed

Stothart, Cary R; Wright, Timothy J; Simons, Daniel J; Boot, Walter R

2017-02-01

We sometimes fail to notice unexpected objects or events when our attention is directed elsewhere, a phenomenon called inattentional blindness. We explored whether unexpected objects that shared the color of consequential objects would be noticed more often. In three pre-registered experiments, participants played a custom video game in which they avoided both low- and high-cost missiles (Experiment 1 and 2) or tried to hit rewarding missiles while avoiding costly ones (Experiment 3). After participants had played the game for about 8min, an unexpected object moved across the screen. Although participants selectively avoided more costly missiles when playing, they were no more likely to notice an unexpected object when its color was associated with greater costs. Apparently, people are no more likely to notice unexpected objects that are associated with negative consequences. Future research should examine whether objects that are themselves consequential are noticed more frequently. Copyright © 2016 Elsevier B.V. All rights reserved.

A Blast of Mistakes: Undiagnosed Cervical Spondylolisthesis Following a Bomb Explosion.

PubMed

Caruso, Riccardo; Marrocco, Luigi; Piccione, Emanuele; Wierzbicki, Venceslao

2017-03-30

BACKGROUND A case of spinal trauma had an unusual clinical course due to medical mistakes, from which we can learn some important lessons. CASE REPORT We report a case of spondylolisthesis following a bomb explosion, which went undiagnosed for a long time because of a series of mistakes that are highlighted in this article. What makes this case unique is that the spondylolisthesis developed during hospital stay, but the patient had no loss of mobility, strength, or sensitivity. CONCLUSIONS This case shows that establishing the conditions of an organ or a body part upon admission to hospital may not be enough when a patient has suffered extensive and serious trauma, and that it is necessary to carry out more checkups over time, especially if there are new clues and symptoms.

Error and its meaning in forensic science.

PubMed

Christensen, Angi M; Crowder, Christian M; Ousley, Stephen D; Houck, Max M

2014-01-01

The discussion of "error" has gained momentum in forensic science in the wake of the Daubert guidelines and has intensified with the National Academy of Sciences' Report. Error has many different meanings, and too often, forensic practitioners themselves as well as the courts misunderstand scientific error and statistical error rates, often confusing them with practitioner error (or mistakes). Here, we present an overview of these concepts as they pertain to forensic science applications, discussing the difference between practitioner error (including mistakes), instrument error, statistical error, and method error. We urge forensic practitioners to ensure that potential sources of error and method limitations are understood and clearly communicated and advocate that the legal community be informed regarding the differences between interobserver errors, uncertainty, variation, and mistakes. © 2013 American Academy of Forensic Sciences.

Evaluating investments in typhoid vaccines in two slums in Kolkata, India.

PubMed

Cook, Joseph; Sur, Dipika; Clemens, John; Whittington, Dale

2009-12-01

New-generation vaccines against typhoid fever have the potential to reduce the burden of disease in areas where the disease is endemic. The case for public expenditure on typhoid Vi polysaccharide vaccines for two low-income, high-incidence slums (Narkeldanga and Tiljala) in Kolkata, India, was examined. Three measures of the economic benefits of the vaccines were used: private and public cost-of-illness (COI) avoided; avoided COI plus mortality risk-reduction benefits; and willingness-to-pay (WTP) derived from stated preference (contingent valuation) studies conducted in Tiljala in 2004. Benefits and costs were examined from a social perspective. The study represents a unique opportunity to evaluate typhoid-vaccine programmes using a wealth of new site-specific epidemiological and economic data. Three typhoid-vaccination strategies (targeting only enrolled school children, targeting all children, and targeting adults and children) would most likely pass a social cost-benefit test, unless benefits are restricted to include only avoided COI. All three strategies would be considered 'very cost-effective' using the standard comparisons of cost per disability-adjusted life-year avoided with per-capita gross domestic product. However, at an average total cost per immunized person of approximately US$ 1.1, a typhoid-vaccination programme would absorb a sixth of existing public-sector spending on health (on a per-capita basis) in India. Because there appears to be significant private economic demand for typhoid vaccines, the Government could design a financially-sustainable programme with user-fees. The results show that a programme where adults pay a higher fee to subsidize vaccines for children (who have higher incidence) would avoid more cases than a uniform user-fee and still achieve revenue-neutrality.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sathaye, Jayant; Andrasko, Ken; Chan, Peter

Greenhouse gas emissions from the forestry sector are estimated to be 8.4 GtCO2-eq./year or about 17percent of the global emissions. We estimate that the cost forreducing deforestation is low in Africa and several times higher in Latin America and Southeast Asia. These cost estimates are sensitive to the uncertainties of how muchunsustainable high-revenue logging occurs, little understood transaction and program implementation costs, and barriers to implementation including governance issues. Due to lack of capacity in the affected countries, achieving reduction or avoidance of carbon emissions will require extensive REDD-plus programs. Preliminary REDD-plus Readiness cost estimates and program descriptions for Indonesia,more » Democratic Republic of the Congo, Ghana, Guyana and Mexico show that roughly one-third of potential REDD-plus mitigation benefits might come from avoided deforestation and the rest from avoided forest degradation and other REDD-plus activities.« less

Active Collision Avoidance for Planetary Landers

NASA Technical Reports Server (NTRS)

Rickman, Doug; Hannan, Mike; Srinivasan, Karthik

2015-01-01

The use of automotive radar systems are being evaluated for collision avoidance in planetary landers. Our focus is to develop a low-cost, light-weight collision avoidance system that overcomes the drawbacks identified with optical-based systems. We also seek to complement the Autonomous Landing and Hazard Avoidance Technology system by providing mission planners an alternative system that can be used on low-cost, small robotic missions and in close approach. Our approach takes advantage of how electromagnetic radiation interacts with solids. As the wavelength increases, the sensitivity of the radiation to isolated solids of a specific particle size decreases. Thus, rocket exhaust-blown dust particles, which have major significance in visible wavelengths, have much less significance at radar wavelengths.

Lane detection algorithm for an onboard camera

NASA Astrophysics Data System (ADS)

Bellino, Mario; Lopez de Meneses, Yuri; Ryser, Peter; Jacot, Jacques

2005-02-01

After analysing the major causes of injuries and death on roads, it is understandable that one of the main goals in the automotive industry is to increase vehicle safety. The European project SPARC (Secure Propulsion using Advanced Redundant Control) is developing the next generation of trucks that will fulfil these aims. The main technologies that will be used in the SPARC project to achieve the desiderated level of safety will be presented. In order to avoid accidents in critical situations, it is necessary to have a representation of the environment of the vehicle. Thus, several solutions using different sensors will be described and analysed. Particularly, a division of this project aims to integrate cameras in automotive vehicles to increase security and prevent driver's mistakes. Indeed, with this vision platform it would be possible to extract the position of the lane with respect to the vehicle, and thus, help the driver to follow the optimal trajectory. A definition of lane is proposed, and a lane detection algorithm is presented. In order to improve the detection, several criteria are explained and detailed. Regrettably, such an embedded camera is subject to the vibration of the truck, and the resulting sequence of images is difficult to analyse. Thus, we present different solutions to stabilize the images and particularly a new approach developed by the "Laboratoire de Production Microtechnique". Indeed, it was demonstrated in previous works that the presence of noise can be used, through a phenomenon called Stochastic Resonance. Thus, instead of decreasing the influence of noise in industrial applications, which has non negligible costs, it is perhaps interesting to use this phenomenon to reveal some useful information, such as for example the contour of the objects and lanes.

Health economic evaluation of vaccination strategies for the prevention of herpes zoster and postherpetic neuralgia in Germany

PubMed Central

2013-01-01

Background Herpes zoster (HZ) is a self-limiting painful skin rash affecting mostly individuals from 50 years of age. The main complication is postherpetic neuralgia (PHN), a long-lasting pain after rash has resolved. A HZ-vaccine has recently been licensed in Europe for individuals older than 50 years. To support an informed decision-making for a potential vaccination recommendation, we conducted a health economic evaluation to identify the most cost-effective vaccination strategy. Methods We developed a static Markov-cohort model, which compared a vaccine-scenario with no vaccination. The cohort entering the model was 50 years of age, vaccinated at age 60, and stayed over life-time in the model. Transition probabilities were based on HZ/PHN-epidemiology and demographic data from Germany, as well as vaccine efficacy (VE) data from clinical trials. Costs for vaccination and HZ/PHN-treatment (in Euros; 2010), as well as outcomes were discounted equally with 3% p.a. We accounted results from both, payer and societal perspective. We calculated benefit-cost-ratio (BCR), number-needed-to-vaccinate (NNV), and incremental cost-effectiveness ratios (ICERs) for costs per HZ-case avoided, per PHN-case avoided, and per quality-adjusted life-year (QALY) gained. Different target age-groups were compared to identify the most cost-effective vaccination strategy. Base-case-analysis as well as structural, descriptive-, and probabilistic-sensitivity-analyses (DSA, PSA) were performed. Results When vaccinating 20% of a cohort of 1 million 50 year old individuals at the age of 60 years, approximately 20,000 HZ-cases will be avoided over life-time. The NNV to avoid one HZ (PHN)-case was 10 (144). However, with a BCR of 0.34 this vaccination-strategy did not save costs. The base-case-analysis yielded an ICER of 1,419 (20,809) Euros per avoided HZ (PHN)-case and 28,146 Euros per QALY gained. Vaccination at the age of 60 was identified in most (sensitivity) analyses to be the most cost-effective vaccination strategy. In DSA, vaccine price and VE were shown to be the most critical input-data. Conclusions According to our evaluation, HZ-vaccination is expected to avoid HZ/PHN-cases and gain QALYs to higher costs. However, the vaccine price had the highest impact on the ICERs. Among different scenarios, targeting individuals aged 60 years seems to represent the most cost-effective vaccination-strategy. PMID:24070414

Assessing Treatment Effects of Inhaled Corticosteroids on Medical Expenses and Exacerbations among COPD Patients: Longitudinal Analysis of Managed Care Claims

PubMed Central

Akazawa, Manabu; Stearns, Sally C; Biddle, Andrea K

2008-01-01

Objective To assess costs, effectiveness, and cost-effectiveness of inhaled corticosteroids (ICS) augmenting bronchodilator treatment for chronic obstructive pulmonary disease (COPD). Data Sources Claims between 1997 and 2005 from a large managed care database. Study Design Individual-level, fixed-effects regression models estimated the effects of initiating ICS on medical expenses and likelihood of severe exacerbation. Bootstrapping provided estimates of the incremental cost per severe exacerbation avoided. Data Extraction Methods COPD patients aged 40 or older with ≥15 months of continuous eligibility were identified. Monthly observations for 1 year before and up to 2 years following initiation of bronchodilators were constructed. Principal Findings ICS treatment reduced monthly risk of severe exacerbation by 25 percent. Total costs with ICS increased for 16 months, but declined thereafter. ICS use was cost saving 46 percent of the time, with an incremental cost-effectiveness ratio of $2,973 per exacerbation avoided; for patients ≥50 years old, ICS was cost saving 57 percent of time. Conclusions ICS treatment reduces exacerbations, with an increase in total costs initially for the full sample. Compared with younger patients with COPD, patients aged 50 or older have reduced costs and improved outcomes. The estimated cost per severe exacerbation avoided, however, may be high for either group because of uncertainty as reflected by the large standard errors of the parameter estimates. PMID:18671750

I've Fallen and I Can't Get up: Can High-Ability Students Recover from Early Mistakes in CAT?

ERIC Educational Resources Information Center

Rulison, Kelly L.; Loken, Eric

2009-01-01

A difficult result to interpret in Computerized Adaptive Tests (CATs) occurs when an ability estimate initially drops and then ascends continuously until the test ends, suggesting that the true ability may be higher than implied by the final estimate. This study explains why this asymmetry occurs and shows that early mistakes by high-ability…

Fixing past mistakes. Answers to questions about reviews, refunds, disclosures.

PubMed

Fitzgerald, T Jeffrey

2003-10-01

A medical group must address practical and legal issues when it discovers improper payments, billing mistakes or alleged misconduct. Its response has a significant impact on how the charges are resolved. A group and its providers can come under fraud and abuse investigations, whistle-blower allegations and Medicare payment reviews. Many questions arise in response to billing errors or allegations of misconduct.

The Mistakes and the Misconceptions of the Eighth Grade Students on the Subject of Angles

ERIC Educational Resources Information Center

Biber, Çagri; Tuna, Abdulkadir; Korkmaz, Samet

2013-01-01

The purpose of this study was to determine the learning levels, mistakes, and misconceptions of the 8th grade students on the subject of "angles in geometry" as well as the possible reasons for these situations. Research sample consisted of 30 students attending the 8th grade of a middle school located in the central district of a…

Low perception of control as a cognitive factor of eating disorders. Its independent effects on measures of eating disorders and its interactive effects with perfectionism and self-esteem.

PubMed

Sassaroli, Sandra; Gallucci, Marcello; Ruggiero, Giovanni Maria

2008-12-01

There is a large body of research about perfectionism and low self-esteem in eating disorders (ED). However, little is known about the influence in ED of a distorted cognition in the domain of control: the perception of low control. The present study examined the main and interactive effects of concern over mistakes (an important dimension of perfectionism), self-esteem, and perception of control on drive for thinness, bulimia, and body dissatisfaction. Forty individuals with ED and 55 controls completed the Multidimensional Perfectionism Scale, the Anxiety Control Questionnaire, the Rosenberg self-esteem scale, and the three symptomatic scales of the Eating Disorder Inventory, which are drive for thinness, bulimia and body dissatisfaction. Multiple linear regression was used to test the hypothesis that perception of low control has a significant effect on the symptomatic scales of the EDI. The ED group had significantly lower perception of control and self-esteem and higher concern over mistakes, drive for thinness, bulimia, and body dissatisfaction than the control group. Analysis of interactive effects suggested that a combination of a low perception of control and a low self-esteem seems to moderate the effects of concern over mistakes on drive for thinness, bulimia, and body dissatisfaction. ED are associated with a tendency to worry about mistakes, a low sense of self-esteem, and a low perception of control over internal feelings and external events. Perception of control and self-esteem seems to moderate the predictive power of concern mistakes on symptoms of ED. The results suggest that a low perception of control is an important cognitive factor in ED.

29 CFR 102.54 - Initiation of formal compliance proceedings; issuance of compliance specification and notice of...

Code of Federal Regulations, 2011 CFR

2011-07-01

... the purposes and policies of the Act or to avoid unnecessary costs or delay, the Regional Director may... policies of the Act or to avoid unnecessary costs or delay, the Regional Director may consolidate with a... formal proceeding, the Regional Director may issue and serve on all parties a compliance specification in...

29 CFR 102.54 - Initiation of formal compliance proceedings; issuance of compliance specification and notice of...

Code of Federal Regulations, 2010 CFR

2010-07-01

... the purposes and policies of the Act or to avoid unnecessary costs or delay, the Regional Director may... policies of the Act or to avoid unnecessary costs or delay, the Regional Director may consolidate with a... formal proceeding, the Regional Director may issue and serve on all parties a compliance specification in...

