The Impact of Resources for Clinical Surveillance on the Control of a Hypothetical Foot-and-Mouth Disease Epidemic in Denmark

PubMed Central

Halasa, Tariq; Boklund, Anette

2014-01-01

The objectives of this study were to assess whether current surveillance capacity is sufficient to fulfill EU and Danish regulations to control a hypothetical foot-and-mouth disease (FMD) epidemic in Denmark, and whether enlarging the protection and/or surveillance zones could minimize economic losses. The stochastic spatial simulation model DTU-DADS was further developed to simulate clinical surveillance of herds within the protection and surveillance zones and used to model spread of FMD between herds. A queuing system was included in the model, and based on daily surveillance capacity, which was 450 herds per day, it was decided whether herds appointed for surveillance would be surveyed on the current day or added to the queue. The model was run with a basic scenario representing the EU and Danish regulations, which includes a 3 km protection and 10 km surveillance zone around detected herds. In alternative scenarios, the protection zone was enlarged to 5 km, the surveillance zone was enlarged to 15 or 20 km, or a combined enlargement of the protection and surveillance zones was modelled. Sensitivity analysis included changing surveillance capacity to 200, 350 or 600 herds per day, frequency of repeated visits for herds in overlapping surveillance zones from every 14 days to every 7, 21 and 30 days, and the size of the zones combined with a surveillance capacity increased to 600 herds per day. The results showed that the default surveillance capacity is sufficient to survey herds on time. Extra resources for surveillance did not improve the situation, but fewer resources could result in larger epidemics and costs. Enlarging the protection zone was a better strategy than the basic scenario. Despite that enlarging the surveillance zone might result in shorter epidemic duration, and lower number of affected herds, it resulted frequently in larger economic losses. PMID:25014351

Real and hypothetical rewards

PubMed Central

Locey, Matthew L.; Jones, Bryan A.; Rachlin, Howard

2012-01-01

Laboratory studies of choice and decision making among real monetary rewards typically use smaller real rewards than those common in real life. When laboratory rewards are large, they are almost always hypothetical. In applying laboratory results meaningfully to real-life situations, it is important to know the extent to which choices among hypothetical rewards correspond to choices among real rewards and whether variation of the magnitude of hypothetical rewards affects behavior in meaningful ways. The present study compared real and hypothetical monetary rewards in two experiments. In Experiment 1, participants played a temporal discounting game that incorporates the logic of a repeated prisoner’s-dilemma (PD) type game versus tit-for-tat; choice of one alternative (“defection” in PD terminology) resulted in a small-immediate reward; choice of the other alternative (“cooperation” in PD terminology) resulted in a larger reward delayed until the following trial. The larger-delayed reward was greater for half of the groups than for the other half. Rewards also differed in type across groups: multiples of real nickels, hypothetical nickels or hypothetical hundred-dollar bills. All groups significantly increased choice of the larger delayed reward over the 40 trials of the experiment. Over the last 10 trials, cooperation was significantly higher when the difference between larger and smaller hypothetical rewards was greater. Reward type (real or hypothetical) made no significant difference in cooperation. In Experiment 2, real and hypothetical rewards were compared in social discounting – the decrease in value to the giver of a reward as social distance increases to the receiver of the reward. Social discount rates were well described by a hyperbolic function. Discounting rates for real and hypothetical rewards did not significantly differ. These results add to the evidence that results of experiments with hypothetical rewards validly apply in everyday

The Future of Clinical Education: Using Futuristic Scenarios to Explore Allied Health Deans' Perspectives on Clinical Education.

PubMed

Romig, Barbara D; Tucker, Ann W; Hewitt, Anne M; O'Sullivan Maillet, Julie

2017-01-01

There is limited information and consensus on the future of clinical education. The Delphi technique was selected to identify agreement among Association of Schools of Allied Health Professions' (ASAHP) allied health deans on the future (2018-2023) of allied health (AH) clinical education. Sixty-one AH deans, 54.9% (61 of 111) of the ASAHP membership, expressed opinions about clinical education through a three-round Delphi study. In conjunction with a conceptual model, four futuristic scenarios were used to encourage deans' feedback on the key factors impacting the future of clinical education. The responses to the four scenarios showed ways the external environment influences which activities the deans recommend. The results presented, by individual scenario and in totality, provide relevant and timely information on the importance and transformation of AH clinical education and its future. Futuristic scenarios, in combination with the Delphi technique, generated information where little exists specific to AH deans' perspectives on AH clinical education. The results offer deans opportunities for future strategic improvements. The use of the futuristic scenarios was suitable for guiding deans' responses and reaching agreement on the future of AH clinical education. These contributions reflect the imminent conditions and healthcare environment identified in the various scenarios and provide additional insight on key factors impacting the future for AH clinical education.

Valuing hypothetical wildfire impacts with a Kuhn–Tucker model of recreation demand

Treesearch

Jose Sanchez; Ken Baerenklau; Armando Gonzalez-Caban

2016-01-01

This study uses a nonmarket valuation method to investigate the recreation values of the San Jacinto Wilderness in southern California. The analysis utilizes survey data from a stated-choice experiment involving backcountry visitors who responded to questions about hypothetical wildfire burn scenarios. Benefits of landscape preservation are derived using a Kuhn-Tucker...

An experimental examination of alcohol consumption, alcohol expectancy, and self‐blame on willingness to report a hypothetical rape

PubMed Central

Maltby, John

2017-01-01

This study experimentally examined the role of victim alcohol intoxication, and self‐blame in perceiving and reporting rape to the police using a hypothetical interactive rape scenario. Participants (N = 79) were randomly assigned to consume alcohol (mean BAC = 0.07%) or tonic water before they engaged in the scenario. Alcohol expectancy was manipulated, and participant beliefs about the beverage they thought they had consumed and their feelings of intoxication were measured. Alcohol consumption and expectancy did not affect the likelihood that the nonconsensual intercourse depicted in the scenario was perceived and would be reported as rape. Participants with higher levels of self‐blame were less likely to say they would report the hypothetical rape. Self‐blame levels were higher for participants who believed they had consumed alcohol, and were associated with increased feelings of intoxication. The implications are discussed. PMID:29243270

Public house patrons' engagement in hypothetical sexual assault: a test of Alcohol Myopia Theory in a field setting.

PubMed

Flowe, Heather D; Stewart, Jade; Sleath, Emma R; Palmer, Francesca T

2011-01-01

Previous research has found that drinking establishments are often antecedent to sexual aggression outcomes. In this study, male participants were randomly selected from public houses (i.e., "pubs") and asked to imagine themselves in a hypothetical intimate encounter in which the female in the scenario stops consenting to sexual contact. Participants were given the option to continue making sexual advances up to and including sexual intercourse against the woman's will. It was hypothesized based on Alcohol Myopia Theory that participant blood alcohol concentration (BAC) levels would be associated with hypothetical sexual aggression when stereotypical cues of a woman's sexual availability (revealing clothing and alcohol use) were present in the scenario. Men's engagement in hypothetical sexual aggression was associated with BAC levels, but only when the woman was wearing revealing clothing. The sobriety of the female actor was not associated with sexual aggression. Results indicate that Alcohol Myopia Theory generalizes to a field setting. © 2011 Wiley Periodicals, Inc.

Excessive Gestational Weight Gain and Subsequent Maternal Obesity at Age 40: A Hypothetical Intervention.

PubMed

Abrams, Barbara; Coyle, Jeremy; Cohen, Alison K; Headen, Irene; Hubbard, Alan; Ritchie, Lorrene; Rehkopf, David H

2017-09-01

To model the hypothetical impact of preventing excessive gestational weight gain on midlife obesity and compare the estimated reduction with the US Healthy People 2020 goal of a 10% reduction of obesity prevalence in adults. We analyzed 3917 women with 1 to 3 pregnancies in the prospective US National Longitudinal Survey of Youth, from 1979 to 2012. We compared the estimated obesity prevalence between 2 scenarios: gestational weight gain as reported and under the scenario of a hypothetical intervention that all women with excessive gestational weight gain instead gained as recommended by the Institute of Medicine (2009). A hypothetical intervention was associated with a significantly reduced estimated prevalence of obesity for first (3.3 percentage points; 95% confidence interval [CI] = 1.0, 5.6) and second (3.0 percentage points; 95% CI = 0.7, 5.2) births, and twice as high in Black as in White mothers, but not significant in Hispanics. The population attributable fraction was 10.7% (95% CI = 3.3%, 18.1%) in first and 9.3% (95% CI = 2.2%, 16.5%) in second births. Development of effective weight-management interventions for childbearing women could lead to meaningful reductions in long-term obesity.

The Effects of Sexual Victimization History, Acute Alcohol Intoxication, and Level of Consensual Sex on Responses to Sexual Assault in a Hypothetical Scenario.

PubMed

Parkhill, Michele R; Norris, Jeanette; Gilmore, Amanda K; Hessler, Danielle M; George, William H; Davis, Kelly Cue; Zawacki, Tina

Assertive resistance to sexual assault can decrease the likelihood of completed rape and its subsequent aftermath; however, this relationship may be influenced by situational characteristics. This study examined how 2 manipulated variables, level of consensual sex during an encounter and acute alcohol intoxication, along with sexual victimization history, affected women's responses to a hypothetical sexual assault scenario. Female participants were assigned to a drink condition (alcohol/control) and to a consent history condition (low/high). Path analysis found that women who were previously victimized, consumed alcohol, and who were in the high consent condition endorsed greater immobility intentions during the assault; only level of consent predicted likelihood of assertive resistance. Resistance strategies were related to subsequent responding. Results suggest that interventions should seek to decrease negative consequences by empowering women to assertively resist unwanted sexual advances.

The Ability of Children with Language Impairment to Dissemble Emotions in Hypothetical Scenarios and Natural Situations

ERIC Educational Resources Information Center

Brinton, Bonnie; Fujiki, Martin; Hurst, Noel Quist; Jones, Emily Rowberry; Spackman, Matthew P.

2015-01-01

Purpose: This study examined the ability of children with language impairment (LI) to dissemble (hide) emotional reactions when socially appropriate to do so. Method: Twenty-two children with LI and their typically developing peers (7;1-10;11 [years;months]) participated in two tasks. First, participants were presented with hypothetical scenarios…

An Efficient Method to Design Premature End-of-Life Trajectories: A Hypothetical Alternate Fate for Cassini

NASA Technical Reports Server (NTRS)

Vaquero, Mar; Senent, Juan

2015-01-01

What would happen if, hypothetically, the highly successful Cassini mission were to end prematurely due to lack of propellant or sudden subsystem failure? A solid plan to quickly produce a solution for any given scenario, regardless of where the spacecraft is along its reference path, must be in place to safely dispose of the spacecraft and meet all planetary protection requirements. As a contingency plan for this hypothetical situation, a method to design viable high-fidelity terminating trajectories based on a hybrid approach that exploits two-body and three-body flyby transfers combined with a numerical optimization scheme is detailed in this paper.

Redefining Perinatal Experience: A Philosophical Exploration of a Hypothetical Case of Gender-Diversity in Labour and Birth.

PubMed

Richardson, Brianna; Price, Sheri; Campbell-Yeo, Marsha

2018-05-18

Using a queer phenomenological approach, the objective of this philosophical analysis is to explore the transgender experience in highly gendered clinical areas, such as the birth unit, and make recommendations on how to provide perinatal care that is inclusive of gender diversity within these areas. This paper aims to describes a hypothetical clinical experience to provide insight on the institutional barriers that currently exist and to provide nurses and midwives with pragmatic strategies to enhance gender-diverse care in general and gendered clinical areas. Currently, general healthcare providers are not sufficiently educated on how to care for and meet the needs of people who identify as lesbian, gay, bisexual, trans, queer, queer or questioning and other communities (LGBTQ+). This vulnerable population continually faces stigma, discrimination, and marginalization, which act as barriers to accessing healthcare services. Although transgender people often have difficulty accessing healthcare in general settings, they experience an even greater challenge within traditionally gendered clinical care areas. Queer Phenomenology was used to guide a critical philosophical analysis of hypothetical case reflecting a clinical scenario regarding a transgender man's experience in labour and birth. Healthcare professionals often provide insufficient care to transgender persons, inadvertently leading to further marginalization of this vulnerable population. Special consideration to provide gender-diverse care throughout the perinatal period is needed. Structures and supports are essential to enhance the care from providers in attending to the unique needs of transgender individuals and reduce oppressive effects from heteronormative environments. Nurses and midwives are leading exemplars of providing person-centered care and are capable of advocating for equitable care amongst all populations to influence systemic change. Strategies for implementing changes that address LGBTQ

Evaluation of Water Year 2011 Glen Canyon Dam Flow Release Scenarios on Downstream Sand Storage along the Colorado River in Arizona

USGS Publications Warehouse

Wright, Scott A.; Grams, Paul E.

2010-01-01

This report describes numerical modeling simulations of sand transport and sand budgets for reaches of the Colorado River below Glen Canyon Dam. Two hypothetical Water Year 2011 annual release volumes were each evaluated with six hypothetical operational scenarios. The six operational scenarios include the current operation, scenarios with modifications to the monthly distribution of releases, and scenarios with modifications to daily flow fluctuations. Uncertainties in model predictions were evaluated by conducting simulations with error estimates for tributary inputs and mainstem transport rates. The modeling results illustrate the dependence of sand transport rates and sand budgets on the annual release volumes as well as the within year operating rules. The six operational scenarios were ranked with respect to the predicted annual sand budgets for Marble Canyon and eastern Grand Canyon reaches. While the actual WY 2011 annual release volume and levels of tributary inputs are unknown, the hypothetical conditions simulated and reported herein provide reasonable comparisons between the operational scenarios, in a relative sense, that may be used by decision makers within the Glen Canyon Dam Adaptive Management Program.

Variation in the management of hypothetical cases of acute agitation in Australasian emergency departments.

PubMed

Chan, Esther W; Taylor, David McD; Knott, Jonathan C; Kong, David C M

2011-02-01

To describe the prescribing practice of emergency medicine clinicians in the management of highly agitated patients and to identify perceived barriers to management and the gaps in training. We undertook an anonymous cross-sectional mail survey of the Australasian College for Emergency Medicine (ACEM) members (fellows and advanced trainees) between June and September 2009. A questionnaire including a case vignette of a hypothetical patient and three clinical scenarios was employed to ascertain prescribing practice and assess perceived barriers to management, confidence and the perceived usefulness of existing and future Clinical Practice Guidelines (CPGs). All 2052 ACEM members were surveyed. However, seven had incorrect postal addresses and could not be reached. Of the remaining 2045, 786/2052 (38.3%, 95% CI 36.2-40.5) responses were received. Of the 786 respondents, 783 were practicing clinicians. If monotherapy was chosen, 622/783 (79.4%, 95% CI 76.4-82.2) of respondents preferred midazolam to manage the common scenario where no history was available, followed by haloperidol 45/783 (5.8%, 95% CI 4.3-7.7) and olanzapine 38/783 (4.9%, 95% CI 3.5-6.7). Most respondents 500/783 (63.9%, 95% CI 60.4-67.2) would also administer another sedative (combination therapy). Important perceived barriers to agitation management included lack of both training (352/783 [45.0%, 95% CI 41.4-48.5]) and a national CPG (313/783 [40.0%, 95% CI 36.5-43.5]). Respondents were generally confident in all aspects of management, although relatively fewer trainees were confident in determining dosing. Institutional CPGs were considered most useful for 415/783 (53.0%, 95% CI 49.4-56.5) respondents. If an ACEM-endorsed CPG were to be developed in the future, 634/783 (81.0%, 95% CI 78.0-83.6) respondents would consider this useful. There is considerable variation in the management of hypothetical cases of acute agitation in Australasian EDs. Benzodiazepines and antipsychotics, either alone or in

Astrophysical implications of hypothetical stable TeV-scale black holes

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

Giddings, Steven B.; Mangano, Michelangelo L.

2008-08-01

We analyze macroscopic effects of TeV-scale black holes, such as could possibly be produced at the LHC, in what is regarded as an extremely hypothetical scenario in which they are stable and, if trapped inside Earth, begin to accrete matter. We examine a wide variety of TeV-scale gravity scenarios, basing the resulting accretion models on first-principles, basic, and well-tested physical laws. These scenarios fall into two classes, depending on whether accretion could have any macroscopic effect on the Earth at times shorter than the Sun's natural lifetime. We argue that cases with such an effect at shorter times than themore » solar lifetime are ruled out, since in these scenarios black holes produced by cosmic rays impinging on much denser white dwarfs and neutron stars would then catalyze their decay on time scales incompatible with their known lifetimes. We also comment on relevant lifetimes for astronomical objects that capture primordial black holes. In short, this study finds no basis for concerns that TeV-scale black holes from the LHC could pose a risk to Earth on time scales shorter than the Earth's natural lifetime. Indeed, conservative arguments based on detailed calculations and the best-available scientific knowledge, including solid astronomical data, conclude, from multiple perspectives, that there is no risk of any significance whatsoever from such black holes.« less

Paying the price: a cross-sectional survey of Australian socioeconomically disadvantaged smokers' responses to hypothetical cigarette price rises.

PubMed

Guillaumier, Ashleigh; Bonevski, Billie; Paul, Christine; D'Este, Catherine; Doran, Christopher; Siahpush, Mohammad

2014-03-01

Increases in tobacco taxation can lead to reductions in tobacco consumption and prevalence of use across social groups. However, use of price-minimisation strategies to manage current and future tobacco use and the role of financial stress is less understood. This study aimed to measure the effect of cigarette price increases on price-minimisation strategy endorsement and financial stress among socioeconomically disadvantaged smokers. Community service organisation welfare recipients in NSW, Australia completed a touchscreen survey. Smoking history, financial stress, highest price to quit and responses to hypothetical cigarette price increases were assessed. Participants were 354 smokers (response rate = 79%). Most participants received income from a government pension (95%), earned hypothetical price rises, significantly more participants endorsed trying to quit in response to the larger increase scenario (P < 0.001), and fewer selected no change to their smoking (P < 0.001). Numerous price-minimisation strategies (e.g. switching to cheaper brands/products) were endorsed, but remained constant across hypothetical scenarios; level of financial stress appeared to have little influence. Smokers indicating they would not change their smoking in response to price rises had higher levels of nicotine dependence. Socially disadvantaged smokers endorsed numerous price-minimising strategies to maintain smoking at hypothetically increased costs. Larger cigarette price rises motivated more smokers to consider quitting, while price-resistant smokers appeared to have a more entrenched smoker status. © 2013 Australasian Professional Society on Alcohol and other Drugs.

The SAFRR (Science Application for Risk Reduction) Tsunami Scenario

USGS Publications Warehouse

Ross, Stephanie L.; Jones, Lucile M.

2013-01-01

The Science Application for Risk Reduction (SAFRR) tsunami scenario depicts a hypothetical but plausible tsunami created by an earthquake offshore from the Alaska Peninsula and its impacts on the California coast. The tsunami scenario is a collaboration between the U.S. Geological Survey (USGS), the California Geological Survey (CGS), the California Governor’s Office of Emergency Services (Cal OES), the National Oceanic and Atmospheric Administration (NOAA), other Federal, State, County, and local agencies, private companies, and academic and other institutions. This document presents evidence for past tsunamis, the scientific basis for the source, likely inundation areas, current velocities in key ports and harbors, physical damage and repair costs, economic consequences, environmental and ecological impacts, social vulnerability, emergency management and evacuation challenges, and policy implications for California associated with this hypothetical tsunami. We also discuss ongoing mitigation efforts by the State of California and new communication products. The intended users are those who need to make mitigation decisions before future tsunamis, and those who will need to make rapid decisions during tsunami events. The results of the tsunami scenario will help managers understand the context and consequences of their decisions and how they may improve preparedness and response. An evaluation component will assess the effectiveness of the scenario process for target stakeholders in a separate report to improve similar efforts in the future.

10 CFR 71.73 - Hypothetical accident conditions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Hypothetical accident conditions. 71.73 Section 71.73... Package, Special Form, and LSA-III Tests 2 § 71.73 Hypothetical accident conditions. (a) Test procedures. Evaluation for hypothetical accident conditions is to be based on sequential application of the tests...

Cost-effectiveness analysis of microdose clinical trials in drug development.

PubMed

Yamane, Naoe; Igarashi, Ataru; Kusama, Makiko; Maeda, Kazuya; Ikeda, Toshihiko; Sugiyama, Yuichi

2013-01-01

Microdose (MD) clinical trials have been introduced to obtain human pharmacokinetic data early in drug development. Here we assessed the cost-effectiveness of microdose integrated drug development in a hypothetical model, as there was no such quantitative research that weighed the additional effectiveness against the additional time and/or cost. First, we calculated the cost and effectiveness (i.e., success rate) of 3 types of MD integrated drug development strategies: liquid chromatography-tandem mass spectrometry, accelerator mass spectrometry, and positron emission tomography. Then, we analyzed the cost-effectiveness of 9 hypothetical scenarios where 100 drug candidates entering into a non-clinical toxicity study were selected by different methods as the conventional scenario without MD. In the base-case, where 70 drug candidates were selected without MD and 30 selected evenly by one of the three MD methods, incremental cost-effectiveness ratio per one additional drug approved was JPY 12.7 billion (US$ 0.159 billion), whereas the average cost-effectiveness ratio of the conventional strategy was JPY 24.4 billion, which we set as a threshold. Integrating MD in the conventional drug development was cost-effective in this model. This quantitative analytical model which allows various modifications according to each company's conditions, would be helpful for guiding decisions early in clinical development.

Generating Scenarios When Data Are Missing

NASA Technical Reports Server (NTRS)

Mackey, Ryan

2007-01-01

The Hypothetical Scenario Generator (HSG) is being developed in conjunction with other components of artificial-intelligence systems for automated diagnosis and prognosis of faults in spacecraft, aircraft, and other complex engineering systems. The HSG accepts, as input, possibly incomplete data on the current state of a system (see figure). The HSG models a potential fault scenario as an ordered disjunctive tree of conjunctive consequences, wherein the ordering is based upon the likelihood that a particular conjunctive path will be taken for the given set of inputs. The computation of likelihood is based partly on a numerical ranking of the degree of completeness of data with respect to satisfaction of the antecedent conditions of prognostic rules. The results from the HSG are then used by a model-based artificial- intelligence subsystem to predict realistic scenarios and states.

SAFRR (Science Application for Risk Reduction) Tsunami Scenario--Executive Summary and Introduction: Chapter A in The SAFRR (Science Application for Risk Reduction) Tsunami Scenario

USGS Publications Warehouse

Ross, Stephanie L.; Jones, Lucile M.; Miller, Kevin H.; Porter, Keith A.; Wein, Anne; Wilson, Rick I.; Bahng, Bohyun; Barberopoulou, Aggeliki; Borrero, Jose C.; Brosnan, Deborah M.; Bwarie, John T.; Geist, Eric L.; Johnson, Laurie A.; Kirby, Stephen H.; Knight, William R.; Long, Kate; Lynett, Patrick; Mortensen, Carl E.; Nicolsky, Dmitry J.; Perry, Suzanne C.; Plumlee, Geoffrey S.; Real, Charles R.; Ryan, Kenneth; Suleimani, Elena; Thio, Hong Kie; Titov, Vasily V.; Whitmore, Paul M.; Wood, Nathan J.

2013-01-01

The Science Application for Risk Reduction (SAFRR) tsunami scenario depicts a hypothetical but plausible tsunami created by an earthquake offshore from the Alaska Peninsula and its impacts on the California coast. The tsunami scenario is a collaboration between the U.S. Geological Survey (USGS), the California Geological Survey, the California Governor’s Office of Emergency Services (Cal OES), the National Oceanic and Atmospheric Administration (NOAA), other Federal, State, County, and local agencies, private companies, and academic and other institutions. This document presents evidence for past tsunamis, the scientific basis for the source, likely inundation areas, current velocities in key ports and harbors, physical damage and repair costs, economic consequences, environmental and ecological impacts, social vulnerability, emergency management and evacuation challenges, and policy implications for California associated with this hypothetical tsunami. We also discuss ongoing mitigation efforts by the State of California and new communication products. The intended users are those who need to make mitigation decisions before future tsunamis, and those who will need to make rapid decisions during tsunami events. The results of the tsunami scenario will help managers understand the context and consequences of their decisions and how they may improve preparedness and response. An evaluation component will assess the effectiveness of the scenario process for target stakeholders in a separate report to improve similar efforts in the future.

Simulations of a hypothetical temperature control structure at Detroit Dam on the North Santiam River, northwestern Oregon

USGS Publications Warehouse

Buccola, Norman L.; Stonewall, Adam J.; Rounds, Stewart A.

2015-01-01

Estimated egg-emergence days for endangered Upper Willamette River Chinook salmon (Oncorhynchus tshawytscha) and Upper Willamette River winter steelhead (Oncorhynchus mykiss) were assessed for all scenarios. Estimated spring Chinook fry emergence under SlidingWeir scenarios was 9 days later immediately downstream of Big Cliff Dam, and 4 days later at Greens Bridge compared with existing structural scenarios at Detroit Dam. Despite the inclusion of a hypothetical sliding weir at Detroit Dam, temperatures exceeded without-dams temperatures during November and December. These late-autumn exceedances likely represent the residual thermal effect of Detroit Lake operated to meet minimum dry-season release rates (supporting instream habitat and irrigation requirements) and lake levels specified by the current (2014) operating rules (supporting recreation and flood mitigation).

Clinical photography in dermatology: ethical and medico-legal considerations in the age of digital and smartphone technology.

PubMed

Kunde, Lauren; McMeniman, Erin; Parker, Malcolm

2013-08-01

Clinical photography has long been an important aspect in the management of dermatological pathology and has many applications in contemporary dermatology practice. With the continuous evolution of digital and smartphone technology, clinicians must maintain ethical and medico-legal standards. This article reviews how dermatology trainees are utilising this technology in their clinical practice and what procedures they follow when taking photos of patients. We review the ethical and legal considerations of clinical photography in dermatology and present a hypothetical medico-legal scenario. Dermatology registrars were surveyed on their use of personal smartphones and digital equipment for photographing patients in their clinical practice. Numerous medico-legal providers were approached to provide medico-legal advice about a hypothetical scenario. We found that the use of these technologies is prevalent among dermatology registrars and all respondents reported regular use. Clinicians should routinely obtain and document adequate patient consent in relation to clinical photography, utilise strict privacy settings on smartphones and other digital devices and ensure that the images are stored on these devices for minimal periods. Express consent documentation in the clinical file puts the clinician in a more defensible position if a complaint is made to the medical board or privacy commissioner. © 2013 The Authors. Australasian Journal of Dermatology © 2013 The Australasian College of Dermatologists.

47 CFR 69.610 - Other hypothetical net balances.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 3 2011-10-01 2011-10-01 false Other hypothetical net balances. 69.610 Section... (CONTINUED) ACCESS CHARGES Exchange Carrier Association § 69.610 Other hypothetical net balances. (a) The hypothetical net balance for an access element other than a Common Line element shall be computed as provided...

47 CFR 69.610 - Other hypothetical net balances.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Other hypothetical net balances. 69.610 Section... (CONTINUED) ACCESS CHARGES Exchange Carrier Association § 69.610 Other hypothetical net balances. (a) The hypothetical net balance for an access element other than a Common Line element shall be computed as provided...

FTM-West Model Results for Selected Fuel Treatment Scenarios

Treesearch

Andrew D. Kramp; Peter J. Ince

2006-01-01

This paper evaluated potential forest product market impacts in the U.S. West of increases in the supply of wood from thinnings to reduce fire hazard. Evaluations are done using the Fuel Treatment Market-West model for a set of hypothetical fuel treatment scenarios, which include stand-density-index (SDI) and thin-from-below (TFB) treatment regimes at alternative...

Forest carbon benefits, costs and leakage effects of carbon reserve scenarios in the United States

Treesearch

Prakash Nepal; Peter J. Ince; Kenneth E. Skog; Sun J. Chang

2013-01-01

This study evaluated the potential effectiveness of future carbon reserve scenarios, where U.S. forest landowners would hypothetically be paid to sequester carbon on their timberland and forego timber harvests for 100 years. Scenarios featured direct payments to landowners of $0 (baseline), $5, $10, or $15 per metric ton of additional forest carbon sequestered on the...

Changes in adolescents' conflict responses associated with consecutive presentation of hypothetical conflict situations.

PubMed

Johnson, H D; LaVoie, J C; Eggenburg, E; Mahoney, M A; Pounds, L

2001-10-01

The advantages of using hypothetical situations are one reason they have been widely used to examine adolescents' responses to conflict situations. One frequently used research protocol involves presenting several conflict scenarios to participants during a single session. However, in real-life situations multiple conflicts rarely occur within short periods of time, and the nature of this presentation may be associated with changes in adolescents' reports of conflict behaviors. Trend analyses of emotional, conflict goal, and conflict tactic responses from grade 8, 10, 12, and college students to consecutively presented conflict situations showed that responses were associated with presentation of the hypothetical situations. Findings revealed an increase in reports of assertive conflict behaviors and a decrease in reports of constructive conflict behaviors with successive situation presentation. Results from the current study suggest that researchers must consider trends in responses when examining findings from successive situation presentation methodologies because adolescent reports of conflict behavior may change as situation presentation proceeds. Copyright 2001 The Association for Professionals in Services for Adolescents.

Simulation of groundwater flow and pumping scenarios for 1900–2050 near Mount Pleasant, South Carolina

USGS Publications Warehouse

Fine, Jason M.; Petkewich, Matthew D.; Campbell, Bruce G.

2017-10-31

/d; Scenario 5—minimize MPW surface-water purchase from the Charleston Water System by adding supply wells and increasing withdrawals from the Middendorf aquifer from 3.9 Mgal/d (in 2015) to 12.16 Mgal/d; and Scenario 6—same as Scenario 1, but with he addition of quarterly model stress periods to simulate seasonal variations in the groundwater withdrawals. Results from the simulations indicated further decline of groundwater levels creating cones of depressions near pumping wells in the Middendorf aquifer in the Mount Pleasant, South Carolina, area between 2015 and 2050 for all six scenarios.Simulation results from Scenario 1 showed an average decline of about 150 feet in the groundwater levels of the MPW production wells. Simulated hydrographs for two area observation wells illustrate the gradual decline in groundwater levels with overall changes in water-level altitudes of –92 and –33 feet, respectively. Simulated groundwater altitudes at a hypothetical observation well located in the MPW well field declined 121 feet between 2015 and 2050.Scenarios 2 and 3 have the same pumping rates as Scenario 1 for the MPW production wells; however, a single hypothetical pumping well was added in the Middendorf aquifer near the town of Moncks Corner, South Carolina. This hypothetical pumping well has a withdrawal rate of 0.5 Mgal/d for Scenario 2 and 1.5 Mgal/d for Scenario 3. A comparison to the 2050 Scenario 1 simulation indicates groundwater altitudes for Scenarios 2 and Scenario 3 are 3 feet and 8 feet lower, respectively, at the MPW production wells.Scenario 4 simulates the maximum pumping capacity of 10.16 Mgal/d for the MPW network of production wells. Simulated 2050 groundwater altitudes for this simulation declined to –359 feet. Simulated hydrographs for two observation wells show groundwater-level declines of 116 and 41 feet, respectively. Simulated differences in groundwater altitudes at a hypothetical observation well located in the MPW well field indicate a water

Integrating Simulation Scenarios and Clinical Practices Guided by Concepts of Translational Medicine

ERIC Educational Resources Information Center

Yang, Jing; Huang, Si-min; Li, Ze-jian; Feng, Lie; Lu, Chun-ting

2018-01-01

Purpose: To develop a novel method for closely and effectively integrating simulation scenarios and clinical practices to improve clinical skills training in the concepts of translational medicine. Methods: Forty-two and 38 third-year medical students in the classes of 2010 and 2009 at Jinan University were selected as an observation group and a…

Comparative effectiveness of incorporating a hypothetical DCIS prognostic marker into breast cancer screening.

PubMed

Trentham-Dietz, Amy; Ergun, Mehmet Ali; Alagoz, Oguzhan; Stout, Natasha K; Gangnon, Ronald E; Hampton, John M; Dittus, Kim; James, Ted A; Vacek, Pamela M; Herschorn, Sally D; Burnside, Elizabeth S; Tosteson, Anna N A; Weaver, Donald L; Sprague, Brian L

2018-02-01

Due to limitations in the ability to identify non-progressive disease, ductal carcinoma in situ (DCIS) is usually managed similarly to localized invasive breast cancer. We used simulation modeling to evaluate the potential impact of a hypothetical test that identifies non-progressive DCIS. A discrete-event model simulated a cohort of U.S. women undergoing digital screening mammography. All women diagnosed with DCIS underwent the hypothetical DCIS prognostic test. Women with test results indicating progressive DCIS received standard breast cancer treatment and a decrement to quality of life corresponding to the treatment. If the DCIS test indicated non-progressive DCIS, no treatment was received and women continued routine annual surveillance mammography. A range of test performance characteristics and prevalence of non-progressive disease were simulated. Analysis compared discounted quality-adjusted life years (QALYs) and costs for test scenarios to base-case scenarios without the test. Compared to the base case, a perfect prognostic test resulted in a 40% decrease in treatment costs, from $13,321 to $8005 USD per DCIS case. A perfect test produced 0.04 additional QALYs (16 days) for women diagnosed with DCIS, added to the base case of 5.88 QALYs per DCIS case. The results were sensitive to the performance characteristics of the prognostic test, the proportion of DCIS cases that were non-progressive in the model, and the frequency of mammography screening in the population. A prognostic test that identifies non-progressive DCIS would substantially reduce treatment costs but result in only modest improvements in quality of life when averaged over all DCIS cases.

Implementation Science Supports Core Clinical Competencies: An Overview and Clinical Example.

PubMed

Kirchner, JoAnn E; Woodward, Eva N; Smith, Jeffrey L; Curran, Geoffrey M; Kilbourne, Amy M; Owen, Richard R; Bauer, Mark S

2016-12-08

Instead of asking clinicians to work faster or longer to improve quality of care, implementation science provides another option. Implementation science is an emerging interdisciplinary field dedicated to studying how evidence-based practice can be adopted into routine clinical care. This article summarizes principles and methods of implementation science, illustrates how they can be applied in a routine clinical setting, and highlights their importance to practicing clinicians as well as clinical trainees. A hypothetical clinical case scenario is presented that explains how implementation science improves clinical practice. The case scenario is also embedded within a real-world implementation study to improve metabolic monitoring for individuals prescribed antipsychotics. Context, recipient, and innovation (ie, the evidence-based practice) factors affected improvement of metabolic monitoring. To address these factors, an external facilitator and a local quality improvement team developed an implementation plan involving a multicomponent implementation strategy that included education, performance reports, and clinician follow-up. The clinic remained compliant with recommended metabolic monitoring at 1-year follow up. Implementation science improves clinical practice by addressing context, recipient, and innovation factors and uses this information to develop and utilize specific strategies that improve clinical practice. It also enriches clinical training, aligning with core competencies by the Accreditation Council for Graduate Medical Education and American Boards of Medical Specialties. By learning how to change clinical practice through implementation strategies, clinicians are more able to adapt in complex systems of practice. © Copyright 2016 Physicians Postgraduate Press, Inc.

Young children's ability to report on past, future, and hypothetical pain states: a cognitive-developmental perspective.

PubMed

Jaaniste, Tiina; Noel, Melanie; von Baeyer, Carl L

2016-11-01

Children are at times asked by clinicians or researchers to rate their pain associated with their past, future, or hypothetical experiences. However, little consideration is typically given to the cognitive-developmental requirements of such pain reports. Consequently, these pain assessment tasks may exceed the abilities of some children, potentially resulting in biased or random responses. This could lead to the over- or under-treatment of children's pain. This review provides an overview of factors, and specifically the cognitive-developmental prerequisites, that may affect a child's ability to report on nonpresent pain states, such as past, future, or hypothetical pain experiences. Children's ability to report on past pains may be influenced by developmental (age, cognitive ability), contextual (mood state, language used by significant others), affective and pain-related factors. The ability to mentally construct and report on future painful experiences may be shaped by memory of past experiences, information provision and learning, contextual factors, knowledge about oneself, cognitive coping style, and cognitive development. Hypothetical pain reports are sometimes used in the development and validation of pain assessment scales, as a tool in assessing cognitive-developmental and social-developmental aspects of children's reports of pain, and for the purposes of training children to use self-report scales. Rating pain associated with hypothetical pain scenarios requires the ability to recognize pain in another person and depends on the child's experience with pain. Enhanced understanding of cognitive-developmental requirements of young children's pain reports could lead to improved understanding, assessment, and treatment of pediatric pain.

Ability to Categorize Food Predicts Hypothetical Food Choices in Head Start Preschoolers.

PubMed

Nicholson, Jody S; Barton, Jennifer M; Simons, Ali L

2018-03-01

To investigate whether preschoolers are able to identify and categorize foods, and whether their ability to classify food as healthy predicts their hypothetical food choice. Structured interviews and body measurements with preschoolers, and teacher reports of classroom performance. Six Head Start centers in a large southeastern region. A total of 235 preschoolers (mean age [SD], 4.73 [0.63] years; 45.4% girls). Teachers implemented a nutrition education intervention across the 2014-2015 school year in which children were taught to identify and categorize food as sometimes (ie, unhealthy) and anytime (ie, healthy). Preschooler responses to a hypothetical snack naming, classifying, and selection scenario. Hierarchical regression analyses to examine predictors of child hypothetical food selection. While controlling for child characteristics and cognitive functioning, preschoolers who were better at categorizing food as healthy or unhealthy were more likely to say they would choose the healthy food. Low-contrast food pairs in which food had to be classified based on multiple dimensions were outside the cognitive abilities of the preschoolers. Nutrition interventions may be more effective in helping children make healthy food choices if developmental limitations in preschoolers' abilities to categorize food is addressed in their curriculum. Classification of food into evaluative categories is challenging for this age group. Categorizing on multiple dimensions is difficult, and dichotomous labeling of food as good or bad is not always accurate in directing children toward making food choices. Future research could evaluate further preschoolers' developmental potential for food categorization and nutrition decision making and consider factors that influence healthy food choices at both snack and mealtime. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Distribution of cow-calf producers' beliefs about reporting cattle with clinical signs of foot-and-mouth disease to a veterinarian before or during a hypothetical outbreak.

PubMed

Delgado, Amy H; Norby, Bo; Scott, H Morgan; Dean, Wesley; McIntosh, W Alex; Bush, Eric

2014-12-01

Understanding the prevalence of cattle producers' beliefs regarding disease reporting can help officials improve surveillance programs with passive data collection. A cross-sectional survey was conducted in Texas in 2008 and 2009 to determine beliefs about reporting cattle with clinical signs consistent with foot-and-mouth disease (FMD) either prior to (scenario 1) or during an on-going outbreak of FMD (scenario 2). Two questionnaires were developed and distributed to Texas cow-calf producers in order to evaluate their behavioral, control, and normative beliefs related to disease reporting. The context for each behavior was provided through the use of scenarios, and belief strength was measured using a 7-point Likert-like scale. Beliefs were compared across scenarios and demographic categories, and the effect of scenario on belief examined using ordinal logistic regression. Respondents agreed that reporting clinically suspect cases would have positive economic and emotional consequences; however, when an outbreak was known to be present, producers were less likely to agree with many of the positive outcomes of reporting. Important barriers to disease reporting indicated by producers included a lack of knowledge related to clinical signs of highly contagious cattle diseases and which cattle are at risk of contracting FMD. In general, beliefs about barriers to reporting did not differ based on scenario. Veterinarians and regulatory authorities were the groups perceived to most strongly expect disease reporting, regardless of the scenario. Risk education for producers related to clinical signs of reportable livestock diseases, post-reporting procedures, and an understanding of FMD introduction and spread may improve the reporting of cattle with clinical signs consistent with FMD. Published by Elsevier B.V.

The SAFRR Tsunami Scenario

USGS Publications Warehouse

Porter, K.; Jones, Lucile M.; Ross, Stephanie L.; Borrero, J.; Bwarie, J.; Dykstra, D.; Geist, Eric L.; Johnson, L.; Kirby, Stephen H.; Long, K.; Lynett, P.; Miller, K.; Mortensen, Carl E.; Perry, S.; Plumlee, G.; Real, C.; Ritchie, L.; Scawthorn, C.; Thio, H.K.; Wein, Anne; Whitmore, P.; Wilson, R.; Wood, Nathan J.; Ostbo, Bruce I.; Oates, Don

2013-01-01

The U.S. Geological Survey and several partners operate a program called Science Application for Risk Reduction (SAFRR) that produces (among other things) emergency planning scenarios for natural disasters. The scenarios show how science can be used to enhance community resiliency. The SAFRR Tsunami Scenario describes potential impacts of a hypothetical, but realistic, tsunami affecting California (as well as the west coast of the United States, Alaska, and Hawaii) for the purpose of informing planning and mitigation decisions by a variety of stakeholders. The scenario begins with an Mw 9.1 earthquake off the Alaska Peninsula. With Pacific basin-wide modeling, we estimate up to 5m waves and 10 m/sec currents would strike California 5 hours later. In marinas and harbors, 13,000 small boats are damaged or sunk (1 in 3) at a cost of $350 million, causing navigation and environmental problems. Damage in the Ports of Los Angeles and Long Beach amount to $110 million, half of it water damage to vehicles and containerized cargo. Flooding of coastal communities affects 1800 city blocks, resulting in $640 million in damage. The tsunami damages 12 bridge abutments and 16 lane-miles of coastal roadway, costing $85 million to repair. Fire and business interruption losses will substantially add to direct losses. Flooding affects 170,000 residents and workers. A wide range of environmental impacts could occur. An extensive public education and outreach program is underway, as well as an evaluation of the overall effort.

External Validity of Contingent Valuation: Comparing Hypothetical and Actual Payments.

PubMed

Ryan, Mandy; Mentzakis, Emmanouil; Jareinpituk, Suthi; Cairns, John

2017-11-01

Whilst contingent valuation is increasingly used in economics to value benefits, questions remain concerning its external validity that is do hypothetical responses match actual responses? We present results from the first within sample field test. Whilst Hypothetical No is always an Actual No, Hypothetical Yes exceed Actual Yes responses. A constant rate of response reversals across bids/prices could suggest theoretically consistent option value responses. Certainty calibrations (verbal and numerical response scales) minimise hypothetical-actual discrepancies offering a useful solution. Helping respondents resolve uncertainty may reduce the discrepancy between hypothetical and actual payments and thus lead to more accurate policy recommendations. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Formaldehyde as hypothetical primer of biohomochirality

NASA Astrophysics Data System (ADS)

Goldanskii, Vitalii I.

1996-07-01

One of the most intriguing and crucial problems of the prebiotic evolution and the origin of life is the explanation of the origin of biohomochirality. A scheme of conversions originated by formaldehyde (FA) as hypothetical primer of biohomochirality is proposed. The merit of FA as executor of this function is based -inter alia - on the distinguished role of FA as one of the earliest and simplest molecules in both warm, terrestrial and cold, extraterrestrial scenarios of the origin of life. The confirmation of the role of FA as primer of biohomochirality would support the option of an RNA world as an alternative to the protein world. The suggested hypothesis puts forward for the first time a concrete sequence of chemical reactions which can lead to biohomochirality. The spontaneous breaking of the mirror symmetry is secured by the application of the well-known Frank scheme (combination of autocatalysis and ``annihilation'' of L and D enantiomers) to the series of interactions of FA ``trimers'' (i.e. C3H6O3 compounds) of (aaa), (apa) and (app) types, where the monomeric groups (a) means ``achirons'' (a=CHn, n>=2 and C=M, M=C,O) and (p) mean ``prochirons'' (p=HC*OM, M=H,C).

Attributions of Responsibility in a Child Sexual Abuse (CSA) Vignette among Respondents with CSA Histories: The Role of Abuse Similarity to a Hypothetical Victim

ERIC Educational Resources Information Center

Harding, Hilary G.; Zinzow, Heidi M.; Burns, Erin E.; Jackson, Joan L.

2010-01-01

Previous research suggests that similarity to a victim may influence attributions of responsibility in hypothetical child sexual abuse scenarios. One aspect of similarity receiving mixed support in the literature is respondent child sexual abuse history. Using a sample of 1,345 college women, the present study examined child sexual abuse history,…

Minesweeper and Hypothetical Thinking Action Research & Pilot Study

ERIC Educational Resources Information Center

Walker, Jacob J.

2010-01-01

This Action Research project and Pilot Study was designed and implemented to improve students' hypothetical thinking abilities by exploring the possibility that learning and playing the computer game Minesweeper may inherently help improve hypothetical thinking. One objective was to use educational tools to make it easier for students to learn the…

Tsunami Simulations in the Western Makran Using Hypothetical Heterogeneous Source Models from World's Great Earthquakes

NASA Astrophysics Data System (ADS)

Rashidi, Amin; Shomali, Zaher Hossein; Keshavarz Farajkhah, Nasser

2018-03-01

The western segment of Makran subduction zone is characterized with almost no major seismicity and no large earthquake for several centuries. A possible episode for this behavior is that this segment is currently locked accumulating energy to generate possible great future earthquakes. Taking into account this assumption, a hypothetical rupture area is considered in the western Makran to set different tsunamigenic scenarios. Slip distribution models of four recent tsunamigenic earthquakes, i.e. 2015 Chile M w 8.3, 2011 Tohoku-Oki M w 9.0 (using two different scenarios) and 2006 Kuril Islands M w 8.3, are scaled into the rupture area in the western Makran zone. The numerical modeling is performed to evaluate near-field and far-field tsunami hazards. Heterogeneity in slip distribution results in higher tsunami amplitudes. However, its effect reduces from local tsunamis to regional and distant tsunamis. Among all considered scenarios for the western Makran, only a similar tsunamigenic earthquake to the 2011 Tohoku-Oki event can re-produce a significant far-field tsunami and is considered as the worst case scenario. The potential of a tsunamigenic source is dominated by the degree of slip heterogeneity and the location of greatest slip on the rupture area. For the scenarios with similar slip patterns, the mean slip controls their relative power. Our conclusions also indicate that along the entire Makran coasts, the southeastern coast of Iran is the most vulnerable area subjected to tsunami hazard.

Tsunami Simulations in the Western Makran Using Hypothetical Heterogeneous Source Models from World's Great Earthquakes

NASA Astrophysics Data System (ADS)

Rashidi, Amin; Shomali, Zaher Hossein; Keshavarz Farajkhah, Nasser

2018-04-01

The western segment of Makran subduction zone is characterized with almost no major seismicity and no large earthquake for several centuries. A possible episode for this behavior is that this segment is currently locked accumulating energy to generate possible great future earthquakes. Taking into account this assumption, a hypothetical rupture area is considered in the western Makran to set different tsunamigenic scenarios. Slip distribution models of four recent tsunamigenic earthquakes, i.e. 2015 Chile M w 8.3, 2011 Tohoku-Oki M w 9.0 (using two different scenarios) and 2006 Kuril Islands M w 8.3, are scaled into the rupture area in the western Makran zone. The numerical modeling is performed to evaluate near-field and far-field tsunami hazards. Heterogeneity in slip distribution results in higher tsunami amplitudes. However, its effect reduces from local tsunamis to regional and distant tsunamis. Among all considered scenarios for the western Makran, only a similar tsunamigenic earthquake to the 2011 Tohoku-Oki event can re-produce a significant far-field tsunami and is considered as the worst case scenario. The potential of a tsunamigenic source is dominated by the degree of slip heterogeneity and the location of greatest slip on the rupture area. For the scenarios with similar slip patterns, the mean slip controls their relative power. Our conclusions also indicate that along the entire Makran coasts, the southeastern coast of Iran is the most vulnerable area subjected to tsunami hazard.

Real and hypothetical monetary rewards modulate risk taking in the brain.

PubMed

Xu, Sihua; Pan, Yu; Wang, You; Spaeth, Andrea M; Qu, Zhe; Rao, Hengyi

2016-07-07

Both real and hypothetical monetary rewards are widely used as reinforcers in risk taking and decision making studies. However, whether real and hypothetical monetary rewards modulate risk taking and decision making in the same manner remains controversial. In this study, we used event-related potentials (ERP) with a balloon analogue risk task (BART) paradigm to examine the effects of real and hypothetical monetary rewards on risk taking in the brain. Behavioral data showed reduced risk taking after negative feedback (money loss) during the BART with real rewards compared to those with hypothetical rewards, suggesting increased loss aversion with real monetary rewards. The ERP data demonstrated a larger feedback-related negativity (FRN) in response to money loss during risk taking with real rewards compared to those with hypothetical rewards, which may reflect greater prediction error or regret emotion after real monetary losses. These findings demonstrate differential effects of real versus hypothetical monetary rewards on risk taking behavior and brain activity, suggesting a caution when drawing conclusions about real choices from hypothetical studies of intended behavior, especially when large rewards are used. The results have implications for future utility of real and hypothetical monetary rewards in studies of risk taking and decision making.

The HayWired Scenario - How Can the San Francisco Bay Region Bounce Back Better?

NASA Astrophysics Data System (ADS)

Hudnut, K. W.; Wein, A. M.; Cox, D. A.; Perry, S. C.; Porter, K.; Johnson, L. A.; Strauss, J. A.

2017-12-01

The HayWired scenario is a hypothetical yet scientifically realistic and quantitative depiction of a moment magnitude (Mw) 7.0 earthquake occurring on April 18, 2018, at 4:18 p.m. on the Hayward Fault in the east bay part of the San Francisco Bay area, California. The hypothetical earthquake has its epicenter in Oakland, and strong ground shaking from the scenario causes a wide range of severe impacts throughout the greater bay region. In the scenario, the Hayward Fault is ruptured along its length for 83 kilometers (about 52 miles). Building on a decades-long series of efforts to reduce earthquake risk in the SF Bay area, the hypothetical HayWired earthquake is used to examine the well-known earthquake hazard of the Hayward Fault, with a focus on newly emerging vulnerabilities. After a major earthquake disaster, reestablishing water services and food-supply chains are, of course, top priorities. However, problems associated with telecommunication outages or "network congestion" will increase and become more urgent as the bay region deepens its reliance on the "Internet of Things." Communications at all levels are crucial during incident response following an earthquake. Damage to critical facilities (such as power plants) from earthquake shaking and to electrical and telecommunications wires and fiber-optic cables that are severed where they cross a fault rupture can trigger cascading Internet and telecommunications outages, and restoring these services is crucially important for emergency-response coordination. Without good communications, emergency-response efficiency is reduced, and as a result, life-saving response functions can be compromised. For these reasons, the name HayWired was chosen for this scenario to emphasize the need to examine our interconnectedness and reliance on telecommunications and other lifelines (such as water and electricity). Earthquake risk in the SF Bay area has been greatly reduced as a result of previous concerted efforts; for

Expert opinion on landslide susceptibility elicted by probabilistic inversion from scenario rankings

NASA Astrophysics Data System (ADS)

Lee, Katy; Dashwood, Claire; Lark, Murray

2016-04-01

For many natural hazards the opinion of experts, with experience in assessing susceptibility under different circumstances, is a valuable source of information on which to base risk assessments. This is particularly important where incomplete process understanding, and limited data, limit the scope to predict susceptibility by mechanistic or statistical modelling. The expert has a tacit model of a system, based on their understanding of processes and their field experience. This model may vary in quality, depending on the experience of the expert. There is considerable interest in how one may elicit expert understanding by a process which is transparent and robust, to provide a basis for decision support. One approach is to provide experts with a set of scenarios, and then to ask them to rank small overlapping subsets of these with respect to susceptibility. Methods of probabilistic inversion have been used to compute susceptibility scores for each scenario, implicit in the expert ranking. It is also possible to model these scores as functions of measurable properties of the scenarios. This approach has been used to assess susceptibility of animal populations to invasive diseases, to assess risk to vulnerable marine environments and to assess the risk in hypothetical novel technologies for food production. We will present the results of a study in which a group of geologists with varying degrees of expertise in assessing landslide hazards were asked to rank sets of hypothetical simplified scenarios with respect to land slide susceptibility. We examine the consistency of their rankings and the importance of different properties of the scenarios in the tacit susceptibility model that their rankings implied. Our results suggest that this is a promising approach to the problem of how experts can communicate their tacit model of uncertain systems to those who want to make use of their expertise.

BOLD responses in reward regions to hypothetical and imaginary monetary rewards

PubMed Central

Miyapuram, Krishna P.; Tobler, Philippe N.; Gregorios-Pippas, Lucy; Schultz, Wolfram

2015-01-01

Monetary rewards are uniquely human. Because money is easy to quantify and present visually, it is the reward of choice for most fMRI studies, even though it cannot be handed over to participants inside the scanner. A typical fMRI study requires hundreds of trials and thus small amounts of monetary rewards per trial (e.g. 5p) if all trials are to be treated equally. However, small payoffs can have detrimental effects on performance due to their limited buying power. Hypothetical monetary rewards can overcome the limitations of smaller monetary rewards but it is less well known whether predictors of hypothetical rewards activate reward regions. In two experiments, visual stimuli were associated with hypothetical monetary rewards. In Experiment 1, we used stimuli predicting either visually presented or imagined hypothetical monetary rewards, together with non-rewarding control pictures. Activations to reward predictive stimuli occurred in reward regions, namely the medial orbitofrontal cortex and midbrain. In Experiment 2, we parametrically varied the amount of visually presented hypothetical monetary reward keeping constant the amount of actually received reward. Graded activation in midbrain was observed to stimuli predicting increasing hypothetical rewards. The results demonstrate the efficacy of using hypothetical monetary rewards in fMRI studies. PMID:21985912

BOLD responses in reward regions to hypothetical and imaginary monetary rewards.

PubMed

Miyapuram, Krishna P; Tobler, Philippe N; Gregorios-Pippas, Lucy; Schultz, Wolfram

2012-01-16

Monetary rewards are uniquely human. Because money is easy to quantify and present visually, it is the reward of choice for most fMRI studies, even though it cannot be handed over to participants inside the scanner. A typical fMRI study requires hundreds of trials and thus small amounts of monetary rewards per trial (e.g. 5p) if all trials are to be treated equally. However, small payoffs can have detrimental effects on performance due to their limited buying power. Hypothetical monetary rewards can overcome the limitations of smaller monetary rewards but it is less well known whether predictors of hypothetical rewards activate reward regions. In two experiments, visual stimuli were associated with hypothetical monetary rewards. In Experiment 1, we used stimuli predicting either visually presented or imagined hypothetical monetary rewards, together with non-rewarding control pictures. Activations to reward predictive stimuli occurred in reward regions, namely the medial orbitofrontal cortex and midbrain. In Experiment 2, we parametrically varied the amount of visually presented hypothetical monetary reward keeping constant the amount of actually received reward. Graded activation in midbrain was observed to stimuli predicting increasing hypothetical rewards. The results demonstrate the efficacy of using hypothetical monetary rewards in fMRI studies. Copyright © 2011 Elsevier Inc. All rights reserved.

SAFRR Tsunami Scenarios and USGS-NTHMP Collaboration

NASA Astrophysics Data System (ADS)

Ross, S.; Wood, N. J.; Cox, D. A.; Jones, L.; Cheung, K. F.; Chock, G.; Gately, K.; Jones, J. L.; Lynett, P. J.; Miller, K.; Nicolsky, D.; Richards, K.; Wein, A. M.; Wilson, R. I.

2015-12-01

Hazard scenarios provide emergency managers and others with information to help them prepare for future disasters. The SAFRR Tsunami Scenario, published in 2013, modeled a hypothetical but plausible tsunami, created by an Mw9.1 earthquake occurring offshore from the Alaskan peninsula, and its impacts on the California coast. It presented the modeled inundation areas, current velocities in key ports and harbors, physical damage and repair costs, economic consequences, environmental impacts, social vulnerability, emergency management, and policy implications for California associated with the scenario tsunami. The intended users were those responsible for making mitigation decisions before and those who need to make rapid decisions during future tsunamis. It provided the basis for many exercises involving, among others, NOAA, the State of Washington, several counties in California, and the National Institutes of Health. The scenario led to improvements in the warning protocol for southern California and highlighted issues that led to ongoing work on harbor and marina safety. Building on the lessons learned in the SAFRR Tsunami Scenario, another tsunami scenario is being developed with impacts to Hawaii and to the source region in Alaska, focusing on the evacuation issues of remote communities with primarily shore parallel roads, and also on the effects of port closures. Community exposure studies in Hawaii (Ratliff et al., USGS-SIR, 2015) provided background for selecting these foci. One complicated and important aspect of any hazard scenario is defining the source event. The USGS is building collaborations with the National Tsunami Hazard Mitigation Program (NTHMP) to consider issues involved in developing a standardized set of tsunami sources to support hazard mitigation work. Other key USGS-NTHMP collaborations involve population vulnerability and evacuation modeling.

Physical Examination for the Academic Psychiatrist: Primer and Common Clinical Scenarios.

PubMed

Azzam, Pierre N; Gopalan, Priya; Brown, Jennifer R; Aquino, Patrick R

2016-04-01

As clinical psychiatry has evolved to mirror the patient care model followed in other medical specialties, psychiatrists are called upon increasingly to utilize general medical skills in routine practice. Psychiatrists who practice in academic settings are often required to generate broad differential diagnoses that include medical and neurologic conditions and, as a result, benefit from incorporating physical examination into their psychiatric assessments. Physical examination allows psychiatrists to follow and to teach patient-informed clinical practices and comprehensive treatment approaches. In this commentary, the authors encourage routine use of a targeted physical examination and outline common scenarios in which physical examination would be useful for the academic psychiatrist: delirium, toxidromes, and unexplained medical conditions (e.g., somatic symptom disorders).

Developing clinical scenarios from a European perspective: successes and challenges.

PubMed

Wiseman, Allison; Horton, Khim

2011-10-01

This paper presents developmental work involving students from the University College Dublin (UCD), Ireland (n=9), University of Surrey, England (n=8) and University of Ljubljana and University of Maribor, Slovenia (n=5) participating in the Erasmus Intensive Programme. The Erasmus programme offers a two week 'Summer School' in the Faculty of Health Sciences, University of Maribor, Slovenia. Using a participatory approach, facilitators from both the UCD and Surrey engaged with students from all of the universities to develop scenarios for simulated learning experiences, in the care of older people, for utilisation on an e learning facility and within the simulated clinical learning environment. Students developed key transferable skills in learning, such as information literacy, cultural diversity, team working, communication, and clinical skills acquisition whilst exploring differences in healthcare delivery in other European countries. Copyright © 2011 Elsevier Ltd. All rights reserved.

Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios

PubMed Central

Majzoub, Ahmad; Esteves, Sandro C.; Ko, Edmund; Ramasamy, Ranjith; Zini, Armand

2016-01-01

Sperm DNA fragmentation (SDF) has been generally acknowledged as a valuable tool for male fertility evaluation. While its detrimental implications on sperm function were extensively investigated, little is known about the actual indications for performing SDF analysis. This review delivers practice based recommendations on commonly encountered scenarios in the clinic. An illustrative description of the different SDF measurement techniques is presented. SDF testing is recommended in patients with clinical varicocele and borderline to normal semen parameters as it can better select varicocelectomy candidates. High SDF is also linked with recurrent spontaneous abortion (RSA) and can influence outcomes of different assisted reproductive techniques. Several studies have shown some benefit in using testicular sperm rather than ejaculated sperm in men with high SDF, oligozoospermia or recurrent in vitro fertilization (IVF) failure. Infertile men with evidence of exposure to pollutants can benefit from sperm DNA testing as it can help reinforce the importance of lifestyle modification (e.g., cessation of cigarette smoking, antioxidant therapy), predict fertility and monitor the patient’s response to intervention. PMID:28078226

Improving environmental assessments by integrating Species Sensitivity Distributions into environmental modeling: examples with two hypothetical oil spills.

PubMed

Bejarano, Adriana C; Mearns, Alan J

2015-04-15

A three dimensional (3D) trajectory model was used to simulate oil mass balance and environmental concentrations of two 795,000 L hypothetical oil spills modeled under physical and chemical dispersion scenarios. Species Sensitivity Distributions (SSD) for Total Hydrocarbon Concentrations (THCs) were developed, and Hazard Concentrations (HC) used as levels of concern. Potential consequences to entrained water column organisms were characterized by comparing model outputs with SSDs, and obtaining the proportion of species affected (PSA) and areas with oil concentrations exceeding HC5s (Area ⩾ HC5). Under the physically-dispersed oil scenario ⩽ 77% of the oil remains on the water surface and strands on shorelines, while with the chemically-dispersed oil scenario ⩽ 67% of the oil is entrained in the water column. For every 10% increase in chemical dispersion effectiveness, the average PSA and Area ⩾ HC5 increases (range: 0.01-0.06 and 0.50-2.9 km(2), respectively), while shoreline oiling decreases (⩽ 2919 L/km). Integrating SSDs into modeling may improve understanding of scales of potential impacts to water column organisms, while providing net environmental benefit comparison of oil spill response options. Copyright © 2015 Elsevier Ltd. All rights reserved.

Recapitulating the clinical scenario of BRCA-associated pancreatic cancer in pre-clinical models.

PubMed

Golan, Talia; Stossel, Chani; Atias, Dikla; Buzhor, Ella; Halperin, Sharon; Cohen, Keren; Raitses-Gurevich, Maria; Glick, Yulia; Raskin, Stephen; Yehuda, Daniel; Feldman, Anna; Schvimer, Michael; Friedman, Eitan; Karni, Rotem; Wilson, Julie M; Denroche, Robert E; Lungu, Ilinca; Bartlett, John M S; Mbabaali, Faridah; Gallinger, Steven; Berger, Raanan

2018-07-01

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal malignancies. BRCA-associated PDAC comprises a clinically relevant subtype. A portion of these patients are highly susceptible to DNA damaging therapeutics, however, responses are heterogeneous and clinical resistance evolves. We have developed unique patient-derived xenograft (PDX) models from metastatic lesions of germline BRCA-mutated patients obtained at distinct time points; before treatment and at progression. Thus, closely mimicking clinical scenarios, to further investigate treatment naïve and resistant patients. DNA was isolated from six BRCA-mutated PDXs and classified by whole-genome sequencing to stable-genome or homologous recombination deficient (HRD)-genome. The sensitivity to DNA-damaging agents was evaluated in vivo in three BRCA-associated PDAC PDXs models: (1) HRD-genome naïve to treatments; (2) stable-genome naïve to treatment; (3) HRD-genome resistant to treatment. Correlation between disease course at tissue acquisition and response to PARP inhibitor (PARPi)/platinum was demonstrated in PDXs in vivo. Only the HRD-genome PDX, naïve to treatment, was sensitive to PARP inhibitor/cisplatin treatments. Our results demonstrate heterogeneous responses to DNA damaging agents/PARPi in BRCA-associated PDX thus reflecting the wide clinical spectrum. An HRD-genome PDX generated from a naïve to treatment biopsy was sensitive to platinum/PARPi whereas no benefit was observed in treating a HRD-genome PDXs generated from a patient that had acquired resistance nor stable-genome PDXs. © 2018 UICC.

Understanding clinical and non-clinical decisions under uncertainty: a scenario-based survey.

PubMed

Simianu, Vlad V; Grounds, Margaret A; Joslyn, Susan L; LeClerc, Jared E; Ehlers, Anne P; Agrawal, Nidhi; Alfonso-Cristancho, Rafael; Flaxman, Abraham D; Flum, David R

2016-12-01

Prospect theory suggests that when faced with an uncertain outcome, people display loss aversion by preferring to risk a greater loss rather than incurring certain, lesser cost. Providing probability information improves decision making towards the economically optimal choice in these situations. Clinicians frequently make decisions when the outcome is uncertain, and loss aversion may influence choices. This study explores the extent to which prospect theory, loss aversion, and probability information in a non-clinical domain explains clinical decision making under uncertainty. Four hundred sixty two participants (n = 117 non-medical undergraduates, n = 113 medical students, n = 117 resident trainees, and n = 115 medical/surgical faculty) completed a three-part online task. First, participants completed an iced-road salting task using temperature forecasts with or without explicit probability information. Second, participants chose between less or more risk-averse ("defensive medicine") decisions in standardized scenarios. Last, participants chose between recommending therapy with certain outcomes or risking additional years gained or lost. In the road salting task, the mean expected value for decisions made by clinicians was better than for non-clinicians(-$1,022 vs -$1,061; <0.001). Probability information improved decision making for all participants, but non-clinicians improved more (mean improvement of $64 versus $33; p = 0.027). Mean defensive decisions decreased across training level (medical students 2.1 ± 0.9, residents 1.6 ± 0.8, faculty1.6 ± 1.1; p-trend < 0.001) and prospect-theory-concordant decisions increased (25.4%, 33.9%, and 40.7%;p-trend = 0.016). There was no relationship identified between road salting choices with defensive medicine and prospect-theory-concordant decisions. All participants made more economically-rational decisions when provided explicit probability information in a non-clinical

Atmospheric transport of radioactive debris to Norway in case of a hypothetical accident related to the recovery of the Russian submarine K-27.

PubMed

Bartnicki, Jerzy; Amundsen, Ingar; Brown, Justin; Hosseini, Ali; Hov, Øystein; Haakenstad, Hilde; Klein, Heiko; Lind, Ole Christian; Salbu, Brit; Szacinski Wendel, Cato C; Ytre-Eide, Martin Album

2016-01-01

The Russian nuclear submarine K-27 suffered a loss of coolant accident in 1968 and with nuclear fuel in both reactors it was scuttled in 1981 in the outer part of Stepovogo Bay located on the eastern coast of Novaya Zemlya. The inventory of spent nuclear fuel on board the submarine is of concern because it represents a potential source of radioactive contamination of the Kara Sea and a criticality accident with potential for long-range atmospheric transport of radioactive particles cannot be ruled out. To address these concerns and to provide a better basis for evaluating possible radiological impacts of potential releases in case a salvage operation is initiated, we assessed the atmospheric transport of radionuclides and deposition in Norway from a hypothetical criticality accident on board the K-27. To achieve this, a long term (33 years) meteorological database has been prepared and used for selection of the worst case meteorological scenarios for each of three selected locations of the potential accident. Next, the dispersion model SNAP was run with the source term for the worst-case accident scenario and selected meteorological scenarios. The results showed predictions to be very sensitive to the estimation of the source term for the worst-case accident and especially to the sizes and densities of released radioactive particles. The results indicated that a large area of Norway could be affected, but that the deposition in Northern Norway would be considerably higher than in other areas of the country. The simulations showed that deposition from the worst-case scenario of a hypothetical K-27 accident would be at least two orders of magnitude lower than the deposition observed in Norway following the Chernobyl accident. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

On some limits of hypothetical thinking.

PubMed

Elqayam, Shira; Handley, Simon J; Evans, Jonathan St B T; Bacon, Alison M

2008-05-01

Faced with extreme demands, hypothetical thinking runs the danger of total failure. Paradoxical propositions such as the Liar ("I am lying") provide an opportunity to test it to its limits, while the Liar's nonparadoxical counterpart, the Truthteller ("I am telling the truth"), provides a useful comparison. Two experiments are reported, one with abstract materials ("If I am a knave then I live in Emerald City") and one with belief-laden materials (a judge says: "If I am a knave then I enjoy pop music"). In both experiments, conditionals with Truthteller-type antecedents were "collapsed" to responses of conditional probability closely resembling estimates of control items. Liar-type antecedents, in contrast, dramatically weakened belief in conditionals in which they were embedded. The results are discussed in the framework of the theory of hypothetical thinking.

47 CFR 69.608 - Carrier Common Line hypothetical net balance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Carrier Common Line hypothetical net balance. 69.608 Section 69.608 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER... net balance. The hypothetical net balance shall be equal to a Carrier Common Line revenue requirement...

47 CFR 69.608 - Carrier Common Line hypothetical net balance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 3 2011-10-01 2011-10-01 false Carrier Common Line hypothetical net balance. 69.608 Section 69.608 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER... net balance. The hypothetical net balance shall be equal to a Carrier Common Line revenue requirement...

How do physicians provide statistical information about antidepressants to hypothetical patients?

PubMed

Gaissmaier, Wolfgang; Anderson, Britta L; Schulkin, Jay

2014-02-01

Little is known about how physicians provide statistical information to patients, which is important for informed consent. In a survey, obstetricians and gynecologists (N = 142) received statistical information about the benefit and side effects of an antidepressant. They received information in various formats, including event rates (antidepressant v. placebo), absolute risks, and relative risks. Participants had to imagine 2 hypothetical patients, 1 for whom they believed the drug to be safe and effective and 1 for whom they did not, and select the information they would give those patients. We assessed whether the information they selected for each patient was complete, transparent, interpretable, or persuasive (i.e., to nudge patients toward a particular option) and compared physicians who gave both patients the same information with those who gave both patients different information. A similar proportion of physicians (roughly 25% each) selected information that was 1) complete and transparent, 2) complete but not transparent, 3) not interpretable for the patient because necessary comparative information was missing, or 4) suited for nudging. Physicians who gave both patients the same information (61% of physicians) more often selected at least complete information, even if it was often not transparent. Physicians who gave both patients different information (39% of physicians), in contrast, more often selected information that was suited for nudging in line with the belief they were asked to imagine. A limitation is that scenarios were hypothetical. Most physicians did not provide complete and transparent information. Clinicians who presented consistent information to different patients tended to present complete information, whereas those who varied what information they chose to present appeared more prone to nudging.

