A systematic review of utility values for chemotherapy-related adverse events.

PubMed

Shabaruddin, Fatiha H; Chen, Li-Chia; Elliott, Rachel A; Payne, Katherine

2013-04-01

Chemotherapy offers cancer patients the potential benefits of improved mortality and morbidity but may cause detrimental outcomes due to adverse drug events (ADEs), some of which requiring time-consuming, resource-intensive and costly clinical management. To appropriately assess chemotherapy agents in an economic evaluation, ADE-related parameters such as the incidence, (dis)utility and cost of ADEs should be reflected within the model parameters. To date, there has been no systematic summary of the existing literature that quantifies the utilities of ADEs due to healthcare interventions in general and chemotherapy treatments in particular. This review aimed to summarize the current evidence base of reported utility values for chemotherapy-related ADEs. A structured electronic search combining terms for utility, utility valuation methods and generic terms for cancer treatment was conducted in MEDLINE and EMBASE in June 2011. Inclusion criteria were: (1) elicitation of utility values for chemotherapy-related ADEs and (2) primary data. Two reviewers identified studies and extracted data independently. Any disagreements were resolved by a third reviewer. Eighteen studies met the inclusion criteria from the 853 abstracts initially identified, collectively reporting 218 utility values for chemotherapy-related ADEs. All 18 studies used short descriptions (vignettes) to obtain the utility values, with nine studies presenting the vignettes used in the valuation exercises. Of the 218 utility values, 178 were elicited using standard gamble (SG) or time trade-off (TTO) approaches, while 40 were elicited using visual analogue scales (VAS). There were 169 utility values of specific chemotherapy-related ADEs (with the top ten being anaemia [34 values], nausea and/or vomiting [32 values], neuropathy [21 values], neutropenia [12 values], diarrhoea [12 values], stomatitis [10 values], fatigue [8 values], alopecia [7 values], hand-foot syndrome [5 values] and skin reaction [5 values]) and 49 of non-specific chemotherapy-related adverse events. In most cases, it was difficult to directly compare the utility values as various definitions and study-specific vignettes were used for the ADEs of interest. This review was designed to provide an overall description of existing literature reporting utility values for chemotherapy-related ADEs. The findings were not exhaustive and were limited to publications that could be identified using the search strategy employed and those reported in the English language. This review identified wide ranges in the utility values reported for broad categories of specific chemotherapy-related ADEs. There were difficulties in comparing the values directly as various study-specific definitions were used for these ADEs and most studies did not make the vignettes used in the valuation exercises available. It is recommended that a basic minimum requirement be developed for the transparent reporting of study designs eliciting utility values, incorporating key criteria such as reporting how the vignettes were developed and presenting the vignettes used in the valuation tasks as well as valuing and reporting the utility values of the ADE-free base states. It is also recommended, in the future, for studies valuing the utilities of chemotherapy-related ADEs to define the ADEs according to the National Cancer Institute (NCI) definitions for chemotherapy-related ADEs as the use of the same definition across studies would ease the comparison and selection of utility values and make the overall inclusion of adverse events within economic models of chemotherapy agents much more straightforward.

Testing the utility of the 3-PG model for growth of Eucalyptus grandis x urophylla with natural and manipulated supplies of water and nutrients

Treesearch

Jose Luiz Stape; Michael G. Ryan; Dan Binkley

2004-01-01

The productivity of fast-growing tropical plantations depends, in part, on the ability of trees to obtain and utilize site resources, and the allocation of fixed carbon (C) to wood production. Simulation models can represent these processes and interactions, but the value of these models depends on their ability to improve predictions of stand growth relative to...

Development and verification of a model for estimating the screening utility in the detection of PCBs in transformer oil.

PubMed

Terakado, Shingo; Glass, Thomas R; Sasaki, Kazuhiro; Ohmura, Naoya

2014-01-01

A simple new model for estimating the screening performance (false positive and false negative rates) of a given test for a specific sample population is presented. The model is shown to give good results on a test population, and is used to estimate the performance on a sampled population. Using the model developed in conjunction with regulatory requirements and the relative costs of the confirmatory and screening tests allows evaluation of the screening test's utility in terms of cost savings. Testers can use the methods developed to estimate the utility of a screening program using available screening tests with their own sample populations.

Key influences on motivations for utility cycling (cycling for transport to and from places).

PubMed

Heesch, Kristiann C; Sahlqvist, Shannon

2013-12-01

Although increases in cycling in Brisbane are encouraging, bicycle mode share to work (the proportion of people travelling to work by bicycle) in the state of Queensland remains low. The aim of this qualitative study was to draw upon the lived experiences of Queensland cyclists to understand the main motivators for utility cycling (cycling as a means to get to and from places) and compare motivators between utility cyclists (those who cycle for utility as well as for recreation) and non-utility cyclists (those who cycle only for recreation). For an online survey, members of a bicycle group (831 utility cyclists and 931 non-utility cyclists, aged 18-90 years) were asked to describe, unprompted, what would motivate them to engage in utility cycling (more often). Responses were coded into themes within four levels of an ecological model. Within an ecological model, built environment influences on motivation were grouped according to whether they related to appeal (safety), convenience (accessibility) or attractiveness (more amenities) and included adequate infrastructure for short trips, bikeway connectivity, end-of-trip facilities at public locations and easy and safe bicycle access to destinations outside of cities. A key social-cultural influence related to improved interactions among different road users. The built and social-cultural environments need to be more supportive of utility cycling before even current utility and non-utility cyclists will be motivated to engage (more often) in utility cycling. SO WHAT?: Additional government strategies and more and better infrastructure that support utility cycling beyond commuter cycling may encourage a utility cycling culture.

Money Earlier or Later? Simple Heuristics Explain Intertemporal Choices Better than Delay Discounting1

PubMed Central

Marzilli Ericson, Keith M.; White, John Myles; Laibson, David; Cohen, Jonathan D.

2015-01-01

Heuristic models have been proposed for many domains of choice. We compare heuristic models of intertemporal choice, which can account for many of the known intertemporal choice anomalies, to discounting models. We conduct an out-of-sample, cross-validated comparison of intertemporal choice models. Heuristic models outperform traditional utility discounting models, including models of exponential and hyperbolic discounting. The best performing models predict choices by using a weighted average of absolute differences and relative (percentage) differences of the attributes of the goods in a choice set. We conclude that heuristic models explain time-money tradeoff choices in experiments better than utility discounting models. PMID:25911124

Optimal urban water conservation strategies considering embedded energy: coupling end-use and utility water-energy models.

NASA Astrophysics Data System (ADS)

Escriva-Bou, A.; Lund, J. R.; Pulido-Velazquez, M.; Spang, E. S.; Loge, F. J.

2014-12-01

Although most freshwater resources are used in agriculture, a greater amount of energy is consumed per unit of water supply for urban areas. Therefore, efforts to reduce the carbon footprint of water in cities, including the energy embedded within household uses, can be an order of magnitude larger than for other water uses. This characteristic of urban water systems creates a promising opportunity to reduce global greenhouse gas emissions, particularly given rapidly growing urbanization worldwide. Based on a previous Water-Energy-CO2 emissions model for household water end uses, this research introduces a probabilistic two-stage optimization model considering technical and behavioral decision variables to obtain the most economical strategies to minimize household water and water-related energy bills given both water and energy price shocks. Results show that adoption rates to reduce energy intensive appliances increase significantly, resulting in an overall 20% growth in indoor water conservation if household dwellers include the energy cost of their water use. To analyze the consequences on a utility-scale, we develop an hourly water-energy model based on data from East Bay Municipal Utility District in California, including the residential consumption, obtaining that water end uses accounts for roughly 90% of total water-related energy, but the 10% that is managed by the utility is worth over 12 million annually. Once the entire end-use + utility model is completed, several demand-side management conservation strategies were simulated for the city of San Ramon. In this smaller water district, roughly 5% of total EBMUD water use, we found that the optimal household strategies can reduce total GHG emissions by 4% and utility's energy cost over 70,000/yr. Especially interesting from the utility perspective could be the "smoothing" of water use peaks by avoiding daytime irrigation that among other benefits might reduce utility energy costs by 0.5% according to our assessment.

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

Satchwell, Andrew; Cappers, Peter; Schwartz, Lisa C.

Many regulators, utilities, customer groups, and other stakeholders are reevaluating existing regulatory models and the roles and financial implications for electric utilities in the context of today’s environment of increasing distributed energy resource (DER) penetrations, forecasts of significant T&D investment, and relatively flat or negative utility sales growth. When this is coupled with predictions about fewer grid-connected customers (i.e., customer defection), there is growing concern about the potential for serious negative impacts on the regulated utility business model. Among states engaged in these issues, the range of topics under consideration is broad. Most of these states are considering whether approachesmore » that have been applied historically to mitigate the impacts of previous “disruptions” to the regulated utility business model (e.g., energy efficiency) as well as to align utility financial interests with increased adoption of such “disruptive technologies” (e.g., shareholder incentive mechanisms, lost revenue mechanisms) are appropriate and effective in the present context. A handful of states are presently considering more fundamental changes to regulatory models and the role of regulated utilities in the ownership, management, and operation of electric delivery systems (e.g., New York “Reforming the Energy Vision” proceeding).« less

Money earlier or later? Simple heuristics explain intertemporal choices better than delay discounting does.

PubMed

Ericson, Keith M Marzilli; White, John Myles; Laibson, David; Cohen, Jonathan D

2015-06-01

Heuristic models have been proposed for many domains involving choice. We conducted an out-of-sample, cross-validated comparison of heuristic models of intertemporal choice (which can account for many of the known intertemporal choice anomalies) and discounting models. Heuristic models outperformed traditional utility-discounting models, including models of exponential and hyperbolic discounting. The best-performing models predicted choices by using a weighted average of absolute differences and relative percentage differences of the attributes of the goods in a choice set. We concluded that heuristic models explain time-money trade-off choices in experiments better than do utility-discounting models. © The Author(s) 2015.

AHP for Risk Management Based on Expected Utility Theory

NASA Astrophysics Data System (ADS)

Azuma, Rumiko; Miyagi, Hayao

This paper presents a model of decision-making considering the risk assessment. The conventional evaluation in AHP is considered to be a kind of utility. When dealing with the risk, however, it is necessary to consider the probability of damage. In order to take risk into decision-making problem, we construct AHP based on expected utility. The risk is considered as a related element of criterion rather than criterion itself. The expected utility is integrated, considering that satisfaction is positive utility and damage by risk is negative utility. Then, evaluation in AHP is executed using the expected utility.

Use of multiattribute utility theory for formulary management in a health system.

PubMed

Chung, Seonyoung; Kim, Sooyon; Kim, Jeongmee; Sohn, Kieho

2010-01-15

The application, utility, and flexibility of the multiattribute utility theory (MAUT) when used as a formulary decision methodology in a Korean medical center were evaluated. A drug analysis model using MAUT consisting of 10 steps was designed for two drug classes of dihydropyridine calcium channel blockers (CCBs) and angiotensin II receptor blockers (ARBs). These two drug classes contain the most diverse agents among cardiovascular drugs on Samsung Medical Center's drug formulary. The attributes identified for inclusion in the drug analysis model were effectiveness, safety, patient convenience, and cost, with relative weights of 50%, 30%, 10%, and 10%, respectively. The factors were incorporated into the model to quantify the contribution of each attribute. For each factor, a utility scale of 0-100 was established, and the total utility score for each alternative was calculated. An attempt was made to make the model adaptable to changing health care and regulatory circumstances. The analysis revealed amlodipine besylate to be an alternative agent, with the highest total utility score among the dihydropyridine CCBs, while barnidipine hydrochloride had the lowest score. For ARBs, losartan potassium had the greatest total utility score, while olmesartan medoxomil had the lowest. A drug analysis model based on the MAUT was successfully developed and used in making formulary decisions for dihydropyridine CCBs and ARBs for a Korean health system. The model incorporates sufficient utility and flexibility of a drug's attributes and can be used as an alternative decision-making tool for formulary management in health systems.

Comparison between the Health Belief Model and Subjective Expected Utility Theory: predicting incontinence prevention behaviour in post-partum women.

PubMed

Dolman, M; Chase, J

1996-08-01

A small-scale study was undertaken to test the relative predictive power of the Health Belief Model and Subjective Expected Utility Theory for the uptake of a behaviour (pelvic floor exercises) to reduce post-partum urinary incontinence in primigravida females. A structured questionnaire was used to gather data relevant to both models from a sample antenatal and postnatal primigravida women. Questions examined the perceived probability of becoming incontinent, the perceived (dis)utility of incontinence, the perceived probability of pelvic floor exercises preventing future urinary incontinence, the costs and benefits of performing pelvic floor exercises and sources of information and knowledge about incontinence. Multiple regression analysis focused on whether or not respondents intended to perform pelvic floor exercises and the factors influencing their decisions. Aggregated data were analysed to compare the Health Belief Model and Subjective Expected Utility Theory directly.

Key data elements for use in cost-utility modeling of biological treatments for rheumatoid arthritis.

PubMed

Ganz, Michael L; Hansen, Brian Bekker; Valencia, Xavier; Strandberg-Larsen, Martin

2015-05-01

Economic evaluation is becoming more common and important as new biologic therapies for rheumatoid arthritis (RA) are developed. While much has been published about how to design cost-utility models for RA to conduct these evaluations, less has been written about the sources of data populating those models. The goal is to review the literature and to provide recommendations for future data collection efforts. This study reviewed RA cost-utility models published between January 2006 and February 2014 focusing on five key sources of data (health-related quality-of-life and utility, clinical outcomes, disease progression, course of treatment, and healthcare resource use and costs). It provided recommendations for collecting the appropriate data during clinical and other studies to support modeling of biologic treatments for RA. Twenty-four publications met the selection criteria. Almost all used two steps to convert clinical outcomes data to utilities rather than more direct methods; most did not use clinical outcomes measures that captured absolute levels of disease activity and physical functioning; one-third of them, in contrast with clinical reality, assumed zero disease progression for biologic-treated patients; little more than half evaluated courses of treatment reflecting guideline-based or actual clinical care; and healthcare resource use and cost data were often incomplete. Based on these findings, it is recommended that future studies collect clinical outcomes and health-related quality-of-life data using appropriate instruments that can convert directly to utilities; collect data on actual disease progression; be designed to capture real-world courses of treatment; and collect detailed data on a wide range of healthcare resources and costs.

Quality of life, health status, and health service utilization related to a new measure of health literacy: FLIGHT/VIDAS.

PubMed

Ownby, Raymond L; Acevedo, Amarilis; Jacobs, Robin J; Caballero, Joshua; Waldrop-Valverde, Drenna

2014-09-01

Researchers have identified significant limitations in some currently used measures of health literacy. The purpose of this paper is to present data on the relation of health-related quality of life, health status, and health service utilization to performance on a new measure of health literacy in a nonpatient population. The new measure was administered to 475 English- and Spanish-speaking community-dwelling volunteers along with existing measures of health literacy and assessments of health-related quality of life, health status, and healthcare service utilization. Relations among measures were assessed via correlations and health status and utilization was tested across levels of health literacy using ANCOVA models. The new health literacy measure is significantly related to existing measures of health literacy as well as to participants' health-related quality of life. Persons with lower levels of health literacy reported more health conditions, more frequent physical symptoms, and greater healthcare service utilization. The new measure of health literacy is valid and shows relations to measures of conceptually related constructs such as quality of life and health behaviors. FLIGHT/VIDAS may be useful to researchers and clinicians interested in a computer administered and scored measure of health literacy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Modeling the Dynamic Interrelations between Mobility, Utility, and Land Asking Price

NASA Astrophysics Data System (ADS)

Hidayat, E.; Rudiarto, I.; Siegert, F.; Vries, W. D.

2018-02-01

Limited and insufficient information about the dynamic interrelation among mobility, utility, and land price is the main reason to conduct this research. Several studies, with several approaches, and several variables have been conducted so far in order to model the land price. However, most of these models appear to generate primarily static land prices. Thus, a research is required to compare, design, and validate different models which calculate and/or compare the inter-relational changes of mobility, utility, and land price. The applied method is a combination of analysis of literature review, expert interview, and statistical analysis. The result is newly improved mathematical model which have been validated and is suitable for the case study location. This improved model consists of 12 appropriate variables. This model can be implemented in the Salatiga city as the case study location in order to arrange better land use planning to mitigate the uncontrolled urban growth.

Predicting research use in nursing organizations: a multilevel analysis.

PubMed

Estabrooks, Carole A; Midodzi, William K; Cummings, Greta G; Wallin, Lars

2007-01-01

No empirical literature was found that explained how organizational context (operationalized as a composite of leadership, culture, and evaluation) influences research utilization. Similarly, no work was found on the interaction of individuals and contextual factors, or the relative importance or contribution of forces at different organizational levels to either such proposed interactions or, ultimately, to research utilization. To determine independent factors that predict research utilization among nurses, taking into account influences at individual nurse, specialty, and hospital levels. Cross-sectional survey data for 4,421 registered nurses in Alberta, Canada were used in a series of multilevel (three levels) modeling analyses to predict research utilization. A multilevel model was developed in MLwiN version 2.0 and used to: (a) estimate simultaneous effects of several predictors and (b) quantify the amount of explained variance in research utilization that could be apportioned to individual, specialty, and hospital levels. There was significant variation in research utilization (p <.05). Factors (remaining in the final model at statistically significant levels) found to predict more research utilization at the three levels of analysis were as follows. At the individual nurse level (Level 1): time spent on the Internet and lower levels of emotional exhaustion. At the specialty level (Level 2): facilitation, nurse-to-nurse collaboration, a higher context (i.e., of nursing culture, leadership, and evaluation), and perceived ability to control policy. At the hospital level (Level 3): only hospital size was significant in the final model. The total variance in research utilization was 1.04, and the intraclass correlations (the percent contribution by contextual factors) were 4% (variance = 0.04, p <.01) at the hospital level and 8% (variance = 0.09, p <.05) at the specialty level. The contribution attributable to individual factors alone was 87% (variance = 0.91, p <.01). Variation in research utilization was explained mainly by differences in individual characteristics, with specialty- and organizational-level factors contributing relatively little by comparison. Among hospital-level factors, hospital size was the only significant determinant of research utilization. Although organizational determinants explained less variance in the model, they were still statistically significant when analyzed alone. These findings suggest that investigations into mechanisms that influence research utilization must address influences at multiple levels of the organization. Such investigations will require careful attention to both methodological and interpretative challenges present when dealing with multiple units of analysis.

A systematic review of health economic models and utility estimation methods in schizophrenia.

PubMed

Németh, Bertalan; Fasseeh, Ahmad; Molnár, Anett; Bitter, István; Horváth, Margit; Kóczián, Kristóf; Götze, Árpád; Nagy, Balázs

2018-06-01

There is a growing need for economic evaluations describing the disease course, as well as the costs and clinical outcomes related to the treatment of schizophrenia. Areas covered: A systematic review on studies describing health economic models in schizophrenia and a targeted literature review on utility mapping algorithms in schizophrenia were carried out. Models found in the review were collated and assessed in detail according to their type and various other attributes. Fifty-nine studies were included in the review. Modeling techniques varied from simple decision trees to complex simulation models. The models used various clinical endpoints as value drivers, 47% of the models used quality-adjusted life years, and eight percent used disability-adjusted life years to measure benefits, while others applied various clinical outcomes. Most models considered patients switching between therapies, and therapeutic adherence, compliance or persistence. The targeted literature review identified four main approaches to map PANSS scores to utility values. Expert commentary: Health economic models developed for schizophrenia showed great variability, with simulation models becoming more frequently used in the last decade. Using PANSS scores as the basis of utility estimations is justifiable.

Novel gene function revealed by mouse mutagenesis screens for models of age-related disease.

PubMed

Potter, Paul K; Bowl, Michael R; Jeyarajan, Prashanthini; Wisby, Laura; Blease, Andrew; Goldsworthy, Michelle E; Simon, Michelle M; Greenaway, Simon; Michel, Vincent; Barnard, Alun; Aguilar, Carlos; Agnew, Thomas; Banks, Gareth; Blake, Andrew; Chessum, Lauren; Dorning, Joanne; Falcone, Sara; Goosey, Laurence; Harris, Shelley; Haynes, Andy; Heise, Ines; Hillier, Rosie; Hough, Tertius; Hoslin, Angela; Hutchison, Marie; King, Ruairidh; Kumar, Saumya; Lad, Heena V; Law, Gemma; MacLaren, Robert E; Morse, Susan; Nicol, Thomas; Parker, Andrew; Pickford, Karen; Sethi, Siddharth; Starbuck, Becky; Stelma, Femke; Cheeseman, Michael; Cross, Sally H; Foster, Russell G; Jackson, Ian J; Peirson, Stuart N; Thakker, Rajesh V; Vincent, Tonia; Scudamore, Cheryl; Wells, Sara; El-Amraoui, Aziz; Petit, Christine; Acevedo-Arozena, Abraham; Nolan, Patrick M; Cox, Roger; Mallon, Anne-Marie; Brown, Steve D M

2016-08-18

Determining the genetic bases of age-related disease remains a major challenge requiring a spectrum of approaches from human and clinical genetics to the utilization of model organism studies. Here we report a large-scale genetic screen in mice employing a phenotype-driven discovery platform to identify mutations resulting in age-related disease, both late-onset and progressive. We have utilized N-ethyl-N-nitrosourea mutagenesis to generate pedigrees of mutagenized mice that were subject to recurrent screens for mutant phenotypes as the mice aged. In total, we identify 105 distinct mutant lines from 157 pedigrees analysed, out of which 27 are late-onset phenotypes across a range of physiological systems. Using whole-genome sequencing we uncover the underlying genes for 44 of these mutant phenotypes, including 12 late-onset phenotypes. These genes reveal a number of novel pathways involved with age-related disease. We illustrate our findings by the recovery and characterization of a novel mouse model of age-related hearing loss.

Novel gene function revealed by mouse mutagenesis screens for models of age-related disease

PubMed Central

Potter, Paul K.; Bowl, Michael R.; Jeyarajan, Prashanthini; Wisby, Laura; Blease, Andrew; Goldsworthy, Michelle E.; Simon, Michelle M.; Greenaway, Simon; Michel, Vincent; Barnard, Alun; Aguilar, Carlos; Agnew, Thomas; Banks, Gareth; Blake, Andrew; Chessum, Lauren; Dorning, Joanne; Falcone, Sara; Goosey, Laurence; Harris, Shelley; Haynes, Andy; Heise, Ines; Hillier, Rosie; Hough, Tertius; Hoslin, Angela; Hutchison, Marie; King, Ruairidh; Kumar, Saumya; Lad, Heena V.; Law, Gemma; MacLaren, Robert E.; Morse, Susan; Nicol, Thomas; Parker, Andrew; Pickford, Karen; Sethi, Siddharth; Starbuck, Becky; Stelma, Femke; Cheeseman, Michael; Cross, Sally H.; Foster, Russell G.; Jackson, Ian J.; Peirson, Stuart N.; Thakker, Rajesh V.; Vincent, Tonia; Scudamore, Cheryl; Wells, Sara; El-Amraoui, Aziz; Petit, Christine; Acevedo-Arozena, Abraham; Nolan, Patrick M.; Cox, Roger; Mallon, Anne-Marie; Brown, Steve D. M.

2016-01-01

Determining the genetic bases of age-related disease remains a major challenge requiring a spectrum of approaches from human and clinical genetics to the utilization of model organism studies. Here we report a large-scale genetic screen in mice employing a phenotype-driven discovery platform to identify mutations resulting in age-related disease, both late-onset and progressive. We have utilized N-ethyl-N-nitrosourea mutagenesis to generate pedigrees of mutagenized mice that were subject to recurrent screens for mutant phenotypes as the mice aged. In total, we identify 105 distinct mutant lines from 157 pedigrees analysed, out of which 27 are late-onset phenotypes across a range of physiological systems. Using whole-genome sequencing we uncover the underlying genes for 44 of these mutant phenotypes, including 12 late-onset phenotypes. These genes reveal a number of novel pathways involved with age-related disease. We illustrate our findings by the recovery and characterization of a novel mouse model of age-related hearing loss. PMID:27534441

Oscillatory dynamics of investment and capacity utilization

NASA Astrophysics Data System (ADS)

Greenblatt, R. E.

2017-01-01

Capitalist economic systems display a wide variety of oscillatory phenomena whose underlying causes are often not well understood. In this paper, I consider a very simple model of the reciprocal interaction between investment, capacity utilization, and their time derivatives. The model, which gives rise periodic oscillations, predicts qualitatively the phase relations between these variables. These predictions are observed to be consistent in a statistical sense with econometric data from the US economy.

The cost-utility of photodynamic therapy in eyes with neovascular macular degeneration--a value-based reappraisal with 5-year data.

PubMed

Brown, Gary C; Brown, Melissa M; Campanella, Joseph; Beauchamp, George R

2005-10-01

To assess the value conferred by photodynamic therapy (PDT) and the cost-utility of PDT for the treatment of classic, subfoveal choroidal neovascularization associated with age-related macular degeneration (ARMD). Average cost-utility analysis utilizing clinical trial data, patient-based time tradeoff utility preferences, and a third party insurer cost perspective. Five-year visual acuity data from the TAP (Treatment of Age-related Macular Degeneration With Photodynamic Therapy) Investigation were modeled into a 12-year, value-based, reference case, cost-utility model utilizing year 2004 Medicare costs and an outcome of dollar/QALY (dollars/quality-adjusted life-year). Discounting of outcomes and costs using net present value analysis with a 3% annual rate was performed as recommended by the Panel for Cost-Effectiveness in Health and Medicine. PDT with verteporfin (Visudyne) dye for classic subfoveal choroidal neovascularization confers an 8.1% quality of life (value) improvement over the 12-year life expectancy of the reference case, while during the last 8 years the value improvement is 9.5%. The average cost-utility of the intervention is dollar 31,103/QALY (quality-adjusted life-year). Extensive one-way sensitivity analysis values range from dollar 20,736/QALY if treatment efficacy is increased by 50% to dollar 62,207 if treatment efficacy is decreased by 50%, indicating robustness of the model. PDT using verteporfin dye to treat classic subfoveal choroidal neovascularization is a very cost-effective treatment by conventional standards. The marked improvement in cost-effectiveness compared with a previous report results from the facts that the treatment benefit increasingly accrues during 5 years of follow-up while the number of yearly treatments diminishes markedly during that time.

Modeling of Depth Cue Integration in Manual Control Tasks

NASA Technical Reports Server (NTRS)

Sweet, Barbara T.; Kaiser, Mary K.; Davis, Wendy

2003-01-01

Psychophysical research has demonstrated that human observers utilize a variety of visual cues to form a perception of three-dimensional depth. However, most of these studies have utilized a passive judgement paradigm, and failed to consider depth-cue integration as a dynamic and task-specific process. In the current study, we developed and experimentally validated a model of manual control of depth that examines how two potential cues (stereo disparity and relative size) are utilized in both first- and second-order active depth control tasks. We found that stereo disparity plays the dominate role for determining depth position, while relative size dominates perception of depth velocity. Stereo disparity also plays a reduced role when made less salient (i.e., when viewing distance is increased). Manual control models predict that position information is sufficient for first-order control tasks, while velocity information is required to perform a second-order control task. Thus, the rules for depth-cue integration in active control tasks are dependent on both task demands and cue quality.

Compartmental and Data-Based Modeling of Cerebral Hemodynamics: Linear Analysis.

PubMed

Henley, B C; Shin, D C; Zhang, R; Marmarelis, V Z

Compartmental and data-based modeling of cerebral hemodynamics are alternative approaches that utilize distinct model forms and have been employed in the quantitative study of cerebral hemodynamics. This paper examines the relation between a compartmental equivalent-circuit and a data-based input-output model of dynamic cerebral autoregulation (DCA) and CO2-vasomotor reactivity (DVR). The compartmental model is constructed as an equivalent-circuit utilizing putative first principles and previously proposed hypothesis-based models. The linear input-output dynamics of this compartmental model are compared with data-based estimates of the DCA-DVR process. This comparative study indicates that there are some qualitative similarities between the two-input compartmental model and experimental results.

A framework for estimating health state utility values within a discrete choice experiment: modeling risky choices.

PubMed

Robinson, Angela; Spencer, Anne; Moffatt, Peter

2015-04-01

There has been recent interest in using the discrete choice experiment (DCE) method to derive health state utilities for use in quality-adjusted life year (QALY) calculations, but challenges remain. We set out to develop a risk-based DCE approach to derive utility values for health states that allowed 1) utility values to be anchored directly to normal health and death and 2) worse than dead health states to be assessed in the same manner as better than dead states. Furthermore, we set out to estimate alternative models of risky choice within a DCE model. A survey was designed that incorporated a risk-based DCE and a "modified" standard gamble (SG). Health state utility values were elicited for 3 EQ-5D health states assuming "standard" expected utility (EU) preferences. The DCE model was then generalized to allow for rank-dependent expected utility (RDU) preferences, thereby allowing for probability weighting. A convenience sample of 60 students was recruited and data collected in small groups. Under the assumption of "standard" EU preferences, the utility values derived within the DCE corresponded fairly closely to the mean results from the modified SG. Under the assumption of RDU preferences, the utility values estimated are somewhat lower than under the assumption of standard EU, suggesting that the latter may be biased upward. Applying the correct model of risky choice is important whether a modified SG or a risk-based DCE is deployed. It is, however, possible to estimate a probability weighting function within a DCE and estimate "unbiased" utility values directly, which is not possible within a modified SG. We conclude by setting out the relative strengths and weaknesses of the 2 approaches in this context. © The Author(s) 2014.

Scale and modeling issues in water resources planning

USGS Publications Warehouse

Lins, H.F.; Wolock, D.M.; McCabe, G.J.

1997-01-01

Resource planners and managers interested in utilizing climate model output as part of their operational activities immediately confront the dilemma of scale discordance. Their functional responsibilities cover relatively small geographical areas and necessarily require data of relatively high spatial resolution. Climate models cover a large geographical, i.e. global, domain and produce data at comparatively low spatial resolution. Although the scale differences between model output and planning input are large, several techniques have been developed for disaggregating climate model output to a scale appropriate for use in water resource planning and management applications. With techniques in hand to reduce the limitations imposed by scale discordance, water resource professionals must now confront a more fundamental constraint on the use of climate models-the inability to produce accurate representations and forecasts of regional climate. Given the current capabilities of climate models, and the likelihood that the uncertainty associated with long-term climate model forecasts will remain high for some years to come, the water resources planning community may find it impractical to utilize such forecasts operationally.

The Utility of Cognitive Plausibility in Language Acquisition Modeling: Evidence from Word Segmentation

ERIC Educational Resources Information Center

Phillips, Lawrence; Pearl, Lisa

2015-01-01

The informativity of a computational model of language acquisition is directly related to how closely it approximates the actual acquisition task, sometimes referred to as the model's "cognitive plausibility." We suggest that though every computational model necessarily idealizes the modeled task, an informative language acquisition…

Relative position control design of receiver UAV in flying-boom aerial refueling phase.

PubMed

An, Shuai; Yuan, Suozhong

2018-02-01

This paper proposes the design of the relative position-keeping control of the receiver unmanned aerial vehicle (UAV) with the time-varying mass in the refueling phase utilizing an inner-outer loop structure. Firstly, the model of the receiver in the refueling phase is established. And then tank model is set up to analyze the influence of fuel transfer on the receiver. Subsequently, double power reaching law based sliding mode controller is designed to control receiver translational motion relative to tanker aircraft in the outer loop while active disturbance rejection control technique is applied to the inner loop to stabilize the receiver. In addition, the closed-loop stabilities of the subsystems are established, respectively. Finally, an aerial refueling model under various refueling strategies is utilized. Simulations and comparative analysis demonstrate the effectiveness and robustness of the proposed controllers. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

WEALTH EFFECT AND DENTAL CARE UTILIZATION IN THE U.S.

PubMed Central

Manski, Richard J.; Moeller, John F.; Chen, Haiyan; Clair, Patricia A. St.; Schimmel, Jody; Pepper, John V.

2012-01-01

Objective The purpose of this article is to examine the relationship of wealth and income and the relative impact of each on dental utilization in a population of older Americans, using data from the Health and Retirement Study (HRS). Methods Data from the Health and Retirement Study (HRS) were analyzed for U.S. individuals aged 51 years and older during the 2008 wave of the HRS. The primary focus of the analysis is the relationship between wealth, income and dental utilization. We estimate a multivariable model of dental use controlling for wealth, income and other potentially confounding covariates. Results We find that both wealth and income each have a strong and independent positive effect on dental care use of older Americans [p<.05]. A test of the interaction between income and wealth in our model failed to show that the impact on dental care utilization as wealth increases depends on a person's income level, or, alternatively, that the impact on dental use as income increases depends on a person's household wealth status [p>.05]. Conclusions Relative to those living in the wealthiest U.S. households, the likelihood of utilizing dental care appears to decrease with a decline in wealth. The likelihood of utilizing dental care also appears to decrease with a decline in income as well. PMID:22515635

Model-Based Learning: A Synthesis of Theory and Research

ERIC Educational Resources Information Center

Seel, Norbert M.

2017-01-01

This article provides a review of theoretical approaches to model-based learning and related research. In accordance with the definition of model-based learning as an acquisition and utilization of mental models by learners, the first section centers on mental model theory. In accordance with epistemology of modeling the issues of semantics,…

Tamoxifen for breast cancer risk reduction: impact of alternative approaches to quality-of-life adjustment on cost-effectiveness analysis.

PubMed

Melnikow, Joy; Birch, Stephen; Slee, Christina; McCarthy, Theodore J; Helms, L Jay; Kuppermann, Miriam

2008-09-01

In cost-effectiveness analysis (CEA), the effects of health-care interventions on multiple health dimensions typically require consideration of both quantity and quality of life. To explore the impact of alternative approaches to quality-of-life adjustment using patient preferences (utilities) on the outcome of a CEA on use of tamoxifen for breast cancer risk reduction. A state transition Markov model tracked hypothetical cohorts of women who did or did not take 5 years of tamoxifen for breast cancer risk reduction. Incremental quality-adjusted effectiveness and cost-effectiveness ratios (ICERs) for models including and excluding a utility adjustment for menopausal symptoms were compared with each other and to a global utility model. Two hundred fifty-five women aged 50 and over with estimated 5-year breast cancer risk >or=1.67% participated in utility assessment interviews. Standard gamble utilities were assessed for specified tamoxifen-related health outcomes, current health, and for a global assessment of possible outcomes of tamoxifen use. Inclusion of a utility for menopausal symptoms in the outcome-specific models substantially increased the ICER; at the threshold 5-year breast cancer risk of 1.67%, tamoxifen was dominated. When a global utility for tamoxifen was used in place of outcome-specific utilities, tamoxifen was dominated under all circumstances. CEAs may be profoundly affected by the types of outcomes considered for quality-of-life adjustment and how these outcomes are grouped for utility assessment. Comparisons of ICERs across analyses must consider effects of different approaches to using utilities for quality-of-life adjustment.

Decision analysis with cumulative prospect theory.

PubMed

Bayoumi, A M; Redelmeier, D A

2000-01-01

Individuals sometimes express preferences that do not follow expected utility theory. Cumulative prospect theory adjusts for some phenomena by using decision weights rather than probabilities when analyzing a decision tree. The authors examined how probability transformations from cumulative prospect theory might alter a decision analysis of a prophylactic therapy in AIDS, eliciting utilities from patients with HIV infection (n = 75) and calculating expected outcomes using an established Markov model. They next focused on transformations of three sets of probabilities: 1) the probabilities used in calculating standard-gamble utility scores; 2) the probabilities of being in discrete Markov states; 3) the probabilities of transitioning between Markov states. The same prophylaxis strategy yielded the highest quality-adjusted survival under all transformations. For the average patient, prophylaxis appeared relatively less advantageous when standard-gamble utilities were transformed. Prophylaxis appeared relatively more advantageous when state probabilities were transformed and relatively less advantageous when transition probabilities were transformed. Transforming standard-gamble and transition probabilities simultaneously decreased the gain from prophylaxis by almost half. Sensitivity analysis indicated that even near-linear probability weighting transformations could substantially alter quality-adjusted survival estimates. The magnitude of benefit estimated in a decision-analytic model can change significantly after using cumulative prospect theory. Incorporating cumulative prospect theory into decision analysis can provide a form of sensitivity analysis and may help describe when people deviate from expected utility theory.

Probing the Relative Importance of Different Attributes in L2 Reading and Listening Comprehension Items: An Application of Cognitive Diagnostic Models

ERIC Educational Resources Information Center

Yi, Yeon-Sook

2017-01-01

The present study examines the relative importance of attributes within and across items by applying four cognitive diagnostic assessment models. The current study utilizes the function of the models that can indicate inter-attribute relationships that reflect the response behaviors of examinees to analyze scored test-taker responses to four forms…

Prospect relativity: how choice options influence decision under risk.

PubMed

Stewart, Neil; Chater, Nick; Stott, Henry P; Reimers, Stian

2003-03-01

In many theories of decision under risk (e.g., expected utility theory, rank-dependent utility theory, and prospect theory), the utility of a prospect is independent of other options in the choice set. The experiments presented here show a large effect of the available options, suggesting instead that prospects are valued relative to one another. The judged certainty equivalent for a prospect is strongly influenced by the options available. Similarly, the selection of a preferred prospect is strongly influenced by the prospects available. Alternative theories of decision under risk (e.g., the stochastic difference model, multialternative decision field theory, and range frequency theory), where prospects are valued relative to one another, can provide an account of these context effects.

Mapping of the DLQI scores to EQ-5D utility values using ordinal logistic regression.

PubMed

Ali, Faraz Mahmood; Kay, Richard; Finlay, Andrew Y; Piguet, Vincent; Kupfer, Joerg; Dalgard, Florence; Salek, M Sam

2017-11-01

The Dermatology Life Quality Index (DLQI) and the European Quality of Life-5 Dimension (EQ-5D) are separate measures that may be used to gather health-related quality of life (HRQoL) information from patients. The EQ-5D is a generic measure from which health utility estimates can be derived, whereas the DLQI is a specialty-specific measure to assess HRQoL. To reduce the burden of multiple measures being administered and to enable a more disease-specific calculation of health utility estimates, we explored an established mathematical technique known as ordinal logistic regression (OLR) to develop an appropriate model to map DLQI data to EQ-5D-based health utility estimates. Retrospective data from 4010 patients were randomly divided five times into two groups for the derivation and testing of the mapping model. Split-half cross-validation was utilized resulting in a total of ten ordinal logistic regression models for each of the five EQ-5D dimensions against age, sex, and all ten items of the DLQI. Using Monte Carlo simulation, predicted health utility estimates were derived and compared against those observed. This method was repeated for both OLR and a previously tested mapping methodology based on linear regression. The model was shown to be highly predictive and its repeated fitting demonstrated a stable model using OLR as well as linear regression. The mean differences between OLR-predicted health utility estimates and observed health utility estimates ranged from 0.0024 to 0.0239 across the ten modeling exercises, with an average overall difference of 0.0120 (a 1.6% underestimate, not of clinical importance). This modeling framework developed in this study will enable researchers to calculate EQ-5D health utility estimates from a specialty-specific study population, reducing patient and economic burden.

An economy-ralated equity analysis of health service utilization by women in economically underdeveloped regions of western China.

PubMed

Qian, Yuyan; Zhou, Zhongliang; Yan, Ju'e; Gao, Jianmin; Wang, Yuping; Yang, Xiaowei; Xu, Yongjian; Li, Yanli

2017-10-27

The Chinese government has long been committed to eliminating the inequality in the utilization of health services; however, it still lacks an analysis or measurement of the economy-related inequality in the utilization of women's health services. The economy-related utilization of health services in women aged 15 years and above was assessed by the horizontal inequity index of a two-week outpatient rate and annual inpatient rate from the 5th National Health Service Survey of Shaanxi Province. The concentration index of each factor was decomposed into the contribution of each factor to the economic-related inequality of health service utilization based on the Probit regression model. The horizontal inequity indexes of the two-week outpatient rate was 0.0493, and the horizontal inequity indexes of the annual impatient rate was 0.0869. The contributions of economic status to the two indexes were 190.71% and 115.80%, respectively. Economic status, age, basic medical insurance, educational status, marital status, urban/rural area, and self-rated health were the main impact factors that affected the inequality in women's health services utilization in Shaanxi. Health service utilization was different between women with different social demographic characteristics, and unequal health service utilization is evident among women in Shaanxi.

The Impact of Green House Adoption on Medicare Spending and Utilization.

PubMed

Grabowski, David C; Afendulis, Christopher C; Caudry, Daryl J; O'Malley, A James; Kemper, Peter

2016-02-01

To evaluate the impact of the Green House (GH) model of nursing home care on Medicare acute hospital, other hospital, skilled nursing facility, and hospice spending and utilization. Medicare claims and enrollment data from 2005 through 2010 merged with resident-level minimum data set (MDS) assessments. Using a difference-in-differences framework, we compared Medicare Part A and hospice expenditures and utilization in 15 nursing homes that adopted the GH model relative to changes over the same time period in 223 matched nonadopting nursing homes. We applied the same method for residents of GH homes and for residents of "legacy" homes, the original nursing homes that stay open alongside the GH home(s). The adoption of GH had no detectable impact on Medicare Part A (plus hospice) spending and utilization across all residents living in the nursing home. When we analyzed residents living in GH homes and legacy units separately, however, we found that the adoption of the GH model reduced overall annual Medicare Part A spending by $7,746 per resident, although this appeared to be partially offset by an increase in spending in legacy homes. To the extent that the GH model reduces Medicare spending, adopting nursing homes do not receive any of the related Medicare savings under traditional payment mechanisms. New approaches that are currently being developed and piloted, which better align financial incentives for providers and payers, could incentivize greater adoption of the GH model. © Health Research and Educational Trust.

Factors Influencing Health Service Utilization Among Asian Immigrant Nail Salon Workers in the Greater New York City Area.