Tradespace and Affordability - Phase 1

DTIC Science & Technology

2013-07-09

assessment options Cost-effectiveness, risk reduction leverage/ROI, rework avoidance Tool, data, scenario availability Contract Number: H98230-08-D-0171...Prepare FED assessment plans and earned value milestones Try to relate earned value to risk -exposure avoided rather than budgeted cost F. Begin...evaluate and iterate plans and enablers I. Assess readiness for Commitment Review Shortfalls identified as risks and covered by risk mitigation

Benchmarking in pathology: development of an activity-based costing model.

PubMed

Burnett, Leslie; Wilson, Roger; Pfeffer, Sally; Lowry, John

2012-12-01

Benchmarking in Pathology (BiP) allows pathology laboratories to determine the unit cost of all laboratory tests and procedures, and also provides organisational productivity indices allowing comparisons of performance with other BiP participants. We describe 14 years of progressive enhancement to a BiP program, including the implementation of 'avoidable costs' as the accounting basis for allocation of costs rather than previous approaches using 'total costs'. A hierarchical tree-structured activity-based costing model distributes 'avoidable costs' attributable to the pathology activities component of a pathology laboratory operation. The hierarchical tree model permits costs to be allocated across multiple laboratory sites and organisational structures. This has enabled benchmarking on a number of levels, including test profiles and non-testing related workload activities. The development of methods for dealing with variable cost inputs, allocation of indirect costs using imputation techniques, panels of tests, and blood-bank record keeping, have been successfully integrated into the costing model. A variety of laboratory management reports are produced, including the 'cost per test' of each pathology 'test' output. Benchmarking comparisons may be undertaken at any and all of the 'cost per test' and 'cost per Benchmarking Complexity Unit' level, 'discipline/department' (sub-specialty) level, or overall laboratory/site and organisational levels. We have completed development of a national BiP program. An activity-based costing methodology based on avoidable costs overcomes many problems of previous benchmarking studies based on total costs. The use of benchmarking complexity adjustment permits correction for varying test-mix and diagnostic complexity between laboratories. Use of iterative communication strategies with program participants can overcome many obstacles and lead to innovations.

39 CFR 3050.24 - Documentation supporting estimates of costs avoided by worksharing and other mail characteristics...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Computer Reader finalization costs, cost per image, and Remote Bar Code Sorter leakage; (8) Percentage of... processing units costs for Carrier Route, High Density, and Saturation mail; (j) Mail processing unit costs...

39 CFR 3050.24 - Documentation supporting estimates of costs avoided by worksharing and other mail characteristics...

Code of Federal Regulations, 2011 CFR

2011-07-01

... Computer Reader finalization costs, cost per image, and Remote Bar Code Sorter leakage; (8) Percentage of... processing units costs for Carrier Route, High Density, and Saturation mail; (j) Mail processing unit costs...

39 CFR 3050.24 - Documentation supporting estimates of costs avoided by worksharing and other mail characteristics...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Computer Reader finalization costs, cost per image, and Remote Bar Code Sorter leakage; (8) Percentage of... processing units costs for Carrier Route, High Density, and Saturation mail; (j) Mail processing unit costs...

39 CFR 3050.24 - Documentation supporting estimates of costs avoided by worksharing and other mail characteristics...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Computer Reader finalization costs, cost per image, and Remote Bar Code Sorter leakage; (8) Percentage of... processing units costs for Carrier Route, High Density, and Saturation mail; (j) Mail processing unit costs...

39 CFR 3050.24 - Documentation supporting estimates of costs avoided by worksharing and other mail characteristics...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Computer Reader finalization costs, cost per image, and Remote Bar Code Sorter leakage; (8) Percentage of... processing units costs for Carrier Route, High Density, and Saturation mail; (j) Mail processing unit costs...

"Watch out!": Effects of instructed threat and avoidance on human free-operant approach-avoidance behavior.

PubMed

Schlund, Michael W; Treacher, Kay; Preston, Oli; Magee, Sandy K; Richman, David M; Brewer, Adam T; Cameron, Gemma; Dymond, Simon

2017-01-01

Approach-avoidance paradigms create a competition between appetitive and aversive contingencies and are widely used in nonhuman research on anxiety. Here, we examined how instructions about threat and avoidance impact control by competing contingencies over human approach-avoidance behavior. Additionally, Experiment 1 examined the effects of threat magnitude (money loss amount) and avoidance cost (fixed ratio requirements), whereas Experiment 2 examined the effects of threat information (available, unavailable and inaccurate) on approach-avoidance. During the task, approach responding was modeled by reinforcing responding with money on a FR schedule. By performing an observing response, participants produced an escalating "threat meter". Instructions stated that the threat meter levels displayed the current probability of losing money, when in fact loss only occurred when the level reached the maximum. Instructions also stated pressing an avoidance button lowered the threat level. Overall, instructions produced cycles of approach and avoidance responding with transitions from approach to avoidance when threat was high and transitions back to approach after avoidance reduced threat. Experiment 1 revealed increasing avoidance cost, but not threat magnitude, shifted approach-avoidance transitions to higher threat levels and increased anxiety ratings, but did not influence the frequency of approach-avoidance cycles. Experiment 2 revealed when threat level information was available or absent earnings were high, but earnings decreased when inaccurate threat information was incompatible with contingencies. Our findings build on prior nonhuman and human approach-avoidance research by highlighting how instructed threat and avoidance can impact human AA behavior and self-reported anxiety. © 2017 Society for the Experimental Analysis of Behavior.

How to take deontological concerns seriously in risk-cost-benefit analysis: a re-interpretation of the precautionary principle.

PubMed

John, S D

2007-04-01

In this paper the coherence of the precautionary principle as a guide to public health policy is considered. Two conditions that any account of the principle must meet are outlined, a condition of practicality and a condition of publicity. The principle is interpreted in terms of a tripartite division of the outcomes of action (good outcomes, normal bad outcomes and special bad outcomes). Such a division of outcomes can be justified on either "consequentialist" or "deontological" grounds. In the second half of the paper, it is argued that the precautionary principle is not necessarily opposed to risk-cost-benefit analysis, but, rather, should be interpreted as suggesting a lowering of our epistemic standards for assessing evidence that there is a link between some policy and "special bad" outcomes. This suggestion is defended against the claim that it mistakes the nature of statistical testing and against the charge that it is unscientific or antiscientific, and therefore irrational.

Optimal consensus algorithm integrated with obstacle avoidance

NASA Astrophysics Data System (ADS)

Wang, Jianan; Xin, Ming

2013-01-01

This article proposes a new consensus algorithm for the networked single-integrator systems in an obstacle-laden environment. A novel optimal control approach is utilised to achieve not only multi-agent consensus but also obstacle avoidance capability with minimised control efforts. Three cost functional components are defined to fulfil the respective tasks. In particular, an innovative nonquadratic obstacle avoidance cost function is constructed from an inverse optimal control perspective. The other two components are designed to ensure consensus and constrain the control effort. The asymptotic stability and optimality are proven. In addition, the distributed and analytical optimal control law only requires local information based on the communication topology to guarantee the proposed behaviours, rather than all agents' information. The consensus and obstacle avoidance are validated through simulations.

The philosophy of 'unity of knowledge and action' in interventional neuroradiology teaching.

PubMed

Lv, Xianli; Wu, Zhongxue

2018-06-01

Despite the continuing emphasis on the importance of clinical skills, these skills do not appear to be improving and may actually be declining. The 'unity of knowledge and action' is a medicine directed precisely at this disease. The 'unity of knowledge and action' helps to learn from failure and successes, learn from mistakes of predecessors and institute a behaviour that prevents repetition of these mistakes.

Identification of mistakes and their correction by a small group discussion as a revision exercise at the end of a teaching module in biochemistry.

PubMed

Bobby, Zachariah; Nandeesha, H; Sridhar, M G; Soundravally, R; Setiya, Sajita; Babu, M Sathish; Niranjan, G

2014-01-01

Graduate medical students often get less opportunity for clarifying their doubts and to reinforce their concepts after lecture classes. The Medical Council of India (MCI) encourages group discussions among students. We evaluated the effect of identifying mistakes in a given set of wrong statements and their correction by a small group discussion by graduate medical students as a revision exercise. At the end of a module, a pre-test consisting of multiple-choice questions (MCQs) was conducted. Later, a set of incorrect statements related to the topic was given to the students and they were asked to identify the mistakes and correct them in a small group discussion. The effects on low, medium and high achievers were evaluated by a post-test and delayed post-tests with the same set of MCQs. The mean post-test marks were significantly higher among all the three groups compared to the pre-test marks. The gain from the small group discussion was equal among low, medium and high achievers. The gain from the exercise was retained among low, medium and high achievers after 15 days. Identification of mistakes in statements and their correction by a small group discussion is an effective, but unconventional revision exercise in biochemistry. Copyright 2014, NMJI.

Rape avoidance behavior among Slovak women.

PubMed

Prokop, Pavol

2013-05-28

Rape has been a recurrent adaptive problem for many species, including humans. Rape is costly to women in terms of disease transmission, partner abandonment, and unwanted pregnancy (among other costs). Therefore, behavioral strategies which allow women to avoid coercive men may have been favored by selection. In line with this evolutionary reasoning, the current research documented that physically stronger women and those in a committed romantic relationship reported more rape avoidance behavior. In addition, virgin women tended to perform more rape avoidance behavior compared with their non-virgin counterparts. Women with high conception risk perceived themselves as physically stronger, which may protect them against a potential rapist. Fear of unwanted pregnancy from rape decreased as age increased, reflecting higher fertility among younger participants. However, older women reported more rape avoidance behavior, which contradicts evolutionary predictions. The results provide some support for evolutionary hypotheses of rape avoidance behavior which suggest that woman's perception of rape is influenced by parental investment and perceived physical condition.

A Low-Cost Simulation Model for R-Wave Synchronized Atrial Pacing in Pediatric Patients with Postoperative Junctional Ectopic Tachycardia

PubMed Central

Michel, Miriam; Egender, Friedemann; Heßling, Vera; Dähnert, Ingo; Gebauer, Roman

2016-01-01

Background Postoperative junctional ectopic tachycardia (JET) occurs frequently after pediatric cardiac surgery. R-wave synchronized atrial (AVT) pacing is used to re-establish atrioventricular synchrony. AVT pacing is complex, with technical pitfalls. We sought to establish and to test a low-cost simulation model suitable for training and analysis in AVT pacing. Methods A simulation model was developed based on a JET simulator, a simulation doll, a cardiac monitor, and a pacemaker. A computer program simulated electrocardiograms. Ten experienced pediatric cardiologists tested the model. Their performance was analyzed using a testing protocol with 10 working steps. Results Four testers found the simulation model realistic; 6 found it very realistic. Nine claimed that the trial had improved their skills. All testers considered the model useful in teaching AVT pacing. The simulation test identified 5 working steps in which major mistakes in performance test may impede safe and effective AVT pacing and thus permitted specific training. The components of the model (exclusive monitor and pacemaker) cost less than $50. Assembly and training-session expenses were trivial. Conclusions A realistic, low-cost simulation model of AVT pacing is described. The model is suitable for teaching and analyzing AVT pacing technique. PMID:26943363

Medical cost and frequent mental distress among the non-elderly US adult population.

PubMed

Bruning, John; Arif, Ahmed A; Rohrer, James E

2014-03-01

Frequent mental distress (FMD) is an important measure of perceived poor mental health. With the rising cost of health care, it is not uncommon for working adults to delay seeking care. The objective of this study was to determine the relationship between avoidance of medical care due to cost and FMD among the non-elderly US population. We analyzed data from 282 044 non-elderly US population from a 2008 Behavioral Risk Factor Surveillance System survey. Multivariable logistic regression models were used to assess the association between avoidance of medical care due to cost and FMD adjusted for covariates. The overall prevalence of FMD in the non-elderly population was 11.1%; whereas it was 24.2% for those reporting avoiding medical care due to cost. Approximately 18% of the population had no health insurance coverage and the prevalence of FMD was significantly greater in this group. The odds of FMD were >2-fold elevated for respondents who were unable to see a doctor because of cost (adjusted odds ratio: 2.40, 99% confidence interval: 2.19, 2.63). These findings highlight the need for affordable medical care for reducing mental distress and improving population health.

Sources of medical error in refractive surgery.

PubMed

Moshirfar, Majid; Simpson, Rachel G; Dave, Sonal B; Christiansen, Steven M; Edmonds, Jason N; Culbertson, William W; Pascucci, Stephen E; Sher, Neal A; Cano, David B; Trattler, William B

2013-05-01

To evaluate the causes of laser programming errors in refractive surgery and outcomes in these cases. In this multicenter, retrospective chart review, 22 eyes of 18 patients who had incorrect data entered into the refractive laser computer system at the time of treatment were evaluated. Cases were analyzed to uncover the etiology of these errors, patient follow-up treatments, and final outcomes. The results were used to identify potential methods to avoid similar errors in the future. Every patient experienced compromised uncorrected visual acuity requiring additional intervention, and 7 of 22 eyes (32%) lost corrected distance visual acuity (CDVA) of at least one line. Sixteen patients were suitable candidates for additional surgical correction to address these residual visual symptoms and six were not. Thirteen of 22 eyes (59%) received surgical follow-up treatment; nine eyes were treated with contact lenses. After follow-up treatment, six patients (27%) still had a loss of one line or more of CDVA. Three significant sources of error were identified: errors of cylinder conversion, data entry, and patient identification error. Twenty-seven percent of eyes with laser programming errors ultimately lost one or more lines of CDVA. Patients who underwent surgical revision had better outcomes than those who did not. Many of the mistakes identified were likely avoidable had preventive measures been taken, such as strict adherence to patient verification protocol or rigorous rechecking of treatment parameters. Copyright 2013, SLACK Incorporated.

Errors prevention in manufacturing process through integration of Poka Yoke and TRIZ

NASA Astrophysics Data System (ADS)

Helmi, Syed Ahmad; Nordin, Nur Nashwa; Hisjam, Muhammad

2017-11-01

Integration of Poka Yoke and TRIZ is a method of solving problems by using a different approach. Poka Yoke is a trial and error method while TRIZ is using a systematic approach. The main purpose of this technique is to get rid of product defects by preventing or correcting errors as soon as possible. Blame the workers for their mistakes is not the best way, but the work process should be reviewed so that every workers behavior or movement may not cause errors. This study is to demonstrate the importance of using both of these methods in which everyone in the industry needs to improve quality, increase productivity and at the same time reducing production cost.

Why revisit your cost-accounting strategy.

PubMed

Arredondo, Ricky

2014-07-01

Healthcare entities seeking to develop effective cost-accounting systems should take six steps to avoid potential pitfalls: Secure broad executive-level support for the effort. Ensure systems are in place to analyze the disparate data. Define measurable objectives to ensure that implementation achieves desired results. Give due consideration to implementation planning. Train support staff sufficiently to avoid underutilization. Develop a sufficiently broad base of staff support for the system.

[Use of cognitive aids in pediatric emergency care : Interdisciplinary consensus statement].