Further tests of entreaties to avoid hypothetical bias in referendum contingent valuation

Treesearch

Thomas C. Brown; Icek Ajzen; Daniel Hrubes

2003-01-01

Over-estimation of willingness to pay in contingent markets has been attributed largely to hypothetical bias. One promising approach for avoiding hypothetical bias is to tell respondents enough about such bias that they self-correct for it. A script designed for this purpose by Cummings and Taylor was used in hypothetical referenda that differed in payment amount. In...

Industrial research for transmutation scenarios

NASA Astrophysics Data System (ADS)

Camarcat, Noel; Garzenne, Claude; Le Mer, Joël; Leroyer, Hadrien; Desroches, Estelle; Delbecq, Jean-Michel

2011-04-01

This article presents the results of research scenarios for americium transmutation in a 22nd century French nuclear fleet, using sodium fast breeder reactors. We benchmark the americium transmutation benefits and drawbacks with a reference case consisting of a hypothetical 60 GWe fleet of pure plutonium breeders. The fluxes in the various parts of the cycle (reactors, fabrication plants, reprocessing plants and underground disposals) are calculated using EDF's suite of codes, comparable in capabilities to those of other research facilities. We study underground thermal heat load reduction due to americium partitioning and repository area minimization. We endeavor to estimate the increased technical complexity of surface facilities to handle the americium fluxes in special fuel fabrication plants, americium fast burners, special reprocessing shops, handling equipments and transport casks between those facilities.

Public-policy issues associated with the SAFRR Tsunami Scenario: Chapter M in The SAFRR (Science Application for Risk Reduction) Tsunami Scenario

USGS Publications Warehouse

Johnson, Laurie; Real, Chuck

2013-01-01

The SAFRR (Science Application for Risk Reduction) tsunami scenario simulates a tsunami generated by a hypothetical magnitude 9.1 earthquake that occurs offshore of the Alaska Peninsula (Kirby and others, 2013). In addition to the work performed by the authors on public-policy issues associated with the SAFRR tsunami scenario, this section of the scenario also reflects the policy discussions of the State of California’s Tsunami Policy Work Group, a voluntary advisory body formed in October 2011, which operates under the California Natural Resources Agency (CNRA), Department of Conservation, and is charged with identifying, evaluating, and making recommendations to resolve issues that are preventing full and effective implementation of tsunami hazard mitigation and risk reduction throughout California’s coastal communities. It also presents the analyses of plans and hazard policies of California’s coastal counties, incorporated cities, and major ports performed by the staff of the California Geological Survey (CGS) and Lauren Prehoda, Office of Environmental and Government Affairs, California Department of Conservation. It also draws on the policy framework and assessment prepared for the ARkStorm Pacific Coast winter storm and catastrophic flooding (Topping and others, 2010).

Hypothetical Insurance and Higher Education

ERIC Educational Resources Information Center

Colburn, Ben; Lazenby, Hugh

2016-01-01

What level of government subsidy of higher education is justified, in what form, and for what reasons? We answer these questions by applying the hypothetical insurance approach, originally developed by Ronald Dworkin in his work on distributive justice. On this approach, when asking how to fund and deliver public services in a particular domain,…

Triage for coronary artery bypass graft surgery in Canada: do patients agree on who should come first?

PubMed

Shufelt, Katy; Chong, Alice; Alter, David A

2007-07-25

The extent to which clinical and non-clinical factors impact on the waiting-list prioritization preferences of patients in the queue is unknown. Using a series of hypothetical scenarios, the objective of this study was to examine the extent to which clinical and non-clinical factors impacted on how patients would prioritize others relative to themselves in the coronary artery bypass surgical queue. Ninety-one consecutive eligible patients awaiting coronary artery bypass grafting surgery at Sunnybrook Health Sciences Centre (median waiting-time duration prior to survey of 8 weeks) were given a self-administered survey consisting of nine scenarios in which clinical and non-clinical characteristic profiles of hypothetical patients (also awaiting coronary artery bypass surgery) were varied. For each scenario, patients were asked where in the queue such hypothetical patients should be placed relative to themselves. The eligible response rate was 65% (59/91). Most respondents put themselves marginally ahead of a hypothetical patient with identical clinical and non-clinical characteristics as themselves. There was a strong tendency for respondents to place patients of higher clinical acuity ahead of themselves in the queue (P < 0.0001). Social independence among young individuals was a positively valued attribute (P < 0.0001), but neither age per se nor financial status, directly impacted on patients waiting-list priority preferences. While patient perceptions generally reaffirmed a bypass surgical triage process based on principals of equity and clinical acuity, the valuation of social independence may justify further debate with regard to the inclusion of non-clinical factors in waiting-list prioritization management systems in Canada, as elsewhere.

The SAFRR Tsunami Scenario: from Publication to Implementation

NASA Astrophysics Data System (ADS)

Ross, S.; Jones, L.; Miller, K.; Wilson, R. I.; Burkett, E. R.; Bwarie, J.; Campbell, N. M.; Johnson, L. A.; Long, K.; Lynett, P. J.; Perry, S. C.; Plumlee, G. S.; Porter, K.; Real, C. R.; Ritchie, L. A.; Wein, A. M.; Whitmore, P.; Wood, N. J.

2014-12-01

The SAFRR Tsunami Scenario modeled a hypothetical but plausible tsunami, created by an Mw9.1 earthquake occurring offshore from the Alaskan peninsula, and its impacts on the California coast. We presented the likely inundation areas, current velocities in key ports and harbors, physical damage and repair costs, economic consequences, environmental impacts, social vulnerability, emergency management, and policy implications for California associated with the scenario tsunami. The intended users were those responsible for making mitigation decisions before and those who need to make rapid decisions during future tsunamis. The Tsunami Scenario process is being evaluated by the University of Colorado's Natural Hazards Center; this is the first time that a USGS scenario of this scale has been formally and systematically evaluated by an external party. The SAFRR Tsunami Scenario was publicly introduced in September, 2013, through a series of regional workshops in California that brought together emergency managers, maritime authorities, first responders, elected officials and staffers, the business sector, state agencies, local media, scientific partners, and special districts such as utilities (http://pubs.usgs.gov/of/2013/1170/). In March, 2014, NOAA's annual tsunami warning exercise, PACIFEX, was based on the SAFRR Tsunami Scenario. Many groups conducted exercises associated with PACIFEX including the State of Washington and several counties in California. San Francisco had the most comprehensive exercise with a 3-day functional exercise based on the SAFRR Tsunami Scenario. In addition, the National Institutes of Health ran an exercise at the Ports of Los Angeles and Long Beach in April, 2014, building on the Tsunami Scenario, focusing on the recovery phase and adding a refinery fire. The benefits and lessons learned include: 1) stimulating dialogue among practitioners to solve problems; 2) seeing groups add extra components to their exercises that best address their

What would you say? Genetic counseling graduate students' and counselors' hypothetical responses to patient requested self-disclosure.

PubMed

Redlinger-Grosse, Krista; Veach, Patricia McCarthy; MacFarlane, Ian M

2013-08-01

Genetic counselor self-disclosure is a complex behavior that lacks extensive characterization. In particular, data are limited about genetic counselors' responses when patients ask them to self-disclose. Accordingly, this study investigated genetic counseling students' (n = 114) and practicing genetic counselors' (n = 123) responses to two hypothetical scenarios in which a female prenatal patient requests self-disclosure. Scenarios were identical except for a final patient question: "Have you ever had an amniocentesis?" or "What would you do if you were me?" Imagining themselves as the counselor, participants wrote a response for each scenario and then explained their response. Differences in disclosure frequency for students vs. counselors and disclosure question were assessed, and themes in participant responses and explanations were extracted via content and thematic analysis methods. Chi-square analyses indicated no significant differences in frequency of student versus counselor disclosure. Self-disclosure was significantly higher for, "Have you ever had an amniocentesis?" (78.5 %) than for, "What would you do if you were me?" (53.2 %) (p < .001). Types of self-disclosures included personal, professional, and mixed disclosures. Prevalent explanations for disclosure and non-disclosure responses included: remain patient focused and support/empower the patient. Additional findings, practice and training implications, and research recommendations are presented.

Designing Asteroid Impact Scenario Trajectories

NASA Astrophysics Data System (ADS)

Chodas, Paul

2016-05-01

In order to study some of the technical and geopolitical issues of dealing with an asteroid on impact trajectory, a number of hypothetical impact scenarios have been presented over the last ten years or so. These have been used, for example, at several of the Planetary Defense Conferences (PDCs), as well as in tabletop exercises with the Federal Emergency Management Agency (FEMA), along with other government agencies. The exercise at the 2015 PDC involved most of the attendees, consisted of seven distinct steps (“injects”), and with all the presentations and discussions, took up nearly 10 hours of conference time. The trajectory for the PDC15 scenario was entirely realistic, and was posted ahead of the meeting. It was made available in the NEO Program’s Horizons ephemeris service so that users could , for example, design their own deflection missions. The simulated asteroid and trajectory had to meet numerous very exacting requirements: becoming observable on the very first day of the conference, yet remaining very difficult to observe for the following 7 years, and far enough away from Earth that it was out of reach of radar until just before impact. It had to be undetectable in the past, and yet provide multiple perihelion opportunities for deflection in the future. It had to impact in a very specific region of the Earth, a specific number of years after discovery. When observations of the asteroid are simulated to generate an uncertainty region, that entire region must impact the Earth along an axis that cuts across specific regions of the Earth, the “risk corridor”. This is important because asteroid deflections generally move an asteroid impact point along this corridor. One scenario had a requirement that the asteroid pass through a keyhole several years before impact. The PDC15 scenario had an additional constraint that multiple simulated kinetic impactor missions altered the trajectory at a deflection point midway between discovery and impact

Pregnant patients' risk perception of prenatal test results with uncertain fetal clinical significance: ultrasound versus advanced genetic testing.

PubMed

Richards, Elliott G; Sangi-Haghpeykar, Haleh; McGuire, Amy L; Van den Veyver, Ignatia B; Fruhman, Gary

2015-12-01

A common concern of utilizing prenatal advanced genetic testing is that a result of uncertain clinical significance will increase patient anxiety. However, prenatal ultrasound may also yield findings of uncertain significance, such as 'soft markers' for fetal aneuploidy, or findings with variable prognosis, such as mild ventriculomegaly. In this study we compared risk perception following uncertain test results from each modality. A single survey with repeated measures design was administered to 133 pregnant women. It included 'intolerance of uncertainty' questions, two hypothetical scenarios involving prenatal ultrasound or advanced genetic testing, and response questions. The primary outcome was risk perception score. Risk perception did not vary significantly between ultrasound and genetic scenarios (p = 0.17). The genetic scenario scored a higher accuracy (p = 0.04) but lower sense of empowerment (p = 0.01). Furthermore, patients were more likely to seek additional testing after an ultrasound than after genetic testing (p = 0.05). There were no differences in other secondary outcomes including perception of life-altering consequences and hypothetical worry, anxiety, confusion, or medical care decisions. Our data suggest that uncertain findings on prenatal genetic testing do not elicit a higher perception of risk or anxiety when compared to ultrasound findings of comparable uncertainty. © 2015 John Wiley & Sons, Ltd. © 2015 John Wiley & Sons, Ltd.

USGS Multi-Hazards Winter Storm Scenario

NASA Astrophysics Data System (ADS)

Cox, D. A.; Jones, L. M.; Perry, S. C.

2008-12-01

The USGS began an inter-disciplinary effort, the Multi Hazards Demonstration Project (MHDP), in 2007 to demonstrate how hazards science can improve a community's resiliency to natural disasters including earthquakes, tsunamis, wildfires, landslides, floods and coastal erosion. The project engages the user community in setting research goals and directs efforts towards research products that can be applied to loss reduction and improved resiliency. The first public product of the MHDP was the ShakeOut Earthquake Scenario published in May 2008. It detailed the realistic outcomes of a hypothetical, but plausible, magnitude 7.8 earthquake on the San Andreas Fault in southern California. Over 300 scientist and experts contributed to designing the earthquake and understanding the impacts of such a disaster, including the geotechnical, engineering, social, cultural, environmental, and economic consequences. The scenario advanced scientific understanding and exposed numerous vulnerabilities related to emergency response and lifeline continuity management. The ShakeOut Scenario was the centerpiece of the Nation's largest-ever emergency response exercise in November 2008, dubbed "The Great Southern California ShakeOut" (www.shakeout.org). USGS Multi-Hazards is now preparing for its next major public project, a Winter Storm Scenario. Like the earthquake scenario, experts will be brought together to examine in detail the possibility, cost and consequences of a winter storm disaster including floods, landslides, coastal erosion and inundation; debris flows; biologic consequences like extirpation of endangered species; physical damages like bridge scour, road closures, dam failure, property loss, and water system collapse. Consideration will be given to the vulnerabilities associated with a catastrophic disruption to the water supply to southern California; the resulting impacts on ground water pumping, seawater intrusion, water supply degradation, and land subsidence; and a

The ShakeOut scenario: A hypothetical Mw7.8 earthquake on the Southern San Andreas Fault

USGS Publications Warehouse

Porter, K.; Jones, L.; Cox, D.; Goltz, J.; Hudnut, K.; Mileti, D.; Perry, S.; Ponti, D.; Reichle, M.; Rose, A.Z.; Scawthorn, C.R.; Seligson, H.A.; Shoaf, K.I.; Treiman, J.; Wein, A.

2011-01-01

In 2008, an earthquake-planning scenario document was released by the U.S. Geological Survey (USGS) and California Geological Survey that hypothesizes the occurrence and effects of a Mw7.8 earthquake on the southern San Andreas Fault. It was created by more than 300 scientists and engineers. Fault offsets reach 13 m and up to 8 m at lifeline crossings. Physics-based modeling was used to generate maps of shaking intensity, with peak ground velocities of 3 m/sec near the fault and exceeding 0.5 m/sec over 10,000 km2. A custom HAZUS??MH analysis and 18 special studies were performed to characterize the effects of the earthquake on the built environment. The scenario posits 1,800 deaths and 53,000 injuries requiring emergency room care. Approximately 1,600 fires are ignited, resulting in the destruction of 200 million square feet of the building stock, the equivalent of 133,000 single-family homes. Fire contributes $87 billion in property and business interruption loss, out of the total $191 billion in economic loss, with most of the rest coming from shakerelated building and content damage ($46 billion) and business interruption loss from water outages ($24 billion). Emergency response activities are depicted in detail, in an innovative grid showing activities versus time, a new format introduced in this study. ?? 2011, Earthquake Engineering Research Institute.

Triage for coronary artery bypass graft surgery in Canada: Do patients agree on who should come first?

PubMed Central

Shufelt, Katy; Chong, Alice; Alter, David A

2007-01-01

Background The extent to which clinical and non-clinical factors impact on the waiting-list prioritization preferences of patients in the queue is unknown. Using a series of hypothetical scenarios, the objective of this study was to examine the extent to which clinical and non-clinical factors impacted on how patients would prioritize others relative to themselves in the coronary artery bypass surgical queue. Methods Ninety-one consecutive eligible patients awaiting coronary artery bypass grafting surgery at Sunnybrook Health Sciences Centre (median waiting-time duration prior to survey of 8 weeks) were given a self-administered survey consisting of nine scenarios in which clinical and non-clinical characteristic profiles of hypothetical patients (also awaiting coronary artery bypass surgery) were varied. For each scenario, patients were asked where in the queue such hypothetical patients should be placed relative to themselves. Results The eligible response rate was 65% (59/91). Most respondents put themselves marginally ahead of a hypothetical patient with identical clinical and non-clinical characteristics as themselves. There was a strong tendency for respondents to place patients of higher clinical acuity ahead of themselves in the queue (P < 0.0001). Social independence among young individuals was a positively valued attribute (P < 0.0001), but neither age per se nor financial status, directly impacted on patients waiting-list priority preferences. Conclusion While patient perceptions generally reaffirmed a bypass surgical triage process based on principals of equity and clinical acuity, the valuation of social independence may justify further debate with regard to the inclusion of non-clinical factors in waiting-list prioritization management systems in Canada, as elsewhere. PMID:17651503

Effects of clinical supervision on resident learning and patient care during simulated ICU scenarios.

PubMed

Piquette, Dominique; Tarshis, Jordan; Regehr, Glenn; Fowler, Robert A; Pinto, Ruxandra; LeBlanc, Vicki R

2013-12-01

Closer supervision of residents' clinical activities has been promoted to improve patient safety, but may additionally affect resident participation in patient care and learning. The objective of this study was to determine the effects of closer supervision on patient care, resident participation, and the development of resident ability to care independently for critically ill patients during simulated scenarios. This quantitative study represents a component of a larger mixed-methods study. Residents were randomized to one of three levels of supervision, defined by the physical proximity of the supervisor (distant, immediately available, and direct). Each resident completed a simulation scenario under the supervision of a critical care fellow, immediately followed by a modified scenario of similar content without supervision. The simulation center of a tertiary, university-affiliated academic center in a large urban city. Fifty-three residents completing a critical care rotation and 24 critical care fellows were recruited between April 2009 and June 2010. None. During the supervised scenarios, lower team performance checklist scores were obtained for distant supervision compared with immediately available and direct supervision (mean [SD], direct: 72% [12%] vs immediately available: 77% [10%] vs distant: 61% [11%]; p = 0.0013). The percentage of checklist items completed by the residents themselves was significantly lower during direct supervision (median [interquartile range], direct: 40% [21%] vs immediately available: 58% [16%] vs distant: 55% [11%]; p = 0.005). During unsupervised scenarios, no significant differences were found on the outcome measures. Care delivered in the presence of senior supervising physicians was more comprehensive than care delivered without access to a bedside supervisor, but was associated with lower resident participation. However, subsequent resident performance during unsupervised scenarios was not adversely affected. Direct

A Strengths-Weaknesses-Opportunities-Threats (SWOT) analysis on the clinical utility of sperm DNA fragmentation testing in specific male infertility scenarios.

PubMed

Esteves, Sandro C; Agarwal, Ashok; Cho, Chak-Lam; Majzoub, Ahmad

2017-09-01

Sperm DNA fragmentation (SDF) is recognized as a leading cause of male infertility because it can impair the paternal genome through distinct pathophysiological mechanisms. Current evidence supports SDF as a major factor in the pathophysiology of several conditions, including varicocele, unexplained infertility, assisted reproductive technology failure, and environmental lifestyle factors, although the mechanisms involved have not been fully described yet. Measurement of the levels of DNA fragmentation in semen provides valuable information on the integrity of paternal chromatin and may guide therapeutic strategies. A recently published clinical practice guideline (CPG) highlighted how to use the information provided by SDF testing in daily practice, which triggered a series of commentaries by leading infertility experts. These commentaries contained an abundance of information and conflicting views about the clinical utility of SDF testing, which underline the complex nature of SDF. A search of papers published in response to the CPG entitled "Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios" was performed within the Translational Andrology and Urology ( TAU ) website (http://tau.amegroups.com/). The start and end dates for the search were May 2017 and August 2017, respectively. Each commentary meeting our inclusion criteria was rated as "supportive without reservation", "supportive with reservation", "not supportive" or "neutral". We recorded whether articles discussed either SDF characteristics as a laboratory test method or clinical scenarios, or both. Subsequently, we extracted the particulars from each commentary and utilized the 'Strengths-Weaknesses-Opportunities-Threats' (SWOT) analysis to understand the perceived advantages and drawbacks of SDF as a specialized sperm function method in clinical practice. Fifty-eight fertility experts from six continents and twenty-two countries contributed

Spacecraft Mission Design for the Mitigation of the 2017 PDC Hypothetical Asteroid Threat

NASA Technical Reports Server (NTRS)

Barbee, Brent W.; Sarli, Bruno V.; Lyzhoft, Joshua; Chodas, Paul W.; Englander, Jacob A.

2017-01-01

This paper presents a detailed mission design analysis results for the 2017 Planetary Defense Conference (PDC) Hypothetical Asteroid Impact Scenario, documented at https://cneos.jpl.nasa.gov/ pd/cs/pdc17/. The mission design includes campaigns for both reconnaissance (flyby or rendezvous) of the asteroid (to characterize it and the nature of the threat it poses to Earth) and mitigation of the asteroid, via kinetic impactor deflection, nuclear explosive device (NED) deflection, or NED disruption. Relevant scenario parameters are varied to assess the sensitivity of the design outcome, such as asteroid bulk density, asteroid diameter, momentum enhancement factor, spacecraft launch vehicle, and mitigation system type. Different trajectory types are evaluated in the mission design process from purely ballistic to those involving optimal midcourse maneuvers, planetary gravity assists, and/or lowthrust solar electric propulsion. The trajectory optimization is targeted around peak deflection points that were found through a novel linear numerical technique method. The optimization process includes constrain parameters, such as Earth departure date, launch declination, spacecraft/asteroid relative velocity and solar phase angle, spacecraft dry mass, minimum/maximum spacecraft distances from Sun and Earth, and Earth/spacecraft communications line of sight. Results show that one of the best options for the 2017 PDC deflection is solar electric propelled rendezvous mission with a single spacecraft using NED for the deflection

Spacecraft Mission Design for the Mitigation of the 2017 PDC Hypothetical Asteroid Threat

NASA Technical Reports Server (NTRS)

Barbee, Brent W.; Sarli, Bruno V.; Lyzhoft, Josh; Chodas, Paul W.; Englander, Jacob A.

2017-01-01

This paper presents a detailed mission design analysis results for the 2017 Planetary Defense Conference (PDC) Hypothetical Asteroid Impact Scenario, documented at https:cneos.jpl.nasa.govpdcspdc17. The mission design includes campaigns for both reconnaissance (flyby or rendezvous) of the asteroid (to characterize it and the nature of the threat it poses to Earth) and mitigation of the asteroid, via kinetic impactor deflection, nuclear explosive device (NED) deflection, or NED disruption. Relevant scenario parameters are varied to assess the sensitivity of the design outcome, such as asteroid bulk density, asteroid diameter, momentum enhancement factor, spacecraft launch vehicle, and mitigation system type. Different trajectory types are evaluated in the mission design process from purely ballistic to those involving optimal midcourse maneuvers, planetary gravity assists, and/or low-thrust solar electric propulsion. The trajectory optimization is targeted around peak deflection points that were found through a novel linear numerical technique method. The optimization process includes constrain parameters, such as Earth departure date, launch declination, spacecraft, asteroid relative velocity and solar phase angle, spacecraft dry mass, minimum/maximum spacecraft distances from Sun and Earth, and Earth-spacecraft communications line of sight. Results show that one of the best options for the 2017 PDC deflection is solar electric propelled rendezvous mission with a single spacecraft using NED for the deflection.

Reactions to Hypothetical, Jealousy Producing Events.

ERIC Educational Resources Information Center

Hansen, Gary L.

1982-01-01

Asked subjects (N=220) how they would feel about their mates' behavior in eight hypothetical situations designed to measure jealousy. Responses indicated that jealousy is likely to be a major issue. Sex role orientation is most consistently related to jealousy with sex role traditional subjects being the most jealous. (Author)

Adolescents' explicit and implicit evaluations of hypothetical and actual peers with different bullying participant roles.

PubMed

Pouwels, J Loes; Lansu, Tessa A M; Cillessen, Antonius H N

2017-07-01

This study examined how adolescents evaluate bullying at three levels of specificity: (a) the general concept of bullying, (b) hypothetical peers in different bullying participant roles, and (c) actual peers in different bullying participant roles. Participants were 163 predominantly ethnic majority adolescents in The Netherlands (58% girls; M age =16.34years, SD=0.79). For the hypothetical peers, we examined adolescents' explicit evaluations as well as their implicit evaluations. Adolescents evaluated the general concept of bullying negatively. Adolescents' explicit evaluations of hypothetical and actual peers in the bullying roles depended on their own role, but adolescents' implicit evaluations of hypothetical peers did not. Adolescents' explicit evaluations of hypothetical peers and actual peers were different. Hypothetical bullies were evaluated negatively by all classmates, whereas hypothetical victims were evaluated relatively positively compared with the other roles. However, when adolescents evaluated their actual classmates, the differences between bullies and the other roles were smaller, whereas victims were evaluated the most negatively of all roles. Further research should take into account that adolescents' evaluations of hypothetical peers differ from their evaluations of actual peers. Copyright © 2017 Elsevier Inc. All rights reserved.

The Application of High Energy Resolution Green's Functions to Threat Scenario Simulation

NASA Astrophysics Data System (ADS)

Thoreson, Gregory G.; Schneider, Erich A.

2012-04-01

Radiation detectors installed at key interdiction points provide defense against nuclear smuggling attempts by scanning vehicles and traffic for illicit nuclear material. These hypothetical threat scenarios may be modeled using radiation transport simulations. However, high-fidelity models are computationally intensive. Furthermore, the range of smuggler attributes and detector technologies create a large problem space not easily overcome by brute-force methods. Previous research has demonstrated that decomposing the scenario into independently simulated components using Green's functions can simulate photon detector signals with coarse energy resolution. This paper extends this methodology by presenting physics enhancements and numerical treatments which allow for an arbitrary level of energy resolution for photon transport. As a result, spectroscopic detector signals produced from full forward transport simulations can be replicated while requiring multiple orders of magnitude less computation time.

47 CFR 69.609 - End User Common Line hypothetical net balances.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 3 2011-10-01 2011-10-01 false End User Common Line hypothetical net balances... net balances. (a) If the company does not participate in the association tariff for such element, the hypothetical net balance shall be zero. (b) If the company does participate in the association tariff for such...

47 CFR 69.609 - End User Common Line hypothetical net balances.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false End User Common Line hypothetical net balances... net balances. (a) If the company does not participate in the association tariff for such element, the hypothetical net balance shall be zero. (b) If the company does participate in the association tariff for such...

Evaluating the impacts of farmers' behaviors on a hypothetical agricultural water market based on double auction

NASA Astrophysics Data System (ADS)

Du, Erhu; Cai, Ximing; Brozović, Nicholas; Minsker, Barbara

2017-05-01

Agricultural water markets are considered effective instruments to mitigate the impacts of water scarcity and to increase crop production. However, previous studies have limited understanding of how farmers' behaviors affect the performance of water markets. This study develops an agent-based model to explicitly incorporate farmers' behaviors, namely irrigation behavior (represented by farmers' sensitivity to soil water deficit λ) and bidding behavior (represented by farmers' rent seeking μ and learning rate β), in a hypothetical water market based on a double auction. The model is applied to the Guadalupe River Basin in Texas to simulate a hypothetical agricultural water market under various hydrological conditions. It is found that the joint impacts of the behavioral parameters on the water market are strong and complex. In particular, among the three behavioral parameters, λ affects the water market potential and its impacts on the performance of the water market are significant under most scenarios. The impacts of μ or β on the performance of the water market depend on the other two parameters. The water market could significantly increase crop production only when the following conditions are satisfied: (1) λ is small and (2) μ is small and/or β is large. The first condition requires efficient irrigation scheduling, and the second requires well-developed water market institutions that provide incentives to bid true valuation of water permits.

Acceptability of hypothetical dengue vaccines among travelers.

PubMed

Benoit, Christine M; MacLeod, William B; Hamer, Davidson H; Sanchez-Vegas, Carolina; Chen, Lin H; Wilson, Mary E; Karchmer, Adolf W; Yanni, Emad; Hochberg, Natasha S; Ooi, Winnie W; Kogelman, Laura; Barnett, Elizabeth D

2013-01-01

Dengue viruses have spread widely in recent decades and cause tens of millions of infections mostly in tropical and subtropical areas. Vaccine candidates are being studied aggressively and may be ready for licensure soon. We surveyed patients with past or upcoming travel to dengue-endemic countries to assess rates and determinants of acceptance for four hypothetical dengue vaccines with variable efficacy and adverse event (AE) profiles. Acceptance ratios were calculated for vaccines with varied efficacy and AE risk. Acceptance of the four hypothetical vaccines ranged from 54% for the vaccine with lower efficacy and serious AE risk to 95% for the vaccine with higher efficacy and minor AE risk. Given equal efficacy, vaccines with lower AE risk were better accepted than those with higher AE risk; given equivalent AE risk, vaccines with higher efficacy were better accepted than those with lower efficacy. History of Japanese encephalitis vaccination was associated with lower vaccine acceptance for one of the hypothetical vaccines. US-born travelers were more likely than non-US born travelers to accept a vaccine with 75% efficacy and a risk of minor AEs (p = 0.003). Compared with North American-born travelers, Asian- and African-born travelers were less likely to accept both vaccines with 75% efficacy. Most travelers would accept a safe and efficacious dengue vaccine if one were available. Travelers valued fewer potential AEs over increased vaccine efficacy. © 2013 International Society of Travel Medicine.

Floating Offshore Wind in California: Gross Potential for Jobs and Economic Impacts from Two Future Scenarios

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

Speer, Bethany; Keyser, David; Tegen, Suzanne

Construction of the first offshore wind farm in the United States began in 2015, using fixed platform structures that are appropriate for shallow seafloors, like those located off of the East Coast and mid-Atlantic. However, floating platforms, which have yet to be deployed commercially, will likely need to anchor to the deeper seafloor if deployed off of the West Coast. To analyze the employment and economic potential for floating offshore wind along the West Coast, the Bureau of Ocean Energy Management (BOEM) has commissioned the National Renewable Energy Laboratory (NREL) to analyze two hypothetical, large-scale deployment scenarios for California: 16more » GW of offshore wind by 2050 (Scenario A) and 10 GW of offshore wind by 2050 (Scenario B). The results of this analysis can be used to better understand the general scales of economic opportunities that could result from offshore wind development. Results show total state gross domestic product (GDP) impacts of $16.2 billion in Scenario B or $39.7 billion in Scenario A for construction; and $3.5 billion in Scenario B or $7.9 billion in Scenario A for the operations phases.« less

Differences in Behavior and Brain Activity during Hypothetical and Real Choices.

PubMed

Camerer, Colin; Mobbs, Dean

2017-01-01

Real behaviors are binding consequential commitments to a course of action, such as harming another person, buying an Apple watch, or fleeing from danger. Cognitive scientists are generally interested in the psychological and neural processes that cause such real behavior. However, for practical reasons, many scientific studies measure behavior using only hypothetical or imagined stimuli. Generalizing from such studies to real behavior implicitly assumes that the processes underlying the two types of behavior are similar. We review evidence of similarity and differences in hypothetical and real mental processes. In many cases, hypothetical choice tasks give an incomplete picture of brain circuitry that is active during real choice. Copyright © 2016. Published by Elsevier Ltd.

Are There Scenarios When the Use of Non-Placebo-Control Groups in Experimental Trial Designs Increase Expected Value to Society?

PubMed

Uyei, Jennifer; Braithwaite, R Scott

2016-01-01

Despite the benefits of the placebo-controlled trial design, it is limited by its inability to quantify total benefits and harms. Such trials, for example, are not designed to detect an intervention's placebo or nocebo effects, which if detected could alter the benefit-to-harm balance and change a decision to adopt or reject an intervention. In this article, we explore scenarios in which alternative experimental trial designs, which differ in the type of control used, influence expected value across a range of pretest assumptions and study sample sizes. We developed a decision model to compare 3 trial designs and their implications for decision making: 2-arm placebo-controlled trial ("placebo-control"), 2-arm intervention v. do nothing trial ("null-control"), and an innovative 3-arm trial design: intervention v. do nothing v. placebo trial ("novel design"). Four scenarios were explored regarding particular attributes of a hypothetical intervention: 1) all benefits and no harm, 2) no biological effect, 3) only biological effects, and 4) surreptitious harm (no biological benefit or nocebo effect). Scenario 1: When sample sizes were very small, the null-control was preferred, but as sample sizes increased, expected value of all 3 designs converged. Scenario 2: The null-control was preferred regardless of sample size when the ratio of placebo to nocebo effect was >1; otherwise, the placebo-control was preferred. Scenario 3: When sample size was very small, the placebo-control was preferred when benefits outweighed harms, but the novel design was preferred when harms outweighed benefits. Scenario 4: The placebo-control was preferred when harms outweighed placebo benefits; otherwise, preference went to the null-control. Scenarios are hypothetical, study designs have not been tested in a real-world setting, blinding is not possible in all designs, and some may argue the novel design poses ethical concerns. We identified scenarios in which alternative experimental study

Tools to share good chairside teaching practice: a clinical scenario and appreciative questionnaire.

PubMed

Sweet, J; Wilson, J; Pugsley, L; Schofield, M

2008-12-13

This article provides a scenario for analysis of good chairside teaching practice to serve as a starting point for continued discussion in this complex field. Documented issues of good chairside teaching practice are cross-referenced to a clinical scenario with explanations in the form of a commentary. This provided the context for generating a set of questions that are provided as tools to support good chairside practice. These tools are designed to be used with 'Appreciative Inquiry', which claims that there is much to be gained by discovering where excellence is possible and elaborating upon this. Although this process can be carried out in single units or departments, it is proposed that collaboration between institutions would allow sharing of valuable innovations and greater understanding of educational training, production of good practice guidance and professional development of staff. This article is the third in a series of three and provides a scaffold for a scenario and questions to encourage collaboration in evolving and sharing good chairside teaching practice. The first article investigated the perceptions of stakeholders in chairside teaching at a single dental school and the second evaluated chairside teaching on a UK wide scale. A further accompanying article reviews some of the educational methodology and innovations in teaching and learning that may be applied to dentistry.

Differential neural circuitry and self-interest in real vs hypothetical moral decisions

PubMed Central

Dalgleish, Tim; Thompson, Russell; Evans, Davy; Schweizer, Susanne; Mobbs, Dean

2012-01-01

Classic social psychology studies demonstrate that people can behave in ways that contradict their intentions—especially within the moral domain. We measured brain activity while subjects decided between financial self-benefit (earning money) and preventing physical harm (applying an electric shock) to a confederate under both real and hypothetical conditions. We found a shared neural network associated with empathic concern for both types of decisions. However, hypothetical and real moral decisions also recruited distinct neural circuitry: hypothetical moral decisions mapped closely onto the imagination network, while real moral decisions elicited activity in the bilateral amygdala and anterior cingulate—areas essential for social and affective processes. Moreover, during real moral decision-making, distinct regions of the prefrontal cortex (PFC) determined whether subjects make selfish or pro-social moral choices. Together, these results reveal not only differential neural mechanisms for real and hypothetical moral decisions but also that the nature of real moral decisions can be predicted by dissociable networks within the PFC. PMID:22711879

Planning guidance for emergency response to a hypothetical nuclear attack on Riyadh, Saudi Arabia

NASA Astrophysics Data System (ADS)

Shubayr, Nasser Ali M.

The threat of nuclear attack will remain imminent in an ever-advancing society. Saudi Arabia is not immune to this threat. This dissertation establishes planning guidance for response to a nuclear attack on Riyadh, the capital of Saudi Arabia, based on a hypothetical scenario of a nuclear detonation. A case scenario of a one-megaton thermonuclear bomb detonated at ground level over Riyadh is used to support the thesis. Previous nuclear tests and the Hiroshima and Nagasaki bombings have been used to present possible effects on Riyadh. US planning guidance and lessons learned from the Chernobyl and Fukushima nuclear plants accidents have been used to develop the emergency response guidance. The planning guidance outlines a rapid response to the nuclear detonation. Four damage zones have been identified; severe damage zone, moderate damage zone, light damage zone and dangerous fallout zone. Actions that are recommended, and those that should be avoided, have been determined for each zone. Shelter/ evacuation evaluation for blast-affected and fallout-affected areas is the basis for the recommendation that shelter in place is the best decision for the first hours to days after the attack. Guidelines for medical care response and population monitoring and decontamination are included to reduce the early and long-term effects of the attack. Recommendations to the Saudi Arabian authorities have been made to facilitate suitable preparedness and response for such an event.

Environmental Influences on Mate Preferences as Assessed by a Scenario Manipulation Experiment

PubMed Central

Marzoli, Daniele; Moretto, Francesco; Monti, Aura; Tocci, Ornella; Roberts, S. Craig; Tommasi, Luca

2013-01-01

Many evolutionary psychology studies have addressed the topic of mate preferences, focusing particularly on gender and cultural differences. However, the extent to which situational and environmental variables might affect mate preferences has been comparatively neglected. We tested 288 participants in order to investigate the perceived relative importance of six traits of an ideal partner (wealth, dominance, intelligence, height, kindness, attractiveness) under four different hypothetical scenarios (status quo/nowadays, violence/post-nuclear, poverty/resource exhaustion, prosperity/global well-being). An equal number of participants (36 women, 36 men) was allotted to each scenario; each was asked to allocate 120 points across the six traits according to their perceived value. Overall, intelligence was the trait to which participants assigned most importance, followed by kindness and attractiveness, and then by wealth, dominance and height. Men appraised attractiveness as more valuable than women. Scenario strongly influenced the relative importance attributed to traits, the main finding being that wealth and dominance were more valued in the poverty and post-nuclear scenarios, respectively, compared to the other scenarios. Scenario manipulation generally had similar effects in both sexes, but women appeared particularly prone to trade off other traits for dominance in the violence scenario, and men particularly prone to trade off other traits for wealth in the poverty scenario. Our results are in line with other correlational studies of situational variables and mate preferences, and represent strong evidence of a causal relationship of environmental factors on specific mate preferences, corroborating the notion of an evolved plasticity to current ecological conditions. A control experiment seems to suggest that our scenarios can be considered as realistic descriptions of the intended ecological conditions. PMID:24069291

Mr. Ngao's proposal: introducing client fees. Case scenarios for training and group discussion.

PubMed

1992-01-01

In this supplement to the issue of "The Family Planning Manager" devoted to fees, a hypothetical case scenario is presented to illustrate the introduction of client fees to a family planning program. Managers are instructed to prepare a plan that includes the necessary information for deciding what to charge for, who to charge, and how much to charge; identifies the administrative changes involved in charging fees; and outlines steps that clinic managers should take before introducing client fees. Decisions should be based on factors such as the objectives of fee charging, client willingness and ability to pay, client perception of the quality of current services, services for which clients would be most willing to pay, estimated cost of providing services, and the cost of new administrative procedures inherent in a fee-for-service approach. Administrative procedures for collecting, handling, and accounting for cash; reporting income and expenses; and implementing a fair and flexible system of waivers and exemptions must be defined. Clients should be informed well in advance of fee introduction, and staff trained to manage potential client complaints.

Clinical decision support for whole genome sequence information leveraging a service-oriented architecture: a prototype.

PubMed

Welch, Brandon M; Rodriguez-Loya, Salvador; Eilbeck, Karen; Kawamoto, Kensaku

2014-01-01

Whole genome sequence (WGS) information could soon be routinely available to clinicians to support the personalized care of their patients. At such time, clinical decision support (CDS) integrated into the clinical workflow will likely be necessary to support genome-guided clinical care. Nevertheless, developing CDS capabilities for WGS information presents many unique challenges that need to be overcome for such approaches to be effective. In this manuscript, we describe the development of a prototype CDS system that is capable of providing genome-guided CDS at the point of care and within the clinical workflow. To demonstrate the functionality of this prototype, we implemented a clinical scenario of a hypothetical patient at high risk for Lynch Syndrome based on his genomic information. We demonstrate that this system can effectively use service-oriented architecture principles and standards-based components to deliver point of care CDS for WGS information in real-time.

Using respondent uncertainty to mitigate hypothetical bias in a stated choice experiment

Treesearch

Richard C. Ready; Patricia A. Champ; Jennifer L. Lawton

2010-01-01

In a choice experiment study, willingness to pay for a public good estimated from hypothetical choices was three times as large as willingness to pay estimated from choices requiring actual payment. This hypothetical bias was related to the stated level of certainty of respondents. We develop protocols to measure respondent certainty in the context of a choice...

Development of a safety decision-making scenario to measure worker safety in agriculture.

PubMed

Mosher, G A; Keren, N; Freeman, S A; Hurburgh, C R

2014-04-01

Human factors play an important role in the management of occupational safety, especially in high-hazard workplaces such as commercial grain-handling facilities. Employee decision-making patterns represent an essential component of the safety system within a work environment. This research describes the process used to create a safety decision-making scenario to measure the process that grain-handling employees used to make choices in a safety-related work task. A sample of 160 employees completed safety decision-making simulations based on a hypothetical but realistic scenario in a grain-handling environment. Their choices and the information they used to make their choices were recorded. Although the employees emphasized safety information in their decision-making process, not all of their choices were safe choices. Factors influencing their choices are discussed, and implications for industry, management, and workers are shared.

A Strengths-Weaknesses-Opportunities-Threats (SWOT) analysis on the clinical utility of sperm DNA fragmentation testing in specific male infertility scenarios

PubMed Central

Agarwal, Ashok; Cho, Chak-Lam; Majzoub, Ahmad

2017-01-01

Background Sperm DNA fragmentation (SDF) is recognized as a leading cause of male infertility because it can impair the paternal genome through distinct pathophysiological mechanisms. Current evidence supports SDF as a major factor in the pathophysiology of several conditions, including varicocele, unexplained infertility, assisted reproductive technology failure, and environmental lifestyle factors, although the mechanisms involved have not been fully described yet. Measurement of the levels of DNA fragmentation in semen provides valuable information on the integrity of paternal chromatin and may guide therapeutic strategies. A recently published clinical practice guideline (CPG) highlighted how to use the information provided by SDF testing in daily practice, which triggered a series of commentaries by leading infertility experts. These commentaries contained an abundance of information and conflicting views about the clinical utility of SDF testing, which underline the complex nature of SDF. Methods A search of papers published in response to the CPG entitled “Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios” was performed within the Translational Andrology and Urology (TAU) website (http://tau.amegroups.com/). The start and end dates for the search were May 2017 and August 2017, respectively. Each commentary meeting our inclusion criteria was rated as “supportive without reservation”, “supportive with reservation”, “not supportive” or “neutral”. We recorded whether articles discussed either SDF characteristics as a laboratory test method or clinical scenarios, or both. Subsequently, we extracted the particulars from each commentary and utilized the ‘Strengths-Weaknesses-Opportunities-Threats’ (SWOT) analysis to understand the perceived advantages and drawbacks of SDF as a specialized sperm function method in clinical practice. Results Fifty-eight fertility experts from six

Distributed coding of actual and hypothetical outcomes in the orbital and dorsolateral prefrontal cortex

PubMed Central

Abe, Hiroshi; Lee, Daeyeol

2011-01-01

SUMMARY Knowledge about hypothetical outcomes from unchosen actions is beneficial only when such outcomes can be correctly attributed to specific actions. Here, we show that during a simulated rock-paper-scissors game, rhesus monkeys can adjust their choice behaviors according to both actual and hypothetical outcomes from their chosen and unchosen actions, respectively. In addition, neurons in both dorsolateral prefrontal cortex and orbitofrontal cortex encoded the signals related to actual and hypothetical outcomes immediately after they were revealed to the animal. Moreover, compared to the neurons in the orbitofrontal cortex, those in the dorsolateral prefrontal cortex were more likely to change their activity according to the hypothetical outcomes from specific actions. Conjunctive and parallel coding of multiple actions and their outcomes in the prefrontal cortex might enhance the efficiency of reinforcement learning and also contribute to their context-dependent memory. PMID:21609828

Creating a Scenario Suitable for Multiple Caregivers

NASA Technical Reports Server (NTRS)

Doerr, Harold; Bacal, Kira; Hurst, Victor

2004-01-01

The HPS can be utilized for the training of a wide variety of caregivers, ranging from physicians to laypeople. Methods: A single scenario was developed and adapted for a number of clinical scenarios and operational environments, ranging from in-flight to the immediate postflight timeline. In this way, different caregivers, from astronauts to search and rescue forces to specialty-boarded physicians, could make use of a single clinical situation. Five crew medical officer analogs and sixty anesthesia residents, serving as flight surgeon analogs, and, were briefed on space medicine and physiology, then were exposed to the scenario and asked to manage the patient as if they were part of the in-flight or recovery team. Results: Basic themes, such as crisis resource management, were standard across the student audiences. Discussion: A single clinical script can easily be adapted for multiple uses.

Floating Offshore Wind in Oregon: Potential for Jobs and Economic Impacts from Two Future Scenarios

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

Jimenez, Tony; Keyser, David; Tegen, Suzanne

Construction of the first offshore wind power plant in the United States began in 2015, off the coast of Rhode Island, using fixed platform structures that are appropriate for shallow seafloors, like those located off of the East Coast and mid-Atlantic. However, floating platforms, which have yet to be deployed commercially, will likely need to anchor to the deeper seafloor if deployed off of the West Coast. To analyze the employment and economic potential for floating offshore wind along the West Coast, the Bureau of Ocean Energy Management (BOEM) commissioned the National Renewable Energy Laboratory (NREL) to analyze two hypothetical,more » large-scale deployment scenarios for Oregon: 5,500 megawatts (MW) of offshore wind deployment in Oregon by 2050 (Scenario A), and 2,900 MW of offshore wind by 2050 (Scenario B). These levels of deployment could power approximately 1,600,000 homes (Scenario A) or 870,000 homes (Scenario B). Offshore wind would contribute to economic development in Oregon in the near future, and more substantially in the long term, especially if equipment and labor are sourced from within the state. According to the analysis, over the 2020-2050 period, Oregon floating offshore wind facilities could support 65,000-97,000 job-years and add $6.8 billion-$9.9 billion to the state GDP (Scenario A).« less

Determining access to assisted reproductive technology: reactions of clinic directors to ethically complex case scenarios.

PubMed

Stern, J E; Cramer, C P; Green, R M; Garrod, A; DeVries, K O

2003-06-01

Our aim was to increase understanding of how patient selection is handled by assisted reproductive technology (ART) clinicians. Ethically complex case scenarios were evaluated by the directors of USA ART clinics. Scenarios included using a son as sperm donor for his father, sex selection without associated disease, treatment of morally irresponsible couples, and a dispute over embryo disposition. Respondents reviewed eight scenarios and gave their opinions on whether to offer treatment. Reasons given for these decisions were placed into one of 13 categories. Survey response rate was 57%. Between 3 and 50% of respondents would treat in each case. Of reasons given, 'conditional' responses (requiring counselling, blood tests or agreement to other 'conditions') were common (31.4%). Non-maleficence (risk) accounted for 29.4% of responses, philosophy of medicine 18.9%, respect for patient autonomy 5.9% and legal concerns 4.6%. Discrimination and threats were each significant in one case. Reasons evoking absolutist beliefs, personal discomfort, commitment to justice, religion and ethical relativism were rare. Clinicians felt conflict between a desire to respect patient autonomy and their discomfort over the risk associated with the procedure. They raised concerns about misuse of medical technology. Attempts to resolve complex issues through negotiation and compromise were common.

Hypothetical contractarianism and the disclosure requirement problem in informed consent.

PubMed

Cust, Kenneth F T

1991-01-01

Two of the more deeply problematic issues surrounding the doctrine of informed consent are providing a justification for the practice of informed consent and providing an account of the nature and amount of information that must be disclosed in order for informed consent to take place. This paper is concerned with the latter problem, the problem of disclosure requirements, but it deals with this problem in a novel way; it approaches the problem by asking what fully informed and fully rational agents would agree to under certain hypothetical conditions. In general terms I juxtapose the hypothetical contractarianism found in Rawls' A Theory of Justice with that found in Gauthier's Morals By Agreement and ask what their respective hypothetical contractors would agree to with respect to choosing a particular standard of disclosure to govern the practice of informed consent. In more specific terms a contrast is made between what a Rawlsian agent behind a veil of ignorance would choose as compared to what, in Gauthier's terms, an ideal actor making an Archimedean choice would choose. The idea of an Archimedean point, and the subsequent choice made from that point, although technically identified by Rawls, originated with Archimedes of Syracuse.

Public health risk management case concerning the city of Isfahan according to a hypothetical release of HF from a chemical plant.

PubMed

Azari, Mansour R; Sadighzadeh, Asghar; Bayatian, Majid

2018-06-19

Accidents have happened in the chemical industries all over the world with serious consequences for the adjacent heavily populated areas. In this study, the impact of the probable hypothetical event, releasing considerable amounts of hydrogen fluoride (HF) as a strong irritant into the atmosphere over the city of Isfahan from a strategic chemical plant, was simulated by computational fluid dynamics (CFD). In this model, the meteorological parameters were integrated into time and space, and dispersion of the pollutants was estimated based on a probable accidental release of HF. According to the hypothetical results of the simulation model in this study, HF clouds reached Isfahan in 20 min and exposed 80% of the general public to HF concentration in the range of 0-34 ppm. Then, they dissipated 240 min after the time of the incident. Supposing the uniform population density within the proximity of the city of Isfahan with the population of 1.75 million, 5% of the population (87,500 people) could be exposed for a few minutes to a HF concentration as high as 34 ppm. This concentration is higher than a very hazardous concentration described as the Immediate Danger to Life and Health (30 ppm). This hypothetical risk evaluation of environmental exposure to HF with the potential of health risks was very instrumental for the general public of Isfahan in terms of risk management. Similar studies based on probable accidental scenarios along with the application of a simulation model for computation of dispersed pollutants are recommended for risk evaluation and management of cities in the developing countries with a fast pace of urbanization around the industrial sites.

Processing counterfactual and hypothetical conditionals: an fMRI investigation.

PubMed

Kulakova, Eugenia; Aichhorn, Markus; Schurz, Matthias; Kronbichler, Martin; Perner, Josef

2013-05-15

Counterfactual thinking is ubiquitous in everyday life and an important aspect of cognition and emotion. Although counterfactual thought has been argued to differ from processing factual or hypothetical information, imaging data which elucidate these differences on a neural level are still scarce. We investigated the neural correlates of processing counterfactual sentences under visual and aural presentation. We compared conditionals in subjunctive mood which explicitly contradicted previously presented facts (i.e. counterfactuals) to conditionals framed in indicative mood which did not contradict factual world knowledge and thus conveyed a hypothetical supposition. Our results show activation in right occipital cortex (cuneus) and right basal ganglia (caudate nucleus) during counterfactual sentence processing. Importantly the occipital activation is not only present under visual presentation but also with purely auditory stimulus presentation, precluding a visual processing artifact. Thus our results can be interpreted as reflecting the fact that counterfactual conditionals pragmatically imply the relevance of keeping in mind both factual and supposed information whereas the hypothetical conditionals imply that real world information is irrelevant for processing the conditional and can be omitted. The need to sustain representations of factual and suppositional events during counterfactual sentence processing requires increased mental imagery and integration efforts. Our findings are compatible with predictions based on mental model theory. Copyright © 2013 Elsevier Inc. All rights reserved.

Evaluation of ground-water flow and land-surface subsidence caused by hypothetical withdrawals in the northern part of the Gulf Coast Aquifer system, Texas

USGS Publications Warehouse

Kasmarek, Mark C.; Reece, Brian D.; Houston, Natalie A.

2005-01-01

During 2003–04 the U.S. Geological Survey, in cooperation with the Texas Water Development Board (TWDB) and the Harris-Galveston Coastal Subsidence District (HGCSD), used the previously developed Northern Gulf Coast Ground-Water Availability Modeling (NGC GAM) model to evaluate the effects of hypothetical projected withdrawals on ground-water flow in the northern part of the Gulf Coast aquifer system and land-surface subsidence in the NGC GAM model area of Texas. The Gulf Coast aquifer system comprises, from the surface, the Chicot and Evangeline aquifers, the Burkeville confining unit, the Jasper aquifer, and the Catahoula confining unit. Two withdrawal scenarios were simulated. The first scenario comprises historical withdrawals from the aquifer system for 1891–2000 and hypothetical projected withdrawals for 2001–50 compiled by the TWDB (TWDB scenario). The projected withdrawals compiled by the TWDB are based on ground-water demands estimated by regional water planning groups. The second scenario is a “merge” of the TWDB scenario with an alternate set of projected withdrawals from the Chicot and Evangeline aquifers in the Houston metropolitan area for 1995–2030 provided by the HGCSD (HGCSD scenario). Under the TWDB scenario withdrawals from the entire system are projected to be about the same in 2050 as in 2000. The simulated potentiometric surfaces of the Chicot aquifer for 2010, 2020, 2030, 2040, and 2050 show relatively little change in configuration from the simulated 2000 potentiometric surface (maximum water-level depths in southern Harris County 150–200 feet below NGVD 29). The simulated decadal potentiometric surfaces of the Evangeline aquifer show the most change between 2000 and 2010. The area of water levels 250– 400 feet below NGVD 29 in western Harris County in 2000 shifts southeastward to southern Harris County, and water levels recover to 200–250 feet below NGVD 29 by 2010. Water levels in southern Harris County recover to 150�

Identification of the conserved hypothetical protein BPSL0317 in Burkholderia pseudomallei K96243

NASA Astrophysics Data System (ADS)

Yusoff, Nur Syamimi; Damiri, Nadzirah; Firdaus-Raih, Mohd

2014-09-01

Burkholderia pseudomallei K96243 is the causative agent of melioidosis, a disease which is endemic in Northern Australia and Southeastern Asia. The genome encodes several essential proteins including those currently annotated as hypothetical proteins. We studied the conservation and the essentiality of expressed hypothetical proteins in normal and different stress conditions. Based on the comparative genomics, we identified a hypothetical protein, BPSL0317, a potential essential gene that is being expressed in all normal and stress conditions. BPSL0317 is also phylogenetically conserved in the Burkholderiales order suggesting that this protein is crucial for survival among the order's members. BPSL0317 therefore has a potential to be a candidate antimicrobial drug target for this group of bacteria.

MisTec - A software application for supporting space exploration scenario options and technology development analysis and planning

NASA Technical Reports Server (NTRS)

Horsham, Gary A. P.

1992-01-01

This structure and composition of a new, emerging software application, which models and analyzes space exploration scenario options for feasibility based on technology development projections is presented. The software application consists of four main components: a scenario generator for designing and inputting scenario options and constraints; a processor which performs algorithmic coupling and options analyses of mission activity requirements and technology capabilities; a results display which graphically and textually shows coupling and options analysis results; and a data/knowledge base which contains information on a variety of mission activities and (power and propulsion) technology system capabilities. The general long-range study process used by NASA to support recent studies is briefly introduced to provide the primary basis for comparison for discussing the potential advantages to be gained from developing and applying this kind of application. A hypothetical example of a scenario option to facilitate the best conceptual understanding of what the application is, how it works, or the operating methodology, and when it might be applied is presented.

MisTec: A software application for supporting space exploration scenario options and technology development analysis and planning

NASA Technical Reports Server (NTRS)

Horsham, Gary A. P.

1991-01-01

The structure and composition of a new, emerging software application, which models and analyzes space exploration scenario options for feasibility based on technology development projections is presented. The software application consists of four main components: a scenario generator for designing and inputting scenario options and constraints; a processor which performs algorithmic coupling and options analyses of mission activity requirements and technology capabilities; a results display which graphically and textually shows coupling and options analysis results; and a data/knowledge base which contains information on a variety of mission activities and (power and propulsion) technology system capabilities. The general long-range study process used by NASA to support recent studies is briefly introduced to provide the primary basis for comparison for discussing the potential advantages to be gained from developing and applying this king of application. A hypothetical example of a scenario option to facilitate the best conceptual understanding of what the application is, how it works, or the operating methodology, and when it might be applied is presented.

Evaluation of a filmed clinical scenario as a teaching resource for an introductory pharmacology unit for undergraduate health students: A pilot study.

PubMed

East, Leah; Hutchinson, Marie

2015-12-01

Simulation is frequently being used as a learning and teaching resource for both undergraduate and postgraduate students, however reporting of the effectiveness of simulation particularly within the pharmacology context is scant. The aim of this pilot study was to evaluate a filmed simulated pharmacological clinical scenario as a teaching resource in an undergraduate pharmacological unit. Pilot cross-sectional quantitative survey. An Australian university. 32 undergraduate students completing a healthcare degree including nursing, midwifery, clinical science, health science, naturopathy, and osteopathy. As a part of an undergraduate online pharmacology unit, students were required to watch a filmed simulated pharmacological clinical scenario. To evaluate student learning, a measurement instrument developed from Bloom's cognitive domains (knowledge, comprehension, application, analysis, synthesis and evaluation) was employed to assess pharmacological knowledge conceptualisation and knowledge application within the following fields: medication errors; medication adverse effects; medication interactions; and, general pharmacology. The majority of participants were enrolled in an undergraduate nursing or midwifery programme (72%). Results demonstrated that the majority of nursing and midwifery students (56.52%) found the teaching resource complementary or more useful compared to a lecture although less so compared to a tutorial. Students' self-assessment of learning according to Bloom's cognitive domains indicated that the filmed scenario was a valuable learning tool. Analysis of variance indicated that health science students reported higher levels of learning compared to midwifery and nursing. Students' self-report of the learning benefits of a filmed simulated clinical scenario as a teaching resource suggest enhanced critical thinking skills and knowledge conceptualisation regarding pharmacology, in addition to being useful and complementary to other teaching and

Explaining the discrepancy between intentions and actions: the case of hypothetical bias in contingent valuation.

PubMed

Ajzen, Icek; Brown, Thomas C; Carvajal, Franklin

2004-09-01

An experiment was designed to account for intention-behavior discrepancies by applying the theory of planned behavior to contingent valuation. College students (N = 160) voted in hypothetical and real payment referenda to contribute $8 to a scholarship fund. Overestimates of willingness to pay in the hypothetical referendum could not be attributed to moderately favorable latent dispositions. Instead, this hypothetical bias was explained by activation of more favorable beliefs and attitudes in the context of a hypothetical rather than a real referendum. A corrective entreaty was found to eliminate this bias by bringing beliefs, attitudes, and intentions in line with those in the real payment situation. As a result, the theory of planned behavior produced more accurate prediction of real payment when participants were exposed to the corrective entreaty.

The real world and lunar base activation scenarios

NASA Technical Reports Server (NTRS)

Schmitt, Harrison H.

1992-01-01

A lunar base or a network of lunar bases may have highly desirable support functions in a national or international program to explore and settle Mars. In addition, He-3 exported from the Moon could be the basis for providing much of the energy needs of humankind in the twenty-first century. Both technical and managerial issues must be addressed when considering the establishment of a lunar base that can serve the needs of human civilization in space. Many of the technical issues become evident in the consideration of hypothetical scenarios for the activation of a network of lunar bases. Specific and realistic assumptions must be made about the conduct of various types of activities in addition to the general assumptions given above. These activities include landings, crew consumables, power production, crew selection, risk management, habitation, science station placement, base planning, science, agriculture, resource evaluation, readaptation, plant activation and test, storage module landings, resource transport module landings, integrated operations, maintenance, Base 2 activation, and management. The development of scenarios for the activation of a lunar base or network of bases will require close attention to the 'real world' of space operations. That world is defined by the natural environment, available technology, realistic objectives, and common sense.

The Mystery Tubes: Teaching Pupils about Hypothetical Modelling

ERIC Educational Resources Information Center

Kenrick, Carole

2017-01-01

This article recounts the author's working experience of one method by which pupils' understanding of the epistemologies of science can be developed, specifically how scientists can develop hypothetical models and test them through simulations. She currently uses this approach for transition lessons with pupils in upper primary or lower secondary…

Responding to home maintenance challenge scenarios: the role of selection, optimization, and compensation in aging-in-place.

PubMed

Kelly, Andrew John; Fausset, Cara Bailey; Rogers, Wendy; Fisk, Arthur D

2014-12-01

This study examined potential issues faced by older adults in managing their homes and their proposed solutions for overcoming hypothetical difficulties. Forty-four diverse, independently living older adults (66-85) participated in structured group interviews in which they discussed potential solutions to manage difficulties presented in four scenarios: perceptual, mobility, physical, and cognitive difficulties. The proposed solutions were classified using the Selection, Optimization, and Compensation (SOC) model. Participants indicated they would continue performing most tasks and reported a range of strategies to manage home maintenance challenges. Most participants reported that they would manage home maintenance challenges using compensation; the most frequently mentioned compensation strategy was using tools and technologies. There were also differences across the scenarios: Optimization was discussed most frequently with perceptual and cognitive difficulty scenarios. These results provide insights into supporting older adults' potential needs for aging-in-place and provide evidence of the value of the SOC model in applied research. © The Author(s) 2012.

A comparison of approaches to mitigate hypothetical bias

Treesearch

Patricia A. Champ; Rebecca Moore; Richard C. Bishop

2009-01-01

We compare two approaches to mitigating hypothetical bias. The study design includes three treatments: an actual payment treatment, a contingent valuation (CV) treatment with a followup certainty question, and a CV treatment with a cheap talk script. Our results suggest that both the follow-up certainty treatment and the cheap talk treatment produce...

Communication: Hypothetical ultralow-density ice polymorphs

NASA Astrophysics Data System (ADS)

Matsui, Takahiro; Hirata, Masanori; Yagasaki, Takuma; Matsumoto, Masakazu; Tanaka, Hideki

2017-09-01

More than 300 kinds of porous ice structures derived from zeolite frameworks and space fullerenes are examined using classical molecular dynamics simulations. It is found that a hypothetical zeolitic ice phase is less dense and more stable than the sparse ice structures reported by Huang et al. [Chem. Phys. Lett. 671, 186 (2017)]. In association with the zeolitic ice structure, even less dense structures, "aeroices," are proposed. It is found that aeroices are the most stable solid phases of water near the absolute zero temperature under negative pressure.

Employment references: defamation law in the clinical laboratory.

PubMed

Parks, D G

1993-01-01

The law of defamation and the risks involved in issuing employment references are discussed. A hypothetical scenario is used to illustrate the legal standards governing the tort of defamation and to apply those standards to employment references. Practical suggestions for a "controlled reference" policy are provided, with the objective of allowing for responsible exchange of employment information and avoiding a defamation lawsuit.

Demand Curves for Hypothetical Cocaine in Cocaine-Dependent Individuals

PubMed Central

Bruner, Natalie R.; Johnson, Matthew W.

2013-01-01

Rationale Drug purchasing tasks have been successfully used to examine demand for hypothetical consumption of abused drugs including heroin, nicotine, and alcohol. In these tasks drug users make hypothetical choices whether to buy drugs, and if so, at what quantity, at various potential prices. These tasks allow for behavioral economic assessment of that drug's intensity of demand (preferred level of consumption at extremely low prices) and demand elasticity (sensitivity of consumption to price), among other metrics. However, a purchasing task for cocaine in cocaine-dependent individuals has not been investigated. Objectives This study examined a novel Cocaine Purchasing Task and the relation between resulting demand metrics and self-reported cocaine use data. Methods Participants completed a questionnaire assessing hypothetical purchases of cocaine units at prices ranging from $0.01 to $1,000. Demand curves were generated from responses on the Cocaine Purchasing Task. Correlations compared metrics from the demand curve to measures of real-world cocaine use. Results Group and individual data were well modeled by a demand curve function. The validity of the Cocaine Purchasing Task was supported by a significant correlation between the demand curve metrics of demand intensity and Omax (determined from Cocaine Purchasing Task data) and self-reported measures of cocaine use. Partial correlations revealed that after controlling for demand intensity, demand elasticity and the related measure, Pmax, were significantly correlated with real-world cocaine use. Conclusions Results indicate that the Cocaine Purchasing Task produces orderly demand curve data, and that these data relate to real-world measures of cocaine use. PMID:24217899

Demand curves for hypothetical cocaine in cocaine-dependent individuals.

PubMed

Bruner, Natalie R; Johnson, Matthew W

2014-03-01

Drug purchasing tasks have been successfully used to examine demand for hypothetical consumption of abused drugs including heroin, nicotine, and alcohol. In these tasks, drug users make hypothetical choices whether to buy drugs, and if so, at what quantity, at various potential prices. These tasks allow for behavioral economic assessment of that drug's intensity of demand (preferred level of consumption at extremely low prices) and demand elasticity (sensitivity of consumption to price), among other metrics. However, a purchasing task for cocaine in cocaine-dependent individuals has not been investigated. This study examined a novel Cocaine Purchasing Task and the relation between resulting demand metrics and self-reported cocaine use data. Participants completed a questionnaire assessing hypothetical purchases of cocaine units at prices ranging from $0.01 to $1,000. Demand curves were generated from responses on the Cocaine Purchasing Task. Correlations compared metrics from the demand curve to measures of real-world cocaine use. Group and individual data were well modeled by a demand curve function. The validity of the Cocaine Purchasing Task was supported by a significant correlation between the demand curve metrics of demand intensity and O max (determined from Cocaine Purchasing Task data) and self-reported measures of cocaine use. Partial correlations revealed that after controlling for demand intensity, demand elasticity and the related measure, P max, were significantly correlated with real-world cocaine use. Results indicate that the Cocaine Purchasing Task produces orderly demand curve data, and that these data relate to real-world measures of cocaine use.

Further evidence of close correspondence for alcohol demand decision making for hypothetical and incentivized rewards.

PubMed

Amlung, Michael; MacKillop, James

2015-04-01

Alcohol purchase tasks (APTs) are increasingly being used to assess behavioral economic demand for alcohol. Prior studies utilizing APTs have typically assessed demand for hypothetical outcomes, making the extent to which these hypothetical measures reflect preferences when actual rewards are at stake an important empirical question. This study examined alcohol demand across hypothetical and incentivized APTs. Nineteen male heavy drinkers completed two APTs - one for hypothetical alcohol and another in which one randomly-selected outcome was provided. Participants were given an opportunity to consume the alcohol associated with their choice on the incentivized APT during a self-administration period in a simulated bar environment. Results indicated generally close correspondence between APT versions, though participants were more sensitive to increases in price and tended to consume more at low prices on the incentivized version. Estimated consumption on the incentivized APT was highly correlated with the amount of alcohol consumed in the laboratory (r=.87, p<.001), suggesting that APT responses are valid indicators of actual drinking behavior. These results provide further evidence of congruence of demand-based decision-making when rewards are hypothetical vs. actually available. Implications for behavioral economic approaches to addictive behavior and directions for future research are discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

Scaffolding for Argumentation in Hypothetical and Theoretical Biology Concepts

ERIC Educational Resources Information Center

Weng, Wan-Yun; Lin, Yu-Ren; She, Hsiao-Ching

2017-01-01

The present study investigated the effects of online argumentation scaffolding on students' argumentation involving hypothetical and theoretical biological concepts. Two types of scaffolding were developed in order to improve student argumentation: continuous scaffolding and withdraw scaffolding. A quasi-experimental design was used with four…

Vietnam's forest transition in retrospect: demonstrating weaknesses in business-as-usual scenarios for REDD.

PubMed

Ankersen, Jeppe; Grogan, Kenneth; Mertz, Ole; Fensholt, Rasmus; Castella, Jean-Christophe; Lestrelin, Guillaume; Nguyen, Dinh Tien; Danielsen, Finn; Brofeldt, Søren; Rasmussen, Kjeld

2015-05-01

One of the prerequisites of the REDD+ mechanism is to effectively predict business-as-usual (BAU) scenarios for change in forest cover. This would enable estimation of how much carbon emission a project could potentially prevent and thus how much carbon credit should be rewarded. However, different factors like forest degradation and the lack of linearity in forest cover transitions challenge the accuracy of such scenarios. Here we predict and validate such BAU scenarios retrospectively based on forest cover changes at village and district level in North Central Vietnam. With the government's efforts to increase the forest cover, land use policies led to gradual abandonment of shifting cultivation since the 1990s. We analyzed Landsat images from 1973, 1989, 1998, 2000, and 2011 and found that the policies in the areas studied did lead to increased forest cover after a long period of decline, but that this increase could mainly be attributed to an increase in open forest and shrub areas. We compared Landsat classifications with participatory maps of land cover/use in 1998 and 2012 that indicated more forest degradation than was captured by the Landsat analysis. The BAU scenarios were heavily dependent on which years were chosen for the reference period. This suggests that hypothetical REDD+ activities in the past, when based on the remote sensing data available at that time, would have been unable to correctly estimate changes in carbon stocks and thus produce relevant BAU scenarios.

Vietnam's Forest Transition in Retrospect: Demonstrating Weaknesses in Business-as-Usual Scenarios for REDD+

NASA Astrophysics Data System (ADS)

Ankersen, Jeppe; Grogan, Kenneth; Mertz, Ole; Fensholt, Rasmus; Castella, Jean-Christophe; Lestrelin, Guillaume; Nguyen, Dinh Tien; Danielsen, Finn; Brofeldt, Søren; Rasmussen, Kjeld

2015-05-01

One of the prerequisites of the REDD+ mechanism is to effectively predict business-as-usual (BAU) scenarios for change in forest cover. This would enable estimation of how much carbon emission a project could potentially prevent and thus how much carbon credit should be rewarded. However, different factors like forest degradation and the lack of linearity in forest cover transitions challenge the accuracy of such scenarios. Here we predict and validate such BAU scenarios retrospectively based on forest cover changes at village and district level in North Central Vietnam. With the government's efforts to increase the forest cover, land use policies led to gradual abandonment of shifting cultivation since the 1990s. We analyzed Landsat images from 1973, 1989, 1998, 2000, and 2011 and found that the policies in the areas studied did lead to increased forest cover after a long period of decline, but that this increase could mainly be attributed to an increase in open forest and shrub areas. We compared Landsat classifications with participatory maps of land cover/use in 1998 and 2012 that indicated more forest degradation than was captured by the Landsat analysis. The BAU scenarios were heavily dependent on which years were chosen for the reference period. This suggests that hypothetical REDD+ activities in the past, when based on the remote sensing data available at that time, would have been unable to correctly estimate changes in carbon stocks and thus produce relevant BAU scenarios.