PubMed

Seo, Jin Young; Chao, Ying-Yu; Yeung, Ka Man; Strauss, Shiela M

2018-06-23

Most nail salon workers in the greater New York City area are Asian immigrant women. They are exposed daily to potentially toxic chemicals and hazards in their workplace, making them more vulnerable for possible health problems. The study's primary purpose was to identify factors influencing past year healthcare utilization among Asian immigrant women working in nail salons. A cross-sectional study was conducted based on a modification of Andersen's behavioral model of healthcare utilization in which 148 Korean and Chinese immigrant women currently working in nail salons were surveyed. The questionnaire included: (1) individual health determinants, (2) health service utilization in the past year, and (3) work environment, work-related health concerns, and work-related health problems. Descriptive statistics and multivariate logistic regression models assessed factors related to past year healthcare utilization. Women who had health insurance (p < .01), a usual source of care (p < .01), low educational attainment (p < .05), and more work-related health symptoms (p < .05) were more likely to visit a primary care provider. Women who had health insurance (p < .01), a usual source of care (p < .05), and low educational attainment (p < .05), were also more likely to visit a woman's health provider. Korean (rather than Chinese) women (p < .05) and women who perceived themselves to be in fair/poor health (p < .05) were more likely to see a traditional provider of Eastern medicine. Asian immigrant women who work in nail salons have workplace health and safety concerns. They generally use Western rather than traditional medicine, with different factors related to these two types of medicine.

The Effects of Geography and Spatial Behavior on Health Care Utilization among the Residents of a Rural Region

PubMed Central

Arcury, Thomas A; Gesler, Wilbert M; Preisser, John S; Sherman, Jill; Spencer, John; Perin, Jamie

2005-01-01

Objective This analysis determines the importance of geography and spatial behavior as predisposing and enabling factors in rural health care utilization, controlling for demographic, social, cultural, and health status factors. Data Sources A survey of 1,059 adults in 12 rural Appalachian North Carolina counties. Study Design This cross-sectional study used a three-stage sampling design stratified by county and ethnicity. Preliminary analysis of health services utilization compared weighted proportions of number of health care visits in the previous 12 months for regular check-up care, chronic care, and acute care across geographic, sociodemographic, cultural, and health variables. Multivariable logistic models identified independent correlates of health services utilization. Data Collection Methods Respondents answered standard survey questions. They located places in which they engaged health related and normal day-to-day activities; these data were entered into a geographic information system for analysis. Principal Findings Several geographic and spatial behavior factors, including having a driver's license, use of provided rides, and distance for regular care, were significantly related to health care utilization for regular check-up and chronic care in the bivariate analysis. In the multivariate model, having a driver's license and distance for regular care remained significant, as did several predisposing (age, gender, ethnicity), enabling (household income), and need (physical and mental health measures, number of conditions). Geographic measures, as predisposing and enabling factors, were related to regular check-up and chronic care, but not to acute care visits. Conclusions These results show the importance of geographic and spatial behavior factors in rural health care utilization. They also indicate continuing inequity in rural health care utilization that must be addressed in public policy. PMID:15663706

Impact of pharmacy benefit design on prescription drug utilization: a fixed effects analysis of plan sponsor data.

PubMed

Roebuck, M Christopher; Liberman, Joshua N

2009-06-01

To study the impact of various elements of pharmacy benefit design on both the absolute and relative utilization of generics, brands, retail pharmacy, and mail service. Panel data on 1,074 plan sponsors covering 21.6 million individuals over 12 calendar quarters (2005-2007). A retrospective analysis of pharmacy claims. To control for potential endogeneity, linear fixed effects models were estimated for each of six dependent variables: the generic utilization rate, the brand utilization rate, the generic dispensing rate (GDR), the retail pharmacy utilization rate, the mail service utilization rate, and the mail distribution rate. Most member cost-share variables were nonlinearly associated with changes in prescription drug utilization. Marginal effects were generally greater in magnitude for brand out-of-pocket costs than for generic out-of-pocket costs. Time dummies, as well as other pharmacy benefit design elements, also yielded significant results. Prior estimates of the effect of member cost sharing on prescription drug utilization may be biased if complex benefit designs, mail service fulfillment, and unmeasured factors such as pharmaceutical pipelines are not accounted for. Commonly cited relative utilization metrics, such as GDR, may be misleading if not examined alongside absolute prescription drug utilization.

Psychocultural Correlates of Mental Health Service Utilization Among African American and European American Girls

PubMed Central

Hipwell, Alison E.; Stepp, Stephanie D.; Keenan, Kate

2015-01-01

Structural equation modeling was used to examine the effects of cultural factors (ethnic identity, perceived discrimination), family relations, and child problem type on mental health service utilization in a community sample of 1,480 adolescent girls (860 African American, 620 European American) between ages 15 and 17 years enrolled in the Pittsburgh Girls Study. Results revealed ethnic identity, caregiver attachment, and conduct disorder were related to service use among African American girls. Among European American girls, correlate patterns differed by clinical need. Findings highlight the need for research on health disparities to examine racially specific influences on service utilization. PMID:25380787

A comprehensive physiologically based pharmacokinetic knowledgebase and web-based interface for rapid model ranking and querying

EPA Science Inventory

Published physiologically based pharmacokinetic (PBPK) models from peer-reviewed articles are often well-parameterized, thoroughly-vetted, and can be utilized as excellent resources for the construction of models pertaining to related chemicals. Specifically, chemical-specific pa...

Carcinogenicity and Mutagenicity Data: New Initiatives to Improve Access and Utility for Modeling

EPA Science Inventory

Currents models for prediction of chemical carcinogenicity and mutagenicity rely upon a relatively small number of publicly available data resources, where the data being modeled are highly summarized and aggregated representations of the actual experimental results. A number of...

Models of Academic Governance and Institutional Power in Southern Baptist Related Liberal Arts Colleges and Universities

ERIC Educational Resources Information Center

Garrison, Michael Shane

2010-01-01

The purpose of this descriptive-quantitative study was to examine which models of academic governance are utilized by Southern Baptist related liberal arts colleges and universities. Special attention was given to the distribution of institutional power among seventeen campus leadership groups or power holders. Using J. Victor Baldridge's models…

Animal models of GM2 gangliosidosis: utility and limitations.

PubMed

Lawson, Cheryl A; Martin, Douglas R

2016-01-01

GM2 gangliosidosis, a subset of lysosomal storage disorders, is caused by a deficiency of the glycohydrolase, β-N-acetylhexosaminidase, and includes the closely related Tay-Sachs and Sandhoff diseases. The enzyme deficiency prevents the normal, stepwise degradation of ganglioside, which accumulates unchecked within the cellular lysosome, particularly in neurons. As a result, individuals with GM2 gangliosidosis experience progressive neurological diseases including motor deficits, progressive weakness and hypotonia, decreased responsiveness, vision deterioration, and seizures. Mice and cats are well-established animal models for Sandhoff disease, whereas Jacob sheep are the only known laboratory animal model of Tay-Sachs disease to exhibit clinical symptoms. Since the human diseases are relatively rare, animal models are indispensable tools for further study of pathogenesis and for development of potential treatments. Though no effective treatments for gangliosidoses currently exist, animal models have been used to test promising experimental therapies. Herein, the utility and limitations of gangliosidosis animal models and how they have contributed to the development of potential new treatments are described.

Animal models of GM2 gangliosidosis: utility and limitations

PubMed Central

Lawson, Cheryl A; Martin, Douglas R

2016-01-01

GM2 gangliosidosis, a subset of lysosomal storage disorders, is caused by a deficiency of the glycohydrolase, β-N-acetylhexosaminidase, and includes the closely related Tay–Sachs and Sandhoff diseases. The enzyme deficiency prevents the normal, stepwise degradation of ganglioside, which accumulates unchecked within the cellular lysosome, particularly in neurons. As a result, individuals with GM2 gangliosidosis experience progressive neurological diseases including motor deficits, progressive weakness and hypotonia, decreased responsiveness, vision deterioration, and seizures. Mice and cats are well-established animal models for Sandhoff disease, whereas Jacob sheep are the only known laboratory animal model of Tay–Sachs disease to exhibit clinical symptoms. Since the human diseases are relatively rare, animal models are indispensable tools for further study of pathogenesis and for development of potential treatments. Though no effective treatments for gangliosidoses currently exist, animal models have been used to test promising experimental therapies. Herein, the utility and limitations of gangliosidosis animal models and how they have contributed to the development of potential new treatments are described. PMID:27499644

Development of a claim review and payment model utilizing diagnosis related groups under the Korean health insurance.

PubMed

Shin, Y S; Yeom, Y K; Hwang, H

1993-02-01

This paper describes the development of a claim review and payment model utilizing the diagnosis related groups (DRGs) for the fee for service-based payment system of the Korean health insurance. The present review process, which examines all claims manually on a case-by-case basis, has been considered to be inefficient, costly, and time-consuming. Differences in case mix among hospitals are controlled in the proposed model using the Korean DRGs. They were developed by modifying the US-DRG system. An empirical test of the model indicated that it can enhance the efficiency as well as the credibility and objectivity of the claim review. Furthermore, it is expected that it can contribute effectively to medical cost containments and to optimal practice pattern of hospitals by establishing a useful mechanism in monitoring the performance of hospitals. However, the performance of this model needs to be upgraded by refining the Korean DRGs which play a key role in the model.

Critically reflective work behavior of health care professionals.

PubMed

Groot, Esther de; Jaarsma, Debbie; Endedijk, Maaike; Mainhard, Tim; Lam, Ineke; Simons, Robert-Jan; Beukelen, Peter van

2012-01-01

Better understanding of critically reflective work behavior (CRWB), an approach for work-related informal learning, is important in order to gain more profound insight in the continuing development of health care professionals. A survey, developed to measure CRWB and its predictors, was distributed to veterinary professionals. The authors specified a model relating CRWB to a Perceived Need for Lifelong Learning, Perceived Workload, and Opportunities for Feedback. Furthermore, research utilization was added to the concept of CRWB. The model was tested against the data, using structural equation modeling (SEM). The model was well represented by the data. Four factors that reflect aspects of CRWB were distinguished: (1) individual CRWB; (2) being critical in interactions with others; (3) cross-checking of information; and (4) openness to new findings. The latter 2 originated from the factor research utilization in CRWB. The Perceived Need for Lifelong Learning predicts CRWB. Neither Perceived Workload nor Opportunities for Feedback of other practitioners was related to CRWB. The results suggest that research utilization, such as cross-checking information and openness to new findings, is essential for CRWB. Furthermore, perceptions of the need for lifelong learning are more relevant for CRWB of health care professionals than qualities of the workplace. Copyright © 2012 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

A utility-theoretic model for QALYs and willingness to pay.

PubMed

Klose, Thomas

2003-01-01

Despite the widespread use of quality-adjusted life years (QALY) in economic evaluation studies, their utility-theoretic foundation remains unclear. A model for preferences over health, money, and time is presented in this paper. Under the usual assumptions of the original QALY-model, an additive separable presentation of the utilities in different periods exists. In contrast to the usual assumption that QALY-weights do solely depend on aspects of health-related quality of life, wealth-standardized QALY-weights might vary with the wealth level in the presented extension of the original QALY-model resulting in an inconsistent measurement of QALYs. Further assumptions are presented to make the measurement of QALYs consistent with lifetime preferences over health and money. Even under these strict assumptions, QALYs and WTP (which also can be defined in this utility-theoretic model) are not equivalent preference-based measures of the effects of health technologies on an individual level. The results suggest that the individual WTP per QALY can depend on the magnitude of the QALY-gain as well as on the disease burden, when health influences the marginal utility of wealth. Further research seems to be indicated on this structural aspect of preferences over health and wealth and to quantify its impact. Copyright 2002 John Wiley & Sons, Ltd.

Comparative evaluation of two asthma care quality measures among Medicaid beneficiaries.

PubMed

Samnaliev, Mihail; Baxter, Jeffrey D; Clark, Robin E

2009-05-01

The relative performance of asthma care quality measures has not been evaluated in Medicaid populations. Using complete claims and pharmaceutical data for 19,076 patients with persistent asthma (based on Health Effectiveness and Data Information Set criteria) in five Medicaid populations, we compared the following two measures of asthma care quality: filling prescriptions for controller asthma medications within 1 year and the ratio of controller medication to the total number of asthma medication prescriptions filled within 1 year. We calculated whether meeting each quality measure was associated with decreased odds of emergency department (ED) treatment episodes. We then compared the odds ratios, receiver operating characteristic (ROC) curves, and deviances between models, using each measure to predict ED utilization in Medicaid populations. Although meeting each measure was associated with lower odds of ED utilization, this decrease was larger if the controller asthma medication measure was met rather than the ratio measure. Additionally, models using the controller medication measure had greater areas under the ROC curve and smaller deviances than models using the ratio measure. Both administrative measures of asthma care quality were associated with lower odds of ED utilization. The controller medication measure of asthma care quality may be better than the ratio measure in relation to emergency asthma care utilization by Medicaid beneficiaries.

Evaluating synoptic systems in the CMIP5 climate models over the Australian region

NASA Astrophysics Data System (ADS)

Gibson, Peter B.; Uotila, Petteri; Perkins-Kirkpatrick, Sarah E.; Alexander, Lisa V.; Pitman, Andrew J.

2016-10-01

Climate models are our principal tool for generating the projections used to inform climate change policy. Our confidence in projections depends, in part, on how realistically they simulate present day climate and associated variability over a range of time scales. Traditionally, climate models are less commonly assessed at time scales relevant to daily weather systems. Here we explore the utility of a self-organizing maps (SOMs) procedure for evaluating the frequency, persistence and transitions of daily synoptic systems in the Australian region simulated by state-of-the-art global climate models. In terms of skill in simulating the climatological frequency of synoptic systems, large spread was observed between models. A positive association between all metrics was found, implying that relative skill in simulating the persistence and transitions of systems is related to skill in simulating the climatological frequency. Considering all models and metrics collectively, model performance was found to be related to model horizontal resolution but unrelated to vertical resolution or representation of the stratosphere. In terms of the SOM procedure, the timespan over which evaluation was performed had some influence on model performance skill measures, as did the number of circulation types examined. These findings have implications for selecting models most useful for future projections over the Australian region, particularly for projections related to synoptic scale processes and phenomena. More broadly, this study has demonstrated the utility of the SOMs procedure in providing a process-based evaluation of climate models.

Utility of Social Modeling for Proliferation Assessment - Preliminary Assessment

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

Coles, Garill A.; Gastelum, Zoe N.; Brothers, Alan J.

2009-06-01

This Preliminary Assessment draft report will present the results of a literature search and preliminary assessment of the body of research, analysis methods, models and data deemed to be relevant to the Utility of Social Modeling for Proliferation Assessment research. This report will provide: 1) a description of the problem space and the kinds of information pertinent to the problem space, 2) a discussion of key relevant or representative literature, 3) a discussion of models and modeling approaches judged to be potentially useful to the research, and 4) the next steps of this research that will be pursued based onmore » this preliminary assessment. This draft report represents a technical deliverable for the NA-22 Simulations, Algorithms, and Modeling (SAM) program. Specifically this draft report is the Task 1 deliverable for project PL09-UtilSocial-PD06, Utility of Social Modeling for Proliferation Assessment. This project investigates non-traditional use of social and cultural information to improve nuclear proliferation assessment, including nonproliferation assessment, proliferation resistance assessments, safeguards assessments and other related studies. These assessments often use and create technical information about the State’s posture towards proliferation, the vulnerability of a nuclear energy system to an undesired event, and the effectiveness of safeguards. This project will find and fuse social and technical information by explicitly considering the role of cultural, social and behavioral factors relevant to proliferation. The aim of this research is to describe and demonstrate if and how social science modeling has utility in proliferation assessment.« less

Clinicians’ Use of Personality Disorder Models within a Particular Treatment Setting: A Longitudinal Comparison of Temporal Consistency and Clinical Utility

PubMed Central

Samuel, Douglas B.; Widiger, Thomas A.

2012-01-01

An active line of current investigation is how the five-factor model (FFM) of personality disorder might be applied by clinicians and particularly, how clinically useful this model is in comparison to the existing nomenclature. The current study is the first to investigate the temporal consistency of clinicians’ application of the FFM and the DSM-IV-TR to their own patients. Results indicated that FFM ratings were relatively stable over six-months of treatment, supporting their use by clinicians, but also indexed potentially important clinical changes. Additionally, ratings of utility provided by the clinicians suggested that the FFM was more useful for clinical decision making than was the DSM-IV-TR model. We understand the clinical utility findings within the context of previous research indicating that the FFM is most useful among patients who are not prototypic for a personality disorder. PMID:24288580

Advance Appropriations for Veteran’s Health Care: Issues and Options for Congress

DTIC Science & Technology

2009-04-28

care system. Utilization Projection Model (UPM) The UPM is based on the Milliman Health Cost Guidelines ( HCGs ), a proprietary set of utilization-rate...benchmarks derived from commercial data.31 The HCGs contain data on utilization for 37 of the 58 EHCPM health service categories. Milliman applies a...complex set of adjustments to the HCG data to reflect the health status of VA enrollees, their reliance on VA, and the relative efficiency of VA

The Utility of the Faces Pain Scale in the Assessment of Shoulder Pain in Turkish Stroke Patients: Its Relation with Quality of Life and Psychologic Status

ERIC Educational Resources Information Center

Dogan, Sebnem Koldas; Ay, Saime; Oztuna, Derya; Aytur, Yesim Kurtais; Evcik, Deniz

2010-01-01

This study was planned to investigate the utility of the vertical Faces Pain Scale (FPS) in the assessment of pain in stroke patients using the shoulder pain model and to assess its utility in the Turkish patient population. The secondary aim was to analyze the association of FPS with the quality of life and depression in the study population.…

A longitudinal study of the effects of dual-earner couples' utilization of family-friendly workplace supports on work and family outcomes.

PubMed

Hammer, Leslie B; Neal, Margaret B; Newsom, Jason T; Brockwood, Krista J; Colton, Cari L

2005-07-01

Little research exists on the effects of the utilization of workplace supports on work-family conflict and job satisfaction. With family systems theory as a framework, 2 waves of national survey data were collected from 234 couples (N = 468) caring for children and for aging parents. Data were analyzed with structural equation modeling techniques. Longitudinal results indicate that individuals' use of workplace supports was related to work-family conflict in the direction opposite to expectations and was related to job satisfaction in the direction consistent with expectations. Differential effects for wives versus husbands were found. In addition, couples' use of workplace supports was only minimally related to wives' outcomes. Results are discussed in terms of gender differences, family systems theory, and methodological and measurement issues related to the longitudinal study of utilization of workplace supports. Copyright 2005 APA, all rights reserved.

Using Confirmatory Factor Analysis to Understand Executive Control in Preschool Children: Sources of Variation in Emergent Mathematic Achievement

ERIC Educational Resources Information Center

Bull, Rebecca; Espy, Kimberly Andrews; Wiebe, Sandra A.; Sheffield, Tiffany D.; Nelson, Jennifer Mize

2011-01-01

Latent variable modeling methods have demonstrated utility for understanding the structure of executive control (EC) across development. These methods are utilized to better characterize the relation between EC and mathematics achievement in the preschool period, and to understand contributing sources of individual variation. Using the sample and…

Wealth-related Inequality in Utilization of Antihypertensive Medicines in Iran: an Ecological Study on Population Level Data.

PubMed

Hashemi-Meshkini, Amir; Kebriaeezadeh, Abbas; Jamshidi, Hamidreza; Akbari-Sari, Ali; Rezaei-Darzi, Ehsan; Mehdipour, Parinaz; Nikfar, Shekoufeh; Farzadfar, Farshad

2016-02-01

We aim to evaluate the trend of national and sub-national (provincial) utilization pattern of antihypertensive medicines in the Iranian population in the past decade and evaluate whether there is any wealth-related inequality in utilization of these medicines among different provinces. Either fixed effect or random effect linear panel data model was used to check the effect of wealth index on utilization of all antihypertensive medicines and each class, adjusting for other covariates including years of schooling, urbanization, mean age, and food type of provinces. The principal component analysis was applied to make summery measures for covariates using available national datasets. The effect of wealth category on the utilization of all antihypertensive medicines among Iranian provinces was positive and significant (0.84; 95% CI: 0.09, 1.59). Accordingly as subgroup analysis, in BBs and CCBs classes, the effects of wealth category on utilization of medicines were positive and significant (0.36; 95% CI: 0.12, 0.60 and 0.27; 95% CI: 0.07, 0.40, respectively). However in ACEIs and Diuretics classes, the effects of wealth category were positive but not significant. In ARBs class, the effect of wealth on utilization was negative and not significant (-0.04; 95% CI: -0.27, 0.18). According to this study, an inequality could be observed in Iran related to wealth category in utilization of total antihypertensive medicines between provinces.

Utility Estimates of Disease-Specific Health States in Prostate Cancer from Three Different Perspectives.

PubMed

Gries, Katharine S; Regier, Dean A; Ramsey, Scott D; Patrick, Donald L

2017-06-01

To develop a statistical model generating utility estimates for prostate cancer specific health states, using preference weights derived from the perspectives of prostate cancer patients, men at risk for prostate cancer, and society. Utility estimate values were calculated using standard gamble (SG) methodology. Study participants valued 18 prostate-specific health states with the five attributes: sexual function, urinary function, bowel function, pain, and emotional well-being. Appropriateness of model (linear regression, mixed effects, or generalized estimating equation) to generate prostate cancer utility estimates was determined by paired t-tests to compare observed and predicted values. Mixed-corrected standard SG utility estimates to account for loss aversion were calculated based on prospect theory. 132 study participants assigned values to the health states (n = 40 men at risk for prostate cancer; n = 43 men with prostate cancer; n = 49 general population). In total, 792 valuations were elicited (six health states for each 132 participants). The most appropriate model for the classification system was a mixed effects model; correlations between the mean observed and predicted utility estimates were greater than 0.80 for each perspective. Developing a health-state classification system with preference weights for three different perspectives demonstrates the relative importance of main effects between populations. The predicted values for men with prostate cancer support the hypothesis that patients experiencing the disease state assign higher utility estimates to health states and there is a difference in valuations made by patients and the general population.

Dental health services utilization and associated factors in children 6 to 12 years old in a low-income country.

PubMed

Medina-Solis, Carlo Eduardo; Maupomé, Gerardo; del Socorro, Herrera Miriam; Pérez-Núñez, Ricardo; Avila-Burgos, Leticia; Lamadrid-Figueroa, Hector

2008-01-01

To determine the factors associated with the dental health services utilization among children ages 6 to 12 in León, Nicaragua. A cross-sectional study was carried out in 1,400 schoolchildren. Using a questionnaire, we determined information related to utilization and independent variables in the previous year. Oral health needs were established by means of a dental examination. To identify the independent variables associated with dental health services utilization, two types of multivariate regression models were used, according to the measurement scale of the outcome variable: a) frequency of utilization as (0) none, (1) one, and (2) two or more, analyzed with the ordered logistic regression and b) the type of service utilized as (0) none, (1) preventive services, (2) curative services, and (3) both services, analyzed with the multinomial logistic regression. The proportion of children who received at least one dental service in the 12 months prior to the study was 27.7 percent. The variables associated with utilization in the two models were older age, female sex, more frequent toothbrushing, positive attitude of the mother toward the child's oral health, higher socioeconomic level, and higher oral health needs. Various predisposing, enabling, and oral health needs variables were associated with higher dental health services utilization. As in prior reports elsewhere, these results from Nicaragua confirmed that utilization inequalities exist between socioeconomic groups. The multinomial logistic regression model evidenced the association of different variables depending on the type of service used.

Disparities in Substance Abuse Treatment Utilization Among Women with Intellectual Disability.

PubMed

Slayter, Elspeth

2016-01-01

Despite concerns about health disparities among women with intellectual disabilities, little is known about substance abuse treatment access in this population. Using standardized performance measures, treatment initiation and engagement were examined retrospectively for women aged 18 to 64 (N = 3,752), men with (N = 5,732) and women without intellectual disability (N = 493,446). Logistic regression models of utilization were conducted. Women in the sample were less likely than men in the sample or women without intellectual disability to utilize treatment, suggesting both gender-related and disability-related barriers. Policy and practice implications for improving the health and welfare of women with intellectual disabilities are discussed.

Data and Model Uncertainties associated with Biogeochemical Groundwater Remediation and their impact on Decision Analysis

NASA Astrophysics Data System (ADS)

Pandey, S.; Vesselinov, V. V.; O'Malley, D.; Karra, S.; Hansen, S. K.

2016-12-01

Models and data are used to characterize the extent of contamination and remediation, both of which are dependent upon the complex interplay of processes ranging from geochemical reactions, microbial metabolism, and pore-scale mixing to heterogeneous flow and external forcings. Characterization is wrought with important uncertainties related to the model itself (e.g. conceptualization, model implementation, parameter values) and the data used for model calibration (e.g. sparsity, measurement errors). This research consists of two primary components: (1) Developing numerical models that incorporate the complex hydrogeology and biogeochemistry that drive groundwater contamination and remediation; (2) Utilizing novel techniques for data/model-based analyses (such as parameter calibration and uncertainty quantification) to aid in decision support for optimal uncertainty reduction related to characterization and remediation of contaminated sites. The reactive transport models are developed using PFLOTRAN and are capable of simulating a wide range of biogeochemical and hydrologic conditions that affect the migration and remediation of groundwater contaminants under diverse field conditions. Data/model-based analyses are achieved using MADS, which utilizes Bayesian methods and Information Gap theory to address the data/model uncertainties discussed above. We also use these tools to evaluate different models, which vary in complexity, in order to weigh and rank models based on model accuracy (in representation of existing observations), model parsimony (everything else being equal, models with smaller number of model parameters are preferred), and model robustness (related to model predictions of unknown future states). These analyses are carried out on synthetic problems, but are directly related to real-world problems; for example, the modeled processes and data inputs are consistent with the conditions at the Los Alamos National Laboratory contamination sites (RDX and Chromium).

LCA-based optimization of wood utilization under special consideration of a cascading use of wood.

PubMed

Höglmeier, Karin; Steubing, Bernhard; Weber-Blaschke, Gabriele; Richter, Klaus

2015-04-01

Cascading, the use of the same unit of a resource in multiple successional applications, is considered as a viable means to improve the efficiency of resource utilization and to decrease environmental impacts. Wood, as a regrowing but nevertheless limited and increasingly in demand resource, can be used in cascades, thereby increasing the potential efficiency per unit of wood. This study aims to assess the influence of cascading wood utilization on optimizing the overall environmental impact of wood utilization. By combining a material flow model of existing wood applications - both for materials provision and energy production - with an algebraic optimization tool, the effects of the use of wood in cascades can be modelled and quantified based on life cycle impact assessment results for all production processes. To identify the most efficient wood allocation, the effects of a potential substitution of non-wood products were taken into account in a part of the model runs. The considered environmental indicators were global warming potential, particulate matter formation, land occupation and an aggregated single score indicator. We found that optimizing either the overall global warming potential or the value of the single score indicator of the system leads to a simultaneous relative decrease of all other considered environmental impacts. The relative differences between the impacts of the model run with and without the possibility of a cascading use of wood were 7% for global warming potential and the single score indicator, despite cascading only influencing a small part of the overall system, namely wood panel production. Cascading led to savings of up to 14% of the annual primary wood supply of the study area. We conclude that cascading can improve the overall performance of a wood utilization system. Copyright © 2015 Elsevier Ltd. All rights reserved.

Health care utilization in a sample of Canadian lesbian women: predictors of risk and resilience.

PubMed

Bergeron, Sherry; Senn, Charlene Y

2003-01-01

This study was designed to test an exploratory path model predicting health care utilization by lesbian women. Using structural equation modeling we examined the joint influence of internalized homophobia, feminism, comfort with health care providers (HCPs), education, and disclosure of sexual identity both in one's life and to one's HCP on health care utilization. Surveys were completed by 254 Canadian lesbian women (54% participation rate) recruited through snowball sampling and specialized media. The majority (95%) of women were White, 3% (n = 7) were women of colour, and the remaining six women did not indicate ethnicity. Participants ranged in age from 18 to 67 with a mean age of 38.85 years (SD = 9.12). In the final path model, higher education predicted greater feminism, more disclosure to HCPs, and better utilization of health services. Feminism predicted both decreased levels of internalized homophobia and increased disclosure across relationships. Being more open about one's sexual identity was related to increased disclosure to HCPs, which in turn, led to better health care utilization. Finally, the more comfortable women were with their HCP the more likely they were to seek preventive care. All paths were significant at p < .01. The path model offers insight into potential target areas for intervention with the goal of improving health care utilization in lesbian women.

Short-term glucagon stimulation test of C-peptide effect on glucose utilization in patients with type 1 diabetes mellitus.

PubMed

Mojto, Viliam; Rausova, Zuzana; Chrenova, Jana; Dedik, Ladislav

2015-12-01

This work aimed to evaluate the use of a four-point glucagon stimulation test of C-peptide effect on glucose utilization in type 1 diabetic patients using a new mathematical model. A group of 32 type 1 diabetic patients and a group of 10 healthy control subjects underwent a four-point glucagon stimulation test with blood sampling at 0, 6, 15 and 30 min after 1 mg glucagon bolus intravenous administration. Pharmacokinetic and pharmacokinetic/pharmacodynamic models of C-peptide effect on glucose utilization versus area under curve (AUC) were used. A two-sample t test and ANOVA with Bonferroni correction were used to test the significance of differences between parameters. A significant difference between control and patient groups regarding the coefficient of whole-body glucose utilization and AUC C-peptide/AUC glucose ratio (p ≪ 0.001 and p = 0.002, respectively) was observed. The high correlation (r = 0.97) between modeled coefficient of whole-body glucose utilization and numerically calculated AUC C-peptide/AUC glucose ratio related to entire cohort indicated the stability of used method. The short-term four-point glucagon stimulation test allows the numerically calculated AUC C-peptide/AUC glucose ratio and/or the coefficient of whole-body glucose utilization calculated from model to be used to diagnostically identify type 1 diabetic patients.

To kill a kangaroo: understanding the decision to pursue high-risk/high-gain resources.

PubMed

Jones, James Holland; Bird, Rebecca Bliege; Bird, Douglas W

2013-09-22

In this paper, we attempt to understand hunter-gatherer foraging decisions about prey that vary in both the mean and variance of energy return using an expected utility framework. We show that for skewed distributions of energetic returns, the standard linear variance discounting (LVD) model for risk-sensitive foraging can produce quite misleading results. In addition to creating difficulties for the LVD model, the skewed distributions characteristic of hunting returns create challenges for estimating probability distribution functions required for expected utility. We present a solution using a two-component finite mixture model for foraging returns. We then use detailed foraging returns data based on focal follows of individual hunters in Western Australia hunting for high-risk/high-gain (hill kangaroo) and relatively low-risk/low-gain (sand monitor) prey. Using probability densities for the two resources estimated from the mixture models, combined with theoretically sensible utility curves characterized by diminishing marginal utility for the highest returns, we find that the expected utility of the sand monitors greatly exceeds that of kangaroos despite the fact that the mean energy return for kangaroos is nearly twice as large as that for sand monitors. We conclude that the decision to hunt hill kangaroos does not arise simply as part of an energetic utility-maximization strategy and that additional social, political or symbolic benefits must accrue to hunters of this highly variable prey.

A model to predict accommodations needed by disabled persons.

PubMed

Babski-Reeves, Kari; Williams, Sabrina; Waters, Tzer Nan; Crumpton-Young, Lesia L; McCauley-Bell, Pamela

2005-09-01

In this paper, several approaches to assist employers in the accommodation process for disabled employees are discussed and a mathematical model is proposed to assist employers in predicting the accommodation level needed by an individual with a mobility-related disability. This study investigates the validity and reliability of this model in assessing the accommodation level needed by individuals utilizing data collected from twelve individuals with mobility-related disabilities. Based on the results of the statistical analyses, this proposed model produces a feasible preliminary measure for assessing the accommodation level needed for persons with mobility-related disabilities. Suggestions for practical application of this model in an industrial setting are addressed.

A theoretical model of the determinants of mortality.

PubMed

Tourangeau, Ann E

2005-01-01

Outcome research in nursing has been criticized for being atheoretical. Although there has been research investigating patient mortality as an outcome, there has been little discussion about models or theories of nursing-related determinants of mortality for hospitalized patients. Yet, unnecessary patient mortality is an important patient safety outcome. This article describes development of beginning theory of determinants of patient mortality culminating with a revised mortality model. Conclusions are made related to plans for further testing and refinement of the revised mortality model. Further, the utility of the proposed model in practice is discussed.

Hierarchical Bayesian spatial models for multispecies conservation planning and monitoring

Treesearch

Carlos Carroll; Devin S. Johnson; Jeffrey R. Dunk; William J. Zielinski

2010-01-01

Biologists who develop and apply habitat models are often familiar with the statistical challenges posed by their data’s spatial structure but are unsure of whether the use of complex spatial models will increase the utility of model results in planning. We compared the relative performance of nonspatial and hierarchical Bayesian spatial models for three vertebrate and...

Valuing SF-6D Health States Using a Discrete Choice Experiment.

PubMed

Norman, Richard; Viney, Rosalie; Brazier, John; Burgess, Leonie; Cronin, Paula; King, Madeleine; Ratcliffe, Julie; Street, Deborah

2014-08-01

SF-6D utility weights are conventionally produced using a standard gamble (SG). SG-derived weights consistently demonstrate a floor effect not observed with other elicitation techniques. Recent advances in discrete choice methods have allowed estimation of utility weights. The objective was to produce Australian utility weights for the SF-6D and to explore the application of discrete choice experiment (DCE) methods in this context. We hypothesized that weights derived using this method would reflect the largely monotonic construction of the SF-6D. We designed an online DCE and administered it to an Australia-representative online panel (n = 1017). A range of specifications investigating nonlinear preferences with respect to additional life expectancy were estimated using a random-effects probit model. The preferred model was then used to estimate a preference index such that full health and death were valued at 1 and 0, respectively, to provide an algorithm for Australian cost-utility analyses. Physical functioning, pain, mental health, and vitality were the largest drivers of utility weights. Combining levels to remove illogical orderings did not lead to a poorer model fit. Relative to international SG-derived weights, the range of utility weights was larger with 5% of health states valued below zero. s. DCEs can be used to investigate preferences for health profiles and to estimate utility weights for multi-attribute utility instruments. Australian cost-utility analyses can now use domestic SF-6D weights. The comparability of DCE results to those using other elicitation methods for estimating utility weights for quality-adjusted life-year calculations should be further investigated. © The Author(s) 2013.

Illness in the Family: Old Myths and New Truths! Unit for Child Studies. Selected Papers Number 19.

ERIC Educational Resources Information Center

Perkins, Richard; Oldenburg, Brian

A multifactorial model of phases in the development and progress of physical illness is described, and the model's utility is illustrated. The model consists of antecedent and concurrent conditions and consequences related to physical, psychological, and social factors and their interaction. The application of the model is illustrated by a…

A Behavioral Theory of the Merger: Dynamics of the Post-Merger Integration Process

DTIC Science & Technology

2014-05-01

management’s integration strategy that often accompanies a merger. Although, some real-world managers do indeed take a laissez faire approach to...1971). Future models might instead utilize other theoretical characteristics to select exchange partners, such as relative expertise, leadership ...Byrne, 1971). Future modelers could also consider other characteristics such as relative expertise, leadership style, and resource availability in this

Design, processing and testing of LSI arrays, hybrid microelectronics task

NASA Technical Reports Server (NTRS)

Himmel, R. P.; Stuhlbarg, S. M.; Ravetti, R. G.; Zulueta, P. J.; Rothrock, C. W.

1979-01-01

Mathematical cost models previously developed for hybrid microelectronic subsystems were refined and expanded. Rework terms related to substrate fabrication, nonrecurring developmental and manufacturing operations, and prototype production are included. Sample computer programs were written to demonstrate hybrid microelectric applications of these cost models. Computer programs were generated to calculate and analyze values for the total microelectronics costs. Large scale integrated (LST) chips utilizing tape chip carrier technology were studied. The feasibility of interconnecting arrays of LSU chips utilizing tape chip carrier and semiautomatic wire bonding technology was demonstrated.

Analysing the primacy of distance in the utilization of health services in the Ahafo-Ano South district, Ghana.

PubMed

Buor, Daniel

2003-01-01

Although the distance factor has been identified as key in the utilization of health services in rural areas of developing countries, it has been analysed without recourse to related factors of travel time and transport cost. Also, the influence of distance on vulnerable groups in utilization has not been an object of survey by researchers. This paper addresses the impact of distance on utilization, and how distance compares with travel time and transport cost that are related to it in the utilization of health services in the Ahafo-Ano South (rural) district in Ghana. The study, a cross-sectional survey, also identifies the position of distance among other important factors of utilization. A sample of 400, drawn through systematic random technique, was used for the survey. Data were analysed using the regression model and some graphic techniques. The main instruments used in data collection were formal (face-by-face) interview and a questionnaire. The survey finds that distance is the most important factor that influences the utilization of health services in the Ahafo-Ano South district. Other key factors are income, service cost and education. The effect of travel time on utilization reflects that of distance and utilization. Recommendations to reduce distance coverage, improve formal education and reduce poverty have been made.

The timing and sources of information for the adoption and implementation of production innovations

NASA Technical Reports Server (NTRS)

Ettlie, J. E.

1976-01-01

Two dimensions (personal-impersonal and internal-external) are used to characterize information sources as they become important during the interorganizational transfer of production innovations. The results of three studies are reviewed for the purpose of deriving a model of the timing and importance of different information sources and the utilization of new technology. Based on the findings of two retrospective studies, it was concluded that the pattern of information seeking behavior in user organizations during the awareness stage of adoption is not a reliable predictor of the eventual utilization rate. Using the additional findings of a real-time study, an empirical model of the relative importance of information sources for successful user organizations is presented. These results are extended and integrated into a theoretical model consisting of a time-profile of successful implementations and the relative importance of four types of information sources during seven stages of the adoption-implementation process.

Dark traits and suicide: Associations between psychopathy, narcissism, and components of the interpersonal-psychological theory of suicide.

PubMed

Harrop, Tiffany M; Preston, Olivia C; Khazem, Lauren R; Anestis, Michael D; Junearick, Regis; Green, Bradley A; Anestis, Joye C

2017-10-01

Studies have identified independent relationships between psychopathy, narcissism, and suicidality. The current study expands upon the extant literature by exploring psychopathic and narcissistic personality traits and components of the interpersonal-psychological theory of suicide, utilizing a 3-factor model of psychopathy and 2-factor model of pathological narcissism in community, undergraduate, and military individuals. We hypothesized that the impulsive-antisocial facets of psychopathy would be related to suicidal desire, whereas all facets of psychopathy would relate to the capability for suicide. We anticipated an association between pathological narcissism, thwarted belongingness, and capability for suicide, but not perceived burdensomeness. We further hypothesized a relationship between physical pain tolerance and persistence and the affective (i.e., callousness) facet of psychopathy. Results partially supported these hypotheses and underscore the need for further examination of these associations utilizing contemporary models of psychopathy and narcissism. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Utility of Cognitive Plausibility in Language Acquisition Modeling: Evidence From Word Segmentation.

PubMed

Phillips, Lawrence; Pearl, Lisa

2015-11-01

The informativity of a computational model of language acquisition is directly related to how closely it approximates the actual acquisition task, sometimes referred to as the model's cognitive plausibility. We suggest that though every computational model necessarily idealizes the modeled task, an informative language acquisition model can aim to be cognitively plausible in multiple ways. We discuss these cognitive plausibility checkpoints generally and then apply them to a case study in word segmentation, investigating a promising Bayesian segmentation strategy. We incorporate cognitive plausibility by using an age-appropriate unit of perceptual representation, evaluating the model output in terms of its utility, and incorporating cognitive constraints into the inference process. Our more cognitively plausible model shows a beneficial effect of cognitive constraints on segmentation performance. One interpretation of this effect is as a synergy between the naive theories of language structure that infants may have and the cognitive constraints that limit the fidelity of their inference processes, where less accurate inference approximations are better when the underlying assumptions about how words are generated are less accurate. More generally, these results highlight the utility of incorporating cognitive plausibility more fully into computational models of language acquisition. Copyright © 2015 Cognitive Science Society, Inc.

A comprehensive physiologically based pharmacokinetic ...

EPA Pesticide Factsheets

Published physiologically based pharmacokinetic (PBPK) models from peer-reviewed articles are often well-parameterized, thoroughly-vetted, and can be utilized as excellent resources for the construction of models pertaining to related chemicals. Specifically, chemical-specific parameters and in vivo pharmacokinetic data used to calibrate these published models can act as valuable starting points for model development of new chemicals with similar molecular structures. A knowledgebase for published PBPK-related articles was compiled to support PBPK model construction for new chemicals based on their close analogues within the knowledgebase, and a web-based interface was developed to allow users to query those close analogues. A list of 689 unique chemicals and their corresponding 1751 articles was created after analysis of 2,245 PBPK-related articles. For each model, the PMID, chemical name, major metabolites, species, gender, life stages and tissue compartments were extracted from the published articles. PaDEL-Descriptor, a Chemistry Development Kit based software, was used to calculate molecular fingerprints. Tanimoto index was implemented in the user interface as measurement of structural similarity. The utility of the PBPK knowledgebase and web-based user interface was demonstrated using two case studies with ethylbenzene and gefitinib. Our PBPK knowledgebase is a novel tool for ranking chemicals based on similarities to other chemicals associated with existi

Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach

PubMed Central

Patel, Rachana; Ladusingh, Laishram

2015-01-01

This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007–08) data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM) and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women’s residing in more urbanized districts increased the utilization. “Inter-district” variation was 14 percent whereas “between-villages” variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and inaccessible considering the inter-districts variation for the program implementation. PMID:26689199

Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach.

PubMed

Patel, Rachana; Ladusingh, Laishram

2015-01-01

This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007-08) data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM) and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women's residing in more urbanized districts increased the utilization. "Inter-district" variation was 14 percent whereas "between-villages" variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and inaccessible considering the inter-districts variation for the program implementation.

Energy Optimization Modeling of Geothermal Power Plant (Case Study: Darajat Geothermal Field Unit III)

NASA Astrophysics Data System (ADS)

Sinaga, R. H. M.; Darmanto, P. S.