PubMed

Wirtz, S; Eich, C; Becke, K; Brenner, S; Callies, A; Harding, U; Höhne, C; Hoffmann, F; Kaufmann, J; Landsleitner, B; Marung, H; Nicolai, T; Reifferscheid, F; Trappe, U; Jung, P

2017-05-01

Preclinical pediatric emergencies are rare events and are therefore often associated with stress and uncertainty for emergency medical service personnel. To ensure adequate treatment of pediatric patients a variety of different cognitive aids exist (e.g. books, apps, rulers, weight-adapted bag systems). Especially the size specifications of the medical equipment and the dosage of emergency medication are individually very different in children and are dependent on parameters, such as body height and weight. Therefore, cognitive aids often enable length measurement whereby it is possible to draw conclusions on body weight for calculating the child's medication dosage. These aids may help to avoid the wrong medication dose or the wrong therapy of children but uncritical and untrained usage of these aids carries a potential risk of mistakes. This recommendation gives an overview of the general requirements and different problems of cognitive aids and should help improve the general framework and the rational basis for the use and further development of cognitive aids in emergency medicine.

"Our Time is Up": A Relational Perspective on the Ending of a Single Psychotherapy Session.

PubMed

Gans, Jerome S

2016-12-31

This paper, written from a relational perspective, examines the final minutes of an individual psychotherapy session, and is organized around the topics of boundary negotiation, unwitting self-disclosures, visual challenges, and countertransference. Attending to session-ending material is important because the separation involved lends heightened emotional intensity to the oftensignificant material that appears in the final minutes. This material often serves as a bridge to the psychotherapeutic work to be taken up in subsequent sessions. Session-ending dynamics call upon the therapist to prioritize empathy, validation, and support for the patient suffering from early deprivation; identify and heal narcissistic injury in the patient wishing to be special; judiciously alter the frame when doing so will benefit the patient and not constitute a boundary violation; avoid re-traumatization; admit mistakes; confront blatant denial; advance agency; address uncomfortable topics; set appropriate limits; and deal authentically with uncomfortable countertransference. Numerous clinical examples serve to illustrate these clinical phenomena.

The Individual and Group Loyalty Scales (IGLS): construction and preliminary validation.

PubMed

Beer, Andrew; Watson, David

2009-05-01

Trait loyalty has received virtually no attention from researchers; consequently, the basic goal of this research was to create a measure of interpersonal loyalty. Principal factor analyses of an initial pool of items revealed 2 factors: Individual Loyalty (e.g., "I stand by my friends, even when they make mistakes") and Group Loyalty (e.g., "I am loyal to my country"). Analyses of a revised item pool identified the same 2 factors in a second sample. Scales based on these factors were internally consistent and only moderately related to one another. Additional analyses indicated that both scales (a) were stable over time; (b) showed moderate to strong self-peer agreement; (c) positively correlated with conscientiousness, agreeableness, altruism, and positive emotionality; and (d) negatively related to an avoidant attachment style. However, these associations all were moderate in magnitude (in fact, none was as high as |.40|), indicating that the Individual and Group Loyalty Scales tap unique variance that is not captured by existing instruments.

Board oversight of executive performance and compensation.

PubMed

Curran, Connie R; Totten, Mary K

2010-01-01

Making sure the relative roles of the board and management are clear and agreed upon is becoming more important as market and regulatory forces compel boards to govern at levels of detail once considered micromanagement, but are now required and necessary in the current environment of heightened governance accountability. A clear understanding of each other's roles and responsibilities is step one in building a solid partnership between the board and chief executive. A second element of building a strong foundation for the board-CEO relationship is taking time early on to establish mutual expectations about working together. The board's responsibilities in CEO performance management and compensation include setting performance expectations and goals that are clear and measurable and coaching and motivating the CEO. When a CEO fails, one of the most important steps for the board to take is to look in the mirror and commit to the rigorous due diligence needed to avoid future mistakes. Boards should always have CEO succession on their agenda.

Specimen preparation for high-resolution cryo-EM

PubMed Central

Passmore, Lori A.; Russo, Christopher J.

2016-01-01

Imaging a material with electrons at near-atomic resolution requires a thin specimen that is stable in the vacuum of the transmission electron microscope. For biological samples, this comprises a thin layer of frozen aqueous solution containing the biomolecular complex of interest. The process of preparing a high-quality specimen is often the limiting step in the determination of structures by single-particle electron cryomicroscopy (cryo-EM). Here we describe a systematic approach for going from a purified biomolecular complex in aqueous solution to high-resolution electron micrographs that are suitable for 3D structure determination. This includes a series of protocols for the preparation of vitrified specimens on various specimen supports, including all-gold and graphene. We also describe techniques for troubleshooting when a preparation fails to yield suitable specimens, and common mistakes to avoid during each part of the process. Finally, we include recommendations for obtaining the highest quality micrographs from prepared specimens with current microscope, detector and support technology. PMID:27572723

Research on the human genome and patentability--the ethical consequences.

PubMed Central

Pompidou, A

1995-01-01

The genome is one of the primordial elements of the human being and is responsible for human identity and its transmission to descendants. The gene as such ought not be appropriated or owned by man. However, any sufficiently complete description of a gene should be capable of being protected as intellectual property. Furthermore, all utilisations of a gene or its elements that permit development of processes or new products should be patentable. Ethics, in the sense of moral action, should come into play from the very first stages of research into the human genome. Protection of intellectual and industrial property is of purely legal concern and need not provoke ethical consideration. By contrast, the use of the results of, and in particular the commercialisation of products deriving from, research into the human genome, ought to be subjected to ethical consideration and control. Considering the economic and societal stakes of such research, ethical analysis ought to be at an international level if mistakes and unforeseen risks of conflict are to be avoided. PMID:7608941

a Matter of Confidence: Gender Differences in Attitudes Toward Engaging in Lab and Course Work in Undergraduate Engineering

NASA Astrophysics Data System (ADS)

Micari, Marina; Pazos, Pilar; Hartmann, Mitra J. Z.

Although there has been a great deal of research on women's experiences in engineering study, there has been little attempt to connect experiential factors to performance in both course and lab. This two-phase study investigated gender differences in undergraduates' experiences in a fluid mechanics course as well as the relationship between experiential factors and student performance in that course. One hundred forty-seven students at a Midwestern research university completed questionnaires related to course experience and perceived engagement. Data were also collected on final grade for 89 students in the second round of data collection. Relative to men, women reported less confidence that they could avoid mistakes in the lab, less experience with mechanical items, less perceived ability in engineering relative to classmates, and less perceived skill in tasks requiring navigation or maneuvering through space. Feelings of engagement were related to grade, but no gender differences were found in either engagement or grade.

Errors analysis of problem solving using the Newman stage after applying cooperative learning of TTW type

NASA Astrophysics Data System (ADS)

Rr Chusnul, C.; Mardiyana, S., Dewi Retno

2017-12-01

Problem solving is the basis of mathematics learning. Problem solving teaches us to clarify an issue coherently in order to avoid misunderstanding information. Sometimes there may be mistakes in problem solving due to misunderstanding the issue, choosing a wrong concept or misapplied concept. The problem-solving test was carried out after students were given treatment on learning by using cooperative learning of TTW type. The purpose of this study was to elucidate student problem regarding to problem solving errors after learning by using cooperative learning of TTW type. Newman stages were used to identify problem solving errors in this study. The new research used a descriptive method to find out problem solving errors in students. The subject in this study were students of Vocational Senior High School (SMK) in 10th grade. Test and interview was conducted for data collection. Thus, the results of this study suggested problem solving errors in students after learning by using cooperative learning of TTW type for Newman stages.

Modular space station phase B extension program cost and schedules. Volume 1: Cost and schedule estimating process and results

NASA Technical Reports Server (NTRS)

Frassinelli, G. J.

1972-01-01

Cost estimates and funding schedules are presented for a given configuration and costing ground rules. Cost methodology is described and the cost evolution from a baseline configuration to a selected configuration is given, emphasizing cases in which cost was a design driver. Programmatic cost avoidance techniques are discussed.

Strategies to fight low-cost rivals.

PubMed

Kumar, Nirmalya

2006-12-01

Companies find it challenging and yet strangely reassuring to take on opponents whose strategies, strengths, and weaknesses resemble their own. Their obsession with familiar rivals, however, has blinded them to threats from disruptive, low-cost competitors. Successful price warriors, such as the German retailer Aldi, are changing the nature of competition by employing several tactics: focusing on just one or a few consumer segments, delivering the basic product or providing one benefit better than rivals do, and backing low prices with superefficient operations. Ignoring cutprice rivals is a mistake because they eventually force companies to vacate entire market segments. Price wars are not the answer, either: Slashing prices usually lowers profits for incumbents without driving the low-cost entrants out of business. Companies take various approaches to competing against cut-price players. Some differentiate their products--a strategy that works only in certain circumstances. Others launch low-cost businesses of their own, as many airlines did in the 1990s--a so-called dual strategy that succeeds only if companies can generate synergies between the existing businesses and the new ventures, as the financial service providers HSBC and ING did. Without synergies, corporations are better off trying to transform themselves into low-cost players, a difficult feat that Ryanair accomplished in the 1990s, or into solution providers. There will always be room for both low-cost and value-added players. How much room each will have depends not only on the industry and customers' preferences, but also on the strategies traditional businesses deploy.

Utilization of lean management principles in the ambulatory clinic setting.

PubMed

Casey, Jessica T; Brinton, Thomas S; Gonzalez, Chris M

2009-03-01

The principles of 'lean management' have permeated many sectors of today's business world, secondary to the success of the Toyota Production System. This management method enables workers to eliminate mistakes, reduce delays, lower costs, and improve the overall quality of the product or service they deliver. These lean management principles can be applied to health care. Their implementation within the ambulatory care setting is predicated on the continuous identification and elimination of waste within the process. The key concepts of flow time, inventory and throughput are utilized to improve the flow of patients through the clinic, and to identify points that slow this process -- so-called bottlenecks. Nonessential activities are shifted away from bottlenecks (i.e. the physician), and extra work capacity is generated from existing resources, rather than being added. The additional work capacity facilitates a more efficient response to variability, which in turn results in cost savings, more time for the physician to interact with patients, and faster completion of patient visits. Finally, application of the lean management principle of 'just-in-time' management can eliminate excess clinic inventory, better synchronize office supply with patient demand, and reduce costs.

Using Risk Assessment Methodologies to Meet Management Objectives

NASA Technical Reports Server (NTRS)

DeMott, D. L.

2015-01-01

Current decision making involves numerous possible combinations of technology elements, safety and health issues, operational aspects and process considerations to satisfy program goals. Identifying potential risk considerations as part of the management decision making process provides additional tools to make more informed management decision. Adapting and using risk assessment methodologies can generate new perspectives on various risk and safety concerns that are not immediately apparent. Safety and operational risks can be identified and final decisions can balance these considerations with cost and schedule risks. Additional assessments can also show likelihood of event occurrence and event consequence to provide a more informed basis for decision making, as well as cost effective mitigation strategies. Methodologies available to perform Risk Assessments range from qualitative identification of risk potential, to detailed assessments where quantitative probabilities are calculated. Methodology used should be based on factors that include: 1) type of industry and industry standards, 2) tasks, tools, and environment 3) type and availability of data and 4) industry views and requirements regarding risk & reliability. Risk Assessments are a tool for decision makers to understand potential consequences and be in a position to reduce, mitigate or eliminate costly mistakes or catastrophic failures.

Why and how I communicate on social and traditional media, and some mistakes along the way

NASA Astrophysics Data System (ADS)

Gleeson, Tom

2017-04-01

I love science and consider water issues crucial for society, which inspires me to try to make water science and issues better known in the broader world through our diverse, modern media landscape. It is tricky, time-consuming and sometimes frustrating, but often very rewarding. I will share some of my history, views, mistakes and successes on communicating on social and traditional media, to hopefully inspire others.

Letters from Abbottabad: Bin Ladin Sidelined?

DTIC Science & Technology

2012-05-03

administration of hudud (deterrent penalties for certain crimes ). He also wanted them to focus on “construction and 3 development” and feared that...committing political mistakes, you have no doubt heard Abu `Umar [al-Baghdadi’s] recent speech ; in my view, it contains obvious mistakes.” In his...mind, not only was the speech unfitting for a leader to make, but it also revealed that “they are extremists (mutashaddidun)…[and that his speech ] is

Recognizing Prefixes in Scientific Quantities

NASA Astrophysics Data System (ADS)

Sokolowski, Andrzej

2015-09-01

Although recognizing prefixes in physical quantities is inherent for practitioners, it might not be inherent for students, who do not use prefixes in their everyday life experiences. This deficiency surfaces in AP Physics exams. For example, readers of an AP Physics exam reported "a common mistake of incorrectly converting nanometers to meters." Similar students' mistakes were reported also by AP Chemistry readers "as in previous years, students still had difficulty converting kJ to J." While traditional teaching focuses on memorizing the symbols of prefixes, little attention is given to helping learners recognize a prefix in a given quantity. I noticed in my teaching practice that by making the processes of identifying prefixes more explicit, students make fewer mistakes on unit conversion. Thus, this paper presents an outline of a lesson that focuses on prefix recognition. It is designed for a first-year college physics class; however, its key points can be addressed to any group of physics students.

Costs and benefits of rapid screening of methicillin-resistant Staphylococcus aureus carriage in intensive care units: a prospective multicenter study

PubMed Central

2012-01-01

Introduction Pre-emptive isolation of suspected methicillin-resistant Staphylococcus aureus (MRSA) carriers is a cornerstone of successful MRSA control policies. Implementation of such strategies is hampered when using conventional cultures with diagnostic delays of three to five days, as many non-carriers remain unnecessarily isolated. Rapid diagnostic testing (RDT) reduces the amount of unnecessary isolation days, but costs and benefits have not been accurately determined in intensive care units (ICUs). Methods Embedded in a multi-center hospital-wide study in 12 Dutch hospitals we quantified cost per isolation day avoided using RDT for MRSA, added to conventional cultures, in ICUs. BD GeneOhm™ MRSA PCR (IDI) and Xpert MRSA (GeneXpert) were subsequently used during 17 and 14 months, and their test characteristics were calculated with conventional culture results as reference. We calculated the number of pre-emptive isolation days avoided and incremental costs of adding RDT. Results A total of 163 patients at risk for MRSA carriage were screened and MRSA prevalence was 3.1% (n = 5). Duration of isolation was 27.6 and 21.4 hours with IDI and GeneXpert, respectively, and would have been 96.0 hours when based on conventional cultures. The negative predictive value was 100% for both tests. Numbers of isolation days were reduced by 44.3% with PCR-based screening at the additional costs of €327.84 (IDI) and €252.14 (GeneXpert) per patient screened. Costs per isolation day avoided were €136.04 (IDI) and €121.76 (GeneXpert). Conclusions In a low endemic setting for MRSA, RDT safely reduced the number of unnecessary isolation days on ICUs by 44%, at the costs of €121.76 to €136.04 per isolation day avoided. PMID:22314204

48 CFR 31.105 - Construction and architect-engineer contracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., include unallowable interest costs, or use improper cost of money rates or computations. Contracting... contracts, including cost-reimbursement subcontracts thereunder; (2) Negotiating indirect cost rates; (3... appropriate they serve to express the parties' understanding and avoid possible subsequent disputes or...