A Comparative Assessment of Life-Cycle Greenhouse Gas Emissions from Hypothetical Electric Airport Transportation Services in Thailand

NASA Astrophysics Data System (ADS)

Koiwanit, J.

2018-05-01

Global warming is an increase of average temperature in the atmosphere, which causes adverse effects on the environment. Carbon dioxide (CO2) from transportation sector is one of the main contributors of the overall greenhouse gases (GHG). To cope with this issue, electric car services are increasingly seen as popular alternative modes of green transportation especially for urban cities as it is more flexible, more environmentally-friendly, and less expensive than the use of conventional vehicles. The study analyses and compare the hypothetical electric car systems from airport transportation services. Center of Environmental Science of Leiden University (CML) 2001, the Life Cycle Impact Assessment (LCIA) method, is applied to convert life cycle inventory data into environmental impacts. The observed results showed that the electric shuttle bus had the highest impact in global warming potential (GWP) compared to other transportation types. Alternatively, this Life Cycle Assessment (LCA) study that evaluated different transportations provided important information for decision makers on quantifying the differences between each scenario.

Cost-benefit assessment of using electronic health records data for clinical research versus current practices: Contribution of the Electronic Health Records for Clinical Research (EHR4CR) European Project.

PubMed

Beresniak, Ariel; Schmidt, Andreas; Proeve, Johann; Bolanos, Elena; Patel, Neelam; Ammour, Nadir; Sundgren, Mats; Ericson, Mats; Karakoyun, Töresin; Coorevits, Pascal; Kalra, Dipak; De Moor, Georges; Dupont, Danielle

2016-01-01

The widespread adoption of electronic health records (EHR) provides a new opportunity to improve the efficiency of clinical research. The European EHR4CR (Electronic Health Records for Clinical Research) 4-year project has developed an innovative technological platform to enable the re-use of EHR data for clinical research. The objective of this cost-benefit assessment (CBA) is to assess the value of EHR4CR solutions compared to current practices, from the perspective of sponsors of clinical trials. A CBA model was developed using an advanced modeling approach. The costs of performing three clinical research scenarios (S) applied to a hypothetical Phase II or III oncology clinical trial workflow (reference case) were estimated under current and EHR4CR conditions, namely protocol feasibility assessment (S1), patient identification for recruitment (S2), and clinical study execution (S3). The potential benefits were calculated considering that the estimated reduction in actual person-time and costs for performing EHR4CR S1, S2, and S3 would accelerate time to market (TTM). Probabilistic sensitivity analyses using Monte Carlo simulations were conducted to manage uncertainty. Should the estimated efficiency gains achieved with the EHR4CR platform translate into faster TTM, the expected benefits for the global pharmaceutical oncology sector were estimated at €161.5m (S1), €45.7m (S2), €204.5m (S1+S2), €1906m (S3), and up to €2121.8m (S1+S2+S3) when the scenarios were used sequentially. The results suggest that optimizing clinical trial design and execution with the EHR4CR platform would generate substantial added value for pharmaceutical industry, as main sponsors of clinical trials in Europe, and beyond. Copyright © 2015 Elsevier Inc. All rights reserved.

Interreality in the management of psychological stress: a clinical scenario.

PubMed

Riva, Giuseppe; Raspelli, Simona; Pallavicini, Federica; Grassi, Alessandra; Algeri, Davide; Wiederhold, Brenda K; Gaggioli, Andrea

2010-01-01

The term "psychological stress" describes a situation in which a subject perceives that environmental demands tax or exceed his or her adaptive capacity. According to the Cochrane Database of Systematic Reviews, the best validated approach covering both stress management and stress treatment is the Cognitive Behavioral (CBT) approach. We aim to design, develop and test an advanced ICT based solution for the assessment and treatment of psychological stress that is able to improve the actual CBT approach. To reach this goal we will use the "interreality" paradigm integrating assessment and treatment within a hybrid environment, that creates a bridge between the physical and virtual worlds. Our claim is that bridging virtual experiences (fully controlled by the therapist, used to learn coping skills and emotional regulation) with real experiences (allowing both the identification of any critical stressors and the assessment of what has been learned) using advanced technologies (virtual worlds, advanced sensors and PDA/mobile phones) is the best way to address the above limitations. To illustrate the proposed concept, a clinical scenario is also presented and discussed: Paola, a 45 years old nurse, with a mother affected by progressive senile dementia.

Explaining the discrepancy between intentions and actions: the case of hypothetical bias in contingent valuation

Treesearch

Icek Ajzen; Thomas C. Brown; Franklin Carvajal

2004-01-01

An experiment was designed to account for intention-behavior discrepancies by applying the theory of planned behavior to contingent valuation. College students (N = 160) voted in hypothetical and real payment referenda to contribute $8 to a scholarship fund. Overestimates of willingness to pay in the hypothetical referendum could not be attributed to moderately...

Population vulnerability and evacuation challenges in California for the SAFRR tsunami scenario: Chapter I in The SAFRR (Science Application for Risk Reduction) Tsunami Scenario

USGS Publications Warehouse

Wood, Nathan; Ratliff, Jamie; Peters, Jeff; Shoaf, Kimberley

2013-01-01

The SAFRR tsunami scenario models the impacts of a hypothetical yet plausible tsunami associated with a magnitude 9.1 megathrust earthquake east of the Alaska Peninsula. This report summarizes community variations in population vulnerability and potential evacuation challenges to the tsunami. The most significant public-health concern for California coastal communities during a distant-source tsunami is the ability to evacuate people out of potential inundation zones. Fatalities from the SAFRR tsunami scenario could be low if emergency managers can implement an effective evacuation in the time between tsunami generation and arrival, as well as keep people from entering tsunami-prone areas until all-clear messages can be delivered. This will be challenging given the estimated 91,956 residents, 81,277 employees, as well as numerous public venues, dependent-population facilities, community-support businesses, and high-volume beaches that are in the 79 incorporated communities and 17 counties that have land in the scenario tsunami-inundation zone. Although all coastal communities face some level of threat from this scenario, the highest concentrations of people in the scenario tsunami-inundation zone are in Long Beach, San Diego, Newport Beach, Huntington Beach, and San Francisco. Communities also vary in the prevalent categories of populations that are in scenario tsunami-inundation zones, such as residents in Long Beach, employees in San Francisco, tourists at public venues in Santa Cruz, and beach or park visitors in unincorporated Los Angeles County. Certain communities have higher percentages of groups that may need targeted outreach and preparedness training, such as renters, the very young and very old, and individuals with limited English-language skills or no English-language skills at all. Sustained education and targeted evacuation messaging is also important at several high-occupancy public venues in the scenario tsunami-inundation zone (for example, city

Impacts on the marine environment in the case of a hypothetical accident involving the recovery of the dumped Russian submarine K-27, based on dispersion of 137Cs.

PubMed

Hosseini, A; Amundsen, I; Brown, J; Dowdall, M; Karcher, M; Kauker, F; Schnur, R

2017-02-01

There is increasing concern regarding the issue of dumped nuclear waste in the Arctic Seas and in particular dumped objects with Spent Nuclear Fuel (SNF). Amongst dumped objects in the Arctic, the dumped Russian submarine K-27 has received great attention as it contains two reactors with highly enriched fuel and lies at a depth of about 30 m under water. To address these concerns a health and environmental impact assessment has been undertaken. Marine dispersion of potentially released radionuclides as a consequence of different hypothetical accident scenarios was modelled using the model NAOSIM. The outputs from the dispersion modelling have been used as inputs to food-chain transfer and environmental dosimetry models. The annual effective doses for subsistence fishing communities of the Barents-Kara seas region do not exceed 0.6 mSv for hypothetical accidents located at Stepovogo fjord or the Barents Sea. For high rate consumers of fish in Norway, following a potential accident at the Gremikha Bay, annual effects doses would be at around 0.15 mSv. Accumulated doses (over 90 days) for various organisms and for all release scenarios considered were never in excess of 150 μGy. The levels of 137 Cs derived for marine organism in areas close to Norway were not values that would likely cause concern from a regulatory perspective although for subsistence fishing communities close to the considered accident locations, it is not inconceivable that some restrictions on fishing etc. would need to be introduced. Copyright © 2016 Elsevier Ltd. All rights reserved.

Hypothetical: The Case for an Australian "Group of Seven"

ERIC Educational Resources Information Center

Turner, Michael; Brown, Alistair

2013-01-01

This paper examines the hypothetical cost-savings that might ensue from a merger of most of Australia's major research universities. The results of the textual analysis show that a merger of these universities has the potential to reduce expenses and professional and support staff salaries, increase comprehensive income returns and improve…

Energy Extraction from a Hypothetical MHK Array in a Section of the Mississippi River

NASA Astrophysics Data System (ADS)

Barco, J.; James, S. C.; Roberts, J. D.; Jones, C. A.; Jepsen, R. A.

2010-12-01

The world is facing many challenges meeting the energy demands for the future. Growing populations and developing economies as well as increasing energy expenditures highlight the need for a spectrum of energy sources. Concerns about pollution and climate change have led to increased interest in all forms of renewable energy to stabilize or decrease consumption of fossil fuels. One promising renewable is marine and hydrokinetic (MHK) energy, which has the potential to make important contributions to energy portfolios of the future. However, a primary question remains: How much energy can be extracted from MHK devices in rivers and oceans without significant environmental effects? This study focuses on the potential energy extraction from different hypothetical MHK array configurations in a section of the Mississippi River located near to Scotlandville Bend, Louisiana. Bathymetry data, obtained from Free Flow Power Corporation (FFP) via the US Army Corps bathymetry survey library, were interpolated onto a DELFT3D curvilinear, orthogonal grid of the system using ArcGIS 9.3.1. Boundary conditions are constrained by the upstream and downstream river flow rates and gage heights obtained from USGS website. Acoustic Doppler Current Profiler (ADCP) measurements obtained from FFP are used for pre-array model validation. Energy extraction is simulated using momentum sinks recently coded into SNL-EFDC, which is an augmented version of US EPA’s Environmental Fluid Dynamics Code (EFDC). SNL-EFDC model includes a new module which considers energy removal by MHK devices and commensurate changes to the turbulent kinetic energy and turbulent kinetic energy dissipation rate. As expected, average velocities decrease downstream of each MHK device due to energy extraction and blunt-body form drag from the MHK support structures. Changes in the flow field can alter sediment transport dynamics around and downstream of an MHK array; various hypothetical scenarios are examined. This

Individual differences in self-appraisals and responses to dating violence scenarios.

PubMed

Katz, J; Street, A; Arias, I

1997-01-01

Previous research suggests that certain types of self-appraisals may predispose individuals to be more or less tolerant of relationship violence. The current study investigates two such appraisals, self-esteem and self-attributions, as correlates of women's responses to hypothetical episodes of relationship violence by their dating partners. Undergraduate women involved in dating relationships (N = 145) reported global self-esteem, attributions for hypothetical partner aggression, and probable responses to the aggression. Results showed that self-esteem and self-attributions emerged as correlates of intentions to forgive violence, whereas only self-attributions emerged as a correlate of intentions to dissolve the relationship. The association between self-attributions and intentions to exit a violent relationship was fully mediated by intentions to forgive the partner. Because self-appraisals may inform prevention programs for women who may experience relationship violence, clinical implications are discussed.

Development and evaluation of a critical care e-learning scenario.

PubMed

Tait, Michael; Tait, Desiree; Thornton, Frances; Edwards, Mark

2008-11-01

This paper describes the development and evaluation of a critical care e-learning scenario for student nurses. At present, there are insufficient opportunities in the United Kingdom (UK) for student nurses to experience clinical placements where their skills in care of the critically-ill can be developed. There is therefore a need for new learning materials that help learners recognise the signs of clinical deterioration and rehearse the management of critically-ill patients. One way of meeting this need is by using electronic care scenarios. Several electronic care scenarios have been developed at Swansea University as part of the eWARD project. This article describes the design and evaluation of a critical care scenario that follows the care of a road casualty (John Macadam) after admission to an intensive care unit. The scenario was designed by an advisory team comprising a clinical lecturer and e-learning specialists. After using the scenario, 144 nursing students completed a Web-based questionnaire that collected demographic and attitudinal data for analysis using SPSS. Nursing students had a strongly positive attitude to the scenario with median scores in excess of 20 compared to maxima of 25 for scales measuring ease-of-use, interactivity, realism and confidence. None of the demographic data collected had a significant effect on these attitudes. The positive attitude of student nurses to this scenario strongly supports its use to help learners to (1) acquire knowledge and awareness when real life placements in these settings are not available and (2) extend their knowledge after coming across similar situations in practice.

Behavioral Economics of Cigarette Purchase Tasks: Within-Subject Comparison of Real, Potentially Real, and Hypothetical Cigarettes

PubMed Central

Wilson, A. George; Franck, Christopher T.; Koffarnus, Mikhail N.

2016-01-01

Abstract Introduction: Hypothetical rewards are commonly used in studies of laboratory-based tobacco demand. However, behavioral economic demand procedures require confirmation that the behavior elicited from real and hypothetical reward types are equivalent, and that results attained from these procedures are comparable to other accepted tasks, such as the hypothetical purchase task. Methods: Nineteen smokers were asked to purchase 1 week’s worth of cigarettes that they would consume over the following week either at one price that incrementally increased across four weekly sessions (“real” sessions) or four prices in a single session (“potentially real” session), one of which was randomly chosen to be actualized. At each session, participants also completed a hypothetical cigarette purchase task. After each week, participants reported the number of cigarettes they actually smoked. Results: Demand was found to be equivalent under both the real and potentially real reward conditions but statistically different from the demand captured in the hypothetical purchase task. However, the amounts purchased at specific prices in the hypothetical purchase task were significantly correlated with the amount purchased at comparable prices in the other two tasks (except for the highest price examined in both tasks of $1.00 per cigarette). Number of cigarettes consumed that were obtained outside of the study was correlated with study cigarette price. Conclusions: Combined, these results suggest that purchasing behavior during potentially real sessions (1) was not functionally different from real sessions, (2) imposes fewer costs to the experimenter, and (3) has high levels of both internal and external validity. PMID:26187389

The effectiveness of a simulated scenario to teach nursing students how to perform a bed bath: A randomized clinical trial.

PubMed

Miranda, Renata Pinto Ribeiro; de Cássia Lopes Chaves, Érika; Silva Lima, Rogério; Braga, Cristiane Giffoni; Simões, Ivandira Anselmo Ribeiro; Fava, Silvana Maria Coelho Leite; Iunes, Denise Hollanda

2017-10-01

Simulation allows students to develop several skills during a bed bath that are difficult to teach only in traditional classroom lectures, such as problem-solving, student interactions with the simulator (patient), reasoning in clinical evaluations, evaluation of responses to interventions, teamwork, communication, security and privacy. This study aimed to evaluate the effectiveness of a simulated bed bath scenario on improving cognitive knowledge, practical performance and satisfaction among nursing students. Randomized controlled clinical trial. Nursing students that were in the fifth period from two educational institutions in Brazil. Nursing students (n=58). The data were collected using the assessments of cognitive knowledge, practical performance and satisfaction were made through a written test about bed baths, an Objective Structured Clinical Examination (OSCE) and a satisfaction questionnaire. We identified that the acquisition and assimilation of cognitive knowledge was significantly higher in the simulation group (p=0.001). The performance was similar in both groups regardless of the teaching strategy (p=0.435). At follow-up, the simulation group had significantly more satisfaction with the teaching method than the control group (p=0.007). The teaching strategy based on a simulated scenario of a bed bath proved to be effective for the acquisition of cognitive knowledge regarding bed baths in clinical practice and improved student satisfaction with the teaching process. Copyright © 2017 Elsevier Ltd. All rights reserved.

Children's Thinking about Counterfactuals and Future Hypotheticals as Possibilities

ERIC Educational Resources Information Center

Beck, Sarah R.; Robinson, Elizabeth J.; Carroll, Daniel J.; Apperly, Ian A.

2006-01-01

Two experiments explored whether children's correct answers to counter factual and future hypothetical questions were based on an understanding of possibilities. Children played a game in which a toy mouse could run down either 1 of 2 slides. Children found it difficult to mark physically both possible outcomes, compared to reporting a single…

Effectiveness of a strategy that uses educational games to implement clinical practice guidelines among Spanish residents of family and community medicine (e-EDUCAGUIA project): a clinical trial by clusters.

PubMed

Del Cura-González, Isabel; López-Rodríguez, Juan A; Sanz-Cuesta, Teresa; Rodríguez-Barrientos, Ricardo; Martín-Fernández, Jesús; Ariza-Cardiel, Gloria; Polentinos-Castro, Elena; Román-Crespo, Begoña; Escortell-Mayor, Esperanza; Rico-Blázquez, Milagros; Hernández-Santiago, Virginia; Azcoaga-Lorenzo, Amaya; Ojeda-Ruiz, Elena; González-González, Ana I; Ávila-Tomas, José F; Barrio-Cortés, Jaime; Molero-García, José M; Ferrer-Peña, Raul; Tello-Bernabé, María Eugenia; Trujillo-Martín, Mar

2016-05-17

Clinical practice guidelines (CPGs) have been developed with the aim of helping health professionals, patients, and caregivers make decisions about their health care, using the best available evidence. In many cases, incorporation of these recommendations into clinical practice also implies a need for changes in routine clinical practice. Using educational games as a strategy for implementing recommendations among health professionals has been demonstrated to be effective in some studies; however, evidence is still scarce. The primary objective of this study is to assess the effectiveness of a teaching strategy for the implementation of CPGs using educational games (e-learning EDUCAGUIA) to improve knowledge and skills related to clinical decision-making by residents in family medicine. The primary objective will be evaluated at 1 and 6 months after the intervention. The secondary objectives are to identify barriers and facilitators for the use of guidelines by residents of family medicine and to describe the educational strategies used by Spanish teaching units of family and community medicine to encourage implementation of CPGs. We propose a multicenter clinical trial with randomized allocation by clusters of family and community medicine teaching units in Spain. The sample size will be 394 residents (197 in each group), with the teaching units as the randomization unit and the residents comprising the analysis unit. For the intervention, both groups will receive an initial 1-h session on clinical practice guideline use and the usual dissemination strategy by e-mail. The intervention group (e-learning EDUCAGUIA) strategy will consist of educational games with hypothetical clinical scenarios in a virtual environment. The primary outcome will be the score obtained by the residents on evaluation questionnaires for each clinical practice guideline. Other included variables will be the sociodemographic and training variables of the residents and the teaching unit

Innovative approach using interprofessional simulation to educate surgical residents in technical and nontechnical skills in high-risk clinical scenarios.

PubMed

Nicksa, Grace A; Anderson, Cristan; Fidler, Richard; Stewart, Lygia

2015-03-01

The Accreditation Council for Graduate Medical Education core competencies stress nontechnical skills that can be difficult to evaluate and teach to surgical residents. During emergencies, surgeons work in interprofessional teams and are required to perform certain procedures. To obtain proficiency in these skills, residents must be trained. To educate surgical residents in leadership, teamwork, effective communication, and infrequently performed emergency surgical procedures with the use of interprofessional simulations. SimMan 3GS was used to simulate high-risk clinical scenarios (15-20 minutes), followed by debriefings with real-time feedback (30 minutes). A modified Oxford Non-Technical Skills scale (score range, 1-4) was used to assess surgical resident performance during the first half of the academic year (July-December 2012) and the second half of the academic year (January-June 2013). Anonymous online surveys were used to solicit participant feedback. Simulations were conducted in the operating room, intensive care unit, emergency department, ward, and simulation center. A total of 43 surgical residents (postgraduate years [PGYs] 1 and 2) participated in interdisciplinary clinical scenarios, with other health care professionals (nursing, anesthesia, critical care, medicine, respiratory therapy, and pharmacy; mean number of nonsurgical participants/session: 4, range 0-9). Thirty seven surgical residents responded to the survey. Simulation of high-risk clinical scenarios: postoperative pulmonary embolus, pneumothorax, myocardial infarction, gastrointestinal bleeding, anaphylaxis with a difficult airway, and pulseless electrical activity arrest. Evaluation of resident skills: communication, leadership, teamwork, problem solving, situation awareness, and confidence in performing emergency procedures (eg, cricothyroidotomy). A total of 31 of 35 (89%) of the residents responding found the sessions useful. Additionally, 28 of 33 (85%) reported improved confidence

C P -invariance violation at short-baseline experiments in 3 +1 neutrino scenarios

NASA Astrophysics Data System (ADS)

de Gouvêa, André; Kelly, Kevin J.; Kobach, Andrew

2015-03-01

New neutrino degrees of freedom allow for more sources of charge parity- (C P ) invariance violation (CPV). We explore the requirements for accessing C P -odd mixing parameters in the so-called 3 +1 scenario, where one assumes the existence of one extra, mostly sterile neutrino degree of freedom, heavier than the other three mass eigenstates. As a first step, we concentrate on the νe→νμ appearance channel in a hypothetical, upgraded version of the ν STORM proposal. We establish that the optimal baseline for CPV studies depends strongly on the value of Δ m142—the new mass-squared difference—and that the ability to observe CPV depends significantly on whether the experiment is performed at the optimal baseline. Even at the optimal baseline, it is very challenging to see CPV in 3 +1 scenarios if one considers only one appearance channel. Full exploration of CPV in short-baseline experiments will require precision measurements of tau appearance, a challenge significantly beyond what is currently being explored by the experimental neutrino community.

[Study on optimal model of hypothetical work injury insurance scheme].

PubMed

Ye, Chi-yu; Dong, Heng-jin; Wu, Yuan; Duan, Sheng-nan; Liu, Xiao-fang; You, Hua; Hu, Hui-mei; Wang, Lin-hao; Zhang, Xing; Wang, Jing

2013-12-01

To explore an optimal model of hypothetical work injury insurance scheme, which is in line with the wishes of workers, based on the problems in the implementation of work injury insurance in China and to provide useful information for relevant policy makers. Multistage cluster sampling was used to select subjects: first, 9 small, medium, and large enterprises were selected from three cities (counties) in Zhejiang Province, China according to the economic development, transportation, and cooperation; then, 31 workshops were randomly selected from the 9 enterprises. Face-to-face interviews were conducted by trained interviewers using a pre-designed questionnaire among all workers in the 31 workshops. After optimization of hypothetical work injury insurance scheme, the willingness to participate in the scheme increased from 73.87%to 80.96%; the average willingness to pay for the scheme increased from 2.21% (51.77 yuan) to 2.38% of monthly wage (54.93 Yuan); the median willingness to pay for the scheme increased from 1% to 1.2% of monthly wage, but decreased from 35 yuan to 30 yuan. The optimal model of hypothetical work injury insurance scheme covers all national and provincial statutory occupational diseases and work accidents, as well as consultations about occupational diseases. The scheme is supposed to be implemented worldwide by the National Social Security Department, without regional differences. The premium is borne by the state, enterprises, and individuals, and an independent insurance fund is kept in the lifetime personal account for each of insured individuals. The premium is not refunded in any event. Compensation for occupational diseases or work accidents is unrelated to the enterprises of the insured workers but related to the length of insurance. The insurance becomes effective one year after enrollment, while it is put into effect immediately after the occupational disease or accident occurs. The optimal model of hypothetical work injury insurance

College Student Reporting Responses to Hypothetical and Actual Safety Concerns

ERIC Educational Resources Information Center

Hollister, Brandon A.; Scalora, Mario J.; Hoff, Sarah M.; Hodges, Heath J.; Marquez, Allissa

2017-01-01

Campus violence prevention often includes proactively reducing crime through noticing and resolving concerning situations. Within these efforts, interventions aimed at enhancing reporting have been considered necessary. The current study explored several reporting influences on college students' responses to hypothetical and actual campus safety…

Elusive but not hypothetical: axillary meristems in Wollemia nobilis

PubMed Central

Burrows, Geoffrey E.

2012-01-01

Background The branches of Wollemia nobilis are unbranched; however, it has been noted that new branches can form from the distal end of damaged ones, and branches can grow from axillary structures once a terminal strobilus has fallen. Tomlinson and Huggett (2011, Annals of Botany 107: 909–916) have recently investigated the formation of these reiterative branches and stated in the title of their paper that ‘Partial shoot reiteration in Wollemia nobilis (Araucariaceae) does not arise from “axillary meristems”’. They go on to state ‘Further research may reveal the presence of these elusive, but still only hypothetical, axillary meristems’. Response In this Viewpoint, I argue that Tomlinson and Huggett do not refer to previously published information that indicates that axillary meristems are present in Wollemia nobilis branch leaf axils, and that their anatomical methods were probably not optimal for locating and examining these minute structures. Thus, whilst I would agree that the axillary meristems in branch leaf axils of Wollemia nobilis are elusive, I contend that they are not hypothetical. PMID:21868407

A multiple-scenario assessment of the effect of a continuous-care, guideline-based decision support system on clinicians' compliance to clinical guidelines.

PubMed

Shalom, Erez; Shahar, Yuval; Parmet, Yisrael; Lunenfeld, Eitan

2015-04-01

To quantify the effect of a new continuous-care guideline (GL)-application engine, the Picard decision support system (DSS) engine, on the correctness and completeness of clinicians' decisions relative to an established clinical GL, and to assess the clinicians' attitudes towards a specific DSS. Thirty-six clinicians, including residents at different training levels and board-certified specialists at an academic OB/GYN department that handles around 15,000 deliveries annually, agreed to evaluate our continuous-care guideline-based DSS and to perform a cross-over assessment of the effects of using our guideline-based DSS. We generated electronic patient records that realistically simulated the longitudinal course of six different clinical scenarios of the preeclampsia/eclampsia/toxemia (PET) GL, encompassing 60 different decision points in total. Each clinician managed three scenarios manually without the Picard DSS engine (Non-DSS mode) and three scenarios when assisted by the Picard DSS engine (DSS mode). The main measures in both modes were correctness and completeness of actions relative to the PET GL. Correctness was further decomposed into necessary and redundant actions, relative to the guideline and the actual patient data. At the end of the assessment, a questionnaire was administered to the clinicians to assess their perceptions regarding use of the DSS. With respect to completeness, the clinicians applied approximately 41% of the GL's recommended actions in the non-DSS mode. Completeness increased to the performance of approximately 93% of the guideline's recommended actions, when using the DSS mode. With respect to correctness, approximately 94.5% of the clinicians' decisions in the non-DSS mode were correct. However, these included 68% of the actions that were correct but redundant, given the patient's data (e.g., repeating tests that had been performed), and 27% of the actions, which were necessary in the context of the GL and of the given scenario

Implications of alternative assumptions regarding future air pollution control in RCP-like scenarios

NASA Astrophysics Data System (ADS)

Chuwah, Clifford; van Noije, Twan; van Vuuren, Detlef; Hazeleger, Wilco; Strunk, Achim; Deetman, Sebastiaan; Mendoza Beltran, Angelica; van Vliet, Jasper

2013-04-01

Estimation of future emissions of short-lived trace gases and aerosols from human activities is a main source of uncertainty in projections of future air quality and climate forcing. The Representative Concentration Pathways (RCPs), however, all assume that worldwide ambitious air pollution control policies will be implemented in the coming decades. In this study, we therefore explore the consequences of four alternative emission scenarios generated using the IMAGE integrated assessment model following the methods used to generate the RCPs. These scenarios combine low and high air pollution variants of the scenarios with radiative forcing targets in 2100 of 2.6 W/m2 and 6.0 W/m2 (the high air pollution variants assume no improvement in emission factors, representing a hypothetical upper end of emission levels). Analysis using the global atmospheric chemistry and transport model TM5 shows that climate mitigation and air pollution control policy variants studied here have similar large-scale effects on the concentrations of ozone and black carbon; the impact of climate policy, however, has a stronger impact on sulphate concentrations. Air pollution control measures could significantly reduce the warming by tropospheric ozone and black carbon and the cooling by sulphate already in 2020, and on the longer term contribute to enhanced warming by methane. These effects tend to cancel each other at the global scale. According to our estimates the effect of the worldwide implementation of air pollution control measures on the total global mean direct radiative forcing in 2050 is +0.09 W/m2 in the 6.0 W/m2 scenario and -0.16 W/m2 in the 2.6 W/m2 scenario.

Scenarios which may lead to the rise of an asteroid-based technical civilisation

NASA Astrophysics Data System (ADS)

Kecskes, Csaba

2002-05-01

In a previous paper, the author described a hypothetical development path of technical civilisations which has the following stages: planet dwellers, asteroid dwellers, interstellar travellers, interstellar space dwellers. In this paper, several scenarios are described which may cause the rise of an asteroid-based technical civilisation. Before such a transition may take place, certain space technologies must be developed fully (now these exist only in very preliminary forms): closed-cycle biological life support systems, space manufacturing systems, electrical propulsion systems. After mastering these technologies, certain events may provide the necessary financial means and social impetus for the foundation of the first asteroid-based colonies. In the first scenario, a rich minority group becomes persecuted and they decide to leave the Earth. In the second scenario, a "cold war"-like situation exists and the leaders of the superpowers order the creation of asteroid-based colonies to show off their empires' technological (and financial) grandiosity. In the third scenario, the basic situation is similar to the second one, but in this case the asteroids are not just occupied by the colonists. With several decades of hard work, an asteroid can be turned into a kinetic energy weapon which can provide the same (or greater) threat as the nuclear arsenal of a present superpower. In the fourth scenario, some military asteroids are moved to Earth-centred orbits and utilised as "solar power satellites" (SPS). This would be a quite economical solution because a "military asteroid" already contains most of the important components of an SPS (large solar collector arrays, power distribution devices, orbit modifying rocket engine), one should add only a large microwave transmitter.

Scenarios which may lead to the rise of an asteroid-based technical civilisation.

PubMed

Kecskes, Csaba

2002-05-01

In a previous paper, the author described a hypothetical development path of technical civilisations which has the following stages: planet dwellers, asteroid dwellers, interstellar travellers, interstellar space dwellers. In this paper, several scenarios are described which may cause the rise of an asteroid-based technical civilisation. Before such a transition may take place, certain space technologies must be developed fully (now these exist only in very preliminary forms): closed-cycle biological life support systems, space manufacturing systems, electrical propulsion systems. After mastering these technologies, certain events may provide the necessary financial means and social impetus for the foundation of the first asteroid-based colonies. In the first scenario, a rich minority group becomes persecuted and they decide to leave the Earth. In the second scenario, a "cold war"-like situation exists and the leaders of the superpowers order the creation of asteroid-based colonies to show off their empires' technological (and financial) grandiosity. In the third scenario, the basic situation is similar to the second one, but in this case the asteroids are not just occupied by the colonists. With several decades of hard work, an asteroid can be turned into a kinetic energy weapon which can provide the same (or greater) threat as the nuclear arsenal of a present superpower. In the fourth scenario, some military asteroids are moved to Earth-centred orbits and utilised as "solar power satellites" (SPS). This would be a quite economical solution because a "military asteroid" already contains most of the important components of an SPS (large solar collector arrays, power distribution devices, orbit modifying rocket engine), one should add only a large microwave transmitter. c2002 Elsevier Science Ltd. All rights reserved.

Workers With AIDS: Hypothetical Supervisors' Willingness to Make EAP Referrals.

ERIC Educational Resources Information Center

Gerstein, Lawrence H.; Duffey, Kim

1992-01-01

Investigated willingness of 86 hypothetical supervisors (86 students enrolled in graduate-level business classes) to refer subordinates with 5 types of problems (Acquired Immune Deficiency Syndrome, human immunodeficiency virus-positive status, alcohol abuse, cocaine abuse, job impairment) to Employee Assistance Programs. More severe worker's…

Diagnosing Crime and Diagnosing Disease: Bias Reduction Strategies in the Forensic and Clinical Sciences.

PubMed

Lockhart, Joseph J; Satya-Murti, Saty

2017-11-01

Cognitive effort is an essential part of both forensic and clinical decision-making. Errors occur in both fields because the cognitive process is complex and prone to bias. We performed a selective review of full-text English language literature on cognitive bias leading to diagnostic and forensic errors. Earlier work (1970-2000) concentrated on classifying and raising bias awareness. Recently (2000-2016), the emphasis has shifted toward strategies for "debiasing." While the forensic sciences have focused on the control of misleading contextual cues, clinical debiasing efforts have relied on checklists and hypothetical scenarios. No single generally applicable and effective bias reduction strategy has emerged so far. Generalized attempts at bias elimination have not been particularly successful. It is time to shift focus to the study of errors within specific domains, and how to best communicate uncertainty in order to improve decision making on the part of both the expert and the trier-of-fact. © 2017 American Academy of Forensic Sciences.

Patient and Physician Views about Protocolized Dialysis Treatment in Randomized Trials and Clinical Care

PubMed Central

Kraybill, Ashley; Dember, Laura M.; Joffe, Steven; Karlawish, Jason; Ellenberg, Susan S.; Madden, Vanessa; Halpern, Scott D.

2016-01-01

Background Pragmatic trials comparing standard-of-care interventions may improve the quality of care for future patients, but raise ethical questions about limitations on decisional autonomy. We sought to understand how patients and physicians view and respond to these questions in the contexts of pragmatic trials and of usual clinical care. Methods We conducted scenario-based, semi-structured interviews with 32 patients with end-stage renal disease (ESRD) receiving maintenance hemodialysis in outpatient dialysis units and with 24 nephrologists. Each participant was presented with two hypothetical scenarios in which a protocolized approach to hemodialysis treatment time was adopted for the entire dialysis unit as part of a clinical trial or a new clinical practice. Results A modified grounded theory analysis revealed three major themes: 1) the value of research, 2) the effect of protocolized care on patient and physician autonomy, and 3) information exchange between patients and physicians, including the mechanism of consent. Most patients and physicians were willing to relinquish decisional autonomy and were more willing to relinquish autonomy for research purposes than in clinical care. Patients’ concerns towards clinical trials were tempered by their desires for certainty for a positive outcome and for physician validation. Patients tended to believe that being informed about research was more important than the actual mechanism of consent, and most were content with being able to opt out from participating. Conclusions This qualitative study suggests the general acceptability of a pragmatic clinical trial comparing standard-of-care interventions that limits decisional autonomy for nephrologists and patients receiving hemodialysis. Future studies are needed to determine whether similar findings would emerge among other patients and providers considering other standard-of-care trials. PMID:27833931

Patient and Physician Views about Protocolized Dialysis Treatment in Randomized Trials and Clinical Care.

PubMed

Kraybill, Ashley; Dember, Laura M; Joffe, Steven; Karlawish, Jason; Ellenberg, Susan S; Madden, Vanessa; Halpern, Scott D

2016-01-01

Pragmatic trials comparing standard-of-care interventions may improve the quality of care for future patients, but raise ethical questions about limitations on decisional autonomy. We sought to understand how patients and physicians view and respond to these questions in the contexts of pragmatic trials and of usual clinical care. We conducted scenario-based, semi-structured interviews with 32 patients with end-stage renal disease (ESRD) receiving maintenance hemodialysis in outpatient dialysis units and with 24 nephrologists. Each participant was presented with two hypothetical scenarios in which a protocolized approach to hemodialysis treatment time was adopted for the entire dialysis unit as part of a clinical trial or a new clinical practice. A modified grounded theory analysis revealed three major themes: 1) the value of research, 2) the effect of protocolized care on patient and physician autonomy, and 3) information exchange between patients and physicians, including the mechanism of consent. Most patients and physicians were willing to relinquish decisional autonomy and were more willing to relinquish autonomy for research purposes than in clinical care. Patients' concerns towards clinical trials were tempered by their desires for certainty for a positive outcome and for physician validation. Patients tended to believe that being informed about research was more important than the actual mechanism of consent, and most were content with being able to opt out from participating. This qualitative study suggests the general acceptability of a pragmatic clinical trial comparing standard-of-care interventions that limits decisional autonomy for nephrologists and patients receiving hemodialysis. Future studies are needed to determine whether similar findings would emerge among other patients and providers considering other standard-of-care trials.

Assessment of the sunk-cost effect in clinical decision-making.

PubMed

Braverman, Jennifer A; Blumenthal-Barby, J S

2012-07-01

Despite the current push toward the practice of evidence-based medicine and comparative effectiveness research, clinicians' decisions may be influenced not only by evidence, but also by cognitive biases. A cognitive bias describes a tendency to make systematic errors in certain circumstances based on cognitive factors rather than evidence. Though health care providers have been shown in several studies to be susceptible to a variety of types of cognitive biases, research on the role of the sunk-cost bias in clinical decision-making is extremely limited. The sunk-cost bias is the tendency to pursue a course of action, even after it has proved to be suboptimal, because resources have been invested in that course of action. This study explores whether health care providers' medical treatment recommendations are affected by prior investments in a course of treatment. Specifically, we surveyed 389 health care providers in a large urban medical center in the United States during August 2009. We asked participants to make a treatment recommendation based on one of four hypothetical clinical scenarios that varied in the source and type of prior investment described. By comparing recommendations across scenarios, we found that providers did not demonstrate a sunk-cost effect; rather, they demonstrated a significant tendency to over-compensate for the effect. In addition, we found that more than one in ten health care providers recommended continuation of an ineffective treatment. Copyright © 2012 Elsevier Ltd. All rights reserved.

Real-time determination of the worst tsunami scenario based on Earthquake Early Warning

NASA Astrophysics Data System (ADS)

Furuya, Takashi; Koshimura, Shunichi; Hino, Ryota; Ohta, Yusaku; Inoue, Takuya

2016-04-01

, width, depth and fault-position. Note that strike is limited with the range obtained from 90 scenarios calculation. From 900 scenarios, we determine the worst tsunami scenarios from disaster management point of view, such as the one with shortest travel time and the highest water level. The method was applied to a hypothetical-earthquake, and verified if it can effectively search the worst tsunami source scenario in real-time, to be used as an input of real-time tsunami inundation forecasting.

Modelling Legal Argument: Reasoning with Cases and Hypotheticals

DTIC Science & Technology

1988-02-01

hypothetically the effect that deciding the new case according to one precedent would have on other well-entrenched I precedents. The evaluation criteria at...plans or justifications for the results. In "transformational" analogy, solutions to pre- 3 vious problems are indexed according to goals achieved; they...information is added [Kolodner, 1983a; Kolodner, 1983b]. The system in- dexes events, "E-mops", according to the aspects of an event that differ from the

Scenario drafting to anticipate future developments in technology assessment.

PubMed

Retèl, Valesca P; Joore, Manuela A; Linn, Sabine C; Rutgers, Emiel J T; van Harten, Wim H

2012-08-16

Health Technology Assessment (HTA) information, and in particular cost-effectiveness data is needed to guide decisions, preferably already in early stages of technological development. However, at that moment there is usually a high degree of uncertainty, because evidence is limited and different development paths are still possible. We developed a multi-parameter framework to assess dynamic aspects of a technology -still in development-, by means of scenario drafting to determine the effects, costs and cost-effectiveness of possible future diffusion patterns. Secondly, we explored the value of this method on the case of the clinical implementation of the 70-gene signature for breast cancer, a gene expression profile for selecting patients who will benefit most from chemotherapy. To incorporate process-uncertainty, ten possible scenarios regarding the introduction of the 70-gene signature were drafted with European experts. Out of 5 most likely scenarios, 3 drivers of diffusion (non-compliance, technical failure, and uptake) were quantitatively integrated in a decision-analytical model. For these scenarios, the cost-effectiveness of the 70-gene signature expressed in Incremental Cost-Effectiveness Ratios (ICERs) was compared to clinical guidelines, calculated from the past (2005) until the future (2020). In 2005 the ICER was €1,9 million/quality-adjusted-life-year (QALY), meaning that the 70-gene signature was not yet cost-effective compared to the current clinical guideline. The ICER for the 70-gene signature improved over time with a range of €1,9 million to €26,145 in 2010 and €1,9 million to €11,123/QALY in 2020 depending on the separate scenario used. From 2010, the 70-gene signature should be cost-effective, based on the combined scenario. The uptake-scenario had strongest influence on the cost-effectiveness. When optimal diffusion of a technology is sought, incorporating process-uncertainty by means of scenario drafting into a decision model may

Scenario drafting to anticipate future developments in technology assessment

PubMed Central

2012-01-01

Background Health Technology Assessment (HTA) information, and in particular cost-effectiveness data is needed to guide decisions, preferably already in early stages of technological development. However, at that moment there is usually a high degree of uncertainty, because evidence is limited and different development paths are still possible. We developed a multi-parameter framework to assess dynamic aspects of a technology -still in development-, by means of scenario drafting to determine the effects, costs and cost-effectiveness of possible future diffusion patterns. Secondly, we explored the value of this method on the case of the clinical implementation of the 70-gene signature for breast cancer, a gene expression profile for selecting patients who will benefit most from chemotherapy. Methods To incorporate process-uncertainty, ten possible scenarios regarding the introduction of the 70-gene signature were drafted with European experts. Out of 5 most likely scenarios, 3 drivers of diffusion (non-compliance, technical failure, and uptake) were quantitatively integrated in a decision-analytical model. For these scenarios, the cost-effectiveness of the 70-gene signature expressed in Incremental Cost-Effectiveness Ratios (ICERs) was compared to clinical guidelines, calculated from the past (2005) until the future (2020). Results In 2005 the ICER was €1,9 million/quality-adjusted-life-year (QALY), meaning that the 70-gene signature was not yet cost-effective compared to the current clinical guideline. The ICER for the 70-gene signature improved over time with a range of €1,9 million to €26,145 in 2010 and €1,9 million to €11,123/QALY in 2020 depending on the separate scenario used. From 2010, the 70-gene signature should be cost-effective, based on the combined scenario. The uptake-scenario had strongest influence on the cost-effectiveness. Conclusions When optimal diffusion of a technology is sought, incorporating process-uncertainty by means of

"Beauty contest" indicator of cognitive ability and free riding strategies. Results from a scenario experiment about pandemic flu immunization.

PubMed

Rönnerstrand, Björn

2017-03-01

High immunization coverage rates are desirable in order to reduce total morbidity and mortality rates, but it may also provide an incentive for herd immunity free riding strategies. The aim of this paper was to investigate the link between cognitive ability and vaccination intention in a hypothetical scenario experiment about Avian Flu immunization. A between-subject scenario experiment was utilized to examine the willingness to undergo vaccination when the vaccination coverage was proclaimed to be 36, 62 and 88%. Respondents were later assigned to a "Beauty contest" experiment, an experimental game commonly used to investigate individual's cognitive ability. Results show that there was a significant negative effect of the proclaimed vaccination uptake among others on the vaccination intention. However, there were no significant association between the "Beauty contest" indicator of cognitive ability and the use of herd immunity free riding strategies.

Substance Abuse Counselors and Moral Reasoning: Hypothetical and Authentic Dilemmas

ERIC Educational Resources Information Center

Sias, Shari M.

2009-01-01

This exploratory study examined the assumption that the level of moral reasoning (Defining Issues Test; J. R. Rest, 1986) used in solving hypothetical and authentic dilemmas is similar for substance abuse counselors (N = 188). The statistical analyses used were paired-sample t tests, Pearson product-moment correlation, and simultaneous multiple…

Low-mass neutralino dark matter in supergravity scenarios: phenomenology and naturalness

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

Peiró, M.; Robles, S., E-mail: mpeirogarcia@gmail.com, E-mail: sandra.robles@uam.es

2017-05-01

The latest experimental results from the LHC and dark matter (DM) searches suggest that the parameter space allowed in supersymmetric theories is subject to strong reductions. These bounds are especially constraining for scenarios entailing light DM particles. Previous studies have shown that light neutralino DM in the Minimal Supersymmetric Standard Model (MSSM), with parameters defined at the electroweak scale, is still viable when the low energy spectrum of the model features light sleptons, in which case, the relic density constraint can be fulfilled. In view of this, we have investigated the viability of light neutralinos as DM candidates in themore » MSSM, with parameters defined at the grand unification scale. We have analysed the optimal choices of non-universalities in the soft supersymmetry-breaking parameters for both, gauginos and scalars, in order to avoid the stringent experimental constraints. We show that light neutralinos, with a mass as low as 25 GeV, are viable in supergravity scenarios if the gaugino mass parameters at high energy are very non universal, while the scalar masses can remain of the same order. These scenarios typically predict a very small cross section of neutralinos off protons and neutrons, thereby being very challenging for direct detection experiments. However, a potential detection of smuons and selectrons at the LHC, together with a hypothetical discovery of a gamma-ray signal from neutralino annihilations in dwarf spheroidal galaxies could shed light on this kind of solutions. Finally, we have investigated the naturalness of these scenarios, taking into account all the potential sources of tuning. Besides the electroweak fine-tuning, we have found that the tuning to reproduce the correct DM relic abundance and that to match the measured Higgs mass can also be important when estimating the total degree of naturalness.« less

Low-mass neutralino dark matter in supergravity scenarios: phenomenology and naturalness

NASA Astrophysics Data System (ADS)

Peiró, M.; Robles, S.

2017-05-01

The latest experimental results from the LHC and dark matter (DM) searches suggest that the parameter space allowed in supersymmetric theories is subject to strong reductions. These bounds are especially constraining for scenarios entailing light DM particles. Previous studies have shown that light neutralino DM in the Minimal Supersymmetric Standard Model (MSSM), with parameters defined at the electroweak scale, is still viable when the low energy spectrum of the model features light sleptons, in which case, the relic density constraint can be fulfilled. In view of this, we have investigated the viability of light neutralinos as DM candidates in the MSSM, with parameters defined at the grand unification scale. We have analysed the optimal choices of non-universalities in the soft supersymmetry-breaking parameters for both, gauginos and scalars, in order to avoid the stringent experimental constraints. We show that light neutralinos, with a mass as low as 25 GeV, are viable in supergravity scenarios if the gaugino mass parameters at high energy are very non universal, while the scalar masses can remain of the same order. These scenarios typically predict a very small cross section of neutralinos off protons and neutrons, thereby being very challenging for direct detection experiments. However, a potential detection of smuons and selectrons at the LHC, together with a hypothetical discovery of a gamma-ray signal from neutralino annihilations in dwarf spheroidal galaxies could shed light on this kind of solutions. Finally, we have investigated the naturalness of these scenarios, taking into account all the potential sources of tuning. Besides the electroweak fine-tuning, we have found that the tuning to reproduce the correct DM relic abundance and that to match the measured Higgs mass can also be important when estimating the total degree of naturalness.

Design and quantification of an extreme winter storm scenario for emergency preparedness and planning exercises in California

USGS Publications Warehouse

Dettinger, M.D.; Martin, Ralph F.; Hughes, M.; Das, T.; Neiman, P.; Cox, D.; Estes, G.; Reynolds, D.; Hartman, R.; Cayan, D.; Jones, L.

2012-01-01

The USGS Multihazards Project is working with numerous agencies to evaluate and plan for hazards and damages that could be caused by extreme winter storms impacting California. Atmospheric and hydrological aspects of a hypothetical storm scenario have been quantified as a basis for estimation of human, infrastructure, economic, and environmental impacts for emergency-preparedness and flood-planning exercises. In order to ensure scientific defensibility and necessary levels of detail in the scenario description, selected historical storm episodes were concatentated to describe a rapid arrival of several major storms over the state, yielding precipitation totals and runoff rates beyond those occurring during the individual historical storms. This concatenation allowed the scenario designers to avoid arbitrary scalings and is based on historical occasions from the 19th and 20th Centuries when storms have stalled over the state and when extreme storms have arrived in rapid succession. Dynamically consistent, hourly precipitation, temperatures, barometric pressures (for consideration of storm surges and coastal erosion), and winds over California were developed for the so-called ARkStorm scenario by downscaling the concatenated global records of the historical storm sequences onto 6- and 2-km grids using a regional weather model of January 1969 and February 1986 storm conditions. The weather model outputs were then used to force a hydrologic model to simulate ARkStorm runoff, to better understand resulting flooding risks. Methods used to build this scenario can be applied to other emergency, nonemergency and non-California applications. ?? 2011 The Author(s).

A Hypothetical Learning Trajectory for Conceptualizing Matrices as Linear Transformations

ERIC Educational Resources Information Center

Andrews-Larson, Christine; Wawro, Megan; Zandieh, Michelle

2017-01-01

In this paper, we present a hypothetical learning trajectory (HLT) aimed at supporting students in developing flexible ways of reasoning about matrices as linear transformations in the context of introductory linear algebra. In our HLT, we highlight the integral role of the instructor in this development. Our HLT is based on the "Italicizing…

Historical and hypothetical future sedimentation and water storage in Kajakai Reservoir, central Afghanistan

USGS Publications Warehouse

Vining, Kevin C.; Vecchia, Aldo V.

2008-01-01

Sedimentation has reduced water storage in Kajakai Reservoir. If current sedimentation rates continue, hypothetical future reservoir water volumes at the spillway elevation of 1,033.5 meters could be reduced about 22 percent from 2006 to 2057. Even if the spillway elevation is raised to 1,045 meters, a severe drought could result in large multiyear irrigation-supply deficits in which reservoir water levels remain below 1,022 meters for more than 4 years. Hypothetical climate change and sedimentation could result in greater water-supply deficits. The chance of having sufficient water supplies in Kajakai Reservoir during the worst month is about 47 percent.

The effect of disease risk probability and disease type on interest in clinic-based versus direct-to-consumer genetic testing services.

PubMed

Sherman, Kerry; Shaw, Laura-Kate; Champion, Katrina; Caldeira, Fernanda; McCaskill, Margaret

2015-10-01

The effect of disease-specific cognitions on interest in clinic-based and direct-to-consumer (DTC) genetic testing was assessed. Participants (N = 309) responded to an online hypothetical scenario and received genetic testing-related messages that varied by risk probability (25, 50, 75 %) and disease type (Alzheimer's disease vs. Type 2 Diabetes). Post-manipulation interest increased for both testing types, but was greater for clinic-based testing. Interest was greater for Type 2 Diabetes than for Alzheimer's disease, the latter perceived as more severe and likely, and less treatable and preventable. For DTC testing only, participants allocated to the high risk condition (75 %) had greater testing interest than those in the low (25 %) category. DTC testing is perceived as a viable, but less preferred, option compared with clinic-based testing. Particularly when considering DTC genetic testing, there is a need to emphasize subjective disease-related perceptions, including risk probability.

Is Silence Golden? Elementary School Teachers' Strategies and Beliefs regarding Hypothetical Shy/Quiet and Exuberant/Talkative Children

ERIC Educational Resources Information Center

Coplan, Robert J.; Hughes, Kathleen; Bosacki, Sandra; Rose-Krasnor, Linda

2011-01-01

The primary goal of the present study was to examine elementary teachers' strategies, attitudes, and beliefs regarding hypothetical shy (i.e., quiet), exuberant (i.e., overly talkative), and average (i.e., typical) children. We explored whether these strategies and beliefs varied as a function of the gender of the hypothetical child as well as…

Preventive health services implemented by family physicians in Portugal—a cross-sectional study based on two clinical scenarios

PubMed Central

Martins, Carlos; Azevedo, Luís Filipe; Santos, Cristina; Sá, Luísa; Santos, Paulo; Couto, Maria; Pereira, Altamiro; Hespanhol, Alberto

2014-01-01

Objectives To assess whether Portuguese family physicians perform preventive health services in accordance with scientific evidence, based on the recommendations of the United States Preventive Services Task Force (USPSTF). Design Cross-sectional study. Setting Primary healthcare, Portuguese National Health Service. Participants 255 Portuguese family physicians selected by a stratified cluster sampling design were invited to participate in a computer-assisted telephone survey. Outcomes Prevalence of compliance with USPSTF recommendations for screening, given a male and female clinical scenario and a set of proposed medical interventions, including frequency of the intervention and performance in their own daily practice. Results A response rate of 95.7% was obtained (n=244). 98–100% of family physicians answered according to the USPSTF recommendations in most interventions. In the male scenario, the lowest concordance was observed in the evaluation of prostate-specific antigen with 37% of family physicians answering according to the USPSTF recommendations. In the female scenario, the lowest concordance was for cholesterol testing with 2% of family physicians complying. Family physicians younger than 50 years had significantly better compliance scores than older ones (mean 77% vs 72%; p<0.001). Conclusions We found a high degree of agreement with USPSTF recommendations among Portuguese family physicians. However, we also found results suggesting excessive use of some medical interventions, raising concerns related to possible harm associated with overdiagnosis and overtreatment. PMID:24861550

Moral emotions and moral judgments in children's narratives: comparing real-life and hypothetical transgressions.

PubMed

Gutzwiller-Helfenfinger, Eveline; Gasser, Luciano; Malti, Tina

2010-01-01

How children make meaning of their own social experiences in situations involving moral issues is central to their subsequent affective and cognitive moral learning. Our study of young children's narratives describing their interpersonal conflicts shows that the emotions and judgments constructed in the course of these real-life narratives differ from the emotions and judgments generated in the context of hypothetical transgressions. In the narratives, all emotions mentioned spontaneously were negative. In contrast, emotions attributed in the interview part covered a broader spectrum. One's own real-life transgressions were judged less severe and more justified than hypothetical transgressions. © Wiley Periodicals, Inc.

Estimating Potential Effects of Hypothetical Oil Spills on Polar Bears

USGS Publications Warehouse

Amstrup, Steven C.; Durner, George M.; McDonald, T.L.; Johnson, W.R.

2006-01-01

Much is known about the transport and fate of oil spilled into the sea and its toxicity to exposed wildlife. Previously, however, there has been no way to quantify the probability that wildlife dispersed over the seascape would be exposed to spilled oil. Polar bears, the apical predator of the arctic, are widely dispersed near the continental shelves of the Arctic Ocean, an area also undergoing considerable hydrocarbon exploration and development. We used 15,308 satellite locations from 194 radiocollared polar bears to estimate the probability that polar bears could be exposed to hypothetical oil spills. We used a true 2 dimensional Gausian kernel density estimator, to estimate the number of bears likely to occur in each 1.00 km2 cell of a grid superimposed over near shore areas surrounding 2 oil production facilities: the existing Northstar oil production facility, and the proposed offshore site for the Liberty production facility. We estimated the standard errors of bear numbers per cell with bootstrapping. Simulated oil spill footprints for September and October, the times during which we hypothesized effects of an oil-spill would be worst, were estimated using real wind and current data collected between 1980 and 1996. We used ARC/Info software to calculate overlap (numbers of bears oiled) between simulated oil-spill footprints and polar bear grid-cell values. Numbers of bears potentially oiled by a hypothetical 5912 barrel spill (the largest spill thought probable from a pipeline breach) ranged from 0 to 27 polar bears for September open water conditions, and from 0 to 74 polar bears in October mixed ice conditions. Median numbers oiled by the 5912 barrel hypothetical spill from the Liberty simulation in September and October were 1 and 3 bears, equivalent values for the Northstar simulation were 3 and 11 bears. In October, 75% of trajectories from the 5912 barrel simulated spill at Liberty oiled 9 or fewer bears while 75% of the trajectories affected 20 or

Detection of functionally important regions in "hypothetical proteins" of known structure.

PubMed

Nimrod, Guy; Schushan, Maya; Steinberg, David M; Ben-Tal, Nir

2008-12-10

Structural genomics initiatives provide ample structures of "hypothetical proteins" (i.e., proteins of unknown function) at an ever increasing rate. However, without function annotation, this structural goldmine is of little use to biologists who are interested in particular molecular systems. To this end, we used (an improved version of) the PatchFinder algorithm for the detection of functional regions on the protein surface, which could mediate its interactions with, e.g., substrates, ligands, and other proteins. Examination, using a data set of annotated proteins, showed that PatchFinder outperforms similar methods. We collected 757 structures of hypothetical proteins and their predicted functional regions in the N-Func database. Inspection of several of these regions demonstrated that they are useful for function prediction. For example, we suggested an interprotein interface and a putative nucleotide-binding site. A web-server implementation of PatchFinder and the N-Func database are available at http://patchfinder.tau.ac.il/.

The impact of arbitrarily applicable relational responding on evaluative learning about hypothetical money and shock outcomes.

PubMed

Dymond, Simon; Molet, Mikael; Davies, Lynette

2017-08-01

Evaluative learning comprises changes in preferences after co-occurrences between conditioned stimuli (CSs) and an unconditioned stimulus (US) of affective value. Co-occurrences may involve relational responding. Two experiments examined the impact of arbitrary relational responding on evaluative preferences for hypothetical money and shock outcomes. In Experiment 1, participants were trained to make arbitrary relational responses by placing CSs of the same size but different colours into boxes and were then instructed that these CSs represented different intensities of hypothetical USs (money or shock). Liking ratings of the CSs were altered in accordance with the underlying bigger/smaller than relations. A reversal of preference was also observed: the CS associated with the smallest hypothetical shock was rated more positively than the CS associated with the smallest amount of hypothetical money. In Experiment 2, procedures from Relational Frame Theory (RFT) established a relational network of more than/less than relations consisting of five CSs (A-B-C-D-E). Overall, evaluative preferences were altered, but not reversed, depending on (a) how stimuli had been related to one another during the learning phase and (b) whether those stimuli referred to money or shocks. The contribution of RFT to evaluative learning research is discussed.

A Study of the Competency of Third Year Medical Students to Interpret Biochemically Based Clinical Scenarios Using Knowledge and Skills Gained in Year 1 and 2

ERIC Educational Resources Information Center

Gowda, Veena Bhaskar S.; Nagaiah, Bhaskar Hebbani; Sengodan, Bharathi

2016-01-01

Medical students build clinical knowledge on the grounds of previously obtained basic knowledge. The study aimed to evaluate the competency of third year medical students to interpret biochemically based clinical scenarios using knowledge and skills gained during year 1 and 2 of undergraduate medical training. Study was conducted on year 3 MBBS…

Overview of the ARkStorm scenario

USGS Publications Warehouse

Porter, Keith; Wein, Anne; Alpers, Charles N.; Baez, Allan; Barnard, Patrick L.; Carter, James; Corsi, Alessandra; Costner, James; Cox, Dale; Das, Tapash; Dettinger, Mike; Done, James; Eadie, Charles; Eymann, Marcia; Ferris, Justin; Gunturi, Prasad; Hughes, Mimi; Jarrett, Robert; Johnson, Laurie; Le-Griffin, Hanh Dam; Mitchell, David; Morman, Suzette; Neiman, Paul; Olsen, Anna; Perry, Suzanne; Plumlee, Geoffrey; Ralph, Martin; Reynolds, David; Rose, Adam; Schaefer, Kathleen; Serakos, Julie; Siembieda, William; Stock, Jonathan; Strong, David; Wing, Ian Sue; Tang, Alex; Thomas, Pete; Topping, Ken; Wills, Chris; Jones, Lucile

2011-01-01

The U.S. Geological Survey, Multi Hazards Demonstration Project (MHDP) uses hazards science to improve resiliency of communities to natural disasters including earthquakes, tsunamis, wildfires, landslides, floods and coastal erosion. The project engages emergency planners, businesses, universities, government agencies, and others in preparing for major natural disasters. The project also helps to set research goals and provides decision-making information for loss reduction and improved resiliency. The first public product of the MHDP was the ShakeOut Earthquake Scenario published in May 2008. This detailed depiction of a hypothetical magnitude 7.8 earthquake on the San Andreas Fault in southern California served as the centerpiece of the largest earthquake drill in United States history, involving over 5,000 emergency responders and the participation of over 5.5 million citizens. This document summarizes the next major public project for MHDP, a winter storm scenario called ARkStorm (for Atmospheric River 1,000). Experts have designed a large, scientifically realistic meteorological event followed by an examination of the secondary hazards (for example, landslides and flooding), physical damages to the built environment, and social and economic consequences. The hypothetical storm depicted here would strike the U.S. West Coast and be similar to the intense California winter storms of 1861 and 1862 that left the central valley of California impassible. The storm is estimated to produce precipitation that in many places exceeds levels only experienced on average once every 500 to 1,000 years. Extensive flooding results. In many cases flooding overwhelms the state's flood-protection system, which is typically designed to resist 100- to 200-year runoffs. The Central Valley experiences hypothetical flooding 300 miles long and 20 or more miles wide. Serious flooding also occurs in Orange County, Los Angeles County, San Diego, the San Francisco Bay area, and other

Experimental and Numerical Models of Complex Clinical Scenarios; Strategies to Improve Relevance and Reproducibility of Joint Replacement Research

PubMed Central

Bechtold, Joan E.; Swider, Pascal; Goreham-Voss, Curtis; Soballe, Kjeld

2016-01-01

This research review aims to focus attention on the effect of specific surgical and host factors on implant fixation, and the importance of accounting for them in experimental and numerical models. These factors affect (a) eventual clinical applicability and (b) reproducibility of findings across research groups. Proper function and longevity for orthopedic joint replacement implants relies on secure fixation to the surrounding bone. Technology and surgical technique has improved over the last 50 years, and robust ingrowth and decades of implant survival is now routinely achieved for healthy patients and first-time (primary) implantation. Second-time (revision) implantation presents with bone loss with interfacial bone gaps in areas vital for secure mechanical fixation. Patients with medical comorbidities such as infection, smoking, congestive heart failure, kidney disease, and diabetes have a diminished healing response, poorer implant fixation, and greater revision risk. It is these more difficult clinical scenarios that require research to evaluate more advanced treatment approaches. Such treatments can include osteogenic or antimicrobial implant coatings, allo- or autogenous cellular or tissue-based approaches, local and systemic drug delivery, surgical approaches. Regarding implant-related approaches, most experimental and numerical models do not generally impose conditions that represent mechanical instability at the implant interface, or recalcitrant healing. Many treatments will work well in forgiving settings, but fail in complex human settings with disease, bone loss, or previous surgery. Ethical considerations mandate that we justify and limit the number of animals tested, which restricts experimental permutations of treatments. Numerical models provide flexibility to evaluate multiple parameters and combinations, but generally need to employ simplifying assumptions. The objectives of this paper are to (a) to highlight the importance of mechanical

Can Clinical Scenario Videos Improve Dental Students' Perceptions of the Basic Sciences and Ability to Apply Content Knowledge?

PubMed

Miller, Cynthia Jayne; Metz, Michael James

2015-12-01

Dental students often have difficulty understanding the importance of basic science classes, such as physiology, for their future careers. To help alleviate this problem, the aim of this study was to create and evaluate a series of video modules using simulated patients and custom-designed animations that showcase medical emergencies in the dental practice. First-year students in a dental physiology course formatively assessed their knowledge using embedded questions in each of the three videos; 108 to 114 of the total 120 first-year students answered the questions, for a 90-95% response rate. These responses indicated that while the students could initially recognize the cause of the medical emergency, they had difficulty in applying their knowledge of physiology to the scenario. In two of the three videos, students drastically improved their ability to answer high-level clinical questions at the conclusion of the video. Additionally, when compared to the previous year of the course, there was a significant improvement in unit exam scores on clinically related questions (6.2% increase). Surveys were administered to the first-year students who participated in the video modules and fourth-year students who had completed the course prior to implementation of any clinical material. The response rate for the first-year students was 96% (115/120) and for the fourth-year students was 57% (68/120). The first-year students indicated a more positive perception of the physiology course and its importance for success on board examinations and their dental career than the fourth-year students. The students perceived that the most positive aspects of the modules were the clear applications of physiology to real-life dental situations, the interactive nature of the videos, and the improved student comprehension of course concepts. These results suggest that online modules may be used successfully to improve students' perceptions of the basic sciences and enhance their ability to

Nanosilver conductive ink: A case study for evaluating the potential risk of nanotechnology under hypothetical use scenarios.

PubMed

Martin, David P; Melby, Nicolas L; Jordan, Shinita M; Bednar, Anthony J; Kennedy, Alan J; Negrete, Maria E; Chappell, Mark A; Poda, Aimee R

2016-11-01

Engineered nanomaterials (ENMs) are being incorporated into a variety of consumer products due to unique properties that offer a variety of advantages over bulk materials. Understanding of the nano-specific risk associated with nano-enabled technologies, however, continues to lag behind research and development, registration with regulators, and commercialization. One example of a nano-enabled technology is nanosilver ink, which can be used in commercial ink-jet printers for the development of low-cost printable electronics. This investigation utilizes a tiered EHS framework to evaluate the potential nano-specific release, exposure and hazard associated with typical use of both nanosilver ink and printed circuits. The framework guides determination of the potential for ENM release from both forms of the technology in simulated use scenarios, including spilling of the ink, aqueous release (washing) from the circuits and UV light exposure. The as-supplied ink merits nano-specific consideration based on the presence of nanoparticles and their persistence in environmentally-relevant media. The material released from the printed circuits upon aqueous exposure was characterized by a number of analysis techniques, including ultracentrifugation and single particle ICP-MS, and the results suggest that a vast majority of the material was ionic in nature and nano-specific regulatory scrutiny may be less relevant. Published by Elsevier Ltd.

From hypothetical scenario to tragic reality: A salutary lesson in risk communication and the Victorian 2009 bushfires.

PubMed

Burns, Robin; Robinson, Priscilla; Smith, Penelope

2010-02-01

To investigate the ways that the risk of a bushfire emergency and communication strategies are perceived by different community segments. A brief questionnaire preceded focus group discussion of a bushfire scenario with four communications from different sources. Groups were recruited to represent different community segments within a bushfire-prone peri-urban Shire in Victoria. Four groups (28 participants) were recruited. Bushfire experience was highest in the over 40-year-olds, who would use a variety of information sources, preferred to receive information from trusted local sources, such as emergency services and the council, and were more likely to be a member of a local organisation than the under 40s. Younger people used television, local papers, and friends, family and neighbours as information sources. Young parents felt disempowered through lack of local knowledge, and trusted government departments less than older residents. All wanted clear, current, specific local information about ground conditions and actions to be taken during a fire outbreak. Knowledge of and preparedness for bushfire is unequally spread throughout a bushfire community. There is a need in public health risk and emergency situations to focus on community development, information and consultation. © 2010 The Authors. Journal Compilation © 2010 Public Health Association of Australia.

Usability evaluation of pharmacogenomics clinical decision support aids and clinical knowledge resources in a computerized provider order entry system: a mixed methods approach.

PubMed

Devine, Emily Beth; Lee, Chia-Ju; Overby, Casey L; Abernethy, Neil; McCune, Jeannine; Smith, Joe W; Tarczy-Hornoch, Peter

2014-07-01

Pharmacogenomics (PGx) is positioned to have a widespread impact on the practice of medicine, yet physician acceptance is low. The presentation of context-specific PGx information, in the form of clinical decision support (CDS) alerts embedded in a computerized provider order entry (CPOE) system, can aid uptake. Usability evaluations can inform optimal design, which, in turn, can spur adoption. The study objectives were to: (1) evaluate an early prototype, commercial CPOE system with PGx-CDS alerts in a simulated environment, (2) identify potential improvements to the system user interface, and (3) understand the contexts under which PGx knowledge embedded in an electronic health record is useful to prescribers. Using a mixed methods approach, we presented seven cardiologists and three oncologists with five hypothetical clinical case scenarios. Each scenario featured a drug for which a gene encoding drug metabolizing enzyme required consideration of dosage adjustment. We used Morae(®) to capture comments and on-screen movements as participants prescribed each drug. In addition to PGx-CDS alerts, 'Infobutton(®)' and 'Evidence' icons provided participants with clinical knowledge resources to aid decision-making. Nine themes emerged. Five suggested minor improvements to the CPOE user interface; two suggested presenting PGx information through PGx-CDS alerts using an 'Infobutton' or 'Evidence' icon. The remaining themes were strong recommendations to provide succinct, relevant guidelines and dosing recommendations of phenotypic information from credible and trustworthy sources; any more information was overwhelming. Participants' median rating of PGx-CDS system usability was 2 on a Likert scale ranging from 1 (strongly agree) to 7 (strongly disagree). Usability evaluation results suggest that participants considered PGx information important for improving prescribing decisions; and that they would incorporate PGx-CDS when information is presented in relevant and

Evaluating the expected effects of disclosure of patient safety incidents using hypothetical cases in Korea.

PubMed

Ock, Minsu; Choi, Eun Young; Jo, Min-Woo; Lee, Sang-Il

2018-01-01

To introduce disclosure of patient safety incidents (DPSI) into a specific country, evidence of the effectiveness of DPSI is essential. Since such a disclosure policy has not been adopted in South Korea, hypothetical cases can be used to measure the effectiveness of DPSI. We evaluated the effectiveness of DPSI using hypothetical cases in a survey with a sample of the Korean general public. We used 8 hypothetical cases reflecting 3 conditions: the clarity of medical errors, the severity of harm, and conducting DPSI. Face-to-face interviews with 700 people using structured questionnaires were conducted. Participants were asked to read each hypothetical case and give remarks on the following: their judgment of a situation as a medical error and of the requirement for an apology, the willingness to revisit or recommend physicians, the intention to file a medical lawsuit and commence criminal proceedings against physicians, the level of trust in physicians, and the expected amount of compensation. The results indicated favorable findings in support of DPSI; DPSI reduced the likelihood of perceiving a situation as a medical error, promoted willingness to revisit and recommend physicians, and discouraged the intention to file a medical lawsuit and take commence criminal proceedings against physicians. Furthermore, DPSI increased patients' trust scores in physicians and reduced the expected amount of compensation. The general public had positive attitudes towards DPSI in South Korea. This result provides empirical evidence for reducing the psychological burden that the introduction of DPSI may have on health professionals.