2016-09-01

Darajat unit III geothermal power plant is developed by PT. Chevron Geothermal Indonesia (CGI). The plant capacity is 121 MW and load 110%. The greatest utilization power is consumed by Hot Well Pump (HWP) and Cooling Tower Fan (CTF). Reducing the utility power can be attempted by utilizing the wet bulb temperature fluctuation. In this study, a modelling process is developed by using Engineering Equation Solver (EES) software version 9.430.The possibility of energy saving is indicated by Specific Steam Consumption (SSC) net in relation to wet bulb temperature fluctuation from 9°C up to 20.5°C. Result shows that the existing daily operation reaches its optimum condition. The installation of Variable Frequency Drive (VFD) could be applied to optimize both utility power of HWP and CTF. The highest gain is obtained by VFD HWP installation as much as 0.80% when wet bulb temperature 18.5 °C.

An empirical analysis of ontology reuse in BioPortal.

PubMed

Ochs, Christopher; Perl, Yehoshua; Geller, James; Arabandi, Sivaram; Tudorache, Tania; Musen, Mark A

2017-07-01

Biomedical ontologies often reuse content (i.e., classes and properties) from other ontologies. Content reuse enables a consistent representation of a domain and reusing content can save an ontology author significant time and effort. Prior studies have investigated the existence of reused terms among the ontologies in the NCBO BioPortal, but as of yet there has not been a study investigating how the ontologies in BioPortal utilize reused content in the modeling of their own content. In this study we investigate how 355 ontologies hosted in the NCBO BioPortal reuse content from other ontologies for the purposes of creating new ontology content. We identified 197 ontologies that reuse content. Among these ontologies, 108 utilize reused classes in the modeling of their own classes and 116 utilize reused properties in class restrictions. Current utilization of reuse and quality issues related to reuse are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

Mechanism of oil bank formation, coalescence in porous media and emulsion and foam stability. Quarterly research progress report, July 1, 1984-September 30, 1984

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

Wasan, D.T.

The relative permeability model for two phase flow in porous media (Wasan 1983; Ramakrishnan and Wasan 1984) provides the necessary fractional flow curves at a given capillary number. These curves can be utilized in modeling both enhanced secondary and tertiary recovery processes. Important parameters in the fractional flow curves of our relative permeability model are the residual wetting and nonwetting phase saturations in a low capillary number flooding process. To understand, what constitutes the residual saturations, this quarter we have studied the displacement of one incompressible fluid by another in a porous medium using the network representation. The Bernoulli percolationmore » model for an infinite lattice graph is utilized in the interpretation of the capillary behavior of the medium, which ultimately determines residual saturations. The calculated capillary pressure-saturation relationship using Bethe lattice results agrees qualitatively with experimental data. 4 references, 2 figures.« less

Friction in Forming of UD Composites

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

Sachs, U.; Haanappel, S. P.; Akkerman, R.

2011-05-04

Inter-ply and tool/ply friction play a dominant role in hot stamp forming of UD fiber-reinforced thermoplastic laminates. This research treats friction measurements of a PEEK-AS4 composite system. To this end, an in-house developed friction tester is utilized to pull a laminate through two heat controlled clamping platens. The friction coefficient is determined by relating the clamp force to the pull force. The geometry of the gap between the clamping platens is monitored with micrometer accuracy. A first approach to describe the relation between the geometry and frictional behavior is undertaken by applying a standard thin-film theory for hydrodynamic lubrication. Experimentalmore » measurements showed that the thin-film theory does not entirely cover the underlying physics. Thus a second model is utilized, which employs a Leonov-model to describe the shear deformation of the matrix material, while its viscosity is described with a multi-mode Maxwell model. The combination of both models shows the potential to capture the complete frictional behavior.« less

Modeling arson - An exercise in qualitative model building

NASA Technical Reports Server (NTRS)

Heineke, J. M.

1975-01-01

A detailed example is given of the role of von Neumann and Morgenstern's 1944 'expected utility theorem' (in the theory of games and economic behavior) in qualitative model building. Specifically, an arsonist's decision as to the amount of time to allocate to arson and related activities is modeled, and the responsiveness of this time allocation to changes in various policy parameters is examined. Both the activity modeled and the method of presentation are intended to provide an introduction to the scope and power of the expected utility theorem in modeling situations of 'choice under uncertainty'. The robustness of such a model is shown to vary inversely with the number of preference restrictions used in the analysis. The fewer the restrictions, the wider is the class of agents to which the model is applicable, and accordingly more confidence is put in the derived results. A methodological discussion on modeling human behavior is included.

Construction of the descriptive system for the assessment of quality of life AQoL-6D utility instrument

PubMed Central

2012-01-01

Background Multi attribute utility (MAU) instruments are used to include the health related quality of life (HRQoL) in economic evaluations of health programs. Comparative studies suggest different MAU instruments measure related but different constructs. The objective of this paper is to describe the methods employed to achieve content validity in the descriptive system of the Assessment of Quality of Life (AQoL)-6D, MAU instrument. Methods The AQoL program introduced the use of psychometric methods in the construction of health related MAU instruments. To develop the AQoL-6D we selected 112 items from previous research, focus groups and expert judgment and administered them to 316 members of the public and 302 hospital patients. The search for content validity across a broad spectrum of health states required both formative and reflective modelling. We employed Exploratory Factor Analysis and Structural Equation Modelling (SEM) to meet these dual requirements. Results and Discussion The resulting instrument employs 20 items in a multi-tier descriptive system. Latent dimension variables achieve sensitive descriptions of 6 dimensions which, in turn, combine to form a single latent QoL variable. Diagnostic statistics from the SEM analysis are exceptionally good and confirm the hypothesised structure of the model. Conclusions The AQoL-6D descriptive system has good psychometric properties. They imply that the instrument has achieved construct validity and provides a sensitive description of HRQoL. This means that it may be used with confidence for measuring health related quality of life and that it is a suitable basis for modelling utilities for inclusion in the economic evaluation of health programs. PMID:22507254

Construction of the descriptive system for the Assessment of Quality of Life AQoL-6D utility instrument.

PubMed

Richardson, Jeffrey R J; Peacock, Stuart J; Hawthorne, Graeme; Iezzi, Angelo; Elsworth, Gerald; Day, Neil A

2012-04-17

Multi attribute utility (MAU) instruments are used to include the health related quality of life (HRQoL) in economic evaluations of health programs. Comparative studies suggest different MAU instruments measure related but different constructs. The objective of this paper is to describe the methods employed to achieve content validity in the descriptive system of the Assessment of Quality of Life (AQoL)-6D, MAU instrument. The AQoL program introduced the use of psychometric methods in the construction of health related MAU instruments. To develop the AQoL-6D we selected 112 items from previous research, focus groups and expert judgment and administered them to 316 members of the public and 302 hospital patients. The search for content validity across a broad spectrum of health states required both formative and reflective modelling. We employed Exploratory Factor Analysis and Structural Equation Modelling (SEM) to meet these dual requirements. The resulting instrument employs 20 items in a multi-tier descriptive system. Latent dimension variables achieve sensitive descriptions of 6 dimensions which, in turn, combine to form a single latent QoL variable. Diagnostic statistics from the SEM analysis are exceptionally good and confirm the hypothesised structure of the model. The AQoL-6D descriptive system has good psychometric properties. They imply that the instrument has achieved construct validity and provides a sensitive description of HRQoL. This means that it may be used with confidence for measuring health related quality of life and that it is a suitable basis for modelling utilities for inclusion in the economic evaluation of health programs.

Wind Technology Modeling Within the System Advisor Model (SAM) (Poster)

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

Blair, N.; Dobos, A.; Ferguson, T.

This poster provides detail for implementation and the underlying methodology for modeling wind power generation performance in the National Renewable Energy Laboratory's (NREL's) System Advisor Model (SAM). SAM's wind power model allows users to assess projects involving one or more large or small wind turbines with any of the detailed options for residential, commercial, or utility financing. The model requires information about the wind resource, wind turbine specifications, wind farm layout (if applicable), and costs, and provides analysis to compare the absolute or relative impact of these inputs. SAM is a system performance and economic model designed to facilitate analysismore » and decision-making for project developers, financers, policymakers, and energy researchers. The user pairs a generation technology with a financing option (residential, commercial, or utility) to calculate the cost of energy over the multi-year project period. Specifically, SAM calculates the value of projects which buy and sell power at retail rates for residential and commercial systems, and also for larger-scale projects which operate through a power purchase agreement (PPA) with a utility. The financial model captures complex financing and rate structures, taxes, and incentives.« less

Social foraging with partial (public) information.

PubMed

Mann, Ofri; Kiflawi, Moshe

2014-10-21

Group foragers can utilize public information to better estimate patch quality and arrive at more efficient patch-departure rules. However, acquiring such information may come at a cost; e.g. reduced search efficiency. We present a Bayesian group-foraging model in which social foragers do not require full awareness of their companions' foraging success; only of their number. In our model, patch departure is based on direct estimates of the number of remaining items. This is achieved by considering all likely combinations of initial patch-quality and group foraging-success; given the individual forager's experience within the patch. Slower rates of information-acquisition by our 'partially-aware' foragers lead them to over-utilize poor patches; more than fully-aware foragers. However, our model suggests that the ensuing loss in long-term intake-rates can be matched by a relatively low cost to the acquisition of full public information. In other words, we suggest that group-size offers sufficient information for optimal patch utilization by social foragers. We suggest, also, that our model is applicable to other situations where resources undergo 'background depletion', which is coincident but independent of the consumer's own utilization. Copyright © 2014 Elsevier Ltd. All rights reserved.

Does the Primary Care Behavioral Health Model Reduce Emergency Department Visits?

PubMed

Serrano, Neftali; Prince, Ronald; Fondow, Meghan; Kushner, Kenneth

2018-04-16

To examine the impact of integrating behavioral health services using the primary care behavioral health (PCBH) model on emergency department (ED) utilization. Utilization data from three Dane County, Wisconsin hospitals and four primary care clinics from 2003 to 2011. We used a retrospective, quasi-experimental, controlled, pre-post study design. Starting in 2007, two clinics began integrating behavioral health into their primary care practices with a third starting in 2010. A fourth, nonimplementing, community clinic served as control. Change in emergency department and primary care utilization (number of visits) for patients diagnosed with mood and anxiety disorders was the outcomes of interest. Retrospective data were obtained from electronic patient records from the three main area hospitals along with primary care data from participating clinics. Following the introduction of the PCBH model, one clinic experienced a statistically significant (p < .01, 95 percent CI 6.3-16.3 percent), 11.3 percent decrease in the ratio of ED visits to primary care encounters, relative to a control site, but two other intervention clinics did not. The PCBH model may be associated with a reduction in ED utilization, but better-controlled studies are needed to confirm this result. © Health Research and Educational Trust.

Physical therapists familiarity and beliefs about health services utilization and health seeking behaviour.

PubMed

Clewley, Derek; Rhon, Dan; Flynn, Tim; Koppenhaver, Shane; Cook, Chad

2018-02-21

Physical therapists' familiarity, perceptions, and beliefs about health services utilization and health seeking behaviour have not been previously assessed. The purposes of this study were to identify physical therapists' characteristics related to familiarity of health services utilization and health seeking behaviour, and to assess what health seeking behaviour factors providers felt were related to health services utilization. We administered a survey based on the Andersen behavioural model of health services utilization to physical therapists using social media campaigns and email between March and June of 2017. In addition to descriptive statistics, we performed binomial logistic regression analysis. We asked respondents to rate familiarity with health services utilization and health seeking behaviour and collected additional characteristic variables. Physical therapists are more familiar with health services utilization than health seeking behaviour. Those who are familiar with either construct tend to be those who assess for health services utilization, use health services utilization for a prognosis, and believe that health seeking behaviour is measurable. Physical therapists rated need and enabling factors as having more influence on health services utilization than predisposing and health belief factors. Physical therapists are generally familiar with health services utilization and health seeking behaviour; however, there appears to be a disconnect between what is familiar, what is perceived to be important, and what can be assessed for both health services utilization and health seeking behaviour. Copyright © 2018 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. All rights reserved.

Psychodrama: A Creative Approach for Addressing Parallel Process in Group Supervision

ERIC Educational Resources Information Center

Hinkle, Michelle Gimenez

2008-01-01

This article provides a model for using psychodrama to address issues of parallel process during group supervision. Information on how to utilize the specific concepts and techniques of psychodrama in relation to group supervision is discussed. A case vignette of the model is provided.

Bias-Corrected Estimation of Noncentrality Parameters of Covariance Structure Models

ERIC Educational Resources Information Center

Raykov, Tenko

2005-01-01

A bias-corrected estimator of noncentrality parameters of covariance structure models is discussed. The approach represents an application of the bootstrap methodology for purposes of bias correction, and utilizes the relation between average of resample conventional noncentrality parameter estimates and their sample counterpart. The…

Online Robot Dead Reckoning Localization Using Maximum Relative Entropy Optimization With Model Constraints

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

Urniezius, Renaldas

2011-03-14

The principle of Maximum relative Entropy optimization was analyzed for dead reckoning localization of a rigid body when observation data of two attached accelerometers was collected. Model constraints were derived from the relationships between the sensors. The experiment's results confirmed that accelerometers each axis' noise can be successfully filtered utilizing dependency between channels and the dependency between time series data. Dependency between channels was used for a priori calculation, and a posteriori distribution was derived utilizing dependency between time series data. There was revisited data of autocalibration experiment by removing the initial assumption that instantaneous rotation axis of a rigidmore » body was known. Performance results confirmed that such an approach could be used for online dead reckoning localization.« less

MAGDM linear-programming models with distinct uncertain preference structures.

PubMed

Xu, Zeshui S; Chen, Jian

2008-10-01

Group decision making with preference information on alternatives is an interesting and important research topic which has been receiving more and more attention in recent years. The purpose of this paper is to investigate multiple-attribute group decision-making (MAGDM) problems with distinct uncertain preference structures. We develop some linear-programming models for dealing with the MAGDM problems, where the information about attribute weights is incomplete, and the decision makers have their preferences on alternatives. The provided preference information can be represented in the following three distinct uncertain preference structures: 1) interval utility values; 2) interval fuzzy preference relations; and 3) interval multiplicative preference relations. We first establish some linear-programming models based on decision matrix and each of the distinct uncertain preference structures and, then, develop some linear-programming models to integrate all three structures of subjective uncertain preference information provided by the decision makers and the objective information depicted in the decision matrix. Furthermore, we propose a simple and straightforward approach in ranking and selecting the given alternatives. It is worth pointing out that the developed models can also be used to deal with the situations where the three distinct uncertain preference structures are reduced to the traditional ones, i.e., utility values, fuzzy preference relations, and multiplicative preference relations. Finally, we use a practical example to illustrate in detail the calculation process of the developed approach.

Valuing Treatments for Parkinson Disease Incorporating Process Utility: Performance of Best-Worst Scaling, Time Trade-Off, and Visual Analogue Scales.

PubMed

Weernink, Marieke G M; Groothuis-Oudshoorn, Catharina G M; IJzerman, Maarten J; van Til, Janine A

2016-01-01

The objective of this study was to compare treatment profiles including both health outcomes and process characteristics in Parkinson disease using best-worst scaling (BWS), time trade-off (TTO), and visual analogue scales (VAS). From the model comprising of seven attributes with three levels, six unique profiles were selected representing process-related factors and health outcomes in Parkinson disease. A Web-based survey (N = 613) was conducted in a general population to estimate process-related utilities using profile-based BWS (case 2), multiprofile-based BWS (case 3), TTO, and VAS. The rank order of the six profiles was compared, convergent validity among methods was assessed, and individual analysis focused on the differentiation between pairs of profiles with methods used. The aggregated health-state utilities for the six treatment profiles were highly comparable for all methods and no rank reversals were identified. On the individual level, the convergent validity between all methods was strong; however, respondents differentiated less in the utility of closely related treatment profiles with a VAS or TTO than with BWS. For TTO and VAS, this resulted in nonsignificant differences in mean utilities for closely related treatment profiles. This study suggests that all methods are equally able to measure process-related utility when the aim is to estimate the overall value of treatments. On an individual level, such as in shared decision making, BWS allows for better prioritization of treatment alternatives, especially if they are closely related. The decision-making problem and the need for explicit trade-off between attributes should determine the choice for a method. Copyright © 2016. Published by Elsevier Inc.

Teacher Adoption of Moodle LMS: A K-12 Diffusion Study

ERIC Educational Resources Information Center

Gagnon, Daniel A.

2012-01-01

This paper describes the diffusion of Moodle within Cherokee County Schools. The diffusion is evaluated using the Bass Model and the RIPPLES model in order to evaluate relative success or failure. The Bass Model of Diffusion was calculated utilizing forecasting by analogy in order to analyze the adoption rates in a county high school. The adoption…

Potential capabilities of lunar laser ranging for geodesy and relativity

NASA Technical Reports Server (NTRS)

Muller, Jurgen; Williams, James G.; Turshev, Slava G.; Shelus, Peter J.

2005-01-01

Here, we review the LLR technique focusing on its impact on Geodesy and Relativity. We discuss the modem observational accuracy and the level of existing LLR modeling. We present the near-term objectives and emphasize improvements needed to fully utilize the scientific potential of LLR.

Individual vision and peak distribution in collective actions

NASA Astrophysics Data System (ADS)

Lu, Peng

2017-06-01

People make decisions on whether they should participate as participants or not as free riders in collective actions with heterogeneous visions. Besides of the utility heterogeneity and cost heterogeneity, this work includes and investigates the effect of vision heterogeneity by constructing a decision model, i.e. the revised peak model of participants. In this model, potential participants make decisions under the joint influence of utility, cost, and vision heterogeneities. The outcomes of simulations indicate that vision heterogeneity reduces the values of peaks, and the relative variance of peaks is stable. Under normal distributions of vision heterogeneity and other factors, the peaks of participants are normally distributed as well. Therefore, it is necessary to predict distribution traits of peaks based on distribution traits of related factors such as vision heterogeneity and so on. We predict the distribution of peaks with parameters of both mean and standard deviation, which provides the confident intervals and robust predictions of peaks. Besides, we validate the peak model of via the Yuyuan Incident, a real case in China (2014), and the model works well in explaining the dynamics and predicting the peak of real case.

Mental health status and healthcare utilization among community dwelling older adults.

PubMed

Adepoju, Omolola; Lin, Szu-Hsuan; Mileski, Michael; Kruse, Clemens Scott; Mask, Andrew

2018-04-27

Shifts in mental health utilization patterns are necessary to allow for meaningful access to care for vulnerable populations. There have been long standing issues in how mental health is provided, which has caused problems in that care being efficacious for those seeking it. To assess the relationship between mental health status and healthcare utilization among adults ≥65 years. A negative binomial regression model was used to assess the relationship between mental health status and healthcare utilization related to office-based physician visits, while a two-part model, consisting of logistic regression and negative binomial regression, was used to separately model emergency visits and inpatient services. The receipt of care in office-based settings were marginally higher for subjects with mental health difficulties. Both probabilities and counts of inpatient hospitalizations were similar across mental health categories. The count of ER visits was similar across mental health categories; however, the probability of having an emergency department visit was marginally higher for older adults who reported mental health difficulties in 2012. These findings are encouraging and lend promise to the recent initiatives on addressing gaps in mental healthcare services.

A spatial dynamic model to assess piospheric land degradation processes of SW Iberian rangelands

NASA Astrophysics Data System (ADS)

Herguido Sevillano, Estela; Ibáñez, Javier; Francisco Lavado Contador, Joaquín; Pulido-Fernández, Manuel; Schnabel, Susanne

2015-04-01

Iberian open wooded rangelands (known as dehesas or montados) constitute valuable agro-silvo-pastoral systems traditionally considered as highly sustainable. Nevertheless, in the recent decades, those systems are undergoing changes of land use and management practices that compromise its sustainability. Some of those changes, as the rising construction of watering points and the high spatial fragmentation and livestock movement restriction associated to fencing, show an aggregated effect with livestock, producing an impact gradient over soil and vegetation. Soil compaction related to livestock pressure is higher around watering points, with bare soil halos and patches of scarce vegetation or nude soil developing with higher frequency in areas close to them. Using the freeware Dinamica EGO as environmental modeling platform, we have developed a theoretic spatial dynamic model that represents some of the processes of land degradation associated to livestock grazing in dehesa fenced enclosures. Spatial resolution is high since every cell in the model is a square unit area of 1 m2. We paid particular attention to the relationships between soil degradation by compaction (porosity), livestock pressure, rainfall, pasture growth and shrub cover and bare soil generation. The model considers pasture growth as related to soil compaction, measured by the pore space in the top 10 cm soil layer. Annual precipitation is randomly generated following a normal distribution. When annual precipitation and pore space increase, also does pasture growth. Besides, there is a feedback between pasture growth and pore space, given that pasture roots increases soil porosity. The cell utility for livestock function has been defined as an exponential function of the distance of a cell to watering points and the amount of pasture present in it. The closer the cell to a pond and the higher the amount of pasture, the higher is cell utility. The latter is modulated by a normal random variable to capture accidental effects. This variable has zero mean and a standard deviation linearly related to the distance to the pond. Livestock utilization of a cell is a function of its relative utility, the stocking rate and the time that animals spend at the enclosure. Since livestock trampling promotes soil compaction, livestock utilization has a negative effect on pore space. The probability of transition from herbaceous to shrubs is also modulated by pore space, and thus livestock utilization, as shrub development needs a minimum porosity value for seeds to successfully germinate. In addition, it is influenced by the proportion of cells occupied by shrubs in a radius where seed dispersal or exclusion by competition may occur. The model contemplates the probability of transition from shrubs to herbaceous through shrub mortality, and the age of the shrubs, which influences seed production and shrub cover. Pasture consumption by livestock and pasture remaining at the end of summer were also modeled, so that it is possible to obtain maps of bare soil at that time. Likewise, the model generates maps of vegetation state (shrubs or herbaceous) and pasture growth. The values of the set of 31 parameters were obtained from field measurements and from publications. Those parameters lacking quantitative information were calibrated by comparing model performance with the dynamics of true enclosures analyzed between 1984 and 2009 in ortophotographs. Stocking rates were inferred from farmers' interviews performed in 2009 about present and past land use and management practices. The model developed is intended to analyze strategies of livestock management in dehesas. Particularly, soil conservation practices as related to livestock pressure can be simulated looking for optimized schemes. Moreover, the model provides the possibility of generating simulations for future climate scenarios, studying the effects of climate change on livestock carrying capacity on these systems. Thanks to the Spanish Ministerio de Economía y Competitividad for financially supporting this study through AMID (CGL2011-23361) project.

Measuring the potential utility of seasonal climate predictions

NASA Astrophysics Data System (ADS)

Tippett, Michael K.; Kleeman, Richard; Tang, Youmin

2004-11-01

Variation of sea surface temperature (SST) on seasonal-to-interannual time-scales leads to changes in seasonal weather statistics and seasonal climate anomalies. Relative entropy, an information theory measure of utility, is used to quantify the impact of SST variations on seasonal precipitation compared to natural variability. An ensemble of general circulation model (GCM) simulations is used to estimate this quantity in three regions where tropical SST has a large impact on precipitation: South Florida, the Nordeste of Brazil and Kenya. We find the yearly variation of relative entropy is strongly correlated with shifts in ensemble mean precipitation and weakly correlated with ensemble variance. Relative entropy is also found to be related to measures of the ability of the GCM to reproduce observations.

A systematic review of the quality of economic models comparing thrombosis inhibitors in patients with acute coronary syndrome undergoing percutaneous coronary intervention.

PubMed

Hatz, Maximilian H M; Leidl, Reiner; Yates, Nichola A; Stollenwerk, Björn

2014-04-01

Thrombosis inhibitors can be used to treat acute coronary syndromes (ACS). However, there are various alternative treatment strategies, of which some have been compared using health economic decision models. To assess the quality of health economic decision models comparing thrombosis inhibitors in patients with ACS undergoing percutaneous coronary intervention, and to identify areas for quality improvement. The literature databases MEDLINE, EMBASE, EconLit, National Health Service Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment (HTA). A review of the quality of health economic decision models was conducted by two independent reviewers, using the Philips checklist. Twenty-one relevant studies were identified. Differences were apparent regarding the model type (six decision trees, four Markov models, eight combinations, three undefined models), the model structure (types of events, Markov states) and the incorporation of data (efficacy, cost and utility data). Critical issues were the absence of particular events (e.g. thrombocytopenia, stroke) and questionable usage of utility values within some studies. As we restricted our search to health economic decision models comparing thrombosis inhibitors, interesting aspects related to the quality of studies of adjacent medical areas that compared stents or procedures could have been missed. This review identified areas where recommendations are indicated regarding the quality of future ACS decision models. For example, all critical events and relevant treatment options should be included. Models also need to allow for changing event probabilities to correctly reflect ACS and to incorporate appropriate, age-specific utility values and decrements when conducting cost-utility analyses.

Risk Decision Making Model for Reservoir Floodwater resources Utilization

NASA Astrophysics Data System (ADS)

Huang, X.

2017-12-01

Floodwater resources utilization(FRU) can alleviate the shortage of water resources, but there are risks. In order to safely and efficiently utilize the floodwater resources, it is necessary to study the risk of reservoir FRU. In this paper, the risk rate of exceeding the design flood water level and the risk rate of exceeding safety discharge are estimated. Based on the principle of the minimum risk and the maximum benefit of FRU, a multi-objective risk decision making model for FRU is constructed. Probability theory and mathematical statistics method is selected to calculate the risk rate; C-D production function method and emergy analysis method is selected to calculate the risk benefit; the risk loss is related to flood inundation area and unit area loss; the multi-objective decision making problem of the model is solved by the constraint method. Taking the Shilianghe reservoir in Jiangsu Province as an example, the optimal equilibrium solution of FRU of the Shilianghe reservoir is found by using the risk decision making model, and the validity and applicability of the model are verified.

Predictions of LDEF radioactivity and comparison with measurements

NASA Technical Reports Server (NTRS)

Armstrong, T. W.; Colborn, B. L.; Harmon, B. A.; Laird, C. E.

1995-01-01

As part of the program to utilize LDEF data for evaluation and improvement of current ionizing radiation environmental models and related predictive methods for future LEO missions, calculations have been carried out to compare with the induced radioactivity measured in metal samples placed on LDEF. The predicted activation is about a factor of two lower than observed, which is attributed to deficiencies in the AP8 trapped proton model. It is shown that this finding based on activation sample data is consistent with comparisons made with other LDEF activation and dose data. Plans for confirming these results utilizing additional LDEF data sets, and plans for model modifications to improve the agreement with LDEF data, are discussed.

Multiattribute health utility scoring for the computerized adaptive measure CAT-5D-QOL was developed and validated.

PubMed

Kopec, Jacek A; Sayre, Eric C; Rogers, Pamela; Davis, Aileen M; Badley, Elizabeth M; Anis, Aslam H; Abrahamowicz, Michal; Russell, Lara; Rahman, Md Mushfiqur; Esdaile, John M

2015-10-01

The CAT-5D-QOL is a previously reported item response theory (IRT)-based computerized adaptive tool to measure five domains (attributes) of health-related quality of life. The objective of this study was to develop and validate a multiattribute health utility (MAHU) scoring method for this instrument. The MAHU scoring system was developed in two stages. In phase I, we obtained standard gamble (SG) utilities for 75 hypothetical health states in which only one domain varied (15 states per domain). In phase II, we obtained SG utilities for 256 multiattribute states. We fit a multiplicative regression model to predict SG utilities from the five IRT domain scores. The prediction model was constrained using data from phase I. We validated MAHU scores by comparing them with the Health Utilities Index Mark 3 (HUI3) and directly measured utilities and by assessing between-group discrimination. MAHU scores have a theoretical range from -0.842 to 1. In the validation study, the scores were, on average, higher than HUI3 utilities and lower than directly measured SG utilities. MAHU scores correlated strongly with the HUI3 (Spearman ρ = 0.78) and discriminated well between groups expected to differ in health status. Results reported here provide initial evidence supporting the validity of the MAHU scoring system for the CAT-5D-QOL. Copyright © 2015 Elsevier Inc. All rights reserved.

Application of the PRECEDE Model to Understanding Mental Health Promoting Behaviors in Hong Kong

ERIC Educational Resources Information Center

Mo, Phoenix K. H.; Mak, Winnie W. S.

2008-01-01

The burdens related to mental illness have been increasingly recognized in many countries. Nevertheless, research in positive mental health behaviors remains scarce. This study utilizes the Predisposing, Reinforcing, and Enabling Causes in Education Diagnosis and Evaluation (PRECEDE) model to identify factors associated with mental health…

Per capita alcohol consumption and suicide mortality in a panel of US states from 1950 to 2002

PubMed Central

Kerr, William C.; Subbaraman, Meenakshi; Ye, Yu

2011-01-01

Introduction and Aims The relationship between per capita alcohol consumption and suicide rates has been found to vary in significance and magnitude across countries. This study utilizes a panel of time-series measures from the US states to estimate the effects of changes in current and lagged alcohol sales on suicide mortality risk. Design and Methods Generalized least squares estimation utilized 53 years of data from 48 US states or state groups to estimate relationships between total and beverage-specific alcohol consumption measures and age-standardized suicide mortality rates in first-differenced semi-logged models. Results An additional liter of ethanol from total alcohol sales was estimated to increase suicide rates by 2.3% in models utilizing a distributed lag specification while no effect was found in models including only current alcohol consumption. A similar result is found for men, while for women both current and distributed lag measures were found to be significantly related to suicide rates with an effect of about 3.2% per liter from current and 5.8% per liter from the lagged measure. Beverage-specific models indicate that spirits is most closely linked with suicide risk for women while beer and wine are for men. Unemployment rates are consistently positively related to suicide rates. Discussion and Conclusions Results suggest that chronic effects, potentially related to alcohol abuse and dependence, are the main source of alcohol’s impact on suicide rates in the US for men and are responsible for about half of the effect for women. PMID:21896069

Utilization of dental health care services in context of the HIV epidemic- a cross-sectional study of dental patients in the Sudan.

PubMed

Nasir, Elwalid Fadul; Astrøm, Anne Nordrehaug; David, Jamil; Ali, Raouf Wahab

2009-11-16

HIV infected patients should be expected in the Sudanese dental health care services with an increasing frequency. Dental care utilization in the context of the HIV epidemic is generally poorly understood. Focusing on Sudanese dental patients with reported unknown HIV status, this study assessed the extent to which Andersen's model in terms of predisposing (socio-demographics), enabling (knowledge, attitudes and perceived risk related to HIV) and need related factors (oral health status) predict dental care utilization. It was hypothesized that enabling factors would add to the explanation of dental care utilization beyond that of predisposing and need related factors. Dental patients were recruited from Khartoum Dental Teaching Hospital (KDTH) and University of Science and Technology (UST) during March-July 2008. A total of 1262 patients (mean age 30.7, 56.5% females and 61% from KDTH) were examined clinically (DMFT) and participated in an interview. A total of 53.9% confirmed having attended a dental clinic for treatment at least once in the past 2 years. Logistic regression analysis revealed that predisposing factors; travelling inside Sudan (OR = 0.5) were associated with lower odds and females were associated with higher odds (OR = 2.0) for dental service utilization. Enabling factors; higher knowledge of HIV transmission (OR = 0.6) and higher HIV related experience (OR = 0.7) were associated with lower odds, whereas positive attitudes towards infected people and high perceived risk of contagion (OR = 1.3) were associated with higher odds for dental care utilization. Among need related factors dental caries experience was strongly associated with dental care utilization (OR = 4.8). Disparity in the history of dental care utilization goes beyond socio-demographic position and need for dental care. Public awareness of HIV infection control and confidence on the competence of dentists should be improved to minimize avoidance behaviour and help establish dental health care patterns in Sudan.

Upper limb strength estimation of physically impaired persons using a musculoskeletal model: A sensitivity analysis.

PubMed

Carmichael, Marc G; Liu, Dikai

2015-01-01

Sensitivity of upper limb strength calculated from a musculoskeletal model was analyzed, with focus on how the sensitivity is affected when the model is adapted to represent a person with physical impairment. Sensitivity was calculated with respect to four muscle-tendon parameters: muscle peak isometric force, muscle optimal length, muscle pennation, and tendon slack length. Results obtained from a musculoskeletal model of average strength showed highest sensitivity to tendon slack length, followed by muscle optimal length and peak isometric force, which is consistent with existing studies. Muscle pennation angle was relatively insensitive. The analysis was repeated after adapting the musculoskeletal model to represent persons with varying severities of physical impairment. Results showed that utilizing the weakened model significantly increased the sensitivity of the calculated strength at the hand, with parameters previously insensitive becoming highly sensitive. This increased sensitivity presents a significant challenge in applications utilizing musculoskeletal models to represent impaired individuals.

Application of symbolic computations to the constitutive modeling of structural materials

NASA Technical Reports Server (NTRS)

Arnold, Steven M.; Tan, H. Q.; Dong, X.

1990-01-01

In applications involving elevated temperatures, the derivation of mathematical expressions (constitutive equations) describing the material behavior can be quite time consuming, involved and error-prone. Therefore intelligent application of symbolic systems to faciliate this tedious process can be of significant benefit. Presented here is a problem oriented, self contained symbolic expert system, named SDICE, which is capable of efficiently deriving potential based constitutive models in analytical form. This package, running under DOE MACSYMA, has the following features: (1) potential differentiation (chain rule), (2) tensor computations (utilizing index notation) including both algebraic and calculus; (3) efficient solution of sparse systems of equations; (4) automatic expression substitution and simplification; (5) back substitution of invariant and tensorial relations; (6) the ability to form the Jacobian and Hessian matrix; and (7) a relational data base. Limited aspects of invariant theory were also incorporated into SDICE due to the utilization of potentials as a starting point and the desire for these potentials to be frame invariant (objective). The uniqueness of SDICE resides in its ability to manipulate expressions in a general yet pre-defined order and simplify expressions so as to limit expression growth. Results are displayed, when applicable, utilizing index notation. SDICE was designed to aid and complement the human constitutive model developer. A number of examples are utilized to illustrate the various features contained within SDICE. It is expected that this symbolic package can and will provide a significant incentive to the development of new constitutive theories.

Organizational Justice As a Predictor of Organizational Silence

ERIC Educational Resources Information Center

Tan, Çetin

2014-01-01

In this study, relation between teachers' perception for organizational justice and their organizational silence was examined. Sample of this study consists of 300 teachers who work at elementary schools in Siirt. Relational Scanning model was utilized in performance of this study. In this study, Organizational Justice Scale and Organizational…

Modeling the predictive value of pain intensity on costs and resources utilization in patients with peripheral neuropathic pain.

PubMed

Pérez, Concepción; Navarro, Ana; Saldaña, María T; Wilson, Koo; Rejas, Javier

2015-03-01

The aim of the present analysis was to model the association and predictive value of pain intensity on cost and resource utilization in patients with chronic peripheral neuropathic pain (PNP) treated in routine clinical practice settings in Spain. We performed a secondary economic analysis based on data from a multicenter, observational, and prospective cost-of-illness study in patients with chronic PNP that is refractory to prior treatment. Pain intensity was measured using the Short-Form McGill Pain Questionnaire. Univariate and multivariate linear regression models were fitted to identify independent predictors of cost and health care/non-health care resource utilization. A total of 1703 patients were included in the current analysis. Pain intensity was an independent predictor of total costs ([total costs]=35.6 [pain intensity]+214.5; coefficient of determination [R(2)]=0.19, P<0.001), direct costs ([direct costs]=10.8 [pain intensity]+257.7; R=0.06, P<0.001), and indirect costs ([indirect costs]=24.8 [pain intensity]-43.4; R(2)=0.20, P<0.001) related to chronic PNP in the univariate analysis. Pain intensity remains significantly associated with total costs, direct costs, and indirect costs after adjustment by other covariates in the multivariate analysis (P<0.001). None of the other variables considered in the multivariate analysis were predictors of resource utilization. Pain intensity predicts the health care and non-health care resource utilization, and costs related to chronic PNP. Management of patients with drugs associated with a higher reduction of pain intensity may have a greater impact on the economic burden of that condition.

Exploring Geographic Variation of Mental Health Risk and Service Utilization of Doctors and Hospitals in Toronto: A Shared Component Spatial Modeling Approach

PubMed Central

Perlman, Christopher

2018-01-01

Mental Health has been known to vary geographically. Different rates of utilization of mental health services in local areas reflect geographic variation of mental health and complexity of health care. Variations and inequalities in how the health care system addresses risks are two critical issues for addressing population mental health. This study examines these issues by analyzing the utilization of mental health services in Toronto at the neighbourhood level. We adopted a shared component spatial modeling approach that allows simultaneous analysis of two main health service utilizations: doctor visits and hospitalizations related to mental health conditions. Our results reflect a geographic variation of both types of mental health service utilization across neighbourhoods in Toronto. We identified hot and cold spots of mental health risks that are common to both or specific to only one type of health service utilization. Based on the evidence found, we discuss intervention strategies, focusing on the hotspots and provision of health services about doctors and hospitals, to improve mental health for the neighbourhoods. Limitations of the study and further research directions are also discussed. PMID:29587426

Transfer and Use of Training Technology: A Model for Matching Training Approaches with Training Settings. Technical Report No. 74-24.

ERIC Educational Resources Information Center

Haverland, Edgar M.

The report describes a project designed to facilitate the transfer and utilization of training technology by developing a model for evaluating training approaches or innovtions in relation to the requirements, resources, and constraints of specific training settings. The model consists of two parallel sets of open-ended questions--one set…

A Multilevel Logit Estimation on the Determinants of Utilization of Preventive Health Care and Healthy Lifestyle Practice in China

PubMed Central

Fan, Lida; Liu, Jianye; Habibov, Nazim N

2015-01-01

The purpose of this study is to provide policy implications by estimating the individual and community level determinants of preventive health-care utilization in China based upon data from the China Health and Nutrition Survey. Two different frameworks, a human capital model and a psychological-behavioral model, are tested using a multilevel logit estimation. The results demonstrate different patterns for medical and nonmedical preventive activities. There is a strong correlation between having medical insurance and utilizing preventive health services. For the usage of medical-related preventive health care (MP), age, gender, education, urban residence, and medical insurance are strong predictors. High income did not provide much of an increase in the usage level of MP, but the lack of income was a huge obstacle for low-income people to overcome. Community variation in number of facilities accounted for about one third of the total variation in the utilization of MP. The utilization of MP in China remains dependent upon the individual's social-economic conditions. PMID:26688776

Patient truthfulness: a test of models of the physician-patient relationship.

PubMed

Vanderpool, H Y; Weiss, G B

1984-11-01

Little attention has been given in medical ethics literature to issues relating to the truthfulness of patients. Beginning with an actual medical case, this paper first explores truth-telling by doctors and patients as related to two prominent models of the physician-patient relationship. Utilizing this discussion and the literature on the truthfulness and accuracy of the information patients convey to doctors, these models are then critically assessed. It is argued that the patient agency (patient autonomy or contractual) model is inherently and seriously flawed in numerous circumstances, even those involving informed and competent adult patients.

[Factors conditioning primary care services utilization. Empirical evidence and methodological inconsistencies].

PubMed

Sáez, M

2003-01-01

In Spain, the degree and characteristics of primary care services utilization have been the subject of analysis since at least the 1980s. One of the main reasons for this interest is to assess the extent to which utilization matches primary care needs. In fact, the provision of an adequate health service for those who most need it is a generally accepted priority. The evidence shows that individual characteristics, mainly health status, are the factors most closely related to primary care utilization. Other personal characteristics, such as gender and age, could act as modulators of health care need. Some family and/or cultural variables, as well as factors related to the health care professional and institutions, could explain some of the observed variability in primary care services utilization. Socioeconomic variables, such as income, reveal a paradox. From an aggregate perspective, income is the main determinant of utilization as well as of health care expenditure. When data are analyzed for individuals, however, income is not related to primary health utilization. The situation is controversial, with methodological implications and, above all, consequences for the assessment of the efficiency in primary care utilization. Review of the literature reveals certain methodological inconsistencies that could at least partly explain the disparity of the empirical results. Among others, the following flaws can be highlighted: design problems, measurement errors, misspecification, and misleading statistical methods.Some solutions, among others, are quasi-experiments, the use of large administrative databases and of primary data sources (design problems); differentiation between types of utilization and between units of analysis other than consultations, and correction of measurement errors in the explanatory variables (measurement errors); consideration of relevant explanatory variables (misspecification); and the use of multilevel models (statistical methods).

Correlation between multispectral photography and near-surface turbidities

NASA Technical Reports Server (NTRS)

Wertz, D. L.; Mealor, W. T.; Steele, M. L.; Pinson, J. W.

1976-01-01

Four-band multispectral photography obtained from an aerial platform at an altitude of about 10,000 feet has been utilized to measure near-surface turbidity at numerous sampling sites in the Ross Barnett Reservoir, Mississippi. Correlation of the photographs with turbidity measurements has been accomplished via an empirical mathematical model which depends upon visual color recognition when the composited photographs are examined on either an I squared S model 600 or a Spectral Data model 65 color-additive viewer. The mathematical model was developed utilizing least-squares, iterative, and standard statistical methods and includes a time-dependent term related to sun angle. This model is consistent with information obtained from two overflights of the target area - July 30, 1973 and October 30, 1973 - and now is being evaluated with regard to information obtained from a third overflight on November 8, 1974.

Application of advanced preclinical models and methods in anesthetic neurotoxicity research.

PubMed

Wang, Cheng; Zhang, Xuan; Liu, Fang

2017-05-01

Recently, there has been increasing concern regarding the potential of anesthetics to disturb the long-term function of the central nervous system (CNS). The field of anesthesia-related toxicology, therefore, has engaged multiple scientific disciplines and utilized a variety of pre-clinical research models in an attempt to identify the basic characteristics of the anesthetic agents that may produce acute and/or chronic adverse effects on the CNS. This review discusses how the application of advanced research approaches and models, such as the nonhuman primate, neural stem cell-derived organotypic slice cultures and/or organs-on-chips systems, can serve as translational models of infantile anesthetic exposure. Utilization of these models may expeditiously decrease the uncertainty in the risk posed to children by postnatal anesthetic exposure. Copyright © 2017. Published by Elsevier Inc.

A non-isotropic multiple-scale turbulence model

NASA Technical Reports Server (NTRS)

Chen, C. P.

1990-01-01

A newly developed non-isotropic multiple scale turbulence model (MS/ASM) is described for complex flow calculations. This model focuses on the direct modeling of Reynolds stresses and utilizes split-spectrum concepts for modeling multiple scale effects in turbulence. Validation studies on free shear flows, rotating flows and recirculating flows show that the current model perform significantly better than the single scale k-epsilon model. The present model is relatively inexpensive in terms of CPU time which makes it suitable for broad engineering flow applications.