The Use of Parenteral Nutrition Support in an Acute Care Hospital and the Cost Implications of Short-term Parenteral Nutrition.

PubMed

Wong, Alvin Tc; Ong, Jeannie Pl; Han, Hsien Hwei

2016-06-01

Parenteral nutrition (PN) is indicated for patients who are unable to progress to oral or enteral nutrition. There are no local studies done on estimating the cost of PN in acute settings. The aims of this study are to describe the demographics, costs of PN and manpower required; and to determine the avoidable PN costs for patients and hospital on short-term PN. Patient data between October 2011 and December 2013 were reviewed. Data collected include demographics, length of stay (LOS), and the indication/duration of PN. PN administration cost was based on the cost of the PN bags, blood tests and miscellaneous items, adjusted to subsidy levels. Manpower costs were based on the average hourly rate. Costs for PN and manpower were approximately S$1.2 million for 2791 PN days. Thirty-six cases (18.8%) of 140 PN days were short-term and considered to be avoidable where patients progressed to oral/enteral diet within 5 days. These short-term cases totalled $59,154.42, where $42,183.15 was payable by the patients. The daily costs for PN is also significantly higher for patients on short-term PN (P <0.001). In our acute hospital, 90% of patients referred for PN were surgical patients. Majority of the cost comes from the direct daily cost of the bag and blood tests, while extensive manpower cost was borne by the hospital; 18.8% of our cohort had short-term avoidable PN. Daily PN may cost up to 60% more in patients receiving short-term PN. Clinicians should assess patient's suitability for oral/enteral feeding to limit the use of short-term PN.

Anesthetic management of external cephalic version.

PubMed

Chalifoux, Laurie A; Sullivan, John T

2013-09-01

Breech presentation is common at term and its reduction through external cephalic version represents a noninvasive opportunity to avoid cesarean delivery and the associated maternal morbidity. In addition to uterine relaxants, neuraxial anesthesia is associated with increased success of version procedures when surgical anesthetic dosing is used. The intervention is likely cost effective given the effect size and the avoided high costs of cesarean delivery. Copyright © 2013 Elsevier Inc. All rights reserved.

[Cost-benefit analysis of a school-based smoking prevention program].

PubMed

Hormigo Amaro, Jordi; García-Altés, Anna; López, M José; Bartoll, Xavier; Nebot, Manel; Ariza, Carles

2009-01-01

To analyze the efficiency of a school-based smoking prevention program in Barcelona (PASE.bcn program). A cost-benefit analysis was performed. As costs we included those corresponding to the design and implementation of the program. As benefits we considered healthcare costs and the productivity losses avoided. This study was conducted from a societal perspective, and the estimations of costs and benefits related to 2005. Assuming an effectiveness of 1%, the PASE.bcn program would achieve a total benefit of 1,558,311.46euro. The healthcare benefits per prevented smoker were 1997.57euro, and the indirect benefits per prevented smoker were 21,260.80euro. Given the total cost of the school-based program (68,526.03euro), the cost-benefit ratio was 22.74. From a societal perspective, the benefits of school-based tobacco prevention programs, in terms of healthcare costs and productivity losses avoided, are far greater than the costs. These results support universal application of this type of intervention.

Interventional pain management at crossroads: the perfect storm brewing for a new decade of challenges.

PubMed

Manchikanti, Laxmaiah; Singh, Vijay; Boswell, Mark V

2010-01-01

The health care industry in general and care of chronic pain in particular are described as recession-proof. However, a perfect storm with a confluence of many factors and events -none of which alone is particularly devastating - is brewing and may create a catastrophic force, even in a small specialty such as interventional pain management. Multiple challenges related to interventional pain management in the current decade will include individual and group physicians, office practices, ambulatory surgery centers (ASCs), and hospital outpatient departments (HOPD). Rising health care costs are discussed on a daily basis in the United States. The critics have claimed that health outcomes are the same as or worse than those in other countries, but others have presented the evidence that the United States has the best health care system. All agree it is essential to reduce costs. Numerous factors contribute to increasing health care costs. They include administrative costs, waste, abuse, and fraud. It has been claimed the U.S. health care system wastes up to $800 billion a year. Of this, fraud accounts for approximately $200 billion a year, involving fraudulent Medicare claims, kickbacks for referrals for unnecessary services, and other scams. Administrative inefficiency and redundant paperwork accounts for 18% of health care waste, whereas medical mistakes account for $50 billion to $100 billion in unnecessary spending each year, or 11% of the total. Further, American physicians spend nearly 8 hours per week on paperwork and employ 1.66 clerical workers per doctor, more than any other country. It has been illustrated that it takes $60,000 to $88,000 per physician per year, equal to one-third of a family practitioner's gross income, and $23 to $31 billion each year in total to interact with health insurance plans. The studies have illustrated that an average physician spends $68,274 per year communicating with insurance companies and performing other non-medical functions. For an office-based practice, the overall total in the United States is $38.7 billion, or $85,276 per physician. In the United States there are 2 types of physician payment systems: private health care and Medicare. Medicare has moved away from the Medicare Economic Index (MEI) and introduced the sustainable growth rate (SGR) formula which has led to cuts in physician payments on a yearly basis. In 2010 and beyond into the new decade, interventional pain management will see significant changes in how we practice medicine. There is focus on avoiding waste, abuse, fraud, and also cutting costs. Evidence-based medicine (EBM) and comparative effectiveness research (CER) have been introduced as cost-cutting and rationing measures, however, with biased approaches. This manuscript will analyze various issues related to interventional pain management with a critical analysis of physician payments, office facility payments, and ASC payments by various payor groups.

Evolving Postmortems as Teams Evolve Through TxP

DTIC Science & Technology

2014-12-01

Instead of waiting for SEI to compile enough data to repeat this kind of analysis for the system integration test domain , a system integration test team...and stand up their Team Test Process (TTP). Some abilities, like planning on how many mistakes will be made by the team in producing a test procedure...can only be performed after the team has determined a) which mistakes count in the domain of system integration testing, b) what units to use to

Applying Lean Sigma solutions to mistake-proof the chemotherapy preparation process.

PubMed

Aboumatar, Hanan J; Winner, Laura; Davis, Richard; Peterson, Aisha; Hill, Richard; Frank, Susan; Almuete, Virna; Leung, T Vivian; Trovitch, Peter; Farmer, Denise

2010-02-01

Errors related to high-alert medications, such as chemotherapeutic agents, have resulted in serious adverse events. A fast-paced application of Lean Sigma methodology was used to safeguard the chemotherapy preparation process against errors and increase compliance with United States Pharmacopeia 797 (USP 797) regulations. On Days 1 and 2 of a Lean Sigma workshop, frontline staff studied the chemotherapy preparation process. During Days 2 and 3, interventions were developed and implementation was started. The workshop participants were satisfied with the speed at which improvements were put to place using the structured workshop format. The multiple opportunities for error identified related to the chemotherapy preparation process, workspace layout, distractions, increased movement around ventilated hood areas, and variation in medication processing and labeling procedures. Mistake-proofing interventions were then introduced via workspace redesign, process redesign, and development of standard operating procedures for pharmacy staff. Interventions were easy to implement and sustainable. Reported medication errors reaching patients and requiring monitoring decreased, whereas the number of reported near misses increased, suggesting improvement in identifying errors before reaching the patients. Application of Lean Sigma solutions enabled the development of a series of relatively inexpensive and easy to implement mistake-proofing interventions that reduce the likelihood of chemotherapy preparation errors and increase compliance with USP 797 regulations. The findings and interventions are generalizable and can inform mistake-proofing interventions in all types of pharmacies.

No evidence of inbreeding avoidance despite demonstrated survival costs in a polygynous rodent.

PubMed

Olson, L E; Blumstein, D T; Pollinger, J R; Wayne, R K

2012-02-01

Individuals are generally predicted to avoid inbreeding because of detrimental fitness effects. However, several recent studies have shown that limited inbreeding is tolerated by some vertebrate species. Here, we examine the costs and benefits of inbreeding in a largely polygynous rodent, the yellow-bellied marmot (Marmota flaviventris). We use a pedigree constructed from 8 years of genetic data to determine the relatedness of all marmots in our study population and examine offspring survival, annual male reproductive success, relatedness between breeding pairs and the effects of group composition on likelihood of male reproduction to assess inbreeding in this species. We found decreased survival in inbred offspring, but equal net reproductive success among males that inbred and those that avoided it. Relatedness between breeding pairs was greater than that expected by chance, indicating that marmots do not appear to avoid breeding with relatives. Further, male marmots do not avoid inbreeding: males mate with equal frequency in groups composed of both related and unrelated females and in groups composed of only female relatives. Our results demonstrate that inbreeding can be tolerated in a polygynous species if the reproductive costs of inbreeding are low and individuals that mate indiscriminately do not suffer decreased reproductive success. © 2011 Blackwell Publishing Ltd.

Relationship Between Quality of Comorbid Condition Care and Costs for Cancer Survivors

PubMed Central

Snyder, Claire F.; Herbert, Robert J.; Blackford, Amanda L.; Neville, Bridget A.; Wolff, Antonio C.; Carducci, Michael A.; Earle, Craig C.

2016-01-01

Purpose: To estimate the association between cancer survivors’ comorbid condition care quality and costs; to determine whether the association differs between cancer survivors and other patients. Methods: Using the SEER–Medicare-linked database, we identified survivors of breast, prostate, and colorectal cancers who were diagnosed in 2004, enrolled in Medicare fee-for-service for at least 12 months before diagnosis, and survived ≥ 3 years. Quality of care was assessed using nine process indicators for chronic conditions, and a composite indicator representing seven avoidable outcomes. Total costs on the basis of Medicare amount paid were grouped as inpatient and outpatient. We examined the association between care quality and costs for cancer survivors, and compared this association among 2:1 frequency-matched noncancer controls, using comparisons of means and generalized linear regressions. Results: Our sample included 8,661 cancer survivors and 17,332 matched noncancer controls. Receipt of recommended care was associated with higher outpatient costs for eight indicators, and higher inpatient and total costs for five indicators. For three measures (visit every 6 months for patients with chronic obstructive pulmonary disease or diabetes, and glycosylated hemoglobin or fructosamine every 6 months for patients with diabetes), costs for cancer survivors who received recommended care increased less than for noncancer controls. The absence of avoidable events was associated with lower costs of each type. An annual eye examination for patients with diabetes was associated with lower inpatient costs. Conclusion: Higher-quality processes of care may not reduce short-term costs, but the prevention of avoidable outcomes reduces costs. The association between quality and cost was similar for cancer survivors and noncancer controls. PMID:27165487

A Cost-effectiveness Analysis of Early vs Late Tracheostomy.

PubMed

Liu, C Carrie; Rudmik, Luke

2016-10-01

The timing of tracheostomy in critically ill patients requiring mechanical ventilation is controversial. An important consideration that is currently missing in the literature is an evaluation of the economic impact of an early tracheostomy strategy vs a late tracheostomy strategy. To evaluate the cost-effectiveness of the early tracheostomy strategy vs the late tracheostomy strategy. This economic analysis was performed using a decision tree model with a 90-day time horizon. The economic perspective was that of the US health care third-party payer. The primary outcome was the incremental cost per tracheostomy avoided. Probabilities were obtained from meta-analyses of randomized clinical trials. Costs were obtained from the published literature and the Healthcare Cost and Utilization Project database. A multivariate probabilistic sensitivity analysis was performed to account for uncertainty surrounding mean values used in the reference case. The reference case demonstrated that the cost of the late tracheostomy strategy was $45 943.81 for 0.36 of effectiveness. The cost of the early tracheostomy strategy was $31 979.12 for 0.19 of effectiveness. The incremental cost-effectiveness ratio for the late tracheostomy strategy compared with the early tracheostomy strategy was $82 145.24 per tracheostomy avoided. With a willingness-to-pay threshold of $50 000, the early tracheostomy strategy is cost-effective with 56% certainty. The adaptation of an early vs a late tracheostomy strategy depends on the priorities of the decision-maker. Up to a willingness-to-pay threshold of $80 000 per tracheostomy avoided, the early tracheostomy strategy has a higher probability of being the more cost-effective intervention.

Measuring Virtual Simulations Value in Training Exercises - USMC Use Case

DTIC Science & Technology

2015-12-04

and cost avoidance and Capt Jonathan Richardson, PM TRASYS, who was the primary author for the After-Action Documentation and Analysis Report ...REFERENCES Cermak J. & McGurk M. (2010, July). Putting a Value On Training. McKinsey Quarterly. Retrieved June 10, 2015 from http://www.mckinsey.com...www.hqmc.marines.mil/Portals/142/Docs/2015CPG_Color.pdf Gordon, S. & Cooley, T. (2013) Phase One Final Report : Cost Avoidance Study of USMC Simulation

Impact of pharmacy student interventions in an urban family medicine clinic.

PubMed

Ginzburg, Regina

2014-06-17

To determine the number of interventions made by pharmacy students at an urban family medicine clinic and the acceptance rate of these recommendations by the healthcare providers. The secondary objective was to investigate the cost avoidance value of the interventions. A prospective, unblinded study was conducted to determine the number and cost avoidance value of clinical interventions made by pharmacy students completing advanced pharmacy practice experiences (APPEs) in an urban family medicine clinic. Eighteen students completed this experience in the 8 months studied. Of the 718 interventions performed, 77% were accepted by physicians, including 58% of the 200 interventions that required immediate action. Projected avoidance was estimated at $61,855. The clinical interventions by pharmacy students were generally well received by healthcare providers and resulted in significant cost savings. Pharmacy students can play an important role in a family medicine clinic.

Radiography student perceptions of clinical stressors.

PubMed

Mason, Starla L

2006-01-01

Technological change and the increasingly rapid pace of life in the United States and globally have contributed to increased levels of stress and burnout experienced by workers and their families. Although studies are available on the levels of workplace stress and burnout affecting radiographers, little to no research has been conducted to assess the stressors encountered by radiography students in the clinical environment. This study was designed to pinpoint the primary sources of stress for radiography students and to determine the most effective measures to alleviate the stress that students experience in the clinical environment. It also sought to identify the clinical activities and practices that enhance learning. A convenience sample of radiography students attending an Association of Collegiate Educators in Radiologic Technology meeting was surveyed. Students were asked to rank their greatest stressors in the clinical environment, the most desired qualities in a clinical instructor and clinical environment, and the clinical practices and activities that best enhance their learning. Descriptive statistics were used to report the results. Data were collected for 82 first-year and second-year students. Students identified 7 primary clinical stressors: fear of making a mistake/repeat, feeling unprepared/inexperienced, intimidation by staff and by instructors, difficult/critical patients, hurtful criticism, too much supervision and negative responses to questions/requests for help. Students indicated that more frequent feedback, availability of the clinical instructor and other staff, assurance that mistakes happen and the opportunity to make mistakes were clinical practices that eased stress. The majority of students cited hands-on learning and repetition as the clinical activities that most reinforced their learning. Summary Radiography students in this survey experience some of the same clinical stressors as radiographers and other allied health workers, although the source of stress may be different. Factors that promote an optimum clinical learning environment for students include instructor availability, opportunities to practice skills and make mistakes, frequent performance feedback and assurance that mistakes happen.