Reinforcing value and hypothetical behavioral economic demand for food and their relation to BMI.

PubMed

Epstein, Leonard H; Paluch, Rocco A; Carr, Katelyn A; Temple, Jennifer L; Bickel, Warren K; MacKillop, James

2018-04-01

Food is a primary reinforcer, and food reinforcement is related to obesity. The reinforcing value of food can be measured by establishing how hard someone will work to get food on progressive-ratio schedules. An alternative way to measure food reinforcement is a hypothetical purchase task which creates behavioral economic demand curves. This paper studies whether reinforcing value and hypothetical behavioral demand approaches are assessing the same or unique aspects of food reinforcement for low (LED) and high (HED) energy density foods using a combination of analytic approaches in females of varying BMI. Results showed absolute reinforcing value for LED and HED foods and relative reinforcing value were related to demand intensity (r's = 0.20-0.30, p's < 0.01), and demand elasticity (r's = 0.17-0.22, p's < 0.05). Correlations between demographic, BMI and restraint, disinhibition and hunger variables with the two measures of food reinforcement were different. Finally, the two measures provided unique contributions to predicting BMI. Potential reasons for differences between the reinforcing value and hypothetical purchase tasks were actual responding versus hypothetical purchasing, choice of reinforcers versus purchasing of individual foods in the demand task, and the differential role of effort in the two tasks. Examples of how a better understanding of food reinforcement may be useful to prevent or treat obesity are discussed, including engaging in alternative non-food reinforcers as substitutes for food, such as crafts or socializing in a non-food environment, and reducing the value of immediate food reinforcers by episodic future thinking. Copyright © 2018. Published by Elsevier Ltd.

The hypothetical protein Atu4866 from Agrobacterium tumefaciens adopts a streptavidin-like fold

PubMed Central

Ai, Xuanjun; Semesi, Anthony; Yee, Adelinda; Arrowsmith, Cheryl H.; Choy, Wing-Yiu; Li, Shawn S.C.

2008-01-01

Atu4866 is a 79-residue conserved hypothetical protein of unknown function from Agrobacterium tumefaciens. Protein sequence alignments show that it shares ≥60% sequence identity with 20 other hypothetical proteins of bacterial origin. However, the structures and functions of these proteins remain unknown so far. To gain insight into the function of this family of proteins, we have determined the structure of Atu4866 as a target of a structural genomics project using solution NMR spectroscopy. Our results reveal that Atu4866 adopts a streptavidin-like fold featuring a β-barrel/sandwich formed by eight antiparallel β-strands. Further structural analysis identified a continuous patch of conserved residues on the surface of Atu4866 that may constitute a potential ligand-binding site. PMID:18042676

Conflict Resolution among Preschool Children: The Appeal of Negotiation in Hypothetical Disputes.

ERIC Educational Resources Information Center

Iskandar, Niveen; And Others

1995-01-01

Using hypothetical puppet interviews, 48 preschool children were interviewed about their preferences for teacher methods of conflict intervention. Puppet vignettes contrasted conflict issue, peer status, and resolution strategy (negotiation, power assertion, and disengagement). Results showed that preschoolers preferred negotiation strategies over…

Identifying patients and clinical scenarios for use of long-acting injectable antipsychotics - expert consensus survey part 1.

PubMed

Sajatovic, Martha; Ross, Ruth; Legacy, Susan N; Correll, Christoph U; Kane, John M; DiBiasi, Faith; Fitzgerald, Heather; Byerly, Matthew

2018-01-01

To assess expert consensus on barriers and facilitators for long-acting injectable antipsychotic (LAI) use and provide clinical recommendations on issues where clinical evidence is lacking, including identifying appropriate clinical situations for LAI use. A 50-question survey comprising 916 response options was distributed to 42 research experts and high prescribers with extensive LAI experience. Respondents rated options on relative appropriateness/importance using a 9-point scale. Consensus was determined using chi-square test of score distributions. Mean (standard deviation) ratings were calculated. Responses to 29 questions (577 options) relating to appropriate patients and clinical scenarios for LAI use are reported. Recommendations aligned with research on risk factors for nonadherence and poor outcomes for patients with schizophrenia/schizoaffective or bipolar disorder. Findings suggested, contrary to general practice patterns, that LAI use may be appropriate earlier in the disease course and in younger patients. Results for bipolar disorder were similar to those for schizophrenia but with less consensus. Numerous facilitators of LAI prescribing were considered important, particularly that LAIs may reduce relapses and improve outcomes. Findings support wider use of LAIs in patients with schizophrenia/schizoaffective and bipolar disorders beyond the setting of poor adherence and earlier use in the disease course.

Environmental sustainability comparison of a hypothetical pneumatic waste collection system and a door-to-door system.

PubMed

Punkkinen, Henna; Merta, Elina; Teerioja, Nea; Moliis, Katja; Kuvaja, Eveliina

2012-10-01

Waste collection is one of the life cycle phases that influence the environmental sustainability of waste management. Pneumatic waste collection systems represent a new way of arranging waste collection in densely populated urban areas. However, limited information is available on the environmental impacts of this system. In this study, we compare the environmental sustainability of conventional door-to-door waste collection with its hypothetical pneumatic alternative. Furthermore, we analyse whether the size of the hypothetical pneumatic system, or the number of waste fractions included, have an impact on the results. Environmental loads are calculated for a hypothetical pneumatic waste collection system modelled on an existing dense urban area in Helsinki, Finland, and the results are compared to those of the prevailing, container-based, door-to-door waste collection system. The evaluation method used is the life-cycle inventory (LCI). In this study, we report the atmospheric emissions of greenhouse gases (GHG), SO(2) and NO(x). The results indicate that replacing the prevailing system with stationary pneumatic waste collection in an existing urban infrastructure would increase total air emissions. Locally, in the waste collection area, emissions would nonetheless diminish, as collection traffic decreases. While the electricity consumption of the hypothetical pneumatic system and the origin of electricity have a significant bearing on the results, emissions due to manufacturing the system's components prove decisive. Copyright © 2012 Elsevier Ltd. All rights reserved.

Willingness to receive a hypothetical avian influenza vaccine among US military personnel in mid-deployment.

PubMed

Porter, Chad K; Fitamaurice, Gina; Tribble, David R; Armstrong, Adam W; Mostafa, Manal; Riddle, Mark S

2013-12-01

Though no avian influenza vaccine currently exists, development efforts have increased. Given recent reports of suboptimal vaccination rates among US military personnel, we sought to assess factors associated with a willingness to receive a hypothetical avian influenza vaccine. A self-administered questionnaire was completed by US military personnel during mid-deployment to Iraq, Afghanistan, and surrounding regions. Respondents were predominately male (86.2%), Army (72.1%), and enlisted (86.3%) with a mean age of 29.6 y. The majority (77.1%) agreed to receive an avian influenza vaccine if available. Exploratory factor analysis (EFA) identified two factors, vaccine importance and disease risk, that best described the individual perceptions and both were associated with an increased willingness to receive the hypothetical vaccine (OR: 8.2 and 1.6, respectively). Importantly, after controlling for these factors differences in the willingness to receive this hypothetical vaccine were observed across gender and branch of service. These results indicated that targeted education on vaccine safety and efficacy as well as disease risk may modify vaccination patterns in this population.

Willingness to receive a hypothetical avian influenza vaccine among US military personnel in mid-deployment

PubMed Central

Porter, Chad K; Fitamaurice, Gina; Tribble, David R; Armstrong, Adam W; Mostafa, Manal; Riddle, Mark S

2013-01-01

Though no avian influenza vaccine currently exists, development efforts have increased. Given recent reports of suboptimal vaccination rates among US military personnel, we sought to assess factors associated with a willingness to receive a hypothetical avian influenza vaccine. A self-administered questionnaire was completed by US military personnel during mid-deployment to Iraq, Afghanistan, and surrounding regions. Respondents were predominately male (86.2%), Army (72.1%), and enlisted (86.3%) with a mean age of 29.6 y. The majority (77.1%) agreed to receive an avian influenza vaccine if available. Exploratory factor analysis (EFA) identified two factors, vaccine importance and disease risk, that best described the individual perceptions and both were associated with an increased willingness to receive the hypothetical vaccine (OR: 8.2 and 1.6, respectively). Importantly, after controlling for these factors differences in the willingness to receive this hypothetical vaccine were observed across gender and branch of service. These results indicated that targeted education on vaccine safety and efficacy as well as disease risk may modify vaccination patterns in this population. PMID:23917256

Dark scenarios

NASA Astrophysics Data System (ADS)

Ahonen, Pasi; Alahuhta, Petteri; Daskala, Barbara; Delaitre, Sabine; Hert, Paul De; Lindner, Ralf; Maghiros, Ioannis; Moscibroda, Anna; Schreurs, Wim; Verlinden, Michiel

In this chapter, we present four "dark scenarios" that highlight the key socio-economic, legal, technological and ethical risks to privacy, identity, trust, security and inclusiveness posed by new AmI technologies. We call them dark scenarios, because they show things that could go wrong in an AmI world, because they present visions of the future that we do not want to become reality. The scenarios expose threats and vulnerabilities as a way to inform policy-makers and planners about issues they need to take into account in developing new policies or updating existing legislation. Before presenting the four scenarios and our analysis of each, we describe the process of how we created the scenarios as well as the elements in our methodology for analysing the scenarios.

Statistical equivalence and test-retest reliability of delay and probability discounting using real and hypothetical rewards.

PubMed

Matusiewicz, Alexis K; Carter, Anne E; Landes, Reid D; Yi, Richard

2013-11-01

Delay discounting (DD) and probability discounting (PD) refer to the reduction in the subjective value of outcomes as a function of delay and uncertainty, respectively. Elevated measures of discounting are associated with a variety of maladaptive behaviors, and confidence in the validity of these measures is imperative. The present research examined (1) the statistical equivalence of discounting measures when rewards were hypothetical or real, and (2) their 1-week reliability. While previous research has partially explored these issues using the low threshold of nonsignificant difference, the present study fully addressed this issue using the more-compelling threshold of statistical equivalence. DD and PD measures were collected from 28 healthy adults using real and hypothetical $50 rewards during each of two experimental sessions, one week apart. Analyses using area-under-the-curve measures revealed a general pattern of statistical equivalence, indicating equivalence of real/hypothetical conditions as well as 1-week reliability. Exceptions are identified and discussed. Copyright © 2013 Elsevier B.V. All rights reserved.

An activity theory perspective of how scenario-based simulations support learning: a descriptive analysis.

PubMed

Battista, Alexis

2017-01-01

The dominant frameworks for describing how simulations support learning emphasize increasing access to structured practice and the provision of feedback which are commonly associated with skills-based simulations. By contrast, studies examining student participants' experiences during scenario-based simulations suggest that learning may also occur through participation. However, studies directly examining student participation during scenario-based simulations are limited. This study examined the types of activities student participants engaged in during scenario-based simulations and then analyzed their patterns of activity to consider how participation may support learning. Drawing from Engeström's first-, second-, and third-generation activity systems analysis, an in-depth descriptive analysis was conducted. The study drew from multiple qualitative methods, namely narrative, video, and activity systems analysis, to examine student participants' activities and interaction patterns across four video-recorded simulations depicting common motivations for using scenario-based simulations (e.g., communication, critical patient management). The activity systems analysis revealed that student participants' activities encompassed three clinically relevant categories, including (a) use of physical clinical tools and artifacts, (b) social interactions, and (c) performance of structured interventions. Role assignment influenced participants' activities and the complexity of their engagement. Importantly, participants made sense of the clinical situation presented in the scenario by reflexively linking these three activities together. Specifically, student participants performed structured interventions, relying upon the use of physical tools, clinical artifacts, and social interactions together with interactions between students, standardized patients, and other simulated participants to achieve their goals. When multiple student participants were present, such as in a

Challenging evidence-based decision-making: a hypothetical case study about return to work.

PubMed

Aas, Randi W; Alexanderson, Kristina

2012-03-01

A hypothetical case study about return to work was used to explore the process of translating research into practice. The method involved constructing a case study derived from the characteristics of a typical, sick-listed employee with non-specific low back pain in Norway. Next, the five-step evidence-based process, including the Patient, Intervention, Co-Interventions and Outcome framework (PICO), was applied to the case study. An inductive analysis produced 10 technical and more fundamental challenges to incorporate research into intervention decisions for an individual with comorbidity. A more dynamic, interactive approach to the evidence-based practice process is proposed. It is recommended that this plus the 10 challenges are validated with real life cases, as the hypothetical case study may not be replicable. Copyright © 2011 John Wiley & Sons, Ltd.

Testing the robustness of management decisions to uncertainty: Everglades restoration scenarios.

PubMed

Fuller, Michael M; Gross, Louis J; Duke-Sylvester, Scott M; Palmer, Mark

2008-04-01

To effectively manage large natural reserves, resource managers must prepare for future contingencies while balancing the often conflicting priorities of different stakeholders. To deal with these issues, managers routinely employ models to project the response of ecosystems to different scenarios that represent alternative management plans or environmental forecasts. Scenario analysis is often used to rank such alternatives to aid the decision making process. However, model projections are subject to uncertainty in assumptions about model structure, parameter values, environmental inputs, and subcomponent interactions. We introduce an approach for testing the robustness of model-based management decisions to the uncertainty inherent in complex ecological models and their inputs. We use relative assessment to quantify the relative impacts of uncertainty on scenario ranking. To illustrate our approach we consider uncertainty in parameter values and uncertainty in input data, with specific examples drawn from the Florida Everglades restoration project. Our examples focus on two alternative 30-year hydrologic management plans that were ranked according to their overall impacts on wildlife habitat potential. We tested the assumption that varying the parameter settings and inputs of habitat index models does not change the rank order of the hydrologic plans. We compared the average projected index of habitat potential for four endemic species and two wading-bird guilds to rank the plans, accounting for variations in parameter settings and water level inputs associated with hypothetical future climates. Indices of habitat potential were based on projections from spatially explicit models that are closely tied to hydrology. For the American alligator, the rank order of the hydrologic plans was unaffected by substantial variation in model parameters. By contrast, simulated major shifts in water levels led to reversals in the ranks of the hydrologic plans in 24.1-30.6% of

USGS SAFRR Tsunami Scenario: Potential Impacts to the U.S. West Coast from a Plausible M9 Earthquake near the Alaska Peninsula

NASA Astrophysics Data System (ADS)

Ross, S.; Jones, L. M.; Wilson, R. I.; Bahng, B.; Barberopoulou, A.; Borrero, J. C.; Brosnan, D.; Bwarie, J. T.; Geist, E. L.; Johnson, L. A.; Hansen, R. A.; Kirby, S. H.; Knight, E.; Knight, W. R.; Long, K.; Lynett, P. J.; Miller, K. M.; Mortensen, C. E.; Nicolsky, D.; Oglesby, D. D.; Perry, S. C.; Porter, K. A.; Real, C. R.; Ryan, K. J.; Suleimani, E. N.; Thio, H. K.; Titov, V. V.; Wein, A. M.; Whitmore, P.; Wood, N. J.

2012-12-01

The U.S. Geological Survey's Science Application for Risk Reduction (SAFRR) project, in collaboration with the California Geological Survey, the California Emergency Management Agency, the National Oceanic and Atmospheric Administration, and other agencies and institutions are developing a Tsunami Scenario to describe in detail the impacts of a tsunami generated by a hypothetical, but realistic, M9 earthquake near the Alaska Peninsula. The overarching objective of SAFRR and its predecessor, the Multi-Hazards Demonstration Project, is to help communities reduce losses from natural disasters. As requested by emergency managers and other community partners, a primary approach has been comprehensive, scientifically credible scenarios that start with a model of a geologic event and extend through estimates of damage, casualties, and societal consequences. The first product was the ShakeOut scenario, addressing a hypothetical earthquake on the southern San Andreas fault, that spawned the successful Great California ShakeOut, an annual event and the nation's largest emergency preparedness exercise. That was followed by the ARkStorm scenario, which addresses California winter storms that surpass hurricanes in their destructive potential. Some of the Tsunami Scenario's goals include developing advanced models of currents and inundation for the event; spurring research related to Alaskan earthquake sources; engaging the port and harbor decision makers; understanding the economic impacts to local, regional and national economy in both the short and long term; understanding the ecological, environmental, and societal impacts of coastal inundation; and creating enhanced communication products for decision-making before, during, and after a tsunami event. The state of California, through CGS and Cal EMA, is using the Tsunami Scenario as an opportunity to evaluate policies regarding tsunami impact. The scenario will serve as a long-lasting resource to teach preparedness and

Event-based knowledge elicitation of operating room management decision-making using scenarios adapted from information systems data

PubMed Central

2011-01-01

Background No systematic process has previously been described for a needs assessment that identifies the operating room (OR) management decisions made by the anesthesiologists and nurse managers at a facility that do not maximize the efficiency of use of OR time. We evaluated whether event-based knowledge elicitation can be used practically for rapid assessment of OR management decision-making at facilities, whether scenarios can be adapted automatically from information systems data, and the usefulness of the approach. Methods A process of event-based knowledge elicitation was developed to assess OR management decision-making that may reduce the efficiency of use of OR time. Hypothetical scenarios addressing every OR management decision influencing OR efficiency were created from published examples. Scenarios are adapted, so that cues about conditions are accurate and appropriate for each facility (e.g., if OR 1 is used as an example in a scenario, the listed procedure is a type of procedure performed at the facility in OR 1). Adaptation is performed automatically using the facility's OR information system or anesthesia information management system (AIMS) data for most scenarios (43 of 45). Performing the needs assessment takes approximately 1 hour of local managers' time while they decide if their decisions are consistent with the described scenarios. A table of contents of the indexed scenarios is created automatically, providing a simple version of problem solving using case-based reasoning. For example, a new OR manager wanting to know the best way to decide whether to move a case can look in the chapter on "Moving Cases on the Day of Surgery" to find a scenario that describes the situation being encountered. Results Scenarios have been adapted and used at 22 hospitals. Few changes in decisions were needed to increase the efficiency of use of OR time. The few changes were heterogeneous among hospitals, showing the usefulness of individualized assessments

Event-based knowledge elicitation of operating room management decision-making using scenarios adapted from information systems data.

PubMed

Dexter, Franklin; Wachtel, Ruth E; Epstein, Richard H

2011-01-07

No systematic process has previously been described for a needs assessment that identifies the operating room (OR) management decisions made by the anesthesiologists and nurse managers at a facility that do not maximize the efficiency of use of OR time. We evaluated whether event-based knowledge elicitation can be used practically for rapid assessment of OR management decision-making at facilities, whether scenarios can be adapted automatically from information systems data, and the usefulness of the approach. A process of event-based knowledge elicitation was developed to assess OR management decision-making that may reduce the efficiency of use of OR time. Hypothetical scenarios addressing every OR management decision influencing OR efficiency were created from published examples. Scenarios are adapted, so that cues about conditions are accurate and appropriate for each facility (e.g., if OR 1 is used as an example in a scenario, the listed procedure is a type of procedure performed at the facility in OR 1). Adaptation is performed automatically using the facility's OR information system or anesthesia information management system (AIMS) data for most scenarios (43 of 45). Performing the needs assessment takes approximately 1 hour of local managers' time while they decide if their decisions are consistent with the described scenarios. A table of contents of the indexed scenarios is created automatically, providing a simple version of problem solving using case-based reasoning. For example, a new OR manager wanting to know the best way to decide whether to move a case can look in the chapter on "Moving Cases on the Day of Surgery" to find a scenario that describes the situation being encountered. Scenarios have been adapted and used at 22 hospitals. Few changes in decisions were needed to increase the efficiency of use of OR time. The few changes were heterogeneous among hospitals, showing the usefulness of individualized assessments. Our technical advance is the

Choices of wilderness environments -- differences between real and hypothetical choice situations

Treesearch

Jean T. Beaulieu; Richard Schreyer

1985-01-01

Factors considered most critical in selecting a specific wilderness environment in which to recreate are likely to vary depending upon the type of environment involved, the range and extent of experience of the recreationists, and the situational context of the decision (whether a real or a hypothetical decision was made). This study examines differences in factors...

The ShakeOut Earthquake Scenario - A Story That Southern Californians Are Writing

USGS Publications Warehouse

Perry, Suzanne; Cox, Dale; Jones, Lucile; Bernknopf, Richard; Goltz, James; Hudnut, Kenneth; Mileti, Dennis; Ponti, Daniel; Porter, Keith; Reichle, Michael; Seligson, Hope; Shoaf, Kimberley; Treiman, Jerry; Wein, Anne

2008-01-01

The question is not if but when southern California will be hit by a major earthquake - one so damaging that it will permanently change lives and livelihoods in the region. How severe the changes will be depends on the actions that individuals, schools, businesses, organizations, communities, and governments take to get ready. To help prepare for this event, scientists of the U.S. Geological Survey (USGS) have changed the way that earthquake scenarios are done, uniting a multidisciplinary team that spans an unprecedented number of specialties. The team includes the California Geological Survey, Southern California Earthquake Center, and nearly 200 other partners in government, academia, emergency response, and industry, working to understand the long-term impacts of an enormous earthquake on the complicated social and economic interactions that sustain southern California society. This project, the ShakeOut Scenario, has applied the best current scientific understanding to identify what can be done now to avoid an earthquake catastrophe. More information on the science behind this project will be available in The ShakeOut Scenario (USGS Open-File Report 2008-1150; http://pubs.usgs.gov/of/2008/1150/). The 'what if?' earthquake modeled in the ShakeOut Scenario is a magnitude 7.8 on the southern San Andreas Fault. Geologists selected the details of this hypothetical earthquake by considering the amount of stored strain on that part of the fault with the greatest risk of imminent rupture. From this, seismologists and computer scientists modeled the ground shaking that would occur in this earthquake. Engineers and other professionals used the shaking to produce a realistic picture of this earthquake's damage to buildings, roads, pipelines, and other infrastructure. From these damages, social scientists projected casualties, emergency response, and the impact of the scenario earthquake on southern California's economy and society. The earthquake, its damages, and

Testing the effectiveness of certainty scales, cheap talk, and dissonance-minimization in reducing hypothetical bias in contingent valuation studies

Treesearch

Mark Morrison; Thomas C. Brown

2009-01-01

Stated preference methods such as contingent valuation and choice modeling are subject to various biases that may lead to differences between actual and hypothetical willingness to pay. Cheap talk, follow-up certainty scales, and dissonance minimization are three techniques for reducing this hypothetical bias. Cheap talk and certainty scales have received considerable...

Scenario planning.

PubMed

Enzmann, Dieter R; Beauchamp, Norman J; Norbash, Alexander

2011-03-01

In facing future developments in health care, scenario planning offers a complementary approach to traditional strategic planning. Whereas traditional strategic planning typically consists of predicting the future at a single point on a chosen time horizon and mapping the preferred plans to address such a future, scenario planning creates stories about multiple likely potential futures on a given time horizon and maps the preferred plans to address the multiple described potential futures. Each scenario is purposefully different and specifically not a consensus worst-case, average, or best-case forecast; nor is scenario planning a process in probabilistic prediction. Scenario planning focuses on high-impact, uncertain driving forces that in the authors' example affect the field of radiology. Uncertainty is the key concept as these forces are mapped onto axes of uncertainty, the poles of which have opposed effects on radiology. One chosen axis was "market focus," with poles of centralized health care (government control) vs a decentralized private market. Another axis was "radiology's business model," with one pole being a unified, single specialty vs a splintered, disaggregated subspecialty. The third axis was "technology and science," with one pole representing technology enabling to radiology vs technology threatening to radiology. Selected poles of these axes were then combined to create 3 scenarios. One scenario, termed "entrepreneurialism," consisted of a decentralized private market, a disaggregated business model, and threatening technology and science. A second scenario, termed "socialized medicine," had a centralized market focus, a unified specialty business model, and enabling technology and science. A third scenario, termed "freefall," had a centralized market focus, a disaggregated business model, and threatening technology and science. These scenarios provide a range of futures that ultimately allow the identification of defined "signposts" that can

Scenario management and automated scenario generation

NASA Astrophysics Data System (ADS)

McKeever, William; Gilmour, Duane; Lehman, Lynn; Stirtzinger, Anthony; Krause, Lee

2006-05-01

The military planning process utilizes simulation to determine the appropriate course of action (COA) that will achieve a campaign end state. However, due to the difficulty in developing and generating simulation level COAs, only a few COAs are simulated. This may have been appropriate for traditional conflicts but the evolution of warfare from attrition based to effects based strategies, as well as the complexities of 4 th generation warfare and asymmetric adversaries have placed additional demands on military planners and simulation. To keep pace with this dynamic, changing environment, planners must be able to perform continuous, multiple, "what-if" COA analysis. Scenario management and generation are critical elements to achieving this goal. An effects based scenario generation research project demonstrated the feasibility of automated scenario generation techniques which support multiple stove-pipe and emerging broad scope simulations. This paper will discuss a case study in which the scenario generation capability was employed to support COA simulations to identify plan effectiveness. The study demonstrated the effectiveness of using multiple simulation runs to evaluate the effectiveness of alternate COAs in achieving the overall campaign (metrics-based) objectives. The paper will discuss how scenario generation technology can be employed to allow military commanders and mission planning staff to understand the impact of command decisions on the battlespace of tomorrow.

Perceptions of, and assistance provided to, a hypothetical rape victim: differences between rape disclosure recipients and nonrecipients.

PubMed

Paul, Lisa A; Kehn, Andre; Gray, Matt J; Salapska-Gelleri, Joanna

2014-01-01

Undergraduate rape disclosure recipients' and nonrecipients' sociodemographic and life experience variables, attitudes towards rape, and responses to a hypothetical rape disclosure were compared to determine differences between them. One hundred ninety-two undergraduates at 3 universities participated in this online survey between November 2011 and April 2012. Participants reported on their rape myth acceptance (RMA) and personal direct and indirect (ie, disclosure receipt) experiences with sexual assault. Participants also responded to a hypothetical rape disclosure. Disclosure recipients were more likely to report a victimization history, and less confusion and perceived ineffectiveness in helping the hypothetical victim. RMA and nonrecipient status predicted perceived victim responsibility; these variables and childhood victimization predicted confusion about helping. RMA also predicted perceived ineffectiveness of one's helping behaviors. Victimization history and female gender predicted victim empathy. These findings can inform sexual assault-related programming for undergraduates through the provision of targeted assistance and corrective information.

Physicians' Initial Forensic Impressions of Hypothetical Cases of Pediatric Traumatic Brain Injury

ERIC Educational Resources Information Center

Laskey, Antoinette L.; Sheridan, Michael J.; Hymel, Kent P.

2007-01-01

Objective: To describe physicians' initial forensic impressions of hypothetical cases of pediatric traumatic brain injury (TBI) and to compare the responses of pathologists and pediatricians. Method: A survey was administered to physicians who attended workshops on pediatric TBI; were members of two national internet list serves; and were members…

The SAFRR tsunami scenario-physical damage in California: Chapter E in The SAFRR (Science Application for Risk Reduction) Tsunami Scenario

USGS Publications Warehouse

Porter, Keith; Byers, William; Dykstra, David; Lim, Amy; Lynett, Patrick; Ratliff, Jaime; Scawthorn, Charles; Wein, Anne; Wilson, Rick

2013-01-01

his chapter attempts to depict a single realistic outcome of the SAFRR (Science Application for Risk Reduction) tsunami scenario in terms of physical damage to and recovery of various aspects of the built environment in California. As described elsewhere in this report, the tsunami is generated by a hypothetical magnitude 9.1 earthquake seaward of the Alaska Peninsula on the Semidi Sector of the Alaska–Aleutian Subduction Zone, 495 miles southwest of Anchorage, at 11:50 a.m. Pacific Daylight Time (PDT) on Thursday March 27, 2014, and arriving at the California coast between 4:00 and 5:40 p.m. (depending on location) the same day. Although other tsunamis could have locally greater impact, this source represents a substantial threat to the state as a whole. One purpose of this chapter is to help operators and users of coastal assets throughout California to develop emergency plans to respond to a real tsunami. Another is to identify ways that operators or owners of these assets can think through options for reducing damage before a future tsunami. A third is to inform the economic analyses for the SAFRR tsunami scenario. And a fourth is to identify research needs to better understand the possible consequences of a tsunami on these assets. The asset classes considered here include the following: Piers, cargo, buildings, and other assets at the Ports of Los Angeles and Long Beach Large vessels in the Ports of Los Angeles and Long Beach Marinas and small craft Coastal buildings Roads and roadway bridges Rail, railway bridges, and rolling stock Agriculture Fire following tsunami Each asset class is examined in a subsection of this chapter. In each subsection, we generally attempt to offer a historical review of damage. We characterize and quantify the assets exposed to loss and describe the modes of damage that have been observed in past tsunamis or are otherwise deemed likely to occur in the SAFRR tsunami scenario. Where practical, we offer a mathematical model of the

Energy Considerations of Hypothetical Space Drives

NASA Technical Reports Server (NTRS)

Millis, Marc G.

2007-01-01

The energy requirements of hypothetical, propellant-less space drives are compared to rockets. This serves to provide introductory estimates for potential benefits and to suggest analytical approaches for further study. A "space drive" is defined as an idealized form of propulsion that converts stored potential energy directly into kinetic energy using only the interactions between the spacecraft and its surrounding space. For Earth-to-orbit, the space drive uses 3.7 times less energy. For deep space travel, energy is proportional to the square of delta-v, whereas rocket energy scales exponentially. This has the effect of rendering a space drive 150-orders-of-magnitude better than a 17,000-s Specific Impulse rocket for sending a modest 5000 kg probe to traverse 5 ly in 50 years. Indefinite levitation, which is impossible for a rocket, could conceivably require 62 MJ/kg for a space drive. Assumption sensitivities and further analysis options are offered to guide further inquires.

Is talk "cheap"? An initial investigation of the equivalence of alcohol purchase task performance for hypothetical and actual rewards.

PubMed

Amlung, Michael T; Acker, John; Stojek, Monika K; Murphy, James G; MacKillop, James

2012-04-01

Behavioral economic alcohol purchase tasks (APTs) are self-report measures of alcohol demand that assess estimated consumption at escalating levels of price. However, the relationship between estimated performance for hypothetical outcomes and choices for actual outcomes has not been determined. The present study examined both the correspondence between choices for hypothetical and actual outcomes, and the correspondence between estimated alcohol consumption and actual drinking behavior. A collateral goal of the study was to examine the effects of alcohol cues on APT performance. Forty-one heavy-drinking adults (56% men) participated in a human laboratory protocol comprising APTs for hypothetical and actual alcohol and money, an alcohol cue reactivity paradigm, an alcohol self-administration period, and a recovery period. Pearson correlations revealed very high correspondence between APT performance for hypothetical and actual alcohol (ps < 0.001). Estimated consumption on the APT was similarly strongly associated with actual consumption during the self-administration period (r = 0.87, p < 0.001). Exposure to alcohol cues significantly increased subjective craving and arousal and had a trend-level effect on intensity of demand, in spite of notable ceiling effects. Associations among motivational indices were highly variable, suggesting multidimensionality. These results suggest there may be close correspondence both between value preferences for hypothetical alcohol and actual alcohol, and between estimated consumption and actual consumption. Methodological considerations and priorities for future studies are discussed. Copyright © 2011 by the Research Society on Alcoholism.

Effects of disclosing financial interests on attitudes toward clinical research.

PubMed

Weinfurt, Kevin P; Hall, Mark A; Dinan, Michaela A; DePuy, Venita; Friedman, Joëlle Y; Allsbrook, Jennifer S; Sugarman, Jeremy

2008-06-01

The effects of disclosing financial interests to potential research participants are not well understood. To examine the effects of financial interest disclosures on potential research participants' attitudes toward clinical research. Computerized experiment conducted with 3,623 adults in the United States with either diabetes mellitus or asthma, grouped by lesser and greater severity. Respondents read a description of a hypothetical clinical trial relevant to their diagnosis that included a financial disclosure statement. Respondents received 1 of 5 disclosure statements. Willingness to participate in the hypothetical clinical trial, relative importance of information about the financial interest, change in trust after reading the disclosure statement, surprise regarding the financial interest, and perceived effect of the financial interest on the quality of the clinical trial. Willingness to participate in the hypothetical clinical trial did not differ substantially among the types of financial disclosures. Respondents viewed the disclosed information as less important than other factors in deciding to participate. Disclosures were associated with some respondents trusting the researchers less, although trust among some respondents increased. Most respondents were not surprised to learn of financial interests. Researchers owning equity were viewed as more troubling than researchers who were compensated for the costs of research through per capita payments. Aside from a researcher holding an equity interest, the disclosure to potential research participants of financial interests in research, as recommended in recent policies, is unlikely to affect willingness to participate in research.

Open Scenario Study: IDA Open Scenario Repository User’s Manual

DTIC Science & Technology

2010-01-01

Thomason, Study Co-Lead Zachary S. Rabold, Sub-Task Lead Ylli Bajraktari Rachel D. Dubin Mary Catherine Flythe Open Scenario Study: IDA Open Scenario... Bajraktari Rachel D. Dubin Mary Catherine Flythe Open Scenario Study: IDA Open Scenario Repository User’s Manual iii Preface This document reports the...vii Appendices A. Identifying Scenario Components...........................................................A-1 B . Acronyms

Improving the Past and the Future: A Temporal Asymmetry in Hypothetical Thinking

ERIC Educational Resources Information Center

Ferrante, Donatella; Girotto, Vittorio; Straga, Marta; Walsh, Clare

2013-01-01

Current views of hypothetical thinking implicitly assume that the content of imaginary thoughts about the past and future should be the same. Two experiments show that, given the same experienced facts of reality, future imagination may differ from past reconstruction. When participants failed a task, their counterfactual thoughts focused on…

33 CFR Appendix B to Part 277 - Hypothetical Example of Cost Apportionment

Code of Federal Regulations, 2013 CFR

2013-07-01

...) $165,489 I b. Fixed charges (owner's share) 284,460 II A fixed charge such as engineering, design and... new bridge is designed for increased loading and width greater than that of the old bridge. Therefore, the estimated annual maintenance cost was based on a hypothetical bridge designed, but not constructed...

33 CFR Appendix B to Part 277 - Hypothetical Example of Cost Apportionment

Code of Federal Regulations, 2014 CFR

2014-07-01

...) $165,489 I b. Fixed charges (owner's share) 284,460 II A fixed charge such as engineering, design and... new bridge is designed for increased loading and width greater than that of the old bridge. Therefore, the estimated annual maintenance cost was based on a hypothetical bridge designed, but not constructed...

33 CFR Appendix B to Part 277 - Hypothetical Example of Cost Apportionment

Code of Federal Regulations, 2010 CFR

2010-07-01

...) $165,489 I b. Fixed charges (owner's share) 284,460 II A fixed charge such as engineering, design and... new bridge is designed for increased loading and width greater than that of the old bridge. Therefore, the estimated annual maintenance cost was based on a hypothetical bridge designed, but not constructed...

33 CFR Appendix B to Part 277 - Hypothetical Example of Cost Apportionment

Code of Federal Regulations, 2011 CFR

2011-07-01

...) $165,489 I b. Fixed charges (owner's share) 284,460 II A fixed charge such as engineering, design and... new bridge is designed for increased loading and width greater than that of the old bridge. Therefore, the estimated annual maintenance cost was based on a hypothetical bridge designed, but not constructed...

33 CFR Appendix B to Part 277 - Hypothetical Example of Cost Apportionment

Code of Federal Regulations, 2012 CFR

2012-07-01

...) $165,489 I b. Fixed charges (owner's share) 284,460 II A fixed charge such as engineering, design and... new bridge is designed for increased loading and width greater than that of the old bridge. Therefore, the estimated annual maintenance cost was based on a hypothetical bridge designed, but not constructed...

Factors affecting the causality assessment of adverse events following immunisation in paediatric clinical trials: An online survey.

PubMed

Voysey, Merryn; Tavana, Rahele; Farooq, Yama; Heath, Paul T; Bonhoeffer, Jan; Snape, Matthew D

2015-12-16

Serious adverse events (SAEs) in clinical trials require reporting within 24h, including a judgment of whether the SAE was related to the investigational product(s). Such assessments are an important component of pharmacovigilance, however classification systems for assigning relatedness vary across study protocols. This on-line survey evaluated the consistency of SAE causality assessment among professionals with vaccine clinical trial experience. Members of the clinical advisory forum of experts (CAFÉ), a Brighton Collaboration online-forum, were emailed a survey containing SAEs from hypothetical vaccine trials which they were asked to classify. Participants were randomised to either two classification options (related/not related to study immunisation) or three options (possibly/probably/unrelated). The clinical scenarios, were (i) leukaemia diagnosed 5 months post-immunisation with a live RSV vaccine, (ii) juvenile idiopathic arthritis (JIA) 3 months post-immunisation with a group A streptococcal vaccine, (iii) developmental delay diagnosed at age 10 months after infant capsular group B meningococcal vaccine, (iv) developmental delay diagnosed at age 10 months after maternal immunisation with a group B streptococcal vaccine. There were 140 respondents (72 two options, 68 three options). Across all respondents, SAEs were considered related to study immunisation by 28% (leukaemia), 74% (JIA), 29% (developmental delay after infant immunisation) and 42% (developmental delay after maternal immunisation). Having only two options made respondents significantly less likely to classify the SAE as immunisation-related for two scenarios (JIA p=0.0075; and maternal immunisation p=0.045). Amongst study investigators (n=43) this phenomenon was observed for three of the four scenarios: (JIA p=0.0236; developmental delay following infant immunisation p=0.0266; and developmental delay after maternal immunisation p=0.0495). SAE causality assessment is inconsistent amongst study

Role of gender norms and group identification on hypothetical and experimental pain tolerance.

PubMed

Pool, Gregory J; Schwegler, Andria F; Theodore, Brian R; Fuchs, Perry N

2007-05-01

Previous research indicates that men typically tolerate more pain in experimental settings than women. One likely explanation for these group differences in pain tolerance is conformity to traditional, gender group social norms (i.e., the ideal man is masculine and tolerates more pain; the ideal woman is feminine and tolerates less pain). According to self-categorization theory, norms guide behavior to the degree that group members adopt the group identity. Therefore, high-identifying men are expected to conform to gender norms and tolerate more pain than high-identifying women who conform to different gender norms as a guide for their behavior. We conducted two studies to investigate whether gender group identification moderates individuals' conformity to pain tolerance and reporting norms. In the first study, participants indicated their gender identification and expected tolerance of a hypothetical painful stimulus. As anticipated, high-identifying men reported significantly greater pain tolerance than high-identifying women. No differences existed between low-identifying men and women. To determine if self-reported pain tolerance in a role-playing scenario corresponds to actual pain tolerance in an experimental setting, the second study examined pain tolerance to a noxious stimulus induced by electrical stimulation of the index finger. The experimental outcome revealed that high-identifying men tolerated more painful stimulation than high-identifying women. Further, high-identifying men tolerated more pain than low-identifying men. These results highlight the influence of social norms on behavior and suggest the need to further explore the role of norms in pain reporting behaviors.

A hypothetical complex between crystalline flavocytochrome b2 and cytochrome c.

PubMed

Tegoni, M; White, S A; Roussel, A; Mathews, F S; Cambillau, C

1993-08-01

Flavocytochrome b2 and cytochrome c are physiological electron transfer partners in yeast mitochondria. The formation of a stable complex between them has been demonstrated both in solution and in the crystalline state. On the basis of the three-dimensional structures, using molecular modeling and energy minimization, we have generated a hypothetical model for the interaction of these redox partners in the crystal lattice. General criteria such as good charge and surface complementarity, plausible orientation, and separation distance of the prosthetic groups, as well as more specific criteria such as the stoichiometry determined in the crystal, and the involvement of both domains and of more than one subunit of flavocytochrome b2 led us to discriminate between several possible interaction sites. In the hypothetical model we present, four cytochrome c molecules interact with a tetramer of flavocytochrome b2. The b2 and c hemes are coplanar, with an edge-to-edge distance of 14 A. The contact surface area is ca. 800 A2. Several electrostatic interactions involving the flavin and the heme domains of flavocytochrome b2 stabilize the binding of cytochrome c.

Perceptions of, and Assistance Provided to, a Hypothetical Rape Victim: Differences Between Rape Disclosure Recipients and Nonrecipients

PubMed Central

Paul, Lisa A.; Kehn, Andre; Gray, Matt J.; Salapska-Gelleri, Joanna

2014-01-01

Objective Undergraduate rape disclosure recipients and nonrecipients’ sociodemographic and life experience variables, attitudes towards rape and responses to a hypothetical rape disclosure were compared to determine differences between them. Participants One-hundred-ninety-two undergraduates at three universities participated in this online survey between November 2011 – April 2012. Methods Participants reported on their rape myth acceptance (RMA) and personal direct and indirect (i.e., disclosure receipt) experiences with sexual assault. Participants also responded to a hypothetical rape disclosure. Results Disclosure recipients were more likely to report a victimization history, and less confusion and perceived ineffectiveness in helping the hypothetical victim. RMA and nonrecipient status predicted perceived victim responsibility; these variables and childhood victimization predicted confusion about helping. RMA also predicted perceived ineffectiveness of one’s helping behaviors. Victimization history and female gender predicted victim empathy. Conclusions These findings can inform sexual assault-related programming for undergraduates through the provision of targeted assistance and corrective information. PMID:24779405

Issues related to diagnosing oral lichen planus among oral pathologists in South India: A pilot survey.

PubMed

Sanketh, D Sharathkumar; Srinivasan, Samuel Raj; Patil, Shankargouda; Ranganathan, Kannan

2017-11-01

In the present study, we simulated clinical scenarios by explicitly describing the history and clinical and histological features of hypothetical patients presenting with oral lichen planus (OLP), oral lichenoid lesion, and epithelial dysplasia in a self-designed questionnaire. By doing so, we aimed to elicit a diagnosis from oral pathologists and trainees, analyze their responses, appraise issues, and propose solutions regarding the diagnosis of OLP. The questionnaire was distributed to 100 oral pathologists and trainees in South India. Six questions were designed to assess awareness of the diagnostic aspects of OLP. Ten questions were hypothetical clinical scenarios (HCS) devised to evaluate respondents' knowledge of diagnostic guidelines and the criteria used by the respondents to render a diagnosis. There were 60 of 100 responses to the questionnaire. More than half the respondents were aware of the World Health Organization and modified guidelines of OLP. We observed considerable variations in diagnoses for the HCS. Our study illustrates the ambiguity in rendering an accurate diagnosis, despite adequate guidelines. Based on the responses for the HCS, we hypothesized that changes in the distribution (unilateral or bilateral) and clinical characteristic of OLP, and habits of patients, have a significant bearing on the clinical and final diagnoses of the lesion. © 2016 John Wiley & Sons Australia, Ltd.

Developing a Hypothetical Multi-Dimensional Learning Progression for the Nature of Matter

ERIC Educational Resources Information Center

Stevens, Shawn Y.; Delgado, Cesar; Krajcik, Joseph S.

2010-01-01

We describe efforts toward the development of a hypothetical learning progression (HLP) for the growth of grade 7-14 students' models of the structure, behavior and properties of matter, as it relates to nanoscale science and engineering (NSE). This multi-dimensional HLP, based on empirical research and standards documents, describes how students…

Responding to cough presentations: an interview study with Cambodian pharmacies participating in a National Tuberculosis Referral Program.

PubMed

Bell, Carolyn A; Pichenda, Koeut; Ilomäki, Jenni; Duncan, Gregory J; Eang, Mao Tan; Saini, Bandana

2016-04-01

Asia-Pacific carries a high burden of respiratory-related mortality. Timely referral and detection of tuberculosis cases optimizes patient and public health outcomes. Registered private pharmacies in Cambodia participate in a National Tuberculosis Referral Program to refer clients with cough suggestive of tuberculosis to public sector clinics for diagnosis and care. The objective of this study was to investigate clinical intentions of pharmacy staff when presented with a hypothetical case of a client with prolonged cough suggestive of tuberculosis. A random sample of 180 pharmacies was selected. Trained interviewers administered a hypothetical case scenario to trained pharmacy staff. Participants provided 'yes'/'no' responses to five clinical actions presented in the scenario. Actions were not mutually exclusive. Data were tabulated and compared using chi-square tests or Fisher's exact tests. Overall, 156 (92%) participants would have referred the symptomatic client in the case scenario. Participants who would have referred the client were less likely to sell a cough medicine (42% vs. 100%, P < 0.001) and less likely to sell an antibiotic (19% vs. 79%, P < 0.001) than those who would not have referred the client. Involving pharmacies in a Referral Program may have introduced concepts of appropriate clinical care when responding to clients presenting with cough suggestive of tuberculosis. However, results showed enhancing clinical competence among all referral programme participants particularly among non-referring pharmacies and those making concurrent sales of cough-related products would optimize pharmacy-initiated referral. Further research into actual clinical practices at Referral Program pharmacies would be justified. © 2015 John Wiley & Sons, Ltd.

HYTESS 2: A Hypothetical Turbofan Engine Simplified Simulation with multivariable control and sensor analytical redundancy

NASA Technical Reports Server (NTRS)

Merrill, W. C.

1986-01-01

A hypothetical turbofan engine simplified simulation with a multivariable control and sensor failure detection, isolation, and accommodation logic (HYTESS II) is presented. The digital program, written in FORTRAN, is self-contained, efficient, realistic and easily used. Simulated engine dynamics were developed from linearized operating point models. However, essential nonlinear effects are retained. The simulation is representative of the hypothetical, low bypass ratio turbofan engine with an advanced control and failure detection logic. Included is a description of the engine dynamics, the control algorithm, and the sensor failure detection logic. Details of the simulation including block diagrams, variable descriptions, common block definitions, subroutine descriptions, and input requirements are given. Example simulation results are also presented.

Ten factors to consider when developing usability scenarios and tasks for health information technology.

PubMed

Russ, Alissa L; Saleem, Jason J

2018-02-01

The quality of usability testing is highly dependent upon the associated usability scenarios. To promote usability testing as part of electronic health record (EHR) certification, the Office of the National Coordinator (ONC) for Health Information Technology requires that vendors test specific capabilities of EHRs with clinical end-users and report their usability testing process - including the test scenarios used - along with the results. The ONC outlines basic expectations for usability testing, but there is little guidance in usability texts or scientific literature on how to develop usability scenarios for healthcare applications. The objective of this article is to outline key factors to consider when developing usability scenarios and tasks to evaluate computer-interface based health information technologies. To achieve this goal, we draw upon a decade of our experience conducting usability tests with a variety of healthcare applications and a wide range of end-users, to include healthcare professionals as well as patients. We discuss 10 key factors that influence scenario development: objectives of usability testing; roles of end-user(s); target performance goals; evaluation time constraints; clinical focus; fidelity; scenario-related bias and confounders; embedded probes; minimize risks to end-users; and healthcare related outcome measures. For each factor, we present an illustrative example. This article is intended to aid usability researchers and practitioners in their efforts to advance health information technologies. The article provides broad guidance on usability scenario development and can be applied to a wide range of clinical information systems and applications. Published by Elsevier Inc.

Using scenario-based training to promote information literacy among on-call consultant pediatricians.

PubMed

Pettersson, Jonas; Bjorkander, Emil; Bark, Sirpa; Holmgren, Daniel; Wekell, Per

2017-07-01

Traditionally, teaching hospital staff to search for medical information relies heavily on educator-defined search methods. In contrast, the authors describe our experiences using real-time scenarios to teach on-call consultant pediatricians information literacy skills as part of a two-year continuing professional development program. Two information-searching workshops were held at Sahlgrenska University Hospital in Gothenburg, Sweden. During the workshops, pediatricians were presented with medical scenarios that were closely related to their clinical practice. Participants were initially encouraged to solve the problems using their own preferred search methods, followed by group discussions led by clinical educators and a medical librarian in which search problems were identified and overcome. The workshops were evaluated using questionnaires to assess participant satisfaction and the extent to which participants intended to implement changes in their clinical practice and reported actual change. A scenario-based approach to teaching clinicians how to search for medical information is an attractive alternative to traditional lectures. The relevance of such an approach was supported by a high level of participant engagement during the workshops and high scores for participant satisfaction, intended changes to clinical practice, and reported benefits in actual clinical practice.

Examining perceptions of the usefulness and usability of a mobile-based system for pharmacogenomics clinical decision support: a mixed methods study

PubMed Central

Blagec, Kathrin; Romagnoli, Katrina M.; Boyce, Richard D.

2016-01-01

Background. Pharmacogenomic testing has the potential to improve the safety and efficacy of pharmacotherapy, but clinical application of pharmacogenetic knowledge has remained uncommon. Clinical Decision Support (CDS) systems could help overcome some of the barriers to clinical implementation. The aim of this study was to evaluate the perception and usability of a web- and mobile-enabled CDS system for pharmacogenetics-guided drug therapy–the Medication Safety Code (MSC) system–among potential users (i.e., physicians and pharmacists). Furthermore, this study sought to collect data on the practicability and comprehensibility of potential layouts of a proposed personalized pocket card that is intended to not only contain the machine-readable data for use with the MSC system but also human-readable data on the patient’s pharmacogenomic profile. Methods. We deployed an emergent mixed methods design encompassing (1) qualitative interviews with pharmacists and pharmacy students, (2) a survey among pharmacogenomics experts that included both qualitative and quantitative elements and (3) a quantitative survey among physicians and pharmacists. The interviews followed a semi-structured guide including a hypothetical patient scenario that had to be solved by using the MSC system. The survey among pharmacogenomics experts focused on what information should be printed on the card and how this information should be arranged. Furthermore, the MSC system was evaluated based on two hypothetical patient scenarios and four follow-up questions on the perceived usability. The second survey assessed physicians’ and pharmacists’ attitude towards the MSC system. Results. In total, 101 physicians, pharmacists and PGx experts coming from various relevant fields evaluated the MSC system. Overall, the reaction to the MSC system was positive across all investigated parameters and among all user groups. The majority of participants were able to solve the patient scenarios based on the

The Scenario Model Intercomparison Project (ScenarioMIP) for CMIP6

DOE PAGES

O'Neill, Brian C.; Tebaldi, Claudia; van Vuuren, Detlef P.; ...

2016-09-28

Projections of future climate change play a fundamental role in improving understanding of the climate system as well as characterizing societal risks and response options. The Scenario Model Intercomparison Project (ScenarioMIP) is the primary activity within Phase 6 of the Coupled Model Intercomparison Project (CMIP6) that will provide multi-model climate projections based on alternative scenarios of future emissions and land use changes produced with integrated assessment models. Here, we describe ScenarioMIP's objectives, experimental design, and its relation to other activities within CMIP6. The ScenarioMIP design is one component of a larger scenario process that aims to facilitate a wide rangemore » of integrated studies across the climate science, integrated assessment modeling, and impacts, adaptation, and vulnerability communities, and will form an important part of the evidence base in the forthcoming Intergovernmental Panel on Climate Change (IPCC) assessments. Furthermore, it will provide the basis for investigating a number of targeted science and policy questions that are especially relevant to scenario-based analysis, including the role of specific forcings such as land use and aerosols, the effect of a peak and decline in forcing, the consequences of scenarios that limit warming to below 2°C, the relative contributions to uncertainty from scenarios, climate models, and internal variability, and long-term climate system outcomes beyond the 21st century. In order to serve this wide range of scientific communities and address these questions, a design has been identified consisting of eight alternative 21st century scenarios plus one large initial condition ensemble and a set of long-term extensions, divided into two tiers defined by relative priority. Some of these scenarios will also provide a basis for variants planned to be run in other CMIP6-Endorsed MIPs to investigate questions related to specific forcings. Harmonized, spatially explicit

The Scenario Model Intercomparison Project (ScenarioMIP) for CMIP6

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

O'Neill, Brian C.; Tebaldi, Claudia; van Vuuren, Detlef P.

2016-01-01

Projections of future climate change play a fundamental role in improving understanding of the climate system as well as characterizing societal risks and response options. The Scenario Model Intercomparison Project (ScenarioMIP) is the primary activity within Phase 6 of the Coupled Model Intercomparison Project (CMIP6) that will provide multi-model climate projections based on alternative scenarios of future emissions and land use changes produced with integrated assessment models. In this paper, we describe ScenarioMIP's objectives, experimental design, and its relation to other activities within CMIP6. The ScenarioMIP design is one component of a larger scenario process that aims to facilitate amore » wide range of integrated studies across the climate science, integrated assessment modeling, and impacts, adaptation, and vulnerability communities, and will form an important part of the evidence base in the forthcoming Intergovernmental Panel on Climate Change (IPCC) assessments. At the same time, it will provide the basis for investigating a number of targeted science and policy questions that are especially relevant to scenario-based analysis, including the role of specific forcings such as land use and aerosols, the effect of a peak and decline in forcing, the consequences of scenarios that limit warming to below 2 °C, the relative contributions to uncertainty from scenarios, climate models, and internal variability, and long-term climate system outcomes beyond the 21st century. To serve this wide range of scientific communities and address these questions, a design has been identified consisting of eight alternative 21st century scenarios plus one large initial condition ensemble and a set of long-term extensions, divided into two tiers defined by relative priority. Some of these scenarios will also provide a basis for variants planned to be run in other CMIP6-Endorsed MIPs to investigate questions related to specific forcings. Harmonized, spatially

The Scenario Model Intercomparison Project (ScenarioMIP) for CMIP6

NASA Astrophysics Data System (ADS)

O'Neill, Brian C.; Tebaldi, Claudia; van Vuuren, Detlef P.; Eyring, Veronika; Friedlingstein, Pierre; Hurtt, George; Knutti, Reto; Kriegler, Elmar; Lamarque, Jean-Francois; Lowe, Jason; Meehl, Gerald A.; Moss, Richard; Riahi, Keywan; Sanderson, Benjamin M.

2016-09-01

Projections of future climate change play a fundamental role in improving understanding of the climate system as well as characterizing societal risks and response options. The Scenario Model Intercomparison Project (ScenarioMIP) is the primary activity within Phase 6 of the Coupled Model Intercomparison Project (CMIP6) that will provide multi-model climate projections based on alternative scenarios of future emissions and land use changes produced with integrated assessment models. In this paper, we describe ScenarioMIP's objectives, experimental design, and its relation to other activities within CMIP6. The ScenarioMIP design is one component of a larger scenario process that aims to facilitate a wide range of integrated studies across the climate science, integrated assessment modeling, and impacts, adaptation, and vulnerability communities, and will form an important part of the evidence base in the forthcoming Intergovernmental Panel on Climate Change (IPCC) assessments. At the same time, it will provide the basis for investigating a number of targeted science and policy questions that are especially relevant to scenario-based analysis, including the role of specific forcings such as land use and aerosols, the effect of a peak and decline in forcing, the consequences of scenarios that limit warming to below 2 °C, the relative contributions to uncertainty from scenarios, climate models, and internal variability, and long-term climate system outcomes beyond the 21st century. To serve this wide range of scientific communities and address these questions, a design has been identified consisting of eight alternative 21st century scenarios plus one large initial condition ensemble and a set of long-term extensions, divided into two tiers defined by relative priority. Some of these scenarios will also provide a basis for variants planned to be run in other CMIP6-Endorsed MIPs to investigate questions related to specific forcings. Harmonized, spatially explicit

Effect of different scenarios for selective dry-cow therapy on udder health, antimicrobial usage, and economics.

PubMed

Scherpenzeel, C G M; den Uijl, I E M; van Schaik, G; Riekerink, R G M Olde; Hogeveen, H; Lam, T J G M

2016-05-01

The goal of dry-cow therapy (DCT) is to reduce the prevalence of intramammary infections (IMI) by eliminating existing IMI at drying off and preventing new IMI from occurring during the dry period. Due to public health concerns, however, preventive use of antimicrobials has become questionable. In this study, we evaluated the effects of 8 scenarios for selecting animals for DCT, taking into account variation in parity and cow-level somatic cell count (SCC) at drying off. The aim of this study was to evaluate udder health, antimicrobial usage, and economics at the herd level when using different scenarios for selecting cows for DCT. To enable calculation and comparison of the effects of different scenarios to select cows for DCT in an "average" herd, we created an example herd, with a virtual herd size of 100 dairy cows to be calving during a year. Udder health, antimicrobial usage, and economics were evaluated during the dry period and the first 100 d in lactation, the period during which the greatest effect of DCT is expected. This leads to an estimated 13,551 cow-days at risk during a year in a 100-cow dairy herd. In addition to a blanket DCT (BDCT) scenario, we developed 7 scenarios to select cows for DCT based on SCC. The scenarios covered a range of possible approaches to select low-SCC cows for DCT, all based on cow-level SCC thresholds on the last milk recording before drying off. The incidence rate of clinical mastitis in the example herd varied from 11.6 to 14.5 cases of clinical mastitis per 10,000 cow-days at risk in the different scenarios, and the prevalence of subclinical mastitis varied from 38.8% in scenario 1 (BDCT) to 48.3% in scenario 8. Total antimicrobial usage for DCT and clinical mastitis treatment varied over the scenarios from 1.27 (scenario 8) to 3.15 animal daily dosages (BDCT), leading to a maximum reduction in antimicrobial usage of 60% for scenario 8 compared with BDCT. The total costs for each of the scenarios showed little variation

Flood hazards along the Toutle and Cowlitz rivers, Washington, from a hypothetical failure of Castle Lake blockage

USGS Publications Warehouse

Laenen, Antonius; Orzol, L.L.

1987-01-01

A recent evaluation of groundwater and material in the blockage impounding Castle Lake shows that the blockage is potentially unstable against failure from piping due to heave and internal erosion when groundwater levels are seasonally high. There is also a remote possibility that a 6.8 or greater magnitude earthquake could occur in the Castle Lake area when groundwater levels are critically high. If this situation occurs, the debris blockage that confines Castle Lake could breach from successive slope failure with liquefaction of a portion of the blockage. A dam-break computer model was used to simulate discharge through a hypothetical breach in the Castle Lake blockage that could be caused by failure by heave, internal erosion, or liquefaction. Approximately 18,500 acre-ft of stored water would be released from an assumed breach that fully developed to a 1,000-ft width over a 15-minute time period. The resulting flood, incorporating 3.4 x 10 to the 6th power cu yd of the debris blockage, would reach a peak magnitude of 1,500,000 cu ft/s (cubic feet per second). The flood is also assumed to incorporate an additional 137x10 to the 6th power cu yd of saturated debris material from downstream deposits. Flow is considered to be hyperconcentrated with sediment throughout the course of the flood. The hypothetical hyperconcentrated flow is routed downstream, superimposed on normal winter flood flows by use of a one-dimensional unsteady-state numerical streamflow simulation model. From a starting magnitude of 1,500,000 cu ft/s, the peak increases to 2,100,000 cu ft/s at N-1 Dam (12 mi downstream) and attenuates to 1,200,000 cu ft/s at Kid Valley (25 mi downstream) , to 100,000 cu ft/s at Longview and the confluence of the Columbia River (65 mi downstream). From time of breach, the flood peak would take 2.2 hr to reach Toutle, 3.8 hr to reach Castle Rock, and 8.5 hr to reach Longview. Communities of Toutle , Castle Rock, Kelso, and Longview would experience extreme to

Health economic evaluation of a serum-based blood test for brain tumour diagnosis: exploration of two clinical scenarios.

PubMed

Gray, Ewan; Butler, Holly J; Board, Ruth; Brennan, Paul M; Chalmers, Anthony J; Dawson, Timothy; Goodden, John; Hamilton, Willie; Hegarty, Mark G; James, Allan; Jenkinson, Michael D; Kernick, David; Lekka, Elvira; Livermore, Laurent J; Mills, Samantha J; O'Neill, Kevin; Palmer, David S; Vaqas, Babar; Baker, Matthew J

2018-05-24

To determine the potential costs and health benefits of a serum-based spectroscopic triage tool for brain tumours, which could be developed to reduce diagnostic delays in the current clinical pathway. A model-based health pre-trial economic assessment. Decision tree models were constructed based on simplified diagnostic pathways. Models were populated with parameters identified from rapid reviews of the literature and clinical expert opinion. Explored as a test in both primary and secondary care (neuroimaging) in the UK health service, as well as application to the USA. Calculations based on an initial cohort of 10 000 patients. In primary care, it is estimated that the volume of tests would approach 75 000 per annum. The volume of tests in secondary care is estimated at 53 000 per annum. The primary outcome measure was quality-adjusted life-years (QALY), which were employed to derive incremental cost-effectiveness ratios (ICER) in a cost-effectiveness analysis. Results indicate that using a blood-based spectroscopic test in both scenarios has the potential to be highly cost-effective in a health technology assessment agency decision-making process, as ICERs were well below standard threshold values of £20 000-£30 000 per QALY. This test may be cost-effective in both scenarios with test sensitivities and specificities as low as 80%; however, the price of the test would need to be lower (less than approximately £40). Use of this test as triage tool in primary care has the potential to be both more effective and cost saving for the health service. In secondary care, this test would also be deemed more effective than the current diagnostic pathway. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Risk analysis of technological hazards: Simulation of scenarios and application of a local vulnerability index.

PubMed

Sanchez, E Y; Represa, S; Mellado, D; Balbi, K B; Acquesta, A D; Colman Lerner, J E; Porta, A A

2018-06-15

The potential impact of a technological accident can be assessed by risk estimation. Taking this into account, the latent or potential condition can be warned and mitigated. In this work we propose a methodology to estimate risk of technological hazards, focused on two components. The first one is the processing of meteorological databases to define the most probably and conservative scenario of study, and the second one, is the application of a local social vulnerability index to classify the population. In this case of study, the risk was estimated for a hypothetical release of liquefied ammonia in a meat-packing industry in the city of La Plata, Argentina. The method consists in integrating the simulated toxic threat zone with ALOHA software, and the layer of sociodemographic classification of the affected population. The results show the areas associated with higher risks of exposure to ammonia, which are worth being addressed for the prevention of disasters in the region. Advantageously, this systemic approach is methodologically flexible as it provides the possibility of being applied in various scenarios based on the available information of both, the exposed population and its meteorology. Furthermore, this methodology optimizes the processing of the input data and its calculation. Copyright © 2018 Elsevier B.V. All rights reserved.

Dying scenarios improve recall as much as survival scenarios.

PubMed

Burns, Daniel J; Hart, Joshua; Kramer, Melanie E

2014-01-01

Merely contemplating one's death improves retention for entirely unrelated material learned subsequently. This "dying to remember" effect seems conceptually related to the survival processing effect, whereby processing items for their relevance to being stranded in the grasslands leads to recall superior to that of other deep processing control conditions. The present experiments directly compared survival processing scenarios with "death processing" scenarios. Results showed that when the survival and dying scenarios are closely matched on key dimensions, and possible congruency effects are controlled, the dying and survival scenarios produced equivalently high recall levels. We conclude that the available evidence (cf. Bell, Roer, & Buchner, 2013; Klein, 2012), while not definitive, is consistent with the possibility of overlapping mechanisms.

Current approaches to challenging scenarios in myeloproliferative neoplasms.

PubMed

Zimran, Eran; Hoffman, Ronald; Kremyanskaya, Marina

2018-06-01

The Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs) including polycythemia vera, essential thrombocythemia and primary myelofibrosis are clonal hematological malignancies that originate at the level of the hematopoietic stem cell, and are characterized by excessive proliferation of cells belonging to one or more of the myeloid lineages. Central to the pathogenesis of the MPNs is constitutive activation of the JAK/STAT signaling pathway due to a family of driver mutations affecting JAK2, CALR or MPL. These disorders share common clinical and laboratory features, a significant burden of systemic symptoms, increased risk of developing arterial and venous thrombotic events, and the potential to progress to myelofibrosis and acute leukemia. Areas covered: We identified four clinical situations which represent challenging management dilemmas for patients with MPNs. Our conclusions and recommendations are based on a literature search using MEDLINE and recent meeting abstracts using the keywords, focusing on publications directly addressing these scenarios and on recent contributions to the field. Expert commentary: Multi-center efforts to study large cohorts of MPN patients have led to more uniform and evidence-based approaches to key aspects in MPN management. However, treatment strategies to deal with specific clinical scenarios are lacking.

A Bayesian prediction model between a biomarker and the clinical endpoint for dichotomous variables.

PubMed

Jiang, Zhiwei; Song, Yang; Shou, Qiong; Xia, Jielai; Wang, William

2014-12-20

Early biomarkers are helpful for predicting clinical endpoints and for evaluating efficacy in clinical trials even if the biomarker cannot replace clinical outcome as a surrogate. The building and evaluation of an association model between biomarkers and clinical outcomes are two equally important concerns regarding the prediction of clinical outcome. This paper is to address both issues in a Bayesian framework. A Bayesian meta-analytic approach is proposed to build a prediction model between the biomarker and clinical endpoint for dichotomous variables. Compared with other Bayesian methods, the proposed model only requires trial-level summary data of historical trials in model building. By using extensive simulations, we evaluate the link function and the application condition of the proposed Bayesian model under scenario (i) equal positive predictive value (PPV) and negative predictive value (NPV) and (ii) higher NPV and lower PPV. In the simulations, the patient-level data is generated to evaluate the meta-analytic model. PPV and NPV are employed to describe the patient-level relationship between the biomarker and the clinical outcome. The minimum number of historical trials to be included in building the model is also considered. It is seen from the simulations that the logit link function performs better than the odds and cloglog functions under both scenarios. PPV/NPV ≥0.5 for equal PPV and NPV, and PPV + NPV ≥1 for higher NPV and lower PPV are proposed in order to predict clinical outcome accurately and precisely when the proposed model is considered. Twenty historical trials are required to be included in model building when PPV and NPV are equal. For unequal PPV and NPV, the minimum number of historical trials for model building is proposed to be five. A hypothetical example shows an application of the proposed model in global drug development. The proposed Bayesian model is able to predict well the clinical endpoint from the observed biomarker

Suit the action to the word, the word to the action: Hypothetical choices and real decisions in Medicare Part D

PubMed Central

Kesternich, Iris; Heiss, Florian; McFadden, Daniel; Winter, Joachim

2016-01-01

In recent years, consumer choice has become an important element of public policy. One reason is that consumers differ in their tastes and needs, which they can express most easily through their own choices. Elements that strengthen consumer choice feature prominently in the design of public insurance markets, for instance in the United States in the recent introduction of prescription drug coverage for older individuals via Medicare Part D. For policy makers who design such a market, an important practical question in the design phase of such a new program is how to deduce enrollment and plan selection preferences prior to its introduction. In this paper, we investigate whether hypothetical choice experiments can serve as a tool in this process. We combine data from hypothetical and real plan choices, elicited around the time of the introduction of Medicare Part D. We first analyze how well the hypothetical choice data predict willingness to pay and market shares at the aggregate level. We then analyze predictions at the individual level, in particular how insurance demand varies with observable characteristics. We also explore whether the extent of adverse selection can be predicted using hypothetical choice data alone. PMID:23317633

Using scenario-based training to promote information literacy among on-call consultant pediatricians

PubMed Central

Pettersson, Jonas; Bjorkander, Emil; Bark, Sirpa; Holmgren, Daniel; Wekell, Per

2017-01-01

Background Traditionally, teaching hospital staff to search for medical information relies heavily on educator-defined search methods. In contrast, the authors describe our experiences using real-time scenarios to teach on-call consultant pediatricians information literacy skills as part of a two-year continuing professional development program. Case Presentation Two information-searching workshops were held at Sahlgrenska University Hospital in Gothenburg, Sweden. During the workshops, pediatricians were presented with medical scenarios that were closely related to their clinical practice. Participants were initially encouraged to solve the problems using their own preferred search methods, followed by group discussions led by clinical educators and a medical librarian in which search problems were identified and overcome. The workshops were evaluated using questionnaires to assess participant satisfaction and the extent to which participants intended to implement changes in their clinical practice and reported actual change. Conclusions A scenario-based approach to teaching clinicians how to search for medical information is an attractive alternative to traditional lectures. The relevance of such an approach was supported by a high level of participant engagement during the workshops and high scores for participant satisfaction, intended changes to clinical practice, and reported benefits in actual clinical practice. PMID:28670215

EDITORIAL: Where next with global environmental scenarios? Where next with global environmental scenarios?

NASA Astrophysics Data System (ADS)

O'Neill, Brian; Pulver, Simone; Van Deveer, Stacy; Garb, Yaakov

2008-12-01

Scenarios have become a standard tool in the portfolio of techniques that scientists and policy-makers use to envision and plan for the future. Defined as plausible, challenging and relevant stories about how the future might unfold that integrate quantitative models with qualitative assessments of social and political trends, scenarios are a central component in assessment processes for a range of global issues, including climate change, biodiversity, agriculture, and energy. Yet, despite their prevalence, systematic analysis of scenarios is in its beginning stages. Fundamental questions remain about both the epistemology and scientific credibility of scenarios and their roles in policymaking and social change. Answers to these questions have the potential to determine the future of scenario analyses. Is scenario analysis moving in the direction of earth system governance informed by global scenarios generated through increasingly complex and comprehensive models integrating socio-economic and earth systems? Or will global environmental scenario analyses lose favour compared to more focused, policy-driven, regionally specific modelling? These questions come at an important time for the climate change issue, given that the scenario community, catalyzed by the Intergovernmental Panel on Climate Change (IPCC), is currently preparing to embark on a new round of scenario development processes aimed at coordinating research and assessment, and informing policy, over the next five to ten years. These and related questions about where next to go with global environmental scenarios animated a workshop held at Brown University (Note1) that brought together leading practitioners and scholars of global environmental change scenarios from research, policy-making, advocacy, and business settings. The workshop aimed to provide an overview of current practices/best practices in scenario production and scenario use across a range of global environmental change arenas. Participants

FRAMING EFFECTS ON PHYSICIANS' JUDGMENT AND DECISION MAKING.