Knowledge, attitudes, practices, and barriers related to research utilization: a survey among pharmacists in Malaysia.

PubMed

Tan, Sin Yee; Hatah, Ernieda

2017-04-01

Background Research utilization is part of evidence-based practice referring to the process of reviewing and critiquing scientific research and applying the findings to one's own clinical practice. Many studies on research utilization have been conducted with doctors and nurses, but to our knowledge, none have been investigated amongst pharmacists. Objective To assess research utilization and its barriers among pharmacists and identify potential influencing factors. Setting Malaysia. Methods This cross-sectional survey was administered online and by mail to a convenient sample of pharmacists working in hospitals, health clinics, and retail pharmacies in rural and urban areas. Main outcome measure Pharmacists' research utilization knowledge, attitudes, and practices. Results Six hundred surveys were mailed to potential respondents, and 466 were returned (77.7% response rate). Twenty-eight respondents completed the survey online. The respondents' research utilization knowledge, attitudes, and practices were found to be moderate. Research utilization was associated with respondents' knowledge and attitude scores (P < 0.001). When factors related to research utilization were modelled, higher educational level was associated with higher level of research utilization (P < 0.001) while less involvement in journal clubs, more years of service (3-7 years and more than 7 years) were associated with low and moderate research utilization, respectively. The main reported barrier to research utilization was lack of sufficient authority to change patient care procedures. Conclusion Pharmacists' research utilization knowledge, attitudes, and practices can be improved by encouraging pharmacists to pursue higher degrees, promoting active participation in institutions' journal clubs, and introducing senior clinical pharmacist specialization.

Grief responses, coping processes, and social support of widows: research with Roy's model.

PubMed

Robinson, J H

1995-01-01

This ex post facto descriptive correlational design study of widows during their second year of bereavement utilizes Roy's adaptation model as a guiding framework. Contextual stimuli (social support, social network, income/education, spiritual beliefs) were related to the cognator function (coping process), which was related to adaptation outcome (grief response). Significant moderate positive relationships were found between social support and coping process, and between social network and coping process. A significant relationship was also found between coping process and grief response. The path model accounted for 18% explained variance.

Activity-Based Costing Systems for Higher Education.

ERIC Educational Resources Information Center

Day, Dennis H.

1993-01-01

Examines traditional costing models utilized in higher education and pinpoints shortcomings related to proper identification of costs. Describes activity-based costing systems as a superior alternative for cost identification, measurement, and allocation. (MLF)

Green leaf volatiles, fire and nonanoic acid activate MAPkinases in the model grass species Lolium temulentum

USDA-ARS?s Scientific Manuscript database

Forage and turf related grasses are utilized in diverse environments where they are routinely subjected to herbicides and exposed to fire and volatiles after cutting, however very little is known concerning the perception or molecular responses to these different stresses or compounds. In the model ...

Exploring the Utility of Workload Models in Academe: A Pilot Study

ERIC Educational Resources Information Center

Boyd, Leanne

2014-01-01

The workload of academics in Australia is increasing. Among the potential ramifications of this are work-related stress and burnout. Unions have negotiated workload models in employment agreements as a means of distributing workload in a fair and transparent manner. This qualitative pilot study aimed to explore how academics perceive their current…

Assessing the Utility of the Willingness/Prototype Model in Predicting Help-Seeking Decisions

ERIC Educational Resources Information Center

Hammer, Joseph H.; Vogel, David L.

2013-01-01

Prior research on professional psychological help-seeking behavior has operated on the assumption that the decision to seek help is based on intentional and reasoned processes. However, research on the dual-process prototype/willingness model (PWM; Gerrard, Gibbons, Houlihan, Stock, & Pomery, 2008) suggests health-related decisions may also…

Spatial scaling and multi-model inference in landscape genetics: Martes americana in northern Idaho

Treesearch

Tzeidle N. Wasserman; Samuel A. Cushman; Michael K. Schwartz; David O. Wallin

2010-01-01

Individual-based analyses relating landscape structure to genetic distances across complex landscapes enable rigorous evaluation of multiple alternative hypotheses linking landscape structure to gene flow. We utilize two extensions to increase the rigor of the individual-based causal modeling approach to inferring relationships between landscape patterns and gene flow...

A model (CMBP) for collaboration between university college and nursing practice to promote research utilization in students' clinical placements: a pilot study.

PubMed

Elsborg Foss, Jette; Kvigne, Kari; Wilde Larsson, Bodil; Athlin, Elsy

2014-08-01

A collaborative project was initiated in Norway between a university college and a hospital in order to improve RNs' and nursing students' research utilization in clinical placements. This paper describes the model (CMBP) that was developed, its first application, and evaluation. The evaluation aimed at describing nurses' and students' experiences of the CMBP related to collaboration, facilitation, learning, and impact on nursing care. Thirty-eight students from the second and third year of nursing education, and four nurses answered questionnaires with closed and open ended questions. In addition two of the nurses wrote diaries. Data were subjected to qualitative and quantitative analysis. Almost all participants reported that collaboration between nursing college and nursing practice had been beneficial. Most students and all nurses reported about valuable learning, increased understanding of research utilization, and improved quality of nursing care. Both students and RNs recommended the CMBP to be used in all clinical placements to support academic learning and increase research utilization in clinical practice. Despite study limitations the findings indicate that the CMBP has a potential to be a useful model for teaching RNs' and students EBP. However, further refinement of the model is needed, followed by a more comprehensive implementation and evaluation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Overrepresentation of extreme events in decision making reflects rational use of cognitive resources.

PubMed

Lieder, Falk; Griffiths, Thomas L; Hsu, Ming

2018-01-01

People's decisions and judgments are disproportionately swayed by improbable but extreme eventualities, such as terrorism, that come to mind easily. This article explores whether such availability biases can be reconciled with rational information processing by taking into account the fact that decision makers value their time and have limited cognitive resources. Our analysis suggests that to make optimal use of their finite time decision makers should overrepresent the most important potential consequences relative to less important, put potentially more probable, outcomes. To evaluate this account, we derive and test a model we call utility-weighted sampling. Utility-weighted sampling estimates the expected utility of potential actions by simulating their outcomes. Critically, outcomes with more extreme utilities have a higher probability of being simulated. We demonstrate that this model can explain not only people's availability bias in judging the frequency of extreme events but also a wide range of cognitive biases in decisions from experience, decisions from description, and memory recall. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

An Integrated Parent-Teacher-Related Service Team Approach to Communication Intervention. Final Report.

ERIC Educational Resources Information Center

Stremel, Kathleen; Wilson, Rebecca

This final report describes a federally funded 3-year project for integrating related services within educational objectives for children (ages 3-10) with dual vision and hearing impairments. A Training-Utilization model of inservice training and technical assistance was developed, implemented, and evaluated to address the communication needs of…

The Presence of a Calling and Academic Satisfaction: Examining Potential Mediators

ERIC Educational Resources Information Center

Duffy, Ryan D.; Allan, Blake A.; Dik, Bryan J.

2011-01-01

The present study examined the relation of calling and academic satisfaction with a diverse sample of 312 undergraduate students. The presence of a calling was moderately correlated with academic satisfaction, and a multiple mediation model was utilized to test three potential mediators to this relation: career decision self-efficacy, work hope,…

Analytic expressions for Atomic Layer Deposition: coverage, throughput, and materials utilization in cross-flow, particle coating, and spatial ALD

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

Yanguas-Gil, Angel; Elam, Jeffrey W.

2014-05-01

In this work, the authors present analytic models for atomic layer deposition (ALD) in three common experimental configurations: cross-flow, particle coating, and spatial ALD. These models, based on the plug-flow and well-mixed approximations, allow us to determine the minimum dose times and materials utilization for all three configurations. A comparison between the three models shows that throughput and precursor utilization can each be expressed by universal equations, in which the particularity of the experimental system is contained in a single parameter related to the residence time of the precursor in the reactor. For the case of cross-flow reactors, the authorsmore » show how simple analytic expressions for the reactor saturation profiles agree well with experimental results. Consequently, the analytic model can be used to extract information about the ALD surface chemistry (e. g., the reaction probability) by comparing the analytic and experimental saturation profiles, providing a useful tool for characterizing new and existing ALD processes. (C) 2014 American Vacuum Society« less

Mapping CHU9D Utility Scores from the PedsQLTM 4.0 SF-15.

PubMed

Mpundu-Kaambwa, Christine; Chen, Gang; Russo, Remo; Stevens, Katherine; Petersen, Karin Dam; Ratcliffe, Julie

2017-04-01

The Pediatric Quality of Life Inventory™ 4.0 Short Form 15 Generic Core Scales (hereafter the PedsQL) and the Child Health Utility-9 Dimensions (CHU9D) are two generic instruments designed to measure health-related quality of life in children and adolescents in the general population and paediatric patient groups living with specific health conditions. Although the PedsQL is widely used among paediatric patient populations, presently it is not possible to directly use the scores from the instrument to calculate quality-adjusted life-years (QALYs) for application in economic evaluation because it produces summary scores which are not preference-based. This paper examines different econometric mapping techniques for estimating CHU9D utility scores from the PedsQL for the purpose of calculating QALYs for cost-utility analysis. The PedsQL and the CHU9D were completed by a community sample of 755 Australian adolescents aged 15-17 years. Seven regression models were estimated: ordinary least squares estimator, generalised linear model, robust MM estimator, multivariate factorial polynomial estimator, beta-binomial estimator, finite mixture model and multinomial logistic model. The mean absolute error (MAE) and the mean squared error (MSE) were used to assess predictive ability of the models. The MM estimator with stepwise-selected PedsQL dimension scores as explanatory variables had the best predictive accuracy using MAE and the equivalent beta-binomial model had the best predictive accuracy using MSE. Our mapping algorithm facilitates the estimation of health-state utilities for use within economic evaluations where only PedsQL data is available and is suitable for use in community-based adolescents aged 15-17 years. Applicability of the algorithm in younger populations should be assessed in further research.

A socio-technical investigation of the smart grid: Implications for demand-side activities of electricity service providers

NASA Astrophysics Data System (ADS)

Corbett, Jacqueline Marie

Enabled by advanced communication and information technologies, the smart grid represents a major transformation for the electricity sector. Vast quantities of data and two-way communications abilities create the potential for a flexible, data-driven, multi-directional supply and consumption network well equipped to meet the challenges of the next century. For electricity service providers ("utilities"), the smart grid provides opportunities for improved business practices and new business models; however, a transformation of such magnitude is not without risks. Three related studies are conducted to explore the implications of the smart grid on utilities' demand-side activities. An initial conceptual framework, based on organizational information processing theory, suggests that utilities' performance depends on the fit between the information processing requirements and capacities associated with a given demand-side activity. Using secondary data and multiple regression analyses, the first study finds, consistent with OIPT, a positive relationship between utilities' advanced meter deployments and demand-side management performance. However, it also finds that meters with only data collection capacities are associated with lower performance, suggesting the presence of information waste causing operational inefficiencies. In the second study, interviews with industry participants provide partial support for the initial conceptual model, new insights are gained with respect to information processing fit and information waste, and "big data" is identified as a central theme of the smart grid. To derive richer theoretical insights, the third study employs a grounded theory approach examining the experience of one successful utility in detail. Based on interviews and documentary data, the paradox of dynamic stability emerges as an essential enabler of utilities' performance in the smart grid environment. Within this context, the frames of opportunity, control, and data limitation interact to support dynamic stability and contribute to innovation within tradition. The main contributions of this thesis include theoretical extensions to OIPT and the development of an emergent model of dynamic stability in relation to big data. The thesis also adds to the green IS literature and identifies important practical implications for utilities as they endeavour to bring the smart grid to reality.

The MIKS (Member Integrated Knowledge System) Model: A Visualization of the Individual Organizational Member's Role When a Knowledge Management System Is Utilized in the Learning Organization

ERIC Educational Resources Information Center

Grobmeier, Cynthia

2007-01-01

Relating knowledge management (KM) case studies in various organizational contexts to existing theoretical constructs of learning organizations, a new model, the MIKS (Member Integrated Knowledge System) Model is proposed to include the role of the individual in the process. Their degree of motivation as well as communication and learning…

A Comparison of Four Estimators of a Population Measure of Model Fit in Covariance Structure Analysis

ERIC Educational Resources Information Center

Zhang, Wei

2008-01-01

A major issue in the utilization of covariance structure analysis is model fit evaluation. Recent years have witnessed increasing interest in various test statistics and so-called fit indexes, most of which are actually based on or closely related to F[subscript 0], a measure of model fit in the population. This study aims to provide a systematic…

Modeling Population and Ecosystem Response to Sublethal Toxicant Exposure

DTIC Science & Technology

2001-09-30

mutualism utilized modified Lotka - Volterra (L-V) competition equations in which the sign of the interspecific interaction term was changed from...within complex communities and ecosystems. Prior to the current award, the PIs formulated and tested general dynamic energy budget models...Nisbet, 1998; chapter 7) make a convincing case that ecosystems do truly have dynamics that can be described by relatively simple, general , models

Predictors of physical therapy clinic performance in the treatment of patients with low back pain syndromes.

PubMed

Resnik, Linda; Liu, Dawei; Mor, Vince; Hart, Dennis L

2008-09-01

Little is known about organizational and service delivery factors related to quality of care in physical therapy. This study sought to identify characteristics related to differences in practice outcomes and service utilization. The sample comprised 114 outpatient clinics and 1,058 therapists who treated 16,281 patients with low back pain syndromes during the period 2000-2001. Clinics participated with the Focus on Therapeutic Outcomes, Inc (FOTO) database. Hierarchical linear models were used to risk adjust treatment outcomes and number of visits per treatment episode. Aggregated residual scores from these models were used to classify each clinic into 1 of 3 categories in each of 3 types of performance groups: (1) effectiveness, (2) utilization, and (3) overall performance (ie, composite measure of effectiveness and utilization). Relationships between clinic classification and the following independent variables were examined by multinomial logistic regression: years of therapist experience, number of physical therapists, ratio of physical therapists to physical therapist assistants, proportion of patients with low back pain syndromes, number of new patients per physical therapist per month, utilization of physical therapist assistants, and setting. Clinics that were lower utilizers of physical therapist assistants were 6.6 times more likely to be classified into the high effectiveness group compared with the low effectiveness group, 6.7 times more likely to be classified in the low utilization group compared with the high utilization group, and 12.4 times more likely to be classified in the best performance group compared with the worst performance group. Serving a higher proportion of patients with low back pain syndromes was associated with an increased likelihood of being classified in the lowest or middle group. Years of physical therapist experience was inversely associated with being classified in the middle utilization group compared with the highest utilization group. These findings suggest that, in the treatment of patients with low back pain syndromes, clinics that are low utilizers of physical therapist assistants are more likely to provide superior care (ie, better patient outcomes and lower service use).

The Effects of Climate Model Similarity on Local, Risk-Based Adaptation Planning

NASA Astrophysics Data System (ADS)

Steinschneider, S.; Brown, C. M.

2014-12-01

The climate science community has recently proposed techniques to develop probabilistic projections of climate change from ensemble climate model output. These methods provide a means to incorporate the formal concept of risk, i.e., the product of impact and probability, into long-term planning assessments for local systems under climate change. However, approaches for pdf development often assume that different climate models provide independent information for the estimation of probabilities, despite model similarities that stem from a common genealogy. Here we utilize an ensemble of projections from the Coupled Model Intercomparison Project Phase 5 (CMIP5) to develop probabilistic climate information, with and without an accounting of inter-model correlations, and use it to estimate climate-related risks to a local water utility in Colorado, U.S. We show that the tail risk of extreme climate changes in both mean precipitation and temperature is underestimated if model correlations are ignored. When coupled with impact models of the hydrology and infrastructure of the water utility, the underestimation of extreme climate changes substantially alters the quantification of risk for water supply shortages by mid-century. We argue that progress in climate change adaptation for local systems requires the recognition that there is less information in multi-model climate ensembles than previously thought. Importantly, adaptation decisions cannot be limited to the spread in one generation of climate models.

Head-twitch response in rodents induced by the hallucinogen 2,5-dimethoxy-4-iodoamphetamine: a comprehensive history, a re-evaluation of mechanisms, and its utility as a model

PubMed Central

Canal, Clint E.; Morgan, Drake

2013-01-01

Two primary animal models persist for assessing hallucinogenic potential of novel compounds and for examining the pharmacological and neurobiological substrates underlying the actions of classical hallucinogens, the two-lever drug discrimination procedure and the drug-induced head-twitch response (HTR) in rodents. The substituted amphetamine hallucinogen, serotonin 2 (5-HT2) receptor agonist, 2,5-dimethoxy-4-iodoamphetamine (DOI) has emerged as the most popular pharmacological tool used in HTR studies of hallucinogens. Synthesizing classic, recent, and relatively overlooked findings, addressing ostensibly conflicting observations, and considering contemporary theories in receptor and behavioural pharmacology, this review provides an up-to-date and comprehensive synopsis of DOI and the HTR model, from neural mechanisms to utility for understanding psychiatric diseases. Also presented is support for the argument that, although both the two-lever drug discrimination and the HTR models in rodents are useful for uncovering receptors, interacting proteins, intracellular signalling pathways, and neurochemical processes affected by DOI and related classical hallucinogens, results from both models suggest they are not reporting hallucinogenic experiences in animals. PMID:22517680

Modeling utilization distributions in space and time

USGS Publications Warehouse

Keating, K.A.; Cherry, S.

2009-01-01

W. Van Winkle defined the utilization distribution (UD) as a probability density that gives an animal's relative frequency of occurrence in a two-dimensional (x, y) plane. We extend Van Winkle's work by redefining the UD as the relative frequency distribution of an animal's occurrence in all four dimensions of space and time. We then describe a product kernel model estimation method, devising a novel kernel from the wrapped Cauchy distribution to handle circularly distributed temporal covariates, such as day of year. Using Monte Carlo simulations of animal movements in space and time, we assess estimator performance. Although not unbiased, the product kernel method yields models highly correlated (Pearson's r - 0.975) with true probabilities of occurrence and successfully captures temporal variations in density of occurrence. In an empirical example, we estimate the expected UD in three dimensions (x, y, and t) for animals belonging to each of two distinct bighorn sheep {Ovis canadensis) social groups in Glacier National Park, Montana, USA. Results show the method can yield ecologically informative models that successfully depict temporal variations in density of occurrence for a seasonally migratory species. Some implications of this new approach to UD modeling are discussed. ?? 2009 by the Ecological Society of America.

Projecting the cost, utilization, and patient care impact of prescribing extended release non-abuse-deterrent opioids to chronic pain patients.

PubMed

Yenikomshian, Mihran Ara; White, Alan G; Carson, Michael E; Garrison, Louis P; Oderda, Gary M; Biskupiak, Joseph E; Hlavacek, Patrick R; Roland, Carl L

To estimate healthcare resource utilization, associated costs, and number needed to harm (NNH) from a physician's decision to prescribe extended-release (ER) non-abuse-deterrent opioids (non-ADO) as compared to ER ADOs in a chronic pain population. A 12-month probabilistic simulation model was developed to estimate the reduction of misuse and/or abuse from a physician's prescribing decisions for 10,000 patients. Model inputs included probabilities for opioid misuse and/or abuse-related events, opioid discontinuation, and switching from ADO to non-ADO. Estimated reductions in abuse associated with ADOs were obtained from positive subjective measures using human abuse liability studies. The model was run separately for commercial, Medicare, Medicaid, and Veterans Administration (VA) populations. The difference in healthcare resource utilization and associated costs (2015 USD) between the ADO and non-ADO simulations was calculated. NNH for non-ADO was also calculated. Misuse and/or abuse-related events for patients prescribed ER non-ADOs ranged from 223-1,410 and associated costs ranged from $20-$98 per patient for commercial and Medicare populations, respectively. Prescribing ER ADOs were associated with 87, 289, 264, and 417 fewer misuse and/or abuse-related events, saving $8, $35, $21, and $29 per patient in commercial, VA, Medicaid, and Medicare populations, respectively. NNH ranged from 185 in the commercial population to 40 in the Medicare population. Results were sensitive to decreases in the probability of misuse and/or abuse events but showed reductions. A physician's decision to prescribe ER ADOs could lead to large reductions in misuse and/or abuse-related events and associated costs across many patient populations.

Supersymmetry Breaking Casimir Warp Drive

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

Obousy, Richard K.; Cleaver, Gerald

2007-01-30

This paper utilizes a recent model which relates the cosmological constant to the Casimir energy of the extra dimensions in brane-world theories. The objective of this paper is to demonstrate that, given some sufficiently advanced civilization with the ability to manipulate the radius of the extra dimension, a local adjustment of the cosmological constant could be created. This adjustment would facilitate an expansion/contraction of the spacetime around a spacecraft creating an exotic form of field-propulsion. This idea is analogous to the Alcubierre bubble, but differs entirely in the approach, utilizing the physics of higher dimensional quantum field theory, instead ofmore » general relativity.« less

Learning What to Want: Context-Sensitive Preference Learning

PubMed Central

Srivastava, Nisheeth; Schrater, Paul

2015-01-01

We have developed a method for learning relative preferences from histories of choices made, without requiring an intermediate utility computation. Our method infers preferences that are rational in a psychological sense, where agent choices result from Bayesian inference of what to do from observable inputs. We further characterize conditions on choice histories wherein it is appropriate for modelers to describe relative preferences using ordinal utilities, and illustrate the importance of the influence of choice history by explaining all major categories of context effects using them. Our proposal clarifies the relationship between economic and psychological definitions of rationality and rationalizes several behaviors heretofore judged irrational by behavioral economists. PMID:26496645

Sources of Biased Inference in Alcohol and Drug Services Research: An Instrumental Variable Approach

PubMed Central

Schmidt, Laura A.; Tam, Tammy W.; Larson, Mary Jo

2012-01-01

Objective: This study examined the potential for biased inference due to endogeneity when using standard approaches for modeling the utilization of alcohol and drug treatment. Method: Results from standard regression analysis were compared with those that controlled for endogeneity using instrumental variables estimation. Comparable models predicted the likelihood of receiving alcohol treatment based on the widely used Aday and Andersen medical care–seeking model. Data were from the National Epidemiologic Survey on Alcohol and Related Conditions and included a representative sample of adults in households and group quarters throughout the contiguous United States. Results: Findings suggested that standard approaches for modeling treatment utilization are prone to bias because of uncontrolled reverse causation and omitted variables. Compared with instrumental variables estimation, standard regression analyses produced downwardly biased estimates of the impact of alcohol problem severity on the likelihood of receiving care. Conclusions: Standard approaches for modeling service utilization are prone to underestimating the true effects of problem severity on service use. Biased inference could lead to inaccurate policy recommendations, for example, by suggesting that people with milder forms of substance use disorder are more likely to receive care than is actually the case. PMID:22152672

A social systems model of hospital utilization.

PubMed Central

Anderson, J G

1976-01-01

A social systems model for the health services system serving the state of New Mexico is presented. Utilization of short-term general hospitals is viewed as a function of sociodemographic characteristics of the population and of the supply of health manpower and facilities available to that population. The model includes a network specifying the causal relationships hypothesized as existing among a set of social, demographic, and economic variables known to be related to the supply of health manpower and facilities and to their utilization. Inclusion of feedback into the model as well as lagged values of physician supply variables permits examination of the dynamic behavior of the social system over time. A method for deriving the reduced form of the structural model is presented along with the reduced-form equations. These equations provide valuable information for policy decisions regarding the likely consequences of changes in the structure of the population and in the supply of health manpower and facilities. The structural and reduced-form equations have been used to predict the consequences for one New Mexico county of state and federal policies that would affect the organization and delivery of health services. PMID:1017949

Online Cancer Information Seeking: Applying and Extending the Comprehensive Model of Information Seeking.

PubMed

Van Stee, Stephanie K; Yang, Qinghua

2017-10-30

This study applied the comprehensive model of information seeking (CMIS) to online cancer information and extended the model by incorporating an exogenous variable: interest in online health information exchange with health providers. A nationally representative sample from the Health Information National Trends Survey 4 Cycle 4 was analyzed to examine the extended CMIS in predicting online cancer information seeking. Findings from a structural equation model supported most of the hypotheses derived from the CMIS, as well as the extension of the model related to interest in online health information exchange. In particular, socioeconomic status, beliefs, and interest in online health information exchange predicted utility. Utility, in turn, predicted online cancer information seeking, as did information-carrier characteristics. An unexpected but important finding from the study was the significant, direct relationship between cancer worry and online cancer information seeking. Theoretical and practical implications are discussed.

Enrollment, expenditures, and utilization after CHIP expansion: evidence from Alabama.

PubMed

Becker, David J; Blackburn, Justin; Morrisey, Michael A; Sen, Bisakha; Kilgore, Meredith L; Caldwell, Cathy; Sellers, Chris; Menachemi, Nir

2015-01-01

In October 2009, Alabama expanded eligibility in its Children's Health Insurance Program (CHIP), known as ALL Kids, from 200% to 300% of the federal poverty level (FPL). We examined the expenditures, utilization, and enrollment behavior of expansion enrollees relative to traditional enrollees (100-200% FPL) and assessed the impact of expansion on total program expenditures. We compared unadjusted mean person-month-level expenditures and utilization of expansion enrollees and various categories of existing enrollees and used a 2-part modeling strategy to examine differences after controlling for enrollee characteristics. We used probit models to examine adjusted differences in reenrollment behavior by eligibility category. Expansion enrollees had higher total monthly expenditures ($10.33, P < .05) than traditional ALL Kids enrollees, including higher outpatient ($5.35, P < .001) and dental ($0.85, P < .01) expenditures but lower emergency department (-$1.34, P < .001) expenditures. Expansion enrollees had marginally lower utilization of emergency department services for low-severity conditions and higher utilization of physician outpatient visits. Expansion enrollees were 4.47 percentage points (P < .001) more likely to reenroll before their contract expiration date than traditional ALL Kids enrollees. As of October 2012, expansion enrollees accounted for approximately 20% of ALL Kids enrollment and expenditures. The expansion population was characterized by moderately higher health expenditures and utilization, and more persistent enrollment relative to fee group enrollees who are subject to the same levels of cost sharing and annual premiums. Although states are prohibited from changing program eligibility until 2019, the costs associated with the expansion population will be important to future policy decisions. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Measuring public understanding on Tenaga Nasional Berhad (TNB) electricity bills using ordered probit model

NASA Astrophysics Data System (ADS)

Zainudin, WNRA; Ramli, NA

2017-09-01

In 2016, Tenaga Nasional Berhad (TNB) had introduced an upgrade in its Billing and Customer Relationship Management (BCRM) as part of its long-term initiative to provide its customers with greater access to billing information. This includes information on real and suggested power consumption by the customers and further details in their billing charges. This information is useful to help TNB customers to gain better understanding on their electricity usage patterns and items involved in their billing charges. Up to date, there are not many studies done to measure public understanding on current electricity bills and whether this understanding could contribute towards positive impacts. The purpose of this paper is to measure public understanding on current TNB electricity bills and whether their satisfaction towards energy-related services, electricity utility services, and their awareness on the amount of electricity consumed by various appliances and equipment in their home could improve this understanding on the electricity bills. Both qualitative and quantitative research methods are used to achieve these objectives. A total of 160 respondents from local universities in Malaysia participated in a survey used to collect relevant information. Using Ordered Probit model, this paper finds respondents that are highly satisfied with the electricity utility services tend to understand their electricity bills better. The electric utility services include management of electricity bills and the information obtained from utility or non-utility supplier to help consumers manage their energy usage or bills. Based on the results, this paper concludes that the probability to understand the components in the monthly electricity bill increases as respondents are more satisfied with their electric utility services and are more capable to value the energy-related services.

Insurer market structure and variation in commercial health care spending.

PubMed

McKellar, Michael R; Naimer, Sivia; Landrum, Mary B; Gibson, Teresa B; Chandra, Amitabh; Chernew, Michael

2014-06-01

To examine the relationship between insurance market structure and health care prices, utilization, and spending. Claims for 37.6 million privately insured employees and their dependents from the Truven Health Market Scan Database in 2009. Measures of insurer market structure derived from Health Leaders Inter study data. Regression models are used to estimate the association between insurance market concentration and health care spending, utilization, and price, adjusting for differences in patient characteristics and other market-level traits. Insurance market concentration is inversely related to prices and spending, but positively related to utilization. Our results imply that, after adjusting for input price differences, a market with two equal size insurers is associated with 3.9 percent lower medical care spending per capita (p = .002) and 5.0 percent lower prices for health care services relative to one with three equal size insurers (p < .001). Greater fragmentation in the insurance market might lead to higher prices and higher spending for care, suggesting some of the gains from insurer competition may be absorbed by higher prices for health care. Greater attention to prices and utilization in the provider market may need to accompany procompetitive insurance market strategies. © Health Research and Educational Trust.

Adolescents' perceptions of socializers' beliefs, career-related conversations, and motivation in mathematics.

PubMed

Lazarides, Rebecca; Rubach, Charlott; Ittel, Angela

2017-03-01

Research based on the Eccles model of parent socialization demonstrated that parents are an important source of value and ability information for their children. Little is known, however, about the bidirectional effects between students' perceptions of their parents' beliefs and behaviors and the students' own domain-specific values. This study analyzed how students' perceptions of parents' beliefs and behaviors and students' mathematics values and mathematics-related career plans affect each other bidirectionally, and analyzed the role of students' gender as a moderator of these relations. Data from 475 students in 11th and 12th grade (girls: 50.3%; 31 classrooms; 12 schools), who participated in 2 waves of the study, were analyzed. Results of longitudinal structural equation models demonstrated that students' perceptions of their parents' mathematics value beliefs at Time 1 affected the students' own mathematics utility value at Time 2. Bidirectional effects were not shown in the full sample but were identified for boys. The paths within the tested model varied for boys and girls. For example, boys', not girls', mathematics intrinsic value predicted their reported conversations with their fathers about future occupational plans. Boys', not girls', perceived parents' mathematics value predicted the mathematics utility value. Findings are discussed in relation to their implications for parents and teachers, as well as in relation to gendered motivational processes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Acoustics based assessment of respiratory diseases using GMM classification.

PubMed

Mayorga, P; Druzgalski, C; Morelos, R L; Gonzalez, O H; Vidales, J

2010-01-01

The focus of this paper is to present a method utilizing lung sounds for a quantitative assessment of patient health as it relates to respiratory disorders. In order to accomplish this, applicable traditional techniques within the speech processing domain were utilized to evaluate lung sounds obtained with a digital stethoscope. Traditional methods utilized in the evaluation of asthma involve auscultation and spirometry, but utilization of more sensitive electronic stethoscopes, which are currently available, and application of quantitative signal analysis methods offer opportunities of improved diagnosis. In particular we propose an acoustic evaluation methodology based on the Gaussian Mixed Models (GMM) which should assist in broader analysis, identification, and diagnosis of asthma based on the frequency domain analysis of wheezing and crackles.

Quality of life among obese patients seeking weight loss surgery: the importance of obesity-related social stigma and functional status.

PubMed

Wee, Christina C; Davis, Roger B; Huskey, Karen W; Jones, Daniel B; Hamel, Mary B

2013-02-01

Obesity is a stigmatizing condition associated with adverse psychosocial consequences. The relative importance of weight stigma in reducing health utility or the value a person places on their current health state is unknown. We conducted a telephone survey of patients with obesity. All were seeking weight loss surgery at two bariatric centers (70 % response rate). We assessed patients' health utility (preference-based quality life measure) via a series of standard gamble scenarios assessing patients' willingness to risk death to lose various amounts of weight or achieve perfect health (range 0 to 1; 0 = death and 1 = most valued health/weight state). Multivariable models assessed associations among quality of life domains from the Short-form 36 (SF-36) and Impact of Weight on Quality of Life-lite (IWQOL-lite) and patients' health utility. Our study sample (n = 574) had a mean body mass index of 46.5 kg/m(2) and a mean health utility of 0.87, reflecting the group's average willingness to accept a 13 % risk of death to achieve their most desired health/weight state; utilities were highly variable, however, with 10 % reporting a utility of 1.00 and 27 % reporting a utility lower than 0.90. Among the IWQOL-lite subscales, Public Distress and Work Life were the only two subscales significantly associated with patients' utility after adjustment for sociodemographic factors. Among the SF-36 subscales, Role Physical, Physical Functioning, and Role Emotional were significantly associated with patients' utility. When the leading subscales on both IWQOL-lite and SF-36 were considered together, Role Physical, Public Distress, and to a lesser degree Role Emotional remained independently associated with patients' health utility. Patients seeking weight loss surgery report health utilities similar to those reported for people living with diabetes or with laryngeal cancer; however, utility values varied widely with more than a quarter of patients willing to accept more than a 10 % risk of death to achieve their most valued health/weight state. Interference with role functioning due to physical limitations and obesity-related social stigma were strong determinants of reduced health utility.

Efficient hemodynamic event detection utilizing relational databases and wavelet analysis

NASA Technical Reports Server (NTRS)

Saeed, M.; Mark, R. G.

2001-01-01

Development of a temporal query framework for time-oriented medical databases has hitherto been a challenging problem. We describe a novel method for the detection of hemodynamic events in multiparameter trends utilizing wavelet coefficients in a MySQL relational database. Storage of the wavelet coefficients allowed for a compact representation of the trends, and provided robust descriptors for the dynamics of the parameter time series. A data model was developed to allow for simplified queries along several dimensions and time scales. Of particular importance, the data model and wavelet framework allowed for queries to be processed with minimal table-join operations. A web-based search engine was developed to allow for user-defined queries. Typical queries required between 0.01 and 0.02 seconds, with at least two orders of magnitude improvement in speed over conventional queries. This powerful and innovative structure will facilitate research on large-scale time-oriented medical databases.

Instructional Design Models and Research on Teacher Thinking: Toward a New Conceptual Model for Research and Development.

ERIC Educational Resources Information Center

Moallem, Mahnaz

Instructional designers believe that it is important to expose pre-service and in-service teachers to Instructional Systems Design (ISD) procedures and products so teachers can utilize them. Educational literature, however, reveals few attempts to relate instructional design theory and methods to teaching practice. This paper proposes a new…

The Mediating Role of Intercultural Wonderment: Connecting Programmatic Components to Global Outcomes in Study Abroad

ERIC Educational Resources Information Center

Engberg, Mark E.; Jourian, T. J.; Davidson, Lisa M.

2016-01-01

This study examines the mediating role of intercultural wonderment in relation to students' development of a global perspective. We utilize both confirmatory factor analysis and structural equation modeling to validate the intercultural wonderment construct and test the direct and indirect effects of the structural pathways in the model,…

The Role of Emotion in Informal Science Learning: Testing an Exploratory Model

ERIC Educational Resources Information Center

Staus, Nancy L.; Falk, John H.

2017-01-01

Although there is substantial research on the effect of emotions on educational outcomes in the classroom, relatively little is known about how emotion affects learning in informal science contexts. We examined the role of emotion in the context of an informal science learning experience by utilizing a path model to investigate the relationships…

The Small, Stand-Alone Early College: Impact on High School Outcomes

ERIC Educational Resources Information Center

Glennie, Elizabeth; Unlu, Fatih; Furey, Jane

2016-01-01

North Carolina's Early College model is the subject of an IES-funded eleven-year longitudinal experimental study that utilized a lottery process to assign early college applicants to either treatment or control groups. This paper presents findings related to high school outcomes. The primary goal of the early college model is to increase the…

Transitioning to an uncertain and competitive environment

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

Davison, J.C.

1996-08-01

The move to greater competition by natural gas and electric utilities has meant change unparalleled since the 1930s. To adapt to this revolution, utilities will have to, first, understand the nature of the restructuring and, second, answer such fundamental questions as what they are selling and how they can operate profitably. Answering these and related questions will likely result in the utility evaluating its own structure and deciding how it can bring the most value to its customers. Both natural gas and electric utilities ultimately may have to choose what business niche they will most profitably operate in as themore » days of operating as vertically integrated entities in a cost-plus environment are all but gone. This paper analyzes the changing natural gas and electric utility industries and presents a model of the utility industry in the future. It explains why restructure is inevitable, what form it may take and how newly configured utilities might withstand the brutality of competition by using GIS predictive tools, such as business geographies.« less

An Index of Trauma Severity Based on Multiattribute Utility: An Illustration of Complex Utility Modeling.

DTIC Science & Technology

1981-10-01

measure for Central Nervus System is the Glasgow Cons Score (GCS), a scale of brain and spinal cord injury (Langfitt [1978]), and is itself an additive...concerns directly relating to the injury itself were identified. These were: 1. Ventilation Severity 2 Circulation Severity 3. Central Nervous System ...interacting system within which these concerns represent interacting parts. Most trauma involves only one of these systems , but more than one may be

Social Disparities in Women’s Health Service Utilization in the United States: A Population-Based Analysis

PubMed Central

Johnson, Timothy; Dalton, Vanessa

2013-01-01

Purpose Poor and disparate reproductive health outcomes in the United States may be related to inadequate and differential women’s health care utilization. We investigated trends in and determinants of adult U.S. women’s health service use, 2006–2010. Methods We analyzed population data from 7,897 women aged 25–44yrs in the National Survey of Family Growth from 2006 to 2010 using multivariable logistic regression. Results Women’s health service utilization in the past year was reported by 74% of the sample. Among non-fertile, sexually active women, 47% used contraceptive services; fewer used pregnancy (21%) and STI (14%) services. In multivariable models, the odds of service use were greater among older, poor, unemployed women and women with less educational attainment than younger and socioeconomically advantaged women. Black women had greater odds of using pregnancy, STI and gynecological exam services than White women (ORs 1.4–1.6). Lack of insurance was associated with service use in all models (ORs 0.4–0.8). Conclusion While age-related differences in women’s health service use may reflect fertility transitions, social disparities mirror reproductive inequalities among U.S. women. Research on women’s health service utilization and outcomes across the reproductive life course and forthcoming sociopolitical climates is needed. PMID:24332620

A country for old men? Long-term home care utilization in Europe.

PubMed

Balia, Silvia; Brau, Rinaldo

2014-10-01

This paper investigates long-term home care utilization in Europe. Data from the first wave of the Survey on Health, Ageing and Retirement (SHARE) on formal (nursing care and paid domestic help) and informal care (support provided by relatives) are used to study the probability and the quantity of both types of care. The overall process is framed in a fully simultaneous equation system that takes the form of a bivariate two-part model where the reciprocal interaction between formal and informal care is estimated. Endogeneity and unobservable heterogeneity are addressed using a common latent factor approach. The analysis of the relative impact of age and disability on home care utilization is enriched by the use of a proximity to death (PtD) indicator built using the second wave of SHARE. All these indicators are important predictors of home care utilization. In particular, a strong significant effect of PtD is found in the paid domestic help and informal care models. The relationship between formal and informal care moves from substitutability to complementarity depending on the type of care considered, and the estimated effects are small in absolute size. This might call for a reconsideration of the effectiveness of incentives for informal care as instruments to reduce public expenditure for home care services. Copyright © 2013 John Wiley & Sons, Ltd.

Progressive segmented health insurance: Colombian health reform and access to health services.

PubMed

Ruiz, Fernando; Amaya, Liliana; Venegas, Stella

2007-01-01

Equal access for poor populations to health services is a comprehensive objective for any health reform. The Colombian health reform addressed this issue through a segmented progressive social health insurance approach. The strategy was to assure universal coverage expanding the population covered through payroll linked insurance, and implementing a subsidized insurance program for the poorest populations, those not affiliated through formal employment. A prospective study was performed to follow-up health service utilization and out-of-pocket expenses using a cohort design. It was representative of four Colombian cities (Cendex Health Services Use and Expenditure Study, 2001). A four part econometric model was applied. The model related medical service utilization and medication with different socioeconomic, geographic, and risk associated variables. Results showed that subsidized health insurance improves health service utilization and reduces the financial burden for the poorest, as compared to those non-insured. Other social health insurance schemes preserved high utilization with variable out-of-pocket expenditures. Family and age conditions have significant effect on medical service utilization. Geographic variables play a significant role in hospital inpatient service utilization. Both, geographic and income variables also have significant impact on out-of-pocket expenses. Projected utilization rates and a simulation favor a dual policy for two-stage income segmented insurance to progress towards the universal insurance goal. Copyright (c) 2006 John Wiley & Sons, Ltd.

First-Principles Integrated Adsorption Modeling for Selective Capture of Uranium from Seawater by Polyamidoxime Sorbent Materials

DOE PAGES

Ladshaw, Austin P.; Ivanov, Alexander S.; Das, Sadananda; ...