Most Frequent Errors in Judo Uki Goshi Technique and the Existing Relations among Them Analysed through T-Patterns

PubMed Central

Gutiérrez, Alfonso; Prieto, Iván; Cancela, José M.

2009-01-01

The purpose of this study is to provide a tool, based on the knowledge of technical errors, which helps to improve the teaching and learning process of the Uki Goshi technique. With this aim, we set out to determine the most frequent errors made by 44 students when performing this technique and how these mistakes relate. In order to do so, an observational analysis was carried out using the OSJUDO-UKG instrument and the data were registered using Match Vision Studio (Castellano, Perea, Alday and Hernández, 2008). The results, analyzed through descriptive statistics, show that the absence of a correct initial unbalancing movement (45,5%), the lack of proper right-arm pull (56,8%), not blocking the faller’s body (Uke) against the thrower’s hip -Tori- (54,5%) and throwing the Uke through the Tori’s side are the most usual mistakes (72,7%). Through the sequencial analysis of T-Patterns obtained with the THÈME program (Magnusson, 1996, 2000) we have concluded that not blocking the body with the Tori’s hip provokes the Uke’s throw through the Tori’s side during the final phase of the technique (95,8%), and positioning the right arm on the dorsal region of the Uke’s back during the Tsukuri entails the absence of a subsequent pull of the Uke’s body (73,3%). Key Points In this study, the most frequent errors in the performance of the Uki Goshi technique have been determined and the existing relations among these mistakes have been shown through T-Patterns. The SOBJUDO-UKG is an observation instrument for detecting mistakes in the aforementioned technique. The results show that those mistakes related to the initial imbalancing movement and the main driving action of the technique are the most frequent. The use of T-Patterns turns out to be effective in order to obtain the most important relations among the observed errors. PMID:24474885

House Construction: How To Reduce Costs

Treesearch

Jerry O. Newman; Norman C. Teter; Constance D. O' Brien

1969-01-01

You're building a house and want to keep down the cost. How can you do it? First, plan carefully "on paper" before you start construction. By doing so, you can avoid costly mistakesinthebuildingandinthe purchase of materials. Careful planning and proper design will reduce not only the initial cost but also the cost of furnishings, utilities, and...

75 FR 25981 - Cost Accounting Standards: Harmonization of Cost Accounting Standards 412 and 413 With the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-10

...), invites public comments concerning the harmonization of Cost Accounting Standards 412 and 413 with the... cost that is based on currently accrued benefits that have been valued using corporate bond rates... that avoid undue cost or contribution volatility. The Board agrees with the public comments that since...

Corrigendum to "Synthesis of hydroxyapatite/multi-walled carbon nanotubes for the removal of fluoride ions from solution" [Appl. Surf. Sci. 412 (2017) 578-590

NASA Astrophysics Data System (ADS)

Ruan, Zhongyuan; Tian, Yaxi; Ruan, Jifu; Cui, Guijia; Iqbal, Kanwal; Iqbal, Anam; Ye, Herui; Yang, Zhangzhong; Yan, Shiqiang

2018-04-01

In our recent paper [1], we reported the synthesis of hydroxyapatite/multi-walled carbon nanotubes (HA-MWCNTs) and studied their performance for the removal of fluoride ions from solution. However, we have made some writing mistakes, especially in the section on adsorption kinetics analysis. Our mistakes were spotted by Prof. Yuandong Huang, who graciously noticed these errors. We are grateful to him, and have decided to write a "Corrigendum".

A simple theory of back-surface-field /BSF/ solar cells

NASA Technical Reports Server (NTRS)

Von Roos, O.

1979-01-01

An earlier calculation of the I-V characteristics of solar cells contains a mistake. The current generated by light within the depletion layer is too large by a factor of 2. When this mistake is corrected, not only are all previous conclusions unchanged, but the agreement with experiment becomes better. Results are presented in graphical form of new computations which not only take account of the factor of 2, but also include more recent data on material parameters.

The Statesman and Commander: Civil-Military Dialogue in the Korean War

DTIC Science & Technology

2016-05-26

they are embarking; neither mistaking it for, nor trying to tum it into, something that is alien to its nature." This monograph explores civil-military...turn it into, something that is alien to its nature.” This monograph explores civil- military relations and their relevance to theater strategy and...mistaking it for, nor trying to turn it into, something that is alien to its nature. ―Carl von Clausewitz, On War In making the decision to employ

Mobile health care operations and return on investment in predominantly underserved children with asthma: the breathmobile program.

PubMed

Morphew, Tricia; Scott, Lyne; Li, Marilyn; Galant, Stanley P; Wong, Webster; Garcia Lloret, Maria I; Jones, Felita; Bollinger, Mary Elizabeth; Jones, Craig A

2013-08-01

Underserved populations have limited access to care. Improved access to effective asthma care potentially improves quality of life and reduces costs associated with emergency department (ED) visits. The purpose of this study is to examine return on investment (ROI) for the Breathmobile Program in terms of improved patient quality-adjusted life years saved and reduced costs attributed to preventable ED visits for 2010, with extrapolation to previous years of operation. It also examines cost-benefit related to reduced morbidity (ED visits, hospitalizations, and school absenteeism) for new patients to the Breathmobile Program during 2008-2009 who engaged in care (≥3 visits). This is a retrospective analysis of data for 15,986 pediatric patients, covering 88,865 visits, participating in 4 Southern California Breathmobile Programs (November 16, 1995-December 31, 2010). The ROI calculation expressed the cost-benefit ratio as the net benefits (ED costs avoided+relative value of quality-adjusted life years saved) over the per annum program costs (∼$500,000 per mobile). The ROI across the 4 California programs in 2010 was $6.73 per dollar invested. Annual estimated emergency costs avoided in the 4 regions were $2,541,639. The relative value of quality-adjusted life years saved was $24,381,000. For patients new to the Breathmobile Program during 2008-2009 who engaged in care (≥3 visits), total annual morbidity costs avoided per patient were $1395. This study suggests that mobile health care is a cost-effective strategy to deliver medical care to underserved populations, consistent with the Triple Aims of Therapy.

An ergonomics study on compatibility of controls of overhead cranes in a heavy engineering factory in West Bengal.

PubMed

Sen, R N; Das, S

2000-04-01

Ergonomics studies, on the machine control and the resultant movements of the cabins and the hooks in 51 electric overhead travelling cranes in a heavy engineering factory, showed that control-movement compatibility is absent in most of the cranes. Also, the layout of the groups of controls and the orientations of each of the individual controls with respect to the operators' seats varied from one crane to another. As the operators were shifted from one crane to another every week, there was a high chance of making mistakes during moving the controls, which might have resulted in severe accidents, especially during periods of high workload. A number of low-cost ergonomics solutions have been recommended to minimize these problems.

[Triple-type theory of statistics and its application in the scientific research of biomedicine].

PubMed

Hu, Liang-ping; Liu, Hui-gang

2005-07-20

To point out the crux of why so many people failed to grasp statistics and to bring forth a "triple-type theory of statistics" to solve the problem in a creative way. Based on the experience in long-time teaching and research in statistics, the "three-type theory" was raised and clarified. Examples were provided to demonstrate that the 3 types, i.e., expressive type, prototype and the standardized type are the essentials for people to apply statistics rationally both in theory and practice, and moreover, it is demonstrated by some instances that the "three types" are correlated with each other. It can help people to see the essence by interpreting and analyzing the problems of experimental designs and statistical analyses in medical research work. Investigations reveal that for some questions, the three types are mutually identical; for some questions, the prototype is their standardized type; however, for some others, the three types are distinct from each other. It has been shown that in some multifactor experimental researches, it leads to the nonexistence of the standardized type corresponding to the prototype at all, because some researchers have committed the mistake of "incomplete control" in setting experimental groups. This is a problem which should be solved by the concept and method of "division". Once the "triple-type" for each question is clarified, a proper experimental design and statistical method can be carried out easily. "Triple-type theory of statistics" can help people to avoid committing statistical mistakes or at least to decrease the misuse rate dramatically and improve the quality, level and speed of biomedical research during the process of applying statistics. It can also help people to improve the quality of statistical textbooks and the teaching effect of statistics and it has demonstrated how to advance biomedical statistics.

Understanding adverse events: human factors.

PubMed Central

Reason, J

1995-01-01

(1) Human rather than technical failures now represent the greatest threat to complex and potentially hazardous systems. This includes healthcare systems. (2) Managing the human risks will never be 100% effective. Human fallibility can be moderated, but it cannot be eliminated. (3) Different error types have different underlying mechanisms, occur in different parts of the organisation, and require different methods of risk management. The basic distinctions are between: Slips, lapses, trips, and fumbles (execution failures) and mistakes (planning or problem solving failures). Mistakes are divided into rule based mistakes and knowledge based mistakes. Errors (information-handling problems) and violations (motivational problems) Active versus latent failures. Active failures are committed by those in direct contact with the patient, latent failures arise in organisational and managerial spheres and their adverse effects may take a long time to become evident. (4) Safety significant errors occur at all levels of the system, not just at the sharp end. Decisions made in the upper echelons of the organisation create the conditions in the workplace that subsequently promote individual errors and violations. Latent failures are present long before an accident and are hence prime candidates for principled risk management. (5) Measures that involve sanctions and exhortations (that is, moralistic measures directed to those at the sharp end) have only very limited effectiveness, especially so in the case of highly trained professionals. (6) Human factors problems are a product of a chain of causes in which the individual psychological factors (that is, momentary inattention, forgetting, etc) are the last and least manageable links. Attentional "capture" (preoccupation or distraction) is a necessary condition for the commission of slips and lapses. Yet, its occurrence is almost impossible to predict or control effectively. The same is true of the factors associated with forgetting. States of mind contributing to error are thus extremely difficult to manage; they can happen to the best of people at any time. (7) People do not act in isolation. Their behaviour is shaped by circumstances. The same is true for errors and violations. The likelihood of an unsafe act being committed is heavily influenced by the nature of the task and by the local workplace conditions. These, in turn, are the product of "upstream" organisational factors. Great gains in safety can ve achieved through relatively small modifications of equipment and workplaces. (8) Automation and increasing advanced equipment do not cure human factors problems, they merely relocate them. In contrast, training people to work effectively in teams costs little, but has achieved significant enhancements of human performance in aviation. (9) Effective risk management depends critically on a confidential and preferable anonymous incident monitoring system that records the individual, task, situational, and organisational factors associated with incidents and near misses. (10) Effective risk management means the simultaneous and targeted deployment of limited remedial resources at different levels of the system: the individual or team, the task, the situation, and the organisation as a whole. PMID:10151618

Cost and benefit estimates of partially-automated vehicle collision avoidance technologies.

PubMed

Harper, Corey D; Hendrickson, Chris T; Samaras, Constantine

2016-10-01

Many light-duty vehicle crashes occur due to human error and distracted driving. Partially-automated crash avoidance features offer the potential to reduce the frequency and severity of vehicle crashes that occur due to distracted driving and/or human error by assisting in maintaining control of the vehicle or issuing alerts if a potentially dangerous situation is detected. This paper evaluates the benefits and costs of fleet-wide deployment of blind spot monitoring, lane departure warning, and forward collision warning crash avoidance systems within the US light-duty vehicle fleet. The three crash avoidance technologies could collectively prevent or reduce the severity of as many as 1.3 million U.S. crashes a year including 133,000 injury crashes and 10,100 fatal crashes. For this paper we made two estimates of potential benefits in the United States: (1) the upper bound fleet-wide technology diffusion benefits by assuming all relevant crashes are avoided and (2) the lower bound fleet-wide benefits of the three technologies based on observed insurance data. The latter represents a lower bound as technology is improved over time and cost reduced with scale economies and technology improvement. All three technologies could collectively provide a lower bound annual benefit of about $18 billion if equipped on all light-duty vehicles. With 2015 pricing of safety options, the total annual costs to equip all light-duty vehicles with the three technologies would be about $13 billion, resulting in an annual net benefit of about $4 billion or a $20 per vehicle net benefit. By assuming all relevant crashes are avoided, the total upper bound annual net benefit from all three technologies combined is about $202 billion or an $861 per vehicle net benefit, at current technology costs. The technologies we are exploring in this paper represent an early form of vehicle automation and a positive net benefit suggests the fleet-wide adoption of these technologies would be beneficial from an economic and social perspective. Copyright © 2016 Elsevier Ltd. All rights reserved.

Vaccination against herpes zoster and postherpetic neuralgia in France: a cost-effectiveness analysis.

PubMed

Bresse, Xavier; Annemans, Lieven; Préaud, Emmanuelle; Bloch, Karine; Duru, Gérard; Gauthier, Aline

2013-06-01

This study assesses the cost-effectiveness of vaccination against herpes zoster (HZ) and postherpetic neuralgia in France, using a published Markov model. The cost-effectiveness of vaccinating individuals aged from 65 years or between 70 and 79 years was evaluated over their lifetime, from a third-party payer perspective. French-specific data were combined with results from clinical studies and international quality-of-life-based (EuroQol five-dimension questionnaire) utilities from the literature. HZ vaccination was highly cost effective in both populations. Incremental cost-effective ratios were estimated between €9513 and 12,304 per quality-adjusted life year gained, corresponding to €2240-2651 per HZ case avoided and €3539-4395 per postherpetic neuralgia case avoided. In addition to epidemiological and clinical evidence, economic evidence also supports the implementation of HZ vaccination in France.

NORMAL HUMAN VARIATION: REFOCUSSING THE ENHANCEMENT DEBATE

PubMed Central

Kahane, Guy; Savulescu, Julian

2015-01-01

This article draws attention to several common mistakes in thinking about biomedical enhancement, mistakes that are made even by some supporters of enhancement. We illustrate these mistakes by examining objections that John Harris has recently raised against the use of pharmacological interventions to directly modulate moral decision-making. We then apply these lessons to other influential figures in the debate about enhancement. One upshot of our argument is that many considerations presented as powerful objections to enhancement are really strong considerations in favour of biomedical enhancement, just in a different direction. Another upshot is that it is unfortunate that much of the current debate focuses on interventions that will radically transform normal human capacities. Such interventions are unlikely to be available in the near future, and may not even be feasible. But our argument shows that the enhancement project can still have a radical impact on human life even if biomedical enhancement operated entirely within the normal human range. PMID:23906367

Pedagogical Content Knowledge: Teacher’s Knowledge of Students in Learning Mathematics on Limit of Function Subject

NASA Astrophysics Data System (ADS)

Ma'rufi; Ketut Budayasa, I.; Juniati, Dwi

2018-01-01

This research aims at describing the profile of high school teacher’s Pedagogical Content Knowledge in learning mathematics from the perspective of teaching experience. Pedagogical Content Knowledge (PCK) covers teacher’s knowledge of subject matter, knowledge of pedagogy, and knowledge of students. The subject of this research was two high school mathematics teachers who have different teaching experience. The data were obtained through interview and observation then analyzed qualitatively. The focus of this research is the novice teacher’s PCK deals with knowledge of students. Knowledge of Student is defined as teacher’s knowledge about the students’ conception and misconception on limit of function material and teacher’s ability to cope with students’ difficulty, mistake, and misconception. The result of this research shows that novice teacher’s ability in analyzing the cause of students’ difficulty, mistake, and misconception was limited. Novice teacher tended to overcome the students’ difficulty, mistake, and misconception by re-explaining the procedure of question completion which is not understood by the students.