PubMed

Bui, Thanh C; Krieger, Heather A; Blumenthal-Barby, Jennifer S

2015-10-01

This study aimed to assess physicians' susceptibility to framing effects in clinical judgment and decision making. A survey was administered online to 159 general internists in the United States. Participants were randomized into two groups, in which clinical scenarios varied in their framings: frequency vs percentage, with cost information vs without, female patient vs male patient, and mortality vs survival. Results showed that physicians' recommendations for patients in hypothetical scenarios were significantly different when the predicted probability of the outcomes was presented in frequency versus percentage form and when it was presented in mortality rate vs survival rate of the same magnitude. Physicians' recommendations were not different for other framing effects.

Biased Interpretation of Ambiguous Social Scenarios in Anorexia Nervosa.

PubMed

Cardi, Valentina; Turton, Robert; Schifano, Sylvia; Leppanen, Jenni; Hirsch, Colette R; Treasure, Janet

2017-01-01

Patients with anorexia nervosa experience increased sensitivity to the risk of social rejection. The aims of this study were to assess the interpretation of ambiguous social scenarios depicting the risk of rejection and to examine the relationship between interpretation biases and clinical symptoms. Thirty-five women with anorexia nervosa and 30 healthy eaters completed clinical questionnaires, alongside a sentence completion task. This task required participants to generate completions to ambiguous social scenarios and to endorse their best completion. Responses were rated as being negative, neutral or positive. Patients endorsed more negative interpretations and fewer neutral and positive interpretations compared with healthy eaters. The frequency of endorsed negative interpretations correlated with depression, anxiety and fear of weight gain and body disturbance. A negative interpretation bias towards social stimuli is present in women with anorexia nervosa and correlates with clinical symptoms. Interventions aimed at reducing this bias could improve illness prognosis. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Customizing clinical narratives for the electronic medical record interface using cognitive methods.

PubMed

Sharda, Pallav; Das, Amar K; Cohen, Trevor A; Patel, Vimla

2006-05-01

As healthcare practice transitions from paper-based to computer-based records, there is increasing need to determine an effective electronic format for clinical narratives. Our research focuses on utilizing a cognitive science methodology to guide the conversion of medical texts to a more structured, user-customized presentation in the electronic medical record (EMR). We studied the use of discharge summaries by psychiatrists with varying expertise-experts, intermediates, and novices. Experts were given two hypothetical emergency care scenarios with narrative discharge summaries and asked to verbalize their clinical assessment. Based on the results, the narratives were presented in a more structured form. Intermediate and novice subjects received a narrative and a structured discharge summary, and were asked to verbalize their assessments of each. A qualitative comparison of the interview transcripts of all subjects was done by analysis of recall and inference made with respect to level of expertise. For intermediate and novice subjects, recall was greater with the structured form than with the narrative. Novices were also able to make more inferences (not always accurate) from the structured form than with the narrative. Errors occurred in assessments using the narrative form but not the structured form. Our cognitive methods to study discharge summary use enabled us to extract a conceptual representation of clinical narratives from end-users. This method allowed us to identify clinically relevant information that can be used to structure medical text for the EMR and potentially improve recall and reduce errors.

Influence of framing on medical decision making.

PubMed

Gong, Jingjing; Zhang, Yan; Feng, Jun; Huang, Yonghua; Wei, Yazhou; Zhang, Weiwei

2013-01-01

Numerous studies have demonstrated the robustness of the framing effect in a variety of contexts, especially in medical decision making. Unfortunately, research is still inconsistent as to how so many variables impact framing effects in medical decision making. Additionally, much attention should be paid to the framing effect not only in hypothetical scenarios but also in clinical experience.

In silico design and screening of hypothetical MOF-74 analogs and their experimental synthesis

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

Witman, Matthew; Ling, Sanliang; Anderson, Samantha

Here, we present the in silico design of metal-organic frameworks (MOFs) exhibiting 1-dimensional rod topologies. We then introduce an algorithm for construction of this family of MOF topologies, and illustrate its application for enumerating MOF-74-type analogs. Furthermore, we perform a broad search for new linkers that satisfy the topological requirements of MOF-74 and consider the largest database of known chemical space for organic compounds, the PubChem database. Our in silico crystal assembly, when combined with dispersion-corrected density functional theory (DFT) calculations, is demonstrated to generate a hypothetical library of open-metal site containing MOF-74 analogs in the 1-D rod topology frommore » which we can simulate the adsorption behavior of CO 2 . We conclude that these hypothetical structures have synthesizable potential through computational identification and experimental validation of a novel MOF-74 analog, Mg 2 (olsalazine).« less

In silico design and screening of hypothetical MOF-74 analogs and their experimental synthesis

DOE PAGES

Witman, Matthew; Ling, Sanliang; Anderson, Samantha; ...

2016-06-21

Here, we present the in silico design of metal-organic frameworks (MOFs) exhibiting 1-dimensional rod topologies. We then introduce an algorithm for construction of this family of MOF topologies, and illustrate its application for enumerating MOF-74-type analogs. Furthermore, we perform a broad search for new linkers that satisfy the topological requirements of MOF-74 and consider the largest database of known chemical space for organic compounds, the PubChem database. Our in silico crystal assembly, when combined with dispersion-corrected density functional theory (DFT) calculations, is demonstrated to generate a hypothetical library of open-metal site containing MOF-74 analogs in the 1-D rod topology frommore » which we can simulate the adsorption behavior of CO 2 . We conclude that these hypothetical structures have synthesizable potential through computational identification and experimental validation of a novel MOF-74 analog, Mg 2 (olsalazine).« less

Further Sensitivity Analysis of Hypothetical Policies to Limit Energy-Related Carbon Dioxide Emissions

EIA Publications

2013-01-01

This analysis supplements the Annual Energy Outlook 2013 alternative cases which imposed hypothetical carbon dioxide emission fees on fossil fuel consumers. It offers further cases that examine the impacts of fees placed only on the emissions from electric power facilities, impacts of returning potential revenues to consumers, and two cap-and-trade policies.

Attitudes toward participating in Phase I clinical trials: an investigation with patient-family-physician triads.

PubMed

Shin, Dong Wook; Cho, Juhee; Kim, So Young; Yang, Hyung Kook; Cho, BeLong; Shin, Dong-Bok; Chun, Mi Son; Min, Young Joo; Kim, Young-Woo; Park, Jong Hyock

2016-12-01

Phase I oncology trials have raised concerns that patients' 'unrealistic' optimism could compromise the validity of informed consent, and that patients often participate in trials to conform to physicians' or family members' recommendations. We aimed to determine whether patients or families-given the same information of risk-benefit profile-are more likely to participate in Phase I trials than their physicians and whether people in family or physician situations are more likely to recommend trial participation to patients than they would want for themselves as patients. We conducted a hypothetical vignette study with a patient-caregiver-oncologist. Three groups-725 patient-caregiver pairs recruited by 134 oncologists-were asked to assume three different roles as patients, caregivers and physicians and provided a scenario of a hypothetical patient with treatment-resistant cancer. They were asked questions regarding their intention to participate in or to recommend a Phase I clinical trial. Acceptance rates of the trial were as follows: (a) in the patients' role: patients (54.1), caregivers (62.3) and physicians (63.4%); (b) in the caregivers' role: 55.6, 64.7 and 70.9%; (c) in the physicians' role: 66.1, 70.8 and 76.1%. Patients or caregivers were not more positive to the trial than physicians. All three groups showed more positive attitudes toward the clinical trial when they assumed the role of caregiver or physician than that of patient. Patients and caregivers seem to make as reasonable decisions as physicians; patients seem to take family members' or physicians' recommendation as their legitimate roles rather than as undue pressure. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Preparing Parents to Make An Informed Choice About Antibiotic Use for Common Acute Respiratory Infections in Children: A Randomised Trial of Brief Decision Aids in a Hypothetical Scenario.

PubMed

Coxeter, Peter D; Del Mar, Chris B; Hoffmann, Tammy C

2017-08-01

Childhood acute respiratory infections (ARIs) are one of the most common reasons for primary care consultations and for receiving an antibiotic. Public awareness of antibiotic benefit and harms for these conditions is low. To facilitate informed decision making, ideally in collaboration with their doctor, parents need clear communication about benefits and harms. Decision aids may be able to facilitate this process. The aim of this study was to evaluate the effectiveness of three decision aids about antibiotic use for common ARIs in children. Adult parents of children aged 1-16 years (n = 120) were recruited from community settings and then randomised using a computer-generated randomisation sequence to receive a decision aid (n = 60) or fact sheet (n = 60). Allocation was concealed and used sealed and opaque sequentially numbered envelopes. Participants self-completed questionnaires at baseline and immediately post-intervention. The primary outcome was informed choice (conceptual and numerical knowledge; attitudes towards, and intention to use, antibiotics for a future ARI). Secondary outcomes were decisional conflict, decisional self-efficacy, and material acceptability. After reading the information, significantly more intervention group participants made an informed choice [57%] compared with control group participants [29%] [difference 28, 95% confidence interval (CI) 11-45%, p < 0.01], and had higher total knowledge [mean difference (MD) 2.8, 95% CI 2.2-3.5, p < 0.01], conceptual knowledge (MD 0.7, 95% CI 0.4-1.1, p < 0.01) and numerical knowledge (MD 2.1, 95% CI 1.6-2.5, p < 0.01). Between-group differences in attitudes or intention to use antibiotics were not significant. Most intervention group participants found the information understandable and liked the aids' format and features. The decision aids prepared parents to make an informed choice about antibiotic use more than fact sheets, in a hypothetical situation. Their effect within a

Parents' Aggressive Influences and Children's Aggressive Problem Solutions with Peers

ERIC Educational Resources Information Center

Duman, Sarah; Margolin, Gayla

2007-01-01

This study examined children's aggressive and assertive solutions to hypothetical peer scenarios in relation to parents' responses to similar hypothetical social scenarios and parents' actual marital aggression. The study included 118 children ages 9 to 10 years old and their mothers and fathers. Children's aggressive solutions correlated with…

Comparison of the hypothetical 57Co brachytherapy source with the 192Ir source

PubMed Central

Toossi, Mohammad Taghi Bahreyni; Rostami, Atefeh; Khosroabadi, Mohsen; Khademi, Sara; Knaup, Courtney

2016-01-01

Aim of the study The 57Co radioisotope has recently been proposed as a hypothetical brachytherapy source due to its high specific activity, appropriate half-life (272 days) and medium energy photons (114.17 keV on average). In this study, Task Group No. 43 dosimetric parameters were calculated and reported for a hypothetical 57Co source. Material and methods A hypothetical 57Co source was simulated in MCNPX, consisting of an active cylinder with 3.5 mm length and 0.6 mm radius encapsulated in a stainless steel capsule. Three photon energies were utilized (136 keV [10.68%], 122 keV [85.60%], 14 keV [9.16%]) for the 57Co source. Air kerma strength, dose rate constant, radial dose function, anisotropy function, and isodose curves for the source were calculated and compared to the corresponding data for a 192Ir source. Results The results are presented as tables and figures. Air kerma strength per 1 mCi activity for the 57Co source was 0.46 cGyh–1 cm 2 mCi–1. The dose rate constant for the 57Co source was determined to be 1.215 cGyh–1U–1. The radial dose function for the 57Co source has an increasing trend due to multiple scattering of low energy photons. The anisotropy function for the 57Co source at various distances from the source is more isotropic than the 192Ir source. Conclusions The 57Co source has advantages over 192Ir due to its lower energy photons, longer half-life, higher dose rate constant and more isotropic anisotropic function. However, the 192Ir source has a higher initial air kerma strength and more uniform radial dose function. These properties make 57Co a suitable source for use in brachytherapy applications. PMID:27688731

Would You Use It With a Seal of Approval? Important Attributes of 2,4-Dinitrophenol (2,4-DNP) as a Hypothetical Pharmaceutical Product.

PubMed

Bleasdale, Emma E; Thrower, Sam N; Petróczi, Andrea

2018-01-01

2,4-Dinitrophenol (2,4-DNP) is an effective but highly dangerous fat burner, not licensed for human consumption. Death cases reported for 2,4-DNP overdose, particularly among young adults, have raised concerns about the ineffective regulatory control, lack of education and risks associated with impurity, and the unknown concentration of 2,4-DNP purchased on the Internet. Using a sequential mixed method design and based on a hypothetical scenario as if 2,4-DNP was a licensed pharmaceutical drug, first we conducted a qualitative study to explore what product attributes people consider when buying a weight-loss aid. Focus group interviews with six females and three males (mean age = 21.6 ± 1.8 years) were audiorecorded, transcribed verbatim, and subjected to thematic analysis. Sixteen attributes were identified for the Best-Worst Scale (BWS) in the quantitative survey with 106 participants (64% female, mean age = 27.1 ± 11.9 years), focusing on 2,4-DNP. Demographics, weight satisfaction, and risk for eating disorder data were collected. In contrast to experienced users such as bodybuilders, our study participants approached 2,4-DNP cautiously. Attributes of 2,4-DNP as a hypothetical weight-loss drug comprised a range of desirable and avoidable features. Of the 16 selected attributes, BWS suggested that long-term side effects were the most and branding was the least important attribute. Effectiveness and short-term side effects were also essential. Those in the >25 year group showed least concerns for legality. Neutral BWS scores for cost, treatment, degree of lifestyle changes required, and specificity required for the hypothetical weight-loss drug to be effective were likely caused by disagreement about their importance among the participants, not indifference. With advances in research, 2,4-DNP as a pharmaceutical drug in the future for treating neurodegenerative diseases and potentially for weight loss is not inconceivable. Caution is

Trait and state disgust: an experimental investigation of disgust and avoidance in colorectal cancer decision scenarios.

PubMed

Reynolds, Lisa M; McCambridge, Sarah A; Bissett, Ian P; Consedine, Nathan S

2014-12-01

To evaluate whether trait and experimentally manipulated state disgust independently and/or interactively predict immediate and anticipated avoidance in decision scenarios related to colorectal cancer (CRC). Eighty participants, aged 18 to 66 years, completed questionnaires assessing trait disgust prior to a laboratory session. Participants were gender block randomized to disgust or control conditions before completing tasks assessing immediate avoidance of a CRC disgust elicitor (stoma bag) and anticipated avoidance in hypothetical CRC scenarios. Manipulation checks confirmed the elicitation of disgust in the experimental condition. Persons in the experimental condition were more likely to exhibit immediate avoidance behaviors in response to a commonly used bowel disease device (stoma bag), and trait disgust predicted time to touch the device. Trait disgust also moderated the influence of state disgust on anticipated avoidance, namely delay in help seeking for bowel symptoms and predicted rating disgusting side effects as more deterring to adherence. The current report suggests the importance of examining disgust in CRC contexts and provides the first empirical demonstration that state and trait aspects of disgust may interactively operate to deter certain types of decisions. It thus furthers understanding of emotions and avoidance in a health context that has had surprisingly little focus to date.

Economic impacts of the SAFRR tsunami scenario in California: Chapter H in The SAFRR (Science Application for Risk Reduction) Tsunami Scenario

USGS Publications Warehouse

Wein, Anne; Rose, Adam; Sue Wing, Ian; Wei, Dan

2013-01-01

This study evaluates the hypothetical economic impacts of the SAFRR (Science Application for Risk Reduction) tsunami scenario to the California economy. The SAFRR scenario simulates a tsunami generated by a hypothetical magnitude 9.1 earthquake that occurs offshore of the Alaska Peninsula (Kirby and others, 2013). Economic impacts are measured by the estimated reduction in California’s gross domestic product (GDP), the standard economic measure of the total value of goods and services produced. Economic impacts are derived from the physical damages from the tsunami as described by Porter and others (2013). The principal physical damages that result in disruption of the California economy are (1) about $100 million in damages to the twin Ports of Los Angeles (POLA) and Long Beach (POLB), (2) about $700 million in damages to marinas, and (3) about $2.5 billion in damages to buildings and contents (properties) in the tsunami inundation zone on the California coast. The study of economic impacts does not include the impacts from damages to roads, bridges, railroads, and agricultural production or fires in fuel storage facilities because these damages will be minimal with respect to the California economy. The economic impacts of damage to other California ports are not included in this study because detailed evaluation of the physical damage to these ports was not available in time for this report. The analysis of economic impacts is accomplished in several steps. First, estimates are made for the direct economic impacts that result in immediate business interruption losses in individual sectors of the economy due to physical damage to facilities or to disruption of the flow of production units (commodities necessary for production). Second, the total economic impacts (consisting of both direct and indirect effects) are measured by including the general equilibrium (essentially quantity and price multiplier effects) of lost production in other sectors by ripple

Interpreting energy scenarios

NASA Astrophysics Data System (ADS)

Iyer, Gokul; Edmonds, James

2018-05-01

Quantitative scenarios from energy-economic models inform decision-making about uncertain futures. Now, research shows the different ways these scenarios are subsequently used by users not involved in their initial development. In the absence of clear guidance from modellers, users may place too much or too little confidence in scenario assumptions and results.

LC-MS/MS based proteomic analysis and functional inference of hypothetical proteins in Desulfovibrio vulgaris

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

Zhang, Weiwen; Culley, David E.; Gritsenko, Marina A.

2006-11-03

ABSTRACT In the previous study, the whole-genome gene expression profiles of D. vulgaris in response to oxidative stress and heat shock were determined. The results showed 24-28% of the responsive genes were hypothetical proteins that have not been experimentally characterized or whose function can not be deduced by simple sequence comparison. To further explore the protecting mechanisms employed in D. vulgaris against the oxidative stress and heat shock, attempt was made in this study to infer functions of these hypothetical proteins by phylogenomic profiling along with detailed sequence comparison against various publicly available databases. By this approach we were abletomore » assign possible functions to 25 responsive hypothetical proteins. The findings included that DVU0725, induced by oxidative stress, may be involved in lipopolysaccharide biosynthesis, implying that the alternation of lipopolysaccharide on cell surface might service as a mechanism against oxidative stress in D. vulgaris. In addition, two responsive proteins, DVU0024 encoding a putative transcriptional regulator and DVU1670 encoding predicted redox protein, were sharing co-evolution atterns with rubrerythrin in Archaeoglobus fulgidus and Clostridium perfringens, respectively, implying that they might be part of the stress response and protective systems in D. vulgaris. The study demonstrated that phylogenomic profiling is a useful tool in interpretation of experimental genomics data, and also provided further insight on cellular response to oxidative stress and heat shock in D. vulgaris.« less

Floating Offshore Wind in Hawaii: Potential for Jobs and Economic Impacts from Three Future Scenarios

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

Jimenez, Tony; Keyser, David; Tegen, Suzanne

Construction of the first offshore wind power plant in the United States began in 2015, off the coast of Rhode Island, using fixed platform structures that are appropriate for shallow seafloors, like those located off the East Coast and mid-Atlantic. However, floating platforms, which have yet to be deployed commercially, will likely need to be anchored to the deeper seafloor if deployed in Hawaiian waters. To analyze the employment and economic potential for floating offshore wind off Hawaii's coasts, the Bureau of Ocean Energy Management commissioned the National Renewable Energy Laboratory (NREL) to analyze two hypothetical deployment scenarios for Hawaii:more » 400 MW of offshore wind by 2050 and 800 MW of offshore wind by 2050. The results of this analysis can be used to better understand the general scale of economic opportunities that could result from offshore wind development.« less

Reasoning about Make-Believe and Hypothetical Suppositions: Towards a Theory of Belief-Contravening Reasoning

ERIC Educational Resources Information Center

Amsel, Eric; Trionfi, Gabriel; Campbell, Richard

2005-01-01

The present study explores how suppositions which conflict with accepted beliefs are represented and reasoned about. Two studies test the predictions regarding the nature and developmental changes in children's ability to represent and reason about hypothetical or make-believe suppositions which violate their everyday knowledge and beliefs. In…

Scenario Evaluator for Electrical Resistivity survey pre-modeling tool

USGS Publications Warehouse

Terry, Neil; Day-Lewis, Frederick D.; Robinson, Judith L.; Slater, Lee D.; Halford, Keith J.; Binley, Andrew; Lane, John W.; Werkema, Dale D.

2017-01-01

Geophysical tools have much to offer users in environmental, water resource, and geotechnical fields; however, techniques such as electrical resistivity imaging (ERI) are often oversold and/or overinterpreted due to a lack of understanding of the limitations of the techniques, such as the appropriate depth intervals or resolution of the methods. The relationship between ERI data and resistivity is nonlinear; therefore, these limitations depend on site conditions and survey design and are best assessed through forward and inverse modeling exercises prior to field investigations. In this approach, proposed field surveys are first numerically simulated given the expected electrical properties of the site, and the resulting hypothetical data are then analyzed using inverse models. Performing ERI forward/inverse modeling, however, requires substantial expertise and can take many hours to implement. We present a new spreadsheet-based tool, the Scenario Evaluator for Electrical Resistivity (SEER), which features a graphical user interface that allows users to manipulate a resistivity model and instantly view how that model would likely be interpreted by an ERI survey. The SEER tool is intended for use by those who wish to determine the value of including ERI to achieve project goals, and is designed to have broad utility in industry, teaching, and research.

‘Imagined guilt’ vs ‘recollected guilt’: implications for fMRI

PubMed Central

Mclatchie, Neil; Giner-Sorolla, Roger; Derbyshire, Stuart W. G.

2016-01-01

Abstract Guilt is thought to maintain social harmony by motivating reparation. This study compared two methodologies commonly used to identify the neural correlates of guilt. The first, imagined guilt, requires participants to read hypothetical scenarios and then imagine themselves as the protagonist. The second, recollected guilt, requires participants to reflect on times they personally experienced guilt. In the fMRI scanner, participants were presented with guilt/neutral memories and guilt/neutral hypothetical scenarios. Contrasts confirmed a priori predictions that guilt memories, relative to guilt scenarios, were associated with significantly greater activity in regions associated with affect [anterior cingulate cortex (ACC), Caudate, Insula, orbital frontal cortex (OFC)] and social cognition [temporal pole (TP), precuneus). Similarly, results indicated that guilt memories, relative to neutral memories, were also associated with greater activity in affective (ACC, amygdala, Insula, OFC) and social cognition (mPFC, TP, precuneus, temporo-parietal junction) regions. There were no significant differences between guilt hypothetical scenarios and neutral hypothetical scenarios in either affective or social cognition regions. The importance of distinguishing between different guilt inductions inside the scanner is discussed. We offer explanations of our results and discuss ideas for future research. PMID:26746179

'Imagined guilt' vs 'recollected guilt': implications for fMRI.

PubMed

Mclatchie, Neil; Giner-Sorolla, Roger; Derbyshire, Stuart W G

2016-05-01

Guilt is thought to maintain social harmony by motivating reparation. This study compared two methodologies commonly used to identify the neural correlates of guilt. The first, imagined guilt, requires participants to read hypothetical scenarios and then imagine themselves as the protagonist. The second, recollected guilt, requires participants to reflect on times they personally experienced guilt. In the fMRI scanner, participants were presented with guilt/neutral memories and guilt/neutral hypothetical scenarios. Contrasts confirmed a priori predictions that guilt memories, relative to guilt scenarios, were associated with significantly greater activity in regions associated with affect [anterior cingulate cortex (ACC), Caudate, Insula, orbital frontal cortex (OFC)] and social cognition [temporal pole (TP), precuneus). Similarly, results indicated that guilt memories, relative to neutral memories, were also associated with greater activity in affective (ACC, amygdala, Insula, OFC) and social cognition (mPFC, TP, precuneus, temporo-parietal junction) regions. There were no significant differences between guilt hypothetical scenarios and neutral hypothetical scenarios in either affective or social cognition regions. The importance of distinguishing between different guilt inductions inside the scanner is discussed. We offer explanations of our results and discuss ideas for future research. © The Author (2016). Published by Oxford University Press.

Putative function of hypothetical proteins expressed by Clostridium perfringens type A strains and their protective efficacy in mouse model.

PubMed

Alam, Syed Imteyaz; Dwivedi, Pratistha

2016-10-01

The whole genome sequencing and annotation of Clostridium perfringens strains revealed several genes coding for proteins of unknown function with no significant similarities to genes in other organisms. Our previous studies clearly demonstrated that hypothetical proteins CPF_2500, CPF_1441, CPF_0876, CPF_0093, CPF_2002, CPF_2314, CPF_1179, CPF_1132, CPF_2853, CPF_0552, CPF_2032, CPF_0438, CPF_1440, CPF_2918, CPF_0656, and CPF_2364 are genuine proteins of C. perfringens expressed in high abundance. This study explored the putative role of these hypothetical proteins using bioinformatic tools and evaluated their potential as putative candidates for prophylaxis. Apart from a group of eight hypothetical proteins (HPs), a putative function was predicted for the rest of the hypothetical proteins using one or more of the algorithms used. The phylogenetic analysis did not suggest an evidence of a horizontal gene transfer event except for HP CPF_0876. HP CPF_2918 is an abundant extracellular protein, unique to C. perfringens species with maximum strain coverage and did not show any significant match in the database. CPF_2918 was cloned, recombinant protein was purified to near homogeneity, and probing with mouse anti-CPF_2918 serum revealed surface localization of the protein in C. perfringens ATCC13124 cultures. The purified recombinant CPF_2918 protein induced antibody production, a mixed Th1 and Th2 kind of response, and provided partial protection to immunized mice in direct C. perfringens challenge. Copyright © 2016 Elsevier B.V. All rights reserved.

Influence of framing on medical decision making

PubMed Central

Gong, Jingjing; Zhang, Yan; Feng, Jun; Huang, Yonghua; Wei, Yazhou; Zhang, Weiwei

2013-01-01

Numerous studies have demonstrated the robustness of the framing effect in a variety of contexts, especially in medical decision making. Unfortunately, research is still inconsistent as to how so many variables impact framing effects in medical decision making. Additionally, much attention should be paid to the framing effect not only in hypothetical scenarios but also in clinical experience. PMID:27034630

Hypothetical Rejuvenated Planets Artist Concept

NASA Image and Video Library

2015-06-25

This artist's concept shows a hypothetical "rejuvenated" planet -- a gas giant that has reclaimed its youthful infrared glow. NASA's Spitzer Space Telescope found tentative evidence for one such planet around a dead star, or white dwarf, called PG 0010+280 (depicted as white dot in illustration). When planets are young, they are warm and toasty due to internal heat left over from their formation. Planets cool over time -- until they are possibly rejuvenated. The theory goes that this Jupiter-like planet, which orbits far from its star, would accumulate some of the material sloughed off by its star as the star was dying. The material would cause the planet to swell in mass. As the material fell onto the planet, it would heat up due to friction and glow with infrared light. The final result would be an old planet, billions of years in age, radiating infrared light as it did in its youth. Spitzer detected an excess infrared light around the white dwarf PG 0010+280. Astronomers aren't sure where the light is coming from, but one possibility is a rejuvenated planet. Future observations may help solve the mystery. A Jupiter-like planet is about ten times the size of a white dwarf. White dwarfs are about the size of Earth, so one white dwarf would easily fit into the Great Red Spot on Jupiter! http://photojournal.jpl.nasa.gov/catalog/PIA19346

The future of scenarios: issues in developing new climate change scenarios

NASA Astrophysics Data System (ADS)

Pitcher, Hugh M.

2009-04-01

In September, 2007, the IPCC convened a workshop to discuss how a new set of scenarios to support climate model runs, mitigation analyses, and impact, adaptation and vulnerability research might be developed. The first phase of the suggested new approach is now approaching completion. This article discusses some of the issues raised by scenario relevant research and analysis since the last set of IPCC scenarios were created (IPCC SRES, 2000) that will need to be addressed as new scenarios are developed by the research community during the second phase. These include (1) providing a logic for how societies manage to transition from historical paths to the various future development paths foreseen in the scenarios, (2) long-term economic growth issues, (3) the appropriate GDP metric to use (purchasing power parity or market exchange rates), (4) ongoing issues with moving from the broad geographic and time scales of the emission scenarios to the finer scales needed for impacts, adaptation and vulnerability analyses and (5) some possible ways to handle the urgent request from the policy community for some guidance on scenario likelihoods. The challenges involved in addressing these issues are manifold; the reward is greater credibility and deeper understanding of an analytic tool that does much to form the context within which many issues in addition to the climate problem will need to be addressed.

Does message framing predict willingness to participate in a hypothetical HIV vaccine trial: an application of Prospect Theory.

PubMed

Evangeli, Michael; Kafaar, Zuhayr; Kagee, Ashraf; Swartz, Leslie; Bullemor-Day, Philippa

2013-01-01

It is vital that enough participants are willing to participate in clinical trials to test HIV vaccines adequately. It is, therefore, necessary to explore what affects peoples' willingness to participate (WTP) in such trials. Studies have only examined individual factors associated with WTP and not the effect of messages about trial participation on potential participants (e.g., whether losses or gains are emphasized, or whether the outcome is certain or uncertain). This study explores whether the effects of message framing on WTP in a hypothetical HIV vaccine trial are consistent with Prospect Theory. This theory suggests that people are fundamentally risk averse and that (1) under conditions of low risk and high certainty, gain-framed messages will be influential (2) under conditions of high risk and low certainty, loss-framed messages will be influential. This cross-sectional study recruited 283 HIV-negative students from a South African university who were given a questionnaire that contained matched certain gain-framed, certain loss-framed, uncertain gain-framed, and uncertain loss-framed statements based on common barriers and facilitators of WTP. Participants were asked to rate how likely each statement was to result in their participation in a hypothetical preventative HIV vaccine trial. Consistent with Prospect Theory predictions, for certain outcomes, gain-framed messages were more likely to result in WTP than loss-framed messages. Inconsistent with predictions, loss-framed message were not more likely to be related to WTP for uncertain outcomes than gain-framed messages. Older students were less likely to express their WTP across the different message frames. Recruitment for HIV vaccine trials should pay attention to how messages about the trial are presented to potential participants.

Take Me Out to the Ballgame, but Keep Me away from the Concession Stand Workers: A Hypothetical Case Involving Negligent Volunteers at Ballparks

ERIC Educational Resources Information Center

Thor, Jennifer Cordon; York, Kenneth M.

2016-01-01

The hypothetical case presented in this article challenges students in a legal environment of business course to answer that question by examining key legal concepts in agency and contract law, and to conduct an ethical analysis in a case involving volunteers. Although the events in the following case are hypothetical, the contract that the…

Developing a Hypothetical Learning Trajectory for the Sampling Distribution of the Sample Means

NASA Astrophysics Data System (ADS)

Syafriandi

2018-04-01

Special types of probability distribution are sampling distributions that are important in hypothesis testing. The concept of a sampling distribution may well be the key concept in understanding how inferential procedures work. In this paper, we will design a hypothetical learning trajectory (HLT) for the sampling distribution of the sample mean, and we will discuss how the sampling distribution is used in hypothesis testing.

A study of the competency of third year medical students to interpret biochemically based clinical scenarios using knowledge and skills gained in year 1 and 2.

PubMed

Gowda, Veena Bhaskar S; Nagaiah, Bhaskar Hebbani; Sengodan, Bharathi

2016-01-01

Medical students build clinical knowledge on the grounds of previously obtained basic knowledge. The study aimed to evaluate the competency of third year medical students to interpret biochemically based clinical scenarios using knowledge and skills gained during year 1 and 2 of undergraduate medical training. Study was conducted on year 3 MBBS students at AIMST University, Malaysia. Clinical scenarios (25) were constructed and administered to student volunteers, making sure at least one question from each system of year 2 was represented. Feedback was obtained on a five-point Likert scale regarding perception of learning biochemistry in MBBS year 1 versus 2. Mean score of test was 18 (72.11%). Performance was comparatively better in questions related to topics learnt in year 1 and reinforced in year 2 compared to those learnt for first time in year 2. In the feedback obtained, 31% strongly agreed and 56% agreed understanding the subject was helped more by learning biochemistry in year 2 than in year 1. Likewise, 36% strongly agreed and 56% agreed appreciating the importance of biochemistry in patient diagnosis was helped more by learning biochemistry in year 2 than year 1. Thirty one percent strongly agreed and 54% agreed that year 1 biochemistry would have been more relevant if case discussions were done simultaneously. Students retain basic science subjects better and appreciate the importance of basic sciences in patient diagnosis if they are reinforced in the context of clinical situations. © 2016 The International Union of Biochemistry and Molecular Biology.

Optimizing Decision Preparedness by Adapting Scenario Complexity and Automating Scenario Generation

NASA Technical Reports Server (NTRS)

Dunne, Rob; Schatz, Sae; Flore, Stephen M.; Nicholson, Denise

2011-01-01

Klein's recognition-primed decision (RPD) framework proposes that experts make decisions by recognizing similarities between current decision situations and previous decision experiences. Unfortunately, military personnel arQ often presented with situations that they have not experienced before. Scenario-based training (S8T) can help mitigate this gap. However, SBT remains a challenging and inefficient training approach. To address these limitations, the authors present an innovative formulation of scenario complexity that contributes to the larger research goal of developing an automated scenario generation system. This system will enable trainees to effectively advance through a variety of increasingly complex decision situations and experiences. By adapting scenario complexities and automating generation, trainees will be provided with a greater variety of appropriately calibrated training events, thus broadening their repositories of experience. Preliminary results from empirical testing (N=24) of the proof-of-concept formula are presented, and future avenues of scenario complexity research are also discussed.

Willingness to pay for three hypothetical malaria vaccines in Nigeria.

PubMed

Udezi, Waka Anthony; Usifoh, Cyril Odianose; Ihimekpen, Omoyeme Oluwatosin

2010-08-01

Unlike some African countries that have reported a approximately 50% reduction in malaria deaths in recent years, Nigeria has shown no evidence of a systematic decline in malaria burden. An important and sustainable reduction in malaria burden cannot be achieved unless an effective and inexpensive malaria vaccine becomes available. The goals of this study were to determine the willingness to pay (WTP) for 3 hypothetical malaria vaccines with different levels of protection (in years), effectiveness, and adverse effects; and to identify factors that influence the price that people are willing to pay in Nigeria. With the aid of a questionnaire, a contingent valuation method using payment cards was used to elicit WTP values for 3 hypothetical malaria vaccines. Payment cards contained both a description of the features of the vaccine being evaluated and price options. The 3 hypothetical vaccines had the following characteristics: vaccine A was 75% effective, protected for 3 years, and was well tolerated; vaccine B was 85% effective, protected for 6 years, and was less well tolerated than vaccine A; and vaccine C was 95% effective and protected for 12 years, but was the least well tolerated. Participants consisted of a convenience sample of individuals who were at the pharmacy waiting area of the state-owned hospitals located in Benin City and Warri, Nigeria. Every third patient or caregiver who was in the pharmacy to fill a prescription was asked to take part in the study as they waited to see the pharmacist. If consent was not granted, the next person in line was approached to be interviewed. Linear multiple regression analysis and nonparametric Kruskal-Wallis, Mann-Whitney, or chi(2) test was applied in inferential analysis, where necessary, to investigate the effects of sociodemographic factors on WTP. Prices on payment cards were expressed in Nigerian naira (NGN 150.00 approximately US $1.00), but study results were expressed in US dollars. A total of 359

ARkStorm: A West Coast Storm Scenario

NASA Astrophysics Data System (ADS)

Cox, D. A.; Jones, L. M.; Ralph, F. M.; Dettinger, M. D.; Porter, K.; Perry, S. C.; Barnard, P. L.; Hoover, D.; Wills, C. J.; Stock, J. D.; Croyle, W.; Ferris, J. C.; Plumlee, G. S.; Alpers, C. N.; Miller, M.; Wein, A.; Rose, A.; Done, J.; Topping, K.

2009-12-01

The United Stated Geological Survey (USGS) Multi-Hazards Demonstration Project (MHDP) is preparing a new emergency-preparedness scenario, called ARkStorm, to address massive U.S. West Coast storms analogous to those that devastated California in 1861-62. Storms of this magnitude are projected to become more frequent and intense as a result of climate change. The MHDP has assembled experts from the National Oceanic and Atmospheric Administration (NOAA), USGS, Scripps Institute of Oceanography, the State of California, California Geological Survey, the University of Colorado, the National Center for Atmospheric Research, and other organizations to design the large, but scientifically plausible, hypothetical scenario storm that would provide emergency responders, resource managers, and the public a realistic assessment of what is historically possible. The ARkStorm patterns the 1861 - 1862 historical events but uses modern modeling methods and data from large storms in 1969 and 1986. The ARkStorm draws heat and moisture from the tropical Pacific, forming Atmospheric Rivers (ARs) that grow in size, gain speed, and with a ferocity equal to hurricanes, slam into the U.S. West Coast for several weeks. Using sophisticated weather models and expert analysis, precipitation, snowlines, wind, and pressure data the modelers will characterize the resulting floods, landslides, and coastal erosion and inundation. These hazards will then be translated into the infrastructural, environmental, agricultural, social, and economic impacts. Consideration will be given to catastrophic disruptions to water supplies resulting from impacts on groundwater pumping, seawater intrusion, water supply degradation, and land subsidence. Possible climate-change forces that could exacerbate the problems will also be evaluated. In contrast to the recent U.S. East and Gulf Coast hurricanes, only recently have scientific and technological advances documented the ferocity and strength of possible future

Using scenarios to test the appropriateness of pharmacist prescribing in asthma management.

PubMed

Hanna, Tamer; Bajorek, Beata; Lemay, Kate; Armour, Carol L

2014-01-01

To explore the potential for community pharmacist prescribing in terms of usefulness, pharmacists' confidence, and appropriateness, in the context of asthma management. Twenty community pharmacists were recruited using convenience sampling from a group of trained practitioners who had already delivered asthma services. These pharmacists were asked to complete a scenario-based questionnaire (9 scenarios) modelled on information from real patients. Pharmacist interventions were independently reviewed and rated on their appropriateness according to the Respiratory Therapeutic Guidelines (TG) by three expert researchers. In seven of nine scenarios (78%), the most common prescribing intervention made by pharmacists agreed with TG recommendations. Although the prescribing intervention was appropriate in the majority of cases, the execution of such interventions was not in line with guidelines (i.e. dosage or frequency) in the majority of scenarios. Due to this, only 47% (76/162) of the interventions overall were considered appropriate. However, pharmacists were deemed to be often following common clinical practice for asthma prescribing. Therefore 81% (132/162) of prescribing interventions were consistent with clinical practice, which is often not guideline driven, indicating a need for specific training in prescribing according to guidelines. Pharmacists reported that they were confident in making prescribing interventions and that this would be very useful in their management of the patients in the scenarios. Community pharmacists may be able to prescribe asthma medications appropriately to help achieve good outcomes for their patients. However, further training in the guidelines for prescribing are required if pharmacists are to support asthma management in this way.

Using scenarios to test the appropriateness of pharmacist prescribing in asthma management

PubMed Central

Hanna, Tamer; Bajorek, Beata; LeMay, Kate; Armour, Carol L.

Objective To explore the potential for community pharmacist prescribing in terms of usefulness, pharmacists’ confidence, and appropriateness, in the context of asthma management. Methods Twenty community pharmacists were recruited using convenience sampling from a group of trained practitioners who had already delivered asthma services. These pharmacists were asked to complete a scenario-based questionnaire (9 scenarios) modelled on information from real patients. Pharmacist interventions were independently reviewed and rated on their appropriateness according to the Respiratory Therapeutic Guidelines (TG) by three expert researchers. Results In seven of nine scenarios (78%), the most common prescribing intervention made by pharmacists agreed with TG recommendations. Although the prescribing intervention was appropriate in the majority of cases, the execution of such interventions was not in line with guidelines (i.e. dosage or frequency) in the majority of scenarios. Due to this, only 47% (76/162) of the interventions overall were considered appropriate. However, pharmacists were deemed to be often following common clinical practice for asthma prescribing. Therefore 81% (132/162) of prescribing interventions were consistent with clinical practice, which is often not guideline driven, indicating a need for specific training in prescribing according to guidelines. Pharmacists reported that they were confident in making prescribing interventions and that this would be very useful in their management of the patients in the scenarios. Conclusions Community pharmacists may be able to prescribe asthma medications appropriately to help achieve good outcomes for their patients. However, further training in the guidelines for prescribing are required if pharmacists are to support asthma management in this way. PMID:24644524

Sexual Assault Disclosure: The Effect of Victim Race and Perpetrator Type on Empathy, Culpability, and Service Referral for Survivors in a Hypothetical Scenario.

PubMed

Franklin, Cortney A; Garza, Alondra D

2018-03-01

The aftermath of sexual assault warrants further attention surrounding the responses provided by those to whom survivors disclose, especially when perpetrator type or victim race may affect whether the bystander response is supportive or attributes culpability to the victim. Disclosure responses have significant consequences for survivors' posttrauma mental health and formal help-seeking behavior. The current study used a sample of 348 self-report, paper-and-pencil surveys administered during the fall 2015 semester to a purposive sample of undergraduate students with a mean age of 20.94 years old at a midsized, Southern public university. Survey design included a randomly assigned 2 × 2 hypothetical sexual assault disclosure vignette. The objective of the study was to assess the effect of perpetrator type (stranger vs. acquaintance) and victim race (White vs. Black) on empathic concern, culpability attributions, and resource referral. Between-subjects factorial ANOVA and multivariate ordinary least squares (OLS) regression models were estimated to identify the role of vignette manipulations, participant-sexual victimization history, and rape myth acceptance on empathy, culpability, and resource referral for the sexual assault survivor portrayed in the vignette. Multivariate analyses included main effects and moderation models. Findings revealed increased culpability and decreased resource referral for victims of acquaintance rape as compared with stranger rape, independent of victim race. Although no direct victim race effects emerged in the multivariate analyses, race moderated the effect of culpability on resource referral indicating culpability attributions decreased resource referral, but only when the victim was Black . Implications from the results presented here include a continued focus on bystander intervention strategies, empathy-building techniques, and educational programming targeting potential sexual assault disclosees and race stereotypes that

Clinical and experimental characteristics of "hypothetically psychosis prone" college students.

PubMed

Cadenhead, K; Kumar, C; Braff, D

1996-01-01

The study of individuals at the boundaries of schizophrenia has historically involved genetic relatives of schizophrenia patients or individuals who meet criteria for schizotypal personality disorder (SPD). Recently, many investigators have turned to the use of psychometric scales, developed to measure psychotic traits or vulnerability to developing schizophrenia, to screen large populations of college students in order to identify individuals who are "psychosis prone" or "schizotypal". To help answer the question of whether students identified with psychometric scales are indeed psychosis prone, we screened 1115 college students with the Perceptual Aberration/ Magical Ideation (PerMag) and Physical Anhedonia (PhysAn) Scales. Individuals who scored 2 standard deviations (SD) above the mean on the scales were selected as experimental subjects (N = 13 PerMag, N = 10 PhysAn) and a subpopulation of matched subjects who scored less than 0.5 SD above the mean were selected as control subjects (N = 24). All subjects then received a full battery of tests, including structured clinical interviews, the MMPI, and psychophysiological measures of information processing, including prepulse inhibition and habituation of the human startle response, visual backward masking and reaction time measures. The results suggest that the PerMag scale, but not the PhysAn scale, identifies individuals with some psychotic, affective and anxiety symptoms when compared to the controls. Neither scale predicts a diagnosis of schizotypal personality disorder or deficits on measures of information processing that characterize schizophrenia or schizotypal personality disordered patients.

Prioritization and willingness to pay for bariatric surgery: the patient perspective

PubMed Central

Gill, Richdeep S.; Majumdar, Sumit R.; Wang, Xiaoming; Tuepah, Rebecca; Klarenbach, Scott W.; Birch, Daniel W.; Karmali, Shahzeer; Sharma, Arya M.; Padwal, Raj S.

2014-01-01

Background Access to publicly funded bariatric surgery is limited, potential candidates face lengthy waits, and no universally accepted prioritization criteria exist. We examined patients’ perspectives regarding prioritization for surgery. Methods We surveyed consecutively recruited patients awaiting bariatric surgery about 9 hypothetical scenarios describing patients waiting for surgery. Respondents were asked to rank the priority of these hypothetical patients on the wait list relative to their own. Scenarios examined variations in age, clinical severity, functional impairment, social dependence and socioeconomic status. Willingness to pay for faster access was assessed using a 5-point ordinal scale and analyzed using multivariable logistic regression. Results The 99 respondents had mean age of 44.7 ± 9.9 years, 76% were women, and the mean body mass index was 47.3 ± SD 7.6. The mean wait for surgery was 34.4 ± 9.4 months. Respondents assigned similar priority to hypothetical patients with characteristics identical to theirs (p = 0.22) and higher priority (greater urgency) to those exhibiting greater clinical severity (p < 0.001) and functional impairment (p = 0.003). Lower priority was assigned to patients at the extremes of age (p = 0.006), on social assistance (p < 0.001) and of high socioeconomic status (p < 0.001). Most (85%) respondents disagreed with payment to expedite access, although participants earning more than $80 000/year were less likely to disagree. Conclusion Most patients waiting for bariatric surgery consider greater clinical severity and functional impairments related to obesity to be important prioritization indicators and disagreed with paying for faster access. These findings may help inform future efforts to develop acceptable prioritization strategies for publicly funded bariatric surgery. PMID:24461224

Prioritization and willingness to pay for bariatric surgery: the patient perspective.

PubMed

Gill, Richdeep S; Majumdar, Sumit R; Wang, Xiaoming; Tuepah, Rebecca; Klarenbach, Scott W; Birch, Daniel W; Karmali, Shahzeer; Sharma, Arya M; Padwal, Raj S

2014-02-01

Access to publicly funded bariatric surgery is limited, potential candidates face lengthy waits, and no universally accepted prioritization criteria exist. We examined patients' perspectives regarding prioritization for surgery. We surveyed consecutively recruited patients awaiting bariatric surgery about 9 hypothetical scenarios describing patients waiting for surgery. Respondents were asked to rank the priority of these hypothetical patients on the wait list relative to their own. Scenarios examined variations in age, clinical severity, functional impairment, social dependence and socioeconomic status. Willingness to pay for faster access was assessed using a 5-point ordinal scale and analyzed using multivariable logistic regression. The 99 respondents had mean age of 44.7 ± 9.9 years, 76% were women, and the mean body mass index was 47.3 ± SD 7.6. The mean wait for surgery was 34.4 ± 9.4 months. Respondents assigned similar priority to hypothetical patients with characteristics identical to theirs (p = 0.22) and higher priority (greater urgency) to those exhibiting greater clinical severity (p < 0.001) and functional impairment (p = 0.003). Lower priority was assigned to patients at the extremes of age (p = 0.006), on social assistance (p < 0.001) and of high socioeconomic status (p < 0.001). Most (85%) respondents disagreed with payment to expedite access, although participants earning more than $80 000/year were less likely to disagree. Most patients waiting for bariatric surgery consider greater clinical severity and functional impairments related to obesity to be important prioritization indicators and disagreed with paying for faster access. These findings may help inform future efforts to develop acceptable prioritization strategies for publicly funded bariatric surgery.

On the hypothetical universal use of statins in primary prevention: an observational analysis on low-risk patients and economic consequences of a potential wide prescription rate.

PubMed

Macchia, Alejandro; Mariani, Javier; Romero, Marilena; Robusto, Fabio; Lepore, Vito; Dettorre, Antonio; Tognoni, Gianni

2015-04-01

Recent guidelines expand indications for statins. However, research on practical economic feasibility and cost-effectiveness in low-risk people is lacking. We aimed to describe the incidence of cardiovascular events (CVE), their total direct costs and the hypothetical effects of wide provision of statins on those rates and expenditures. We conducted a population-based cohort study using administrative data among low risk individuals. Estimators of effects of statins were taken from Cholesterol Treatment trialist metaanalysis and from Heart Protection Study trial. Two statin prices were used for analyses: National Italian Health System (€ 0.36) and the International Drug Price Indicator (€ 0.021). Overall, 920,067 persons at low risk were identified and 14,849 CVE were registered (incidence rate 27.3 per 10,000 person-years). Direct costs for hospitalizations for CVE were 143 M €. Universal provision of statins would result in a significant decrease in CVE rates, from 27.3 to 17.5 per 10,000 person-years (PY) (95% confidence interval (CI): 15.8-19.4). Universal prescription of simvastatin 20 mg would cost 802 M €. Otherwise, provision of simvastatin at International Drug Price Indicator's prices would be both clinically effective and cost saving in men older than age 44 (observed expenditures 120 M €, expected 97.4 M €) but not in women (observed expenditures 22.7 M €, expected 36.5 M €). Among a low-risk population, hypothetical universal provision of low-cost simvastatin to men over 44 years could be both clinically effective and a cost-saving strategy.

Evidence-practice gap for dental sealant application: results from a dental practice-based research network in Japan.

PubMed

Yokoyama, Yoko; Kakudate, Naoki; Sumida, Futoshi; Matsumoto, Yuki; Gilbert, Gregg H; Gordan, Valeria V

2016-12-01

The study aims were: (i) to examine dentist practice patterns regarding treatment recommendations for dental sealants; and (ii) to identify characteristics associated with this recommendation. The study was performed using a cross-sectional questionnaire survey (Clinicaltrials.gov registration number NCT01680848). Participants were Japanese dentists (n = 282) recruited from the Dental Practice-based Research Network Japan. Three clinical photographs of the occlusal surface of a mandibular first molar were presented, portraying increasing depths of cavitation in a 12-year-old patient with high caries risk. Sealants would be an appropriate treatment in all three scenarios. We asked about the treatment decision for each case. We then performed multiple logistic regression analyses to evaluate associations between the decision to recommend sealants, and dentist, patient and practice characteristics. Responses were obtained from 189 dentists (response rate = 67%). In the hypothetical scenarios, dentists' recommendations for sealants for the 12-year-old patient varied from 16% to 26% across the three hypothetical clinical scenarios. Multiple logistic regression analysis indicated that dentist agreement with the efficacy of assessment for caries risk showed a significant association with the percentages of patients receiving sealants. Dentist practice patterns for sealant treatment recommendation show changes that are dependent on caries severity. The dentists' recommendations for sealants for the 12-year-old patient were low for all three selected scenarios, based on indications for sealants in the American Dental Association guidelines. Recommending a sealant showed a significant relationship with the dentist having a higher agreement with efficacy of caries risk assessment. © 2016 FDI World Dental Federation.

The compatibility heuristic in non-categorical hypothetical reasoning: inferences between conditionals and disjunctions.

PubMed

Espino, Orlando; Byrne, Ruth M J

2013-11-01

A new theory explains how people make hypothetical inferences from a premise consistent with several alternatives to a conclusion consistent with several alternatives. The key proposal is that people rely on a heuristic that identifies compatible possibilities. It is tested in 7 experiments that examine inferences between conditionals and disjunctions. Participants accepted inferences between conditionals and inclusive disjunctions when a compatible possibility was immediately available, in their binary judgments that a conclusion followed or not (Experiment 1a) and ternary judgments that included it was not possible to know (Experiment 1b). The compatibility effect was amplified when compatible possibilities were more readily available, e.g., for 'A only if B' conditionals (Experiment 2). It was eliminated when compatible possibilities were not available, e.g., for 'if and only if A B' bi-conditionals and exclusive disjunctions (Experiment 3). The compatibility heuristic occurs even for inferences based on implicit negation e.g., 'A or B, therefore if C D' (Experiment 4), and between universals 'All A's are B's' and disjunctions (Experiment 5a) and universals and conditionals (Experiment 5b). The implications of the results for alternative theories of the cognitive processes underlying hypothetical deductions are discussed. Copyright © 2013. Published by Elsevier Inc.

OPPORTUNITY COSTS OF REWARD DELAYS AND THE DISCOUNTING OF HYPOTHETICAL MONEY AND CIGARETTES

PubMed Central

Johnson, Patrick S.; Herrmann, Evan S.; Johnson, Matthew W.

2015-01-01

Humans are reported to discount delayed rewards at lower rates than nonhumans. However, nonhumans are studied in tasks that restrict reinforcement during delays, whereas humans are typically studied in tasks that do not restrict reinforcement during delays. In nonhuman tasks, the opportunity cost of restricted reinforcement during delays may increase delay discounting rates. The present within-subjects study used online crowdsourcing (Amazon Mechanical Turk, or MTurk) to assess the discounting of hypothetical delayed money (and cigarettes in smokers) under four hypothetical framing conditions differing in the availability of reinforcement during delays. At one extreme, participants were free to leave their computer without returning, and engage in any behavior during reward delays (modeling typical human tasks). At the opposite extreme, participants were required to stay at their computer and engage in little other behavior during reward delays (modeling typical nonhuman tasks). Discounting rates increased as an orderly function of opportunity cost. Results also indicated predominantly hyperbolic discounting, the “magnitude effect,” steeper discounting of cigarettes than money, and positive correlations between discounting rates of these commodities. This is the first study to test the effects of opportunity costs on discounting, and suggests that procedural differences may partially account for observed species differences in discounting. PMID:25388973

Opportunity costs of reward delays and the discounting of hypothetical money and cigarettes.

PubMed

Johnson, Patrick S; Herrmann, Evan S; Johnson, Matthew W

2015-01-01

Humans are reported to discount delayed rewards at lower rates than nonhumans. However, nonhumans are studied in tasks that restrict reinforcement during delays, whereas humans are typically studied in tasks that do not restrict reinforcement during delays. In nonhuman tasks, the opportunity cost of restricted reinforcement during delays may increase delay discounting rates. The present within-subjects study used online crowdsourcing (Amazon Mechanical Turk, or MTurk) to assess the discounting of hypothetical delayed money (and cigarettes in smokers) under four hypothetical framing conditions differing in the availability of reinforcement during delays. At one extreme, participants were free to leave their computer without returning, and engage in any behavior during reward delays (modeling typical human tasks). At the opposite extreme, participants were required to stay at their computer and engage in little other behavior during reward delays (modeling typical nonhuman tasks). Discounting rates increased as an orderly function of opportunity cost. Results also indicated predominantly hyperbolic discounting, the "magnitude effect," steeper discounting of cigarettes than money, and positive correlations between discounting rates of these commodities. This is the first study to test the effects of opportunity costs on discounting, and suggests that procedural differences may partially account for observed species differences in discounting. © Society for the Experimental Analysis of Behavior.

Land-Use Scenarios: National-Scale Housing-Density Scenarios Consistent with Climate Change Storylines (Final Report)

EPA Science Inventory

EPA announced the availability of the final report, Land-Use Scenarios: National-Scale Housing-Density Scenarios Consistent with Climate Change Storylines. This report describes the scenarios and models used to generate national-scale housing density scenarios for the con...

Power generation costs and ultimate thermal hydraulic power limits in hypothetical advanced designs with natural circulation

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

Duffey, R.B.; Rohatgi, U.S.

Maximum power limits for hypothetical designs of natural circulation plants can be described analytically. The thermal hydraulic design parameters are those which limit the flow, being the elevations, flow areas, and loss coefficients. WE have found some simple ``design`` equations for natural circulation flow to power ratio, and for the stability limit. The analysis of historical and available data for maximum capacity factor estimation shows 80% to be reasonable and achievable. The least cost is obtained by optimizing both hypothetical plant performance for a given output,a nd the plant layout and design. There is also scope to increase output andmore » reduce cost by considering design variations of primary and secondary pressure, and by optimizing component elevations and loss coefficients. The design limits for each are set by stability and maximum flow considerations, which deserve close and careful evaluation.« less

Critical Review of Willingness to Pay for Clinical Oral Health Interventions

PubMed Central

Tan, Sharon Hui Xuan; Vernazza, Christopher R; Nair, Rahul

2017-01-01

Objectives This critical review aimed to identify, consolidate and evaluate the quality of Willingness to Pay (WTP) studies applied to clinical contexts in the field of dentistry. Methods PubMed and Web of Science databases were systematically searched for relevant publications. Screening and data extraction was then performed. Primary literature in English-language were included to assess the WTP for oral health interventions, when the valuations were applied to a clinical measure. Twenty-six publications met the inclusion criteria. Results WTP was elicited mainly via face-to-face interviews (13 publications) and questionnaires (12 publications). The majority (24) of publications selected an out-of-pocket payment vehicle. Eleven publications adopted a bidding method, nine publications adopted an open-ended format, and the remaining six studies adopted a payment card or choice method. Pre-testing was reported in only nine publications, and few studies accounted for starting point bias. Eight of 11 publications found that higher incomes were associated with higher WTP values. The female gender, a younger age and higher education levels were associated with a higher WTP in select studies. Conclusions Only a small minority of the studies used strategies to avoid well documented biases related to WTP elicitation. Cost versus benefit of many clinical scenarios remain uninvestigated. Clinical significance WTP studies in dentistry may benefit from pre-testing and the inclusion of a script to minimise hypothetical bias. They may also be better conducted face-to-face and via a shuffled payment card method. Income levels, and potentially education levels, gender and age, should be assessed for their influence on WTP values. PMID:28662842

Evaluating Potential for Large Releases from CO2 StorageReservoirs: Analogs, Scenarios, and Modeling Needs

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

Birkholzer, Jens; Pruess, Karsten; Lewicki, Jennifer

2005-09-19

While the purpose of geologic storage of CO{sub 2} in deep saline formations is to trap greenhouse gases underground, the potential exists for CO{sub 2} to escape from the target reservoir, migrate upward along permeable pathways, and discharge at the land surface. Such discharge is not necessarily a serious concern, as CO{sub 2} is a naturally abundant and relatively benign gas in low concentrations. However, there is a potential risk to health, safety and environment (HSE) in the event that large localized fluxes of CO{sub 2} were to occur at the land surface, especially where CO{sub 2} could accumulate. Inmore » this paper, we develop possible scenarios for large CO{sub 2} fluxes based on the analysis of natural analogues, where large releases of gas have been observed. We are particularly interested in scenarios which could generate sudden, possibly self-enhancing, or even eruptive release events. The probability for such events may be low, but the circumstances under which they might occur and potential consequences need to be evaluated in order to design appropriate site selection and risk management strategies. Numerical modeling of hypothetical test cases is needed to determine critical conditions for such events, to evaluate whether such conditions may be possible at designated storage sites, and, if applicable, to evaluate the potential HSE impacts of such events and design appropriate mitigation strategies.« less

In Sickness but Not in Wealth: Field Evidence on Patients' Risk Preferences in Financial and Health Domains.

PubMed

Galizzi, Matteo M; Miraldo, Marisa; Stavropoulou, Charitini

2016-05-01

We present results from a hypothetical framed field experiment assessing whether risk preferences significantly differ across the health and financial domains when they are elicited through the same multiple price list paired-lottery method. We consider a sample of 300 patients attending outpatient clinics in a university hospital in Athens during the Greek financial crisis. Risk preferences in finance were elicited using paired-lottery questions with hypothetical payments. The questions were adapted to the health domain by framing the lotteries as risky treatments in hypothetical health care scenarios. Using maximum likelihood methods, we estimated the degree of risk aversion, allowing for the estimates to be dependent on domain and individual characteristics. The subjects in our sample, who were exposed to both health and financial distress, tended to be less risk averse in the financial domain than in the health domain. © The Author(s) 2016.

Tropical peatland carbon dynamics simulated for scenarios of disturbance and restoration and climate change

NASA Astrophysics Data System (ADS)

Frolking, S. E.; Warren, M.; Dai, Z.; Kurnianto, S.; Hagen, S. C.

2015-12-01

Tropical peatlands contain a globally significant carbon pool. Southeast Asian peatlands are being deforested, drained and burned at very high rates, mostly for conversion to industrial oil palm or pulp and paper plantations. The climate mitigation potential of tropical peatlands has gained increasing attention in recent years as persistent greenhouse gas emissions can be avoided or decreased if peatlands remain intact or are rehabilitated. In addition, peatland conservation or rehabilitation for climate mitigation also includes multiple co-benefits such as maintenance of ecosystem services, biodiversity, and air quality from reduced fire occurrence. Inventory guidelines and methodologies have only recently become available, and are based on few data from a limited number of sites. Few heuristic tools are available to evaluate the impact of management practices on carbon dynamics in tropical peatlands, and the potential climate mitigation benefits of peatland restoration. We used a process based dynamic tropical peatland model to explore the C dynamics of several peatland management trajectories represented by hypothetical scenarios, within the context of simulated 21st century climate change. All scenarios with land use, including those with optimal restoration, simulate C loss over the 21st century, with C losses ranging from 10% to essentially 100% of pre-disturbance values. Fire, either prescribed as part of a crop rotation cycle, or stochastic occurrences in sub-optimally managed degraded land can be the dominant C-loss pathway, particularly in the drier climate scenario we tested. A single 25-year oil palm rotation, with a prescribed initial burn, lost 40-50 kg C/m2, equivalent to accumulation during the previous 500 years, 10-30% of which was restored in 75 years of optimal restoration. Our results indicate that even under the most optimistic scenario of hydrological and forest restoration and the wettest climate regime, only about one-third of the carbon

Putting flow-ecology relationships into practice: A decision-support system to assess fish community response to water-management scenarios

USGS Publications Warehouse

Cartwright, Jennifer M.; Caldwell, Casey; Nebiker, Steven; Knight, Rodney

2017-01-01

This paper presents a conceptual framework to operationalize flow–ecology relationships into decision-support systems of practical use to water-resource managers, who are commonly tasked with balancing multiple competing socioeconomic and environmental priorities. We illustrate this framework with a case study, whereby fish community responses to various water-management scenarios were predicted in a partially regulated river system at a local watershed scale. This case study simulates management scenarios based on interactive effects of dam operation protocols, withdrawals for municipal water supply, effluent discharges from wastewater treatment, and inter-basin water transfers. Modeled streamflow was integrated with flow–ecology relationships relating hydrologic departure from reference conditions to fish species richness, stratified by trophic, reproductive, and habitat characteristics. Adding a hypothetical new water-withdrawal site was predicted to increase the frequency of low-flow conditions with adverse effects for several fish groups. Imposition of new reservoir release requirements was predicted to enhance flow and fish species richness immediately downstream of the reservoir, but these effects were dissipated further downstream. The framework presented here can be used to translate flow–ecology relationships into evidence-based management by developing decision-support systems for conservation of riverine biodiversity while optimizing water availability for human use.

Clinical decision-making: midwifery students' recognition of, and response to, post partum haemorrhage in the simulation environment.

PubMed

Scholes, Julie; Endacott, Ruth; Biro, MaryAnne; Bulle, Bree; Cooper, Simon; Miles, Maureen; Gilmour, Carole; Buykx, Penny; Kinsman, Leigh; Boland, Rosemarie; Jones, Jan; Zaidi, Fawzia

2012-03-23

This paper reports the findings of a study of how midwifery students responded to a simulated post partum haemorrhage (PPH). Internationally, 25% of maternal deaths are attributed to severe haemorrhage. Although this figure is far higher in developing countries, the risk to maternal wellbeing and child health problem means that all midwives need to remain vigilant and respond appropriately to early signs of maternal deterioration. Simulation using a patient actress enabled the research team to investigate the way in which 35 midwifery students made decisions in a dynamic high fidelity PPH scenario. The actress wore a birthing suit that simulated blood loss and a flaccid uterus on palpation. The scenario provided low levels of uncertainty and high levels of relevant information. The student's response to the scenario was videoed. Immediately after, they were invited to review the video, reflect on their performance and give a commentary as to what affected their decisions. The data were analysed using Dimensional Analysis. The students' clinical management of the situation varied considerably. Students struggled to prioritize their actions where more than one response was required to a clinical cue and did not necessarily use mnemonics as heuristic devices to guide their actions. Driven by a response to single cues they also showed a reluctance to formulate a diagnosis based on inductive and deductive reasoning cycles. This meant they did not necessarily introduce new hypothetical ideas against which they might refute or confirm a diagnosis and thereby eliminate fixation error. The students response demonstrated that a number of clinical skills require updating on a regular basis including: fundal massage technique, the use of emergency standing order drugs, communication and delegation of tasks to others in an emergency and working independently until help arrives. Heuristic devices helped the students to evaluate their interventions to illuminate what else could

Clinical decision-making: midwifery students' recognition of, and response to, post partum haemorrhage in the simulation environment

PubMed Central

2012-01-01

Background This paper reports the findings of a study of how midwifery students responded to a simulated post partum haemorrhage (PPH). Internationally, 25% of maternal deaths are attributed to severe haemorrhage. Although this figure is far higher in developing countries, the risk to maternal wellbeing and child health problem means that all midwives need to remain vigilant and respond appropriately to early signs of maternal deterioration. Methods Simulation using a patient actress enabled the research team to investigate the way in which 35 midwifery students made decisions in a dynamic high fidelity PPH scenario. The actress wore a birthing suit that simulated blood loss and a flaccid uterus on palpation. The scenario provided low levels of uncertainty and high levels of relevant information. The student's response to the scenario was videoed. Immediately after, they were invited to review the video, reflect on their performance and give a commentary as to what affected their decisions. The data were analysed using Dimensional Analysis. Results The students' clinical management of the situation varied considerably. Students struggled to prioritise their actions where more than one response was required to a clinical cue and did not necessarily use mnemonics as heuristic devices to guide their actions. Driven by a response to single cues they also showed a reluctance to formulate a diagnosis based on inductive and deductive reasoning cycles. This meant they did not necessarily introduce new hypothetical ideas against which they might refute or confirm a diagnosis and thereby eliminate fixation error. Conclusions The students response demonstrated that a number of clinical skills require updating on a regular basis including: fundal massage technique, the use of emergency standing order drugs, communication and delegation of tasks to others in an emergency and working independently until help arrives. Heuristic devices helped the students to evaluate their

Performance of the 2012 Systemic Lupus International Collaborating Clinics and the 1997 American College of Rheumatology classification criteria for systemic lupus erythematosus in a real-life scenario.

PubMed

Amezcua-Guerra, Luis M; Higuera-Ortiz, Violeta; Arteaga-García, Ulises; Gallegos-Nava, Selma; Hübbe-Tena, Claudia

2015-03-01

To evaluate the performance of the 2012 Systemic Lupus International Collaborating Clinics (SLICC) criteria in classifying systemic lupus erythematosus (SLE) in an uncontrolled real-life scenario. Chart review study was performed in which each criterion from the 1997 American College of Rheumatology (ACR) and the 2012 SLICC criteria to classify SLE was applied to patients from an outpatient rheumatology clinic. The clinical diagnosis was used as the gold standard. The sensitivity and specificity of the 2012 SLICC criteria were 92% and 99%, respectively, compared with the 1997 ACR criteria, which were 97% and 99%, respectively. The 2012 SLICC criteria were similar to the 1997 ACR criteria in terms of positive (98.9% versus 99%) and negative (92.5% versus 97.1%) predictive values as well as positive (92 versus 97) and negative (0.08 versus 0.03) likelihood ratios. A concordance of 0.96 (95% confidence interval [95% CI] 0.92–1.00) was observed between clinical diagnosis and the 1997 ACR criteria, while the concordance was 0.91 (95% CI 0.85–0.97) for the 2012 SLICC criteria. Seven SLE patients classified by the 1997 ACR criteria did not meet the 2012 SLICC criteria because of either the new definition for lymphopenia (2 patients) or the presence of isolated cutaneous involvement (5 patients), while 2 SLE patients who were classified by the 2012 SLICC criteria did not meet the 1997 ACR criteria because of either the presence of erosive arthritis or biopsy-proven nephritis with circulating antinuclear antibodies. Overall, the 1997 ACR and the 2012 SLICC criteria are similar to classify SLE in an uncontrolled real-life scenario, although several new items contained in the 2012 SLICC criteria could represent a step forward for research purposes in selected clinical settings.

Hypothetical midlife interventions in women and risk of type 2 diabetes.

PubMed

Danaei, Goodarz; Pan, An; Hu, Frank B; Hernán, Miguel A

2013-01-01

Randomized trials have examined short-term effects of lifestyle interventions for diabetes prevention only among high-risk individuals. Prospective studies have examined the associations between lifestyle factors and diabetes in healthy populations but have not characterized the intervention. We estimated the long-term effects of hypothetical lifestyle interventions on diabetes in a prospective study of healthy women, using the parametric g-formula. Using data from the Nurses' Health Study, we followed 76,402 women from 1984 to 2008. We estimated the risk of type 2 diabetes under eight hypothetical interventions: quitting smoking, losing weight by 5% every 2 years if overweight/obese, exercising at least 30 minutes a day, eating less than three servings a week of red meat, eating at least two servings a day of whole grain, drinking two or more cups of coffee a day, drinking five or more grams of alcohol a day, and drinking less than one serving of soda a week. The 24-year risk of diabetes was 9.6% under no intervention and 4.3% when all interventions were imposed (55% lower risk [95% confidence interval = 47 to 63%]). The most effective interventions were weight loss (24% lower risk), physical activity (19%), and moderate alcohol use (19%). Overweight/obese women would benefit the most, with 10.8 percentage point reduction in 24-year risk of diabetes. The validity of these estimates relies on the absence of unmeasured confounding, measurement error, and model misspecification. A combination of dietary and nondietary lifestyle modifications, begun in midlife or later in relatively healthy women, could have prevented at least half of the cases of type 2 diabetes in this cohort of U.S. women.