2018-03-27

Nuclear power is a relatively carbon-free energy source that has the capacity to be utilized today in an effort to stem the tides of global warming. The growing demand for nuclear energy, however, could put significant strain on our uranium ore resources, and the mining activities utilized to extract that ore can leave behind long-term environmental damage. A potential solution to enhance the supply of uranium fuel is to recover uranium from seawater using amidoximated adsorbent fibers. This technology has been studied for decades but is currently plagued by the material’s relatively poor selectivity of uranium over its main competitormore » vanadium. In this work, we investigate the binding schemes between uranium, vanadium, and the amidoxime functional groups on the adsorbent surface. Using quantum chemical methods, binding strengths are approximated for a set of complexation reactions between uranium and vanadium with amidoxime functionalities. Those approximations are then coupled with a comprehensive aqueous adsorption model developed in this work to simulate the adsorption of uranium and vanadium under laboratory conditions. Experimental adsorption studies with uranium and vanadium over a wide pH range are performed, and the data collected are compared against simulation results to validate the model. It was found that coupling ab initio calculations with process level adsorption modeling provides accurate predictions of the adsorption capacity and selectivity of the sorbent materials. Furthermore, this work demonstrates that this multiscale modeling paradigm could be utilized to aid in the selection of superior ligands or ligand compositions for the selective capture of metal ions. Furthermore, this first-principles integrated modeling approach opens the door to the in silico design of next-generation adsorbents with potentially superior efficiency and selectivity for uranium over vanadium in seawater.« less

First-Principles Integrated Adsorption Modeling for Selective Capture of Uranium from Seawater by Polyamidoxime Sorbent Materials

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

Ladshaw, Austin P.; Ivanov, Alexander S.; Das, Sadananda

Nuclear power is a relatively carbon-free energy source that has the capacity to be utilized today in an effort to stem the tides of global warming. The growing demand for nuclear energy, however, could put significant strain on our uranium ore resources, and the mining activities utilized to extract that ore can leave behind long-term environmental damage. A potential solution to enhance the supply of uranium fuel is to recover uranium from seawater using amidoximated adsorbent fibers. This technology has been studied for decades but is currently plagued by the material’s relatively poor selectivity of uranium over its main competitormore » vanadium. In this work, we investigate the binding schemes between uranium, vanadium, and the amidoxime functional groups on the adsorbent surface. Using quantum chemical methods, binding strengths are approximated for a set of complexation reactions between uranium and vanadium with amidoxime functionalities. Those approximations are then coupled with a comprehensive aqueous adsorption model developed in this work to simulate the adsorption of uranium and vanadium under laboratory conditions. Experimental adsorption studies with uranium and vanadium over a wide pH range are performed, and the data collected are compared against simulation results to validate the model. It was found that coupling ab initio calculations with process level adsorption modeling provides accurate predictions of the adsorption capacity and selectivity of the sorbent materials. Furthermore, this work demonstrates that this multiscale modeling paradigm could be utilized to aid in the selection of superior ligands or ligand compositions for the selective capture of metal ions. Furthermore, this first-principles integrated modeling approach opens the door to the in silico design of next-generation adsorbents with potentially superior efficiency and selectivity for uranium over vanadium in seawater.« less

First-Principles Integrated Adsorption Modeling for Selective Capture of Uranium from Seawater by Polyamidoxime Sorbent Materials.

PubMed

Ladshaw, Austin P; Ivanov, Alexander S; Das, Sadananda; Bryantsev, Vyacheslav S; Tsouris, Costas; Yiacoumi, Sotira

2018-04-18

Nuclear power is a relatively carbon-free energy source that has the capacity to be utilized today in an effort to stem the tides of global warming. The growing demand for nuclear energy, however, could put significant strain on our uranium ore resources, and the mining activities utilized to extract that ore can leave behind long-term environmental damage. A potential solution to enhance the supply of uranium fuel is to recover uranium from seawater using amidoximated adsorbent fibers. This technology has been studied for decades but is currently plagued by the material's relatively poor selectivity of uranium over its main competitor vanadium. In this work, we investigate the binding schemes between uranium, vanadium, and the amidoxime functional groups on the adsorbent surface. Using quantum chemical methods, binding strengths are approximated for a set of complexation reactions between uranium and vanadium with amidoxime functionalities. Those approximations are then coupled with a comprehensive aqueous adsorption model developed in this work to simulate the adsorption of uranium and vanadium under laboratory conditions. Experimental adsorption studies with uranium and vanadium over a wide pH range are performed, and the data collected are compared against simulation results to validate the model. It was found that coupling ab initio calculations with process level adsorption modeling provides accurate predictions of the adsorption capacity and selectivity of the sorbent materials. Furthermore, this work demonstrates that this multiscale modeling paradigm could be utilized to aid in the selection of superior ligands or ligand compositions for the selective capture of metal ions. Therefore, this first-principles integrated modeling approach opens the door to the in silico design of next-generation adsorbents with potentially superior efficiency and selectivity for uranium over vanadium in seawater.

Plan, formulate, discuss and correlate a NASTRAN finite element vibrations model of the Boeing Model 360 helicopter airframe

NASA Technical Reports Server (NTRS)

Gabel, R.; Lang, P. F.; Smith, L. A.; Reed, D. A.

1989-01-01

Boeing Helicopter, together with other United States helicopter manufacturers, participated in a finite element applications program to emplace in the United States a superior capability to utilize finite element analysis models in support of helicopter airframe design. The activities relating to planning and creating a finite element vibrations model of the Boeing Model 36-0 composite airframe are summarized, along with the subsequent analytical correlation with ground shake test data.

Activity-based costs of blood transfusions in surgical patients at four hospitals.

PubMed

Shander, Aryeh; Hofmann, Axel; Ozawa, Sherri; Theusinger, Oliver M; Gombotz, Hans; Spahn, Donat R

2010-04-01

Blood utilization has long been suspected to consume more health care resources than previously reported. Incomplete accounting for blood costs has the potential to misdirect programmatic decision making by health care systems. Determining the cost of supplying patients with blood transfusions requires an in-depth examination of the complex array of activities surrounding the decision to transfuse. To accurately determine the cost of blood in a surgical population from a health system perspective, an activity-based costing (ABC) model was constructed. Tasks and resource consumption (materials, labor, third-party services, capital) related to blood administration were identified prospectively at two US and two European hospitals. Process frequency (i.e., usage) data were captured retrospectively from each hospital and used to populate the ABC model. All major process steps, staff, and consumables to provide red blood cell (RBC) transfusions to surgical patients, including usage frequencies, and direct and indirect overhead costs contributed to per-RBC-unit costs between $522 and $1183 (mean, $761 +/- $294). These exceed previously reported estimates and were 3.2- to 4.8-fold higher than blood product acquisition costs. Annual expenditures on blood and transfusion-related activities, limited to surgical patients, ranged from $1.62 to $6.03 million per hospital and were largely related to the transfusion rate. Applicable to various hospital practices, the ABC model confirms that blood costs have been underestimated and that they are geographically variable and identifies opportunities for cost containment. Studies to determine whether more stringent control of blood utilization improves health care utilization and quality, and further reduces costs, are warranted.

A cost effectiveness study of eribulin versus standard single-agent cytotoxic chemotherapy for women with previously treated metastatic breast cancer.

PubMed

Lopes, Gilberto; Glück, Stefan; Avancha, Kiran; Montero, Alberto J

2013-01-01

Eribulin was FDA approved in 2012 as a treatment for patients with MBC who have previously received at least two prior chemotherapy regimens. The aim of this analysis was to assess the cost effectiveness of eribulin versus the three most commonly utilized drugs (TPC) in the EMBRACE trial: vinorelbine, gemcitabine, and capecitabine (X); and to other branded FDA approved drugs: ixabepilone (I), liposomal-doxorubicin (D), and nab-paclitaxel. We created a decision-analytical and a Markov model using clinical data from the EMBRACE trial. Health utilities were derived from the published literature. Costs for drug acquisition, physician visits, and laboratory tests were obtained from Medicare Services Drug Payment Table and Physician Fee Schedule and are represented in 2012 USD. Life-years saved (LY), quality-adjusted life years (QALY), and incremental cost effectiveness ratio (ICER) were calculated. Eribulin added 0.208 LY and 0.119 QALY with an incremental cost over TPC of $25,458, and therefore an ICER of $213,742 per QALY. The main drivers of the model were drug cost, PFS, OS, and health utility values. The results of the model were robust in sensitivity analyses. Relative to I, D, A, and X, the ICER for eribulin was $76,823, $109,283, $129,773, and $167,267, respectively. Even with a more contemporary willingness-to-pay threshold of approximately $120,000 per QALY, eribulin was not found to be cost effective in the treatment of MBC relative to TPC; relative to some more expensive branded drugs, eribulin appears to be cost effective.

Power system modeling and optimization methods vis-a-vis integrated resource planning (IRP)

NASA Astrophysics Data System (ADS)

Arsali, Mohammad H.

1998-12-01

The state-of-the-art restructuring of power industries is changing the fundamental nature of retail electricity business. As a result, the so-called Integrated Resource Planning (IRP) strategies implemented on electric utilities are also undergoing modifications. Such modifications evolve from the imminent considerations to minimize the revenue requirements and maximize electrical system reliability vis-a-vis capacity-additions (viewed as potential investments). IRP modifications also provide service-design bases to meet the customer needs towards profitability. The purpose of this research as deliberated in this dissertation is to propose procedures for optimal IRP intended to expand generation facilities of a power system over a stretched period of time. Relevant topics addressed in this research towards IRP optimization are as follows: (1) Historical prospective and evolutionary aspects of power system production-costing models and optimization techniques; (2) A survey of major U.S. electric utilities adopting IRP under changing socioeconomic environment; (3) A new technique designated as the Segmentation Method for production-costing via IRP optimization; (4) Construction of a fuzzy relational database of a typical electric power utility system for IRP purposes; (5) A genetic algorithm based approach for IRP optimization using the fuzzy relational database.

Impact of an alcohol misuse intervention for health care workers --2: Employee assistance programme utilization, on-the-job injuries, job loss and health services utilization.

PubMed

Lapham, Sandra C; McMillan, Garnett; Gregory, Cindy

2003-01-01

We evaluated the effects of an enhanced substance misuse (SM) prevention/early intervention programme on referrals to an employee assistance programme, health care utilization rates, on-the-job injury rates and job termination rates among health care professionals employed in a managed care organization. The intervention was implemented at one site, with the remaining sites serving as the comparison group. Existing data from hospital databases were used to compare events occurring in the periods before and after initiation of the intervention. To account for baseline differences in age, gender and job class, logistic regression models produced adjusted means for events per employee month-at-risk. We found that employee assistance referrals and non-SM-related in-patient hospitalizations increased significantly post-intervention, while rates of total out-patient SM-related visits decreased at both the intervention and comparison sites post-intervention. There was a small, statistically significant decrease in the monthly rate (OR = 0.92) of non-SM out-patient utilization at the intervention site, once the intervention was in place. No differences potentially attributable to the intervention were detected in job turnover or injury rates. We conclude that, while the intervention did not appear to affect health care utilization for SM-related problems, it was associated with increased referrals for employee assistance.

Evaluation of HIV/AIDS prevention resources in Liberia: strategy and implications.

PubMed

Kennedy, Stephen B; Johnson, Knowlton; Harris, Albert O; Lincoln, Adams; Neace, William; Collins, David

2004-03-01

The purpose of this preliminary study was to assess the HIV/AIDS prevention needs, services, and resources in Liberia, including the readiness of local providers to conduct HIV/AIDS-related prevention programs based on a set of six key dimensions (prevention needs, knowledge, leadership, environment, risky behaviors, and resources). A valid self-administered qualitative-based health survey, based on a community readiness model, was utilized as the primary data collection source. A cross-sectional design that utilized a convenient sample of key informants such as health coordinators, program directors, and health administrator from both public and private HIV/AIDS-based organizations was used. Furthermore, an extensive review of the National Library of Medicine database of published articles from mid-1980 to 2002 was simultaneously conducted to gauge the extent of scientific publications on HIV/AIDS-related prevention services in Liberia. The findings from this study strongly suggest that Liberia is in a stage of vague awareness, as defined by the Tri-Ethnic Center community readiness framework, regarding HIV/AIDS-related activities, including a significant lack of HIV/AIDS-related resources and scientific publications. Accordingly, there is a critical need to acquire adequate resources and build capacity to implement effective HIV/AIDS-related prevention programming services in order to avert the negative public health consequences associated with HIV/AIDS, including the implementation of relevant evaluation and dissemination strategies. Most importantly, this model has the potential to be utilized in other resource-constraint settings, especially in the developing world, to assess prevention-related resources and programmatic readiness. This is the first published study to evaluate Liberia's HIV/AIDS prevention resources and to systematically document the extent and magnitude of the HIV/AIDS crises in the country.

Grades as Information

ERIC Educational Resources Information Center

Grant, Darren

2007-01-01

We determine how much observed student performance in microeconomics principles can be attributed, inferentially, to three kinds of student academic "productivity," the instructor, demographics, and unmeasurables. The empirical approach utilizes an ordered probit model that relates student performance in micro to grades in prior…

Final Report: Development of a Chemical Model to Predict the Interactions between Supercritical CO2, Fluid and Rock in EGS Reservoirs

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

McPherson, Brian J.; Pan, Feng

2014-09-24

This report summarizes development of a coupled-process reservoir model for simulating enhanced geothermal systems (EGS) that utilize supercritical carbon dioxide as a working fluid. Specifically, the project team developed an advanced chemical kinetic model for evaluating important processes in EGS reservoirs, such as mineral precipitation and dissolution at elevated temperature and pressure, and for evaluating potential impacts on EGS surface facilities by related chemical processes. We assembled a new database for better-calibrated simulation of water/brine/ rock/CO2 interactions in EGS reservoirs. This database utilizes existing kinetic and other chemical data, and we updated those data to reflect corrections for elevated temperaturemore » and pressure conditions of EGS reservoirs.« less

Utilization of building information modeling in infrastructure’s design and construction

NASA Astrophysics Data System (ADS)

Zak, Josef; Macadam, Helen

2017-09-01

Building Information Modeling (BIM) is a concept that has gained its place in the design, construction and maintenance of buildings in Czech Republic during recent years. This paper deals with description of usage, applications and potential benefits and disadvantages connected with implementation of BIM principles in the preparation and construction of infrastructure projects. Part of the paper describes the status of BIM implementation in Czech Republic, and there is a review of several virtual design and construction practices in Czech Republic. Examples of best practice are presented from current infrastructure projects. The paper further summarizes experiences with new technologies gained from the application of BIM related workflows. The focus is on the BIM model utilization for the machine control systems on site, quality assurance, quality management and construction management.

Maneuver Estimation Model for Relative Orbit Determination

DTIC Science & Technology

2005-03-21

data arc, later shown by Gauss’ methods to be the astroid Ceres, Gauss developed the theory of probability, leading to the Principle of Maximum...Motion Relative motion describes the position of one satellite with respect to another. With more satellites placed in the GEO belt , relative motion... belt become more limited in number. Organizations involved in communications who own one of the coveted slots look for ways to best utilize and exploit

Smoking as a decision among pregnant and non-pregnant women.

PubMed

Ortendahl, Monica

2006-10-01

The purpose was to examine values and beliefs related to smoking, and to test the validity of a decision model based on the product of the value of smoking-related events and states, and the belief that these will occur, (in decision research labeled Expected Utility, or EU). Over a two-week period eighty women, divided into subgroups consisting of pregnant vs. non-pregnant women, and those intending vs. those not intending to quit smoking, performed evaluations of values and beliefs for the two conditions of quitting and not quitting smoking. For both pregnant and non-pregnant women expected utility of smoking was negative. Of all the four groups pregnant women not intending to quit smoking estimated the expected utility of smoking as least negative. A decision analytic approach is applicable to describe the addictive behavior of smoking. Values as well as beliefs about smoking should be stressed in smoking cessation programs, especially among pregnant women.

Medicaid-covered alcohol and drug treatment use among people with intellectual disabilities: evidence of disparities.

PubMed

Slayter, Elspeth

2010-10-01

For some, community inclusion facilitates access to alcohol and drugs and, therefore, the potential for developing substance abuse disorders. However, little is known about substance abuse treatment use among people with intellectual disabilities. Using standardized performance measures, substance abuse treatment utilization was examined for Medicaid-covered people with intellectual disabilities and substance abuse (N=9,484) versus people without intellectual disabilities (N=915,070). The sociobehavioral model of healthcare use guides multivariate logistic regression analyses of substance abuse treatment utilization patterns, revealing disability-related disparities. Factors associated with utilization included being non-White, living in a nonurban area, having a serious mental illness, and living in a state with a generous Medicaid plan for substance abuse treatment. Implications relate to health policy, service delivery patterns, and the need for cross-system collaboration in the use of integrated treatment approaches.

Validating clustering of molecular dynamics simulations using polymer models.

PubMed

Phillips, Joshua L; Colvin, Michael E; Newsam, Shawn

2011-11-14

Molecular dynamics (MD) simulation is a powerful technique for sampling the meta-stable and transitional conformations of proteins and other biomolecules. Computational data clustering has emerged as a useful, automated technique for extracting conformational states from MD simulation data. Despite extensive application, relatively little work has been done to determine if the clustering algorithms are actually extracting useful information. A primary goal of this paper therefore is to provide such an understanding through a detailed analysis of data clustering applied to a series of increasingly complex biopolymer models. We develop a novel series of models using basic polymer theory that have intuitive, clearly-defined dynamics and exhibit the essential properties that we are seeking to identify in MD simulations of real biomolecules. We then apply spectral clustering, an algorithm particularly well-suited for clustering polymer structures, to our models and MD simulations of several intrinsically disordered proteins. Clustering results for the polymer models provide clear evidence that the meta-stable and transitional conformations are detected by the algorithm. The results for the polymer models also help guide the analysis of the disordered protein simulations by comparing and contrasting the statistical properties of the extracted clusters. We have developed a framework for validating the performance and utility of clustering algorithms for studying molecular biopolymer simulations that utilizes several analytic and dynamic polymer models which exhibit well-behaved dynamics including: meta-stable states, transition states, helical structures, and stochastic dynamics. We show that spectral clustering is robust to anomalies introduced by structural alignment and that different structural classes of intrinsically disordered proteins can be reliably discriminated from the clustering results. To our knowledge, our framework is the first to utilize model polymers to rigorously test the utility of clustering algorithms for studying biopolymers.

Validating clustering of molecular dynamics simulations using polymer models

PubMed Central

2011-01-01

Background Molecular dynamics (MD) simulation is a powerful technique for sampling the meta-stable and transitional conformations of proteins and other biomolecules. Computational data clustering has emerged as a useful, automated technique for extracting conformational states from MD simulation data. Despite extensive application, relatively little work has been done to determine if the clustering algorithms are actually extracting useful information. A primary goal of this paper therefore is to provide such an understanding through a detailed analysis of data clustering applied to a series of increasingly complex biopolymer models. Results We develop a novel series of models using basic polymer theory that have intuitive, clearly-defined dynamics and exhibit the essential properties that we are seeking to identify in MD simulations of real biomolecules. We then apply spectral clustering, an algorithm particularly well-suited for clustering polymer structures, to our models and MD simulations of several intrinsically disordered proteins. Clustering results for the polymer models provide clear evidence that the meta-stable and transitional conformations are detected by the algorithm. The results for the polymer models also help guide the analysis of the disordered protein simulations by comparing and contrasting the statistical properties of the extracted clusters. Conclusions We have developed a framework for validating the performance and utility of clustering algorithms for studying molecular biopolymer simulations that utilizes several analytic and dynamic polymer models which exhibit well-behaved dynamics including: meta-stable states, transition states, helical structures, and stochastic dynamics. We show that spectral clustering is robust to anomalies introduced by structural alignment and that different structural classes of intrinsically disordered proteins can be reliably discriminated from the clustering results. To our knowledge, our framework is the first to utilize model polymers to rigorously test the utility of clustering algorithms for studying biopolymers. PMID:22082218

In Vivo High-Frequency Contrast-Enhanced Ultrasonography of Choroidal Melanoma in Rabbits: Imaging Features and Histopathologic Correlations

PubMed Central

Kang, Shin J.; Zhang, Qing; Patel, Samirkumar R.; Berezovsky, Damian; Yang, Hua; Wang, Yanggan; Grossniklaus, Hans E.

2013-01-01

Purpose To evaluate the utility of in vivo imaging of rabbit model of choroidal melanoma utilizing high-frequency contrast-enhanced ultrasound (HF-CE-US) with 2-or 3-dimensional modes, and to correlate the sonographic findings with histopathologic characteristics. Methods Five New Zealand white rabbits which were immunosuppressed with daily cyclosporin A were inoculated into their right eyes with aliquots of 1.5×106 / 50 µL of 92.1 human uveal melanoma cells cultured in RPMI. At week 4, the tumor-bearing eyes were imaged using high-frequency ultrasound with microbubble contrast agent to determine the 2-dimensional tumor size and relative blood volume and by 3-dimensional mode to determine tumor volume. Histologic tumor burden was quantified in enucleated eyes by ImageJ software, and microvascular density (MVD) was determined by counting vascular channels in PAS without hematoxylin sections. Results Utilizing HF-CE-US, melanomas were visualized as relatively hyperechoic regions in the images. The correlation coefficients of sonographic size or volume compared with histologic area were 0.72 and 0.70, respectively. The sonographic tumor relative blood volume correlated with the histologic tumor vascularity (R2=0.92, P=0.04) Conclusions There is a positive correlation between in vivo sonographic tumor volume/size and histologic tumor size in our rabbit choroidal melanoma model. HF-CE-US corresponds to microvascular density and blood volume. PMID:23645822

An investigation of the speeding-related crash designation through crash narrative reviews sampled via logistic regression.

PubMed

Fitzpatrick, Cole D; Rakasi, Saritha; Knodler, Michael A

2017-01-01

Speed is one of the most important factors in traffic safety as higher speeds are linked to increased crash risk and higher injury severities. Nearly a third of fatal crashes in the United States are designated as "speeding-related", which is defined as either "the driver behavior of exceeding the posted speed limit or driving too fast for conditions." While many studies have utilized the speeding-related designation in safety analyses, no studies have examined the underlying accuracy of this designation. Herein, we investigate the speeding-related crash designation through the development of a series of logistic regression models that were derived from the established speeding-related crash typologies and validated using a blind review, by multiple researchers, of 604 crash narratives. The developed logistic regression model accurately identified crashes which were not originally designated as speeding-related but had crash narratives that suggested speeding as a causative factor. Only 53.4% of crashes designated as speeding-related contained narratives which described speeding as a causative factor. Further investigation of these crashes revealed that the driver contributing code (DCC) of "driving too fast for conditions" was being used in three separate situations. Additionally, this DCC was also incorrectly used when "exceeding the posted speed limit" would likely have been a more appropriate designation. Finally, it was determined that the responding officer only utilized one DCC in 82% of crashes not designated as speeding-related but contained a narrative indicating speed as a contributing causal factor. The use of logistic regression models based upon speeding-related crash typologies offers a promising method by which all possible speeding-related crashes could be identified. Published by Elsevier Ltd.

Schizophrenia: multi-attribute utility theory approach to selection of atypical antipsychotics.

PubMed

Bettinger, Tawny L; Shuler, Garyn; Jones, Donnamaria R; Wilson, James P

2007-02-01

Current guidelines/algorithms recommend atypical antipsychotics as first-line agents for the treatment of schizophrenia. Because there are extensive healthcare costs associated with the treatment of schizophrenia, many institutions and health systems are faced with making restrictive formulary decisions regarding the use of atypical antipsychotics. Often, medication acquisition costs are the driving force behind formulary decisions, while other treatment factors are not considered. To apply a multi-attribute utility theory (MAUT) analysis to aid in the selection of a preferred agent among the atypical antipsychotics for the treatment of schizophrenia. Five atypical antipsychotics (risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole) were selected as the alternative agents to be included in the MAUT analysis. The attributes identified for inclusion in the analysis were efficacy, adverse effects, cost, and adherence, with relative weights of 35%, 35%, 20%, and 10%, respectively. For each agent, attribute scores were calculated, weighted, and then summed to generate a total utility score. The agent with the highest total utility score was considered the preferred agent. Aripiprazole, with a total utility score of 75.8, was the alternative agent with the highest total utility score in this model. This was followed by ziprasidone, risperidone, and quetiapine, with total utility scores of 71.8, 69.0, and 65.9, respectively. Olanzapine received the lowest total utility score. A sensitivity analysis was performed and failed to displace aripiprazole as the agent with the highest total utility score. This model suggests that aripiprazole should be considered a preferred agent for the treatment of schizophrenia unless found to be otherwise inappropriate.

Understanding Service Utilization Disparities and Depression in Latinos: The Role of Fatalismo.

PubMed

Anastasia, Elizabeth A; Bridges, Ana J

2015-12-01

Research demonstrates a disparity between need and utilization of mental health services for Latinos. Cultural variations in perceptions of mental illness may be partially responsible for this discrepancy. Past research with Latinos has shown links between fatalismo, a cultural value similar to external locus of control, and both depression and lower service utilization in medical care, while links to psychiatric care have not been investigated. The current study therefore aimed to explore the associations between fatalismo, depression, and past year mental health service utilization by Latinos. A community sample of 83 Latino adults were recruited during local cultural events. Participants completed self-report measures of depression, fatalism, and past year service utilization. Analyses using structural equation modeling showed fatalismo was directly negatively related to past year medical service utilization (β = -.35). In contrast, the link between fatalismo and past year mental health service utilization was mediated by self-reported depressive symptoms (indirect β = .19, p < .001). We conclude that while fatalismo is associated with depression in Latinos, other barriers likely serve as more salient deterrents of service utilization.

Friends with Faces: How Social Networks Can Enhance Face Recognition and Vice Versa

NASA Astrophysics Data System (ADS)

Mavridis, Nikolaos; Kazmi, Wajahat; Toulis, Panos

The "friendship" relation, a social relation among individuals, is one of the primary relations modeled in some of the world's largest online social networking sites, such as "FaceBook." On the other hand, the "co-occurrence" relation, as a relation among faces appearing in pictures, is one that is easily detectable using modern face detection techniques. These two relations, though appearing in different realms (social vs. visual sensory), have a strong correlation: faces that co-occur in photos often belong to individuals who are friends. Using real-world data gathered from "Facebook," which were gathered as part of the "FaceBots" project, the world's first physical face-recognizing and conversing robot that can utilize and publish information on "Facebook" was established. We present here methods as well as results for utilizing this correlation in both directions. Both algorithms for utilizing knowledge of the social context for faster and better face recognition are given, as well as algorithms for estimating the friendship network of a number of individuals given photos containing their faces. The results are quite encouraging. In the primary example, doubling of the recognition accuracy as well as a sixfold improvement in speed is demonstrated. Various improvements, interesting statistics, as well as an empirical investigation leading to predictions of scalability to much bigger data sets are discussed.

Active Redesign of a Medicaid Care Management Strategy for Greater Return on Investment: Predicting Impactability.

PubMed

DuBard, C Annette; Jackson, Carlos T

2018-04-01

Care management of high-cost/high-needs patients is an increasingly common strategy to reduce health care costs. A variety of targeting methodologies have emerged to identify patients with high historical or predicted health care utilization, but the more pertinent question for program planners is how to identify those who are most likely to benefit from care management intervention. This paper describes the evolution of complex care management targeting strategies in Community Care of North Carolina's (CCNC) work with the statewide non-dual Medicaid population, culminating in the development of an "Impactability Score" that uses administrative data to predict achievable savings. It describes CCNC's pragmatic approach for estimating intervention effects in a historical cohort of 23,455 individuals, using a control population of 14,839 to determine expected spending at an individual level, against which actual spending could be compared. The actual-to-expected spending difference was then used as the dependent variable in a multivariate model to determine the predictive contribution of a multitude of demographic, clinical, and utilization characteristics. The coefficients from this model yielded the information required to build predictive models for prospective use. Model variables related to medication adherence and historical utilization unexplained by disease burden proved to be more important predictors of impactability than any given diagnosis or event, disease profile, or overall costs of care. Comparison of this approach to alternative targeting strategies (emergency department super-utilizers, inpatient super-utilizers, or patients with highest Hierarchical Condition Category risk scores) suggests a 2- to 3-fold higher return on investment using impactability-based targeting.

The use of geospatial web services for exchanging utilities data

NASA Astrophysics Data System (ADS)

Kuczyńska, Joanna

2013-04-01

Geographic information technologies and related geo-information systems currently play an important role in the management of public administration in Poland. One of these tasks is to maintain and update Geodetic Evidence of Public Utilities (GESUT), part of the National Geodetic and Cartographic Resource, which contains an important for many institutions information of technical infrastructure. It requires an active exchange of data between the Geodesy and Cartography Documentation Centers and institutions, which administrate transmission lines. The administrator of public utilities, is legally obliged to provide information about utilities to GESUT. The aim of the research work was to develop a universal data exchange methodology, which can be implemented on a variety of hardware and software platforms. This methodology use Unified Modeling Language (UML), eXtensible Markup Language (XML), and Geography Markup Language (GML). The proposed methodology is based on the two different strategies: Model Driven Architecture (MDA) and Service Oriented Architecture (SOA). Used solutions are consistent with the INSPIRE Directive and ISO 19100 series standards for geographic information. On the basis of analysis of the input data structures, conceptual models were built for both databases. Models were written in the universal modeling language: UML. Combined model that defines a common data structure was also built. This model was transformed into developed for the exchange of geographic information GML standard. The structure of the document describing the data that may be exchanged is defined in the .xsd file. Network services were selected and implemented in the system designed for data exchange based on open source tools. Methodology was implemented and tested. Data in the agreed data structure and metadata were set up on the server. Data access was provided by geospatial network services: data searching possibilities by Catalog Service for the Web (CSW), data collection by Web Feature Service (WFS). WFS provides also operation for modification data, for example to update them by utility administrator. The proposed solution significantly increases the efficiency of data exchange and facilitates maintenance the National Geodetic and Cartographic Resource.

Deriving movement properties and the effect of the environment from the Brownian bridge movement model in monkeys and birds.

PubMed

Buchin, Kevin; Sijben, Stef; van Loon, E Emiel; Sapir, Nir; Mercier, Stéphanie; Marie Arseneau, T Jean; Willems, Erik P

2015-01-01

The Brownian bridge movement model (BBMM) provides a biologically sound approximation of the movement path of an animal based on discrete location data, and is a powerful method to quantify utilization distributions. Computing the utilization distribution based on the BBMM while calculating movement parameters directly from the location data, may result in inconsistent and misleading results. We show how the BBMM can be extended to also calculate derived movement parameters. Furthermore we demonstrate how to integrate environmental context into a BBMM-based analysis. We develop a computational framework to analyze animal movement based on the BBMM. In particular, we demonstrate how a derived movement parameter (relative speed) and its spatial distribution can be calculated in the BBMM. We show how to integrate our framework with the conceptual framework of the movement ecology paradigm in two related but acutely different ways, focusing on the influence that the environment has on animal movement. First, we demonstrate an a posteriori approach, in which the spatial distribution of average relative movement speed as obtained from a "contextually naïve" model is related to the local vegetation structure within the monthly ranging area of a group of wild vervet monkeys. Without a model like the BBMM it would not be possible to estimate such a spatial distribution of a parameter in a sound way. Second, we introduce an a priori approach in which atmospheric information is used to calculate a crucial parameter of the BBMM to investigate flight properties of migrating bee-eaters. This analysis shows significant differences in the characteristics of flight modes, which would have not been detected without using the BBMM. Our algorithm is the first of its kind to allow BBMM-based computation of movement parameters beyond the utilization distribution, and we present two case studies that demonstrate two fundamentally different ways in which our algorithm can be applied to estimate the spatial distribution of average relative movement speed, while interpreting it in a biologically meaningful manner, across a wide range of environmental scenarios and ecological contexts. Therefore movement parameters derived from the BBMM can provide a powerful method for movement ecology research.

The impact of sea surface currents in wave power potential modeling

NASA Astrophysics Data System (ADS)

Zodiatis, George; Galanis, George; Kallos, George; Nikolaidis, Andreas; Kalogeri, Christina; Liakatas, Aristotelis; Stylianou, Stavros

2015-11-01

The impact of sea surface currents to the estimation and modeling of wave energy potential over an area of increased economic interest, the Eastern Mediterranean Sea, is investigated in this work. High-resolution atmospheric, wave, and circulation models, the latter downscaled from the regional Mediterranean Forecasting System (MFS) of the Copernicus marine service (former MyOcean regional MFS system), are utilized towards this goal. The modeled data are analyzed by means of a variety of statistical tools measuring the potential changes not only in the main wave characteristics, but also in the general distribution of the wave energy and the wave parameters that mainly affect it, when using sea surface currents as a forcing to the wave models. The obtained results prove that the impact of the sea surface currents is quite significant in wave energy-related modeling, as well as temporally and spatially dependent. These facts are revealing the necessity of the utilization of the sea surface currents characteristics in renewable energy studies in conjunction with their meteo-ocean forecasting counterparts.

Variables affecting the financial viability of your practice: a case study.

PubMed

Binderman, J

2001-01-01

Utilizing the discussion of variables affecting practice financial viability, a case study is considered. The case study reveals the relative impact multiple variables have upon the bottom line, including: practice capacity, percentage of capitation, and fee-for-service in the practice, as well as patient visit rates and patient churning. This article presents basic financial information through a case study model, utilizing a series of worksheets that can be adapted to any practice situation to encourage improved financial viability.

The Role of Implicit Negative Feedback in SLA: Models and Recasts in Japanese and Spanish.

ERIC Educational Resources Information Center

Long, Michael; Inagaki, Shunji; Ortega, Lourdes

1998-01-01

Two experiments were conducted to assess relative utility of models and recasts in second-language (L2) Japanese and Spanish. Using pretest, posttest, control group design, each study provided evidence of adults' ability to learn from implicit negative feedback; in one case, support for notion that reactive implicit negative feedback can be more…

A shock spectra and impedance method to determine a bound for spacecraft structural loads

NASA Technical Reports Server (NTRS)

Bamford, R.; Trubert, M.

1974-01-01

A method to determine a bound of structural loads for a spacecraft mounted on a launch vehicle is developed. The method utilizes the interface shock spectra and the relative impedance of the spacecraft and launch vehicle. The method is developed for single-degree-of-freedom models and then generalized to multidegree-of-freedom models.

Community College Capital Analysis Model; A Report to the Washington State Legislature. Performance Audit Report No. 75-12.

ERIC Educational Resources Information Center

O'Brien, John E.

This performance audit was conducted to provide the Legislature with an evaluation of the Capital Analysis Model (CAM) utilized in the development of the Washington State Community College System capital budget request to the Legislature. The CAM is a tool for measuring projected capital facilities needs in relation to current capital facilities,…

Application of Relational Contracting Methods to Federal Construction Projects

DTIC Science & Technology

2011-03-24

59 viii List of Figures Page Figure 1 Wittgenstein Model (Chan et al., 2010...a precise and comprehensive definition of the concept (Chan et al, 2010). Ludwig Wittgenstein argued that complex concepts are unable to be defined...recently, Chan et al. (2010) utilized the Wittgenstein concept and both of these previous researchers’ work to develop a model of the elements of

On the Utility of National Datasets and Resource Cost Models for Estimating Faculty Instructional Costs in Higher Education

ERIC Educational Resources Information Center

Morphew, Christopher; Baker, Bruce

2007-01-01

In this article, the authors present the results of a research study in which they used two national datasets to construct and examine a model that estimates relative faculty instructional costs for specific undergraduate degree programs and also identifies differences in these costs by region and institutional type. They conducted this research…

Measuring Care-Related Quality of Life of Caregivers for Use in Economic Evaluations: CarerQol Tariffs for Australia, Germany, Sweden, UK, and US.

PubMed

Hoefman, Renske J; van Exel, Job; Brouwer, Werner B F

2017-04-01

Informal care is often not included in economic evaluations in healthcare, while the impact of caregiving can be relevant for cost-effectiveness recommendations from a societal perspective. The impact of informal care can be measured and valued with the CarerQol instrument, which measures the impact of informal care on seven important burden dimensions (CarerQol-7D) and values this in terms of general quality of life (CarerQol-VAS). The CarerQol can be included at the effect side of multi-criteria analyses of patient interventions or in cost-effectiveness or utility analysis of interventions targeted at caregivers. At present, utility scores based on relative utility weights for the CarerQol-7D are only available for the Netherlands. This study calculates CarerQol-7D tariffs for Australia, Germany, Sweden, UK, and US. Data were collected among the general population in Australia, Germany, Sweden, UK, and US by an Internet survey. Utility weights were collected with a discrete choice experiment with two unlabeled alternatives described in terms of the seven CarerQol-7D dimensions. An efficient experimental design with priors obtained from the Netherlands was used to create the choice sets. Data was analyzed with a panel mixed multinomial logit model with random parameters. In all five countries, the CarerQol-7D dimensions were significantly associated with the utility of informal care situations. Physical health problems were most strongly associated with the utility for informal care situations. The tariff was constructed by adding up the relative utility weights per category of all CarerQol-7D dimensions for each country separately. The CarerQol tariffs for Australia, Germany, Sweden, UK, and US facilitate the inclusion of informal care in economic evaluations.

Preliminary investigation of Brain Network Activation (BNA) and its clinical utility in sport-related concussion.

PubMed

Reches, A; Kutcher, J; Elbin, R J; Or-Ly, H; Sadeh, B; Greer, J; McAllister, D J; Geva, A; Kontos, A P

2017-01-01

The clinical diagnosis and management of patients with sport-related concussion is largely dependent on subjectively reported symptoms, clinical examinations, cognitive, balance, vestibular and oculomotor testing. Consequently, there is an unmet need for objective assessment tools that can identify the injury from a physiological perspective and add an important layer of information to the clinician's decision-making process. The goal of the study was to evaluate the clinical utility of the EEG-based tool named Brain Network Activation (BNA) as a longitudinal assessment method of brain function in the management of young athletes with concussion. Athletes with concussion (n = 86) and age-matched controls (n = 81) were evaluated at four time points with symptom questionnaires and BNA. BNA scores were calculated by comparing functional networks to a previously defined normative reference brain network model to the same cognitive task. Subjects above 16 years of age exhibited a significant decrease in BNA scores immediately following injury, as well as notable changes in functional network activity, relative to the controls. Three representative case studies of the tested population are discussed in detail, to demonstrate the clinical utility of BNA. The data support the utility of BNA to augment clinical examinations, symptoms and additional tests by providing an effective method for evaluating objective electrophysiological changes associated with sport-related concussions.

Preliminary investigation of Brain Network Activation (BNA) and its clinical utility in sport-related concussion

PubMed Central

Reches, A.; Kutcher, J.; Elbin, R. J.; Or-Ly, H.; Sadeh, B.; Greer, J.; McAllister, D. J.; Geva, A.; Kontos, A. P.

2017-01-01

ABSTRACT Background: The clinical diagnosis and management of patients with sport-related concussion is largely dependent on subjectively reported symptoms, clinical examinations, cognitive, balance, vestibular and oculomotor testing. Consequently, there is an unmet need for objective assessment tools that can identify the injury from a physiological perspective and add an important layer of information to the clinician’s decision-making process. Objective: The goal of the study was to evaluate the clinical utility of the EEG-based tool named Brain Network Activation (BNA) as a longitudinal assessment method of brain function in the management of young athletes with concussion. Methods: Athletes with concussion (n = 86) and age-matched controls (n = 81) were evaluated at four time points with symptom questionnaires and BNA. BNA scores were calculated by comparing functional networks to a previously defined normative reference brain network model to the same cognitive task. Results: Subjects above 16 years of age exhibited a significant decrease in BNA scores immediately following injury, as well as notable changes in functional network activity, relative to the controls. Three representative case studies of the tested population are discussed in detail, to demonstrate the clinical utility of BNA. Conclusion: The data support the utility of BNA to augment clinical examinations, symptoms and additional tests by providing an effective method for evaluating objective electrophysiological changes associated with sport-related concussions. PMID:28055228

Extremum Seeking Control of Smart Inverters for VAR Compensation

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

Arnold, Daniel; Negrete-Pincetic, Matias; Stewart, Emma

2015-09-04

Reactive power compensation is used by utilities to ensure customer voltages are within pre-defined tolerances and reduce system resistive losses. While much attention has been paid to model-based control algorithms for reactive power support and Volt Var Optimization (VVO), these strategies typically require relatively large communications capabilities and accurate models. In this work, a non-model-based control strategy for smart inverters is considered for VAR compensation. An Extremum Seeking control algorithm is applied to modulate the reactive power output of inverters based on real power information from the feeder substation, without an explicit feeder model. Simulation results using utility demand informationmore » confirm the ability of the control algorithm to inject VARs to minimize feeder head real power consumption. In addition, we show that the algorithm is capable of improving feeder voltage profiles and reducing reactive power supplied by the distribution substation.« less

The upper respiratory pyramid: early factors and later treatment utilization in World Trade Center exposed firefighters.

PubMed

Niles, Justin K; Webber, Mayris P; Liu, Xiaoxue; Zeig-Owens, Rachel; Hall, Charles B; Cohen, Hillel W; Glaser, Michelle S; Weakley, Jessica; Schwartz, Theresa M; Weiden, Michael D; Nolan, Anna; Aldrich, Thomas K; Glass, Lara; Kelly, Kerry J; Prezant, David J

2014-08-01

We investigated early post 9/11 factors that could predict rhinosinusitis healthcare utilization costs up to 11 years later in 8,079 World Trade Center-exposed rescue/recovery workers. We used bivariate and multivariate analytic techniques to investigate utilization outcomes; we also used a pyramid framework to describe rhinosinusitis healthcare groups at early (by 9/11/2005) and late (by 9/11/2012) time points. Multivariate models showed that pre-9/11/2005 chronic rhinosinusitis diagnoses and nasal symptoms predicted final year healthcare utilization outcomes more than a decade after WTC exposure. The relative proportion of workers on each pyramid level changed significantly during the study period. Diagnoses of chronic rhinosinusitis within 4 years of a major inhalation event only partially explain future healthcare utilization. Exposure intensity, early symptoms and other factors must also be considered when anticipating future healthcare needs. © 2014 Wiley Periodicals, Inc.

Cardio-Vascular Disease and Cancer

PubMed Central

Mitchell-Fearon, K.; Willie-Tyndale, D.; Waldron, N.; Holder-Nevins, D.; James, K.; Laws, H.; Eldemire-Shearer, D.

2015-01-01

Objective: To report the level of utilization of clinical preventive services by older adults in Jamaica and to identify independent factors associated with utilization. Method: A nationally representative, community-based survey of 2,943 older adults was undertaken. Utilization frequency for six preventive, cardiovascular or cancer-related services was calculated. Logistic regression models were used to determine the independent factors associated with each service. Results: A dichotomy in annual utilization rates exists with cardiovascular services having much higher uptake than those for cancer (83.1% for blood pressure, 76.7% blood glucose, 68.1% cholesterol, 35.1% prostate, 11.3% mammograms, and 9.6% papanicolaou smears). Age, source of routine care, and having a chronic disease were most frequently associated with uptake. Discussion: Education of providers and patients on the need for utilizing preventive services in older adults is important. Improved access to services in the public sector may also help increase uptake of services. PMID:28138475

The Upper Respiratory Pyramid: Early Factors and Later Treatment Utilization in World Trade Center Exposed Firefighters

PubMed Central

Niles, Justin K.; Webber, Mayris P.; Liu, Xiaoxue; Zeig-Owens, Rachel; Hall, Charles B.; Cohen, Hillel W.; Glaser, Michelle S.; Weakley, Jessica; Schwartz, Theresa M.; Weiden, Michael D.; Nolan, Anna; Aldrich, Thomas K.; Glass, Lara; Kelly, Kerry J.; Prezant, David J.