The cost-effectiveness of beta-radiation therapy for treatment of in-stent restenosis: an analysis at 290-day follow-up.

PubMed

Beusterien, Kathleen M; Plante, Kathryn M; Waksman, Ron; Raizner, Albert E; Annis, Marijke; Goss, Thomas F

2002-01-01

We studied the cost-effectiveness of percutaneous coronary intervention (PCI) plus beta-radiation (Radiotherapy) vs. PCI alone for treating in-stent restenosis. We analyzed medical resource data collected at US sites during the Intimal Hyperplasia Inhibition with beta In-stent Trial (INHIBIT) to compare the incremental costs between Radiotherapy and PCI alone for each repeat target lesion revascularization (TLR) avoided. Costs were assigned for cardiac-related medical services using the Medicare payer perspective. Radiotherapy increased initial inpatient costs by US$3360 (P<.001). In the Radiotherapy and PCI alone groups, the mean per-patient rates for TLR were 0.13 vs. 0.30 (P=.001), and mean per-patient total costs were US$19,286 vs. US$18,349 (P<.001), respectively. The incremental cost of Radiotherapy relative to PCI alone was US$5512 per TLR avoided, which compares favorably to the observed mean per-patient cost of treating restenosis (US$16,852). beta-radiation is a cost-effective adjunct to PCI in treating patients with in-stent restenosis.

Cost savings from a telemedicine model of care in northern Queensland, Australia.

PubMed

Thaker, Darshit A; Monypenny, Richard; Olver, Ian; Sabesan, Sabe

2013-09-16

To conduct a cost analysis of a telemedicine model for cancer care (teleoncology) in northern Queensland, Australia, compared with the usual model of care from the perspective of the Townsville and other participating hospital and health services. Retrospective cost-savings analysis; and a one-way sensitivity analysis performed to test the robustness of findings in net savings. Records of all patients managed by means of teleoncology at the Townsville Cancer Centre (TCC) and its six rural satellite centres in northern Queensland, Australia between 1 March 2007 and 30 November 2011. Costs for set-up and staffing to manage the service, and savings from avoidance of travel expenses for specialist oncologists, patients and their escorts, and for aeromedical retrievals. There were 605 teleoncology consultations with 147 patients over 56 months, at a total cost of $442 276. The cost for project establishment was $36 000, equipment/maintenance was $143 271, and staff was $261 520. The estimated travel expense avoided was $762 394; this figure included the costs of travel for patients and escorts of $658 760, aeromedical retrievals of $52 400 and travel for specialists of $47 634, as well as an estimate of accommodation costs for a proportion of patients of $3600. This resulted in a net saving of $320 118. Costs would have to increase by 72% to negate the savings. The teleoncology model of care at the TCC resulted in net savings, mainly due to avoidance of travel costs. Such savings could be redirected to enhancing rural resources and service capabilities. This teleoncology model is applicable to geographically distant areas requiring lengthy travel.

Consensual punishment does not promote cooperation in the six-person prisoner's dilemma game with noisy public monitoring

PubMed Central

van Miltenburg, Nynke; Buskens, Vincent

2017-01-01

We study the effects of different punishment institutions on cooperation in a six-person prisoner’s dilemma game in which actors observe others’ cooperation with some noise (i.e. imperfect public monitoring). Previous research has shown that peer punishment can sustain cooperation, if a certain proportion of group members punish defectors at a cost to themselves. However, in the presence of noise, co-operators will sometimes be mistaken for defectors and punished, and defectors will sometimes be mistaken for co-operators and escape punishment. Both types of mistakes are detrimental for cooperation because cooperation is discouraged and defection is encouraged. By means of a laboratory experiment, we study whether this adverse effect of noise can be mitigated by consensual punishment. The more other group members have to agree on punishing a defector, the less likely will a co-operator be punished by mistake. We compare a punishment institution in which each subject decides individually whether to punish another, with institutions in which punishments are only implemented if subjects reach sufficient consensus that a particular group member should be punished. In conditions without noise, we find that cooperation and subjects’ payoffs are higher if more consensus is required before a punishment is implemented. In conditions with noise, cooperation is lower if more consensus is required. Moreover, with noise, subjects’ payoffs are lower under all punishment institutions than in the control condition without punishment opportunities. Our results narrow down the conditions under which punishment institutions can promote cooperation if such cooperation is noisy. PMID:29176900

Consensual punishment does not promote cooperation in the six-person prisoner's dilemma game with noisy public monitoring.

PubMed

van Miltenburg, Nynke; Przepiorka, Wojtek; Buskens, Vincent

2017-01-01

We study the effects of different punishment institutions on cooperation in a six-person prisoner's dilemma game in which actors observe others' cooperation with some noise (i.e. imperfect public monitoring). Previous research has shown that peer punishment can sustain cooperation, if a certain proportion of group members punish defectors at a cost to themselves. However, in the presence of noise, co-operators will sometimes be mistaken for defectors and punished, and defectors will sometimes be mistaken for co-operators and escape punishment. Both types of mistakes are detrimental for cooperation because cooperation is discouraged and defection is encouraged. By means of a laboratory experiment, we study whether this adverse effect of noise can be mitigated by consensual punishment. The more other group members have to agree on punishing a defector, the less likely will a co-operator be punished by mistake. We compare a punishment institution in which each subject decides individually whether to punish another, with institutions in which punishments are only implemented if subjects reach sufficient consensus that a particular group member should be punished. In conditions without noise, we find that cooperation and subjects' payoffs are higher if more consensus is required before a punishment is implemented. In conditions with noise, cooperation is lower if more consensus is required. Moreover, with noise, subjects' payoffs are lower under all punishment institutions than in the control condition without punishment opportunities. Our results narrow down the conditions under which punishment institutions can promote cooperation if such cooperation is noisy.

Allergen avoidance.

PubMed

Woodcock, A; Custovic, A

2000-12-09

Allergen exposure is a risk factor for sensitisation, prevalence and severity of allergic disease. Effective allergen avoidance strategies have been devised. The cost-benefit in public health terms should be established by prospective controlled studies that are under way around the world.

The Language of Fairness: how Cross-Linguistic Norms in Spanish and English Influence Reactions to Unfair Treatment.

PubMed

Birk, Sam J; Kausel, Edgar E

2016-11-14

We integrate recent findings from the linguistics literature with the organizational justice literature to examine how the language used to encode justice violations influences fairness perceptions. The study focused on the use of non-agentive syntax to encode mistakes in Spanish ("The vase was broken") versus using agentive syntax in English ("She broke the vase") influences event fairness perceptions. We hypothesized that when justice violations are encoded using Spanish, because the non-agentive syntax makes the responsible party less salient, the event would be perceived as less unfair. In Study 1 (n = 111), English-speaking participants rated the fairness of an event in which a mistake was made and an employee received a negative outcome. They rated it as more unfair (p < .01, η2 = .06) when the scenario was presented in agentive syntax. Experiment 2 (n = 70) used native English- and Spanish-speakers who watched a video of manager making a mistake. We found that Spanish-speakers used less agentive syntax (p < .01, η2 = .21), perceived the event as less unfair (p < .001, η2 = .23), and were more willing to help the manager who made the mistake. In Experiment 3 (n = 101) we replicated this effect controlling for cross-cultural differences and native language; further, we found an interaction between entity fairness (event vs. entity) and native language (Spanish vs. English) on citizenship intentions (p < .01, η2 = .08). These results extend our understanding of how language may influence relevant workplace attitudes.

Evidence for frequent incest in a cooperatively breeding mammal.

PubMed

Nichols, H J; Cant, M A; Hoffman, J I; Sanderson, J L

2014-12-01

As breeding between relatives often results in inbreeding depression, inbreeding avoidance is widespread in the animal kingdom. However, inbreeding avoidance may entail fitness costs. For example, dispersal away from relatives may reduce survival. How these conflicting selection pressures are resolved is challenging to investigate, but theoretical models predict that inbreeding should occur frequently in some systems. Despite this, few studies have found evidence of regular incest in mammals, even in social species where relatives are spatio-temporally clustered and opportunities for inbreeding frequently arise. We used genetic parentage assignments together with relatedness data to quantify inbreeding rates in a wild population of banded mongooses, a cooperatively breeding carnivore. We show that females regularly conceive to close relatives, including fathers and brothers. We suggest that the costs of inbreeding avoidance may sometimes outweigh the benefits, even in cooperatively breeding species where strong within-group incest avoidance is considered to be the norm.

Evidence for frequent incest in a cooperatively breeding mammal

PubMed Central

Nichols, H. J.; Cant, M. A.; Hoffman, J. I.; Sanderson, J. L.

2014-01-01

As breeding between relatives often results in inbreeding depression, inbreeding avoidance is widespread in the animal kingdom. However, inbreeding avoidance may entail fitness costs. For example, dispersal away from relatives may reduce survival. How these conflicting selection pressures are resolved is challenging to investigate, but theoretical models predict that inbreeding should occur frequently in some systems. Despite this, few studies have found evidence of regular incest in mammals, even in social species where relatives are spatio-temporally clustered and opportunities for inbreeding frequently arise. We used genetic parentage assignments together with relatedness data to quantify inbreeding rates in a wild population of banded mongooses, a cooperatively breeding carnivore. We show that females regularly conceive to close relatives, including fathers and brothers. We suggest that the costs of inbreeding avoidance may sometimes outweigh the benefits, even in cooperatively breeding species where strong within-group incest avoidance is considered to be the norm. PMID:25540153

Fear of feces? Trade-offs between disease risk and foraging drive animal activity around raccoon latrines

USGS Publications Warehouse

Weinstein, Sara B.; Moura, Chad W.; Mendez, Jon Francis; Lafferty, Kevin D.

2017-01-01

Fear of predation alters prey behavior, which can indirectly alter entire landscapes. A parasite-induced ecology of fear might also exist if animals avoid parasite-contaminated resources when infection costs outweigh foraging benefits. To investigate whether animals avoid parasite contaminated sites, and if such avoidance balances disease costs and foraging gains, we monitored animal behavior at raccoon latrines – sites that concentrate both seeds and pathogenic parasite eggs. Using wildlife cameras, we documented over 40 potentially susceptible vertebrate species in latrines and adjacent habitat. Latrine contact rates reflected background activity, diet preferences and disease risk. Disease-tolerant raccoons and rats displayed significant site attraction, while susceptible birds and small mammals avoided these high-risk sites. This suggests that parasites, like predators, might create a landscape of fear for vulnerable hosts. Such non-consumptive parasite effects could alter disease transmission, population dynamics, and even ecosystem structure.

49 CFR 1152.36 - Submission of revenue and cost data.

Code of Federal Regulations, 2014 CFR

2014-10-01

...-freight cars j. Revenue taxes k. Property taxes 6. Off-branch costs a. Off-branch costs (other than return.... Holding gain (loss) XXXX 16. Total return on value (line 14 minus 15) 3 XXXX 17. Avoidable loss from...

49 CFR 1152.36 - Submission of revenue and cost data.

Code of Federal Regulations, 2011 CFR

2011-10-01

...-freight cars j. Revenue taxes k. Property taxes 6. Off-branch costs a. Off-branch costs (other than return.... Holding gain (loss) XXXX 16. Total return on value (line 14 minus 15) 3 XXXX 17. Avoidable loss from...

49 CFR 1152.36 - Submission of revenue and cost data.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-freight cars j. Revenue taxes k. Property taxes 6. Off-branch costs a. Off-branch costs (other than return.... Holding gain (loss) XXXX 16. Total return on value (line 14 minus 15) 3 XXXX 17. Avoidable loss from...

49 CFR 1152.36 - Submission of revenue and cost data.

Code of Federal Regulations, 2012 CFR

2012-10-01

...-freight cars j. Revenue taxes k. Property taxes 6. Off-branch costs a. Off-branch costs (other than return.... Holding gain (loss) XXXX 16. Total return on value (line 14 minus 15) 3 XXXX 17. Avoidable loss from...

49 CFR 1152.36 - Submission of revenue and cost data.

Code of Federal Regulations, 2013 CFR

2013-10-01

...-freight cars j. Revenue taxes k. Property taxes 6. Off-branch costs a. Off-branch costs (other than return.... Holding gain (loss) XXXX 16. Total return on value (line 14 minus 15) 3 XXXX 17. Avoidable loss from...

No evidence for inbreeding avoidance in a natural population of song sparrows (Melospiza melodia).

PubMed

Keller, L F; Arcese, P

1998-09-01

We studied mate choice and inbreeding avoidance a natural population of song sparrows (Melospiza melodia) on Mandarte Island, Canada. Inbreeding occurred regularly: 59% all matings were between known relatives. We tested for inbreeding avoidance by comparing the observed levels of inbreeding to those expected if mate choice had been random with respect to relatedness. Independent of our assumptions about the availability of mates in the random mating model, we found that the expected and observed distributions of inbreeding coefficients were similar, as was the expected and observed frequency of close (f >/= 0.125) inbreeding. Furthermore, there was no difference in relatedness observed pairs and those that would have resulted had birds mated instead with their nearest neighbors. The only evidence to suggest any inbreeding avoidance was a reduced rate of parent-offspring matings as compared to one random mating model but not the other. Hence, despite substantial inbreeding depression in this population, we found little evidence for inbreeding avoidance through mate choice. We present a simple model to suggest that variation in inbreeding avoidance behaviors in birds may arise from differences in survival rates: in species with low survival rates, the costs of forfeiting matings to avoid inbreeding may exceed the costs of inbreeding.

Audit of the annual reports of directors of public health: production methods.

PubMed

Sidhu, K S

1992-07-01

An audit of production methods used for the Directors of Public Health (DsPH) Annual Report of the health of their local population. Postal questionnaire survey. 23 Departments of Public Health in the West Midlands Region. Costs and problems relating to different production techniques used. The majority of DsPH favoured reports with figures and graphs. This led to most DsPH using in-house desktop publishing or employing external graphic designers. Those using the former technique had more problems related to computers and felt they spent too much medical time working on the document. However, they also valued the relative low cost, editorial freedom and the ability to correct mistakes easily. Departments which employed external graphic designers generally paid more, but appreciated the extra time made available by delegating the work. They also felt that the expertise was valuable in document design. However, inaccuracies were cited as being more difficult to correct. Perhaps the best way of producing an annual report is to amalgamate the two commonest production techniques (i.e. external graphic design and in-house desktop publishing).

Usefulness of ct scans and radiographs in the assessment of cervical spine injuries in polytrauma patients - own experience.