Parents’ Aggressive Influences and Children's Aggressive Problem Solutions with Peers

PubMed Central

Duman, Sarah; Margolin, Gayla

2009-01-01

This study examined children's aggressive and assertive solutions to hypothetical peer scenarios in relation to parents’ responses to similar hypothetical social scenarios and parents’ actual marital aggression. The study included 118 9−10 year old children, and their mothers and fathers. Children's aggressive solutions correlated with same-sex parents’ actual marital aggression. For children with mothers who exhibit low actual marital aggression, mothers’ aggressive solutions to hypothetical situations corresponded with children's tendencies to propose aggressive but not assertive solutions. In a 3-way interaction, fathers’ aggressive solutions to peer scenarios and marital aggression, combined, exacerbated girls’ aggressive problem solving, but had the opposite effect for boys. Discussion addresses the complexity, particularly with respect to parent and child gender combinations, in understanding parents’ aggressive influences on children's peer relationships. PMID:17206880

Attitudes and Behavioural Intentions of Typically Developing Adolescents towards a Hypothetical Peer with Asperger Syndrome

ERIC Educational Resources Information Center

Fleva, Eleni

2014-01-01

This study examines the attitudes and the behavioural intentions of typically developing (TD) adolescents towards a hypothetical peer with Asperger syndrome (AS). Participants (N = 179, M age = 13.7 years) viewed two PowerPoint presentations one of a TD male target and one of a male target with AS. The target with AS was introduced either with…

[Study on willingness to participate and willingness to pay for hypothetical industrial injury insurance scheme].

PubMed

Wu, Yuan; Dong, Hengjin; Duan, Shengnan; Liu, Xiaofang; Ye, Chiyu; You, Hua; Hu, Huimei; Wang, Linhao; Zhang, Xing; Wang, Jing

2014-10-01

To investigate workers' willingness to participate and wiliness to pay for a hypothetical industrial injury insurance scheme, to analyze the influential factors, and to provide information for policy making of the government. Multistage cluster sampling was used to select subjects: In the first stage, 9 small, medium, orlarge enterprises were selected fromthree cities (counties) in Zhejiang province, China, according to the level of economic development, transportation convenience, and cooperation of government agencies; in the second stage, several workshops were randomly selected from each of the 9 enterprises. Face-to-face interviews among all workers in the workshops were conducted by trained interviewers using a pre-designed questionnaire. It was found that 73.87% (2095) of all workers were willing to participate in the hypothetical work injury insurance scheme and to pay 2.21% of monthly wage (51.77 yuan) on average, and more than half of the workers were willing to pay less than 1%of monthly wage (35 yuan). Of the 741 workers who were not willing to participate, 327 thought that the premium should be borne by the state or enterprises, instead of individuals, and others were not willing to participate because of low income, unstable job, or poor understanding of the hypothetical industrial injury insurance scheme. Logistic regression analysis showed that workers with higher education levels, longer length of services, longer weekly working time, or more knowledge of occupational diseases showed higher willingness to participate in the scheme; workers who were exposed to physical hazards, had health records, or had participated in the existing medical insurance or industrial injury insurance were more willing to participate. Multiple linear regression analysis showed that with increasing average monthly wage, weekly working time, and self?health evaluation, the proportion of workers with willingness to pay increased; however, with increasing work intensity and

Method matters: impact of in-scenario instruction on simulation-based teamwork training.

PubMed

Escher, Cecilia; Rystedt, Hans; Creutzfeldt, Johan; Meurling, Lisbet; Nyström, Sofia; Dahlberg, Johanna; Edelbring, Samuel; Nordahl Amorøe, Torben; Hult, Håkan; Felländer-Tsai, Li; Abrandt-Dahlgren, Madeleine

2017-01-01

The rationale for introducing full-scale patient simulators in training to improve patient safety is to recreate clinical situations in a realistic setting. Although high-fidelity simulators mimic a wide range of human features, simulators differ from the body of a sick patient. The gap between the simulator and the human body implies a need for facilitators to provide information to help participants understand scenarios. The authors aimed at describing different methods that facilitators in our dataset used to provide such extra scenario information and how the different methods to convey information affected how scenarios played out. A descriptive qualitative study was conducted to examine the variation of methods to deliver extra scenario information to participants. A multistage approach was employed. The authors selected film clips from a shared database of 31 scenarios from three participating simulation centers. A multidisciplinary research team performed a collaborative analysis of representative film clips focusing on the interplay between participants, facilitators, and the physical environment. After that, the entire material was revisited to further examine and elaborate the initial findings. The material displayed four distinct methods for facilitators to convey information to participants in simulation-based teamwork training. The choice of method had impact on the participating teams regarding flow of work, pace, and team communication. Facilitators' close access to the teams' activities when present in the simulation suite, either embodied or disembodied in the simulation, facilitated the timing for providing information, which was critical for maintaining the flow of activities in the scenario. The mediation of information by a loudspeaker or an earpiece from the adjacent operator room could be disturbing for team communication. In-scenario instruction is an essential component of simulation-based teamwork training that has been largely overlooked

Willingness to Know the Cause of Death and Hypothetical Acceptability of the Minimally Invasive Autopsy in Six Diverse African and Asian Settings: A Mixed Methods Socio-Behavioural Study

PubMed Central

Maixenchs, Maria; Anselmo, Rui; Zielinski-Gutiérrez, Emily; Odhiambo, Frank O.; Akello, Clarah; Zaidi, S. Shujaat H.; Soofi, Sajid Bashir; Bhutta, Zulfiqar A.; Diarra, Kounandji; Djitèye, Mahamane; Dembélé, Roukiatou; Sow, Samba; Minsoko, Pamela Cathérine Angoissa; Agnandji, Selidji Todagbe; Ismail, Mamudo R.; Carrilho, Carla; Ordi, Jaume; Menéndez, Clara; Bassat, Quique

2016-01-01

Background The minimally invasive autopsy (MIA) is being investigated as an alternative to complete diagnostic autopsies for cause of death (CoD) investigation. Before potential implementation of the MIA in settings where post-mortem procedures are unusual, a thorough assessment of its feasibility and acceptability is essential. Methods and Findings We conducted a socio-behavioural study at the community level to understand local attitudes and perceptions related to death and the hypothetical feasibility and acceptability of conducting MIAs in six distinct settings in Gabon, Kenya, Mali, Mozambique, and Pakistan. A total of 504 interviews (135 key informants, 175 health providers [including formal health professionals and traditional or informal health providers], and 194 relatives of deceased people) were conducted. The constructs “willingness to know the CoD” and “hypothetical acceptability of MIAs” were quantified and analysed using the framework analysis approach to compare the occurrence of themes related to acceptability across participants. Overall, 75% (379/504) of the participants would be willing to know the CoD of a relative. The overall hypothetical acceptability of MIA on a relative was 73% (366/504). The idea of the MIA was acceptable because of its perceived simplicity and rapidity and particularly for not “mutilating” the body. Further, MIAs were believed to help prevent infectious diseases, address hereditary diseases, clarify the CoD, and avoid witchcraft accusations and conflicts within families. The main concerns regarding the procedure included the potential breach of confidentiality on the CoD, the misperception of organ removal, and the incompatibility with some religious beliefs. Formal health professionals were concerned about possible contradictions between the MIA findings and the clinical pre-mortem diagnoses. Acceptability of the MIA was equally high among Christian and Islamic communities. However, in the two predominantly

Reduction of dark-band-like metal artifacts caused by dental implant bodies using hypothetical monoenergetic imaging after dual-energy computed tomography.

PubMed

Tanaka, Ray; Hayashi, Takafumi; Ike, Makiko; Noto, Yoshiyuki; Goto, Tazuko K

2013-06-01

The aim of this study was to evaluate the usefulness of hypothetical monoenergetic images after dual-energy computed tomography (DECT) for assessment of the bone encircling dental implant bodies. Seventy-two axial images of implantation sites clipped out from image data scanned using DECT in dual-energy mode were used. Subjective assessment on reduction of dark-band-like artifacts (R-DBAs) and diagnosability of adjacent bone condition (D-ABC) in 3 sets of DECT images-a fused image set (DE120) and 2 sets of hypothetical monoenergetic images (ME100, ME190)-was performed and the results were statistically analyzed. With regards to R-DBAs and D-ABC, significant differences among DE120, ME100, and ME190 were observed. The ME100 and ME190 images revealed more artifact reduction and diagnosability than those of DE120. DECT imaging followed by hypothetical monoenergetic image construction can cause R-DBAs and increase D-ABC and may be potentially used for the evaluation of postoperative changes in the bone encircling implant bodies. Copyright © 2013 Elsevier Inc. All rights reserved.

Using scenarios to capture work processes in shared home care.

PubMed

Hägglund, Maria; Scandurra, Isabella; Koch, Sabine

2007-01-01

Shared home care is increasingly common, and in order to develop ICT that support such complex cooperative work it is crucial obtain an understanding of the work routines, information demands, and other central preconditions at the clinical level before the development is initiated. Scenarios are proposed as a technique that can be useful for capturing work processes in shared home care and experiences from the Old@Home project are presented. The scenarios are useful not only in the initial phases of the development project but throughout the development process, improving the accessibility of end user requirements and usability issues for the design team, and as a basis for use cases and further design.

Death in dental clinic: Indian scenario

PubMed Central

Seshappa, Kedarnath Nakkalahalli; Rangaswamy, Shruthi

2016-01-01

Deaths during dental treatment or as a result of dental treatment are rare, but the unfortunate fact is that such deaths do occur. Unexpected death of a patient can be emotionally draining and even harrowing to his or her relatives. The death of a patient may bring an enormous feeling of anxiety both at the personal and professional level, stress, profound grief, damage to self-esteem, loss of self-confidence, reputation, and specter of litigation on a dental surgeon. No dentist can be guaranteed to be free of such an incident during the course of his or her practice. The dentist should respond in a compassionate and respectful manner in case of such unfortunate tragic events, and also ensure self-protection. This article emphasizes on prevention of such incidents and throws some light on how to respond in case of an unfortunate death in a dental clinic, including the medico-legal aspects. PMID:27555720

Perceptions of, and Assistance Provided to, a Hypothetical Rape Victim: Differences between Rape Disclosure Recipients and Nonrecipients

ERIC Educational Resources Information Center

Paul, Lisa A.; Kehn, Andre; Gray, Matt J.; Salapska-Gelleri, Joanna

2014-01-01

Objective: Undergraduate rape disclosure recipients' and nonrecipients' sociodemographic and life experience variables, attitudes towards rape, and responses to a hypothetical rape disclosure were compared to determine differences between them. Participants: One hundred ninety-two undergraduates at 3 universities participated in this online survey…

Simulation of broad-band strong ground motion for a hypothetical Mw 7.1 earthquake on the Enriquillo Fault in Haiti

NASA Astrophysics Data System (ADS)

Douilly, Roby; Mavroeidis, George P.; Calais, Eric

2017-10-01

The devastating 2010 Mw 7.0 Haiti earthquake demonstrated the need to improve mitigation and preparedness for future seismic events in the region. Previous studies have shown that the earthquake did not occur on the Enriquillo Fault, the main plate boundary fault running through the heavily populated Port-au-Prince region, but on the nearby and previously unknown transpressional Léogâne Fault. Slip on that fault has increased stresses on the segment of Enriquillo Fault to the east of Léogâne, which terminates in the ˜3-million-inhabitant capital city of Port-au-Prince. In this study, we investigate ground shaking in the vicinity of Port-au-Prince, if a hypothetical rupture similar to the 2010 Haiti earthquake occurred on that segment of the Enriquillo Fault. We use a finite element method and assumptions on regional tectonic stress to simulate the low-frequency ground motion components using dynamic rupture propagation for a 52-km-long segment. We consider eight scenarios by varying parameters such as hypocentre location, initial shear stress and fault dip. The high-frequency ground motion components are simulated using the specific barrier model in the context of the stochastic modeling approach. The broad-band ground motion synthetics are subsequently obtained by combining the low-frequency components from the dynamic rupture simulation with the high-frequency components from the stochastic simulation using matched filtering at a crossover frequency of 1 Hz. Results show that rupture on a vertical Enriquillo Fault generates larger horizontal permanent displacements in Léogâne and Port-au-Prince than rupture on a south-dipping Enriquillo Fault. The mean horizontal peak ground acceleration (PGA), computed at several sites of interest throughout Port-au-Prince, has a value of ˜0.45 g, whereas the maximum horizontal PGA in Port-au-Prince is ˜0.60 g. Even though we only consider a limited number of rupture scenarios, our results suggest more intense ground

Hypothetical Preclinical Alzheimer Disease Groups and Longitudinal Cognitive Change.

PubMed

Soldan, Anja; Pettigrew, Corinne; Cai, Qing; Wang, Mei-Cheng; Moghekar, Abhay R; O'Brien, Richard J; Selnes, Ola A; Albert, Marilyn S

2016-06-01

Clinical trials testing treatments for Alzheimer disease (AD) are increasingly focused on cognitively normal individuals in the preclinical phase of the disease. To optimize observing a treatment effect, such trials need to enroll cognitively normal individuals likely to show cognitive decline over the duration of the trial. To identify which group of cognitively normal individuals shows the greatest cognitive decline over time based on their cerebrospinal fluid biomarker profile. In this cohort study, cognitively normal participants were classified into 1 of the following 4 hypothetical preclinical AD groups using baseline cerebrospinal fluid levels of Aβ and tau or Aβ and phosphorylated tau (p-tau): stage 0 (high Aβ and low tau), stage 1 (low Aβ and low tau), stage 2 (low Aβ and high tau), and suspected non-AD pathology (SNAP) (high Aβ and high tau). The data presented herein were collected between August 1995 and August 2014. An a priori cognitive composite score based on the following 4 tests previously shown to predict progression from normal cognition to symptom onset of mild cognitive impairment or dementia: Paired Associates immediate recall, Logical Memory delayed recall, Boston Naming, and Digit-Symbol Substitution. Linear mixed-effects models were used to compare the cognitive composite scores across the 4 groups over time, adjusting for baseline age, sex, education, and their interactions with time. Two hundred twenty-two cognitively normal participants were included in the analyses (mean follow-up, 11.0 years [range, 0-18.3 years] and mean baseline age, 56.9 years [range, 22.1-85.8 years]). Of these, 102 were stage 0, 46 were stage 1, 28 were stage 2, and 46 were SNAP. Individuals in stage 2 (low Aβ and high tau [or p-tau]) had lower baseline cognitive scores and a greater decline in the cognitive composite score relative to the other 3 groups (β ≤ -0.06 for all and P ≤ .001 for the rate of decline for all). Individuals in stage 0

Explicating the Role of Mathematical Tasks in Conceptual Learning: An Elaboration of the Hypothetical Learning Trajectory

ERIC Educational Resources Information Center

Simon, Martin A.; Tzur, Ron

2004-01-01

Simon's (1995) development of the construct of hypothetical learning trajectory (HLT) offered a description of key aspects of planning mathematics lessons. An HLT consists of the goal for the students' learning, the mathematical tasks that will be used to promote student learning, and hypotheses about the process of the students' learning.…

A hypothetical learning trajectory for conceptualizing matrices as linear transformations

NASA Astrophysics Data System (ADS)

Andrews-Larson, Christine; Wawro, Megan; Zandieh, Michelle

2017-08-01

In this paper, we present a hypothetical learning trajectory (HLT) aimed at supporting students in developing flexible ways of reasoning about matrices as linear transformations in the context of introductory linear algebra. In our HLT, we highlight the integral role of the instructor in this development. Our HLT is based on the 'Italicizing N' task sequence, in which students work to generate, compose, and invert matrices that correspond to geometric transformations specified within the problem context. In particular, we describe the ways in which the students develop local transformation views of matrix multiplication (focused on individual mappings of input vectors to output vectors) and extend these local views to more global views in which matrices are conceptualized in terms of how they transform a space in a coordinated way.

Undergraduate Nurse Variables that Predict Academic Achievement and Clinical Competence in Nursing

ERIC Educational Resources Information Center

Blackman, Ian; Hall, Margaret; Darmawan, I Gusti Ngurah.

2007-01-01

A hypothetical model was formulated to explore factors that influenced academic and clinical achievement for undergraduate nursing students. Sixteen latent variables were considered including the students' background, gender, type of first language, age, their previous successes with their undergraduate nursing studies and status given for…

Conserved hypothetical protein Rv1977 in Mycobacterium tuberculosis strains contains sequence polymorphisms and might be involved in ongoing immune evasion.

PubMed

Jiang, Yi; Liu, Haican; Wang, Xuezhi; Li, Guilian; Qiu, Yan; Dou, Xiangfeng; Wan, Kanglin

2015-01-01

Host immune pressure and associated parasite immune evasion are key features of host-pathogen co-evolution. A previous study showed that human T cell epitopes of Mycobacterium tuberculosis are evolutionarily hyperconserved and thus it was deduced that M. tuberculosis lacks antigenic variation and immune evasion. Here, we selected 151 clinical Mycobacterium tuberculosis isolates from China, amplified gene encoding Rv1977 and compared the sequences. The results showed that Rv1977, a conserved hypothetical protein, is not conserved in M. tuberculosis strains and there are polymorphisms existed in the protein. Some mutations, especially one frameshift mutation, occurred in the antigen Rv1977, which is uncommon in M.tb strains and may lead to the protein function altering. Mutations and deletion in the gene all affect one of three T cell epitopes and the changed T cell epitope contained more than one variable position, which may suggest ongoing immune evasion.

Toward a Framework for Benefit-Risk Assessment in Diagnostic Imaging: Identifying Scenario-specific Criteria.

PubMed

Agapova, Maria; Bresnahan, Brian W; Linnau, Ken F; Garrison, Louis P; Higashi, Mitchell; Kessler, Larry; Devine, Beth

2017-05-01

Diagnostic imaging has many effects and there is no common definition of value in diagnostic radiology. As benefit-risk trade-offs are rarely made explicit, it is not clear which framework is used in clinical guideline development. We describe initial steps toward the creation of a benefit-risk framework for diagnostic radiology. We performed a literature search and an online survey of physicians to identify and collect benefit-risk criteria (BRC) relevant to diagnostic imaging tests. We operationalized a process for selection of BRC with the use of four clinical use case scenarios that vary by diagnostic alternatives and clinical indication. Respondent BRC selections were compared across clinical scenarios and between radiologists and nonradiologists. Thirty-six BRC were identified and organized into three domains: (1) those that account for differences attributable only to the test or device (n = 17); (2) those that account for clinical management and provider experiences (n = 12); and (3) those that capture patient experience (n = 7). Forty-eight survey participants selected 22 criteria from the initial list in the survey (9-11 per case). Engaging ordering physicians increased the number of criteria selected in each of the four clinical scenarios presented. We developed a process for standardizing selection of BRC in guideline development. These results suggest that a process relying on elements of comparative effectiveness and the use of standardized BRC may ensure consistent examination of differences among alternatives by way of making explicit implicit trade-offs that otherwise enter the decision-making space and detract from consistency and transparency. These findings also highlight the need for multidisciplinary teams that include input from ordering physicians. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Clinical embryology teaching: is it relevant anymore?

PubMed

Scott, Karen M; Charles, Antony Robert; Holland, Andrew J A

2013-10-01

Embryology finds itself jostling for precious space in the crowded medical curriculum, yet remains important for helping students understand birth defects. It has been suggested that teaching embryology through clinical scenarios can increase its relevance and interest. The aim of this research was to determine the attitudes of final-year medical students to learning embryology and whether clinical scenarios aid understanding. Final-year medical students undertaking their paediatric rotation in 2009 and 2010 were invited to attend an optional lecture on clinical embryology and participate in the research. In the lecture, three clinical scenarios were presented, in which the lecturer traced the normal development of a foetus and the abnormal development that resulted in a birth defect. Outcomes were assessed quantitatively using a paper-based survey. The vast majority of students who valued embryology teaching in their medical programme thought it would assist them with clinical management, and believed learning through case scenarios helped their understanding. Students were divided in their beliefs about when embryology should be taught in the medical programme and whether it would increase their workload. Embryology teaching appears to be a valuable part of the medical curriculum. Embryology teaching was valued when taught in the clinical environment in later years of the medical programme. Students, clinicians and medical educators should be proactive in finding clinical learning opportunities for embryology teaching. © 2013 Royal Australasian College of Surgeons.

The Top 10 Ethical Challenges in Dental Practice in Indian Scenario: Dentist Perspective

PubMed Central

Kemparaj, Vanishree M.; Panchmal, Ganesh Shenoy; Kadalur, Umashankar Gangadaraiah

2018-01-01

Aim: This exploratory qualitative research is an attempt to assess the health care ethical challenges in dental practice in an Indian scenario. Methodology: Qualitative indepth interview was conducted on 20 dental professionals to assess the ethical challenges prevailing in dental practice in Indian scenario. After obtaining the responses the verbatims were categorized into categories and finally 36 themes emerged. Later from two group of 6 panellists each after conducting focus group discussion the themes of ethical issues occurring in dental practice were ranked based on order of significance impact on the practice, patient and society using Delphi method. Result: The top ten ethical challenges listed by the panellists are inadequate sterilization and waste management in dental clinics, poor knowledge and attitude towards ethics among our dental practitioners, in competence among dental professional, increase in cost of oral health service, poor informed consent process, requirement of consensus about the treatment procedures among dentists, Conflict in Advertising, clustering of dental clinics in urban areas, disagreement with treatment modalities among dentist and patient, poor medical record maintenance among our dental practitioners. Conclusion: The study attempts to bring the prevailing ethical challenges in oral health care practice in Indian scenario. PMID:29599593

Acceptability of Hypothetical Microbicides among Women in Sex Establishments in Rural Areas in Southern China

PubMed Central

Wang, Yu; Liao, Su-Su; Weeks, Margaret R.; Jiang, Jing-Mei; Abbott, Maryann; Zhou, Yue-Jiao; He, Bin; Liu, Wei; Mosack, Katie E.

2010-01-01

Objectives and Goal The objectives of this study were to measure the potential acceptability of a hypothetical microbicide among women in sex establishments in rural areas of Southern China, and demographic, behavioral and social context factors likely to affect microbicide acceptability. Study Design This was a cross-sectional survey, using a quota sampling, among 300 women from sex establishments in three rural towns. An interviewer-administered standardized questionnaire was used to measure the acceptability score of hypothetical microbicides’ characteristics, as well as sexual relationships and behaviors, and other contextual factors. Results Findings showed a generally positive response to microbicides, indicated by an acceptability index score of 2.89 (SD, 0.56, scale of 1–4) in the overall sample. Multivariate analysis shows the acceptability score varied significantly by study sites, type of sex-work establishments, marital status, sex partner type, vaginal product experience, locus of control by partners and locus of control by chance. Conclusions Microbicides may be acceptable among sex workers in rural settings in China; however, contextual factors should be carefully considered in education and promotion of microbicides in the future. PMID:17767093

Mudflow hazards along the Toutle and Cowlitz Rivers from a hypothetical failure of Spirit Lake blockage

USGS Publications Warehouse

Swift, C.H.; Kresch, D.L.

1983-01-01

The debris avalanche accompanying the May 18, 1980, eruption of Mount St. Helens, in southwestern Washington, buried the former outlet of Spirit Lake, located 5 miles north of the volcano, to a depth ranging to 500 feet. Since that time, Spirit Lake has had no natural outlet and its lake level and contents have increased significantly. Erosion at the crest of the debris dam on the surface of the blockage and recent studies of theblockage stratigraphy and soil properties showing that the effective crest elevation is lower than the surface crest have led to concern that the lake may someday breach through or spill over the top of the blockage. A study was made by the U.S. Geological Survey to determine the extent of inundation that might result downstream in the Toutle and Cowlitz Rivers if a hypothetical breach should occur and generate a mudflow flood of catastrophic proportions. A hypothetical breach of Spirit Lake produced a hypothetical mudflow hydrograph with a peak discharge of 2.65 million cu ft/s and a sediment concentration of 65 percent by volume at Camp Baker on the North Fork Toutle River. Elevations determined by the hydraulic routing of the mudflow were used to prepare inundation maps, indicating depths of inundation to be about 60 feet at Castle Rock and Lexington; 30-40 feet at Toutle, Toutle Lake at Silver Lake, Kelson, and Longview; and 15-20 feet at Toledo. Travel times for the peak elevation were estimated to be about 15 hours to Kid Valley on the North Fork Toutle River, 21 hours to Castle Rock, 22 hours to Toledo, and 23 hours to Kelso and Longview on the Cowlitz River. (USGS)

Minor Consent and Delivery of Adolescent Vaccines

PubMed Central

Ford, Carol A.; Skiles, Martha P.; English, Abigail; Cai, Jianwen; Agans, Robert P.; Stokley, Shannon; Markowitz, Lauri; Koumans, Emilia H.

2016-01-01

Purpose To explore whether, and to what extent, minor consent influences adolescent vaccine delivery in the United States. Methods A telephone survey was completed by 263 professionals with responsibilities for adolescent health care and/or vaccination in 43 states. Measures included perceived frequency of unaccompanied minor visits and perceived likelihood of vaccine delivery to unaccompanied minors in hypothetical scenarios that varied by adolescent age, vaccine type, visit type, and clinical setting. Results Among the 76 respondents most familiar with private primary care clinics, 47.1% reported perceptions that 17-year-old patients often present without a parent/legal guardian. Among the 104 respondents most familiar with public primary care clinics, 56.7% reported that 17-year-old patients often present alone. In response to hypothetical scenarios, approximately 30% of respondents familiar with private clinics and 50% of respondents familiar with public clinics reported perceptions that unaccompanied 17-year-old adolescents would not receive influenza, Tdap, or human papillomavirus vaccines during routine check-ups because they could not provide consent. Perceived likelihood of unaccompanied minors receiving vaccines when seen for confidential services in primary care, sexually transmitted disease, and Title X/family planning clinics varied significantly by vaccine type and clinical setting. On average, respondents reported that they would support minors having the ability to self-consent for vaccines at age 14. Conclusions The inability of minors to consent for vaccines is likely one barrier to vaccination. Interventions to increase adolescent vaccination should consider strategies that increase the ability of unaccompanied minors, particularly older minors, to receive vaccines within the context of legal, ethical, and professional guidelines. PMID:24074605

Human papillomavirus vaccine knowledge and hypothetical acceptance among women in Appalachia Ohio

PubMed Central

Hade, Erinn M.; Gorsline, Melissa R.; DeGraffinreid, Cecilia R.; Katz, Mira L.; Kobrin, Sarah C.; Paskett, Electra D.

2013-01-01

Objective To assess hypothetical acceptance of the human papillomavirus (HPV) vaccine for themselves and a daughter age 9–12 years among Appalachia Ohio women. Methods Women with an abnormal Pap smear and randomly selected women with a normal Pap smear from 17 clinics completed an interview in 2006–2008. Results From 1131 original study participants, 807 (71%) completed a survey about the HPV vaccine for their daughters and themselves. Nearly half, 380 (47%), of the participants had heard of a vaccine to prevent cancer, and 362 (95%) of respondents had heard of HPV. The participants were then told that the FDA had approved a vaccine to prevent HPV. Only 379 (38%) participants identified girls ages 9–12 years as a group who should get the vaccine. After being given the official HPV vaccine recommendation statement, 252 (31%) wanted the vaccine; 198 (25%) were “not sure”; and 353 (44%) did not want the vaccine for themselves. With respect to giving the HPV vaccine to a daughter ages 9–12 years, participants responded “yes” 445 (55%); “not sure” 163 (20%); or “no” 185 (23%). Numerous reasons were provided supporting and opposing vaccine acceptance for themselves and for a daughter. Their physician’s recommendation for the HPV vaccine increased vaccine acceptance to 86% for themselves and 90% for a daughter. Conclusion Knowledge, acceptance, and barriers about the HPV vaccine vary among women living in Appalachia Ohio. Physician recommendation is a key facilitator for vaccine diffusion in this region. PMID:22749839

Children's Use and Knowledge of Display Rules for Anger following Hypothetical Vignettes versus following Live Peer Interaction.

ERIC Educational Resources Information Center

Parker, Elizabeth H.; Hubbard, Julie A.; Ramsden, Sally R.; Relyea, Nicole; Dearing, Karen F.; Smithmyer, Catherine M.; Schimmel, Kelly D.

2001-01-01

Examined correspondence between second-graders' use and knowledge of anger display rules. Found that children's responses were moderately related across two contexts. Following live interactions, compared to hypothetical vignettes, children reported feeling and expressing less anger, intending to hide their anger more, and dissembling their anger…

Low frequency (<1Hz) Large Magnitude Earthquake Simulations in Central Mexico: the 1985 Michoacan Earthquake and Hypothetical Rupture in the Guerrero Gap

NASA Astrophysics Data System (ADS)

Ramirez Guzman, L.; Contreras Ruíz Esparza, M.; Aguirre Gonzalez, J. J.; Alcántara Noasco, L.; Quiroz Ramírez, A.

2012-12-01

We present the analysis of simulations at low frequency (<1Hz) of historical and hypothetical earthquakes in Central Mexico, by using a 3D crustal velocity model and an idealized geotechnical structure of the Valley of Mexico. Mexico's destructive earthquake history bolsters the need for a better understanding regarding the seismic hazard and risk of the region. The Mw=8.0 1985 Michoacan earthquake is among the largest natural disasters that Mexico has faced in the last decades; more than 5000 people died and thousands of structures were damaged (Reinoso and Ordaz, 1999). Thus, estimates on the effects of similar or larger magnitude earthquakes on today's population and infrastructure are important. Moreover, Singh and Mortera (1991) suggest that earthquakes of magnitude 8.1 to 8.4 could take place in the so-called Guerrero Gap, an area adjacent to the region responsible for the 1985 earthquake. In order to improve previous estimations of the ground motion (e.g. Furumura and Singh, 2002) and lay the groundwork for a numerical simulation of a hypothetical Guerrero Gap scenario, we recast the 1985 Michoacan earthquake. We used the inversion by Mendoza and Hartzell (1989) and a 3D velocity model built on the basis of recent investigations in the area, which include a velocity structure of the Valley of Mexico constrained by geotechnical and reflection experiments, and noise tomography, receiver functions, and gravity-based regional models. Our synthetic seismograms were computed using the octree-based finite element tool-chain Hercules (Tu et al., 2006), and are valid up to a frequency of 1 Hz, considering realistic velocities in the Valley of Mexico ( >60 m/s in the very shallow subsurface). We evaluated the model's ability to reproduce the available records using the goodness-of-fit analysis proposed by Mayhew and Olsen (2010). Once the reliablilty of the model was established, we estimated the effects of a large magnitude earthquake in Central Mexico. We built a

Acceptability of Pre-Exposure Prophylaxis (PrEP) as an HIV prevention strategy: Barriers and facilitators to PrEP uptake among at-risk Peruvian populations

PubMed Central

Galea, Jerome T.; Kinsler, Janni J.; Salazar, Ximena; Lee, Sung-Jae; Giron, Maziel; Sayles, Jennifer N.; Cáceres, Carlos; Cunningham, William E.

2010-01-01

This study examined Pre-Exposure Prophylaxis (PrEP) acceptability among female sex workers, male-to-female transgendered persons, and men who have sex with men in Lima, Peru. Focus groups explored social issues associated with PrEP acceptability and conjoint analysis assessed preferences among eight hypothetical PrEP scenarios with varying attribute profiles and their relative impact on acceptability. Conjoint analysis revealed that PrEP acceptability ranged from 19.8 to 82.5 out of a possible score of 100 across the eight hypothetical PrEP scenarios. Out-of-pocket cost had the greatest impact on PrEP acceptability (25.2, p <0.001), followed by efficacy (21.4, p <0.001) and potential side effects (14.7, p <0.001). Focus group data supported these findings, and also revealed that potential sexual risk disinhibition, stigma and discrimination associated with PrEP use, and mistrust of health care professionals were also concerns. These issues will require careful attention when planning for PrEP roll-out if proven efficacious in ongoing clinical trials. PMID:21571973

Cardiopulmonary resuscitation: knowledge and opinions among the U.S. general public. State of the science-fiction.

PubMed

Marco, Catherine A; Larkin, Gregory L

2008-12-01

Cardiopulmonary resuscitation is undertaken more than 250,000 times annually in the United States. This study was undertaken to determine knowledge and opinions of the general public regarding cardiopulmonary resuscitation. Validated multisite community-based cross-sectional survey. Knowledge and opinions about resuscitative practices and outcomes, using hypothetical clinical scenarios and other social, spiritual, and environmental considerations. Among 1831 participants representing 38 states, markedly inaccurate perceptions of cardiac arrest were reported. Participants' mean estimate of predicted survival rate after cardiac arrest was 54% (median 50%, IQR 35-75%), and mean estimated duration of resuscitative efforts in the ED was 28min (median 15min; IQR 10-30). Projected age and health status were independent predictors of resuscitation preferences in a series of 4 hypothetical scenarios. Participants indicated that physicians should consider patient and family wishes as the most important factors when making resuscitation decisions. Participants considered advanced technology and physician communication to be the most important actions during attempted resuscitation. Inaccurate perceptions regarding resuscitation and survival rates exist among the lay public. Participants indicated strong preferences regarding resuscitation and advance directives.

Critical review of willingness to pay for clinical oral health interventions.

PubMed

Tan, Sharon Hui Xuan; Vernazza, Christopher R; Nair, Rahul

2017-09-01

This critical review aimed to identify, consolidate and evaluate the quality of Willingness to Pay (WTP) studies applied to clinical contexts in the field of dentistry. PubMed and Web of Science databases were systematically searched for relevant publications. Screening and data extraction was then performed. Primary literature in English-language were included to assess the WTP for oral health interventions, when the valuations were applied to a clinical measure. Twenty-six publications met the inclusion criteria. WTP was elicited mainly via face-to-face interviews (13 publications) and questionnaires (12 publications). The majority (24) of publications selected an out-of-pocket payment vehicle. Eleven publications adopted a bidding method, nine publications adopted an open-ended format, and the remaining six studies adopted a payment card or choice method. Pre-testing was reported in only nine publications, and few studies accounted for starting point bias. Eight of 11 publications found that higher incomes were associated with higher WTP values. The female gender, a younger age and higher education levels were associated with a higher WTP in select studies. Only a small minority of the studies used strategies to avoid well documented biases related to WTP elicitation. Cost versus benefit of many clinical scenarios remain uninvestigated. WTP studies in dentistry may benefit from pre-testing and the inclusion of a script to minimise hypothetical bias. They may also be better conducted face-to-face and via a shuffled payment card method. Income levels, and potentially education levels, gender and age, should be assessed for their influence on WTP values. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Simulation of Reclaimed-Water Injection and Pumping Scenarios and Particle-Tracking Analysis near Mount Pleasant, South Carolina

USGS Publications Warehouse

Petkewich, Matthew D.; Campbell, Bruce G.

2009-01-01

observation wells in the Mount Pleasant area. When compared to the Base Case simulation, 2050 groundwater altitudes for Scenario 2 are between 2 and 106 feet lower for production wells and observation wells and between 11 and 27 feet higher for the injection wells in the Mount Pleasant area. Water budgets for the model area immediately surrounding the Mount Pleasant area were calculated for 2011 and for 2050. The largest flow component for the 2050 water budget in the Mount Pleasant area is discharge through wells at rates between 7.1 and 10.9 million gallons of water per day. This groundwater is replaced predominantly by between 6.0 and 7.8 million gallons per day of lateral groundwater flow within the Middendorf aquifer for the Base Case and two scenarios and through reclaimed-water injection of 3 million gallons per day for Scenarios 1 and 2. In addition, between 175,000 and 319,000 gallons of groundwater are removed from this area per day because of the regional hydraulic gradient. Additional sources of water to this area are groundwater storage releases at rates between 86,800 and 116,000 gallons per day and vertical flow from over- and underlying confining units at rates between 69,100 and 150,000 gallons per day. Reclaimed water injected into the Middendorf aquifer at three hypothetical injection wells moved to the Mount Pleasant Waterworks production wells in 18 to 256 years as indicated by particle-tracking simulations. Time of travel varied from 18 to 179 years for simulated conditions of 20 percent uniform aquifer porosity and between 25 to 256 years for 30 percent uniform aquifer porosity.

A real-time computer model to assess resident work-hours scenarios.

PubMed

McDonald, Furman S; Ramakrishna, Gautam; Schultz, Henry J

2002-07-01

To accurately model residents' work hours and assess options to forthrightly meet Residency Review Committee-Internal Medicine (RRC-IM) requirements. The requirements limiting residents' work hours are clearly defined by the Accreditation Council for Graduate Medical Education (ACGME) and the RRC-IM: "When averaged over any four-week rotation or assignment, residents must not spend more than 80 hours per week in patient care duties."(1) The call for the profession to realistically address work-hours violations is of paramount importance.(2) Unfortunately, work hours are hard to calculate. We developed an electronic model of residents' work-hours scenarios using Microsoft Excel 97. This model allows the input of multiple parameters (i.e., call frequency, call position, days off, short-call, weeks per rotation, outpatient weeks, clinic day of the week, additional time due to clinic) and start and stop times for post-call, non-call, short-call, and weekend days. For each resident on a rotation, the model graphically demonstrates call schedules, plots clinic days, and portrays all possible and preferred days off. We tested the model for accuracy in several scenarios. For example, the model predicted average work hours of 85.1 hours per week for fourth-night-call rotations. This was compared with logs of actual work hours of 84.6 hours per week. Model accuracy for this scenario was 99.4% (95% CI 96.2%-100%). The model prospectively predicted work hours of 89.9 hours/week in the cardiac intensive care unit (CCU). Subsequent surveys found mean CCU work hours of 88, 1 hours per week. Model accuracy for this scenario was 98% (95% CI 93.2-100%). Thus validated, we then used the model to test proposed scenarios for complying with RRC-IM limits. The flexibility of the model allowed demonstration of the full range of work-hours scenarios in every rotation of our 36-month program. Demonstrations of status-quo work-hours scenarios were presented to faculty as well as real

Risk, Benefit, and Cost Thresholds for Emergency Department Testing: A Cross-sectional, Scenario-based Study.

PubMed

Meka, Arjun Prasad; Porath, Jonathan Douglas; Iyengar, Rahul; Morrow, Chelsea; Fagerlin, Angela; Meurer, William J

2017-06-01

While diagnostic testing is common in the emergency department, the value of some testing is questionable. The purpose of this study was to assess how varying levels of benefit, risk, and costs influenced an individual's desire to have diagnostic testing. A survey through Amazon Mechanical Turk presented hypothetical clinical situations: low-risk chest pain and minor traumatic brain injury. Each scenario included three given variables (benefit, risk, and cost), that was independently randomly varied over four possible values (0.1, 1, 5, and 10% for benefit and risk and $0, $100, $500, and $1,000 for the individual's personal cost for receiving the test). Benefit was defined as the probability of finding the target disease (traumatic intracranial hemorrhage or acute coronary syndrome). One-thousand unique respondents completed the survey. With an increased benefit from 0.1% to 10%, the percentage of respondents who accepted a diagnostic test went from 28.4% to 53.1%. (odds ratio [OR] = 3.42; 95% confidence interval [CI] = 2.57-4.54). As risk increased from 0.1% to 10%, this number decreased from 52.5% to 28.5%. (OR = 0.33; 95% CI = 0.25-0.44). Increasing cost from $0 to $1,000 had the greatest change of those accepting the test from 61.1% to 21.4%, respectively (OR = 0.15; 95% CI = 0.11-0.2). The desire for testing was strongly sensitive to the benefits, risks, and costs. Many participants wanted a test when there was no added cost, regardless of benefit or risk levels, but far fewer elected to receive the test as cost increased incrementally. This suggests that out-of-pocket costs may deter patients from undergoing diagnostic testing with low potential benefit. © 2016 by the Society for Academic Emergency Medicine.

FHWA scenario planning guidebook

DOT National Transportation Integrated Search

2011-02-01

The purpose of this guidebook is to assist transportation agencies with carrying out a scenario planning process from start to finish. Transportation agencies can use the guidebook as a framework to develop a scenario planning approach tailored to th...

Quantitative Microbial Risk Assessment of Freshwater Impacted by Animal Fecal Material

EPA Science Inventory

We evaluated the potential for human illness from a hypothetical recreational exposure to freshwater impacted by land-applied, agricultural animal fecal material. The hypothetical exposure scenario included the following characteristics: 1) fresh cattle manure, pig slurry, or ch...

Simulation of groundwater flow and chloride transport in the “1,200-foot” sand with scenarios to mitigate saltwater migration in the “2,000-foot” sand in the Baton Rouge area, Louisiana

USGS Publications Warehouse

Heywood, Charles E.; Lovelace, John K.; Griffith, Jason M.

2015-07-16

Seven hypothetical scenarios predict the effects of different groundwater withdrawal options on groundwater levels and the transport of chloride within the “1,200-foot” sand and the “2,000-foot” sand during 2015–2112. The predicted water levels and concentrations for all scenarios are depicted in maps for the years 2047 and 2112. The first scenario is a base case for comparison to the six other scenarios and simulates continuation of 2012 reported groundwater withdrawals through 2112 (100 years). The second scenario that simulates increased withdrawals from industrial wells in the “1,200-foot” sand predicts that water levels will be 12–25 ft lower by 2047 and that there will be a negligible difference in chloride concentrations within the “1,200-foot” sand. The five other scenarios simulate the effects of various withdrawal schemes on water levels and chloride concentrations within the “2,000-foot” sand. Amongst these five other scenarios, three of the scenarios simulate only various withdrawal reductions, whereas the two others also incorporate withdrawals from a scavenger well that is designed to extract salty water from the base of the “2,000-foot” sand. Two alternative pumping rates (2.5 Mgal/d and 1.25 Mgal/d) are simulated in each of the scavenger-well scenarios. For the “2,000-foot” sand scenarios, comparison of the predicted effects of the scenarios is facilitated by graphs of predicted chloride concentrations through time at selected observation wells, plots of salt mass in the aquifer through time, and a summary of the predicted plume area and average concentration. In all scenarios, water levels essentially equilibrate by 2047, after 30 years of simulated constant withdrawal rates. Although predicted water-level recovery within the “2,000-foot” sand is greatest for the scenario with the greatest reduction in groundwater withdrawal from that aquifer, the scavenger-well scenarios are most effective in mitigating the

Errors Affect Hypothetical Intertemporal Food Choice in Women

PubMed Central

Sellitto, Manuela; di Pellegrino, Giuseppe

2014-01-01

Growing evidence suggests that the ability to control behavior is enhanced in contexts in which errors are more frequent. Here we investigated whether pairing desirable food with errors could decrease impulsive choice during hypothetical temporal decisions about food. To this end, healthy women performed a Stop-signal task in which one food cue predicted high-error rate, and another food cue predicted low-error rate. Afterwards, we measured participants’ intertemporal preferences during decisions between smaller-immediate and larger-delayed amounts of food. We expected reduced sensitivity to smaller-immediate amounts of food associated with high-error rate. Moreover, taking into account that deprivational states affect sensitivity for food, we controlled for participants’ hunger. Results showed that pairing food with high-error likelihood decreased temporal discounting. This effect was modulated by hunger, indicating that, the lower the hunger level, the more participants showed reduced impulsive preference for the food previously associated with a high number of errors as compared with the other food. These findings reveal that errors, which are motivationally salient events that recruit cognitive control and drive avoidance learning against error-prone behavior, are effective in reducing impulsive choice for edible outcomes. PMID:25244534

The origin of platyrrhines: An evaluation of the Antarctic scenario and the floating island model.

PubMed

Houle, A

1999-08-01

This paper evaluates whether 1) protoplatyrrhines could have migrated to South America via Antarctica, and 2) the floating island model is a plausible transoceanic mode of dispersal for land vertebrates like protoplatyrrhines. Results show that Eocene Antarctica and Australia supported large and dense forests, and that the Antarctic fauna was comprised of many species of vertebrates, including placental and marsupial land mammals. However, no primate remains have ever been reported from these continents. Antarctica and South America were connected until the Middle Eocene (i.e., after the oldest Asian anthropoids), but two major water barriers existed between Antarctica and Asia since the Early Eocene. The Eocene and Oligocene water gap separating Africa and Antarctica was excessively large. Thus, all scenarios involving an Antarctic route have been rejected. The African scenario is difficult to falsify because only one water barrier existed, both paleowinds and paleocurrents were favorable, and Paleogene African anthropoids show phylogenetic affinities to platyrrhines. I tested whether a journey on a hypothetical floating island over the Paleogene Atlantic Ocean exceeds the survival limit of a genetically viable group of animals such as protoplatyrrhines. Studies of water deprivation suggest that they could have been able, with a body weight averaging 1 kg, to survive without water for at least 13 days. I have used the present Atlantic Ocean as a model for the velocity of Paleogene paleowinds and paleocurrents. Considering winds as the key accelerating force of floating islands, the Paleogene Atlantic water barrier could have been crossed, in the most conservative scenario, in 8 days at 50 Mya, 11 days at 40 Mya, and 15 days at 30 Mya. In order to survive a transoceanic journey, however, protoplatyrrhines had to be preadapted to strong seasonal variations in water availability in their original (African) environment. Once on the sea, their brains would have

A High Resolution Study of Black Sea Circulation and Hypothetical Oil Spills

NASA Astrophysics Data System (ADS)

Dietrich, D. E.; Bowman, M. J.; Korotenko, K. A.

2008-12-01

A 1/24 deg resolution adaptation of the DieCAST ocean model simulates a realistically intense Rim Current and ubiquitous mesoscale coastal anticyclonic eddies that result from anticyclonic vorticity generation by laterally differential bottom drag forces that are amplified near Black Sea coastal headlands. Climatological and synoptic surface forcings are compared. The effects of vertical momentum transfer by known (by Synop region fishermen, as reported by Ballard National Geographic article) big amplitude internal waves are parameterized by big vertical viscosity. Sensitivity to vertical viscosity is shown. Results of simulated hypothetical oil spills are shown. A simple method to nowcast/forecast the Black Sea currents is described and early results are shown.

Innovations in science and scenarios for assessment.

PubMed

Kunkel, Kenneth E; Moss, Richard; Parris, Adam

Scenarios for the Third National Climate Assessment (NCA3) were produced for physical climate and sea level rise with substantial input from disciplinary and regional experts. These scenarios underwent extensive review and were published as NOAA Technical Reports. For land use/cover and socioeconomic conditions, scenarios already developed by other agencies were specified for use in the NCA3. Efforts to enhance participatory scenario planning as an assessment activity were pursued, but with limited success. Issues and challenges included the timing of availability of scenarios, the need for guidance in use of scenarios, the need for approaches to nest information within multiple scales and sectors, engagement and collaboration of end users in scenario development, and development of integrated scenarios. Future assessments would benefit from an earlier start to scenarios development, the provision of training in addition to guidance documents, new and flexible approaches for nesting information, ongoing engagement and advice from both scientific and end user communities, and the development of consistent and integrated scenarios.

Scenario Development for the Southwestern United States

NASA Astrophysics Data System (ADS)

Mahmoud, M.; Gupta, H.; Stewart, S.; Liu, Y.; Hartmann, H.; Wagener, T.

2006-12-01

The primary goal of employing a scenario development approach for the U.S. southwest is to inform regional policy by examining future possibilities related to regional vegetation change, water-leasing, and riparian restoration. This approach is necessary due to a lack of existing explicit water resources application of scenarios to the entire southwest region. A formal approach for scenario development is adopted and applied towards water resources issues within the arid and semi-arid regions of the U.S. southwest following five progressive and reiterative phases: scenario definition, scenario construction, scenario analysis, scenario assessment, and risk management. In the scenario definition phase, the inputs of scientists, modelers, and stakeholders were collected in order to define and construct relevant scenarios to the southwest and its water sustainability needs. From stakeholder-driven scenario workshops and breakout sessions, the three main axes of principal change were identified to be climate change, population development patterns, and quality of information monitoring technology. Based on the extreme and varying conditions of these three main axes, eight scenario narratives were drafted to describe the state of each scenario's respective future and the events which led to it. Events and situations are described within each scenario narrative with respect to key variables; variables that are both important to regional water resources (as distinguished by scientists and modelers), and are good tracking and monitoring indicators of change. The current phase consists of scenario construction, where the drafted scenarios are re-presented to regional scientists and modelers to verify that proper key variables are included (or excluded) from the eight narratives. The next step is to construct the data sets necessary to implement the eight scenarios on the respective computational models of modelers investigating vegetation change, water-leasing, and riparian

NPE 2010 results - Independent performance assessment by simulated CTBT violation scenarios

NASA Astrophysics Data System (ADS)

Ross, O.; Bönnemann, C.; Ceranna, L.; Gestermann, N.; Hartmann, G.; Plenefisch, T.

2012-04-01

For verification of compliance to the Comprehensive Nuclear-Test-Ban Treaty (CTBT) the global International Monitoring System (IMS) is currently being built up. The IMS is designed to detect nuclear explosions through their seismic, hydroacoustic, infrasound, and radionuclide signature. The IMS data are collected, processed to analysis products, and distributed to the state signatories by the International Data Centre (IDC) in Vienna. The state signatories themselves may operate National Data Centers (NDC) giving technical advice concerning CTBT verification to the government. NDC Preparedness Exercises (NPE) are regularly performed to practice the verification procedures for the detection of nuclear explosions in the framework of CTBT monitoring. The initial focus of the NPE 2010 was on the component of radionuclide detections and the application of Atmospheric Transport Modeling (ATM) for defining the source region of a radionuclide event. The exercise was triggered by fictitious radioactive noble gas detections which were calculated beforehand secretly by forward ATM for a hypothetical xenon release scenario starting at location and time of a real seismic event. The task for the exercise participants was to find potential source events by atmospheric backtracking and to analyze in the following promising candidate events concerning their waveform signals. The study shows one possible way of solution for NPE 2010 as it was performed at German NDC by a team without precedent knowledge of the selected event and release scenario. The ATM Source Receptor Sensitivity (SRS) fields as provided by the IDC were evaluated in a logical approach in order to define probable source regions for several days before the first reported fictitious radioactive xenon finding. Additional information on likely event times was derived from xenon isotopic ratios where applicable. Of the considered seismic events in the potential source region all except one could be identified as

Research Ethics in Emerging Forms of Online Learning: Issues Arising from a Hypothetical Study on a MOOC

ERIC Educational Resources Information Center

Esposito, Antonella

2012-01-01

This paper is concerned with how research ethics is evolving along with emerging online research methods and settings. In particular, it focuses on ethics issues implied in a hypothetical virtual ethnography study aiming to gain insights on participants' experience in an emergent context of networked learning, namely a MOOC--Massive Online Open…

Combinatorial structure of genome rearrangements scenarios.

PubMed

Ouangraoua, Aïda; Bergeron, Anne

2010-09-01

In genome rearrangement theory, one of the elusive questions raised in recent years is the enumeration of rearrangement scenarios between two genomes. This problem is related to the uniform generation of rearrangement scenarios and the derivation of tests of statistical significance of the properties of these scenarios. Here we give an exact formula for the number of double-cut-and-join (DCJ) rearrangement scenarios between two genomes. We also construct effective bijections between the set of scenarios that sort a component as well studied combinatorial objects such as parking functions, labeled trees, and prüfer codes.

Web Based Tool for Mission Operations Scenarios

NASA Technical Reports Server (NTRS)

Boyles, Carole A.; Bindschadler, Duane L.

2008-01-01

A conventional practice for spaceflight projects is to document scenarios in a monolithic Operations Concept document. Such documents can be hundreds of pages long and may require laborious updates. Software development practice utilizes scenarios in the form of smaller, individual use cases, which are often structured and managed using UML. We have developed a process and a web-based scenario tool that utilizes a similar philosophy of smaller, more compact scenarios (but avoids the formality of UML). The need for a scenario process and tool became apparent during the authors' work on a large astrophysics mission. It was noted that every phase of the Mission (e.g., formulation, design, verification and validation, and operations) looked back to scenarios to assess completeness of requirements and design. It was also noted that terminology needed to be clarified and structured to assure communication across all levels of the project. Attempts to manage, communicate, and evolve scenarios at all levels of a project using conventional tools (e.g., Excel) and methods (Scenario Working Group meetings) were not effective given limitations on budget and staffing. The objective of this paper is to document the scenario process and tool created to offer projects a low-cost capability to create, communicate, manage, and evolve scenarios throughout project development. The process and tool have the further benefit of allowing the association of requirements with particular scenarios, establishing and viewing relationships between higher- and lower-level scenarios, and the ability to place all scenarios in a shared context. The resulting structured set of scenarios is widely visible (using a web browser), easily updated, and can be searched according to various criteria including the level (e.g., Project, System, and Team) and Mission Phase. Scenarios are maintained in a web-accessible environment that provides a structured set of scenario fields and allows for maximum

Innovations in science and scenarios for assessment

DOE PAGES

Kunkel, Kenneth E.; Moss, Richard; Parris, Adam

2015-08-29

Scenarios for the Third National Climate Assessment (NCA3) were produced for physical climate and sea level rise with substantial input from disciplinary and regional experts. These scenarios underwent extensive review and were published as NOAA Technical Reports. For land use/cover and socioeconomic conditions, scenarios already developed by other agencies were specified for use in the NCA3. Efforts to enhance participatory scenario planning as an assessment activity were pursued, but with limited success. Issues and challenges included the timing of availability of scenarios, the need for guidance in use of scenarios, the need for approaches to nest information within multiple scalesmore » and sectors, engagement and collaboration of end users in scenario development, and development of integrated scenarios. Future assessments would benefit from an earlier start to scenarios development, the provision of training in addition to guidance documents, new and flexible approaches for nesting information, ongoing engagement and advice from both scientific and end user communities, and the development of consistent and integrated scenarios.« less

Purification and characterization of a thermostable hypothetical xylanase from Aspergillus oryzae HML366.

PubMed

He, Haiyan; Qin, Yongling; Li, Nan; Chen, Guiguang; Liang, Zhiqun

2015-03-01

In the current study, fermentation broth of Aspergillus oryzae HML366 in sugar cane bagasse was subjected to ultrafiltration and ion exchange chromatography, and two xylanases, XynH1 and XynH2, were purified. Time-of-flight mass spectrometry coupled with SDS-PAGE analysis revealed that XynH1 is identical to the hypothetical A. oryzae RIB40 protein XP_001826985.1, with a molecular weight of 33.671 kDa. Likewise, XynH2 was identified as xylanase XynF1 with a molecular weight of 35.402 kDa. Sequence analysis indicated that XynH1 belongs to glycosyl hydrolases family 10. The specific activity of XynH1 was measured at 476.9 U/mg. Optimal xylanase activity was observed at pH 6.0, and enzyme remained active within pH 4.0-10.0 and at a temperature below 70 °C. Mg(2+), Mn(2+), Ca(2+), and K(+) enhanced the XynH1 xylanase activity to 146, 122, 114, and 108%, respectively. XynH1 hydrolyzed Birchwood xylan and Larchwood xylan effectively. The K m and V max of XynH1 values determined were 1.16 mM and 336 μmol/min/mg with Birchwood xylan as the substrate. A. oryzae HML366 xylanase XynH1 showed superior heat and pH tolerance, therefore may have significant applications in paper and biofuel industries. These studies constitute the first investigation of the xylanase activities of the hypothetical protein XP_001826985.1 form A. oryzae.

Gene expression profile and immunological evaluation of unique hypothetical unknown proteins of Mycobacterium leprae by using quantitative real-time PCR.

PubMed

Kim, Hee Jin; Prithiviraj, Kalyani; Groathouse, Nathan; Brennan, Patrick J; Spencer, John S

2013-02-01

The cell-mediated immunity (CMI)-based in vitro gamma interferon release assay (IGRA) of Mycobacterium leprae-specific antigens has potential as a promising diagnostic means to detect those individuals in the early stages of M. leprae infection. Diagnosis of leprosy is a major obstacle toward ultimate disease control and has been compromised in the past by the lack of specific markers. Comparative bioinformatic analysis among mycobacterial genomes identified potential M. leprae-specific proteins called "hypothetical unknowns." Due to massive gene decay and the prevalence of pseudogenes, it is unclear whether any of these proteins are expressed or are immunologically relevant. In this study, we performed cDNA-based quantitative real-time PCR to investigate the expression status of 131 putative open reading frames (ORFs) encoding hypothetical unknowns. Twenty-six of the M. leprae-specific antigen candidates showed significant levels of gene expression compared to that of ESAT-6 (ML0049), which is an important T cell antigen of low abundance in M. leprae. Fifteen of 26 selected antigen candidates were expressed and purified in Escherichia coli. The seroreactivity to these proteins of pooled sera from lepromatous leprosy patients and cavitary tuberculosis patients revealed that 9 of 15 recombinant hypothetical unknowns elicited M. leprae-specific immune responses. These nine proteins may be good diagnostic reagents to improve both the sensitivity and specificity of detection of individuals with asymptomatic leprosy.

Genetic Literacy and Patient Perceptions of IBD Testing Utility and Disease Control: A Randomized Vignette Study of Genetic Testing

PubMed Central

Hooker, Gillian W.; Peay, Holly; Erby, Lori; Bayless, Theodore; Biesecker, Barbara B.; Roter, Debra L.

2014-01-01

Background Findings from inflammatory bowel disease (IBD) genome-wide association studies are being translated clinically into prognostic and diagnostic indicators of disease. Yet, patient perception and understanding of these tests and their applicability to providing risk information is unclear. The goal of this study was to determine, using hypothetical scenarios, whether patients with IBD perceive genetic testing to be useful for risk assessment, whether genetic test results impact perceived control, and whether low genetic literacy may be a barrier to patient understanding of these tests. Methods Two hundred fifty seven patients with IBD from the Johns Hopkins gastroenterology clinics were randomized to receive a vignette depicting either a genetic testing scenario or a standard blood testing scenario. Participants were asked questions about the vignette and responses were compared between groups. Results Perceptions of test utility for risk assessment were higher among participants responding to the genetic vignette (P < 0.001). There were no significant differences in perceptions of control over IBD after hypothetical testing between vignettes (P = 0.24). Participant responses were modified by genetic literacy, measured using a scale developed for this study. Participants randomized to the genetic vignette who scored higher on the genetic literacy scale perceived greater utility of testing for risk assessment (P = 0.008) and more control after testing (P = 0.02). Conclusions Patients with IBD perceive utility in genetic testing for providing information relevant to family members, and this appreciation is promoted by genetic literacy. Low genetic literacy among patients poses a potential threat to effective translation of genetic and genomic tests. PMID:24691112

Mars base buildup scenarios

NASA Technical Reports Server (NTRS)

Blacic, J. D.

1986-01-01

Two Mars surface based build-up scenarios are presented in order to help visualize the mission and to serve as a basis for trade studies. In the first scenario, direct manned landings on the Martian surface occur early in the missions and scientific investigation is the main driver and rationale. In the second senario, Earth development of an infrastructure to exploit the volatile resources of the Martian moons for economic purposes is emphasized. Scientific exploration of the surface is delayed at first in this scenario relative to the first, but once begun develops rapidly, aided by the presence of a permanently manned orbital station.

Patients' self-interested preferences: empirical evidence from a priority setting experiment.

PubMed

Alvarez, Begoña; Rodríguez-Míguez, Eva

2011-04-01

This paper explores whether patients act according to self-interest in priority setting experiments. The analysis is based on a ranking experiment, conducted in Galicia (Spain), to elicit preferences regarding the prioritization of patients on a waiting list for an elective surgical intervention (prostatectomy for benign prostatic hyperplasia). Participants were patients awaiting a similar intervention and members of the general populations. All of them were asked to rank hypothetical patients on a waiting list. A rank-ordered logit was then applied to their responses in order to obtain a prioritization scoring system. Using these estimations, we first test for differences in preferences between patients and general population. Second, we implement a procedure based on the similarity between respondents (true patients) and the hypothetical scenarios they evaluate (hypothetical patients) to analyze whether patients provide self-interested rankings. Our results show that patient preferences differ significantly from general population preferences. The findings also indicate that, when patients rank the hypothetical scenarios on the waiting list, they consider not only the explicit attributes but also the similarity of each scenario to their own. In particular, they assign a higher priority to scenarios that more closely match their own states. We also find that such a preference structure increases their likelihood of reporting "irrational" answers. Copyright © 2011 Elsevier Ltd. All rights reserved.

Testing long-period ground-motion simulations of scenario earthquakes using the Mw 7.2 El Mayor-Cucapah mainshock: Evaluation of finite-fault rupture characterization and 3D seismic velocity models

USGS Publications Warehouse

Graves, Robert W.; Aagaard, Brad T.

2011-01-01

Using a suite of five hypothetical finite-fault rupture models, we test the ability of long-period (T>2.0 s) ground-motion simulations of scenario earthquakes to produce waveforms throughout southern California consistent with those recorded during the 4 April 2010 Mw 7.2 El Mayor-Cucapah earthquake. The hypothetical ruptures are generated using the methodology proposed by Graves and Pitarka (2010) and require, as inputs, only a general description of the fault location and geometry, event magnitude, and hypocenter, as would be done for a scenario event. For each rupture model, two Southern California Earthquake Center three-dimensional community seismic velocity models (CVM-4m and CVM-H62) are used, resulting in a total of 10 ground-motion simulations, which we compare with recorded ground motions. While the details of the motions vary across the simulations, the median levels match the observed peak ground velocities reasonably well, with the standard deviation of the residuals generally within 50% of the median. Simulations with the CVM-4m model yield somewhat lower variance than those with the CVM-H62 model. Both models tend to overpredict motions in the San Diego region and underpredict motions in the Mojave desert. Within the greater Los Angeles basin, the CVM-4m model generally matches the level of observed motions, whereas the CVM-H62 model tends to overpredict the motions, particularly in the southern portion of the basin. The variance in the peak velocity residuals is lowest for a rupture that has significant shallow slip (<5 km depth), whereas the variance in the residuals is greatest for ruptures with large asperities below 10 km depth. Overall, these results are encouraging and provide confidence in the predictive capabilities of the simulation methodology, while also suggesting some regions in which the seismic velocity models may need improvement.

Cost-effectiveness analysis of interferon beta-1b for the treatment of patients with a first clinical event suggestive of multiple sclerosis.

PubMed

Caloyeras, John P; Zhang, Bin; Wang, Cheng; Eriksson, Marianne; Fredrikson, Sten; Beckmann, Karola; Knappertz, Volker; Pohl, Christoph; Hartung, Hans-Peter; Shah, Dhvani; Miller, Jeffrey D; Sandbrink, Rupert; Lanius, Vivian; Gondek, Kathleen; Russell, Mason W

2012-05-01

To assess, from a Swedish societal perspective, the cost effectiveness of interferon β-1b (IFNB-1b) after an initial clinical event suggestive of multiple sclerosis (MS) (ie, early treatment) compared with treatment after onset of clinically definite MS (CDMS) (ie, delayed treatment). A Markov model was developed, using patient level data from the BENEFIT trial and published literature, to estimate health outcomes and costs associated with IFNB-1b for hypothetical cohorts of patients after an initial clinical event suggestive of MS. Health states were defined by Kurtzke Expanded Disability Status Scale (EDSS) scores. Model outcomes included quality-adjusted life years (QALYs), total costs (including both direct and indirect costs), and incremental cost-effectiveness ratios. Sensitivity analyses were performed on key model parameters to assess the robustness of model results. In the base case scenario, early IFNB-1b treatment was economically dominant (ie, less costly and more effective) versus delayed IFNB-1b treatment when QALYs were used as the effectiveness metric. Sensitivity analyses showed that the cost-effectiveness results were sensitive to model time horizon. Compared with the delayed treatment strategy, early treatment of MS was also associated with delayed EDSS progressions, prolonged time to CDMS diagnosis, and a reduction in frequency of relapse. Early treatment with IFNB-1b for a first clinical event suggestive of MS was found to improve patient outcomes while controlling costs. Copyright © 2012 Elsevier HS Journals, Inc. All rights reserved.

Self-Reflection of Video-Recorded High-Fidelity Simulations and Development of Clinical Judgment.

PubMed

Bussard, Michelle E

2016-09-01

Nurse educators are increasingly using high-fidelity simulators to improve prelicensure nursing students' ability to develop clinical judgment. Traditionally, oral debriefing sessions have immediately followed the simulation scenarios as a method for students to connect theory to practice and therefore develop clinical judgment. Recently, video recording of the simulation scenarios is being incorporated. This qualitative, interpretive description study was conducted to identify whether self-reflection on video-recorded high-fidelity simulation (HFS) scenarios helped prelicensure nursing students to develop clinical judgment. Tanner's clinical judgment model was the framework for this study. Four themes emerged from this study: Confidence, Communication, Decision Making, and Change in Clinical Practice. This study indicated that self-reflection of video-recorded HFS scenarios is beneficial for prelicensure nursing students to develop clinical judgment. [J Nurs Educ. 2016;55(9):522-527.]. Copyright 2016, SLACK Incorporated.

Determinants of physician empathy during medical education: hypothetical conclusions from an exploratory qualitative survey of practicing physicians

PubMed Central

2014-01-01

Background Empathy is an outcome-relevant physician characteristic and thus a crucial component of high-quality communication in health care. However, the factors that promote and inhibit the development of empathy during medical education have not been extensively researched. Also, currently there is no explicit research on the perspective of practicing physicians on the subject. Therefore the aim of our study was to explore physicians’ views of the positive and negative influences on the development of empathy during their medical education, as well as in their everyday work as physicians. Method We administered a written Qualitative Short Survey to 63 physicians in seven specialties. They were able to respond anonymously. Our open-ended question was: “What educational content in the course of your studies and/or your specialist training had a positive or negative effect on your empathy?” We analyzed the data using thematic content analysis following Mayring’s approach. Results Forty-two physicians took part in our survey. All together, they mentioned 68 specific factors (37 positive, 29 negative, 2 neutral) from which six themes emerged: 1. In general, medical education does not promote the development of empathy. 2. Recognizing the psycho-social dimensions of care fosters empathy. 3. Interactions with patients in medical practice promote empathy. 4. Physicians’ active self-development through reflective practice helps the development of empathy. 5. Interactions with colleagues can both promote and inhibit empathy through their role modeling of empathic and non-empathic behavior. 6. Stress, time pressure, and adverse working conditions are detrimental to empathy development. Conclusions Our results provide an overview of what might influence the development of clinical empathy, as well as hypothetical conclusions about how to promote it. Reflective practice seems to be lacking in current medical curricula and could be incorporated. Raising physicians�

DEVELOPMENT OF IMPACT ORIENTED CLIMATE SCENARIOS

EPA Science Inventory

Appropriate scenarios of future climate must be developed prior to any assessment of the impacts of climate change. he information needed by impact assessors was examined in consultation with those having experience in scenario use. ost assessors require regional scenarios with a...

Alternative scenarios: harnessing mid-level providers and evidence-based practice in primary dental care in England through operational research.

PubMed

Wanyonyi, Kristina L; Radford, David R; Harper, Paul R; Gallagher, Jennifer E

2015-09-15

In primary care dentistry, strategies to reconfigure the traditional boundaries of various dental professional groups by task sharing and role substitution have been encouraged in order to meet changing oral health needs. The aim of this research was to investigate the potential for skill mix use in primary dental care in England based on the undergraduate training experience in a primary care team training centre for dentists and mid-level dental providers. An operational research model and four alternative scenarios to test the potential for skill mix use in primary care in England were developed, informed by the model of care at a primary dental care training centre in the south of England, professional policy including scope of practice and contemporary evidence-based preventative practice. The model was developed in Excel and drew on published national timings and salary costs. The scenarios included the following: "No Skill Mix", "Minimal Direct Access", "More Prevention" and "Maximum Delegation". The scenario outputs comprised clinical time, workforce numbers and salary costs required for state-funded primary dental care in England. The operational research model suggested that 73% of clinical time in England's state-funded primary dental care in 2011/12 was spent on tasks that may be delegated to dental care professionals (DCPs), and 45- to 54-year-old patients received the most clinical time overall. Using estimated National Health Service (NHS) clinical working patterns, the model suggested alternative NHS workforce numbers and salary costs to meet the dental demand based on each developed scenario. For scenario 1:"No Skill Mix", the dentist-only scenario, 81% of the dentists currently registered in England would be required to participate. In scenario 2: "Minimal Direct Access", where 70% of examinations were delegated and the primary care training centre delegation patterns for other treatments were practised, 40% of registered dentists and eight times

Scenarios for gluino coannihilation

DOE PAGES

Ellis, John; Evans, Jason L.; Luo, Feng; ...

2016-02-11

In this article, we study supersymmetric scenarios in which the gluino is the next-to-lightest supersymmetric particle (NLSP), with a mass sufficiently close to that of the lightest supersymmetric particle (LSP) that gluino coannihilation becomes important. One of these scenarios is the MSSM with soft supersymmetry-breaking squark and slepton masses that are universal at an input GUT renormalization scale, but with non-universal gaugino masses. The other scenario is an extension of the MSSM to include vector-like supermultiplets. In both scenarios, we identify the regions of parameter space where gluino coannihilation is important, and discuss their relations to other regions of parametermore » space where other mechanisms bring the dark matter density into the range allowed by cosmology. In the case of the non-universal MSSM scenario, we find that the allowed range of parameter space is constrained by the requirement of electroweak symmetry breaking, the avoidance of a charged LSP and the measured mass of the Higgs boson, in particular, as well as the appearance of other dark matter (co)annihilation processes. Nevertheless, LSP masses m X ≲ 8TeV with the correct dark matter density are quite possible. In the case of pure gravity mediation with additional vector-like supermultiplets, changes to the anomaly-mediated gluino mass and the threshold effects associated with these states can make the gluino almost degenerate with the LSP, and we find a similar upper bound.« less

Effect of framing as gain versus loss on understanding and hypothetical treatment choices: survival and mortality curves.