2015-01-01

Background We investigated early post 9/11 factors that could predict rhinosinusitis healthcare utilization costs up to 11 years later in 8,079 World Trade Center-exposed rescue/recovery workers. Methods We used bivariate and multivariate analytic techniques to investigate utilization outcomes; we also used a pyramid framework to describe rhinosinusitis healthcare groups at early (by 9/11/2005) and late (by 9/11/2012) time points. Results Multivariate models showed that pre-9/11/2005 chronic rhinosinusitis diagnoses and nasal symptoms predicted final year healthcare utilization outcomes more than a decade after WTC exposure. The relative proportion of workers on each pyramid level changed significantly during the study period. Conclusions Diagnoses of chronic rhinosinusitis within 4 years of a major inhalation event only partially explain future healthcare utilization. Exposure intensity, early symptoms and other factors must also be considered when anticipating future healthcare needs. PMID:24898816

A Qualitative Study of Underutilization of the AIDS Drug Assistance Program

PubMed Central

Olson, Kristin M.; Godwin, Noah C.; Wilkins, Sara Anne; Mugavero, Michael J.; Moneyham, Linda D.; Slater, Larry Z.; Raper, James L.

2014-01-01

In our previous work, we demonstrated underutilization of the AIDS Drug Assistance Program (ADAP) at an HIV clinic in Alabama. In order to understand barriers and facilitators to utilization of ADAP, we conducted focus groups of ADAP enrollees. Focus groups were stratified by sex, race, and historical medication possession ratio as a measure of program utilization. We grouped factors according to the social-ecological model. We found that multiple levels of influence, including patient and clinic-related factors, influenced utilization of antiretroviral medications. Patients introduced issues that illustrated high-priority needs for ADAP policy and implementation, suggesting that in order to improve ADAP utilization, the following issues must be addressed: patient transportation, ADAP medication refill schedules and procedures, mailing of medications, and the ADAP recertification process. These findings can inform a strategy of approaches to improve ADAP utilization, which may have widespread implications for ADAP programs across the United States. PMID:24503498

Forgiveness and Suicidal Behavior: Cynicism and Psychache as Serial Mediators.

PubMed

Dangel, Trever J; Webb, Jon R; Hirsch, Jameson K

2018-02-17

Research is burgeoning regarding the beneficial association of forgiveness with numerous health-related outcomes; however, its particular relationship to suicidal behavior has received relatively little attention. Both cynicism and psychache, or agonizing psychological pain, have displayed deleterious associations with suicidal behavior, but have rarely been incorporated into more comprehensive models of suicidal behavior. Consistent with the recent development of a theoretical model regarding the forgiveness-suicidal behavior association, the present study utilized an undergraduate sample of college students (N = 312) to test a mediation-based model of the cross-sectional association of forgiveness with suicidal behavior, as serially mediated by cynicism and psychache. Dispositional forgiveness of self and forgiveness of uncontrollable situations were each indirectly associated with less suicidal behavior via less psychache. Also, dispositional forgiveness of others was indirectly associated with less suicidal behavior via less cynicism and less psychache, in a serial fashion. The present results are consistent with the extent literature on the forgiveness-suicidal behavior association, cynicism, and psychache, and pending future studies, may be utilized to inform further treatment efforts for individuals at a high risk of attempting suicide.

A laboratory-calibrated model of coho salmon growth with utility for ecological analyses

USGS Publications Warehouse

Manhard, Christopher V.; Som, Nicholas A.; Perry, Russell W.; Plumb, John M.

2018-01-01

We conducted a meta-analysis of laboratory- and hatchery-based growth data to estimate broadly applicable parameters of mass- and temperature-dependent growth of juvenile coho salmon (Oncorhynchus kisutch). Following studies of other salmonid species, we incorporated the Ratkowsky growth model into an allometric model and fit this model to growth observations from eight studies spanning ten different populations. To account for changes in growth patterns with food availability, we reparameterized the Ratkowsky model to scale several of its parameters relative to ration. The resulting model was robust across a wide range of ration allocations and experimental conditions, accounting for 99% of the variation in final body mass. We fit this model to growth data from coho salmon inhabiting tributaries and constructed ponds in the Klamath Basin by estimating habitat-specific indices of food availability. The model produced evidence that constructed ponds provided higher food availability than natural tributaries. Because of their simplicity (only mass and temperature are required as inputs) and robustness, ration-varying Ratkowsky models have utility as an ecological tool for capturing growth in freshwater fish populations.

MoCog1: A computer simulation of recognition-primed human decision making, considering emotions

NASA Technical Reports Server (NTRS)

Gevarter, William B.

1992-01-01

The successful results of the first stage of a research effort to develop a versatile computer model of motivated human cognitive behavior are reported. Most human decision making appears to be an experience-based, relatively straightforward, largely automatic response to situations, utilizing cues and opportunities perceived from the current environment. The development, considering emotions, of the architecture and computer program associated with such 'recognition-primed' decision-making is described. The resultant computer program (MoCog1) was successfully utilized as a vehicle to simulate earlier findings that relate how an individual's implicit theories orient the individual toward particular goals, with resultant cognitions, affects, and behavior in response to their environment.

MoCog1: A computer simulation of recognition-primed human decision making

NASA Technical Reports Server (NTRS)

Gevarter, William B.

1991-01-01

The results of the first stage of a research effort to develop a 'sophisticated' computer model of human cognitive behavior are described. Most human decision making is an experience-based, relatively straight-forward, largely automatic response to internal goals and drives, utilizing cues and opportunities perceived from the current environment. The development of the architecture and computer program (MoCog1) associated with such 'recognition-primed' decision making is discussed. The resultant computer program was successfully utilized as a vehicle to simulate earlier findings that relate how an individual's implicit theories orient the individual toward particular goals, with resultant cognitions, affects, and behavior in response to their environment.

Use of Theory-Driven Research in Counseling: Investigating Three Counseling Psychology Journals from 1990 to 1999

ERIC Educational Resources Information Center

Karr, Carolyn A.; Larson, Lisa M.

2005-01-01

Three major journals in counseling psychology were sampled from 1990 to 1999 to assess the percentage of quantitative, empirical articles that were theory driven. Only 43% of the studies utilized a theory or model, and 57% predicted the relation between the variables, with few studies specifying the strength of the relation. Studies sampled in the…

Public Relations Behavior as a Function of Organizational Type: A Comparison of Manufacturing versus Service Organizations.

ERIC Educational Resources Information Center

Lauzen, Martha M.; Dozier, David M.

A study was conducted to examine the model of public relations practiced and level of research utilization in service versus manufacturing organizations. The study was a secondary analysis of a survey of the International Association of Business Communicators conducted in August 1987. Questionnaires were mailed to 760 people from the 1987…

Effects of Selection and Training on Unit-Level Performance over Time: A Latent Growth Modeling Approach

ERIC Educational Resources Information Center

Van Iddekinge, Chad H.; Ferris, Gerald R.; Perrewe, Pamela L.; Perryman, Alexa A.; Blass, Fred R.; Heetderks, Thomas D.

2009-01-01

Surprisingly few data exist concerning whether and how utilization of job-related selection and training procedures affects different aspects of unit or organizational performance over time. The authors used longitudinal data from a large fast-food organization (N = 861 units) to examine how change in use of selection and training relates to…

Forecasting need and demand for home health care: a selective review

PubMed Central

Sharma, Rabinder K.

1980-01-01

Three models for forecasting home health care (HHC) needs are analyzed: HSA/SP model (Health Systems Agency of Southwestern Pennsylvania); Florida model (Florida State Department of Health and Rehabilitative Services); and Rhode Island model (Rhode Island Department of Community Affairs). A utilization approach to forecasting is also presented. In the HSA/SP and Florida models, need for HHC is based on a certain proportion of (a) hospital admissions and (b) patients entering HHC from other sources. The major advantage of these models is that they are relatively easy to use and explain; their major weaknesses are an imprecise definition of need and an incomplete model specification. The Rhode Island approach defines need for HHC in terms of the health status of the population as measured by chronic activity limitations. The major strengths of this approach are its explicit assumptions and its emphasis on consumer needs. The major drawback is that it requires considerable local area data. The utilization approach is based on extrapolation from observed utilization experience of the target population. Its main limitation is that it is based on current market imperfections; its major advantage is that it exposes existing deficiencies in HHC. The author concludes that each approach should be tested empirically in order to refine it, and that need and demand approaches be used jointly in the planning process. PMID:6893631

Enhanced Vehicle Beddown Approximations for the Improved Theater Distribution Model

DTIC Science & Technology

2014-03-27

processed utilizing a heuristic routing and scheduling procedure the authors called the Airlift Planning Algorithm ( APA ). The linear programming model...LINGO 13 environment. The model is then solved by LINGO 13 and solution data is passed back to the Excel environment in a readable format . All original...DSS is relatively unchanged when solutions to the ITDM are referenced for comparison testing. Readers are encouraged to see Appendix I for ITDM VBA

Attention-Based Recurrent Temporal Restricted Boltzmann Machine for Radar High Resolution Range Profile Sequence Recognition.

PubMed

Zhang, Yifan; Gao, Xunzhang; Peng, Xuan; Ye, Jiaqi; Li, Xiang

2018-05-16

The High Resolution Range Profile (HRRP) recognition has attracted great concern in the field of Radar Automatic Target Recognition (RATR). However, traditional HRRP recognition methods failed to model high dimensional sequential data efficiently and have a poor anti-noise ability. To deal with these problems, a novel stochastic neural network model named Attention-based Recurrent Temporal Restricted Boltzmann Machine (ARTRBM) is proposed in this paper. RTRBM is utilized to extract discriminative features and the attention mechanism is adopted to select major features. RTRBM is efficient to model high dimensional HRRP sequences because it can extract the information of temporal and spatial correlation between adjacent HRRPs. The attention mechanism is used in sequential data recognition tasks including machine translation and relation classification, which makes the model pay more attention to the major features of recognition. Therefore, the combination of RTRBM and the attention mechanism makes our model effective for extracting more internal related features and choose the important parts of the extracted features. Additionally, the model performs well with the noise corrupted HRRP data. Experimental results on the Moving and Stationary Target Acquisition and Recognition (MSTAR) dataset show that our proposed model outperforms other traditional methods, which indicates that ARTRBM extracts, selects, and utilizes the correlation information between adjacent HRRPs effectively and is suitable for high dimensional data or noise corrupted data.

Spare parts management for nuclear power generation facilities

NASA Astrophysics Data System (ADS)

Scala, Natalie Michele

With deregulation, utilities in the power sector face a much more urgent imperative to emphasize cost efficiencies as compared to the days of regulation. One major opportunity for cost savings is through reductions in spare parts inventories. Most utilities are accustomed to carrying large volumes of expensive, relatively slow-moving parts because of a high degree of risk-averseness. This attitude towards risk is rooted in the days of regulation. Under regulation, companies recovered capital inventory costs by incorporating them into the base rate charged to their customers. In a deregulated environment, cost recovery is no longer guaranteed. Companies must therefore reexamine their risk profile and develop policies for spare parts inventory that are appropriate for a competitive business environment. This research studies the spare parts inventory management problem in the context of electric utilities, with a focus on nuclear power. It addresses three issues related to this problem: criticality, risk, and policy. With respect to criticality and risk, a methodology is presented that incorporates the use of influence diagrams and the Analytic Hierarchy Process (AHP). A new method is developed for group aggregation in the AHP when Saaty and Vargas' (2007) dispersion test fails and decision makers are unwilling or unable to revise their judgments. With respect to policy, a quantitative model that ranks the importance of keeping a part in inventory and recommends a corresponding stocking policy through the use of numerical simulation is developed. This methodology and its corresponding models will enable utilities that have transitioned from a regulated to a deregulated environment become more competitive in their operations while maintaining safety and reliability standards. Furthermore, the methodology developed is general enough so that other utility plants, especially those in the nuclear sector, will be able to use this approach. In addition to regulated utilities, other industries, such as aerospace, and the military can also benefit from extensions to these models, as risk profiles and subsequent policies can be adjusted to align with the business environment in which each industry or company operates.

Utility-free heuristic models of two-option choice can mimic predictions of utility-stage models under many conditions

PubMed Central

Piantadosi, Steven T.; Hayden, Benjamin Y.

2015-01-01

Economists often model choices as if decision-makers assign each option a scalar value variable, known as utility, and then select the option with the highest utility. It remains unclear whether as-if utility models describe real mental and neural steps in choice. Although choices alone cannot prove the existence of a utility stage, utility transformations are often taken to provide the most parsimonious or psychologically plausible explanation for choice data. Here, we show that it is possible to mathematically transform a large set of common utility-stage two-option choice models (specifically ones in which dimensions are can be decomposed into additive functions) into a heuristic model (specifically, a dimensional prioritization heuristic) that has no utility computation stage. We then show that under a range of plausible assumptions, both classes of model predict similar neural responses. These results highlight the difficulties in using neuroeconomic data to infer the existence of a value stage in choice. PMID:25914613

Effects of Process Parameters on Copper Powder Compaction Process Using Multi-Particle Finite Element Method

NASA Astrophysics Data System (ADS)

Güner, F.; Sofuoğlu, H.

2018-01-01

Powder metallurgy (PM) has been widely used in several industries; especially automotive and aerospace industries and powder metallurgy products grow up every year. The mechanical properties of the final product that is obtained by cold compaction and sintering in powder metallurgy are closely related to the final relative density of the process. The distribution of the relative density in the die is affected by parameters such as compaction velocity, friction coefficient and temperature. Moreover, most of the numerical studies utilizing finite element approaches treat the examined environment as a continuous media with uniformly homogeneous porosity whereas Multi-Particle Finite Element Method (MPFEM) treats every particles as an individual body. In MPFEM, each of the particles can be defined as an elastic- plastic deformable body, so the interactions of the particles with each other and the die wall can be investigated. In this study, each particle was modelled and analyzed as individual deformable body with 3D tetrahedral elements by using MPFEM approach. This study, therefore, was performed to investigate the effects of different temperatures and compaction velocities on stress distribution and deformations of copper powders of 200 µm-diameter in compaction process. Furthermore, 3-D MPFEM model utilized von Mises material model and constant coefficient of friction of μ=0.05. In addition to MPFEM approach, continuum modelling approach was also performed for comparison purposes.

Laboratory study on the high-temperature capture of HCl gas by dry-injection of calcium-based sorbents.

PubMed

Shemwell, B; Levendis, Y A; Simons, G A

2001-01-01

This is a laboratory study on the reduction of combustion-generated hydrochloric acid (HCl) emissions by in-furnace dry-injection of calcium-based sorbents. HCl is a hazardous gaseous pollutant emitted in significant quantities by municipal and hazardous waste incinerators, coal-fired power plants, and other industrial furnaces. Experiments were conducted in a laboratory furnace at gas temperatures of 600-1000 degrees C. HCl gas diluted with N2, and sorbent powders fluidized in a stream of air were introduced into the furnace concurrently. Chlorination of the sorbents occurred in the hot zone of the furnace at gas residence times approximately 1 s. The sorbents chosen for these experiments were calcium formate (CF), calcium magnesium acetate (CMA), calcium propionate (CP), calcium oxide (CX), and calcium carbonate (CC). Upon release of organic volatiles, sorbents calcine to CaO at approximately 700 degrees C, and react with the HCl according to the reaction CaO + 2HCl <=> CaCl2 + H2O. At the lowest temperature case examined herein, 600 degrees C, direct reaction of HCl with CaCO3 may also be expected. The effectiveness of the sorbents to capture HCl was interpreted using the "pore tree" mathematical model for heterogeneous diffusion reactions. Results show that the thin-walled, highly porous cenospheres formed from the pyrolysis and calcination of CF, CMA, and CP exhibited high relative calcium utilization at the upper temperatures of this study. Relative utilizations under these conditions reached 80%. The less costly low-porosity sorbents, calcium carbonate and calcium oxide also performed well. Calcium carbonate reached a relative utilization of 54% in the mid-temperature range, while the calcium oxide reached an 80% relative utilization at the lowest temperature examined. The data matched theoretical predictions of sorbent utilization using the mathematical model, with activation energy and pre-exponential factors for the calcination reaction of 17,000 K and 300,000 (g gas/cm2/s/atm gas), respectively. Thus, the kinetics of the calcination reaction were found to be much faster (approximately 500 times) than those of the sulfation reaction examined previously in this laboratory.

Predicting SF-6D utility scores from the Oswestry disability index and numeric rating scales for back and leg pain.

PubMed

Carreon, Leah Y; Glassman, Steven D; McDonough, Christine M; Rampersaud, Raja; Berven, Sigurd; Shainline, Michael

2009-09-01

Cross-sectional cohort. The purpose of this study is to provide a model to allow estimation of utility from the Short Form (SF)-6D using data from the Oswestry Disability Index (ODI), Back Pain Numeric Rating Scale (BPNRS), and the Leg Pain Numeric Rating Scale (LPNRS). Cost-utility analysis provides important information about the relative value of interventions and requires a measure of utility not often available from clinical trial data. The ODI and numeric rating scales for back (BPNRS) and leg pain (LPNRS), are widely used disease-specific measures for health-related quality of life in patients with lumbar degenerative disorders. The purpose of this study is to provide a model to allow estimation of utility from the SF-6D using data from the ODI, BPNRS, and the LPNRS. SF-36, ODI, BPNRS, and LPNRS were prospectively collected before surgery, at 12 and 24 months after surgery in 2640 patients undergoing lumbar fusion for degenerative disorders. Spearman correlation coefficients for paired observations from multiple time points between ODI, BPNRS, and LPNRS, and SF-6D utility scores were determined. Regression modeling was done to compute the SF-6D score from the ODI, BPNRS, and LPNRS. Using a separate, independent dataset of 2174 patients in which actual SF-6D and ODI scores were available, the SF-6D was estimated for each subject and compared to their actual SF-6D. In the development sample, the mean age was 52.5 +/- 15 years and 34% were male. In the validation sample, the mean age was 52.9 +/- 14.2 years and 44% were male. Correlations between the SF-6D and the ODI, BPNRS, and LPNRS were statistically significant (P < 0.0001) with correlation coefficients of 0.82, 0.78, and 0.72, respectively. The regression equation using ODI, BPNRS,and LPNRS to predict SF-6D had an R of 0.69 and a root mean square error of 0.076. The model using ODI alone had an R of 0.67 and a root mean square error of 0.078. The correlation coefficient between the observed and estimated SF-6D score was 0.80. In the validation analysis, there was no statistically significant difference (P = 0.11) between actual mean SF-6D (0.55 +/- 0.12) and the estimated mean SF-6D score (0.55 +/- 0.10) using the ODI regression model. This regression-based algorithm may be used to predict SF-6D scores in studies of lumbar degenerative disease that have collected ODI but not utility scores.

Predicting SF-6D utility scores from the Oswestry Disability Index and Numeric Rating Scales for Back and Leg Pain

PubMed Central

Carreon, Leah Y.; Glassman, Steven D.; McDonough, Christine M.; Rampersaud, Raja; Berven, Sigurd; Shainline, Michael

2012-01-01

Study Design Cross-sectional cohort Objective The purpose of this study is to provide a model to allow estimation of utility from the SF-6D using data from the ODI, BPNRS, and the LPNRS. Summary of Background Data Cost-utility analysis provides important information about the relative value of interventions and requires a measure of utility not often available from clinical trial data. The Oswestry Disability Index (ODI) and numeric rating scales for back (BPNRS) and leg pain (LPNRS), are widely used disease-specific measures for health-related quality of life in patients with lumbar degenerative disorders. The purpose of this study is to provide a model to allow estimation of utility from the SF-6D using data from the ODI, BPNRS, and the LPNRS. Methods SF-36, ODI, BPNRS and LPNRS were prospectively collected pre-operatively, at 12 and 24 months post-operatively in 2640 patients undergoing lumbar fusion for degenerative disorders. Spearman correlation coefficients for paired observations from multiple time points between ODI, BPNRS and LPNRS and SF-6D utility scores were determined. Regression modeling was done to compute the SF-6D score from the ODI, BPNRS and LPNRS. Using a separate, independent dataset of 2174 patients in which actual SF-6D and ODI scores were available, the SF-6D was estimated for each subject and compared to their actual SF-6D. Results In the development sample, the mean age was 52.5 ± 15 years and 34% were male. In the validation sample the mean age was 52.9 ± 14.2 years and 44% were male. Correlations between the SF-6D and the ODI, BPNRS and LPNRS were statistically significant (p<0.0001) with correlation coefficients of 0.82, 0.78, and 0.72 respectively. The regression equation using ODI, BPNRS and LPNRS to predict SF-6D had an R2 of 0.69 and a root mean square error (RMSE) of 0.076. The model using ODI alone had an R2 of 0.67 and a RMSE of 0.078. The correlation coefficient between the observed and estimated SF-6D score was 0.80. In the validation analysis, there was no statistically significant difference (p=0.11) between actual mean SF-6D (0.55 ± 0.12) and the estimated mean SF-6D score (0.55 ± 0.10) using the ODI regression model. Conclusion This regression-based algorithm may be used to predict SF-6D scores in studies of lumbar degenerative disease that have collected ODI but not utility scores. PMID:19730215

The impact of chronic hepatitis B on quality of life: a multinational study of utilities from infected and uninfected persons.

PubMed

Levy, Adrian R; Kowdley, Kris V; Iloeje, Uchenna; Tafesse, Eskinder; Mukherjee, Jayanti; Gish, Robert; Bzowej, Natalie; Briggs, Andrew H

2008-01-01

Chronic hepatitis B (CHB) is a condition that results in substantial morbidity and mortality worldwide because of progressive liver damage. Investigators undertaking economic evaluations of new therapeutic agents require estimates of health-related quality of life (HRQOL). Recently, evidence has begun to accumulate that differences in cultural backgrounds have a quantifiable impact on perceptions of health. The objective was to elicit utilities for six health states that occur after infection with the hepatitis B virus from infected and uninfected respondents living in jurisdictions with low and with high CHB endemicity. Standard gamble utilities were elicited from hepatitis patients and uninfected respondents using an interviewer-administered survey in the United States, Canada, United Kingdom, Spain, Hong Kong, and mainland China. Generalized linear models were used to the effect on utilities of current health, age and sex, jurisdiction and, for infected respondents, current disease state. The sample included 534 CHB-infected patients and 600 uninfected respondents. CHB and compensated cirrhosis had a moderate impact on HRQOL with utilities ranging from 0.68 to 0.80. Decompensated cirrhosis and hepatocellular carcinoma had a stronger impact with utilities ranging from 0.35 to 0.41. Significant variation was observed between countries, with both types of respondents in mainland China and Hong Kong reporting systematically lower utilities. Health states related to CHB infection have substantial reductions in HRQOL and the utilities reported in this study provide valuable information for comparing new treatment options. The observed intercountry differences suggest that economic evaluations may benefit from country-specific utility estimates. The extent that systematic intercountry differences in utilities hold true for other infectious and chronic diseases remains an open question and has considerable implications for the proper conduct and interpretation of economic evaluations.

Validation of the conceptual research utilization scale: an application of the standards for educational and psychological testing in healthcare.

PubMed

Squires, Janet E; Estabrooks, Carole A; Newburn-Cook, Christine V; Gierl, Mark

2011-05-19

There is a lack of acceptable, reliable, and valid survey instruments to measure conceptual research utilization (CRU). In this study, we investigated the psychometric properties of a newly developed scale (the CRU Scale). We used the Standards for Educational and Psychological Testing as a validation framework to assess four sources of validity evidence: content, response processes, internal structure, and relations to other variables. A panel of nine international research utilization experts performed a formal content validity assessment. To determine response process validity, we conducted a series of one-on-one scale administration sessions with 10 healthcare aides. Internal structure and relations to other variables validity was examined using CRU Scale response data from a sample of 707 healthcare aides working in 30 urban Canadian nursing homes. Principal components analysis and confirmatory factor analyses were conducted to determine internal structure. Relations to other variables were examined using: (1) bivariate correlations; (2) change in mean values of CRU with increasing levels of other kinds of research utilization; and (3) multivariate linear regression. Content validity index scores for the five items ranged from 0.55 to 1.00. The principal components analysis predicted a 5-item 1-factor model. This was inconsistent with the findings from the confirmatory factor analysis, which showed best fit for a 4-item 1-factor model. Bivariate associations between CRU and other kinds of research utilization were statistically significant (p < 0.01) for the latent CRU scale score and all five CRU items. The CRU scale score was also shown to be significant predictor of overall research utilization in multivariate linear regression. The CRU scale showed acceptable initial psychometric properties with respect to responses from healthcare aides in nursing homes. Based on our validity, reliability, and acceptability analyses, we recommend using a reduced (four-item) version of the CRU scale to yield sound assessments of CRU by healthcare aides. Refinement to the wording of one item is also needed. Planned future research will include: latent scale scoring, identification of variables that predict and are outcomes to conceptual research use, and longitudinal work to determine CRU Scale sensitivity to change.

Unmitigated agency, social support, and psychological adjustment in men with cancer.

PubMed

Hoyt, Michael A; Stanton, Annette L

2011-04-01

Unmitigated agency (UA), a gender-linked characteristic, has been associated with poorer cancer adjustment. Support from one's social network typically predicts adjustment but may be poorly matched to UA. The influence of UA on the utility of social support on adjustment over time is examined. Men with cancer (N=55) were assessed initially and 6 months later on three indicators of adjustment. Multilevel modeling analyses varied by adjustment indicator. UA was associated with increased cancer-related psychosocial symptoms but not depressive symptoms or cancer-related thought intrusion. Social support predicted fewer depressive symptoms and less cancer-related thought intrusion. However, a cross-level interaction revealed that the utility of social support on cancer-related thought intrusion was weaker for men with greater levels of UA. Men with cancer likely respond differently to changes in social support depending on their endorsement of UA. © 2011 The Authors. Journal of Personality © 2011, Wiley Periodicals, Inc.

A Standardized Relative Resource Cost Model for Medical Care: Application to Cancer Control Programs

PubMed Central

2013-01-01

Medicare data represent 75% of aged and permanently disabled Medicare beneficiaries enrolled in the fee-for-service (FFS) indemnity option, but the data omit 25% of beneficiaries enrolled in Medicare Advantage health maintenance organizations (HMOs). Little research has examined how longitudinal patterns of utilization differ between HMOs and FFS. The Burden of Cancer Study developed and implemented an algorithm to assign standardized relative costs to HMO and Medicare FFS data consistently across time and place. Medicare uses 15 payment systems to reimburse FFS providers for covered services. The standardized relative resource cost algorithm (SRRCA) adapts these various payment systems to utilization data. We describe the rationale for modifications to the Medicare payment systems and discuss the implications of these modifications. We applied the SRRCA to data from four HMO sites and the linked Surveillance, Epidemiology, and End Results–Medicare data. Some modifications to Medicare payment systems were required, because data elements needed to categorize utilization were missing from both data sources. For example, data were not available to create episodes for home health services received, so we assigned costs per visit based on visit type (nurse, therapist, and aide). For inpatient utilization, we modified Medicare’s payment algorithm by changing it from a flat payment per diagnosis-related group to daily rates for diagnosis-related groups to differentiate shorter versus longer stays. The SRRCA can be used in multiple managed care plans and across multiple FFS delivery systems within the United States to create consistent relative cost data for economic analyses. Prior to international use of the SRRCA, data need to be standardized. PMID:23962514

Optimum electric utility spot price determinations for small power producing facilities operating under PURPA provisions

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

Ghoudjehbaklou, H.; Puttgen, H.B.

This paper outlines an optimum spot price determination procedure in the general context of the Public Utility Regulatory Policies Act, PURPA, provisions. PURPA stipulates that local utilities must offer to purchase all available excess electric energy from Qualifying Facilities, QF, at fair market prices. As a direct consequence of these PURPA regulations, a growing number of owners are installing power producing facilities and optimize their operational schedules to minimize their utility related costs or, in some cases, actually maximize their revenues from energy sales to the local utility. In turn, the utility strives to use spot prices which maximize itsmore » revenues from any given Small Power Producing Facility, SPPF, a schedule while respecting the general regulatory and contractual framework. the proposed optimum spot price determination procedure fully models the SPPF operation, it enforces the contractual and regulatory restrictions, and it ensures the uniqueness of the optimum SPPF schedule.« less

Optimum electric utility spot price determinations for small power producing facilities operating under PURPA provisions

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

Ghoudjehbaklou, H.; Puttgen, H.B.

The present paper outlines an optimum spot price determination procedure in the general context of the Public Utility Regulatory Policies Act, PURPA, provisions. PURPA stipulates that local utilities must offer to purchase all available excess electric energy from Qualifying Facilities, QF, at fair market prices. As a direct consequence of these PURPA regulations, a growing number of owners are installing power producing facilities and optimize their operational schedules to minimize their utility related costs or, in some cases, actually maximize their revenues from energy sales to the local utility. In turn, the utility will strive to use spot prices whichmore » maximize its revenues from any given Small Power Producing Facility, SPPF, schedule while respecting the general regulatory and contractual framework. The proposed optimum spot price determination procedure fully models the SPPF operation, it enforces the contractual and regulatory restrictions, and it ensures the uniqueness of the optimum SPPF schedule.« less

On the Impact of Execution Models: A Case Study in Computational Chemistry

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

Chavarría-Miranda, Daniel; Halappanavar, Mahantesh; Krishnamoorthy, Sriram

2015-05-25

Efficient utilization of high-performance computing (HPC) platforms is an important and complex problem. Execution models, abstract descriptions of the dynamic runtime behavior of the execution stack, have significant impact on the utilization of HPC systems. Using a computational chemistry kernel as a case study and a wide variety of execution models combined with load balancing techniques, we explore the impact of execution models on the utilization of an HPC system. We demonstrate a 50 percent improvement in performance by using work stealing relative to a more traditional static scheduling approach. We also use a novel semi-matching technique for load balancingmore » that has comparable performance to a traditional hypergraph-based partitioning implementation, which is computationally expensive. Using this study, we found that execution model design choices and assumptions can limit critical optimizations such as global, dynamic load balancing and finding the correct balance between available work units and different system and runtime overheads. With the emergence of multi- and many-core architectures and the consequent growth in the complexity of HPC platforms, we believe that these lessons will be beneficial to researchers tuning diverse applications on modern HPC platforms, especially on emerging dynamic platforms with energy-induced performance variability.« less

A Web-based Distributed Voluntary Computing Platform for Large Scale Hydrological Computations

NASA Astrophysics Data System (ADS)

Demir, I.; Agliamzanov, R.

2014-12-01

Distributed volunteer computing can enable researchers and scientist to form large parallel computing environments to utilize the computing power of the millions of computers on the Internet, and use them towards running large scale environmental simulations and models to serve the common good of local communities and the world. Recent developments in web technologies and standards allow client-side scripting languages to run at speeds close to native application, and utilize the power of Graphics Processing Units (GPU). Using a client-side scripting language like JavaScript, we have developed an open distributed computing framework that makes it easy for researchers to write their own hydrologic models, and run them on volunteer computers. Users will easily enable their websites for visitors to volunteer sharing their computer resources to contribute running advanced hydrological models and simulations. Using a web-based system allows users to start volunteering their computational resources within seconds without installing any software. The framework distributes the model simulation to thousands of nodes in small spatial and computational sizes. A relational database system is utilized for managing data connections and queue management for the distributed computing nodes. In this paper, we present a web-based distributed volunteer computing platform to enable large scale hydrological simulations and model runs in an open and integrated environment.

Organizational climate with gender equity and burnout among university academics in Japan.

PubMed

Taka, Fumiaki; Nomura, Kyoko; Horie, Saki; Takemoto, Keisuke; Takeuchi, Masumi; Takenoshita, Shinichi; Murakami, Aya; Hiraike, Haruko; Okinaga, Hiroko; Smith, Derek R

2016-12-07

We investigated relationships between the perception of organizational climate with gender equity and psychological health among 94 women and 211 men in a Japanese private university in 2015 using the Copenhagen Burnout Inventory (i.e., personal, work-related and student-related burnout). Perceptions of organizational climate with respect to gender equity were measured with two scales including organizational engagement with a gender equal society in the workplace (consisting of three domains of 'Women utilization', 'Organizational promotion of gender equal society' and 'Consultation service'); and a gender inequality in academia scale that had been previously developed. Multivariable linear models demonstrated significant statistical interactions between gender and perceptions of organizational climate; 'Women utilization' or lack of 'Inequality in academia' alleviated burnout only in women. In consequence of this gender difference, when 'Women utilization' was at a lower level, both personal (p=.038) and work-related (p=.010) burnout scores were higher in women, and the student-related burnout score was lower in women when they perceived less inequality in academia than in men (p=.030). As such, it is suggested organizational fairness for gender equity may be a useful tool to help mitigate psychological burnout among women in academia.

Exploring the association of dental care utilization with oral impacts on daily performances (OIDP) - a prospective study of ageing people in Norway and Sweden.

PubMed

Gülcan, Ferda; Ekbäck, Gunnar; Ordell, Sven; Klock, Kristin S; Lie, Stein Atle; Åstrøm, Anne Nordrehaug

2018-01-01

To explore the association of dental health care utilization with oral impacts on daily performances (OIDP) across time focusing ageing Norwegian and Swedish adults adjusting for predisposing, enabling, and need related-factors as defined by Andersen's model. Data were based on Norwegian and Swedish 1942 birth-cohorts conducted in 2007 (age 65) and 2012 (age 70). In Norway, the response rates ranged from 54% to 58%. Corresponding figures in Sweden were from 72% to 73%. Self-administered questionnaires assessed OIDP, dental care utilization and predisposing, enabling and need related factors. Logistic regression with robust variance estimation was used to adjust for clustering in repeated data. Significant covariates of OIDP were satisfaction with dental services, dental care avoidance due to financial constraints, frightening experience with dental care during childhood and patient initiated dental visiting. Frequency and regularity of dental attendance were associated with OIDP in the Swedish cohort, only. In spite of country differences in the public co-financing of dental care, dental care utilization indicators were associated with OIDP across time in both cohorts. Encouraging regular and dentist initiated visiting patterns and strengthening beliefs in keeping own teeth could be useful in attempts to reduce poor oral health related quality of life in ageing people.

Insurer Market Structure and Variation in Commercial Health Care Spending

PubMed Central

McKellar, Michael R; Naimer, Sivia; Landrum, Mary B; Gibson, Teresa B; Chandra, Amitabh; Chernew, Michael

2014-01-01

Objective To examine the relationship between insurance market structure and health care prices, utilization, and spending. Data Sources Claims for 37.6 million privately insured employees and their dependents from the Truven Health Market Scan Database in 2009. Measures of insurer market structure derived from Health Leaders Inter study data. Methods Regression models are used to estimate the association between insurance market concentration and health care spending, utilization, and price, adjusting for differences in patient characteristics and other market-level traits. Results Insurance market concentration is inversely related to prices and spending, but positively related to utilization. Our results imply that, after adjusting for input price differences, a market with two equal size insurers is associated with 3.9 percent lower medical care spending per capita (p = .002) and 5.0 percent lower prices for health care services relative to one with three equal size insurers (p < .001). Conclusion Greater fragmentation in the insurance market might lead to higher prices and higher spending for care, suggesting some of the gains from insurer competition may be absorbed by higher prices for health care. Greater attention to prices and utilization in the provider market may need to accompany procompetitive insurance market strategies. PMID:24303879

Key Technology Research on Open Architecture for The Sharing of Heterogeneous Geographic Analysis Models

NASA Astrophysics Data System (ADS)

Yue, S. S.; Wen, Y. N.; Lv, G. N.; Hu, D.

2013-10-01

In recent years, the increasing development of cloud computing technologies laid critical foundation for efficiently solving complicated geographic issues. However, it is still difficult to realize the cooperative operation of massive heterogeneous geographical models. Traditional cloud architecture is apt to provide centralized solution to end users, while all the required resources are often offered by large enterprises or special agencies. Thus, it's a closed framework from the perspective of resource utilization. Solving comprehensive geographic issues requires integrating multifarious heterogeneous geographical models and data. In this case, an open computing platform is in need, with which the model owners can package and deploy their models into cloud conveniently, while model users can search, access and utilize those models with cloud facility. Based on this concept, the open cloud service strategies for the sharing of heterogeneous geographic analysis models is studied in this article. The key technology: unified cloud interface strategy, sharing platform based on cloud service, and computing platform based on cloud service are discussed in detail, and related experiments are conducted for further verification.

Estimating the Rate of Occurrence of Renal Stones in Astronauts

NASA Technical Reports Server (NTRS)

Myers, J.; Goodenow, D.; Gokoglu, S.; Kassemi, M.

2016-01-01

Changes in urine chemistry, during and post flight, potentially increases the risk of renal stones in astronauts. Although much is known about the effects of space flight on urine chemistry, no inflight incidence of renal stones in US astronauts exists and the question "How much does this risk change with space flight?" remains difficult to accurately quantify. In this discussion, we tackle this question utilizing a combination of deterministic and probabilistic modeling that implements the physics behind free stone growth and agglomeration, speciation of urine chemistry and published observations of population renal stone incidences to estimate changes in the rate of renal stone presentation. The modeling process utilizes a Population Balance Equation based model developed in the companion IWS abstract by Kassemi et al. (2016) to evaluate the maximum growth and agglomeration potential from a specified set of urine chemistry values. Changes in renal stone occurrence rates are obtained from this model in a probabilistic simulation that interrogates the range of possible urine chemistries using Monte Carlo techniques. Subsequently, each randomly sampled urine chemistry undergoes speciation analysis using the well-established Joint Expert Speciation System (JESS) code to calculate critical values, such as ionic strength and relative supersaturation. The Kassemi model utilizes this information to predict the mean and maximum stone size. We close the assessment loop by using a transfer function that estimates the rate of stone formation from combining the relative supersaturation and both the mean and maximum free stone growth sizes. The transfer function is established by a simulation analysis which combines population stone formation rates and Poisson regression. Training this transfer function requires using the output of the aforementioned assessment steps with inputs from known non-stone-former and known stone-former urine chemistries. Established in a Monte Carlo system, the entire renal stone analysis model produces a probability distribution of the stone formation rate and an expected uncertainty in the estimate. The utility of this analysis will be demonstrated by showing the change in renal stone occurrence predicted by this method using urine chemistry distributions published in Whitson et al. 2009. A comparison to the model predictions to previous assessments of renal stone risk will be used to illustrate initial validation of the model.

Predictors of Health Service Utilization Among Older Men in Jamaica.

PubMed

Willie-Tyndale, Douladel; McKoy Davis, Julian; Holder-Nevins, Desmalee; Mitchell-Fearon, Kathryn; James, Kenneth; Waldron, Norman K; Eldemire-Shearer, Denise

2018-01-03

To determine the relative influence of sociodemographic, socioeconomic, psychosocial, and health variables on health service utilization in the last 12 months. Data were analyzed for 1,412 men ≥60 years old from a 2012 nationally representative community-based survey in Jamaica. Associations between six health service utilization variables and several explanatory variables were explored. Logistic regression models were used to identify independent predictors of each utilization measure and determine the strengths of associations. More than 75% reported having health visits and blood pressure checks. Blood sugar (69.6%) and cholesterol (63.1%) checks were less common, and having a prostate check (35.1%) was the least utilized service. Adjusted models confirmed that the presence of chronic diseases and health insurance most strongly predicted utilization. A daughter or son as the main source of financial support (vs self) doubled or tripled, respectively, the odds of routine doctors' visits. Compared with primary or lower education, tertiary education doubled [2.37 (1.12, 4.95)] the odds of a blood pressure check. Regular attendance at club/society/religious organizations' meetings increased the odds of having a prostate check by 45%. Although need and financial resources most strongly influenced health service utilization, psychosocial variables may be particularly influential for underutilized services. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Utilities: a solution of a decision problem?].

PubMed

Koller, Michael; Ohmann, Christian; Lorenz, Wilfried

2008-01-01

Utility is a concept that originates from utilitarianism, a highly influential philosophical school in the Anglo-American world. The cornerstone of utilitarianism is the principle of maximum happiness or utility. In the medical sciences, this utility approach has been adopted and developed within the field of medical decision making. On an operational level, utility is the evaluation of a health state or an outcome on a one-dimensional scale ranging from 0 (death) to 1 (perfect health). By adding the concept of expectancy, the graphic representation of both concepts in a decision tree results in the specification of expected utilities and helps to resolve complex medical decision problems. Criticism of the utility approach relates to the rational perspective on humans (which is rejected by a considerable fraction of research in psychology) and to the artificial methods used in the evaluation of utility, such as Standard Gamble or Time Trade Off. These may well be the reason why the utility approach has never been accepted in Germany. Nevertheless, innovative concepts for defining goals in health care are urgently required, as the current debate in Germany on "Nutzen" (interestingly translated as 'benefit' instead of as 'utility') and integrated outcome models indicates. It remains to be seen whether this discussion will lead to a re-evaluation of the utility approach.

Effect of explicit dimension instruction on speech category learning

PubMed Central

Chandrasekaran, Bharath; Yi, Han-Gyol; Smayda, Kirsten E.; Maddox, W. Todd

2015-01-01

Learning non-native speech categories is often considered a challenging task in adulthood. This difficulty is driven by cross-language differences in weighting critical auditory dimensions that differentiate speech categories. For example, previous studies have shown that differentiating Mandarin tonal categories requires attending to dimensions related to pitch height and direction. Relative to native speakers of Mandarin, the pitch direction dimension is under-weighted by native English speakers. In the current study, we examined the effect of explicit instructions (dimension instruction) on native English speakers' Mandarin tone category learning within the framework of a dual-learning systems (DLS) model. This model predicts that successful speech category learning is initially mediated by an explicit, reflective learning system that frequently utilizes unidimensional rules, with an eventual switch to a more implicit, reflexive learning system that utilizes multidimensional rules. Participants were explicitly instructed to focus and/or ignore the pitch height dimension, the pitch direction dimension, or were given no explicit prime. Our results show that instruction instructing participants to focus on pitch direction, and instruction diverting attention away from pitch height resulted in enhanced tone categorization. Computational modeling of participant responses suggested that instruction related to pitch direction led to faster and more frequent use of multidimensional reflexive strategies, and enhanced perceptual selectivity along the previously underweighted pitch direction dimension. PMID:26542400

PBPK Models for Gasoline-Ethanol Biofuels in Adult and Pregnant Rats**

EPA Science Inventory

As utilization of biofuels (BF) in the commercial marketplace has increased in recent years, so has the need for evaluation of exposure-related health effects, such as developmental neurotoxicity. This research describes the development of inhalation life-stage physiologically-ba...