PubMed

Paszkowska, Emilia; Wasilewski, Grzegorz; Szalcunas-Olsztyn, Anna; Widawski, Tomasz; Stefanowicz, Elzbieta

2010-01-01

This paper evaluates the usefulness of spiral CT and conventional radiographs in the assessment of cervical spine injuries in polytrauma patients. The data are used as a basis for determining a precise and quick method for the assessment of the severity of cervical spine injuries that is also possibly least inconvenient for the patient.This approach is important due to the high risk of cervical spine injuries in patients with severe polytrauma and head injuries, as appropriate diagnostic work-up will help avoid unnecessary examinations and shorten time to diagnosis. The study population consisted of 46 polytrauma patients hospitalized at the Intensive Care Unit of the Regional Hospital in Olsztyn. The efficacy of the diagnosis of cervical spine injuries on the basis of conventional radiographs and spiral CT studies was compared. Conventional radiographs failed to cover the entire cervical spine in all patient, and the assessment of most radiographic images was either difficult or unclear. Spiral CT studies with reformations were able to provide complete image of injuries to bony structures in all patients. Spiral CT with reformations (MPR and VRT) should be the basic modality in the diagnosis of cervical spine fractures. An appropriate treatment method may be selected and mistakes in the interpretation of injuries may be avoided on the basis of CT studies. Its other advantages are the short time required to perform the scan and the possibility of supporting vital functions in polytrauma patients during the examination.

Health economic evaluation of an infection prevention and control program: are quality and patient safety programs worth the investment?

PubMed

Raschka, Stefanie; Dempster, Linda; Bryce, Elizabeth

2013-09-01

The effect of regional consolidation of an infection prevention and control (IPC) program on reduction of selected health care-acquired infections (HAIs), the economic burden of these illnesses, and where the potential for greatest financial benefit in reducing infection rates lies was assessed. Cost-benefit analysis (in Canadian $) was used to evaluate the effectiveness of a regional IPC program in preventing incident cases of HAIs. The costs of managing these infections, as well as the operational costs of the IPC program were compared against reductions in HAI rates over a 4-year period. Benefits were calculated as cost avoided by reducing HAI cases year over year. The Health Authority spent more than $66.3 million managing 24,937 HAI cases over the 4-year evaluation period. Urinary tract infections, methicillin-resistant Staphylococcus aureus, and bacteremias incurred the greatest costs. A reduction of 4,739 HAI cases led to avoided costs of $9.1 million in 4 years; the IPC program budget was $6.7 million during this period. Regionalization of the IPC program with standardized policies, procedures, and initiatives led to a 19% reduction in selected HAIs over 4 years and a cost avoidance of at least $9 million. This was particularly evident in years 3 and 4 of the program when $7.2 million (79% of the total) savings were realized. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Evolution of Inbreeding Avoidance and Inbreeding Preference through Mate Choice among Interacting Relatives.

PubMed

Duthie, A Bradley; Reid, Jane M

2016-12-01

While extensive population genetic theory predicts conditions favoring evolution of self-fertilization versus outcrossing, there is no analogous theory that predicts conditions favoring evolution of inbreeding avoidance or inbreeding preference enacted through mate choice given obligate biparental reproduction. Multiple interacting processes complicate the dynamics of alleles underlying such inbreeding strategies, including sexual conflict, distributions of kinship, genetic drift, purging of mutation load, direct costs, and restricted kin discrimination. We incorporated these processes into an individual-based model to predict conditions where selection should increase or decrease frequencies of alleles causing inbreeding avoidance or inbreeding preference when females or males controlled mating. Selection for inbreeding avoidance occurred given strong inbreeding depression when either sex chose mates, while selection for inbreeding preference occurred given very weak inbreeding depression when females chose but never occurred when males chose. Selection for both strategies was constrained by direct costs and restricted kin discrimination. Purging was negligible, but allele frequencies were strongly affected by drift in small populations, while selection for inbreeding avoidance was weak in larger populations because inbreeding risk decreased. Therefore, while selection sometimes favored alleles underlying inbreeding avoidance or preference, evolution of such strategies may be much more restricted and stochastic than is commonly presumed.

Recalculating the Economic Cost of Suicide

ERIC Educational Resources Information Center

Yang, Bijou; Lester, David

2007-01-01

These authors argue that estimates of the net economic cost of suicide should go beyond accounting for direct medical costs and indirect costs from loss of earnings by those who commit suicide. There are potential savings from (a) not having to treat the depressive and other psychiatric disorders of those who kill themselves; (b) avoidance of…

Financial Impact of Direct-Acting Oral Anticoagulants in Medicaid: Budgetary Assessment Based on Number Needed to Treat.

PubMed

Fairman, Kathleen A; Davis, Lindsay E; Kruse, Courtney R; Sclar, David A

2017-04-01

Faced with rising healthcare costs, state Medicaid programs need short-term, easily calculated budgetary estimates for new drugs, accounting for medical cost offsets due to clinical advantages. To estimate the budgetary impact of direct-acting oral anticoagulants (DOACs) compared with warfarin, an older, lower-cost vitamin K antagonist, on 12-month Medicaid expenditures for nonvalvular atrial fibrillation (NVAF) using number needed to treat (NNT). Medicaid utilization files, 2009 through second quarter 2015, were used to estimate OAC cost accounting for generic/brand statutory minimum (13/23%) and assumed maximum (13/50%) manufacturer rebates. NNTs were calculated from clinical trial reports to estimate avoided medical events for a hypothetical population of 500,000 enrollees (approximate NVAF prevalence × Medicaid enrollment) under two DOAC market share scenarios: 2015 actual and 50% increase. Medical service costs were based on published sources. Costs were inflation-adjusted (2015 US$). From 2009-2015, OAC reimbursement per claim increased by 173 and 279% under maximum and minimum rebate scenarios, respectively, while DOAC market share increased from 0 to 21%. Compared with a warfarin-only counterfactual, counts of ischemic strokes, intracranial hemorrhages, and systemic embolisms declined by 36, 280, and 111, respectively; counts of gastrointestinal hemorrhages increased by 794. Avoided events and reduced monitoring, respectively, offset 3-5% and 15-24% of increased drug cost. Net of offsets, DOAC-related cost increases were US$258-US$464 per patient per year (PPPY) in 2015 and US$309-US$579 PPPY after market share increase. Avoided medical events offset a small portion of DOAC-related drug cost increase. NNT-based calculations provide a transparent source of budgetary-impact information for new medications.

Cost-Effectiveness Analysis of Nasal Continuous Positive Airway Pressure Versus Nasal High Flow Therapy as Primary Support for Infants Born Preterm.

PubMed

Huang, Li; Roberts, Calum T; Manley, Brett J; Owen, Louise S; Davis, Peter G; Dalziel, Kim M

2018-05-01

To compare the cost-effectiveness of 2 common "noninvasive" modes of respiratory support for infants born preterm. An economic evaluation was conducted as a component of a multicenter, randomized control trial from 2013 to 2015 enrolling infants born preterm at ≥28 weeks of gestation with respiratory distress, <24 hours old, who had not previously received endotracheal intubation and mechanical ventilation or surfactant. The economic evaluation was conducted from a healthcare sector perspective and the time horizon was from birth until death or first discharge. The cost-effectiveness of continuous positive airway pressure (CPAP) vs high-flow with "rescue" CPAP backup and high-flow without rescue CPAP backup (as sole primary support) were analyzed by using the hospital cost of inpatient stay in a tertiary center and the rates of endotracheal intubation and mechanical ventilation during admission. Hospital inpatient cost records for 435 infants enrolled in all Australian centers were obtained. With "rescue" CPAP backup, an incremental cost-effectiveness ratio was estimated of A$179 000 (US$123 000) per ventilation avoided if CPAP was used compared with high flow. Without rescue CPAP backup, cost per ventilation avoided was A$7000 (US$4800) if CPAP was used compared with high flow. As sole primary support, CPAP is highly likely to be cost-effective compared with high flow. Neonatal units choosing to use only one device should apply CPAP as primary respiratory support. Compared with high-flow with rescue CPAP backup, CPAP is unlikely to be cost-effective if willingness to pay per ventilation avoided is less than A$179 000 (US$123 000). Copyright © 2018 Elsevier Inc. All rights reserved.

[On some misused terms in entomological publications].

PubMed

Hilje, Luko

2011-09-01

A glossary is presented, despite being a non-exhaustive one, which includes a little more than one hundred terms frequently misused in entomological publications. They are organized in accordance to their degree of acceptance by the Real Academia Española. Each one is accompanied by its correct alternative (sometimes with a brief justification of the suggested term), and its proper use is illustrated with an example. Moreover, in addition to idiomatic mistakes themselves, a brief list of rather common conceptual mistakes is included, which correct use is explained.

A Budget Impact Model of Hemophilia Bypassing Agent Prophylaxis Relative to Recombinant Factor VIIa On-Demand.

PubMed

Mehta, Darshan A; Oladapo, Abiola O; Epstein, Joshua D; Novack, Aaron R; Neufeld, Ellis J; Hay, Joel W

2016-02-01

Hemophilia patients use factor-clotting concentrates (factor VIII for hemophilia A and factor IX for hemophilia B) for improved blood clotting. These products are used to prevent or stop bleeding episodes. However, some hemophilia patients develop inhibitors (i.e., the patient's immune system develops antibodies against these factor concentrates). Hence, these patients do not respond well to the factor concentrates. A majority of hemophilia patients with inhibitors are managed on-demand with the following bypassing agents: recombinant factor VIIa (rFVIIa) and activated prothrombin complex concentrate (aPCC). The recently published U.S. registries Dosing Observational Study in Hemophilia (DOSE) and Hemostasis and Thrombosis Research Society (HTRS) reported higher rFVIIa on-demand use for bleed management than previously described. To estimate aPCC and rFVIIa prophylaxis costs relative to rFVIIa on-demand treatment cost based on rFVIIa doses reported in U.S. registries. A literature-based cost model was developed assuming a base case on-demand annual bleed rate (ABR) of 28.7 per inhibitor patient, which was taken from a randomized phase 3 clinical trial. The doses for rFVIIa on-demand were taken from the median dose per bleed reported by the DOSE and HTRS registries. Model inputs for aPCC and rFVIIa prophylaxis (i.e., dosing and efficacy) were derived from respective randomized clinical trials. Cost analysis was from the U.S. payer perspective, and only direct drug costs were considered. The drug cost was based on the Medicare Part B 2014 average sale price (ASP). Two-way sensitivity and threshold analyses were performed by simultaneously varying on-demand ABR, prophylaxis efficacy, and unit drug cost. In addition to studying relative costs associated with on-demand and prophylaxis treatments, relative cost per bleeding episode avoided were also calculated for aPCC and rFVIIa prophylaxis treatments. The prophylaxis efficacy reported in the trials were used to determine the number of bleeding episodes avoided. Based on the median on-demand dose of 695 mcg per kg per bleed, reported by the DOSE registry, the annual rFVIIa on-demand cost was $34,009 per kg of body weight. The annual rFVIIa on-demand cost was $22,020 per kg of body weight when the median dose of 450 mcg per kg per bleed reported by the HTRS registry was considered. The annual cost rose to $38,461 per kg of body weight when the rFVIIa on-demand dose of 786 mcg per kg per bleed among patients infusing an initial dose ≥ 250 mcg per kg was considered. The aPCC (85 units per kg per every other day) and rFVIIa (90 mcg per kg per every day) annual prophylaxis costs were $26,536 and $60,700, respectively. Also, aPCC and rFVIIa prophyaxis treatments were estimated to prevent a total of 20.8 and 12.9 annual bleeding episodes, respectively. When compared with the on-demand dose of 695 mcg per kg per bleed (DOSE registry), the annual aPCC and rFVIIa prophylaxis costs were 21.9% lower and 78.4% higher, respectively. Additionally, aPCC prophylaxis saved $360 per kg for each bleeding episode avoided. rFVIIa prophylaxis cost $2,066 per kg for each bleeding episode avoided. Compared with the on-demand dose of 450 mcg per kg per bleed (HTRS registry), aPCC and rFVIIa prophylaxis costs were 20.5% and 174.9% higher, respectively. In this case, aPCC and rFVIIa prophylaxis treatment costs were $217 per kg and $2,995 per kg, respectively, for each bleeding episode avoided. aPCC and rFVIIa prophylaxis costs were 31.0% lower and 57.8% higher, respectively, when compared with the rFVIIa on-demand dose of 786 mcg per kg per bleed, among patients infusing an initial dose ≥ 250 mcg per kg (HTRS registry). In this case, aPCC prophylaxis saved $573 per kg for each bleeding episode avoided, while rFVIIa prophylaxis costs $1,724 per kg for each bleeding episode avoided. Results of the 2-way sensitivity analyses were robust in the majority of the scenarios considered. aPCC prophylaxis may be cost saving for managing hemophilia patients with inhibitors who bleed frequently and infuse significant quantities of rFVIIa on-demand.

Development of a module for Cost-Benefit analysis of risk reduction measures for natural hazards for the CHANGES-SDSS platform

NASA Astrophysics Data System (ADS)

Berlin, Julian; Bogaard, Thom; Van Westen, Cees; Bakker, Wim; Mostert, Eric; Dopheide, Emile

2014-05-01

Cost benefit analysis (CBA) is a well know method used widely for the assessment of investments either in the private and public sector. In the context of risk mitigation and the evaluation of risk reduction alternatives for natural hazards its use is very important to evaluate the effectiveness of such efforts in terms of avoided monetary losses. However the current method has some disadvantages related to the spatial distribution of the costs and benefits, the geographical distribution of the avoided damage and losses, the variation in areas that are benefited in terms of invested money and avoided monetary risk. Decision-makers are often interested in how the costs and benefits are distributed among different administrative units of a large area or region, so they will be able to compare and analyse the cost and benefits per administrative unit as a result of the implementation of the risk reduction projects. In this work we first examined the Cost benefit procedure for natural hazards, how the costs are assessed for several structural and non-structural risk reduction alternatives, we also examined the current problems of the method such as the inclusion of cultural and social considerations that are complex to monetize , the problem of discounting future values using a defined interest rate and the spatial distribution of cost and benefits. We also examined the additional benefits and the indirect costs associated with the implementation of the risk reduction alternatives such as the cost of having a ugly landscape (also called negative benefits). In the last part we examined the current tools and software used in natural hazards assessment with support to conduct CBA and we propose design considerations for the implementation of the CBA module for the CHANGES-SDSS Platform an initiative of the ongoing 7th Framework Programme "CHANGES of the European commission. Keywords: Risk management, Economics of risk mitigation, EU Flood Directive, resilience, prevention, cost benefit analysis, spatial distribution of costs and benefits

Health service costs and clinical gains of psychotherapy for personality disorders: a randomized controlled trial of day-hospital-based step-down treatment versus outpatient treatment at a specialist practice

PubMed Central

2013-01-01

Background Day-hospital-based treatment programmes have been recommended for poorly functioning patients with personality disorders (PD). However, more research is needed to confirm the cost-effectiveness of such extensive programmes over other, presumably simpler, treatment formats. Methods This study compared health service costs and psychosocial functioning for PD patients randomly allocated to either a day-hospital-based treatment programme combining individual and group psychotherapy in a step-down format, or outpatient individual psychotherapy at a specialist practice. It included 107 PD patients, 46% of whom had borderline PD, and 40% of whom had avoidant PD. Costs included the two treatment conditions and additional primary and secondary in- and outpatient services. Psychosocial functioning was assessed using measures of global (observer-rated GAF) and occupational (self-report) functioning. Repeated assessments over three years were analysed using mixed models. Results The costs of step-down treatment were higher than those of outpatient treatment, but these high costs were compensated by considerably lower costs of other health services. However, costs and clinical gains depended on the type of PD. For borderline PD patients, cost-effectiveness did not differ by treatment condition. Health service costs declined during the trial, and functioning improved to mild impairment levels (GAF > 60). For avoidant PD patients, considerable adjuvant health services expanded the outpatient format. Clinical improvements were nevertheless superior to the step-down condition. Conclusion Our results indicate that decisions on treatment format should differentiate between PD types. For borderline PD patients, the costs and gains of step-down and outpatient treatment conditions did not differ. For avoidant PD patients, the outpatient format was a better alternative, leaning, however, on costly additional health services in the early phase of treatment. Trial registration Clinical Trials NCT00378248 PMID:24268099

Collision avoidance system cost-benefit analysis : volume I - technical manual

DOT National Transportation Integrated Search

1981-09-01

Collision-avoidance systems under development in the U.S.A., Japan and Germany were evaluated. The performance evaluation showed that the signal processing and the control law of a system were the key parameters that decided the system's capability, ...