PubMed

Armstrong, Katrina; Schwartz, J Sanford; Fitzgerald, Genevieve; Putt, Mary; Ubel, Peter A

2002-01-01

Presentation of information using survival or mortality (i.e., incidence) curves offers a potentially powerful method of communication because such curves provide information about risk over time in a relatively simple graphic format. However, the effect of framing as survival versus mortality on understanding and treatment choice is not known. In this study, 451 individuals awaiting jury duty at the Philadelphia City Courthouse were randomized to receive 1 of 3 questionnaires: (1) survival curves, (2) mortality curves, or (3) both survival and mortality curves. Each questionnaire included a brief description of a hypothetical treatment decision, survival curve graphs and/or mortality curve graphs presenting the outcome of the treatment, and questions measuring understanding of the information contained in the graphs and preference for undergoing treatment. After completing a brief practice exercise, participants were asked to answer questions assessing their ability to interpret single points on a curve and the difference between curves, and then to decide whether they would choose to undergo preventive surgery for 3 different scenarios in which the benefit of surgery varied. Participants who received only survival curves or who received both survival and mortality curves were significantly more accurate in answering questions about the information than participants who received only mortality curves (P < 0.05). For 2 of the 3 treatment presentations, participants who received only mortality curves were significantly less likely to prefer preventive surgery than participants who received survival curves only or both survival and mortality curves (P < 0.05). The effect of framing on understanding was greatest among participants with less than a college education and among non-Caucasian participants. Framing graphic risk information as chance of death over time results in lower levels of understanding and less interest in preventive surgery than framing as chance of

Simulation-Based Assessment of ECMO Clinical Specialists.

PubMed

Fehr, James J; Shepard, Mark; McBride, Mary E; Mehegan, Mary; Reddy, Kavya; Murray, David J; Boulet, John R

2016-06-01

The aims of the study were (1) to create multiple scenarios that simulate a range of urgent and emergent extracorporeal membrane oxygenation (ECMO) events and (2) to determine whether these scenarios can provide reliable and valid measures of a specialist's advanced skill in managing ECMO emergencies. Multiscenario simulation-based performance assessment was performed. The study was conducted in the Saigh Pediatric Simulation Center at St. Louis Children's Hospital. ECMO clinical specialists participated in the study. Twenty-five ECMO specialists completed 8 scenarios presenting acute events in simulated ECMO patients. Participants were evaluated by 2 separate reviewers for completion of key actions and for global performance. The scores were highest for the hemodilution scenario, whereas the air entrainment scenario had the lowest scores. Psychometric analysis demonstrated that ECMO specialists with more than 1 year of experience outperformed the specialists with less than 1 year of experience. Participants endorsed these sessions as important and representative of events that might be encountered in practice. The scenarios could serve as a component of an ECMO education curriculum and be used to assess clinical specialists' readiness to manage ECMO emergencies.

Nuclear Security Futures Scenarios.

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

Keller, Elizabeth James Kistin; Warren, Drake Edward; Hayden, Nancy Kay

This report provides an overview of the scenarios used in strategic futures workshops conducted at Sandia on September 21 and 29, 2016. The workshops, designed and facilitated by analysts in Center 100, used scenarios to enable thought leaders to think collectively about the changing aspects of global nuclear security and the potential implications for the US Government and Sandia National Laboratories.

Gene Expression Profile and Immunological Evaluation of Unique Hypothetical Unknown Proteins of Mycobacterium leprae by Using Quantitative Real-Time PCR

PubMed Central

Prithiviraj, Kalyani; Groathouse, Nathan; Brennan, Patrick J.; Spencer, John S.

2013-01-01

The cell-mediated immunity (CMI)-based in vitro gamma interferon release assay (IGRA) of Mycobacterium leprae-specific antigens has potential as a promising diagnostic means to detect those individuals in the early stages of M. leprae infection. Diagnosis of leprosy is a major obstacle toward ultimate disease control and has been compromised in the past by the lack of specific markers. Comparative bioinformatic analysis among mycobacterial genomes identified potential M. leprae-specific proteins called “hypothetical unknowns.” Due to massive gene decay and the prevalence of pseudogenes, it is unclear whether any of these proteins are expressed or are immunologically relevant. In this study, we performed cDNA-based quantitative real-time PCR to investigate the expression status of 131 putative open reading frames (ORFs) encoding hypothetical unknowns. Twenty-six of the M. leprae-specific antigen candidates showed significant levels of gene expression compared to that of ESAT-6 (ML0049), which is an important T cell antigen of low abundance in M. leprae. Fifteen of 26 selected antigen candidates were expressed and purified in Escherichia coli. The seroreactivity to these proteins of pooled sera from lepromatous leprosy patients and cavitary tuberculosis patients revealed that 9 of 15 recombinant hypothetical unknowns elicited M. leprae-specific immune responses. These nine proteins may be good diagnostic reagents to improve both the sensitivity and specificity of detection of individuals with asymptomatic leprosy. PMID:23239802

Ancillary health effects of climate mitigation scenarios as drivers of policy uptake: a review of air quality, transportation and diet co-benefits modeling studies

NASA Astrophysics Data System (ADS)

Chang, Kelly M.; Hess, Jeremy J.; Balbus, John M.; Buonocore, Jonathan J.; Cleveland, David A.; Grabow, Maggie L.; Neff, Roni; Saari, Rebecca K.; Tessum, Christopher W.; Wilkinson, Paul; Woodward, Alistair; Ebi, Kristie L.

2017-11-01

Background: Significant mitigation efforts beyond the Nationally Determined Commitments (NDCs) coming out of the 2015 Paris Climate Agreement are required to avoid warming of 2 °C above pre-industrial temperatures. Health co-benefits represent selected near term, positive consequences of climate policies that can offset mitigation costs in the short term before the beneficial impacts of those policies on the magnitude of climate change are evident. The diversity of approaches to modeling mitigation options and their health effects inhibits meta-analyses and syntheses of results useful in policy-making. Methods/Design: We evaluated the range of methods and choices in modeling health co-benefits of climate mitigation to identify opportunities for increased consistency and collaboration that could better inform policy-making. We reviewed studies quantifying the health co-benefits of climate change mitigation related to air quality, transportation, and diet published since the 2009 Lancet Commission ‘Managing the health effects of climate change’ through January 2017. We documented approaches, methods, scenarios, health-related exposures, and health outcomes. Results/Synthesis: Forty-two studies met the inclusion criteria. Air quality, transportation, and diet scenarios ranged from specific policy proposals to hypothetical scenarios, and from global recommendations to stakeholder-informed local guidance. Geographic and temporal scope as well as validity of scenarios determined policy relevance. More recent studies tended to use more sophisticated methods to address complexity in the relevant policy system. Discussion: Most studies indicated significant, nearer term, local ancillary health benefits providing impetus for policy uptake and net cost savings. However, studies were more suited to describing the interaction of climate policy and health and the magnitude of potential outcomes than to providing specific accurate estimates of health co-benefits. Modeling

Fertilizer Emission Scenario Tool for crop management system scenarios

EPA Pesticide Factsheets

The Fertilizer Emission Scenario Tool for CMAQ is a high-end computer interface that simulates daily fertilizer application information for any gridded domain. It integrates the Weather Research and Forecasting model and CMAQ.

Scenario-based and scenario-neutral assessment of climate change impacts on operational performance of a multipurpose reservoir

Treesearch

Allison G. Danner; Mohammad Safeeq; Gordon E. Grant; Charlotte Wickham; Desirée Tullos; Mary V. Santelmann

2017-01-01

Scenario-based and scenario-neutral impacts assessment approaches provide complementary information about how climate change-driven effects on streamflow may change the operational performance of multipurpose dams. Examining a case study of Cougar Dam in Oregon, United States, we simulated current reservoir operations under scenarios of plausible future hydrology....

Hypothetical performance of syndrome-based management of acute paediatric admissions of children aged more than 60 days in a Kenyan district hospital.

PubMed Central

English, Mike; Berkley, James; Mwangi, Isiah; Mohammed, Shebbe; Ahmed, Maimuna; Osier, Faith; Muturi, Neema; Ogutu, Bernhards; Marsh, Kevin; Newton, Charles R. J. C.

2003-01-01

OBJECTIVE: To investigate whether the outpatient, syndrome-based approach of the Integrated Management of Childhood Illness (IMCI) protocol could be extended to the inpatient arena to give clear and simple minimum standards of care for poorly resourced facilities. METHODS: A prospective, one-year admission cohort retrospectively compared hypothetical performance of syndrome-based management with paediatrician-defined final diagnosis. Admission syndrome definitions were based on local adaptations to the IMCI protocol that encompassed 20 clinical features, measurement of oxygen saturation, and malaria microscopy. FINDINGS: After 315 children with clinically obvious diagnoses (e.g. sickle cell disease and burns) were excluded, 3705 admission episodes were studied. Of these, 2334 (63%) met criteria for at least one severe syndrome (mortality 8% vs <1% for "non-severe" cases), and half of these had features of two or more severe syndromes. No cases of measles were seen. Syndrome-based treatment would have been appropriate (sensitivity >95%) for severe pneumonia, severe malaria, and diarrhoea with severe dehydration, and probably for severe malnutrition (sensitivity 71%). Syndrome-directed treatment suggested the use of broad-spectrum antibiotics in 75/133 (56% sensitivity) children with bacteraemic and 63/71 (89% sensitivity) children with meningitis. CONCLUSIONS: Twenty clinical features, oxygen saturation measurements, and results of malaria blood slides could be used for inpatient, syndrome-based management of acute paediatric admissions. The addition of microscopy of the cerebrospinal fluid and haemoglobin measurements would improve syndrome-directed treatment considerably. This approach might rationalize admission policy and standardize inpatient paediatric care in resource-poor countries, although the clinical detection of bacteraemia remains a problem. PMID:12764512

Exploring NASA Human Spaceflight and Pioneering Scenarios

NASA Technical Reports Server (NTRS)

Zapata, Edgar; Wilhite, Alan

2015-01-01

The life cycle cost analysis of space exploration scenarios is explored via a merger of (1) scenario planning, separating context and (2) modeling and analysis of specific content. Numerous scenarios are presented, leading to cross-cutting recommendations addressing life cycle costs, productivity, and approaches applicable to any scenarios. Approaches address technical and non-technical factors.

Land-Use Scenarios: National-Scale Housing-Density ...

EPA Pesticide Factsheets

EPA announced the availability of the final report, Land-Use Scenarios: National-Scale Housing-Density Scenarios Consistent with Climate Change Storylines. This report describes the scenarios and models used to generate national-scale housing density scenarios for the conterminous US to the year 2100 as part of the Integrated Climate and Land Use Scenarios (ICLUS) project. The report was prepared by the Global Change Research Program (GCRP) in the National Center for Environmental Assessment (NCEA) of the Office of Research and Development (ORD) at the U.S. Environmental Protection Agency (EPA). The ICLUS report describes the methods used to develop land-use scenarios by decade from the year 2000 to 2100 that are consistent with these storylines.

Gene modification therapies: views of parents of people with Down syndrome.

PubMed

Michie, Marsha; Allyse, Megan

2018-06-21

In considering gene modification technologies, the priorities of patient communities must be a central consideration. The purpose of this study is to assess views of families with Down syndrome (DS) regarding potential genome-based interventions. We constructed an anonymous online survey for family members of people with DS. Participants were asked to agree or disagree with scenarios describing hypothetical interventions to silence or significantly alter the physical and cognitive effects of a trisomy 21, and also with scenarios depicting currently available physical interventions. All 532 respondents were parents of people with DS. For each of the five scenarios, over half said they would approve the intervention or would advise their children with DS to do so. Responses to hypothetical prenatal and pediatric cognitive interventions were significantly affected by participants' assessments of the impact of DS on their children's and their families' lives, while physical and adult cognitive scenarios were not. Future interventions to address genetic conditions will impact patient communities and cannot succeed without their input and support. While many parents of people with DS indicated approval for hypothetical genetic therapies, these results indicate a need for continuing dialogue about benefits and drawbacks of gene modification technologies.

Shifting College Students' Epistemological Framing Using Hypothetical Debate Problems

ERIC Educational Resources Information Center

Hu, Dehui; Rebello, N. Sanjay

2014-01-01

Developing expertise in physics problem solving requires the ability to use mathematics effectively in physical scenarios. Novices and experts often perceive the use of mathematics in physics differently. Students' perceptions and how they frame the use of mathematics in physics play an important role in their physics problem solving. In this…

40 CFR 68.28 - Alternative release scenario analysis.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 15 2011-07-01 2011-07-01 false Alternative release scenario analysis... scenario analysis. (a) The number of scenarios. The owner or operator shall identify and analyze at least... release scenario under § 68.25; and (ii) That will reach an endpoint offsite, unless no such scenario...

Epidemiological and partial budget analysis for treatment of subclinical Staphylococcus aureus intramammary infections considering microbiological and cytological scenarios.

PubMed

Petzer, Inge-Marié; Etter, Eric M C; Donkin, Edward F; Webb, Edward C; Karzis, Joanne

2017-12-01

An innovative method was investigated to aid in the elimination of Staphylococcus aureus (S. aureus) intramammary infections (IMI) from dairy herds. A stochastic model explore the economic benefit of three-day or eight-day treatment of subclinical IMI in all S. aureus infected cows or in only those with a somatic cell count (SCC) exceeding 200,000 cells/ml. An epidemiological model was developed to run parallel to the economic model that would predict the S. aureus IMI likely to persist, develop new infections and clinical mastitis. In the economic model a first algorithm was used to consider the low prevalence (LP) scenario and made use of S. aureus prevalence information provided by retrospective analysis of microbiological and cytological results in South Africa (2008-2012). The data used considered Staphylococcus aureus prevalence from [1.495; 1.595] 95% to [6.72; 6.95] 95% for SCC≤200,000 and SCC>200,000 cells/ml respectively. A second algorithm considered the high prevalence (HP) scenario to evaluate a simulated situation with a 5[U1] [R12] to 25% prevalence. Scenarios of low or high transmission ratio (TR) were included in the model according to the hygiene management on the farm. Probabilities and costs were calculated over 255days. The economic models predicted average cost indices for low S. aureus IMI and low TR to vary from -3179 ZAR (South African Rands) when subclinical cases with SCC higher than 200,000 cell/ml were treated for eight days, to -3663 ZAR when all subclinical S. aureus IMI were treated for three days. With a HP and high TR of S. aureus the average cost indices changed from -18,042 ZAR when none to -5433 ZAR per 255days when all S. aureus IMI were treated for eight days. The epidemiological model in this study predicted substantial benefit of treatment mainly in high TR scenarios. New IMI decreased up to77% in the three-day and up to 91% in the eight-day treatment scenarios. In the HP scenarios, persistent IMI were reduced by 94%. The

A tool for the consensual analysis of decision-making scenarios.

PubMed

Hunt, Geoffrey; Merzeder, Christine; Bischofberger, Iren

2018-05-01

The authors believe there is a need for novel ways of enhancing professional judgment and discretion in the contemporary healthcare environment. The objective is to provide a framework to guide a discursive analysis of an ongoing clinical scenario by a small group of healthcare professionals (4-12) to achieve consensual understanding in the decision-making necessary to resolve specific healthcare inadequacies and promote organisational learning. REPVAD is an acronym for the framework's five decision-making dimensions of reasoning, evidence, procedures, values, attitudes and defences. The design is set out in terms of well-defined definitions of the dimensions, a rationale for using REPVAD, and explications of dimensions one at a time. Furthermore, the REPVAD process of application to a scenario is set out, and a didactic scenario is given to show how REPVAD works together with a sample case. A discussion is fleshed out in four real life student cases, and a conclusion indicates strengths and weaknesses and the possibility of further development and transferability. In terms of findings, the model has been tried, tested and refined over a number of years in the development of advanced practitioners at university healthcare faculties in two European countries. Consent was obtained from the four participating students.

Two hypothetical nystagmus procedures: augmented tenotomy and reattachment and augmented tendon suture (Sans tenotomy).

PubMed

Dell'Osso, Louis F; Tomsak, Robert L; Thurtell, Matthew J

2009-01-01

To review the hypothetical mechanism and therapeutic benefits of the four-muscle tenotomy and reattachment (T&R) procedure using knowledge accrued over the 10 years since its proposal; to describe an augmented tendon suture (ATS) technique to improve the procedure based on one of the originally suggested alternative methods (mechanical); and to hypothesize a new ATS procedure to achieve the same therapeutic benefits without extraocular muscle tenotomy or reattachment to the globe. Standard surgical methods were used. The T&R procedure damps and improves infantile nystagmus syndrome (INS) waveforms, improves eXtended Nystagmus Acuity Function (NAFX) values, broadens the NAFX peak versus gaze angle, and damps slow eye movements but not saccades. The T&R procedure also damps acquired pendular and downbeat nystagmus, decreasing the patients' oscillopsia, and lowers the target acquisition time in INS. The T&R procedure directly affects only the enthesis of the tendon; there is idiosyncratic variation in the distribution of afferent fibers in the tendons. The ATS technique consists of placing several additional sutures in the tendon proximal to the tenotomy. Based on the hypothetical proprioceptive mechanism for the beneficial effects of the T&R procedure, the authors hypothesize that the ATS technique will maximize the therapeutic benefits and that an ATS procedure, using only tendon sutures without tenotomy, will duplicate the therapeutic effects of T&R. Eliminating the tenotomy component results in a simpler procedure more suitable for single-session, multi-muscle surgery that may be required for improving the waveforms of multiplanar nystagmus and less prone to cause complications. Copyright 2009, SLACK Incorporated.

Two alternative solar energy scenarios for Western Europe

NASA Astrophysics Data System (ADS)

Nakicenovic, N.

1982-11-01

Two limiting scenarios that lead to a sustainable energy system in Western Europe toward the end of the next century are described. The scenarios consider exclusively solar energy futures: one based on centralized solar technologies (hard scenario) and the other on decentralized user-oriented technologies (soft scenario). While both scenarios eliminate Western Europe's dependence on domestic and foreign fossil energy sources, the hard solar scenario requires substantial imports of solar produced hydrogen. Fundamental but different changes of the whole energy system, economic structure and lifestyles are necessary in order to achieve sustainable solar energy futures in the scenarios.

Applying the Land Use Portfolio Model to Estimate Natural-Hazard Loss and Risk - A Hypothetical Demonstration for Ventura County, California

USGS Publications Warehouse

Dinitz, Laura B.

2008-01-01

-MH currently performs analyses for earthquakes, floods, and hurricane wind. HAZUS-MH loss estimates, however, do not account for some uncertainties associated with the specific natural-hazard scenarios, such as the likelihood of occurrence within a particular time horizon or the effectiveness of alternative risk-reduction options. Because of the uncertainties involved, it is challenging to make informative decisions about how to cost-effectively reduce risk from natural-hazard events. Risk analysis is one approach that decision-makers can use to evaluate alternative risk-reduction choices when outcomes are unknown. The Land Use Portfolio Model (LUPM), developed by the U.S. Geological Survey (USGS), is a geospatial scenario-based tool that incorporates hazard-event uncertainties to support risk analysis. The LUPM offers an approach to estimate and compare risks and returns from investments in risk-reduction measures. This paper describes and demonstrates a hypothetical application of the LUPM for Ventura County, California, and examines the challenges involved in developing decision tools that provide quantitative methods to estimate losses and analyze risk from natural hazards.

Soil erosion risk scenarios in the Mediterranean environment using RUSLE and GIS: An application model for Calabria (southern Italy)

NASA Astrophysics Data System (ADS)

Terranova, O.; Antronico, L.; Coscarelli, R.; Iaquinta, P.

2009-11-01

Soil erosion by water (WSE) has become a relevant issue at the Mediterranean level. In particular, natural conditions and human impact have made the Calabria (southern Italy) particularly prone to intense WSE. The purpose of this investigation is to identify areas highly affected by WSE in Calabria by comparing the scenarios obtained by assuming control and preventive measures and actions, as well as actual conditions generated by forest fires, also in the presence of conditions of maximum rainfall erosion. Geographic Information System techniques have been adopted to treat data of reasonable spatial resolution obtained at a regional scale for application to the RUSLE model. This work is based on the comparison of such data with a basic scenario that has been defined by the present situation (present scenario). In this scenario: (i) R has been assessed by means of an experimental relation adjusted to Calabria on the basis of 5-min observations; (ii) K has been drawn from the soil map of Calabria including 160 soilscapes; (iii) LS has been estimated according to the RUSLE2 model by using (among other subfactors) a 40-m square cell DTM; (iv) C has been derived by processing the data inferred from the project Corine Land Cover, whose legend includes 35 different land uses on three levels; and (v) P has been hypothesized as equal to 1. For the remaining three hypothesized scenarios, the RUSLE factors have been adjusted according to experimental data and to data in the literature. In particular, forest areas subject to fire have been randomly generated as far as fire location, extension, structure, and intensity are concerned. The values obtained by the application of the RUSLE model have emphasized that land management by means of measures and actions for reducing WSE causes a notable reduction of the erosive rate decreasing from ~30 to 12.3 Mg ha - 1 y - 1 . On the other hand, variations induced by hypothetical wildfires in forests on 10% of the regional territory

International Considerations Associated with Economic Planning for Recovery from a Generalized Disaster

DTIC Science & Technology

1988-06-01

typical approach in addressing the recovery problem has been to impose a hypothetical nuclear disaster scenario on the U.S. economy and to speculate on...system and international trade in the aftermath of a nuclear disaster in Chapter 7 is provided in the context of a number of dimensions of a...hypothetical nuclear conflict. The dimensions of a hypothetical nuclear disaster must be defined because planning must necessarily be flexible enough to

Medical Scenarios Relevant to Spaceflight

NASA Technical Reports Server (NTRS)

Bacal, Kira; Hurs, Victor; Doerr, Harold

2004-01-01

The Medical Operational Support Team (MOST) was tasked by the JSC Space Medicine and Life Sciences Directorate (SLSD) to incorporate medical simulation into 1) medical training for astronaut-crew medical officers (CMO) and medical flight control teams and 2) evaluations of procedures and resources required for medical care aboard the International Space Station (ISS). Development of evidence-based medical scenarios that mimic the physiology observed during spaceflight will be needed for the MOST to complete these two tasks. The MOST used a human patient simulator, the ISS-like resources in the Medical Simulation Laboratory (MSL), and evidence from space operations, military operations and medical literature to develop space relevant medical scenarios. These scenarios include conditions concerning airway management, Advanced Cardiac Life Support (ACLS) and mitigating anaphylactic symptoms. The MOST has used these space relevant medical scenarios to develop a preliminary space medical training regimen for NASA flight surgeons, Biomedical Flight Controllers (Biomedical Engineers; BME) and CMO-analogs. This regimen is conducted by the MOST in the MSL. The MOST has the capability to develop evidence-based space-relevant medical scenarios that can help SLSD I) demonstrate the proficiency of medical flight control teams to mitigate space-relevant medical events and 2) validate nextgeneration medical equipment and procedures for space medicine applications.

Futures Scenario in Science Learning

ERIC Educational Resources Information Center

Lloyd, David; Vanderhout, Annastasia; Lloyd, Lisa; Atkins, David

2010-01-01

In this article we describe our experiences in developing futures scenarios in two science contexts, space science and atmospheric science/climate change. Futures scenario writing can develop scientific literacy by connecting science learning to students' lifeworlds--past, present and future. They also provide a synthesising mechanism for…

Exploring factors that might influence primary-care provider discussion of and recommendation for prostate and colon cancer screening.

PubMed

Kistler, Christine E; Vu, Maihan; Sutkowi-Hemstreet, Anne; Gizlice, Ziya; Harris, Russell P; Brewer, Noel T; Lewis, Carmen L; Dolor, Rowena J; Barclay, Colleen; Sheridan, Stacey L

2018-01-01

Primary-care providers may contribute to the use of low-value cancer screening. We sought to examine circumstances under which primary-care providers would discuss and recommend two types of cancer screening services across a spectrum of net benefit and other factors known to influence screening. This was a cross sectional survey of 126 primary-care providers in 24 primary-care clinics in the US. Participants completed surveys with two hypothetical screening scenarios for prostate or colorectal cancer (CRC). Patients in the scenarios varied by age and screening-request status. For each scenario, providers indicated whether they would discuss and recommend screening. Providers also reported on their screening attitudes and the influence of other factors known to affect screening (short patient visits, worry about lawsuits, clinical reminders/performance measures, and screening guidelines). We examined associations between providers' attitudes and their screening recommendations for hypothetical 90-year-olds (the lowest-value screening). Providers reported they would discuss cancer screening more often than they would recommend it ( P <0.001). More providers would discuss and recommend screening for CRC than prostate cancer ( P <0.001), for younger than older patients ( P <0.001), and when the patient requested it than when not ( P <0.001). For a 90-year-old patient, every point increase in cancer-specific screening attitude increased the likelihood of a screening recommendation (30% for prostate cancer and 30% for CRC). While most providers' reported practice patterns aligned with net benefit, some providers would discuss and recommend low-value cancer screening, particularly when faced with a patient request. More work appears to be needed to help providers to discuss and recommend screening that aligns with value.

Useful global-change scenarios: current issues and challenges

NASA Astrophysics Data System (ADS)

Parson, E. A.

2008-10-01

Scenarios are increasingly used to inform global-change debates, but their connection to decisions has been weak and indirect. This reflects the greater number and variety of potential users and scenario needs, relative to other decision domains where scenario use is more established. Global-change scenario needs include common elements, e.g., model-generated projections of emissions and climate change, needed by many users but in different ways and with different assumptions. For these common elements, the limited ability to engage diverse global-change users in scenario development requires extreme transparency in communicating underlying reasoning and assumptions, including probability judgments. Other scenario needs are specific to users, requiring a decentralized network of scenario and assessment organizations to disseminate and interpret common elements and add elements requiring local context or expertise. Such an approach will make global-change scenarios more useful for decisions, but not less controversial. Despite predictable attacks, scenario-based reasoning is necessary for responsible global-change decisions because decision-relevant uncertainties cannot be specified scientifically. The purpose of scenarios is not to avoid speculation, but to make the required speculation more disciplined, more anchored in relevant scientific knowledge when available, and more transparent.

Improving the past and the future: a temporal asymmetry in hypothetical thinking.

PubMed

Ferrante, Donatella; Girotto, Vittorio; Stragà, Marta; Walsh, Clare

2013-02-01

Current views of hypothetical thinking implicitly assume that the content of imaginary thoughts about the past and future should be the same. Two experiments show that, given the same experienced facts of reality, future imagination may differ from past reconstruction. When participants failed a task, their counterfactual thoughts focused on uncontrollable features of their attempt (e.g., "Things would have been better if the allocated time were longer/if I had better logic skills"). But their prefactual thoughts focused on controllable features of their ensuing endeavor (e.g., "Things will be better next time if I concentrate more/if I use another strategy"). This finding suggests that compared with prefactual thinking, counterfactual thinking may be less subject to reality checks and less likely to serve preparatory goals. 2013 APA, all rights reserved

Influence of the disease label 'polycystic ovary syndrome' on intention to have an ultrasound and psychosocial outcomes: a randomised online study in young women.

PubMed

Copp, Tessa; McCaffery, Kirsten; Azizi, Lamiae; Doust, Jenny; Mol, Ben W J; Jansen, Jesse

2017-04-01

Does the disease label 'polycystic ovary syndrome' (PCOS) have an impact on desire for medical testing and psychosocial outcomes? When given the disease label PCOS in a hypothetical scenario, participants had higher intention to have an ultrasound, perceived the condition to be more severe and had lower self-esteem than those not given the disease label. Widening diagnostic criteria and improved imaging sensitivity have increased the number of reproductive-aged women diagnosed with PCOS from 4% to 8% to up to 21%. The uncertain clinical benefit of knowing this diagnosis needs to be weighed against the potential for poor psychological outcomes in women labelled with PCOS. This experimental online study randomised 181 young women to receive one of four hypothetical scenarios of a doctor's visit in a 2 (PCOS disease label versus no disease label) x 2 (information about unreliability of ultrasounds in clarifying diagnosis versus no information) design. Participants were university students (mean age: 19.4). After presenting the scenario, intention to have an ultrasound, negative affect, self-esteem, perceived severity of condition, credibility of the doctor and interest in a second opinion were measured. Participants were then presented with a second scenario, where the possibility of PCOS overdiagnosis was mentioned. Change in intention and perceived severity were then measured. Participants given the PCOS label had significantly higher intention to have an ultrasound (mean = 6.62 versus mean = 5.76, P = 0.033, 95% CI(difference) = 0.069-1.599), perceived the condition to be more severe (17.17 versus 15.82, P = 0.019, 95% CI(difference) = 0.229-2.479) and had lower self-esteem (25.86 versus 27.56, P = 0.031, 95% CI(difference) = -3.187 to -0.157). After receiving overdiagnosis information, both intention and perceived severity decreased, regardless of condition (both P < 0.001). This study used hypothetical scenarios; it is likely that for women facing a real

Negative mental imagery in public speaking anxiety: Forming cognitive resistance by taxing visuospatial working memory.

PubMed

Homer, Sophie R; Deeprose, Catherine; Andrade, Jackie

2016-03-01

This study sought to reconcile two lines of research. Previous studies have identified a prevalent and causal role of negative imagery in social phobia and public speaking anxiety; others have demonstrated that lateral eye movements during visualisation of imagery reduce its vividness, most likely by loading the visuospatial sketchpad of working memory. It was hypothesised that using eye movements to reduce the intensity of negative imagery associated with public speaking may reduce anxiety resulting from imagining a public speaking scenario compared to an auditory control task. Forty undergraduate students scoring high in anxiety on the Personal Report of Confidence as a Speaker scale took part. A semi-structured interview established an image that represented the participant's public speaking anxiety, which was then visualised during an eye movement task or a matched auditory task. Reactions to imagining a hypothetical but realistic public speaking scenario were measured. As hypothesised, representative imagery was established and reduced in vividness more effectively by the eye movement task than the auditory task. The public speaking scenario was then visualised less vividly and generated less anxiety when imagined after performing the eye movement task than after the auditory task. Self-report measures and a hypothetical scenario rather than actual public speaking were used. Replication is required in larger as well as clinical samples. Visuospatial working memory tasks may preferentially reduce anxiety associated with personal images of feared events, and thus provide cognitive resistance which reduces emotional reactions to imagined, and potentially real-life future stressful experiences. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluating Global Land-use Change Scenario: Carbon Emission in RCP Scenarios and its Effects on Climate Response

NASA Astrophysics Data System (ADS)

Kato, E.; Kawamiya, M.

2011-12-01

In CMIP5 experiments, new emissions scenarios for GCMs and Earth System Models (ESMs) have been constructed as Representative Concentration Pathways (RCPs) by a community effort of Integrated Assessment Modeling (IAM) groups. In RCP scenarios, regional land-use scenarios have been depicted based on the socio-economic assumption of IAMs, and also downscaled spatially explicit land-use maps from the regional scenarios are prepared. In the land-use harmonization project, integrated gridded land-use transition data for the past and future time period has been developed from the reconstruction based on HYDE 3 agricultural data and FAO wood harvest data, and the future land-use scenarios from IAMs. These gridded land-use dataset are used as a forcing of some ESMs participating to the CMIP5 experiments, to assess the biogeochemical and biogeophysical effects of land-use and land cover change in the climate change simulation. In this study, global net CO2 emissions from land-use change for RCP scenarios are evaluated with an offline terrestrial biogeochemical model, VISIT (Vegetation Integrative SImulation Tool). Also the emissions are evaluated with coupled ESM, MIROC-ESM following the LUCID-CMIP5 protocol to see the effect of land-use and land cover change on climate response. Using the model output, consistency of the land-use change CO2 emission scenarios provided by RCPs are evaluated in terms of effect of CO2 fertilization, climate change, and land-use transition itself including the effect of biomass crops production with CCS. We find that a land-use scenario with decreased agricultural land-use intensity such as RCP 6.0 shows possibility of further absorption of CO2 through the climate-carbon feedback, and cooling effect through both biogeochemical and biogeophysical effects.

Comparative analysis of chemical similarity methods for modular natural products with a hypothetical structure enumeration algorithm.

PubMed

Skinnider, Michael A; Dejong, Chris A; Franczak, Brian C; McNicholas, Paul D; Magarvey, Nathan A

2017-08-16

Natural products represent a prominent source of pharmaceutically and industrially important agents. Calculating the chemical similarity of two molecules is a central task in cheminformatics, with applications at multiple stages of the drug discovery pipeline. Quantifying the similarity of natural products is a particularly important problem, as the biological activities of these molecules have been extensively optimized by natural selection. The large and structurally complex scaffolds of natural products distinguish their physical and chemical properties from those of synthetic compounds. However, no analysis of the performance of existing methods for molecular similarity calculation specific to natural products has been reported to date. Here, we present LEMONS, an algorithm for the enumeration of hypothetical modular natural product structures. We leverage this algorithm to conduct a comparative analysis of molecular similarity methods within the unique chemical space occupied by modular natural products using controlled synthetic data, and comprehensively investigate the impact of diverse biosynthetic parameters on similarity search. We additionally investigate a recently described algorithm for natural product retrobiosynthesis and alignment, and find that when rule-based retrobiosynthesis can be applied, this approach outperforms conventional two-dimensional fingerprints, suggesting it may represent a valuable approach for the targeted exploration of natural product chemical space and microbial genome mining. Our open-source algorithm is an extensible method of enumerating hypothetical natural product structures with diverse potential applications in bioinformatics.

[The effect of a scenario-based simulation communication course on improving the communication skills of nurses].

PubMed

Huang, Ya-Hsuan; Hsieh, Suh-Ing; Hsu, Li-Ling

2014-04-01

Limited disease knowledge is frequently the cause of disease-related anxiety in myocardial infarction patients. The ability to communicate effectively serves multiple purposes in the professional nursing practice. By communicating effectively with myocardial infarction patients, nurses may help reduce their anxiety by keeping them well informed about their disease and teaching them self-care strategies. This research evaluates the communication skills of nurses following scenario-based simulation education in the context of communication with myocardial infarction patients. This study used an experimental design and an educational intervention. The target population comprised nurses of medicine (clinical qualified level N to N2 for nursing) working at a municipal hospital in Taipei City, Taiwan. A total 122 participants were enrolled. Stratified block randomization divided participants into an experimental group and a control group. The experimental group received clinical scenario-based simulation education for communication. The control group received traditional class-based education for communication. Both groups received a pre-test and a Communication Skills Checklist post-test assessment. Results were analyzed using SPSS 17.0 for Windows software. A t-test showed significant increases in communication skills (p < .001) in the experimental group and ANCOVA results identified significant between-group differences (p < .001) in communication skills following the education intervention. The results indicate that clinical scenario-based simulation education for communication is significantly more effective than traditional class-based education in enhancing the ability of nurses to communicate effectively with myocardial infarction patients.

Teaching childbirth with high-fidelity simulation. Is it better observing the scenario during the briefing session?

PubMed

Cuerva, Marcos J; Piñel, Carlos S; Martin, Lourdes; Espinosa, Jose A; Corral, Octavio J; Mendoza, Nicolás

2018-02-12

The design of optimal courses for obstetric undergraduate teaching is a relevant question. This study evaluates two different designs of simulator-based learning activity on childbirth with regard to respect to the patient, obstetric manoeuvres, interpretation of cardiotocography tracings (CTG) and infection prevention. This randomised experimental study which differs in the content of their briefing sessions consisted of two groups of undergraduate students, who performed two simulator-based learning activities on childbirth. The first briefing session included the observations of a properly performed scenario according to Spanish clinical practice guidelines on care in normal childbirth by the teachers whereas the second group did not include the observations of a properly performed scenario, and the students observed it only after the simulation process. The group that observed a properly performed scenario after the simulation obtained worse grades during the simulation, but better grades during the debriefing and evaluation. Simulator use in childbirth may be more fruitful when the medical students observe correct performance at the completion of the scenario compared to that at the start of the scenario. Impact statement What is already known on this subject? There is a scarcity of literature about the design of optimal high-fidelity simulation training in childbirth. It is known that preparing simulator-based learning activities is a complex process. Simulator-based learning includes the following steps: briefing, simulation, debriefing and evaluation. The most important part of high-fidelity simulations is the debriefing. A good briefing and simulation are of high relevance in order to have a fruitful debriefing session. What do the results of this study add? Our study describes a full simulator-based learning activity on childbirth that can be reproduced in similar facilities. The findings of this study add that high-fidelity simulation training in

Water use implications of biofuel scenarios

NASA Astrophysics Data System (ADS)

Teter, J.; Mishra, G. S.; Yeh, S.

2012-12-01

Existing studies rely upon attributional lifecycle analysis (LCA) approaches to estimate water intensity of biofuels in liters of irrigated/evapotranspiration water consumed for biofuel production. Such approaches can be misleading. From a policy perspective, a better approach is to compare differential water impacts among scenarios on a landscape scale. We address the shortcomings of existing studies by using consequential LCA, and incorporate direct and indirect land use (changes) of biofuel scenarios, marginal vs. average biofuel water use estimates, future climate, and geographic heterogeneity. We use the outputs of a partial equilibrium economic model, climate and soil data, and a process-based crop-soil-climate-water model to estimate differences in green water (GW - directly from precipitation to soil) and blue water (BW - supplied by irrigation) use among three scenarios: (1) business-as-usual (BAU), (2) Renewable Fuels Standard (RFS) mandates, and (3) a national Low Carbon Fuel Standard (LCFS) plus the RFS scenario. We use spatial statistical methods to interpolate key climatic variables using daily climate observations for the contiguous USA. Finally, we use FAO's crop model AquaCrop to estimate the domestic GW and BW impacts of biofuel policies from 2007-2035. We assess the differences among scenarios along the following metrics: (1) crop area expansion at the county level, including prime and marginal lands, (2) crop-specific and overall annual/seasonal water balances including (a) water inflows (irrigation & precipitation), (b) crop-atmosphere interactions: (evaporation & transpiration) and (d) soil-water flows (runoff & soil infiltration), in mm 3 /acre over the relevant time period. The functional unit of analysis is the BW and GW requirements of biofuels (mm3 per Btu biofuel) at the county level. Differential water use impacts among scenarios are a primarily a function of (1) land use conversion, in particular that of formerly uncropped land classes

Development of nonproliferation and assessment scenarios.

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

Finley, Melissa; Barnett, Natalie Beth

2005-10-01

The overall objective of the Nonproliferation and Assessments Scenario Development project is to create and analyze potential and plausible scenarios that would lead to an adversary's ability to acquire and use a biological weapon. The initial three months of funding was intended to be used to develop a scenario to demonstrate the efficacy of this analysis methodology; however, it was determined that a substantial amount of preliminary data collection would be needed before a proof of concept scenario could be developed. We have dedicated substantial effort to determine the acquisition pathways for Foot and Mouth Disease Virus, and similar processesmore » will be applied to all pathogens of interest. We have developed a biosecurity assessments database to capture information on adversary skill locales, available skill sets in specific regions, pathogen sources and regulations involved in pathogen acquisition from legitimate facilities. FY06 funding, once released, will be dedicated to data collection on acquisition, production and dissemination requirements on a pathogen basis. Once pathogen data has been collected, scenarios will be developed and scored.« less

Threatened species and the potential loss of phylogenetic diversity: conservation scenarios based on estimated extinction probabilities and phylogenetic risk analysis.

PubMed

Faith, Daniel P

2008-12-01

New species conservation strategies, including the EDGE of Existence (EDGE) program, have expanded threatened species assessments by integrating information about species' phylogenetic distinctiveness. Distinctiveness has been measured through simple scores that assign shared credit among species for evolutionary heritage represented by the deeper phylogenetic branches. A species with a high score combined with a high extinction probability receives high priority for conservation efforts. Simple hypothetical scenarios for phylogenetic trees and extinction probabilities demonstrate how such scoring approaches can provide inefficient priorities for conservation. An existing probabilistic framework derived from the phylogenetic diversity measure (PD) properly captures the idea of shared responsibility for the persistence of evolutionary history. It avoids static scores, takes into account the status of close relatives through their extinction probabilities, and allows for the necessary updating of priorities in light of changes in species threat status. A hypothetical phylogenetic tree illustrates how changes in extinction probabilities of one or more species translate into changes in expected PD. The probabilistic PD framework provided a range of strategies that moved beyond expected PD to better consider worst-case PD losses. In another example, risk aversion gave higher priority to a conservation program that provided a smaller, but less risky, gain in expected PD. The EDGE program could continue to promote a list of top species conservation priorities through application of probabilistic PD and simple estimates of current extinction probability. The list might be a dynamic one, with all the priority scores updated as extinction probabilities change. Results of recent studies suggest that estimation of extinction probabilities derived from the red list criteria linked to changes in species range sizes may provide estimated probabilities for many different species

Carbon-oxygen clusters as hypothetical high energy-density materials

NASA Astrophysics Data System (ADS)

Evangelisti, Stefano

1997-05-01

An an initio investigation on the hypothetical systems C nO n ( n = 2, 3, 4) is presented. Calculations have been performed at SCF and MP2 level, using a [3s2p1 d] basis set on each atom. At this level of approximation, two metastable structures have been found. They are C 2O 2 with C 2v symmetry (an irregular tetrahedron) and C 4O 4 with T d symmetry (two regular tetrahedra copenetrating each other). On the other hand, the search of local minima with C nv structures has failed for n = 3, 4. For the two metastable structures also larger basis sets have been used, up to [4s3p2d1f] (in the case of C 4O 4, at SCF level only). The computed energy release of the dissociation reaction (C nO n → n CO) of the two metastable structures is very high (about 100 kcal per mole of CO produced). It is of the same magnitude of the energy computed for the corresponding isoelectronic structures N 4 and N 8. If these or similar CO-clusters could be synthesized, these systems are candidates to be high energy-density materials (HEDM).

Community Solar Scenario Tool | Integrated Energy Solutions | NREL

Science.gov Websites

Community Solar Scenario Tool Community Solar Scenario Tool The Community Solar Scenario Tool (CSST ) provides a "first cut" analysis of different community or shared solar program options. NREL sponsoring utility. Community Solar Scenario Tool -Beta Version Available as a Microsoft Excel file, which

Investigating the consequences of urban volcanism using a scenario approach II: Insights into transportation network damage and functionality

NASA Astrophysics Data System (ADS)

Blake, Daniel M.; Deligne, Natalia I.; Wilson, Thomas M.; Lindsay, Jan M.; Woods, Richard

2017-06-01

Transportation networks are critical infrastructure in urban environments. Before, during and following volcanic activity, these networks can incur direct and indirect impacts, which subsequently reduces the Level-of-Service available to transportation end-users. Additionally, reductions in service can arise from management strategies including evacuation zoning, causing additional complications for transportation end-users and operators. Here, we develop metrics that incorporate Level-of-Service for transportation end-users as the key measure of vulnerability for multi-hazard volcanic impact and risk assessments. A hypothetical eruption scenario recently developed for the Auckland Volcanic Field, New Zealand, is applied to describe potential impacts of a small basaltic eruption on different transportation modes, namely road, rail, and activities at airports and ports. We demonstrate how the new metrics can be applied at specific locations worldwide by considering the geophysical hazard sequence and evacuation zones in this scenario, a process that was strongly informed by consultation with transportation infrastructure providers and emergency management officials. We also discuss the potential implications of modified hazard sequences (e.g. different wind profiles during the scenario, and unrest with no resulting eruption) on transportation vulnerability and population displacement. The vent area of the eruption scenario used in our study is located north of the Māngere Bridge suburb of Auckland. The volcanic activity in the scenario progresses from seismic unrest, through phreatomagmatic explosions generating pyroclastic surges to a magmatic phase generating a scoria cone and lava flows. We find that most physical damage to transportation networks occurs from pyroclastic surges during the initial stages of the eruption. However, the most extensive service reduction across all networks occurs 6 days prior to the eruption onset, largely attributed to the

Economic Implications of Potential Changes to Regulatory and Reimbursement Policies for Medical Devices

PubMed Central

Reed, Shelby D.; Shea, Alisa M.

2007-01-01

Objective To evaluate the impact of regulatory scenarios on the financial viability of medical device companies. Design We developed a model to calculate the expected net present value of a hypothetical product throughout preclinical development, clinical testing, regulatory approval, and postmarketing. We tested 3 scenarios: (1) the current regulatory environment; (2) a scenario in which medical devices are subject to the same evidence standards required for pharmaceuticals; and (3) a scenario consistent with the Coverage with Evidence Development: Coverage with Study Participation (CSP) policy proposed by the Centers for Medicare and Medicaid Services, whereby Medicare will pay for beneficiaries to receive new devices that are not currently determined to be “reasonable and necessary” if the patients participate in clinical studies or registries. Measurements and Main results When applying assumptions consistent with the implantable cardioverter-defibrillator market, the net present value at the start of development was an estimated $553 million in the current regulatory environment, $322 million in the pharmaceutical scenario, and $403 million in the CSP scenario. Sensitivity analyses showed that the device industry would likely be profitable in all 3 scenarios over a range of assumptions. Conclusions The environment in which the medical device industry operates is financially attractive. Furthermore, when compared with the alternative of applying the same evidence standards for pharmaceuticals to medical devices, the CSP policy offers improved financial incentives for medical device companies. PMID:18095045

Life cycle assessment of a packaging waste recycling system in Portugal

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

Ferreira, S.; Cabral, M.; Cruz, N.F. da, E-mail: nunocruz@tecnico.ulisboa.pt

Highlights: • We modeled a real packaging waste recycling system. • The analysis was performed using the life cycle assessment methodology. • The 2010 situation was compared with scenarios where the materials were not recycled. • The “Baseline” scenario seems to be more beneficial to the environment. - Abstract: Life Cycle Assessment (LCA) has been used to assess the environmental impacts associated with an activity or product life cycle. It has also been applied to assess the environmental performance related to waste management activities. This study analyses the packaging waste management system of a local public authority in Portugal. Themore » operations of selective and refuse collection, sorting, recycling, landfilling and incineration of packaging waste were considered. The packaging waste management system in operation in 2010, which we called “Baseline” scenario, was compared with two hypothetical scenarios where all the packaging waste that was selectively collected in 2010 would undergo the refuse collection system and would be sent directly to incineration (called “Incineration” scenario) or to landfill (“Landfill” scenario). Overall, the results show that the “Baseline” scenario is more environmentally sound than the hypothetical scenarios.« less

Scripting Scenarios for the Human Patient Simulator

NASA Technical Reports Server (NTRS)

Bacal, Kira; Miller, Robert; Doerr, Harold

2004-01-01

The Human Patient Simulator (HPS) is particularly useful in providing scenario-based learning which can be tailored to fit specific scenarios and which can be modified in realtime to enhance the teaching environment. Scripting these scenarios so as to maximize learning requires certain skills, in order to ensure that a change in student performance, understanding, critical thinking, and/or communication skills results. Methods: A "good" scenario can be defined in terms of applicability, learning opportunities, student interest, and clearly associated metrics. Obstacles to such a scenario include a lack of understanding of the applicable environment by the scenario author(s), a desire (common among novices) to cover too many topics, failure to define learning objectives, mutually exclusive or confusing learning objectives, unskilled instructors, poor preparation , disorganized approach, or an inappropriate teaching philosophy (such as "trial by fire" or education through humiliation). Results: Descriptions of several successful teaching programs, used in the military, civilian, and NASA medical environments , will be provided, along with sample scenarios. Discussion: Simulator-based lessons have proven to be a time- and cost-efficient manner by which to educate medical personnel. Particularly when training for medical care in austere environments (pre-hospital, aeromedical transport, International Space Station, military operations), the HPS can enhance the learning experience.

Modeling the Effects of Duration and Size of the Control Zones on the Consequences of a Hypothetical African Swine Fever Epidemic in Denmark

PubMed Central

Halasa, Tariq; Bøtner, Anette; Mortensen, Sten; Christensen, Hanne; Wulff, Sisse Birk; Boklund, Anette

2018-01-01

African swine fever (ASF) is a notifiable infectious disease. The disease is endemic in certain regions in Eastern Europe constituting a risk of ASF spread toward Western Europe. Therefore, as part of contingency planning, it is important to continuously explore strategies that can effectively control an epidemic of ASF. A previously published and well documented simulation model for ASF virus spread between herds was used to examine the epidemiologic and economic impacts of the duration and size of the control zones around affected herds. In the current study, scenarios were run, where the duration of the protection and surveillance zones were reduced from 50 and 45 days to 35 and 25 days or to 35 and 25 days, respectively. These scenarios were run with or without enlargement of the surveillance zone around detected herds from 10 to 15 km. The scenarios were also run with only clinical or clinical and serological surveillance of herds within the zones. Sensitivity analysis was conducted on influential input parameters in the model. The model predicts that reducing the duration of the protection and surveillance zones has no impact on the epidemiological consequences of the epidemics, while it may result in a substantial reduction in the total economic losses. In addition, the model predicts that increasing the size of the surveillance zone from 10 to 15 km may reduce both the epidemic duration and the total economic losses, in case of large epidemics. The ranking of the control strategies by the total costs of the epidemics was not influenced by changes of input parameters in the sensitivity analyses. PMID:29616228

An Updated Comprehensive Risk Analysis for Radioisotopes Identified of High Risk to National Security in the Event of a Radiological Dispersion Device Scenario

NASA Astrophysics Data System (ADS)

Robinson, Alexandra R.

An updated global survey of radioisotope production and distribution was completed and subjected to a revised "down-selection methodology" to determine those radioisotopes that should be classified as potential national security risks based on availability and key physical characteristics that could be exploited in a hypothetical radiological dispersion device. The potential at-risk radioisotopes then were used in a modeling software suite known as Turbo FRMAC, developed by Sandia National Laboratories, to characterize plausible contamination maps known as Protective Action Guideline Zone Maps. This software also was used to calculate the whole body dose equivalent for exposed individuals based on various dispersion parameters and scenarios. Derived Response Levels then were determined for each radioisotope using: 1) target doses to members of the public provided by the U.S. EPA, and 2) occupational dose limits provided by the U.S. Nuclear Regulatory Commission. The limiting Derived Response Level for each radioisotope also was determined.

Three Hypothetical Inflammation Pathobiology Phenotypes and Pediatric Sepsis-Induced Multiple Organ Failure Outcome.

PubMed

Carcillo, Joseph A; Halstead, E Scott; Hall, Mark W; Nguyen, Trung C; Reeder, Ron; Aneja, Rajesh; Shakoory, Bita; Simon, Dennis

2017-06-01

We hypothesize that three inflammation pathobiology phenotypes are associated with increased inflammation, proclivity to develop features of macrophage activation syndrome, and multiple organ failure-related death in pediatric severe sepsis. Prospective cohort study comparing children with severe sepsis and any of three phenotypes: 1) immunoparalysis-associated multiple organ failure (whole blood ex vivo tumor necrosis factor response to endotoxin < 200 pg/mL), 2) thrombocytopenia-associated multiple organ failure (new onset thrombocytopenia with acute kidney injury and a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 activity < 57%), and/or 3) sequential multiple organ failure with hepatobiliary dysfunction (respiratory distress followed by liver dysfunction with soluble Fas ligand > 200 pg/mL), to those without any of these phenotypes. Tertiary children's hospital PICU. One hundred consecutive severe sepsis admissions. Clinical data were recorded daily, and blood was collected twice weekly. Multiple organ failure developed in 75 cases and eight died. Multiple organ failure cases with any of the three inflammation phenotypes (n = 37) had higher inflammation (C-reactive protein, p = 0.009 and ferritin, p < 0.001) than multiple organ failure cases without any of these phenotypes (n = 38) or cases with only single organ failure (n = 25). Development of features of macrophage activation syndrome and death were more common among multiple organ failure cases with any of the phenotypes (macrophage activation syndrome: 10/37, 27%; death: 8/37, 22%) compared to multiple organ failure cases without any phenotype (macrophage activation syndrome: 1/38, 3%; p = 0.003 and death: 0/38, 0%; p = 0.002). Our approach to phenotype categorization remains hypothetical, and the phenotypes identified need to be confirmed in multicenter studies of pediatric multiple organ dysfunction syndrome.

Maximising the Effectiveness of a Scenario Planning Process: Tips for Scenario Planners in Higher Education

ERIC Educational Resources Information Center

Sayers, Nicola

2011-01-01

Scenario planning is a tool which can help organisations and people to think about, and plan for, the long-term future. In basic terms, it involves creating a number of in-depth scenarios (stories), each of which tells of a different possible future for an organisation or issue, and considering how each different future might influence…

Postoperative electrolyte management: Current practice patterns of surgeons and residents.

PubMed

Angarita, Fernando A; Dueck, Andrew D; Azouz, Solomon M

2015-07-01

Managing postoperative electrolyte imbalances often is driven by dogma. To identify areas of improvement, we assessed the practice pattern of postoperative electrolyte management among surgeons and residents. An online survey was distributed among attending surgeons and surgical residents at the University of Toronto. The survey was designed according to a systematic approach for formulating self-administered questionnaires. Questions addressed workload, decision making in hypothetical clinical scenarios, and improvement strategies. Of 232 surveys distributed, 156 were completed (response rate: 67%). The majority stated that junior residents were responsible for managing electrolytes at 13 University of Toronto-affiliated hospitals. Supervision was carried out predominately by senior residents (75%). Thirteen percent reported management went unsupervised. Approximately 59% of residents were unaware how often attending surgeons assessed patients' electrolytes. Despite the majority of residents (53.7%) reporting they were never given tools or trained in electrolyte replacement, they considered themselves moderately or extremely confident. The management of hypothetical clinical scenarios differed between residents and attending surgeons. The majority (50.5%) of respondents considered that an electrolyte replacement protocol is the most appropriate improvement strategy. Electrolyte replacement represents an important component of surgeons' workload. Despite reporting that formal training in electrolyte management is limited, residents consider themselves competent; however, their practice is highly variable and often differs from pharmacologic-directed recommendations. Optimizing how postoperative electrolytes are managed in surgical wards requires building a framework that improves knowledge, training, and limits unnecessary interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

Adaptive memory: the survival scenario enhances item-specific processing relative to a moving scenario.

PubMed

Burns, Daniel J; Hart, Joshua; Griffith, Samantha E; Burns, Amy D

2013-01-01

Nairne, Thompson, and Pandeirada (2007) found that retention of words rated for their relevance to survival is superior to that of words encoded under numerous other deep processing conditions. They suggested that our memory systems might have evolved to confer an advantage for survival-relevant information. Burns, Burns, and Hwang (2011) suggested a two-process explanation of the proximate mechanisms responsible for the survival advantage. Whereas most control tasks encourage only one type of processing, the survival task encourages both item-specific and relational processing. They found that when control tasks encouraged both types of processing, the survival processing advantage was eliminated. However, none of their control conditions included non-survival scenarios (e.g., moving, vacation, etc.), so it is not clear how this two-process explanation would explain the survival advantage when scenarios are used as control conditions. The present experiments replicated the finding that the survival scenario improves recall relative to a moving scenario in both a between-lists and within-list design and also provided evidence that this difference was accompanied by an item-specific processing difference, not a difference in relational processing. The implications of these results for several existing accounts of the survival processing effect are discussed.

Cancer Survivors’ Health Worries and Associations with Lifestyle Practices

PubMed Central

Mosher, Catherine E.; Lipkus, Isaac M.; Sloane, Richard; Kraus, William E.; Snyder, Denise Clutter; Peterson, Bercedis; Jones, Lee W.; Demark-Wahnefried, Wendy

2013-01-01

This study examined among recently diagnosed breast and prostate cancer survivors (N = 678) associations between worry about a future diagnosis of heart disease or cancer and hypothetical and actual adherence to exercise and dietary guidelines. Greater worry about future illness was reported under the hypothetical scenario of non-adherence to guidelines relative to the scenario of adherence. Worry about potential heart disease was associated with actual adherence to guidelines, whereas worry about a potential cancer diagnosis was not. Findings suggest that the motivational properties of worry should be considered when developing interventions to reduce heart disease risk among cancer survivors. PMID:18987083

The Good, the Bad, and the Irrelevant: Neural Mechanisms of Learning Real and Hypothetical Rewards and Effort

PubMed Central

Kolling, Nils; Nelissen, Natalie; Wittmann, Marco K.; Harmer, Catherine J.; Rushworth, Matthew F. S.

2015-01-01

Natural environments are complex, and a single choice can lead to multiple outcomes. Agents should learn which outcomes are due to their choices and therefore relevant for future decisions and which are stochastic in ways common to all choices and therefore irrelevant for future decisions between options. We designed an experiment in which human participants learned the varying reward and effort magnitudes of two options and repeatedly chose between them. The reward associated with a choice was randomly real or hypothetical (i.e., participants only sometimes received the reward magnitude associated with the chosen option). The real/hypothetical nature of the reward on any one trial was, however, irrelevant for learning the longer-term values of the choices, and participants ought to have only focused on the informational content of the outcome and disregarded whether it was a real or hypothetical reward. However, we found that participants showed an irrational choice bias, preferring choices that had previously led, by chance, to a real reward in the last trial. Amygdala and ventromedial prefrontal activity was related to the way in which participants' choices were biased by real reward receipt. By contrast, activity in dorsal anterior cingulate cortex, frontal operculum/anterior insula, and especially lateral anterior prefrontal cortex was related to the degree to which participants resisted this bias and chose effectively in a manner guided by aspects of outcomes that had real and more sustained relationships with particular choices, suppressing irrelevant reward information for more optimal learning and decision making. SIGNIFICANCE STATEMENT In complex natural environments, a single choice can lead to multiple outcomes. Human agents should only learn from outcomes that are due to their choices, not from outcomes without such a relationship. We designed an experiment to measure learning about reward and effort magnitudes in an environment in which other features

Changing clinical scenario in Chandipura virus infection.

PubMed

Sudeep, A B; Gurav, Y K; Bondre, V P

2016-06-01

Chandipura virus (CHPV) (Vesiculovirus: Rhabdoviridae) garnered global attention as an emerging neurotropic pathogen inflicting high mortality in children within 24 h of commencement of symptoms. The 2003-2004 outbreaks in Central India witnessed case fatality rates ranging from 56-75 per cent in Andhra Pradesh and Gujarat with typical encephalitic symptoms. Due to the acute sickness and rapid deterioration, the precise mechanism of action of the virus is still unknown. Recent studies have shown increased expression of CHPV phosphoprotein upto 6 h post infection (PI) demonstrating CHPV replication in neuronal cells and the rapid destruction of the cells by apoptosis shed light on the probable mechanism of rapid death in children. Phlebotomine sandflies are implicated as vectors due to their predominance in endemic areas, repeated virus isolations and their ability to transmit the virus by transovarial and venereal routes. Significant contributions have been made in the development of diagnostics and prophylactics, vaccines and antivirals. Two candidate vaccines, viz. a recombinant vaccine and a killed vaccine and siRNAs targeting P and M proteins have been developed and are awaiting clinical trials. Rhabdomyosarcoma and Phlebotomus papatasi cell lines as well as embryonated chicken eggs have been found useful in virus isolation and propagation. Despite these advancements, CHPV has been a major concern in Central India and warrants immediate attention from virologists, neurologists, paediatricians and the government for containing the virus.

Scenario analysis of the future of medicines.

PubMed Central

Leufkens, H.; Haaijer-Ruskamp, F.; Bakker, A.; Dukes, G.

1994-01-01

Planning future policy for medicines poses difficult problems. The main players in the drug business have their own views as to how the world around them functions and how the future of medicines should be shaped. In this paper we show how a scenario analysis can provide a powerful teaching device to readjust peoples' preconceptions. Scenarios are plausible, not probable or preferable, portraits of alternative futures. A series of four of alternative scenarios were constructed: "sobriety in sufficiency," "risk avoidance," "technology on demand," and "free market unfettered." Each scenario was drawn as a narrative, documented quantitatively wherever possible, that described the world as it might be if particular trends were to dominate development. The medical community and health policy markers may use scenarios to take a long term view in order to be prepared adequately for the future. PMID:7987110

Misrepresentation of the IPCC CO2 emission scenarios

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

Manning, Martin; Edmonds, James A.; Emori, S.

2010-06-01

Estimates of recent fossil fuel CO2 emissions have been compared with the IPCC SRES (Special Report on Emission Scenarios) emission scenarios that had been developed for analysis of future climate change, impacts and mitigation. In some cases this comparison uses averages across subgroups of SRES scenarios and for one category of greenhouse gases (industrial sources of CO2). That approach can be misleading and cause confusion as it is inconsistent with many of the papers on future climate change projections that are based on a specific subset of closely scrutinized SRES scenarios, known as illustrative marker scenarios. Here, we show thatmore » comparison between recent estimates of fossil fuel emissions trends and the SRES illustrative marker scenarios leads to the conclusion that recent trends are not outside the SRES range. Furthermore, the recent economic downturn appears to have brought actual emission back toward the middle of the SRES illustrative marker scenarios. We also note that SRES emission scenarios are designed to reflect potential alternative long-term trends in a world without climate policy intervention and the trend in the resulting climate change is not sensitive to short-term fluctuations.« less

The effects of restaurant menu calorie labeling on hypothetical meal choices of females with disordered eating.

PubMed

Haynos, Ann F; Roberto, Christina A

2017-03-01

Concerns have been raised that obesity public policy measures may have harmful effects on individuals with eating disorders. However, little research has investigated this topic. We examined the impact of a popular obesity public policy, menu calorie labeling, on hypothetical food choices of women with disordered eating. Seven hundred sixteen adult females completed an online survey in which they were randomly assigned to receive a restaurant menu with or without calorie information listed. Participants selected foods representative of a meal they would choose to consume and answered questions on restaurant ordering and menu labeling. Participants completed the Eating Disorder Examination Questionnaire (Fairburn & Beglin, ) to assess global eating pathology. Diagnoses of anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) were also derived from this measure. Generalized linear modeling examined the impact of menu label condition, disordered eating, and the menu label by disordered eating interaction on hypothetical food selection and related variables. When disordered eating was examined continuously, menu labeling did not differentially affect food selections of those with elevated disordered eating (p = .45). However, when examined by eating disorder diagnosis, participants with AN or BN ordered significantly fewer (p < .001) and participants with BED ordered significantly more (p = .001) calories in the menu label versus no label condition. Menu labeling may decrease the calories ordered among individuals with AN or BN and increase calories ordered among individuals with BED. © 2017 Wiley Periodicals, Inc.

The effects of restaurant menu calorie labeling on hypothetical meal choices of females with disordered eating

PubMed Central

Haynos, Ann F.; Roberto, Christina A.

2017-01-01

Objective Concerns have been raised that obesity public policy measures may have harmful effects on individuals with eating disorders. However, little research has investigated this topic. We examined the impact of a popular obesity public policy, menu calorie labeling, on hypothetical food choices of women with disordered eating. Methods 716 adult females completed an online survey in which they were randomly assigned to receive a restaurant menu with or without calorie information listed. Participants selected foods representative of a meal they would choose to consume and answered questions on restaurant ordering and menu labeling. Participants completed the Eating Disorder Examination Questionnaire (Fairburn & Beglin, 1994) to assess global eating pathology. Diagnoses of anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) were also derived from this measure. Generalized linear modeling examined the impact of menu label condition, disordered eating, and the menu label by disordered eating interaction on hypothetical food selection and related variables. Results When disordered eating was examined continuously, menu labeling did not differentially affect food selections of those with elevated disordered eating (p = .45). However, when examined by eating disorder diagnosis, participants with AN or BN ordered significantly fewer (p < .001) and participants with BED ordered significantly more (p = .001) calories in the menu label versus no label condition. Discussion Menu labeling may decrease the calories ordered among individuals with AN or BN and increase calories ordered among individuals with BED. PMID:28130796

Beyond "utilitarianism": maximizing the clinical impact of moral judgment research.

PubMed

Rosas, Alejandro; Koenigs, Michael

2014-01-01

The use of hypothetical moral dilemmas--which pit utilitarian considerations of welfare maximization against emotionally aversive "personal" harms--has become a widespread approach for studying the neuropsychological correlates of moral judgment in healthy subjects, as well as in clinical populations with social, cognitive, and affective deficits. In this article, we propose that a refinement of the standard stimulus set could provide an opportunity to more precisely identify the psychological factors underlying performance on this task, and thereby enhance the utility of this paradigm for clinical research. To test this proposal, we performed a re-analysis of previously published moral judgment data from two clinical populations: neurological patients with prefrontal brain damage and psychopathic criminals. The results provide intriguing preliminary support for further development of this assessment paradigm.

An Assessment of the Hypothetical Impact of Drug Abuse on Combat Capability. Volume I.

DTIC Science & Technology

1979-12-01

25 I .4 Jill 1.6 MICROCOPY RESOLUTION TEST CHART NATIONAt BIURIA OF gMANI£ IWOI) A LEVEL AD SAI-80-113-WA AN ASSESSMENT OF THE HYPOTHETICAL IMPACTo OF...potential loss of unit effectiveness in each of these units. The resulting measure of unit effectiveness provides a powerful analy- tic tool for comparing...C *u LL C^ C at ta 0c *j I La u4U *c 11:1 - LuU~ *2 Cj Cc uj cl0 !2o Liq Q 4’ U w 0D 0C cnV cz Co 4-1 LLU 0U 0 U. 4 Ken Rn U, 0 -I 0u L SSMAIDU IIn

Decision-support tool for assessing biomanufacturing strategies under uncertainty: stainless steel versus disposable equipment for clinical trial material preparation.

PubMed

Farid, Suzanne S; Washbrook, John; Titchener-Hooker, Nigel J

2005-01-01

This paper presents the application of a decision-support tool, SIMBIOPHARMA, for assessing different manufacturing strategies under uncertainty for the production of biopharmaceuticals. SIMBIOPHARMA captures both the technical and business aspects of biopharmaceutical manufacture within a single tool that permits manufacturing alternatives to be evaluated in terms of cost, time, yield, project throughput, resource utilization, and risk. Its use for risk analysis is demonstrated through a hypothetical case study that uses the Monte Carlo simulation technique to imitate the randomness inherent in manufacturing subject to technical and market uncertainties. The case study addresses whether start-up companies should invest in a stainless steel pilot plant or use disposable equipment for the production of early phase clinical trial material. The effects of fluctuating product demands and titers on the performance of a biopharmaceutical company manufacturing clinical trial material are analyzed. The analysis highlights the impact of different manufacturing options on the range in possible outcomes for the project throughput and cost of goods and the likelihood that these metrics exceed a critical threshold. The simulation studies highlight the benefits of incorporating uncertainties when evaluating manufacturing strategies. Methods of presenting and analyzing information generated by the simulations are suggested. These are used to help determine the ranking of alternatives under different scenarios. The example illustrates the benefits to companies of using such a tool to improve management of their R&D portfolios so as to control the cost of goods.

Modeling and Composing Scenario-Based Requirements with Aspects

NASA Technical Reports Server (NTRS)

Araujo, Joao; Whittle, Jon; Ki, Dae-Kyoo

2004-01-01

There has been significant recent interest, within the Aspect-Oriented Software Development (AOSD) community, in representing crosscutting concerns at various stages of the software lifecycle. However, most of these efforts have concentrated on the design and implementation phases. We focus in this paper on representing aspects during use case modeling. In particular, we focus on scenario-based requirements and show how to compose aspectual and non-aspectual scenarios so that they can be simulated as a whole. Non-aspectual scenarios are modeled as UML sequence diagram. Aspectual scenarios are modeled as Interaction Pattern Specifications (IPS). In order to simulate them, the scenarios are transformed into a set of executable state machines using an existing state machine synthesis algorithm. Previous work composed aspectual and non-aspectual scenarios at the sequence diagram level. In this paper, the composition is done at the state machine level.

Use of discrete event simulation to improve a mental health clinic.

PubMed

Kim, Bo; Elstein, Yisraela; Shiner, Brian; Konrad, Renata; Pomerantz, Andrew S; Watts, Bradley V

2013-01-01

To improve clinic design, trial-and-error is commonly used to discover strategies that lead to improvement. Our goal was to predict the effects of various changes before undertaking them. Systems engineers collaborated with staff at an integrated primary care-mental health care clinic to create a computer simulation that mirrored how the clinic currently operates. We then simulated hypothetical changes to the staffing to understand their effects on percentage of patients seen outside scheduled clinic hours and service completion time. We found that, out of the change options being considered by the clinic, extending daily clinic hours by two and including an additional psychiatrist are likely to result in the greatest incremental decreases in patients seen outside clinic hours and in service time. Simulation in partnership with engineers can be an attractive tool for improving mental health clinics, particularly when changes are costly and thus trial-and-error is not desirable. © 2013.

[Scenario analysis--a method for long-term planning].