PBPK Models for Gasoline-Ethanol Biofuels in Adult and Pregnant Rats

EPA Science Inventory

As utilization of biofuels (BF) in the commercial marketplace has increased in recent years, so has the need for evaluation of exposure-related health effects, such as developmental neurotoxicity. This research describes the development of inhalation life-stage physiologically-ba...

PBPK Models for Gasoline-Ethanol Biofuels in Adult and Pregnant Rats####

EPA Science Inventory

As utilization of biofuels (BF) in the commercial marketplace has increased in recent years, so has the need for evaluation of exposure-related health effects, such as developmental neurotoxicity. This research describes the development of inhalation life-stage physiologically-ba...

PBPK Models for Gasoline-Ethanol Biofuels in Adult and Pregnant Rats###

EPA Science Inventory

As utilization of biofuels (BF) in the commercial marketplace has increased in recent years, so has the need for evaluation of exposure-related health effects, such as developmental neurotoxicity. This research describes the development of inhalation life-stage physiologically-ba...

PBPK Models for Gasoline-Ethanol Biofuels in Adult and Pregnant Rats@@@@

EPA Science Inventory

As utilization of biofuels (BF) in the commercial marketplace has increased in recent years, so has the need for evaluation of exposure-related health effects, such as developmental neurotoxicity. This research describes the development of inhalation life-stage physiologically-ba...

RECENT APPLICATIONS OF SOURCE APPORTIONMENT METHODS AND RELATED NEEDS

EPA Science Inventory

Traditional receptor modeling studies have utilized factor analysis (like principal component analysis, PCA) and/or Chemical Mass Balance (CMB) to assess source influences. The limitations with these approaches is that PCA is qualitative and CMB requires the input of source pr...

Whither Sex Education? Excellence in Comprehensive Program Development.

ERIC Educational Resources Information Center

Southern, Stephen

A review of recent sex education literature is presented in an attempt to integrate observations and recommendations related to both program development and innovation acceptance. A Developmental Research and Utilization Model is employed to systematically guide planning, implementation, evaluation, advocacy, and institutionalization. Curriculum…

Particle Physics: From School to University.

ERIC Educational Resources Information Center

Barlow, Roger

1992-01-01

Discusses the teaching of particle physics as part of the A-level physics course in British secondary schools. Utilizes the quark model of hadrons and the conceptual kinematics of particle collisions, as examples, to demonstrate practical instructional possibilities in relation to student expectations. (JJK)

A systematic literature review of health state utility values in head and neck cancer.

PubMed

Meregaglia, Michela; Cairns, John

2017-09-02

Health state utility values (HSUVs) are essential parameters in model-based economic evaluations. This study systematically identifies HSUVs in head and neck cancer and provides guidance for selecting them from a growing body of health-related quality of life studies. We systematically reviewed the published literature by searching PubMed, EMBASE and The Cochrane Library using a pre-defined combination of keywords. The Tufts Cost-Effectiveness Analysis Registry and the School of Health and Related Research Health Utilities Database (ScHARRHUD) specifically containing health utilities were also queried, in addition to the Health Economics Research Centre database of mapping studies. Studies were considered for inclusion if reporting original HSUVs assessed using established techniques. The characteristics of each study including country, design, sample size, cancer subsite addressed and demographics of responders were summarized narratively using a data extraction form. Quality scoring and critical appraisal of the included studies were performed based on published recommendations. Of a total 1048 records identified by the search, 28 studies qualified for data extraction and 346 unique HSUVs were retrieved from them. HSUVs were estimated using direct methods (e.g. standard gamble; n = 10 studies), multi-attribute utility instruments (MAUIs; n = 13) and mapping techniques (n = 3); two studies adopted both direct and indirect approaches. Within the MAUIs, the EuroQol 5-dimension questionnaire (EQ-5D) was the most frequently used (n = 11), followed by the Health Utility Index Mark 3 (HUI3; n = 2), the 15D (n = 2) and the Short Form-Six Dimension (SF-6D; n = 1). Different methods and types of responders (i.e. patients, healthy subjects, clinical experts) influenced the magnitude of HSUVs for comparable health states. Only one mapping study developed an original algorithm using head and neck cancer data. The identified studies were considered of intermediate quality. This review provides a dataset of HSUVs systematically retrieved from published studies in head and neck cancer. There is currently a lack of research for some disease phases including recurrent and metastatic cancer, and treatment-related complications. In selecting HSUVs for cost-effectiveness modeling purposes, preference should be given to EQ-5D utility values; however, mapping to EQ-5D is a potentially valuable technique that should be further developed in this cancer population.

Evaluating mediation and moderation effects in school psychology: A presentation of methods and review of current practice

PubMed Central

Fairchild, Amanda J.; McQuillin, Samuel D.

2017-01-01

Third variable effects elucidate the relation between two other variables, and can describe why they are related or under what conditions they are related. This article demonstrates methods to analyze two third-variable effects: moderation and mediation. The utility of examining moderation and mediation effects in school psychology is described and current use of the analyses in applied school psychology research is reviewed and evaluated. Proper statistical methods to test the effects are presented, and different effect size measures for the models are provided. Extensions of the basic moderator and mediator models are also described. PMID:20006988

Evaluating mediation and moderation effects in school psychology: a presentation of methods and review of current practice.

PubMed

Fairchild, Amanda J; McQuillin, Samuel D

2010-02-01

Third variable effects elucidate the relation between two other variables, and can describe why they are related or under what conditions they are related. This article demonstrates methods to analyze two third-variable effects: moderation and mediation. The utility of examining moderation and mediation effects in school psychology is described and current use of the analyses in applied school psychology research is reviewed and evaluated. Proper statistical methods to test the effects are presented, and different effect size measures for the models are provided. Extensions of the basic moderator and mediator models are also described.

A Note on the Fractal Behavior of Hydraulic Conductivity and Effective Porosity for Experimental Values in a Confined Aquifer

PubMed Central

De Bartolo, Samuele; Fallico, Carmine; Veltri, Massimo

2013-01-01

Hydraulic conductivity and effective porosity values for the confined sandy loam aquifer of the Montalto Uffugo (Italy) test field were obtained by laboratory and field measurements; the first ones were carried out on undisturbed soil samples and the others by slug and aquifer tests. A direct simple-scaling analysis was performed for the whole range of measurement and a comparison among the different types of fractal models describing the scale behavior was made. Some indications about the largest pore size to utilize in the fractal models were given. The results obtained for a sandy loam soil show that it is possible to obtain global indications on the behavior of the hydraulic conductivity versus the porosity utilizing a simple scaling relation and a fractal model in coupled manner. PMID:24385876

Net reclassification index at event rate: properties and relationships.

PubMed

Pencina, Michael J; Steyerberg, Ewout W; D'Agostino, Ralph B

2017-12-10

The net reclassification improvement (NRI) is an attractively simple summary measure quantifying improvement in performance because of addition of new risk marker(s) to a prediction model. Originally proposed for settings with well-established classification thresholds, it quickly extended into applications with no thresholds in common use. Here we aim to explore properties of the NRI at event rate. We express this NRI as a difference in performance measures for the new versus old model and show that the quantity underlying this difference is related to several global as well as decision analytic measures of model performance. It maximizes the relative utility (standardized net benefit) across all classification thresholds and can be viewed as the Kolmogorov-Smirnov distance between the distributions of risk among events and non-events. It can be expressed as a special case of the continuous NRI, measuring reclassification from the 'null' model with no predictors. It is also a criterion based on the value of information and quantifies the reduction in expected regret for a given regret function, casting the NRI at event rate as a measure of incremental reduction in expected regret. More generally, we find it informative to present plots of standardized net benefit/relative utility for the new versus old model across the domain of classification thresholds. Then, these plots can be summarized with their maximum values, and the increment in model performance can be described by the NRI at event rate. We provide theoretical examples and a clinical application on the evaluation of prognostic biomarkers for atrial fibrillation. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Numerical algebraic geometry for model selection and its application to the life sciences

PubMed Central

Gross, Elizabeth; Davis, Brent; Ho, Kenneth L.; Bates, Daniel J.

2016-01-01

Researchers working with mathematical models are often confronted by the related problems of parameter estimation, model validation and model selection. These are all optimization problems, well known to be challenging due to nonlinearity, non-convexity and multiple local optima. Furthermore, the challenges are compounded when only partial data are available. Here, we consider polynomial models (e.g. mass-action chemical reaction networks at steady state) and describe a framework for their analysis based on optimization using numerical algebraic geometry. Specifically, we use probability-one polynomial homotopy continuation methods to compute all critical points of the objective function, then filter to recover the global optima. Our approach exploits the geometrical structures relating models and data, and we demonstrate its utility on examples from cell signalling, synthetic biology and epidemiology. PMID:27733697

Comparison of melibiose utilizing baker's yeast strains produced by genetic engineering and classical breeding.

PubMed

Vincent, S F; Bell, P J; Bissinger, P; Nevalainen, K M

1999-02-01

Yeast strains currently used in the baking industry cannot fully utilize the trisaccharide raffinose found in beet molasses due to the absence of melibiase (alpha-galactosidase) activity. To overcome this deficiency, the MEL1 gene encoding melibiase enzyme was introduced into baker's yeast by both classical breeding and recombinant DNA technology. Both types of yeast strains were capable of vigorous fermentation in the presence of high levels of sucrose, making them suitable for the rapidly developing Asian markets where high levels of sugar are used in bread manufacture. Melibiase expression appeared to be dosage-dependent, with relatively low expression sufficient for complete melibiose utilization in a model fermentation system.

More-Realistic Digital Modeling of a Human Body

NASA Technical Reports Server (NTRS)

Rogge, Renee

2010-01-01

A MATLAB computer program has been written to enable improved (relative to an older program) modeling of a human body for purposes of designing space suits and other hardware with which an astronaut must interact. The older program implements a kinematic model based on traditional anthropometric measurements that do provide important volume and surface information. The present program generates a three-dimensional (3D) whole-body model from 3D body-scan data. The program utilizes thin-plate spline theory to reposition the model without need for additional scans.

Reaching unanimous agreements within agent-based negotiation teams with linear and monotonic utility functions.

PubMed

Sanchez-Anguix, Victor; Julian, Vicente; Botti, Vicente; García-Fornes, Ana

2012-06-01

In this article, an agent-based negotiation model for negotiation teams that negotiate a deal with an opponent is presented. Agent-based negotiation teams are groups of agents that join together as a single negotiation party because they share an interest that is related to the negotiation process. The model relies on a trusted mediator that coordinates and helps team members in the decisions that they have to take during the negotiation process: which offer is sent to the opponent, and whether the offers received from the opponent are accepted. The main strength of the proposed negotiation model is the fact that it guarantees unanimity within team decisions since decisions report a utility to team members that is greater than or equal to their aspiration levels at each negotiation round. This work analyzes how unanimous decisions are taken within the team and the robustness of the model against different types of manipulations. An empirical evaluation is also performed to study the impact of the different parameters of the model.

Atmospheric and oceanographic research review, 1978. [global weather, ocean/air interactions, and climate

NASA Technical Reports Server (NTRS)

1978-01-01

Research activities related to global weather, ocean/air interactions, and climate are reported. The global weather research is aimed at improving the assimilation of satellite-derived data in weather forecast models, developing analysis/forecast models that can more fully utilize satellite data, and developing new measures of forecast skill to properly assess the impact of satellite data on weather forecasting. The oceanographic research goal is to understand and model the processes that determine the general circulation of the oceans, focusing on those processes that affect sea surface temperature and oceanic heat storage, which are the oceanographic variables with the greatest influence on climate. The climate research objective is to support the development and effective utilization of space-acquired data systems in climate forecast models and to conduct sensitivity studies to determine the affect of lower boundary conditions on climate and predictability studies to determine which global climate features can be modeled either deterministically or statistically.

Overhead longwave infrared hyperspectral material identification using radiometric models

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

Zelinski, M. E.

Material detection algorithms used in hyperspectral data processing are computationally efficient but can produce relatively high numbers of false positives. Material identification performed as a secondary processing step on detected pixels can help separate true and false positives. This paper presents a material identification processing chain for longwave infrared hyperspectral data of solid materials collected from airborne platforms. The algorithms utilize unwhitened radiance data and an iterative algorithm that determines the temperature, humidity, and ozone of the atmospheric profile. Pixel unmixing is done using constrained linear regression and Bayesian Information Criteria for model selection. The resulting product includes an optimalmore » atmospheric profile and full radiance material model that includes material temperature, abundance values, and several fit statistics. A logistic regression method utilizing all model parameters to improve identification is also presented. This paper details the processing chain and provides justification for the algorithms used. Several examples are provided using modeled data at different noise levels.« less

An empirical analysis of Moscovitch's reconceptualised model of social anxiety: How is it different from fear of negative evaluation?

PubMed

Kizilcik, Isilay N; Gregory, Bree; Baillie, Andrew J; Crome, Erica

2016-01-01

Cognitive-behavioural models propose that excessive fear of negative evaluation is central to social anxiety. Moscovitch (2009) instead proposes that perceived deficiencies in three self attributes: fears of showing signs of anxiety, deficits in physical appearance, or deficits in social competence are at the core of social anxiety. However, these attributes are likely to overlap with fear of negative evaluation. Responses to an online survey of 286 participants with a range of social anxiety severity were analysed using hierarchical multiple regression to identify the overall unique predictive value of Moscovitch's model. Altogether, Moscovitch's model provided improvements in the prediction of safety behaviours, types of fears and cognitions; however only the fear of showing anxiety subscale provided unique information. This research supports further investigations into the utility of this revised model, particularly related to utility of explicitly assessing and addressing fears of showing anxiety. Copyright © 2015 Elsevier Ltd. All rights reserved.

Social capital, outpatient care utilization and choice between different levels of health facilities in rural and urban areas of Bhutan.

PubMed

Herberholz, Chantal; Phuntsho, Sonam

2018-06-18

This study examines the factors that explain outpatient care utilization and the choice between different levels of health facilities in Bhutan, focusing on individual social capital, given Bhutan's geography of remote and sparsely populated areas. The more isolated the living, the more important individual social capital may become. Standard factors proposed by the Andersen model of healthcare utilization serve as control variables. Data for 2526 households from the 2012 Bhutan Living Standards Survey, which contains a social capital module covering structural, cognitive and output dimensions of social capital, are used. The results from the logistic regression analysis show that individual social capital is positively related with the probability of seeking treatment when ill or injured. Informal social contacts and perceived help and support are most important in rural areas, whereas specific trust matters in urban areas. The explanatory power of the model using a subset of the data for urban areas only, however, is very low as most predisposing and enabling factors are insignificant, which is not surprising though in view of better access to health facilities in urban areas and the fact that healthcare is provided free of charge in Bhutan. Multinomial regression results further show that structural and output dimensions of social capital influence the likelihood of seeking care at secondary or tertiary care facilities relative to primary care facilities. Moreover, economic status and place of residence are significantly associated with healthcare utilization and choice of health facility. The findings with respect to social capital suggest that strategizing and organizing social capital may help improve healthcare utilization in Bhutan. Copyright © 2018 Elsevier Ltd. All rights reserved.

Virtual medicine: Utilization of the advanced cardiac imaging patient avatar for procedural planning and facilitation.

PubMed

Shinbane, Jerold S; Saxon, Leslie A

Advances in imaging technology have led to a paradigm shift from planning of cardiovascular procedures and surgeries requiring the actual patient in a "brick and mortar" hospital to utilization of the digitalized patient in the virtual hospital. Cardiovascular computed tomographic angiography (CCTA) and cardiovascular magnetic resonance (CMR) digitalized 3-D patient representation of individual patient anatomy and physiology serves as an avatar allowing for virtual delineation of the most optimal approaches to cardiovascular procedures and surgeries prior to actual hospitalization. Pre-hospitalization reconstruction and analysis of anatomy and pathophysiology previously only accessible during the actual procedure could potentially limit the intrinsic risks related to time in the operating room, cardiac procedural laboratory and overall hospital environment. Although applications are specific to areas of cardiovascular specialty focus, there are unifying themes related to the utilization of technologies. The virtual patient avatar computer can also be used for procedural planning, computational modeling of anatomy, simulation of predicted therapeutic result, printing of 3-D models, and augmentation of real time procedural performance. Examples of the above techniques are at various stages of development for application to the spectrum of cardiovascular disease processes, including percutaneous, surgical and hybrid minimally invasive interventions. A multidisciplinary approach within medicine and engineering is necessary for creation of robust algorithms for maximal utilization of the virtual patient avatar in the digital medical center. Utilization of the virtual advanced cardiac imaging patient avatar will play an important role in the virtual health care system. Although there has been a rapid proliferation of early data, advanced imaging applications require further assessment and validation of accuracy, reproducibility, standardization, safety, efficacy, quality, cost effectiveness, and overall value to medical care. Copyright © 2018 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

Predicting attitude toward methamphetamine use: the role of antidrug campaign exposure and conversations about meth in Montana.

PubMed

Richards, Adam S

2014-01-01

This investigation utilized the integrative model of behavioral prediction to assess the Montana Meth Project (MMP) campaign by testing theoretical antecedents of attitude toward methamphetamine (meth) use. College students in Montana (N = 403) were surveyed about their exposure to MMP ads and communication about meth in conversation. Structural equation modeling showed that the data fit the specified model well. Significant parameters indicated that only beliefs about the negative relational outcomes of meth use, and not about personal well-being or physical appearance, were related to attitude. Attention, rather than encoded exposure, to MMP ads related to each belief about meth use. Conversation frequency related to engagement with MMP ads, and a conversational partner's conveyed attitude toward meth use related to personal and physical beliefs as well as attitudes. Theoretical and practical implications of the findings are discussed.

Military children's difficulty with reintegration after deployment: A relational turbulence model perspective.

PubMed

Knobloch, Leanne K; Knobloch-Fedders, Lynne M; Yorgason, Jeremy B; Ebata, Aaron T; McGlaughlin, Patricia C

2017-08-01

This study drew on the relational turbulence model to investigate how the interpersonal dynamics of military couples predict parents' reports of the reintegration difficulty of military children upon homecoming after deployment. Longitudinal data were collected from 118 military couples once per month for 3 consecutive months after reunion. Military couples reported on their depressive symptoms, characteristics of their romantic relationship, and the reintegration difficulty of their oldest child. Results of dyadic growth curve models indicated that the mean levels of parents' depressive symptoms (H1), relationship uncertainty (H2), and interference from a partner (H3) were positively associated with parents' reports of military children's reintegration difficulty. These findings suggest that the relational turbulence model has utility for illuminating the reintegration difficulty of military children during the postdeployment transition. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Utility of Behavioral Economics in Expanding the Free-Feed Model of Obesity

PubMed Central

Rasmussen, Erin B.; Robertson, Stephen H.; Rodriguez, Luis R.

2016-01-01

Animal models of obesity are numerous and diverse in terms of identifying specific neural and peripheral mechanisms related to obesity; however, they are limited when it comes to behavior. The standard behavioral measure of food intake in most animal models occurs in a free-feeding environment. While easy and cost-effective for the researcher, the free-feeding environment omits some of the most important features of obesity-related food consumption—namely, properties of food availability, such as effort and delay to obtaining food. Behavior economics expands behavioral measures of obesity animal models by identifying such behavioral mechanisms. First, economic demand analysis allows researchers to understand the role of effort in food procurement, and how physiological and neural mechanisms are related. Second, studies on delay discounting contribute to a growing literature that shows that sensitivity to delayed food- and food-related outcomes is likely a fundamental process of obesity. Together, these data expand the animal model in a manner that better characterizes how environmental factors influence food consumption. PMID:26923097

Effects of atmospheric variability on energy utilization and conservation. [Space heating energy demand modeling; Program HEATLOAD

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

Reiter, E.R.; Johnson, G.R.; Somervell, W.L. Jr.

Research conducted between 1 July 1975 and 31 October 1976 is reported. A ''physical-adaptive'' model of the space-conditioning demand for energy and its response to changes in weather regimes was developed. This model includes parameters pertaining to engineering factors of building construction, to weather-related factors, and to socio-economic factors. Preliminary testing of several components of the model on the city of Greeley, Colorado, yielded most encouraging results. Other components, especially those pertaining to socio-economic factors, are still under development. Expansion of model applications to different types of structures and larger regions is presently underway. A CRT-display model for energy demandmore » within the conterminous United States also has passed preliminary tests. A major effort was expended to obtain disaggregated data on energy use from utility companies throughout the United States. The study of atmospheric variability revealed that the 22- to 26-day vacillation in the potential and kinetic energy modes of the Northern Hemisphere is related to the behavior of the planetary long-waves, and that the midwinter dip in zonal available potential energy is reflected in the development of blocking highs. Attempts to classify weather patterns over the eastern and central United States have proceeded satisfactorily to the point where testing of our method for longer time periods appears desirable.« less

The cost effectiveness of teriparatide as a first-line treatment for glucocorticoid-induced and postmenopausal osteoporosis patients in Sweden.

PubMed

Murphy, Daniel R; Smolen, Lee J; Klein, Timothy M; Klein, Robert W

2012-10-30

This paper presents the model and results to evaluate the use of teriparatide as a first-line treatment of severe postmenopausal osteoporosis (PMO) and glucocorticoid-induced osteoporosis (GIOP). The study's objective was to determine if teriparatide is cost effective against oral bisphosphonates for two large and high risk cohorts. A computer simulation model was created to model treatment, osteoporosis related fractures, and the remaining life of PMO and GIOP patients. Natural mortality and additional mortality from osteoporosis related fractures were included in the model. Costs for treatment with both teriparatide and oral bisphosphonates were included. Drug efficacy was modeled as a reduction to the relative fracture risk for subsequent osteoporosis related fractures. Patient health utilities associated with age, gender, and osteoporosis related fractures were included in the model. Patient costs and utilities were summarized and incremental cost-effectiveness ratios (ICERs) for teriparatide versus oral bisphosphonates and teriparatide versus no treatment were estimated.For each of the PMO and GIOP populations, two cohorts differentiated by fracture history were simulated. The first contained patients with both a historical vertebral fracture and an incident vertebral fracture. The second contained patients with only an incident vertebral fracture. The PMO cohorts simulated had an initial Bone Mineral Density (BMD) T-Score of -3.0. The GIOP cohorts simulated had an initial BMD T-Score of -2.5. The ICERs for teriparatide versus bisphosphonate use for the one and two fracture PMO cohorts were €36,995 per QALY and €19,371 per QALY. The ICERs for teriparatide versus bisphosphonate use for the one and two fracture GIOP cohorts were €20,826 per QALY and €15,155 per QALY, respectively. The selection of teriparatide versus oral bisphosphonates as a first-line treatment for the high risk PMO and GIOP cohorts evaluated is justified at a cost per QALY threshold of €50,000.

Individual and contextual factors influencing dental health care utilization by preschool children: a multilevel analysis

PubMed

Piovesan, Chaiana; Ardenghi, Thiago Machado; Mendes, Fausto Medeiros; Agostini, Bernardo Antonio; Michel-Crosato, Edgard

2017-03-30

The effect of contextual factors on dental care utilization was evaluated after adjustment for individual characteristics of Brazilian preschool children. This cross-sectional study assessed 639 preschool children aged 1 to 5 years from Santa Maria, a town in Rio Grande do Sul State, located in southern Brazil. Participants were randomly selected from children attending the National Children's Vaccination Day and 15 health centers were selected for this research. Visual examinations followed the ICDAS criteria. Parents answered a questionnaire about demographic and socioeconomic characteristics. Contextual influences on children's dental care utilization were obtained from two community-related variables: presence of dentists and presence of workers' associations in the neighborhood. Unadjusted and adjusted multilevel logistic regression models were used to describe the association between outcome and predictor variables. A prevalence of 21.6% was found for regular use of dental services. The unadjusted assessment of the associations of dental health care utilization with individual and contextual factors included children's ages, family income, parents' schooling, mothers' participation in their children's school activities, dental caries, and presence of workers' associations in the neighborhood as the main outcome covariates. Individual variables remained associated with the outcome after adding contextual variables in the model. In conclusion, individual and contextual variables were associated with dental health care utilization by preschool children.

Models of Physiology/Cognition Relations: Their Prevalence in the Literature and Their Utility in Examining the Effect of Blood Pressure on Vocabulary and Memory for Designs.

ERIC Educational Resources Information Center

Sinnott, Jan D.; And Others

Interest in physiology/cognition relations is increasing, in step with the realization that the individual ages as a whole, adaptive, living system. If a physiological system declines, a person's cognitive abilities may be reduced, unless some compensatory mechanism operates. Understanding this set of relationships permits potential interventions.…

Application of solar energy to air conditioning systems

NASA Technical Reports Server (NTRS)

Nash, J. M.; Harstad, A. J.

1976-01-01

The results of a survey of solar energy system applications of air conditioning are summarized. Techniques discussed are both solar powered (absorption cycle and the heat engine/Rankine cycle) and solar related (heat pump). Brief descriptions of the physical implications of various air conditioning techniques, discussions of status, proposed technological improvements, methods of utilization and simulation models are presented, along with an extensive bibliography of related literature.

Driver performance modelling and its practical application to railway safety.

PubMed

Hamilton, W Ian; Clarke, Theresa

2005-11-01

This paper reports on the development and main features of a model of driver information processing. The work was conducted on behalf of Network Rail to meet a requirement to understand and manage the driver's interaction with the infrastructure through lineside reminder appliances. The model utilises cognitive theory and modelling techniques to describe driver performance in relation to infrastructure features and operational conditions. The model is capable of predicting the performance time, workload and error consequences of different operational conditions. The utility of the model is demonstrated through reports of its application to the following studies: Research on the effect of line speed on driver interaction with signals and signs. Calculation of minimum reading times for signals. Development of a human factors signals passed at danger (SPAD) hazard checklist, and a method to resolve conflicts between signal sighting solutions. Research on the demands imposed on drivers by European train control system (ETCS) driving in a UK context. The paper also reports on a validation of the model's utility as a tool for assessing cab and infrastructure drivability.

Blunted Hypothalamo-pituitary Adrenal Axis Response to Predator Odor Predicts High Stress Reactivity

PubMed Central

Whitaker, Annie M.; Gilpin, Nicholas W.

2015-01-01

Individuals with trauma- and stress-related disorders exhibit increases in avoidance of trauma-related stimuli, heightened anxiety and altered neuroendocrine stress responses. Our laboratory uses a rodent model of stress that mimics the avoidance symptom cluster associated with stress-related disorders. Animals are classified as ‘Avoiders’ or Non-Avoiders' post-stress based on avoidance of predator-odor paired context. Utilizing this model, we are able to examine subpopulation differences in stress reactivity. Here, we used this predator odor model of stress to examine differences in anxiety-like behavior and hypothalamo-pituitary adrenal (HPA) axis function in animals that avoid a predator-paired context relative to those that do not. Rats were exposed to predator odor stress paired with a context and tested for avoidance (24 hours and 11 days), anxiety-like behavior (48 hours and 5 days) and HPA activation following stress. Control animals were exposed to room air. Predator odor stress produced avoidance in approximately 65% of the animals at 24 hours that persisted 11 days post-stress. Both Avoiders and Non-Avoiders exhibited heightened anxiety-like behavior at 48 hours and 5 days post-stress when compared to unstressed Controls. Non-Avoiders exhibited significant increases in circulating adrenocorticotropin hormone (ACTH) and corticosterone (CORT) concentrations immediately following predator odor stress compared to Controls and this response was significantly attenuated in Avoiders. There was an inverse correlation between circulating ACTH/CORT concentrations and avoidance, indicating that lower levels of ACTH/CORT predicted higher levels of avoidance. These results suggest that stress effects on HPA stress axis activation predict long-term avoidance of stress-paired stimuli, and builds on previous data showing the utility of this model for exploring the neurobiological mechanisms of trauma- and stress-related disorders. PMID:25824191

Blunted hypothalamo-pituitary adrenal axis response to predator odor predicts high stress reactivity.

PubMed

Whitaker, Annie M; Gilpin, Nicholas W

2015-08-01

Individuals with trauma- and stress-related disorders exhibit increases in avoidance of trauma-related stimuli, heightened anxiety and altered neuroendocrine stress responses. Our laboratory uses a rodent model of stress that mimics the avoidance symptom cluster associated with stress-related disorders. Animals are classified as 'Avoiders' or 'Non-Avoiders' post-stress based on avoidance of predator-odor paired context. Utilizing this model, we are able to examine subpopulation differences in stress reactivity. Here, we used this predator odor model of stress to examine differences in anxiety-like behavior and hypothalamo-pituitary adrenal (HPA) axis function in animals that avoid a predator-paired context relative to those that do not. Rats were exposed to predator odor stress paired with a context and tested for avoidance (24h and 11days), anxiety-like behavior (48h and 5days) and HPA activation following stress. Control animals were exposed to room air. Predator odor stress produced avoidance in approximately 65% of the animals at 24h that persisted 11days post-stress. Both Avoiders and Non-Avoiders exhibited a heightened anxiety-like behavior at 48h and 5days post-stress when compared to unstressed Controls. Non-Avoiders exhibited significant increases in circulating adrenocorticotropin hormone (ACTH) and corticosterone (CORT) concentrations immediately following predator odor stress compared to Controls and this response was significantly attenuated in Avoiders. There was an inverse correlation between circulating ACTH/CORT concentrations and avoidance, indicating that lower levels of ACTH/CORT predicted higher levels of avoidance. These results suggest that stress effects on HPA stress axis activation predict long-term avoidance of stress-paired stimuli, and build on previous data showing the utility of this model for exploring the neurobiological mechanisms of trauma- and stress-related disorders. Copyright © 2015. Published by Elsevier Inc.

Has income-related inequity in health care utilization and expenditures been improved? Evidence from the Korean National Health and Nutrition Examination Survey of 2005 and 2010.

PubMed

Kim, Eunkyoung; Kwon, Soonman; Xu, Ke

2013-09-01

The purpose of this study is to examine and explain the extent of income-related inequity in health care utilization and expenditures to compare the extent in 2005 and 2010 in Korea. We employed the concentration indices and the horizontal inequity index proposed by Wagstaff and van Doorslaer based on one- and two-part models. This study was conducted using data from the 2005 and 2010 Korean National Health and Nutrition Examination Survey. We examined health care utilization and expenditures for different types of health care providers, including health centers, physician clinics, hospitals, general hospitals, dental care, and licensed traditional medical practitioners. The results show the equitable distribution of overall health care utilization with pro-poor tendencies and modest pro-rich inequity in the amount of medical expenditures in 2010. For the decomposition analysis, non-need variables such as income, education, private insurance, and occupational status have contributed considerably to pro-rich inequality in health care over the period between 2005 and 2010. We found that health care utilization in Korea in 2010 was fairly equitable, but the poor still have some barriers to accessing primary care and continuing to receive medical care.

SPATIAL ACCURACY: A CRITICAL FACTOR IN GIS-RELATED ACTIVITIES

EPA Science Inventory

Onsite analyses are critical to making timely decisions. The results of these decisions may not be realized for many years. In order to increase the value of onsite analyses and to create and utilize meaningful environmental models, the Environmental Protection Agency (EPA) dev...

A Cost-Utility Model of Care for Peristomal Skin Complications

PubMed Central

Inglese, Gary; Manson, Andrea; Townshend, Arden

2016-01-01

PURPOSE: The aim of this study was to evaluate the economic and humanistic implications of using ostomy components to prevent subsequent peristomal skin complications (PSCs) in individuals who experience an initial, leakage-related PSC event. DESIGN: Cost-utility analysis. METHODS: We developed a simple decision model to consider, from a payer's perspective, PSCs managed with and without the use of ostomy components over 1 year. The model evaluated the extent to which outcomes associated with the use of ostomy components (PSC events avoided; quality-adjusted life days gained) offset the costs associated with their use. RESULTS: Our base case analysis of 1000 hypothetical individuals over 1 year assumes that using ostomy components following a first PSC reduces recurrent events versus PSC management without components. In this analysis, component acquisition costs were largely offset by lower resource use for ostomy supplies (barriers; pouches) and lower clinical utilization to manage PSCs. The overall annual average resource use for individuals using components was about 6.3% ($139) higher versus individuals not using components. Each PSC event avoided yielded, on average, 8 additional quality-adjusted life days over 1 year. CONCLUSIONS: In our analysis, (1) acquisition costs for ostomy components were offset in whole or in part by the use of fewer ostomy supplies to manage PSCs and (2) use of ostomy components to prevent PSCs produced better outcomes (fewer repeat PSC events; more health-related quality-adjusted life days) over 1 year compared to not using components. PMID:26633166

Frequency Domain Reflectometry Modeling and Measurement for Nondestructive Evaluation of Nuclear Power Plant Cables

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

Glass, Samuel W.; Fifield, Leonard S.; Jones, Anthony M.

Cable insulation polymers are among the more susceptible materials to age-related degradation within a nuclear power plant. This is recognized by both regulators and utilities, so all plants have developed cable aging management programs to detect damage before critical component failure in compliance with regulatory guidelines. Although a wide range of tools are available to evaluate cables and cable systems, cable aging management programs vary in how condition monitoring and NDE is conducted as utilities search for the most reliable and cost-effective ways to assess cable system condition. Frequency domain reflectometry (FDR) is emerging as one valuable tool to locatemore » and assess damaged portions of a cable system with minimal cost and only requires access in most cases to one of the cable terminal ends. This work examines a physics-based model of a cable system and relates it to FDR measurements for a better understanding of specific damage influences on defect detectability.« less

Integrating epidemiology, psychology, and economics to achieve HPV vaccination targets.

PubMed

Basu, Sanjay; Chapman, Gretchen B; Galvani, Alison P

2008-12-02

Human papillomavirus (HPV) vaccines provide an opportunity to reduce the incidence of cervical cancer. Optimization of cervical cancer prevention programs requires anticipation of the degree to which the public will adhere to vaccination recommendations. To compare vaccination levels driven by public perceptions with levels that are optimal for maximizing the community's overall utility, we develop an epidemiological game-theoretic model of HPV vaccination. The model is parameterized with survey data on actual perceptions regarding cervical cancer, genital warts, and HPV vaccination collected from parents of vaccine-eligible children in the United States. The results suggest that perceptions of survey respondents generate vaccination levels far lower than those that maximize overall health-related utility for the population. Vaccination goals may be achieved by addressing concerns about vaccine risk, particularly those related to sexual activity among adolescent vaccine recipients. In addition, cost subsidizations and shifts in federal coverage plans may compensate for perceived and real costs of HPV vaccination to achieve public health vaccination targets.

Using confirmatory factor analysis to understand executive control in preschool children: sources of variation in emergent mathematic achievement

PubMed Central

Bull, Rebecca; Espy, Kimberly Andrews; Wiebe, Sandra A.; Sheffield, Tiffany D.; Nelson, Jennifer Mize

2010-01-01

Latent variable modeling methods have demonstrated utility for understanding the structure of executive control (EC) across development. These methods are utilized to better characterize the relation between EC and mathematics achievement in the preschool period, and to understand contributing sources of individual variation. Using the sample and battery of laboratory tasks described in Wiebe, Espy and Charak (2008), latent EC was related strongly to emergent mathematics achievement in preschool, and was robust after controlling for crystallized intellectual skills. The relation between crystallized skills and emergent mathematics differed between girls and boys, although the predictive association between EC and mathematics did not. Two dimensions of the child’s social environment contributed to mathematics achievement: social network support through its relation to EC and environmental stressors through its relation with crystallized skills. These findings underscore the need to examine the dimensions, mechanisms, and individual pathways that influence the development of early competence in basic cognitive processes that underpin early academic achievement. PMID:21676089

Using confirmatory factor analysis to understand executive control in preschool children: sources of variation in emergent mathematic achievement.

PubMed

Bull, Rebecca; Espy, Kimberly Andrews; Wiebe, Sandra A; Sheffield, Tiffany D; Nelson, Jennifer Mize

2011-07-01

Latent variable modeling methods have demonstrated utility for understanding the structure of executive control (EC) across development. These methods are utilized to better characterize the relation between EC and mathematics achievement in the preschool period, and to understand contributing sources of individual variation. Using the sample and battery of laboratory tasks described in Wiebe, Espy and Charak (2008), latent EC was related strongly to emergent mathematics achievement in preschool, and was robust after controlling for crystallized intellectual skills. The relation between crystallized skills and emergent mathematics differed between girls and boys, although the predictive association between EC and mathematics did not. Two dimensions of the child 's social environment contributed to mathematics achievement: social network support through its relation to EC and environmental stressors through its relation with crystallized skills. These findings underscore the need to examine the dimensions, mechanisms, and individual pathways that influence the development of early competence in basic cognitive processes that underpin early academic achievement. © 2010 Blackwell Publishing Ltd.

Comparison of Numerically Simulated and Experimentally Measured Performance of a Rotating Detonation Engine

NASA Technical Reports Server (NTRS)

Paxson, Daniel E.; Fotia, Matthew L.; Hoke, John; Schauer, Fred

2015-01-01

A quasi-two-dimensional, computational fluid dynamic (CFD) simulation of a rotating detonation engine (RDE) is described. The simulation operates in the detonation frame of reference and utilizes a relatively coarse grid such that only the essential primary flow field structure is captured. This construction and other simplifications yield rapidly converging, steady solutions. Viscous effects, and heat transfer effects are modeled using source terms. The effects of potential inlet flow reversals are modeled using boundary conditions. Results from the simulation are compared to measured data from an experimental RDE rig with a converging-diverging nozzle added. The comparison is favorable for the two operating points examined. The utility of the code as a performance optimization tool and a diagnostic tool are discussed.

A heart failure initiative to reduce the length of stay and readmission rates.

PubMed

White, Sabrina Marie; Hill, Alethea

2014-01-01

The purpose of this pilot was to improve multidisciplinary coordination of care and patient education and foster self-management behaviors. The primary and secondary outcomes achieved from this pilot were to decrease the 30-day readmission rate and heart failure length of stay. The primary practice site was an inpatient medical-surgical nursing unit. The length of stay decreased from 6.05% to 4.42% for heart failure diagnostic-related group 291 as a result of utilizing the model. The length of stay decreased from 3.9% to 3.09%, which was also less than the national rate of 3.8036% for diagnostic-related group 292. In addition, the readmission rate decreased from 23.1% prior to January 2013 to 12.9%. Implementation of standards of care coordination can decrease length of stay, readmission rate, and improve self-management. Implementation of evidence-based heart failure guidelines, improved interdisciplinary coordination of care, patient education, self-management skills, and transitional care at the time of discharge improved overall heart failure outcome measures. Utilizing the longitudinal model of care to transition patients to home aided in evaluating social support, resource allocation and utilization, access to care postdischarge, and interdisciplinary coordination of care. The collaboration between disciplines improved continuity of care, patient compliance to their discharge regimen, and adequate discharge follow-up.

Explaining differences in perceived health-related quality of life: a study within the Spanish population.

PubMed

Martín-Fernández, Jesús; Ariza-Cardiel, Gloria; Polentinos-Castro, Elena; Sanz-Cuesta, Teresa; Sarria-Santamera, Antonio; Del Cura-González, Isabel

2017-09-25

To assess the burden of several determinants on health-related quality of life (HRQOL) and to study its heterogeneity among the different Spanish regions. Cross-sectional study. Data were obtained from the Spanish National Health Survey (2012), and HRQOL was measured using the EQ-5D-5L questionnaire (utility and visual analogue scale -VAS- scores). Demographic variables, physical health condition, social variables, mental health status, and lifestyle were also analysed. Tobit regression models were employed to study the relationships between expressed HRQOL and personal characteristics. A total of 20,979 surveys were obtained. Of them, 62.4% expressed a utility score of 1, corresponding to perfect health (95%CI: 61.8%-63.2%), and 54.2% showed VAS scores ≥80 (95%CI: 53.5%-54.9%). HRQOL was mainly described as a function of age, chronic limitation in daily activities, and mental health status. Belonging to a higher-class strata and physical activity were related to better self-perceived HRQOL. Ageing worsened perceived HRQOL, but did not influence its determinants, and differences in HRQOL by regions were also not significant after model adjustment. HRQOL perception in the Spanish population varied slightly depending on the measure used (utilities index or VAS). Age, chronic limitations in daily life, and mental health status best explained the variability in perception, and no meaningful differences in HRQOL perception among regions were found after adjustment. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

WE-G-204-02: Utility of a Channelized Hotelling Model Observer Over a Large Range of Angiographic Exposure Levels

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

Fetterly, K; Favazza, C

2015-06-15

Purpose: Mathematical model observers provide a figure of merit that simultaneously considers a test object and the contrast, noise, and spatial resolution properties of an imaging system. The purpose of this work was to investigate the utility of a channelized Hotelling model observer (CHO) to assess system performance over a large range of angiographic exposure conditions. Methods: A 4 mm diameter disk shaped, iodine contrast test object was placed on a 20 cm thick Lucite phantom and 1204 image frames were acquired using fixed x-ray beam quality and for several detector target dose (DTD) values in the range 6 tomore » 240 nGy. The CHO was implemented in the spatial domain utilizing 96 Gabor functions as channels. Detectability index (DI) estimates were calculated using the “resubstitution” and “holdout” methods to train the CHO. Also, DI values calculated using discrete subsets of the data were used to estimate a minimally biased DI as might be expected from an infinitely large dataset. The relationship between DI, independently measured CNR, and changes in results expected assuming a quantum limited detector were assessed over the DTD range. Results: CNR measurements demonstrated that the angiography system is not quantum limited due to relatively increasing contamination from electronic noise that reduces CNR for low DTD. Direct comparison of DI versus CNR indicates that the CHO relatively overestimates DI for low DTD and/or underestimates DI values for high DTD. The relative magnitude of the apparent bias error in the DI values was ∼20% over the 40x DTD range investigated. Conclusion: For the angiography system investigated, the CHO can provide a minimally biased figure of merit if implemented over a restricted exposure range. However, bias leads to overestimates of DI for low exposures. This work emphasizes the need to verify CHO model performance during real-world application.« less

Novel model of neuronal bioenergetics: postsynaptic utilization of glucose but not lactate correlates positively with Ca2+ signalling in cultured mouse glutamatergic neurons

PubMed Central

Bak, Lasse K.; Obel, Linea F.; Walls, Anne B.; Schousboe, Arne; Faek, Sevan A.A.; Jajo, Farah S.; Waagepetersen, Helle S.