Levelized Cost and Levelized Avoided Cost of New Generation Resources in the Annual Energy Outlook

EIA Publications

2017-01-01

This paper presents average values of levelized costs for generating technologies entering service in 2019, 2022, and 2040 as represented in the National Energy Modeling System (NEMS) for the Annual Energy Outlook 2017 (AEO2017) Reference case.

32 CFR 162.3 - Definition.

Code of Federal Regulations, 2012 CFR

2012-07-01

.... Benefits resulting from PECIs are classified as savings or as cost avoidance: (1) Savings. Benefits that... achieved. Examples include costs for manpower authorizations and or funded work-year reductions, reduced or... manpower or costs that would be necessary, if present management practices were continued. The effect of...

32 CFR 162.3 - Definition.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... Benefits resulting from PECIs are classified as savings or as cost avoidance: (1) Savings. Benefits that... achieved. Examples include costs for manpower authorizations and or funded work-year reductions, reduced or... manpower or costs that would be necessary, if present management practices were continued. The effect of...

32 CFR 162.3 - Definition.

Code of Federal Regulations, 2014 CFR

2014-07-01

.... Benefits resulting from PECIs are classified as savings or as cost avoidance: (1) Savings. Benefits that... achieved. Examples include costs for manpower authorizations and or funded work-year reductions, reduced or... manpower or costs that would be necessary, if present management practices were continued. The effect of...

32 CFR 162.3 - Definition.

Code of Federal Regulations, 2011 CFR

2011-07-01

.... Benefits resulting from PECIs are classified as savings or as cost avoidance: (1) Savings. Benefits that... achieved. Examples include costs for manpower authorizations and or funded work-year reductions, reduced or... manpower or costs that would be necessary, if present management practices were continued. The effect of...

32 CFR 162.3 - Definition.

Code of Federal Regulations, 2013 CFR

2013-07-01

.... Benefits resulting from PECIs are classified as savings or as cost avoidance: (1) Savings. Benefits that... achieved. Examples include costs for manpower authorizations and or funded work-year reductions, reduced or... manpower or costs that would be necessary, if present management practices were continued. The effect of...

Constrained trajectory optimization for kinematically redundant arms

NASA Technical Reports Server (NTRS)

Carignan, Craig R.; Tarrant, Janice M.

1990-01-01

Two velocity optimization schemes for resolving redundant joint configurations are compared. The Extended Moore-Penrose Technique minimizes the joint velocities and avoids obstacles indirectly by adjoining a cost gradient to the solution. A new method can incorporate inequality constraints directly to avoid obstacles and singularities in the workspace. A four-link arm example is used to illustrate singularity avoidance while tracking desired end-effector paths.

Cost-effectiveness analysis of early versus non-early intervention in acute migraine based on evidence from the 'Act when Mild' study.

PubMed

Slof, John

2012-05-01

In spite of the important progress made in the abortive treatment of acute migraine episodes since the introduction of triptans, reduction of pain and associated symptoms is in many cases still not as effective nor as fast as would be desirable. Recent research pays more attention to the timing of the treatment, and taking triptans early in the course of an attack when pain is still mild has been found more efficacious than the usual strategy of waiting for the attack to develop to a higher pain intensity level. To investigate the cost effectiveness of early versus non-early intervention with almotriptan in acute migraine. An economic evaluation was conducted from the perspectives of French society and the French public health system based on patient-level data collected in the AwM (Act when Mild) study, a placebo-controlled trial that compared the response to early and non-early treatment of acute migraine with almotriptan. Incremental cost-effectiveness ratios (ICERs) were determined in terms of QALYs, migraine hours and productive time lost. Costs were expressed in Euros (year 2010 values). Bootstrapping was used to derive cost-effectiveness acceptability curves. Early treatment has shown to lead to shorter attack duration, less productive time lost, better quality of life, and is, with 92% probability, overall cost saving from a societal point of view. In terms of drug costs only, however, non-early treatment is less expensive. From the public health system perspective, the (bootstrap) mean ICER of early treatment amounts to €0.38 per migraine hour avoided, €1.29 per hour of productive time lost avoided, and €14,296 per QALY gained. Considering willingness-to-pay values of approximately €1 to avoid an hour of migraine, €10 to avoid the loss of a productive hour, or €30,000 to gain one QALY, the approximate probability that early treatment is cost effective is 90%, 90% and 70%, respectively. These results remain robust in different scenarios for the major elements of the economic evaluation. Compared with non-early treatment, a strategy of early treatment of acute migraine with almotriptan when pain is still mild is, with high probability, cost saving from the French societal perspective and can be considered cost effective from the public health system point of view.

Impact of pharmacist interventions on cost avoidance in an ambulatory cancer center.

PubMed

Randolph, Laura A; Walker, Cheri K; Nguyen, Ann T; Zachariah, Subi R

2018-01-01

Objective To provide a foundation to justify the presence of a full-time clinical pharmacist in the ambulatory cancer center in addition to an existing centralized pharmacist through cost avoidance calculation and patient and staff satisfaction surveys. Methods The prospective, pilot study took place in an ambulatory cancer center over four weeks in 2014. Cost avoidance values were assigned to interventions performed by a pharmacy resident, who was present in the ambulatory cancer center during clinic hours, along with a centralized oncology pharmacist routinely working with the cancer center. Anonymous patient and staff satisfaction surveys based on a 5-point Likert scale were distributed to assess the perceived benefit of a pharmacist located in the ambulatory cancer center. Results Data collection took place over approximately one month. After evaluation of 962 interventions from both pharmacists, the estimated cost avoidance was US$282,741 per pharmacist per year, yielding a net benefit of US$138,441. The most common interventions made by the resident included chemotherapy regimen review (n = 290, 69%) and patient counseling (n = 102, 24%), while the majority of the centralized pharmacist's interventions was chemotherapy regimen review (n = 525, 97%). Results from the anonymous patient and staff surveys revealed an overall positive perception of the pharmacy resident while in the ambulatory cancer center. Conclusion A full-time clinical pharmacist in an ambulatory cancer center is both financially beneficial and positively perceived by patients and staff.

Avoided electricity subsidy payments can finance substantial appliance efficiency incentive programs: Case study of Mexico

DOE Office of Scientific and Technical Information (OSTI.GOV)

Leventis, Greg; Gopal, Anand; Rue du Can, Stephane de la

Numerous countries use taxpayer funds to subsidize residential electricity for a variety of socioeconomic objectives. These subsidies lower the value of energy efficiency to the consumer while raising it for the government. Further, while it would be especially helpful to have stringent Minimum Energy Performance Standards (MEPS) for appliances and buildings in this environment, they are hard to strengthen without imposing a cost on ratepayers. In this secondbest world, where the presence of subsidies limits the government’s ability to strengthen standards, we find that avoided subsidies are a readily available source of financing for energy efficiency incentive programs. Here, wemore » introduce the LBNL Energy Efficiency Revenue Analysis (LEERA) model to estimate the appliance efficiency improvements that can be achieved in Mexico by the revenue neutral financing of incentive programs from avoided subsidy payments. LEERA uses the detailed techno-economic analysis developed by LBNL for the Super-efficient Equipment and Appliance Deployment (SEAD) Initiative to calculate the incremental costs of appliance efficiency improvements. We analyze Mexico’s tariff structures and the long-run marginal cost of supply to calculate the marginal savings for the government from appliance efficiency. We find that avoided subsidy payments alone can finance incentive programs that cover the full incremental cost of refrigerators that are 27% more efficient and TVs that are 32% more efficient than baseline models. We find less substantial market transformation potential for room ACs primarily because AC energy savings occur at less subsidized tariffs.« less

Hospital cost accounting: implementing the system successfully.

PubMed

Burik, D; Duvall, T J

1985-05-01

To successfully implement a cost accounting system, certain key steps should be undertaken. These steps include developing and installing software; developing cost center budgets and inter-cost center allocations; developing service item standard costs; generating cost center level and patient level standard cost reports and reconciling these costs to actual costs; generating product line profitability reports and reconciling these reports to the financial statements; and providing ad hoc reporting capabilities. By following these steps, potential problems in the implementation process can be anticipated and avoided.

Comparing outcomes and costs between contingent and combined first-trimester screening strategies for Down's syndrome.

PubMed

Martín, I; Gibert, M J; Aulesa, C; Alsina, M; Casals, E; Bauça, J M

2015-06-01

To compare a contingent strategy with a combined strategy for prenatal detection of Down's syndrome (DS) in terms of cost, outcomes and safety. The contingent strategy was based on a simulation, removing measurement of the free beta subunit of human chorionic gonadotropin (free βhCG) and calculating the DS risk retrospectively in 32,371 pregnant women who had been screened with the combined strategy in the first trimester. In the contingent strategy, a risk between 1:31 and 1:1000 in the first trimester indicated further testing in the second trimester (alpha-fetoprotein, inhibin A, unconjugated oestriol and free βhCG). The cut-off risk values for the contingent and combined strategies in the first trimester were 1:30 and 1:250, respectively, and the cut-off risk value for integrated screening in the second trimester was 1:250. Costs were compared in terms of avoided DS births, and the ratio of loss of healthy fetuses following invasive procedures per avoided DS birth was calculated. The combined strategy had sensitivity of 40/44 (90.9%) and a false-positive rate of 2.8%. Corresponding values for the contingent strategy were 39/44 (88.6%) and 1.3%, respectively. Only 11% of pregnant women required tests in the second trimester, and the approximate cost reduction for each avoided DS birth was 5000€. The ratio of lost healthy fetuses following invasive procedures per avoided DS birth improved by up to 0.65. The contingent strategy has similar effectiveness to the combined strategy, but has lower costs and fewer invasive procedures. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Experimental study on visual detection for fatigue of fixed-position staff.

PubMed

Nie, Baisheng; Huang, Xin; Chen, Yang; Li, Anjin; Zhang, Ruming; Huang, Jinxin

2017-11-01

Fatigue can lead to decreased work performance and poorer safety and health condition. Fatigue is ubiquitous in production and in life, while the research on it is mainly concentrated in the automotive driving, aircraft piloting and other fields, and it is insufficient to study on the fatigue of fixed-position staff. This paper puts forward a non-contact visual image method, which can monitor the extent of fatigue of fixed-position staff. Fatigue threshold used in judgment is obtained by processing the recorded data of visual images of the experimental subjects when fatiguing and by analyzing eye closure time, percentage of eyelid closure (PERCLOS) value, frequency and number of blinks. The results show that there is significant difference among the four indicators before and after experiment subjects undergo fatigue. The fatigue of experimental subjects is obvious when eye closure time is 3.5 s/min, PERCLOS value 6%, and blink frequency 0.4 times/s. This provides a reference for a wider range of detection of fatigue and a method for avoiding mistakes and accidents. Copyright © 2017 Elsevier Ltd. All rights reserved.

The excuse principle can maintain cooperation through forgivable defection in the Prisoner's Dilemma game

PubMed Central

Krams, Indrikis; Kokko, Hanna; Vrublevska, Jolanta; Āboliņš-Ābols, Mikus; Krama, Tatjana; Rantala, Markus J.

2013-01-01

Reciprocal altruism describes a situation in which an organism acts in a manner that temporarily reduces its fitness while increasing another organism's fitness, but there is an ultimate fitness benefit based on an expectation that the other organism will act in a similar manner at a later time. It creates the obvious dilemma in which there is always a short-term benefit to cheating, therefore cooperating individuals must avoid being exploited by non-cooperating cheaters. This is achieved by following various decision rules, usually variants of the tit-for-tat (TFT) strategy. The strength of TFT, however, is also its weakness—mistakes in implementation or interpretation of moves, or the inability to cooperate, lead to a permanent breakdown in cooperation. We show that pied flycatchers (Ficedula hypoleuca) use a TFT with an embedded ‘excuse principle’ to forgive the neighbours that were perceived as unable to cooperate during mobbing of predators. The excuse principle dramatically increases the stability of TFT-like behavioural strategies within the Prisoner's Dilemma game. PMID:23864603

Antioxidant Properties of Brazilian Tropical Fruits by Correlation between Different Assays

PubMed Central

Pereira Lima, Giuseppina Pace; Fabris, Sabrina

2013-01-01

Four different assays (the Folin-Ciocalteu, DPPH, enzymatic method, and inhibitory activity on lipid peroxidation) based on radically different physicochemical principles and normally used to determine the antioxidant activity of food have been confronted and utilized to investigate the antioxidant activity of fruits originated from Brazil, with particular attention to more exotic and less-studied species (jurubeba, Solanum paniculatum; pequi, Caryocar brasiliense; pitaya, Hylocereus undatus; siriguela, Spondias purpurea; umbu, Spondias tuberosa) in order to (i) verify the correlations between results obtained by the different assays, with the final purpose to obtain more reliable results avoiding possible measuring-method linked mistakes and (ii) individuate the more active fruit species. As expected, the different methods give different responses, depending on the specific assay reaction. Anyhow all results indicate high antioxidant properties for siriguela and jurubeba and poor values for pitaya, umbu, and pequi. Considering that no marked difference of ascorbic acid content has been detected among the different fruits, experimental data suggest that antioxidant activities of the investigated Brazilian fruits are poorly correlated with this molecule, principally depending on their total polyphenolic content. PMID:24106692

The will: from metaphysical freedom to normative functionalism.

PubMed

Felthous, Alan R

2008-01-01

Free will is regarded by some as the most and by others as the least relevant concept for criminal responsibility. Contributions from religious and philosophical thinkers over the classical and medieval Christian eras demonstrate that, despite the passionate and historically consequential debates over the meaning of "freedom," the unifying theme that joined the will with the intellect remained persistent and pervasive. Leading historical jurists in England eventually dropped the descriptor "free," but retained the central importance of the will to criminal responsibility and emphasized its dependence on the intellect to function properly. Modern rationalist philosophers denied the will's metaphysical freedom, but not its existence. Today the neurosciences reveal more and more about how the will functions, even as lawyers and psychiatrists hesitate to utter the word. In properly avoiding metaphysical freedom within forensic inquiry and discourse, it is a grave conceptual mistake to overlook the will itself. Once greater conceptual clarity on the empirical nature of the will is achieved and accepted, the law itself could rediscover the core mental faculty behind human agency, the will.