PubMed

Stavem, K

2000-01-10

Scenarios are known from the film industry, as detailed descriptions of films. This has given name to scenario analysis, a method for long term planning using descriptions of composite future pictures. This article is an introduction to the scenario method. Scenarios describe plausible, not necessarily probable, developments. They focus on problems and questions that decision makers must be aware of and prepare to deal with, and the consequences of alternative decisions. Scenarios are used in corporate and governmental planning, and they can be useful and complementary to traditional planning and extrapolation of past experience. The method is particularly useful in a rapidly changing world with shifting external conditions.

Hydrologic evaluation of a hypothetical coal-mining site near Chrisney, Spencer County, Indiana

USGS Publications Warehouse

Zogorski, John S.; Ramey, Daniel S.; Lambert, Paul W.; Martin, Jeffrey D.; Warner, Robert E.

1980-01-01

was completed to improve the understanding of the kinds of information needed to make such assessments by: (a) reviewing the regulations to determine what hydrologic information is required; (b) preparing an example hydrologic assessment based on the regulations; and (c) using the experience gained in (a) and (b) to identify areas lacking or needing additional data to make the required assessment. Hydrologic data for the study area were obtained from published and unpublished reports, maps, aerial photographs, personal interviews with residents in the area of the hypothetical mine site, and discussions with experts in the field. Where data were unavailable, "synthetic" data were generated by extrapolation from proximate or similar watersheds and (or) by assumptions based on experience or theory. Some field data were collected to corroborate and augment information originating from all these sources.

Understanding the Role of Message Frames on African-American Willingness to Participate in a Hypothetical Diabetes Prevention Study.

PubMed

Langford, Aisha T; Larkin, Knoll; Resnicow, Ken; Zikmund-Fisher, Brian J; Fagerlin, Angela

2017-08-01

The objective of this research was to evaluate the impact of message framing (e.g., highlighting health disparities vs. progress toward reducing disparities) on willingness to enroll in a hypothetical research study. African-American (AA, n = 1513) and White (n = 362) adults completed an online survey about diabetes, health behaviors including physical activity, and attitudes about research. AA participants were randomized to view a general message (same message as provided to all White participants) or 1 of 4 alternate messages that framed the need for people to participate in research in terms of race and/or health disparities. Among AAs, there were no differences in willingness to enroll in the study by message frame. However, individual characteristics including younger age, female sex, attitudes about research, a sense of obligation, and community responsibility were significant predictors of willingness to enroll in the study. AA participants who received the general message were equally willing as White participants to enroll in the study. Highlighting race and health disparities in study recruitment materials may not be needed to increase interest among AAs. Factors beyond race appear to be stronger motivators for participation. Unlike previous research, racial framing did not suppress motivation to enroll in our hypothetical study.

Personality and Behavior in Social Dilemmas: Testing the Situational Strength Hypothesis and the Role of Hypothetical Versus Real Incentives.

PubMed

Lozano, José H

2016-02-01

Previous research aimed at testing the situational strength hypothesis suffers from serious limitations regarding the conceptualization of strength. In order to overcome these limitations, the present study attempts to test the situational strength hypothesis based on the operationalization of strength as reinforcement contingencies. One dispositional factor of proven effect on cooperative behavior, social value orientation (SVO), was used as a predictor of behavior in four social dilemmas with varying degree of situational strength. The moderating role of incentive condition (hypothetical vs. real) on the relationship between SVO and behavior was also tested. One hundred undergraduates were presented with the four social dilemmas and the Social Value Orientation Scale. One-half of the sample played the social dilemmas using real incentives, whereas the other half used hypothetical incentives. Results supported the situational strength hypothesis in that no behavioral variability and no effect of SVO on behavior were found in the strongest situation. However, situational strength did not moderate the effect of SVO on behavior in situations where behavior showed variability. No moderating effect was found for incentive condition either. The implications of these results for personality theory and assessment are discussed. © 2014 Wiley Periodicals, Inc.

29 CFR 2590.715-2715 - Summary of benefits and coverage and uniform glossary.

Code of Federal Regulations, 2014 CFR

2014-07-01

... definitions of standard insurance terms and medical terms so that consumers may compare health coverage and... scenarios (including pregnancy and serious or chronic medical conditions) in accordance with this paragraph... scenario is a hypothetical situation, consisting of a sample treatment plan for a specified medical...

29 CFR 2590.715-2715 - Summary of benefits and coverage and uniform glossary.

Code of Federal Regulations, 2012 CFR

2012-07-01

... definitions of standard insurance terms and medical terms so that consumers may compare health coverage and... scenarios (including pregnancy and serious or chronic medical conditions) in accordance with this paragraph... scenario is a hypothetical situation, consisting of a sample treatment plan for a specified medical...

29 CFR 2590.715-2715 - Summary of benefits and coverage and uniform glossary.

Code of Federal Regulations, 2013 CFR

2013-07-01

... definitions of standard insurance terms and medical terms so that consumers may compare health coverage and... scenarios (including pregnancy and serious or chronic medical conditions) in accordance with this paragraph... scenario is a hypothetical situation, consisting of a sample treatment plan for a specified medical...

Chronic Pain as a Hypothetical Construct: A Practical and Philosophical Consideration

PubMed Central

Doleys, Daniel M.

2017-01-01

Pain has been defined by the International Association for the Study of Pain (IASP) as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” Chronic pain is usually described as pain that has persisted for 3–6 months and/or beyond the expected time of healing. The numerical pain rating (NPR) is the customary metric and often considered as a proxy for the subjective experience of chronic pain. This definition of pain (chronic) has been of significant heuristic value. However, the definition and the models it has spawned tend to encourage the interpretation of pain as a measurable entity and implies that the patient’s experience of pain can be fully comprehended by someone other than the person in pain. Several major models of pain have been scrutinized and found to propagate the notion of pain as a ‘thing’ and fall prey to biomedical reductionism and Cartesian (mind-body) dualism. Furthermore, the NPR does not appear to capture the complexity of chronic pain and correlates poorly with other clinically meaningful outcomes. It, and other aspects of the current notion of chronic pain, appear to be an extension of our reliance on the philosophical principles of reductionism and materialism. These and other shortcomings identified in the IASP definition have resulted in an increased interest in a reexamination and possible updating of our view of pain (chronic) and its definition. The present paper describes an alternative view of pain, in particular chronic pain. It argues that chronic pain should be understood as a separate phenomenon from, rather than an extension of, acute pain and interpreted as a hypothetical construct (HC). HCs are contrasted to intervening variables (IV) and the use of HCs in science is illustrated. The acceptance of the principles of nonlinearity and emergence are seen as important characteristics. The practical implications and barriers of this

Molecular Diagnostic Analysis of Outbreak Scenarios

ERIC Educational Resources Information Center

Morsink, M. C.; Dekter, H. E.; Dirks-Mulder, A.; van Leeuwen, W. B.

2012-01-01

In the current laboratory assignment, technical aspects of the polymerase chain reaction (PCR) are integrated in the context of six different bacterial outbreak scenarios. The "Enterobacterial Repetitive Intergenic Consensus Sequence" (ERIC) PCR was used to analyze different outbreak scenarios. First, groups of 2-4 students determined optimal…

Alternative Geothermal Power Production Scenarios

DOE Data Explorer

Sullivan, John

2014-03-14

The information given in this file pertains to Argonne LCAs of the plant cycle stage for a set of ten new geothermal scenario pairs, each comprised of a reference and improved case. These analyses were conducted to compare environmental performances among the scenarios and cases. The types of plants evaluated are hydrothermal binary and flash and Enhanced Geothermal Systems (EGS) binary and flash plants. Each scenario pair was developed by the LCOE group using GETEM as a way to identify plant operational and resource combinations that could reduce geothermal power plant LCOE values. Based on the specified plant and well field characteristics (plant type, capacity, capacity factor and lifetime, and well numbers and depths) for each case of each pair, Argonne generated a corresponding set of material to power ratios (MPRs) and greenhouse gas and fossil energy ratios.

Development and Validation of Videotaped Scenarios

PubMed Central

Noel, Nora E.; Maisto, Stephen A.; Johnson, James D.; Jackson, Lee A.; Goings, Christopher D.; Hagman, Brett T.

2013-01-01

Researchers using scenarios often neglect to validate perceived content and salience of embedded stimuli specifically with intended participants, even when such meaning is integral to the study. For example, sex and aggression stimuli are heavily influenced by culture, so participants may not perceive what researchers intended in sexual aggression scenarios. Using four studies, the authors describe the method of scenario validation to produce two videos assessing alcohol-related sexual aggression. Both videos are identical except for the presence in one video of antiforce cues that are extremely salient to the young heterosexual men. Focus groups and questionnaires validate these men's perceptions that (a) the woman was sexually interested, (b) the sexual cues were salient, (c) the antiforce cues were salient (antiaggression video only), and (e) these antiforce cues inhibited acceptance of forced sex. Results show the value of carefully selecting and validating content when assessing socially volatile variables and provide a useful template for developing culturally valid scenarios. PMID:18252938

Exploring factors that might influence primary-care provider discussion of and recommendation for prostate and colon cancer screening

PubMed Central

Kistler, Christine E; Vu, Maihan; Sutkowi-Hemstreet, Anne; Gizlice, Ziya; Harris, Russell P; Brewer, Noel T; Lewis, Carmen L; Dolor, Rowena J; Barclay, Colleen; Sheridan, Stacey L

2018-01-01

Background Primary-care providers may contribute to the use of low-value cancer screening. Objective We sought to examine circumstances under which primary-care providers would discuss and recommend two types of cancer screening services across a spectrum of net benefit and other factors known to influence screening. Patients and methods This was a cross sectional survey of 126 primary-care providers in 24 primary-care clinics in the US. Participants completed surveys with two hypothetical screening scenarios for prostate or colorectal cancer (CRC). Patients in the scenarios varied by age and screening-request status. For each scenario, providers indicated whether they would discuss and recommend screening. Providers also reported on their screening attitudes and the influence of other factors known to affect screening (short patient visits, worry about lawsuits, clinical reminders/performance measures, and screening guidelines). We examined associations between providers’ attitudes and their screening recommendations for hypothetical 90-year-olds (the lowest-value screening). Results Providers reported they would discuss cancer screening more often than they would recommend it (P<0.001). More providers would discuss and recommend screening for CRC than prostate cancer (P<0.001), for younger than older patients (P<0.001), and when the patient requested it than when not (P<0.001). For a 90-year-old patient, every point increase in cancer-specific screening attitude increased the likelihood of a screening recommendation (30% for prostate cancer and 30% for CRC). Discussion While most providers’ reported practice patterns aligned with net benefit, some providers would discuss and recommend low-value cancer screening, particularly when faced with a patient request. Conclusion More work appears to be needed to help providers to discuss and recommend screening that aligns with value. PMID:29844698

Perceptions of Child Sexual Abuse in a Hypothetical Cybersexploitation Case: The Importance of Perpetrator Honesty, Outcome Type, and Respondent Gender

ERIC Educational Resources Information Center

Davies, Michelle; Rogers, Paul; Hood, Paul A.

2009-01-01

This study investigated perceptions of child sexual abuse in a hypothetical cybersexploitation case. Men were predicted to be more negative toward the victim than were women. Victims were predicted to be more negatively judged when they consented to sex than when they did not and when they were lied to than when they were not. Two hundred and…

The SAFRR Tsunami Scenario: Improving Resilience for California from a Plausible M9 Earthquake near the Alaska Peninsula

NASA Astrophysics Data System (ADS)

Ross, S.; Jones, L.; Wilson, R. I.; Bahng, B.; Barberopoulou, A.; Borrero, J. C.; Brosnan, D.; Bwarie, J.; Geist, E. L.; Johnson, L.; Kirby, S. H.; Knight, W.; Long, K.; Lynett, P. J.; Miller, K.; Mortensen, C. E.; Nicolsky, D.; Oglesby, D. D.; Perry, S. C.; Plumlee, G. S.; Porter, K. A.; Real, C. R.; Ryan, K. J.; Suleimani, E.; Thio, H. K.; Titov, V.; Wein, A. M.; Whitmore, P.; Wood, N. J.

2013-12-01

The SAFRR Tsunami Scenario models a hypothetical but plausible tsunami, created by an Mw9.1 earthquake occurring offshore from the Alaskan peninsula, and its impacts on the California coast. We present the likely inundation areas, current velocities in key ports and harbors, physical damage and repair costs, economic consequences, environmental impacts, social vulnerability, emergency management, and policy implications for California associated with the tsunami scenario. The intended users are those who must make mitigation decisions before and rapid decisions during future tsunamis. Around a half million people would be present in the scenario's inundation area in residences, businesses, public venues, parks and beaches. Evacuation would likely be ordered for the State of California's maximum mapped tsunami inundation zone, evacuating an additional quarter million people from residences and businesses. Some island and peninsula communities would face particular evacuation challenges because of limited access options and short warning time, caused by the distance between Alaska and California. Evacuations may also be a challenge for certain dependent-care populations. One third of the boats in California's marinas could be damaged or sunk, costing at least 700 million in repairs to boats and docks, and potentially much more to address serious issues due to sediment transport and environmental contamination. Fires would likely start at many sites where fuel and petrochemicals are stored in ports and marinas. Tsunami surges and bores may travel several miles inland up coastal rivers. Debris clean-up and recovery of inundated and damaged areas will take days, months, or years depending on the severity of impacts and the available resources for recovery. The Ports of Los Angeles and Long Beach (POLA/LB) would be shut down for a miniμm of two days due to strong currents. Inundation of dry land in the ports would result in 100 million damages to cargo and additional

Computational mining for hypothetical patterns of amino acid side chains in protein data bank (PDB)

NASA Astrophysics Data System (ADS)

Ghani, Nur Syatila Ab; Firdaus-Raih, Mohd

2018-04-01

The three-dimensional structure of a protein can provide insights regarding its function. Functional relationship between proteins can be inferred from fold and sequence similarities. In certain cases, sequence or fold comparison fails to conclude homology between proteins with similar mechanism. Since the structure is more conserved than the sequence, a constellation of functional residues can be similarly arranged among proteins of similar mechanism. Local structural similarity searches are able to detect such constellation of amino acids among distinct proteins, which can be useful to annotate proteins of unknown function. Detection of such patterns of amino acids on a large scale can increase the repertoire of important 3D motifs since available known 3D motifs currently, could not compensate the ever-increasing numbers of uncharacterized proteins to be annotated. Here, a computational platform for an automated detection of 3D motifs is described. A fuzzy-pattern searching algorithm derived from IMagine an Amino Acid 3D Arrangement search EnGINE (IMAAAGINE) was implemented to develop an automated method for searching of hypothetical patterns of amino acid side chains in Protein Data Bank (PDB), without the need for prior knowledge on related sequence or structure of pattern of interest. We present an example of the searches, which is the detection of a hypothetical pattern derived from known structural motif of C2H2 structural pattern from zinc fingers. The conservation of particular patterns of amino acid side chains in unrelated proteins is highlighted. This approach can act as a complementary method for available structure- and sequence-based platforms and may contribute in improving functional association between proteins.

Modeling a novel hypothetical use of postal collection boxes as automated external defibrillator access points.

PubMed

Srinivasan, Sanjana; Salerno, Jessica; Hajari, Hadi; Weiss, Lenny S; Salcido, David D

2017-11-01

Optimizing placement of Automated External Defibrillators (AED) can increase survival after an out-of-hospital cardiac arrest (OHCA). Using postal collection boxes (PCB) as locations for AEDs could potentially enhance accessibility and streamline maintenance. In this study, we modeled the hypothetical effects of deploying AEDs at PCB locations. We hypothesized that PCB-AEDs would increase AED coverage overall and in residential areas, and reduce the distance from OHCA to an AED. AEDs in Pittsburgh, PA were identified by the University of Pittsburgh Resuscitation Logistics and Informatics Venture (n=747). PCB locations were obtained from the United States Postal Service (n=479). OHCA locations from 2009 to 2014 were obtained from the Pittsburgh site of the Resuscitation Outcomes Consortium. AED coverage assuming a ¼ mile radius around each AED was estimated for known AEDs, PCB-AEDs (hypothetical AED locations), and known AEDs augmented by PCB-AEDs, both overall and for residential and non-residential zones. Linear distance from each OHCA to the nearest AED was calculated and compared between the sets. The set of known AEDs augmented with PCB-AEDs covered more of the city overall (55% vs 30%), as well as greater proportions of residential (62% vs 27%) and non-residential areas (45% vs 30%). The median distance from OHCA to AED was significantly shorter when known AEDs were augmented with PCB-AEDs (0.12mi vs 0.32mi; p=0.001). Augmenting existing publicly accessible AEDs with AEDs deployed at PCBs can increase AED spatial coverage in both residential and non-residential areas, and reduce the distance from AED to OHCA. Copyright © 2017 Elsevier B.V. All rights reserved.

The HayWired Earthquake Scenario

USGS Publications Warehouse

Detweiler, Shane T.; Wein, Anne M.

2017-04-24

ForewordThe 1906 Great San Francisco earthquake (magnitude 7.8) and the 1989 Loma Prieta earthquake (magnitude 6.9) each motivated residents of the San Francisco Bay region to build countermeasures to earthquakes into the fabric of the region. Since Loma Prieta, bay-region communities, governments, and utilities have invested tens of billions of dollars in seismic upgrades and retrofits and replacements of older buildings and infrastructure. Innovation and state-of-the-art engineering, informed by science, including novel seismic-hazard assessments, have been applied to the challenge of increasing seismic resilience throughout the bay region. However, as long as people live and work in seismically vulnerable buildings or rely on seismically vulnerable transportation and utilities, more work remains to be done.With that in mind, the U.S. Geological Survey (USGS) and its partners developed the HayWired scenario as a tool to enable further actions that can change the outcome when the next major earthquake strikes. By illuminating the likely impacts to the present-day built environment, well-constructed scenarios can and have spurred officials and citizens to take steps that change the outcomes the scenario describes, whether used to guide more realistic response and recovery exercises or to launch mitigation measures that will reduce future risk.The HayWired scenario is the latest in a series of like-minded efforts to bring a special focus onto the impacts that could occur when the Hayward Fault again ruptures through the east side of the San Francisco Bay region as it last did in 1868. Cities in the east bay along the Richmond, Oakland, and Fremont corridor would be hit hardest by earthquake ground shaking, surface fault rupture, aftershocks, and fault afterslip, but the impacts would reach throughout the bay region and far beyond. The HayWired scenario name reflects our increased reliance on the Internet and telecommunications and also alludes to the

Attributions of Blame and Credibility in a Hypothetical Child Sexual Abuse Case: Roles of Victim Disability, Victim Resistance and Respondent Gender

ERIC Educational Resources Information Center

Rogers, Paul; Titterington, Leigh; Davies, Michelle

2009-01-01

This study examines the effects victim disability (physical vs. intellectual vs. none), victim resistance (physical vs. verbal vs. none) and respondent gender (male vs. female) have on attributions of blame and credibility in a hypothetical case of child sexual abuse. Three hundred and thirty-five respondents read a fictional police statement…

New climate change scenarios for the Netherlands.

PubMed

van den Hurk, B; Tank, A K; Lenderink, G; Ulden, A van; Oldenborgh, G J van; Katsman, C; Brink, H van den; Keller, F; Bessembinder, J; Burgers, G; Komen, G; Hazeleger, W; Drijfhout, S

2007-01-01

A new set of climate change scenarios for 2050 for the Netherlands was produced recently. The scenarios span a wide range of possible future climate conditions, and include climate variables that are of interest to a broad user community. The scenario values are constructed by combining output from an ensemble of recent General Climate Model (GCM) simulations, Regional Climate Model (RCM) output, meteorological observations and a touch of expert judgment. For temperature, precipitation, potential evaporation and wind four scenarios are constructed, encompassing ranges of both global mean temperature rise in 2050 and the strength of the response of the dominant atmospheric circulation in the area of interest to global warming. For this particular area, wintertime precipitation is seen to increase between 3.5 and 7% per degree global warming, but mean summertime precipitation shows opposite signs depending on the assumed response of the circulation regime. Annual maximum daily mean wind speed shows small changes compared to the observed (natural) variability of this variable. Sea level rise in the North Sea in 2100 ranges between 35 and 85 cm. Preliminary assessment of the impact of the new scenarios on water management and coastal defence policies indicate that particularly dry summer scenarios and increased intensity of extreme daily precipitation deserves additional attention in the near future.

What did the doctor say? Health literacy and recall of medical instructions.

PubMed

McCarthy, Danielle M; Waite, Katherine R; Curtis, Laura M; Engel, Kirsten G; Baker, David W; Wolf, Michael S

2012-04-01

Limited literacy has repeatedly been linked to problems comprehending health information, although the majority of studies to date have focused on reading various print health materials. We sought to investigate patients' ability to recall spoken medical instructions in the context of a hypothetical clinical encounter, and whether limited health literacy would adversely affect performance on the task. A total of 755 patients aged 55 to 74 were recruited from 1 academic internal medicine clinic and 3 federally qualified health centers. Participants' health literacy skills and recall of spoken medical instructions for 2 standard hypothetical video scenarios [wound care, gastroesophageal reflux disease (GERD) diagnosis] were assessed. The majority (71.6%) of participants had adequate health literacy skills, and these individuals performed significantly better in correctly recalling spoken information than those with marginal and low literacy in both scenarios: [wound care-mean (SD): low 2.5 (1.3) vs. marginal 3.5 (1.3) vs. adequate 4.6 (1.1); P<0.001), GERD: low 4.2(1.7) vs. marginal 5.2 (1.7) vs. adequate 6.5 (1.7); P<0.001]. Regardless of literacy level, overall recall of information was poor. Few recognized pain (28.5%) or fever (28.2%) as signs of infection. Only 40.5% of participants correctly recalled when to take their GERD pills. Many older adults may have difficulty remembering verbal instructions conveyed during clinical encounters. We found those with lower health literacy to have poorer ability to recall information. Greater provider awareness of the impact of low health literacy on the recall of spoken instructions may guide providers to communicate more effectively and employ strategies to confirm patient understanding.

What Did the Doctor Say? Health Literacy and Recall of Medical Instructions

PubMed Central

McCarthy, Danielle M; Waite, Katherine R; Curtis, Laura M; Engel, Kirsten G; Baker, David W; Wolf, Michael S

2011-01-01

Background Limited literacy has repeatedly been linked to problems comprehending health information, although the majority of studies to date have focused on reading various print health materials. We sought to investigate patients’ ability to recall spoken medical instructions in the context of a hypothetical clinical encounter, and whether limited health literacy would adversely affect performance on the task. Methods A total of 755 patients age 55–74 were recruited from one academic internal medicine clinic and three federally qualified health centers. Participants’ health literacy skills and recall of spoken medical instructions for two standard, hypothetical video scenarios (wound care, GERD diagnosis)were assessed. Results The majority (71.6%) of participants had adequate health literacy skills, and these individuals performed significantly better in correctly recalling spoken information than those with marginal and low literacy in both scenarios: [wound care - mean (SD): low 2.5 (1.3) vs. marginal 3.5 (1.3) vs adequate 4.6 (1.1); p<0.001), GERD: low 4.2(1.7) vs. marginal 5.2(1.7) vs. adequate 6.5 (1.7);p<0.001]. Regardless of literacy level, overall recall of information was poor. Few recognized pain (28.5%) or fever (28.2%) as signs of infection. Only 40.5% of participants correctly recalled when to take their GERD pills. Conclusions Many older adults may have difficulty remembering verbal instructions conveyed during clinical encounters. We found those with lower health literacy to have poorer ability to recall information. Greater provider awareness of the impact of low health literacy on the recall of spoken instructions may guide providers to communicate more effectively and employ strategies to confirm patient understanding. PMID:22411440

Transportation accident scenarios for commercial spent fuel

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

Wilmot, E L

1981-02-01

A spectrum of high severity, low probability, transportation accident scenarios involving commercial spent fuel is presented together with mechanisms, pathways and quantities of material that might be released from spent fuel to the environment. These scenarios are based on conclusions from a workshop, conducted in May 1980 to discuss transportation accident scenarios, in which a group of experts reviewed and critiqued available literature relating to spent fuel behavior and cask response in accidents.

The scenario-based generalization of radiation therapy margins.

PubMed

Fredriksson, Albin; Bokrantz, Rasmus

2016-03-07

We give a scenario-based treatment plan optimization formulation that is equivalent to planning with geometric margins if the scenario doses are calculated using the static dose cloud approximation. If the scenario doses are instead calculated more accurately, then our formulation provides a novel robust planning method that overcomes many of the difficulties associated with previous scenario-based robust planning methods. In particular, our method protects only against uncertainties that can occur in practice, it gives a sharp dose fall-off outside high dose regions, and it avoids underdosage of the target in 'easy' scenarios. The method shares the benefits of the previous scenario-based robust planning methods over geometric margins for applications where the static dose cloud approximation is inaccurate, such as irradiation with few fields and irradiation with ion beams. These properties are demonstrated on a suite of phantom cases planned for treatment with scanned proton beams subject to systematic setup uncertainty.

Soil erosion and sediment delivery in a mountain catchment under scenarios of land use change using a spatially distributed numerical model

NASA Astrophysics Data System (ADS)

Alatorre, L. C.; Beguería, S.; Lana-Renault, N.; Navas, A.; García-Ruiz, J. M.

2012-05-01

Soil erosion and sediment yield are strongly affected by land use/land cover (LULC). Spatially distributed erosion models are of great interest to assess the expected effect of LULC changes on soil erosion and sediment yield. However, they can only be applied if spatially distributed data is available for their calibration. In this study the soil erosion and sediment delivery model WATEM/SEDEM was applied to a small (2.84 km2) experimental catchment in the Central Spanish Pyrenees. Model calibration was performed based on a dataset of soil redistribution rates derived from point 137Cs inventories, allowing capture differences per land use in the main model parameters. Model calibration showed a good convergence to a global optimum in the parameter space, which was not possible to attain if only external (not spatially distributed) sediment yield data were available. Validation of the model results against seven years of recorded sediment yield at the catchment outlet was satisfactory. Two LULC scenarios were then modeled to reproduce land use at the beginning of the twentieth century and a hypothetic future scenario, and to compare the simulation results to the current LULC situation. The results show a reduction of about one order of magnitude in gross erosion (3180 to 350 Mg yr-1) and sediment delivery (11.2 to 1.2 Mg yr-1 ha-1) during the last decades as a result of the abandonment of traditional land uses (mostly agriculture) and subsequent vegetation recolonization. The simulation also allowed assessing differences in the sediment sources and sinks within the catchment.

Ground-motion modeling of the 1906 San Francisco Earthquake, part II: Ground-motion estimates for the 1906 earthquake and scenario events

USGS Publications Warehouse

Aagaard, Brad T.; Brocher, T.M.; Dolenc, D.; Dreger, D.; Graves, R.W.; Harmsen, S.; Hartzell, S.; Larsen, S.; McCandless, K.; Nilsson, S.; Petersson, N.A.; Rodgers, A.; Sjogreen, B.; Zoback, M.L.

2008-01-01

We estimate the ground motions produce by the 1906 San Francisco earthquake making use of the recently developed Song et al. (2008) source model that combines the available geodetic and seismic observations and recently constructed 3D geologic and seismic velocity models. Our estimates of the ground motions for the 1906 earthquake are consistent across five ground-motion modeling groups employing different wave propagation codes and simulation domains. The simulations successfully reproduce the main features of the Boatwright and Bundock (2005) ShakeMap, but tend to over predict the intensity of shaking by 0.1-0.5 modified Mercalli intensity (MMI) units. Velocity waveforms at sites throughout the San Francisco Bay Area exhibit characteristics consistent with rupture directivity, local geologic conditions (e.g., sedimentary basins), and the large size of the event (e.g., durations of strong shaking lasting tens of seconds). We also compute ground motions for seven hypothetical scenarios rupturing the same extent of the northern San Andreas fault, considering three additional hypocenters and an additional, random distribution of slip. Rupture directivity exerts the strongest influence on the variations in shaking, although sedimentary basins do consistently contribute to the response in some locations, such as Santa Rosa, Livermore, and San Jose. These scenarios suggest that future large earthquakes on the northern San Andreas fault may subject the current San Francisco Bay urban area to stronger shaking than a repeat of the 1906 earthquake. Ruptures propagating southward towards San Francisco appear to expose more of the urban area to a given intensity level than do ruptures propagating northward.

System analysis with improved thermo-mechanical fuel rod models for modeling current and advanced LWR materials in accident scenarios

NASA Astrophysics Data System (ADS)

Porter, Ian Edward

A nuclear reactor systems code has the ability to model the system response in an accident scenario based on known initial conditions at the onset of the transient. However, there has been a tendency for these codes to lack the detailed thermo-mechanical fuel rod response models needed for accurate prediction of fuel rod failure. This proposed work will couple today's most widely used steady-state (FRAPCON) and transient (FRAPTRAN) fuel rod models with a systems code TRACE for best-estimate modeling of system response in accident scenarios such as a loss of coolant accident (LOCA). In doing so, code modifications will be made to model gamma heating in LWRs during steady-state and accident conditions and to improve fuel rod thermal/mechanical analysis by allowing axial nodalization of burnup-dependent phenomena such as swelling, cladding creep and oxidation. With the ability to model both burnup-dependent parameters and transient fuel rod response, a fuel dispersal study will be conducted using a hypothetical accident scenario under both PWR and BWR conditions to determine the amount of fuel dispersed under varying conditions. Due to the fuel fragmentation size and internal rod pressure both being dependent on burnup, this analysis will be conducted at beginning, middle and end of cycle to examine the effects that cycle time can play on fuel rod failure and dispersal. Current fuel rod and system codes used by the Nuclear Regulatory Commission (NRC) are compilations of legacy codes with only commonly used light water reactor materials, Uranium Dioxide (UO2), Mixed Oxide (U/PuO 2) and zirconium alloys. However, the events at Fukushima Daiichi and Three Mile Island accident have shown the need for exploration into advanced materials possessing improved accident tolerance. This work looks to further modify the NRC codes to include silicon carbide (SiC), an advanced cladding material proposed by current DOE funded research on accident tolerant fuels (ATF). Several

Interpreting the Clinical Significance of Capacity Scores for Informed Consent in Alzheimer Disease Clinical Trials

PubMed Central

Karlawish, Jason; Kim, Scott Y. H.; Knopman, David; van Dyck, Christopher H.; James, Bryan D.; Bioethics, M.; Marson, Daniel

2014-01-01

Objective Among Alzheimer disease (AD) patients enrolled in a clinical trial, the authors assessed the ability of a standardized capacity assessment procedure to identify persons who are capable of giving their own informed consent. Design Cross-sectional interview. Setting Thirteen sites participating in a randomized and placebo controlled study of simvastatin for the treatment of mild to moderate AD. Participants Persons with mild to moderate AD and their study partners enrolled in the simvastatin clinical trial. Measurements Interviews to assess decision-making capacity using the MacArthur Competency Assessment Tool for Clinical Research (MacCAT-CR). Results Judges blinded to the subject’s clinical status had a high rate of agreement on patients capable of giving their own informed consent (κ = 0.73). The understanding subscale had the best receiver operator characteristic and an analysis of positive and negative predictive values over a range of hypothetical prevalences of incapacity to consent demonstrated the value of a range of understanding cut-points. Conclusion Among mild to moderate AD patients, enrolled in an actual clinical trial, these results suggest evidence based guidelines for using the MacCAT-CR understanding subscale to help guide judgments about whether a patient has the capacity to consent. PMID:18556397

Group 1: Scenario design and development issues

NASA Technical Reports Server (NTRS)

Sherwin, P.

1981-01-01

All LOFT scenarios and flight segments should be designed on the basis of a detailed statement of specific objectives. These objectives must state what kind of situation is to be addressed and why. The origin, routing, and destination of a particular scenario should be dictated by the specific objectives for that scenario or leg. Other factors to be considered are the desired weather, climate, etc. Simulator visual system, as well as other capabilities and limitations must be considered at a very early stage of scenario design. The simulator navigation area must be apropriate and must coincide with current Jeppeson charts. Much of the realism of LOFT is destroyed if the crew is unable to use current manuals and other materials.

The impact of SOA for achieving healthcare interoperability. An empirical investigation based on a hypothetical adoption.

PubMed

Daskalakis, S; Mantas, J

2009-01-01

The evaluation of a service-oriented prototype implementation for healthcare interoperability. A prototype framework was developed, aiming to exploit the use of service-oriented architecture (SOA) concepts for achieving healthcare interoperability and to move towards a virtual patient record (VPR) paradigm. The prototype implementation was evaluated for its hypothetical adoption. The evaluation strategy was based on the initial proposition of the DeLone and McLean model of information systems (IS) success [1], as modeled by Iivari [2]. A set of SOA and VPR characteristics were empirically encapsulated within the dimensions of IS success model, combined with measures from previous research works. The data gathered was analyzed using partial least squares (PLS). The results highlighted that system quality is a partial predictor of system use but not of user satisfaction. On the contrary, information quality proved to be a significant predictor of user satisfaction and partially a strong significant predictor of system use. Moreover, system use did not prove to be a significant predictor of individual impact whereas the bi-directional relation between use and user satisfaction did not confirm. Additionally, user satisfaction was found to be a strong significant predictor of individual impact. Finally, individual impact proved to be a strong significant predictor of organizational impact. The empirical study attempted to obtain hypothetical, but still useful beliefs and perceptions regarding the SOA prototype implementation. The deduced observations can form the basis for further investigation regarding the adaptability of SOA implementations with VPR characteristics in the healthcare domain.

Hydrogeology, ground-water quality, and the possible effects of a hypothetical radioactive water spill, Plainsboro Township, New Jersey

USGS Publications Warehouse

Lewis, J.C.; Spitz, F.J.

1987-01-01

Princeton University, under contract to the Department of Energy , maintains a Tokamak fusion test reactor in New Jersey. The U.S. Geological Survey investigated groundwater flow and estimated the effects of a hypothetical spill of radioactive water at the site on the local groundwater system. The study included test drilling; aquifer testing; measurement of water levels, infiltration capacity, and stream discharge; and a simulation of the hypothetical spill. The Triassic Stockton Formation-a water supply aquifer composed primarily of jointed siltstone and sandstone-underlies the site. The aquifer is confined by overlying weathered bedrock and underlying unjointed rock. Weathered bedrock is overlain by unconsolidated, partially saturated material which ranges from 6 to 39 ft in thickness. Groundwater recharge is by lateral flow into the study area, stream leakage, and precipitation. Discharge is by pumpage, evapotranspiration, stream inflow, and lateral flow out of the study area. Transmissivity of the aquifer is about 1,740 sq ft/day, and the storage coefficient is about 0.0002. The average linear velocity of groundwater at the site ranges from 100 to 270 ft/yr depending on location and time of year. The velocity over a large part of the site is controlled by on-site pumpage. Groundwater samples were collected and analyzed for common ions, trace metals, and tritium. The analyses reported no concentrations of common ions or trace metals which exceeded the criteria for drinking water standards recommended by the EPA, except for some instances of moderately high concentrations of iron and manganese. Iron and manganese are common in groundwater and surface water in the area and are not indicative of an on-site source of contamination. Tritium concentrations in the collected samples were also considered representative of background levels and were well below the maximum concentration permitted by the EPA. The fate of spilled radioactive water after a hypothetical

Non-invasive prenatal testing for single gene disorders: exploring the ethics.

PubMed

Deans, Zuzana; Hill, Melissa; Chitty, Lyn S; Lewis, Celine

2013-07-01

Non-invasive prenatal testing for single gene disorders is now clearly on the horizon. This new technology offers obvious clinical benefits such as safe testing early in pregnancy. Before widespread implementation, it is important to consider the possible ethical implications. Four hypothetical scenarios are presented that highlight how ethical ideals of respect for autonomy, privacy and fairness may come into play when offering non-invasive prenatal testing for single gene disorders. The first scenario illustrates the moral case for using these tests for 'information only', identifying a potential conflict between larger numbers of women seeking the benefits of the test and the wider social impact of funding tests that do not offer immediate clinical benefit. The second scenario shows how the simplicity and safety of non-invasive prenatal testing could lead to more autonomous decision-making and, conversely, how this could also lead to increased pressure on women to take up testing. In the third scenario we show how, unless strong safeguards are put in place, offering non-invasive prenatal testing could be subject to routinisation with informed consent undermined and that woman who are newly diagnosed as carriers may be particularly vulnerable. The final scenario introduces the possibility of a conflict of the moral rights of a woman and her partner through testing for single gene disorders. This analysis informs our understanding of the potential impacts of non-invasive prenatal testing for single gene disorders on clinical practice and has implications for future policy and guidelines for prenatal care.

Effects of Scenario Planning on Participant Mental Models

ERIC Educational Resources Information Center

Glick, Margaret B.; Chermack, Thomas J.; Luckel, Henry; Gauck, Brian Q.

2012-01-01

Purpose: The purpose of this paper is to assess the effects of scenario planning on participant mental model styles. Design/methodology/approach: The scenario planning literature is consistent with claims that scenario planning can change individual mental models. These claims are supported by anecdotal evidence and stories from the practical…

What Do You Think Would Make You Happier? What Do You Think You Would Choose?*

PubMed Central

Benjamin, Daniel J.; Kimball, Miles S.; Heffetz, Ori; Rees-Jones, Alex

2011-01-01

Would people choose what they think would maximize their subjective well-being (SWB)? We present survey respondents with hypothetical scenarios and elicit both choice and predicted SWB rankings of two alternatives. While choice and predicted SWB rankings usually coincide in our data, we find systematic reversals. We identify factors—such as predicted sense of purpose, control over one’s life, family happiness, and social status—that help explain hypothetical choice controlling for predicted SWB. We explore how our findings vary by SWB measure and by scenario. Our results have implications regarding the use of SWB survey questions as a proxy for utility. PMID:23275649

Child-Specific Exposure Scenarios Examples (Final Report) ...

EPA Pesticide Factsheets

EPA announced the availability of the final report, Child-Specific Exposure Scenarios Examples. This report is intended to be a companion document to the Exposure Factors Handbook (U.S. EPA 2011). The example scenarios were compiled from questions and inquiries received from users of the Exposure Factors Handbook (EFH) on how to select data from the EFH to assess childhood exposures. The scenarios presented in this report promote the use of the standard set of age groups recommended by the U.S. EPA in the report entitled Guidance on Selecting Age Groups for Monitoring and Assessing Childhood Exposures to Environmental Contaminants (U.S. EPA 2005). The purpose of the Child-Specific Exposure Scenarios Examples Report is to outline scenarios for various child-specific exposure pathways and to demonstrate how data from the Exposure Factors Handbook (U.S. EPA, 2011) may be applied for estimating exposures. The handbook provides data on drinking water consumption, soil ingestion, mouthing behavior, inhalation rates, dermal factors including skin area and soil adherence factors, consumption of fruits and vegetables, fish, meats, dairy products, homegrown foods, human milk, activity patterns, body weight, and consumer products. The example scenarios presented here have been selected to best demonstrate the use of the various key data sets in the Child-Specific Exposure Factors Handbook (U.S. EPA, 2008a), and represent commonly encountered exposure pathways. An exhausti

Alternative scenarios utilizing nonterrestrial resources

NASA Technical Reports Server (NTRS)

Eldred, Charles H.; Roberts, Barney B.

1992-01-01

A collection of alternative scenarios that are enabled or substantially enhanced by the utilization of nonterrestrial resources is provided. We take a generalized approach to scenario building so that our report will have value in the context of whatever goals are eventually chosen. Some of the topics covered include the following: lunar materials processing; asteroid mining; lunar resources; construction of a large solar power station; solar dynamic power for the space station; reduced gravity; mission characteristics and options; and tourism.

Incorporating scenario-based simulation into a hospital nursing education program.

PubMed

Nagle, Beth M; McHale, Jeanne M; Alexander, Gail A; French, Brian M

2009-01-01

Nurse educators are challenged to provide meaningful and effective learning opportunities for both new and experienced nurses. Simulation as a teaching and learning methodology is being embraced by nursing in academic and practice settings to provide innovative educational experiences to assess and develop clinical competency, promote teamwork, and improve care processes. This article provides an overview of the historical basis for using simulation in education, simulation methodologies, and perceived advantages and disadvantages. It also provides a description of the integration of scenario-based programs using a full-scale patient simulator into nursing education programming at a large academic medical center.

How do chiropractors manage clinical risk? A questionnaire study.

PubMed

Wangler, Martin; Peterson, Cynthia; Zaugg, Beatrice; Thiel, Haymo; Finch, Rob

2013-06-08

The literature on chiropractic safety tends to focus on adverse events and little is known about how chiropractors ensure safety and manage risk in the course of their daily practice. The purpose of this study was to investigate how chiropractors manage potentially risky clinical scenarios. We also sought to establish how chiropractors perceive the safety climate in their workplace and thus whether there is an observable culture of safety within the profession. An online questionnaire was designed to determine which of nine management options would be chosen by the respondent in response to four defined clinical case scenarios. Safety climate within the respondent's practice setting was measured by seeking the level of agreement with 23 statements relating to six different safety dimensions. 260 licensed chiropractors in Switzerland and 1258 UK members of The Royal College of Chiropractors were invited to complete the questionnaire. Questionnaire responses were analysed quantitatively in respect of the four clinical scenarios and the nine management options to determine the likelihood of each option being undertaken, with results recorded in terms of % likelihood. Gender differences in response to the management options for each scenario were evaluated using the Mann-Whitney U (MWU) test. Positive agreement with elements comprising each of the six safety dimensions contributed to a composite '% positive agreement' score calculated for each dimension. Questionnaire responses were received from 76% (200/260) of Swiss participants and 31% (393/1258) of UK members of The Royal College of Chiropractors. There was a general trend for Swiss and UK chiropractors to manage clinical scenarios where treatment appears not to be successful, not indicated, possibly harmful or where a patient is apparently getting worse, by re-evaluating their care. Stopping treatment and/or incident reporting to a safety incident reporting and learning system were generally found to be unlikely

Endorsement of Interpersonal Strategies for Dealing with Hypothetical Everyday Arthritis Problems as a Function of Marital Status, Gender, and Problem Severity

ERIC Educational Resources Information Center

Strough, Jonell; McFall, Joseph P.; Schuller, Kelly L.

2010-01-01

We used hypothetical vignettes to examine whether older adults' endorsement of interpersonal strategies for dealing with health-related (arthritis) everyday problems varied as a function of marital status, gender, and the severity of the problem. Adults 60 years and older (N= 127, M= 71.40 years, SD = 7.21) rated interpersonal (i.e., discuss with…

Imagined Contact Improves Intentions towards a Hypothetical Peer with Asperger Syndrome but Not Attitudes towards Peers with Asperger Syndrome in General

ERIC Educational Resources Information Center

Fleva, Eleni

2015-01-01

The aim of this study is twofold. First, to investigate whether the imagined contact method (an indirect method of contact) can improve behavioural intentions towards a hypothetical peer with Asperger syndrome (AS). Second, to test whether the effect of the method can be generalised on attitudes towards young people with AS in general.…

Research Participants' Preferences for Hypothetical Secondary Results from Genomic Research.

PubMed

Wynn, Julia; Martinez, Josue; Duong, Jimmy; Chiuzan, Codruta; Phelan, Jo C; Fyer, Abby; Klitzman, Robert L; Appelbaum, Paul S; Chung, Wendy K

2017-08-01

Secondary or incidental results can be identified in genomic research that increasingly uses whole exome/genome sequencing. Understanding research participants' preferences for secondary results and what influences these decisions is important for patient education, counseling, and consent, and for the development of policies regarding return of secondary results. Two hundred nineteen research participants enrolled in genomic studies were surveyed regarding hypothetical preferences for specific types of secondary results, and these preferences were correlated with demographic information and psychosocial data. The majority of research participants (73%) indicated a preference to learn about all results offered, with no clear pattern regarding which results were not desired by the remaining participants. Participants who reported greater interest in genetic privacy were less likely to indicate a preference to learn all results, as were individuals who self-identified as Jewish. Although most research participants preferred to receive all secondary results offered, a significant subset preferred to exclude some results, suggesting that an all-or-none policy would not be ideal for all participants. The correlations between preferences to receive secondary results, religious identification, and privacy concerns demonstrate the need for culturally sensitive counseling and educational materials accessible to all education levels to allow participants to make the best choices for themselves.

Scenario Planning at College of Marin.

ERIC Educational Resources Information Center

College of Marin, Kentfield, CA.

This article reviews the scenario planning process implemented at the College of Marin (California). Scenario planning is a creative process in which a group of people who share a common fate develop stories about different ways their future might unfold, and use these stories to make decisions about what path to take. The Global Business Network…

Emissions Scenarios and Fossil-fuel Peaking

NASA Astrophysics Data System (ADS)

Brecha, R.

2008-12-01

Intergovernmental Panel on Climate Change (IPCC) emissions scenarios are based on detailed energy system models in which demographics, technology and economics are used to generate projections of future world energy consumption, and therefore, of greenhouse gas emissions. Built into the assumptions for these scenarios are estimates for ultimately recoverable resources of various fossil fuels. There is a growing chorus of critics who believe that the true extent of recoverable fossil resources is much smaller than the amounts taken as a baseline for the IPCC scenarios. In a climate optimist camp are those who contend that "peak oil" will lead to a switch to renewable energy sources, while others point out that high prices for oil caused by supply limitations could very well lead to a transition to liquid fuels that actually increase total carbon emissions. We examine a third scenario in which high energy prices, which are correlated with increasing infrastructure, exploration and development costs, conspire to limit the potential for making a switch to coal or natural gas for liquid fuels. In addition, the same increasing costs limit the potential for expansion of tar sand and shale oil recovery. In our qualitative model of the energy system, backed by data from short- and medium-term trends, we have a useful way to gain a sense of potential carbon emission bounds. A bound for 21st century emissions is investigated based on two assumptions: first, that extractable fossil-fuel resources follow the trends assumed by "peak oil" adherents, and second, that little is done in the way of climate mitigation policies. If resources, and perhaps more importantly, extraction rates, of fossil fuels are limited compared to assumptions in the emissions scenarios, a situation can arise in which emissions are supply-driven. However, we show that even in this "peak fossil-fuel" limit, carbon emissions are high enough to surpass 550 ppm or 2°C climate protection guardrails. Some

Climate change and growth scenarios for California wildfire

Treesearch

A.L. Westerling; B.P. Bryant; H.K. Preisler; T.P. Holmes; H.G. Hildalgo; T. Das; S.R. Shrestha

2011-01-01

Large wildfire occurrence and burned area are modeled using hydroclimate and landsurface characteristics under a range of future climate and development scenarios. The range of uncertainty for future wildfire regimes is analyzed over two emissions pathways (the Special Report on Emissions Scenarios [SRES] A2 and B1 scenarios); three global climate models (Centre...

Scenario Development Process at the Vertical Motion Simulator

NASA Technical Reports Server (NTRS)

Reardon, Scott E.; Beard, Steven D.; Lewis, Emily

2017-01-01

There has been a significant effort within the simulation community to standardize many aspects of flight simulation. More recently, an effort has begun to develop a formal scenario definition language for aviation. A working group within the AIAA Modeling and Simulation Technical Committee has been created to develop a standard aviation scenario definition language, though much of the initial effort has been tailored to training simulators. Research and development (R&D) simulators, like the Vertical Motion Simulator (VMS), and training simulators have different missions and thus have different scenario requirements. The purpose of this paper is to highlight some of the unique tasks and scenario elements used at the VMS so they may be captured by scenario standardization efforts. The VMS most often performs handling qualities studies and transfer of training studies. Three representative handling qualities simulation studies and two transfer of training simulation studies are described in this paper. Unique scenario elements discussed in this paper included special out-the-window (OTW) targets and environmental conditions, motion system parameters, active inceptor parameters, and configurable vehicle math model parameters.

The Influence of Simulated Home and Neighbourhood Densification on Perceived Liveability

ERIC Educational Resources Information Center

Thomas, J. A.; Walton, D.; Lamb, S.

2011-01-01

This study experimentally manipulated neighbourhood density and home location to reveal the effect of these changes on perceived liveability. Two hypothetical scenarios were provided to 106 households using a Computer-Aided Personal Interview (CAPI). The first scenario examined a densification of the participant's current property, and the second…

New Methods for Crafting Locally Decision-Relevant Scenarios

NASA Astrophysics Data System (ADS)

Lempert, R. J.

2015-12-01

Scenarios can play an important role in helping decision makers to imagine future worlds, both good and bad, different than the one with which we are familiar and to take concrete steps now to address the risks generated by climate change. At their best, scenarios can effectively represent deep uncertainty; integrate over multiple domains; and enable parties with different expectation and values to expand the range of futures they consider, to see the world from different points of view, and to grapple seriously with the potential implications of surprising or inconvenient futures. These attributes of scenario processes can prove crucial in helping craft effective responses to climate change. But traditional scenario methods can also fail to overcome difficulties related to choosing, communicating, and using scenarios to identify, evaluate, and reach consensus on appropriate policies. Such challenges can limit scenario's impact in broad public discourse. This talk will demonstrate how new decision support approaches can employ new quantitative tools that allow scenarios to emerge from a process of deliberation with analysis among stakeholders, rather than serve as inputs to it, thereby increasing the impacts of scenarios on decision making. This talk will demonstrate these methods in the design of a decision support tool to help residents of low lying coastal cities grapple with the long-term risks of sea level rise. In particular, this talk will show how information from the IPCC SSP's can be combined with local information to provide a rich set of locally decision-relevant information.

What strategy is needed for attaining the EU air quality regulations under future climate change scenarios? A sensitivity analysis over Europe

NASA Astrophysics Data System (ADS)

Jiménez-Guerrero, P.; Baró, R.; Gómez-Navarro, J. J.; Lorente-Plazas, R.; García-Valero, J. A.; Hernández, Z.; Montávez, J. P.

2012-04-01

A wide number of studies show that several areas over Europe exceed some of the air quality thresholds established in the legislation. These exceedances will become more frequent under future climate change scenarios, since the policies aimed at improving air quality in the EU directives have not accounted for the variations in the climate. Climate change alone will influence the future concentrations of atmospheric pollutants through modifications of gas-phase chemistry, transport, removal, and natural emissions. In this sense, chemistry transport models (CTMs) play a key role in assessing and understanding the emissions abatement plans through the use of sensitivity analysis strategies. These sensitivity analyses characterize the change in model output due to variations in model input parameters. Since the management strategies of air pollutant emission is one of the predominant factors for controlling urban air quality, this work assesses the impact of various emission reduction scenarios in air pollution levels over Europe under two climate change scenarios. The methodology includes the use of a climate version of the meteorological model MM5 coupled with the CHIMERE chemistry transport model. Experiments span the periods 1971-2000, as a reference, and 2071-2100, as two future enhanced greenhouse gas and aerosol scenarios (SRES A2 and B2). The atmospheric simulations have an horizontal resolution of 25 km and 23 vertical layers up to 100 hPa, and are driven by the global climate model ECHO-G . In order to represent the sensitivity of the chemistry and transport of aerosols, tropospheric ozone and other photochemical species, several hypothetical scenarios of emission control have been implemented to quantify the influence of diverse emission sources in the area, such as on-road traffic, port and industrial emissions, among others. The modeling strategy lies on a sensitivity analysis to determine the emission reduction and strategy needed in the target area in

New trends in transportation and land use scenario planning : five case studies of regional and local scenario planning efforts

DOT National Transportation Integrated Search

2010-04-01

This report summarizes important findings from a literature review on scenario planning processes and a scan of stakeholders. It also presents case studies on innovative, next generation scenario planning efforts. The project team defined next ...

Emergency physicians' knowledge and attitudes of clinical decision support in the electronic health record: a survey-based study.

PubMed

Ballard, Dustin W; Rauchwerger, Adina S; Reed, Mary E; Vinson, David R; Mark, Dustin G; Offerman, Steven R; Chettipally, Uli K; Graetz, Ilana; Dayan, Peter; Kuppermann, Nathan

2013-04-01

The objective was to investigate clinician knowledge of and attitudes toward clinical decision support (CDS) and its incorporation into the electronic health record (EHR). This was an electronic survey of emergency physicians (EPs) within an integrated health care delivery system that uses a complete EHR. Randomly assigned respondents completed one of two questionnaires, both including a hypothetical vignette and self-reported knowledge of and attitudes about CDS. One vignette version included CDS, and the other did not (NCDS). The vignette described a scenario in which a cranial computed tomography (CCT) is not recommended by validated prediction rules (the Pediatric Emergency Care Applied Research Network [PECARN] rules). In both survey versions, subjects responded first with their likely approach to evaluation and then again after receiving either CDS (the PECARN prediction rules) or no additional support. Descriptive statistics were used for self-reported responses and multivariate logistic regression was used to identify predictors of self-reported knowledge and use of the PECARN rules, as well as use of vignette responses. There were 339 respondents (68% response rate), with 172 of 339 (51%) randomized to the CDS version. Initially, 25% of respondents to each version indicated they would order CCTs. After CDS, 30 of 43 (70%) of respondents who initially would order CCTs changed their management decisions to no CCT versus two of 41 (5%) with the NCDS version (chi-square, p = 0.003). In response to self-report questions, 81 of 338 respondents (24%) reported having never heard of the PECARN prediction rules, 122 of 338 (36%) were aware of the rules but not their specifics, and 135 of 338 (40%) reported knowing the rules and their specifics. Respondents agreed with favorable statements about CDS (75% to 96% agreement across seven statements) and approaches to its implementation into the EHR (60% to 93% agreement across seven statements). In multivariable analyses

Looking for a hypothetical jovian metabolisms to explain a paucity of ammonia

NASA Astrophysics Data System (ADS)

Wong, M. L.

2017-12-01

One startling find from Juno's reconnaissance of Jupiter is a factor-of-two depletion from expected concentrations of NH3 in the 7-bar region of the atmosphere. Here, we investigate hypothetical NH3-consuming metabolisms of putative jovian life. Classically, astrobiologists state life's requirements as: liquid water, sources of CHNOPS, and the availability of free energy. On Jupiter, water clouds condense at a pressure of 7 bars—a region where the temperature is 300 K—providing droplets of liquid water. With its tight gravitational grip on hydrogen, Jupiter has bountiful reductants containing CHNOPS in the form of H2O, CH4, H2S, NH3, and PH3. However, the O-rich oxidants often considered for astrobiological systems on other worlds are largely absent. Instead, hypothetical metabolisms may rely on sulfur species as electron acceptors. Exposed to ultraviolet radiation, H2S will photolyze and react to form polysulfur (Sx, where x ≥ 8). Polysulfur may contribute to the coloration of Jupiter's upper atmosphere, particularly of the Great Red Spot. Polysulfur that rains down to the region of Jupiter's atmosphere where liquid water exists can provide significant redox disequilibrium from which free energy can be liberated. For instance, the reaction 16/3 NH3 + S8 ⟶ 8 H2S + 8/3 N2has a ΔG = -38.8 kJ per mol NH3 at 300 K and 7 bars. This reaction is promising in that: 1) it recycles S8 back to H2S, which can then be lofted to higher altitudes and create more S8; 2) it creates N2, which Juno cannot detect using its microwave radiometer. In order to be a plausible metabolism, we must show: 1) that this reaction is kinetically inhibited, i.e. that abiotic processes cannot easily resolve this disequilibrium; 2) that enough S8 is produced photochemically and is transported to the 7 bar region on short enough timescales to provide the requisite disequilibrium. Finally, copious lightning in the water cloud region—the flash rate has been estimated to be 30 flashes year-1

Analysis of JT-60SA operational scenarios

NASA Astrophysics Data System (ADS)

Garzotti, L.; Barbato, E.; Garcia, J.; Hayashi, N.; Voitsekhovitch, I.; Giruzzi, G.; Maget, P.; Romanelli, M.; Saarelma, S.; Stankiewitz, R.; Yoshida, M.; Zagórski, R.

2018-02-01

Reference scenarios for the JT-60SA tokamak have been simulated with one-dimensional transport codes to assess the stationary state of the flat-top phase and provide a profile database for further physics studies (e.g. MHD stability, gyrokinetic analysis) and diagnostics design. The types of scenario considered vary from pulsed standard H-mode to advanced non-inductive steady-state plasmas. In this paper we present the results obtained with the ASTRA, CRONOS, JINTRAC and TOPICS codes equipped with the Bohm/gyro-Bohm, CDBM and GLF23 transport models. The scenarios analysed here are: a standard ELMy H-mode, a hybrid scenario and a non-inductive steady state plasma, with operational parameters from the JT-60SA research plan. Several simulations of the scenarios under consideration have been performed with the above mentioned codes and transport models. The results from the different codes are in broad agreement and the main plasma parameters generally agree well with the zero dimensional estimates reported previously. The sensitivity of the results to different transport models and, in some cases, to the ELM/pedestal model has been investigated.

Combination of Face Regions in Forensic Scenarios.

PubMed

Tome, Pedro; Fierrez, Julian; Vera-Rodriguez, Ruben; Ortega-Garcia, Javier

2015-07-01

This article presents an experimental analysis of the combination of different regions of the human face on various forensic scenarios to generate scientific knowledge useful for the forensic experts. Three scenarios of interest at different distances are considered comparing mugshot and CCTV face images using MORPH and SC face databases. One of the main findings is that inner facial regions combine better in mugshot and close CCTV scenarios and outer facial regions combine better in far CCTV scenarios. This means, that depending of the acquisition distance, the discriminative power of the facial regions change, having in some cases better performance than the full face. This effect can be exploited by considering the fusion of facial regions which results in a very significant improvement of the discriminative performance compared to just using the full face. © 2015 American Academy of Forensic Sciences.

Pharmacy Students’ Interpretation of Academic Integrity

PubMed Central

Jiang, Hai; McKauge, Leigh

2014-01-01

Objective. To explore pharmacy students’ recognition and interpretation of situations constituting breaches of academic integrity. Methods. A survey instrument comprising 10 hypothetical student(s) scenarios was completed by 852 students in the bachelor of pharmacy program at an Australian university. The scenarios were relevant to current modes of assessment and presented degrees of ambiguity around academic integrity. Results. Identification of the hypothetical student(s) at fault, particularly in the deliberately ambiguous scenarios, was not related to the respondents’ year of study or sex. Students with fewer years of postsecondary education were more definitive in their interpretation of contentious cases. Respondents from all 4 years of study reported witnessing many of these behaviors among their peers. Conclusion. This study provided novel insight into the ambiguity surrounding academic integrity and students’ perceptions relating to the deliberate or inadvertent involvement of other parties. PMID:25147391

Ground motion modeling of the 1906 San Francisco earthquake II: Ground motion estimates for the 1906 earthquake and scenario events

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

Aagaard, B; Brocher, T; Dreger, D

2007-02-09

We estimate the ground motions produced by the 1906 San Francisco earthquake making use of the recently developed Song et al. (2008) source model that combines the available geodetic and seismic observations and recently constructed 3D geologic and seismic velocity models. Our estimates of the ground motions for the 1906 earthquake are consistent across five ground-motion modeling groups employing different wave propagation codes and simulation domains. The simulations successfully reproduce the main features of the Boatwright and Bundock (2005) ShakeMap, but tend to over predict the intensity of shaking by 0.1-0.5 modified Mercalli intensity (MMI) units. Velocity waveforms at sitesmore » throughout the San Francisco Bay Area exhibit characteristics consistent with rupture directivity, local geologic conditions (e.g., sedimentary basins), and the large size of the event (e.g., durations of strong shaking lasting tens of seconds). We also compute ground motions for seven hypothetical scenarios rupturing the same extent of the northern San Andreas fault, considering three additional hypocenters and an additional, random distribution of slip. Rupture directivity exerts the strongest influence on the variations in shaking, although sedimentary basins do consistently contribute to the response in some locations, such as Santa Rosa, Livermore, and San Jose. These scenarios suggest that future large earthquakes on the northern San Andreas fault may subject the current San Francisco Bay urban area to stronger shaking than a repeat of the 1906 earthquake. Ruptures propagating southward towards San Francisco appear to expose more of the urban area to a given intensity level than do ruptures propagating northward.« less

Evidence-based dentistry: a model for clinical practice.

PubMed

Faggion, Clóvis M; Tu, Yu-Kang

2007-06-01

Making decisions in dentistry should be based on the best evidence available. The objective of this study was to demonstrate a practical procedure and model that clinicians can use to apply the results of well-conducted studies to patient care by critically appraising the evidence with checklists and letter grade scales. To demonstrate application of this model for critically appraising the quality of research evidence, a hypothetical case involving an adult male with chronic periodontitis is used as an example. To determine the best clinical approach for this patient, a four-step, evidence-based model is demonstrated, consisting of the following: definition of a research question using the PICO format, search and selection of relevant literature, critical appraisal of identified research reports using checklists, and the application of evidence. In this model, the quality of research evidence was assessed quantitatively based on different levels of quality that are assigned letter grades of A, B, and C by evaluating the studies against the QUOROM (Quality of Reporting Meta-Analyses) and CONSORT (Consolidated Standards of Reporting Trials) checklists in a tabular format. For this hypothetical periodontics case, application of the model identified the best available evidence for clinical decision making, i.e., one randomized controlled trial and one systematic review of randomized controlled trials. Both studies showed similar answers for the research question. The use of a letter grade scale allowed an objective analysis of the quality of evidence. A checklist-driven model that assesses and applies evidence to dental practice may substantially improve dentists' decision making skill.

JAXA's Space Exploration Scenario

NASA Astrophysics Data System (ADS)

Sato, N. S.

2018-04-01

Japan Aerospace Exploration Agency (JAXA) has been studying space exploration scenario, including human exploration for Japan since 2015, which encompasses goals, knowledge gap assessment, and architecture. assessment, and technology roadmap.

Establishing a cost-effective national surveillance system for Bluetongue using scenario tree modelling.

PubMed

Hadorn, Daniela C; Racloz, Vanessa; Schwermer, Heinzpeter; Stärk, Katharina D C

2009-01-01

Vector-borne diseases pose a special challenge to veterinary authorities due to complex and time-consuming surveillance programs taking into account vector habitat. Using stochastic scenario tree modelling, each possible surveillance activity of a future surveillance system can be evaluated with regard to its sensitivity and the expected cost. The overall sensitivity of various potential surveillance systems, composed of different combinations of surveillance activities, is calculated and the proposed surveillance system is optimized with respect to the considered surveillance activities, the sensitivity and the cost. The objective of this project was to use stochastic scenario tree modelling in combination with a simple cost analysis in order to develop the national surveillance system for Bluetongue in Switzerland. This surveillance system was established due to the emerging outbreak of Bluetongue virus serotype 8 (BTV-8) in Northern Europe in 2006. Based on the modelling results, it was decided to implement an improved passive clinical surveillance in cattle and sheep through campaigns in order to increase disease awareness alongside a targeted bulk milk testing strategy in 200 dairy cattle herds located in high-risk areas. The estimated median probability of detection of cases (i.e. sensitivity) of the surveillance system in this combined approach was 96.4%. The evaluation of the prospective national surveillance system predicted that passive clinical surveillance in cattle would provide the highest probability to detect BTV-8 infected animals, followed by passive clinical surveillance in sheep and bulk milk testing of 200 dairy cattle farms in high-risk areas. This approach is also applicable in other countries and to other epidemic diseases.

Design and evaluation of simulation scenarios for a program introducing patient safety, teamwork, safety leadership, and simulation to healthcare leaders and managers.

PubMed

Cooper, Jeffrey B; Singer, Sara J; Hayes, Jennifer; Sales, Michael; Vogt, Jay W; Raemer, Daniel; Meyer, Gregg S

2011-08-01

We developed a training program to introduce managers and informal leaders of healthcare organizations to key concepts of teamwork, safety leadership, and simulation to motivate them to act as leaders to improve safety within their sphere of influence. This report describes the simulation scenario and debriefing that are core elements of that program. Twelve teams of clinician and nonclinician managers were selected from a larger set of volunteers to participate in a 1-day, multielement training program. Two simulation exercises were developed: one for teams of nonclinicians and the other for clinicians or mixed groups. The scenarios represented two different clinical situations, each designed to engage participants in discussions of their safety leadership and teamwork issues immediately after the experience. In the scenarios for nonclinicians, participants conducted an anesthetic induction and then managed an ethical situation. The scenario for clinicians simulated a consulting visit to an emergency room that evolved into a problem-solving challenge. Participants in this scenario had a limited time to prepare advice for hospital leadership on how to improve observed safety and cultural deficiencies. Debriefings after both types of scenarios were conducted using principles of "debriefing with good judgment." We assessed the relevance and impact of the program by analyzing participant reactions to the simulation through transcript data and facilitator observations as well as a postcourse questionnaire. The teams generally reported positive perceptions of the relevance and quality of the simulation with varying types and degrees of impact on their leadership and teamwork behaviors. These kinds of clinical simulation exercises can be used to teach healthcare leaders and managers safety leadership and teamwork skills and behaviors.

Positive versus negative framing of a hypothetical infant immunization: the influence of involvement.

PubMed

Donovan, R J; Jalleh, G

2000-02-01

Framing studies dealing with health messages show mixed results, although a tendency in favor of negative framing. Involvement has been hypothesized to account for these conflicting results. The authors selected a realistic issue (immunization of infants) deemed high or low involving depending on the respondent's circumstances: women with an infant or who were pregnant or intending to get pregnant in the next 12 months were deemed to be high involved; women in none of these categories were deemed to be low involved. A convenience sample of adult women was presented with a hypothetical "new" immunization that protected infants against respiratory complaints such as bronchitis and pneumonia Side effects (the common flu) were framed positively (90% chance of no side effects) or negatively (10% chance of side effects). The authors found positive framing to be superior for low-involved respondents, but there was no framing effect for high-involved respondents.

Meaningful Intuitions: The Evidential Role of Intuitions in the Study of Language

ERIC Educational Resources Information Center

Maynes, Jeffrey

2012-01-01

Philosophical theories are often repudiated, or taken to be repudiated, by identifying counter-examples. These counter-examples are typically based upon our natural response to a real or hypothetical scenario, also called our intuition about the scenario. This methodology of appealing to intuition has been the focus of recent debates about…

Teachers' Mindsets for Students with and without Disabilities

ERIC Educational Resources Information Center

Gutshall, C. Anne

2013-01-01

Research suggests beliefs about the stability of ability can be dichotomized into two mindsets: fixed and growth (Dweck, C., 1999). Teachers' (n = 238) beliefs regarding the stability of ability (mindset) and the stability of ability for 4 hypothetical students scenarios (mindset for scenarios) were measured. Mindset scores were related to…

Willingness to Participate in Clinical Trials Among African Americans and Whites Previously Exposed To Clinical Research

PubMed Central

Durant, Raegan W.; Legedza, Anna T.; Marcantonio, Edward R.; Freeman, Marcie B.; Landon, Bruce E.

2011-01-01

The objective of this study was to identify racial differences in willingness to participate in a population with previous exposure to clinical research. A survey instrument was administered to community-dwelling whites and African Americans who were voluntarily receiving a lay research and health education newsletter from a local Boston geriatric clinical research institution. The survey instrument assessed willingness to participate in 3 hypothetical clinical trials (diet trial for obesity, medication trial for hypertension [HTN], chemotherapy trial for cancer). Surveys were received from 473 whites and 279 African Americans (53% response rate) with mean age 74 (SD ± 9). In multivariate models, race was not significantly related to willingness to participate in the multivariate models for any of the 3 trials. Previous trial participation was related to a higher odds of willingness to participate in the diet trial only (OR 1.8, 95% CI 1.2,2.6). Lower levels of trust in one’s primary care physician were associated with a lower odds of willingness to participate in clinical trials for the diet and HTN trials (OR 0.5, 95% CI 0.3,0.8 and OR 0.6, 95% CI 0.3,0.9, respectively). These findings suggest that, within populations previously exposed to clinical research, African Americans are no less willing to participate in clinical trials compared to whites. PMID:21526582

From scenarios to domain models: processes and representations

NASA Astrophysics Data System (ADS)

Haddock, Gail; Harbison, Karan

1994-03-01

The domain specific software architectures (DSSA) community has defined a philosophy for the development of complex systems. This philosophy improves productivity and efficiency by increasing the user's role in the definition of requirements, increasing the systems engineer's role in the reuse of components, and decreasing the software engineer's role to the development of new components and component modifications only. The scenario-based engineering process (SEP), the first instantiation of the DSSA philosophy, has been adopted by the next generation controller project. It is also the chosen methodology of the trauma care information management system project, and the surrogate semi-autonomous vehicle project. SEP uses scenarios from the user to create domain models and define the system's requirements. Domain knowledge is obtained from a variety of sources including experts, documents, and videos. This knowledge is analyzed using three techniques: scenario analysis, task analysis, and object-oriented analysis. Scenario analysis results in formal representations of selected scenarios. Task analysis of the scenario representations results in descriptions of tasks necessary for object-oriented analysis and also subtasks necessary for functional system analysis. Object-oriented analysis of task descriptions produces domain models and system requirements. This paper examines the representations that support the DSSA philosophy, including reference requirements, reference architectures, and domain models. The processes used to create and use the representations are explained through use of the scenario-based engineering process. Selected examples are taken from the next generation controller project.

Child-Specific Exposure Scenarios Examples (Final Report)

EPA Science Inventory

EPA announced the availability of the final report, Child-Specific Exposure Scenarios Examples. This report is intended to be a companion document to the Exposure Factors Handbook (U.S. EPA 2011). The example scenarios were compiled from questions and inquiries r...