2012-01-01

We have previously investigated the relative roles of extracellular glucose and lactate as fuels for glutamatergic neurons during synaptic activity. The conclusion from these studies was that cultured glutamatergic neurons utilize glucose rather than lactate during NMDA (N-methyl-d-aspartate)-induced synaptic activity and that lactate alone is not able to support neurotransmitter glutamate homoeostasis. Subsequently, a model was proposed to explain these results at the cellular level. In brief, the intermittent rises in intracellular Ca2+ during activation cause influx of Ca2+ into the mitochondrial matrix thus activating the tricarboxylic acid cycle dehydrogenases. This will lead to a lower activity of the MASH (malate–aspartate shuttle), which in turn will result in anaerobic glycolysis and lactate production rather than lactate utilization. In the present work, we have investigated the effect of an ionomycin-induced increase in intracellular Ca2+ (i.e. independent of synaptic activity) on neuronal energy metabolism employing 13C-labelled glucose and lactate and subsequent mass spectrometric analysis of labelling in glutamate, alanine and lactate. The results demonstrate that glucose utilization is positively correlated with intracellular Ca2+ whereas lactate utilization is not. This result lends further support for a significant role of glucose in neuronal bioenergetics and that Ca2+ signalling may control the switch between glucose and lactate utilization during synaptic activity. Based on the results, we propose a compartmentalized CiMASH (Ca2+-induced limitation of the MASH) model that includes intracellular compartmentation of glucose and lactate metabolism. We define pre- and post-synaptic compartments metabolizing glucose and glucose plus lactate respectively in which the latter displays a positive correlation between oxidative metabolism of glucose and Ca2+ signalling. PMID:22385215

Novel model of neuronal bioenergetics: postsynaptic utilization of glucose but not lactate correlates positively with Ca2+ signalling in cultured mouse glutamatergic neurons.

PubMed

Bak, Lasse K; Obel, Linea F; Walls, Anne B; Schousboe, Arne; Faek, Sevan A A; Jajo, Farah S; Waagepetersen, Helle S

2012-04-05

We have previously investigated the relative roles of extracellular glucose and lactate as fuels for glutamatergic neurons during synaptic activity. The conclusion from these studies was that cultured glutamatergic neurons utilize glucose rather than lactate during NMDA (N-methyl-d-aspartate)-induced synaptic activity and that lactate alone is not able to support neurotransmitter glutamate homoeostasis. Subsequently, a model was proposed to explain these results at the cellular level. In brief, the intermittent rises in intracellular Ca2+ during activation cause influx of Ca2+ into the mitochondrial matrix thus activating the tricarboxylic acid cycle dehydrogenases. This will lead to a lower activity of the MASH (malate-aspartate shuttle), which in turn will result in anaerobic glycolysis and lactate production rather than lactate utilization. In the present work, we have investigated the effect of an ionomycin-induced increase in intracellular Ca2+ (i.e. independent of synaptic activity) on neuronal energy metabolism employing 13C-labelled glucose and lactate and subsequent mass spectrometric analysis of labelling in glutamate, alanine and lactate. The results demonstrate that glucose utilization is positively correlated with intracellular Ca2+ whereas lactate utilization is not. This result lends further support for a significant role of glucose in neuronal bioenergetics and that Ca2+ signalling may control the switch between glucose and lactate utilization during synaptic activity. Based on the results, we propose a compartmentalized CiMASH (Ca2+-induced limitation of the MASH) model that includes intracellular compartmentation of glucose and lactate metabolism. We define pre- and post-synaptic compartments metabolizing glucose and glucose plus lactate respectively in which the latter displays a positive correlation between oxidative metabolism of glucose and Ca2+ signalling.

VA health service utilization for homeless and low-income Veterans: a spotlight on the VA Supportive Housing (VASH) program in greater Los Angeles.

PubMed

Gabrielian, Sonya; Yuan, Anita H; Andersen, Ronald M; Rubenstein, Lisa V; Gelberg, Lillian

2014-05-01

The US Department of Housing and Urban Development (HUD)-VA Supportive Housing (VASH) program-the VA's Housing First effort-is central to efforts to end Veteran homelessness. Yet, little is known about health care utilization patterns associated with achieving HUD-VASH housing. We compare health service utilization at the VA Greater Los Angeles among: (1) formerly homeless Veterans housed through HUD-VASH (HUD-VASH Veterans); (2) currently homeless Veterans; (3) housed, low-income Veterans not in HUD-VASH; and (4) housed, not low-income Veterans. We performed a secondary database analysis of Veterans (n=62,459) who received VA Greater Los Angeles care between October 1, 2010 and September 30, 2011. We described medical/surgical and mental health utilization [inpatient, outpatient, and emergency department (ED)]. We controlled for demographics, need, and primary care use in regression analyses of utilization data by housing and income status. HUD-VASH Veterans had more inpatient, outpatient, and ED use than currently homeless Veterans. Adjusting for demographics and need, HUD-VASH Veterans and the low-income housed Veterans had similar likelihoods of medical/surgical inpatient and outpatient utilization, compared with the housed, not low-income group. Adjusting first for demographics and need (model 1), then also for primary care use (model 2), HUD-VASH Veterans had the greatest decrease in incident rates of specialty medical/surgical, mental health, and ED care from models 1 to 2, becoming similar to the currently homeless, compared with the housed, not low-income group. Our findings suggest that currently homeless Veterans underuse health care relative to housed Veterans. HUD-VASH may address this disparity by providing housing and linkages to primary care.

VA Health Service Utilization for Homeless and Low-income Veterans

PubMed Central

Gabrielian, Sonya; Yuan, Anita H.; Andersen, Ronald M.; Rubenstein, Lisa V.; Gelberg, Lillian

2016-01-01

Background The US Department of Housing and Urban Development (HUD)-VA Supportive Housing (VASH) program—the VA’s Housing First effort—is central to efforts to end Veteran homelessness. Yet, little is known about health care utilization patterns associated with achieving HUD-VASH housing. Objectives We compare health service utilization at the VA Greater Los Angeles among: (1) formerly homeless Veterans housed through HUD-VASH (HUD-VASH Veterans); (2) currently homeless Veterans; (3) housed, low-income Veterans not in HUD-VASH; and (4) housed, not low-income Veterans. Research Design We performed a secondary database analysis of Veterans (n = 62,459) who received VA Greater Los Angeles care between October 1, 2010 and September 30, 2011. We described medical/surgical and mental health utilization [inpatient, outpatient, and emergency department (ED)]. We controlled for demographics, need, and primary care use in regression analyses of utilization data by housing and income status. Results HUD-VASH Veterans had more inpatient, outpatient, and ED use than currently homeless Veterans. Adjusting for demographics and need, HUD-VASH Veterans and the low-income housed Veterans had similar likelihoods of medical/surgical inpatient and outpatient utilization, compared with the housed, not low-income group. Adjusting first for demographics and need (model 1), then also for primary care use (model 2), HUD-VASH Veterans had the greatest decrease in incident rates of specialty medical/surgical, mental health, and ED care from models 1 to 2, becoming similar to the currently homeless, compared with the housed, not low-income group. Conclusions Our findings suggest that currently homeless Veterans underuse health care relative to housed Veterans. HUD-VASH may address this disparity by providing housing and linkages to primary care. PMID:24714583

Physiologically based pharmacokinetic model of amphotericin B disposition in rats following administration of deoxycholate formulation (Fungizone®): pooled analysis of published data.

PubMed

Kagan, Leonid; Gershkovich, Pavel; Wasan, Kishor M; Mager, Donald E

2011-06-01

The time course of tissue distribution of amphotericin B (AmB) has not been sufficiently characterized despite its therapeutic importance and an apparent disconnect between plasma pharmacokinetics and clinical outcomes. The goals of this work were to develop and evaluate a physiologically based pharmacokinetic (PBPK) model to characterize the disposition properties of AmB administered as deoxycholate formulation in healthy rats and to examine the utility of the PBPK model for interspecies scaling of AmB pharmacokinetics. AmB plasma and tissue concentration-time data, following single and multiple intravenous administration of Fungizone® to rats, from several publications were combined for construction of the model. Physiological parameters were fixed to literature values. Various structural models for single organs were evaluated, and the whole-body PBPK model included liver, spleen, kidney, lung, heart, gastrointestinal tract, plasma, and remainder compartments. The final model resulted in a good simultaneous description of both single and multiple dose data sets. Incorporation of three subcompartments for spleen and kidney tissues was required for capturing a prolonged half-life in these organs. The predictive performance of the final PBPK model was assessed by evaluating its utility in predicting pharmacokinetics of AmB in mice and humans. Clearance and permeability-surface area terms were scaled with body weight. The model demonstrated good predictions of plasma AmB concentration-time profiles for both species. This modeling framework represents an important basis that may be further utilized for characterization of formulation- and disease-related factors in AmB pharmacokinetics and pharmacodynamics.

Environmental assessment of gas management options at the Old Ammässuo landfill (Finland) by means of LCA-modeling (EASEWASTE).

PubMed

Manfredi, Simone; Niskanen, Antti; Christensen, Thomas H

2009-05-01

The current landfill gas (LFG) management (based on flaring and utilization for heat generation of the collected gas) and three potential future gas management options (LFG flaring, heat generation and combined heat and power generation) for the Old Ammässuo landfill (Espoo, Finland) were evaluated by life-cycle assessment modeling. The evaluation accounts for all resource utilization and emissions to the environment related to the gas generation and management for a life-cycle time horizon of 100 yr. The assessment criteria comprise standard impact categories (global warming, photo-chemical ozone formation, stratospheric ozone depletion, acidification and nutrient enrichment) and toxicity-related impact categories (human toxicity via soil, via water and via air, eco-toxicity in soil and in water chronic). The results of the life-cycle impact assessment show that disperse emissions of LFG from the landfill surface determine the highest potential impacts in terms of global warming, stratospheric ozone depletion, and human toxicity via soil. Conversely, the impact potentials estimated for other categories are numerically-negative when the collected LFG is utilized for energy generation, demonstrating that net environmental savings can be obtained. Such savings are proportional to the amount of gas utilized for energy generation and the gas energy recovery efficiency achieved, which thus have to be regarded as key parameters. As a result, the overall best performance is found for the heat generation option - as it has the highest LFG utilization/energy recovery rates - whereas the worst performance is estimated for the LFG flaring option, as no LFG is here utilized for energy generation. Therefore, to reduce the environmental burdens caused by the current gas management strategy, more LFG should be used for energy generation. This inherently requires a superior LFG capture rate that, in addition, would reduce fugitive emissions of LFG from the landfill surface, bringing further environmental benefits.

Cognitive status is a determinant of health resource utilization among individuals with a history of falls: a 12-month prospective cohort study.

PubMed

Davis, J C; Dian, L; Khan, K M; Bryan, S; Marra, C A; Hsu, C L; Jacova, P; Chiu, B K; Liu-Ambrose, T

2016-03-01

Falls are a costly public health problem worldwide. The literature is devoid of prospective data that identifies factors among fallers that significantly drive health care resource utilization. We found that cognitive function--specifically, executive functions--and cognitive status are significant determinants of health resource utilization among older fallers. Although falls are costly, there are no prospective data examining factors among fallers that drive health care resource utilization. We identified key determinants of health resource utilization (HRU) at 6 and 12 months among older adults with a history of falls. Specifically, with the increasing recognition that cognitive impairment is associated with increased falls risk, we investigated cognition as a potential driver of health resource utilization. This 12-month prospective cohort study at the Vancouver Falls Prevention Clinic (n = 319) included participants with a history of at least one fall in the previous 12 months. Based on their cognitive status, participants were divided into two groups: (1) no mild cognitive impairment (MCI) and (2) MCI. We constructed two linear regression models with HRU at 6 and 12 months as the dependent variables for each model, respectively. Predictors relating to mobility, global cognition, executive functions, and cognitive status (MCI versus no MCI) were examined. Age, sex, comorbidities, depression status, and activities of daily living were included regardless of statistical significance. Global cognition, comorbidities, working memory, and cognitive status (MCI versus no MCI ascertained using the Montreal Cognitive Assessment (MoCA)) were significant determinants of total HRU at 6 months. The number of medical comorbidities and global cognition were significant determinants of total HRU at 12 months. MCI status was a determinant of HRU at 6 months among older adults with a history of falls. As such, efforts to minimize health care resource use related to falls, it is important to tailor future interventions to be effective for people with MCI who fall. ClinicalTrials.gov Identifier: NCT01022866.

Air pollution and general practitioner access and utilization: a population based study in Sarnia, 'Chemical Valley,' Ontario

PubMed Central

2011-01-01

Background Health impacts of poor environmental quality have been identified in studies around the world and in Canada. While many of the studies have identified associations between air pollution and mortality or morbidity, few have focused on the role of health care as a potential moderator of impacts. This study assessed the determinants of health care access and utilization in the context of ambient air pollution in Sarnia, Ontario, Canada. Methods Residents of Sarnia participated in a Community Health Study administered by phone, while several ambient air pollutants including nitrogen dioxide (NO2), sulphur dioxide (SO2) and the volatile organic compounds benzene, toluene, ethylbenzene, mp- and o-xylene (BTEX) were monitored across the city. Land Use Regression models were used to estimate individual exposures to the measured pollutants and logistic regression models were utilized to assess the relative influence of environmental, socioeconomic and health related covariates on general practitioner access and utilization outcomes. Results The results show that general practitioner use increased with levels of exposure to nitrogen dioxide (NO2- Odds Ratio [OR]: 1.16, p < 0.05) and sulphur dioxide (SO2- OR: 1.61, p < 0.05). Low household income was a stronger predictor of having no family doctor in areas exposed to high concentrations of NO2 and SO2. Respondents without regular care living in high pollution areas were also more likely to report travelling or waiting for care in excess of 20 minutes (OR: 3.28, p < 0.05) than their low exposure counterparts (OR: 1.11, p > 0.05). Conclusions This study provides evidence for inequitable health care access and utilization in Sarnia, with particular relevance to its situation as a sentinel high exposure environment. Levels of exposure to pollution appears to influence utilization of health care services, but poor access to primary health care services additionally burden certain groups in Sarnia, Ontario, Canada. PMID:21827645

Scoping out the literature on mobile needle and syringe programs-review of service delivery and client characteristics, operation, utilization, referrals, and impact.

PubMed

Strike, Carol; Miskovic, Miroslav

2018-02-08

Needle and syringe program (NSP) service delivery models encompass fixed sites, mobile services, vending machines, pharmacies, peer NSPs, street outreach, and inter-organizational agreements to add NSP services to other programs. For programs seeking to implement or improve mobile services, access to a synthesis of the evidence related to mobile services is beneficial, but lacking. We used a scoping study method to search MEDLINE, PSYCHInfo, Embase, Scopus, and Sociological for relevant literature. We identified 39 relevant manuscripts published between 1975 and November 2017 after removing duplicates and non-relevant manuscripts from the 1313 identified by the search. Charting of the data showed that these publications reported findings related to the service delivery model characteristics, client characteristics, service utilization, specialized interventions offered on mobile NSPs, linking clients to other services, and impact on injection risk behaviors. Mobile NSPs are implemented in high-, medium-, and low-income countries; provide equipment distribution and many other harm reduction services; face limitations to service complement, confidentiality, and duration of interactions imposed by physical space; adapt to changes in locations and types of drug use; attract people who engage in high-risk/intensity injection behavior and who are often not reached by other service models; and may lead to reduced injection-related risks. It is not clear from the literature reviewed, what are, or if there are, a "core and essential" complement of services that mobile NSPs should offer. Decisions about service complement for mobile NSPs need to be made in relation to the context and also other available services. Reports of client visits to mobile NSP provide a picture of the volume and frequency of utilization but are difficult to compare given varied measures and reference periods. Mobile NSPs have an important role to play in improving HIV and HCV prevention efforts across the world. However, more work is needed to create clearer assessment metrics and to improve access to NSP services across the world.

The "proactive" model of learning: Integrative framework for model-free and model-based reinforcement learning utilizing the associative learning-based proactive brain concept.

PubMed

Zsuga, Judit; Biro, Klara; Papp, Csaba; Tajti, Gabor; Gesztelyi, Rudolf

2016-02-01

Reinforcement learning (RL) is a powerful concept underlying forms of associative learning governed by the use of a scalar reward signal, with learning taking place if expectations are violated. RL may be assessed using model-based and model-free approaches. Model-based reinforcement learning involves the amygdala, the hippocampus, and the orbitofrontal cortex (OFC). The model-free system involves the pedunculopontine-tegmental nucleus (PPTgN), the ventral tegmental area (VTA) and the ventral striatum (VS). Based on the functional connectivity of VS, model-free and model based RL systems center on the VS that by integrating model-free signals (received as reward prediction error) and model-based reward related input computes value. Using the concept of reinforcement learning agent we propose that the VS serves as the value function component of the RL agent. Regarding the model utilized for model-based computations we turned to the proactive brain concept, which offers an ubiquitous function for the default network based on its great functional overlap with contextual associative areas. Hence, by means of the default network the brain continuously organizes its environment into context frames enabling the formulation of analogy-based association that are turned into predictions of what to expect. The OFC integrates reward-related information into context frames upon computing reward expectation by compiling stimulus-reward and context-reward information offered by the amygdala and hippocampus, respectively. Furthermore we suggest that the integration of model-based expectations regarding reward into the value signal is further supported by the efferent of the OFC that reach structures canonical for model-free learning (e.g., the PPTgN, VTA, and VS). (c) 2016 APA, all rights reserved).

Big Data Provenance: Challenges, State of the Art and Opportunities.

PubMed

Wang, Jianwu; Crawl, Daniel; Purawat, Shweta; Nguyen, Mai; Altintas, Ilkay

2015-01-01

Ability to track provenance is a key feature of scientific workflows to support data lineage and reproducibility. The challenges that are introduced by the volume, variety and velocity of Big Data, also pose related challenges for provenance and quality of Big Data, defined as veracity. The increasing size and variety of distributed Big Data provenance information bring new technical challenges and opportunities throughout the provenance lifecycle including recording, querying, sharing and utilization. This paper discusses the challenges and opportunities of Big Data provenance related to the veracity of the datasets themselves and the provenance of the analytical processes that analyze these datasets. It also explains our current efforts towards tracking and utilizing Big Data provenance using workflows as a programming model to analyze Big Data.

Animal models of Parkinson's disease: limits and relevance to neuroprotection studies.

PubMed

Bezard, Erwan; Yue, Zhenyu; Kirik, Deniz; Spillantini, Maria Grazia

2013-01-01

Over the last two decades, significant strides has been made toward acquiring a better knowledge of both the etiology and pathogenesis of Parkinson's disease (PD). Experimental models are of paramount importance to obtain greater insights into the pathogenesis of the disease. Thus far, neurotoxin-based animal models have been the most popular tools employed to produce selective neuronal death in both in vitro and in vivo systems. These models have been commonly referred to as the pathogenic models. The current trend in modeling PD revolves around what can be called the disease gene-based models or etiologic models. The value of utilizing multiple models with a different mechanism of insult rests on the premise that dopamine-producing neurons die by stereotyped cascades that can be activated by a range of insults, from neurotoxins to downregulation and overexpression of disease-related genes. In this position article, we present the relevance of both pathogenic and etiologic models as well as the concept of clinically relevant designs that, we argue, should be utilized in the preclinical development phase of new neuroprotective therapies before embarking into clinical trials. Copyright © 2013 Movement Disorders Society.

Health Care Utilization and Costs After Initiating Budesonide/Formoterol Combination or Fluticasone/Salmeterol Combination Among COPD Patients New to ICS/LABA Treatment.

PubMed

Davis, Jill R; Kern, David M; Williams, Setareh A; Tunceli, Ozgur; Wu, Bingcao; Hollis, Sally; Strange, Charlie; Trudo, Frank

2016-03-01

Chronic obstructive pulmonary disease (COPD) affects approximately 15 million people in the United States and accounts for approximately $36 billion in economic burden, primarily due to medical costs. To address the increasing clinical and economic burden, the Global Initiative for Chronic Obstructive Lung Disease emphasizes the use of therapies that help prevent COPD exacerbations, including inhaled corticosteroid/long-acting beta2-agonist (ICS/LABA). To evaluate health care costs and utilization among COPD patients newly initiating ICS/LABA combination therapy with budesonide/formoterol (BFC) or fluticasone/salmeterol (FSC) in a managed care system. COPD patients aged 40 years and older who initiated BFC (160/4.5 μg) or FSC (250/50 μg) treatment between March 1, 2009, and March 31, 2012, were identified using claims data from major U.S. health plans. BFC and FSC patients were propensity score matched (1:1) on age, sex, prior asthma diagnosis, prior COPD-related health care utilization, and respiratory medication use. COPD-related, pneumonia-related, and all-cause costs and utilization were analyzed during the 12-month follow-up period. Post-index costs were assessed with generalized linear models (GLMs) with gamma distribution. Health care utilization data were analyzed via logistic regression (any event vs. none) and GLMs with negative binomial distribution (number of visits) and were adjusted for the analogous pre-index variable as well as pre-index characteristics that remained imbalanced after matching. After matching, each cohort had 3,697 patients balanced on age (mean 64 years), sex (female 52% BFC and 54% FSC), asthma and other comorbid conditions, prior COPD-related health care utilization, and respiratory medication use. During the 12-month follow-up, COPD-related costs averaged $316 less for BFC versus FSC patients ($4,326 vs. $4,846; P = 0.003), reflecting lower inpatient ($966 vs. $1,202; P < 0.001), pharmacy ($1,482 vs. $1,609; P = 0.002), and outpatient/office ($1,378 vs. $1,436; P = 0.048) costs, but higher emergency department ($257 vs. $252; P = 0.033) costs. Pneumonia-related health care costs were also lower on average for BFC patients ($2,855 vs. $3,605; P < 0.001). Similarly, initiating BFC was associated with lower all-use health care costs versus initiating FSC ($21,580 vs. $24,483; P < 0.001, respectively). No differences in health care utilization were found between the 2 groups. In this study, although no difference was observed in rates of health care utilization, COPD patients initiating BFC treatment incurred lower average COPD-related, pneumonia-related, and all-cause costs versus FSC initiators, which was driven by cumulative differences in inpatient, outpatient, and pharmacy costs.

Life expectancy impacts due to heating energy utilization in China: Distribution, relations, and policy implications.

PubMed

Wang, Shaobin; Luo, Kunli

2018-01-01

The relation between life expectancy and energy utilization is of particular concern. Different viewpoints concerned the health impacts of heating policy in China. However, it is still obscure that what kind of heating energy or what pattern of heating methods is the most related with the difference of life expectancies in China. The aim of this paper is to comprehensively investigate the spatial relations between life expectancy at birth (LEB) and different heating energy utilization in China by using spatial autocorrelation models including global spatial autocorrelation, local spatial autocorrelation and hot spot analysis. The results showed that: (1) Most of heating energy exhibit a distinct north-south difference, such as central heating supply, stalks and domestic coal. Whereas spatial distribution of domestic natural gas and electricity exhibited west-east differences. (2) Consumption of central heating, stalks and domestic coal show obvious spatial dependence. Whereas firewood, natural gas and electricity did not show significant spatial autocorrelation. It exhibited an extinct south-north difference of heat supply, stalks and domestic coal which were identified to show significant positive spatial autocorrelation. (3) Central heating, residential boilers and natural gas did not show any significant correlations with LEB. While, the utilization of domestic coal and biomass showed significant negative correlations with LEB, and household electricity shows positive correlations. The utilization of domestic coal in China showed a negative effect on LEB, rather than central heating. To improve the solid fuel stoves and control consumption of domestic coal consumption and other low quality solid fuel is imperative to improve the public health level in China in the future. Copyright © 2017 Elsevier B.V. All rights reserved.

Utilization of Communication Robot in Patient Education.

PubMed

Ishiguro, Keitaro; Majima, Yukie

2016-01-01

In Japan, the population is expected to decrease. Moreover, the proportion of elderly people living alone among the elderly population is expected to increase for both men and women. Therefore, the demand for elderly care is increasing year by year. In this paper, we aim at making environment in which elderly people can receive interactive guidance, and reducing the burden on medical staff such as caregivers and nurses. So, we design a patient education by ARCS model which classifies concepts related to learning motivation, and consider to utilize a communication robot "Pepper".

Numerical orbit generators of artificial earth satellites

NASA Astrophysics Data System (ADS)

Kugar, H. K.; Dasilva, W. C. C.

1984-04-01

A numerical orbit integrator containing updatings and improvements relative to the previous ones that are being utilized by the Departmento de Mecanica Espacial e Controle (DMC), of INPE, besides incorporating newer modellings resulting from the skill acquired along the time is presented. Flexibility and modularity were taken into account in order to allow future extensions and modifications. Characteristics of numerical accuracy, processing quickness, memory saving as well as utilization aspects were also considered. User's handbook, whole program listing and qualitative analysis of accuracy, processing time and orbit perturbation effects were included as well.

Remote Sensing in Archeology: Classifying Bajos of the Paten, Guatemala

NASA Technical Reports Server (NTRS)

Lowry, James D., Jr.

1998-01-01

This project focuses on the adaptation of human populations to their environments from prehistoric times to the present. It emphasizes interdisciplinary research to develop ecological baselines through the use of remotely sensed imagery, in situ field work, and the modeling of human population dynamics. It utilizes cultural and biological data from dated archaeological sites to assess the subsistence and settlement patterns of human societies in response to changing climatic and environmental conditions. The utilization of remote sensing techniques in archaeology is relatively new, exciting, and opens many doors.

Confronting human papilloma virus/oropharyngeal cancer: a model for interprofessional collaboration.

PubMed

Fried, Jacquelyn L

2014-06-01

A collaborative practice model related to Human Papilloma Virus (HPV) associated oropharyngeal cancer highlights the role of the dental hygienist in addressing this condition. The incidence of HPV associated head and neck cancer is rising. Multiple professionals including the dental hygienist can work collaboratively to confront this growing public health concern. A critical review applies the growth and utilization of interprofessional education (IPE) and interprofessional collaboration (IPC) to multi-disciplinary models addressing the human papilloma virus and oropharyngeal cancers. A model related to HPV associated oropharyngeal cancer addresses an oral systemic condition that supports the inclusion of a dental hygienist on collaborative teams addressing prevention, detection, treatment and cure of OPC. Copyright © 2014 Elsevier Inc. All rights reserved.

A stochastic conflict resolution model for trading pollutant discharge permits in river systems.

PubMed

Niksokhan, Mohammad Hossein; Kerachian, Reza; Amin, Pedram

2009-07-01

This paper presents an efficient methodology for developing pollutant discharge permit trading in river systems considering the conflict of interests of involving decision-makers and the stakeholders. In this methodology, a trade-off curve between objectives is developed using a powerful and recently developed multi-objective genetic algorithm technique known as the Nondominated Sorting Genetic Algorithm-II (NSGA-II). The best non-dominated solution on the trade-off curve is defined using the Young conflict resolution theory, which considers the utility functions of decision makers and stakeholders of the system. These utility functions are related to the total treatment cost and a fuzzy risk of violating the water quality standards. The fuzzy risk is evaluated using the Monte Carlo analysis. Finally, an optimization model provides the trading discharge permit policies. The practical utility of the proposed methodology in decision-making is illustrated through a realistic example of the Zarjub River in the northern part of Iran.

Simple Decision-Analytic Functions of the AUC for Ruling Out a Risk Prediction Model and an Added Predictor.

PubMed

Baker, Stuart G

2018-02-01

When using risk prediction models, an important consideration is weighing performance against the cost (monetary and harms) of ascertaining predictors. The minimum test tradeoff (MTT) for ruling out a model is the minimum number of all-predictor ascertainments per correct prediction to yield a positive overall expected utility. The MTT for ruling out an added predictor is the minimum number of added-predictor ascertainments per correct prediction to yield a positive overall expected utility. An approximation to the MTT for ruling out a model is 1/[P (H(AUC model )], where H(AUC) = AUC - {½ (1-AUC)} ½ , AUC is the area under the receiver operating characteristic (ROC) curve, and P is the probability of the predicted event in the target population. An approximation to the MTT for ruling out an added predictor is 1 /[P {(H(AUC Model:2 ) - H(AUC Model:1 )], where Model 2 includes an added predictor relative to Model 1. The latter approximation requires the Tangent Condition that the true positive rate at the point on the ROC curve with a slope of 1 is larger for Model 2 than Model 1. These approximations are suitable for back-of-the-envelope calculations. For example, in a study predicting the risk of invasive breast cancer, Model 2 adds to the predictors in Model 1 a set of 7 single nucleotide polymorphisms (SNPs). Based on the AUCs and the Tangent Condition, an MTT of 7200 was computed, which indicates that 7200 sets of SNPs are needed for every correct prediction of breast cancer to yield a positive overall expected utility. If ascertaining the SNPs costs $500, this MTT suggests that SNP ascertainment is not likely worthwhile for this risk prediction.

The association between use of mealtime insulin pens versus vials and healthcare charges and resource utilization in patients with type 2 diabetes: a retrospective cohort study.

PubMed

Eby, Elizabeth L; Boye, Kristina S; Lage, Maureen J

2013-10-01

To compare all-cause and diabetes-related resource utilization and healthcare charges among adults with type 2 diabetes mellitus who initiated therapy with mealtime insulin disposable pens or vials. Data were obtained from the Innovus inVision database from January 1, 2006 through June 30, 2010. Generalized linear models with a gamma distribution and log link estimated the association between medical charges and use of mealtime insulin pens vs vials in the 1 year post-index date, while generalized linear models with a negative binomial distribution estimated resource utilization. Controlling for patient characteristics, general health, and patient copayments, insulin therapy initiation with disposable pens, compared to vials, was associated with significantly fewer all-cause hospitalizations (1.45 vs. 1.66; p < 0.0001) as well as a significantly shorter hospital length of stay (2.16 days vs. 3.53 days; p < 0.0001). Pen use, compared to vials, was also associated with significantly fewer diabetes-related hospitalizations (1.36 vs. 1.47; p < 0.0001), and shorter hospital length of stay (1.12 days vs. 1.72 days; p < 0.0001). Despite higher diabetes-related drug charges ($3593 vs. $2755; p < 0.0001) associated with the use of pens, results showed significantly lower all-cause total healthcare charges ($42,150 vs. $53,340; p < 0.0001) and significantly lower diabetes-related total healthcare charges ($12,722 vs. $14,540; p < 0.0001) for patients who initiated therapy on mealtime insulin with pens compared to vials. Data were drawn from administrative claims and included only patients with medical and outpatient prescription drug benefit coverage. Hence, the results may not be generalizable. The retrospective analyses relied on diagnostic codes to identify patients, assess patient general health, and determine other values, rather than formal, clinical assessments. The analyses did not include indirect healthcare costs. The administration of mealtime insulin via disposable pens, compared to vials, was associated with a significant reduction in all-cause and diabetes-related resource utilization and total healthcare charges.

Utilizing Physical Input-Output Model to Inform Nitrogen related Ecosystem Services

EPA Science Inventory

Here we describe the development of nitrogen PIOTs for the midwestern US state of Illinois with large inputs of nitrogen from agriculture and industry. The PIOTs are used to analyze the relationship between regional economic activities and ecosystem services in order to identify...

Zoning of agricultural field using a fuzzy indicators model

USDA-ARS?s Scientific Manuscript database

Zoning of agricultural fields is an important task for utilization of precision farming technology. One method for deciding how to subdivide a field into a few relatively homogenous zones is using applications of fuzzy sets theory. Data collected from a precision agriculture study in central Texas...

Computer-Aided Design and Optimization of High-Performance Vacuum Electronic Devices

DTIC Science & Technology

2006-08-15

approximations to the metric, and space mapping wherein low-accuracy (coarse mesh) solutions can potentially be used more effectively in an...interface and algorithm development. • Work on space - mapping or related methods for utilizing models of varying levels of approximation within an

Corporate Publics and Rhetorical Strategies: The Case of Union Carbide's Bhopal Crisis.

ERIC Educational Resources Information Center

Ice, Richard

1991-01-01

Examines the role of rhetorical strategies in repairing damaged corporate relationships. Demonstrates the utility of an integrated model (multiple-publics concept and strategies of apologia) to corporate public relations through a case study of Union Carbide's justification of the Bhopal gas leak. (KEH)

Online Learning Programs: Evaluation's Challenging Future

ERIC Educational Resources Information Center

Nord, Derek

2011-01-01

With the vast array of contextual factors, pedagogical approaches, models of implementation, and purposes of education and training related to online learning, educators, learners, and the general public alike are seeking answers regarding utility and effectiveness of online learning. This article identifies and responds to many of the challenges…

Computational Analysis of Stereospecificity in the Cope Rearrangement

ERIC Educational Resources Information Center

Glish, Laura; Hanks, Timothy W.

2007-01-01

The Cope rearrangement is a highly stereospecific, concerted reaction of considerable synthetic utility. Experimental product distributions from the reaction of disubstituted 1,5-hexadienes can be readily understood by computer modeling of the various possible transitions states. Semi-empirical methods give relative energies of transition states…

Impact Of Three-Phase Relative Permeability and Hysteresis Models On Forecasts of Storage Associated with CO2-EOR

NASA Astrophysics Data System (ADS)

Jia, W.; Pan, F.; McPherson, B. J. O. L.

2015-12-01

Due to the presence of multiple phases in a given system, CO2 sequestration with enhanced oil recovery (CO2-EOR) includes complex multiphase flow processes compared to CO2 sequestration in deep saline aquifers (no hydrocarbons). Two of the most important factors are three-phase relative permeability and hysteresis effects, both of which are difficult to measure and are usually represented by numerical interpolation models. The purposes of this study included quantification of impacts of different three-phase relative permeability models and hysteresis models on CO2 sequestration simulation results, and associated quantitative estimation of uncertainty. Four three-phase relative permeability models and three hysteresis models were applied to a model of an active CO2-EOR site, the SACROC unit located in western Texas. To eliminate possible bias of deterministic parameters on the evaluation, a sequential Gaussian simulation technique was utilized to generate 50 realizations to describe heterogeneity of porosity and permeability, initially obtained from well logs and seismic survey data. Simulation results of forecasted pressure distributions and CO2 storage suggest that (1) the choice of three-phase relative permeability model and hysteresis model have noticeable impacts on CO2 sequestration simulation results; (2) influences of both factors are observed in all 50 realizations; and (3) the specific choice of hysteresis model appears to be somewhat more important relative to the choice of three-phase relative permeability model in terms of model uncertainty.

Application of MAGSAT to Lithospheric Modeling in South America. Part 2: Synthesis of Geologic and Seismic Data for Development of Integrated Crustal Models

NASA Technical Reports Server (NTRS)

Keller, G. R.; Lidiak, E. G.; Hinze, W. J.; Braile, L. W.; Vonfrese, R. R. B. (Principal Investigator)

1984-01-01

Research activities performed on MAGSAT scalar data over South America, Central America, and the adjacent marine areas are summarized. The geologic utility of magnetic anomalies detected by satellite is demonstrated by focusing on the spherical-Earth interpretation of scalar MAGSAT data in combination with ancillary geological and geophysical data to obtain lithospheric models for these regions related to their contemporary crustal dynamics processes, geologic history, current volcanism seismicity and natural resources.

System Identification and Uncertainty Quantification Using Orthogonal Excitations and the Semi-span Super Sonic Transport (S4T) Model

NASA Technical Reports Server (NTRS)

Heeg, Jennifer; Wieseman, Carol D.

2012-01-01

Orthogonal harmonic multisine excitations were utilized in a wind tunnel test and in simulation of the SemiSpan Supersonic Transport model to assess aeroservoelastic characteristics. Fundamental issues associated with analyzing sinusoidal signals were examined, including spectral leakage, excitation truncation, and uncertainties on frequency response functions and mean-square coherence. Simulation allowed for evaluation of these issues relative to a truth model, while wind tunnel data introduced real-world implementation issues.

Zymomonas mobilis as a model system for production of biofuels and biochemicals

DOE PAGES

Yang, Shihui; Fei, Qiang; Zhang, Yaoping; ...

2016-09-15

Zymomonas mobilis is a natural ethanologen with many desirable industrial biocatalyst characteristics. In this review, we will discuss work to develop Z. mobilis as a model system for biofuel production from the perspectives of substrate utilization, development for industrial robustness, potential product spectrum, strain evaluation and fermentation strategies. Lastly, this review also encompasses perspectives related to classical genetic tools and emerging technologies in this context.

Zymomonas mobilis as a model system for production of biofuels and biochemicals

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

Yang, Shihui; Fei, Qiang; Zhang, Yaoping

Zymomonas mobilis is a natural ethanologen with many desirable industrial biocatalyst characteristics. In this review, we will discuss work to develop Z. mobilis as a model system for biofuel production from the perspectives of substrate utilization, development for industrial robustness, potential product spectrum, strain evaluation and fermentation strategies. Lastly, this review also encompasses perspectives related to classical genetic tools and emerging technologies in this context.

Stress and Family Quality of Life in Parents of Children with Autism Spectrum Disorder: Parent Gender and the Double ABCX Model

ERIC Educational Resources Information Center

McStay, Rebecca L.; Trembath, David; Dissanayake, Cheryl

2014-01-01

Past research has supported the utility of the Double ABCX model of family adaptation for parents raising a child with autism spectrum disorder (ASD). What remains unclear is the impact of family-related variables on outcomes in both mothers and fathers within the same family. We explored the potential predictors of maternal and paternal stress…

Importance of the type of provider seen to begin health care for a new episode low back pain: associations with future utilization and costs.

PubMed

Fritz, Julie M; Kim, Jaewhan; Dorius, Josette

2016-04-01

Low back pain (LBP) care can involve many providers. The provider chosen for entry into care may predict future health care utilization and costs. The objective of this study was to explore associations between entry settings and future LBP-related utilization and costs. A retrospective review of claims data identified new entries into health care for LBP. We examined the year after entry to identify utilization outcomes (imaging, surgeon or emergency visits, injections, surgery) and total LBP-related costs. Multivariate models with inverse probability weighting on propensity scores were used to evaluate relationships between utilization and cost outcomes with entry setting. 747 patients were identified (mean age = 38.2 (± 10.7) years, 61.2% female). Entry setting was primary care (n = 409, 54.8%), chiropractic (n = 207, 27.7%), physiatry (n = 83, 11.1%) and physical therapy (n = 48, 6.4%). Relative to primary care, entry in physiatry increased risk for radiographs (OR = 3.46, P = 0.001), advanced imaging (OR = 3.38, P < 0.001), injections (OR = 4.91, P < 0.001), surgery (OR = 4.76, P = 0.012) and LBP-related costs (standardized Β = 0.67, P < 0.001). Entry in chiropractic was associated with decreased risk for advanced imaging (OR = 0.21, P = 0.001) or a surgeon visit (OR = 0.13, P = 0.005) and increased episode of care duration (standardized Β = 0.51, P < 0.001). Entry in physical therapy decreased risk of radiographs (OR = 0.39, P = 0.017) and no patient entering in physical therapy had surgery. Entry setting for LBP was associated with future health care utilization and costs. Consideration of where patients chose to enter care may be a strategy to improve outcomes and reduce costs. © 2015 John Wiley & Sons, Ltd.

The application of the heuristic-systematic processing model to treatment decision making about prostate cancer.

PubMed

Steginga, Suzanne K; Occhipinti, Stefano

2004-01-01

The study investigated the utility of the Heuristic-Systematic Processing Model as a framework for the investigation of patient decision making. A total of 111 men recently diagnosed with localized prostate cancer were assessed using Verbal Protocol Analysis and self-report measures. Study variables included men's use of nonsystematic and systematic information processing, desire for involvement in decision making, and the individual differences of health locus of control, tolerance of ambiguity, and decision-related uncertainty. Most men (68%) preferred that decision making be shared equally between them and their doctor. Men's use of the expert opinion heuristic was related to men's verbal reports of decisional uncertainty and having a positive orientation to their doctor and medical care; a desire for greater involvement in decision making was predicted by a high internal locus of health control. Trends were observed for systematic information processing to increase when the heuristic strategy used was negatively affect laden and when men were uncertain about the probabilities for cure and side effects. There was a trend for decreased systematic processing when the expert opinion heuristic was used. Findings were consistent with the Heuristic-Systematic Processing Model and suggest that this model has utility for future research in applied decision making about health.

Mapping health outcome measures from a stroke registry to EQ-5D weights.

PubMed

Ghatnekar, Ola; Eriksson, Marie; Glader, Eva-Lotta

2013-03-07

To map health outcome related variables from a national register, not part of any validated instrument, with EQ-5D weights among stroke patients. We used two cross-sectional data sets including patient characteristics, outcome variables and EQ-5D weights from the national Swedish stroke register. Three regression techniques were used on the estimation set (n=272): ordinary least squares (OLS), Tobit, and censored least absolute deviation (CLAD). The regression coefficients for "dressing", "toileting", "mobility", "mood", "general health" and "proxy-responders" were applied to the validation set (n=272), and the performance was analysed with mean absolute error (MAE) and mean square error (MSE). The number of statistically significant coefficients varied by model, but all models generated consistent coefficients in terms of sign. Mean utility was underestimated in all models (least in OLS) and with lower variation (least in OLS) compared to the observed. The maximum attainable EQ-5D weight ranged from 0.90 (OLS) to 1.00 (Tobit and CLAD). Health states with utility weights <0.5 had greater errors than those with weights ≥ 0.5 (P<0.01). This study indicates that it is possible to map non-validated health outcome measures from a stroke register into preference-based utilities to study the development of stroke care over time, and to compare with other conditions in terms of utility.

Relative resilience to noise of standard and sequential approaches to measurement-based quantum computation

NASA Astrophysics Data System (ADS)

Gallagher, C. B.; Ferraro, A.

2018-05-01

A possible alternative to the standard model of measurement-based quantum computation (MBQC) is offered by the sequential model of MBQC—a particular class of quantum computation via ancillae. Although these two models are equivalent under ideal conditions, their relative resilience to noise in practical conditions is not yet known. We analyze this relationship for various noise models in the ancilla preparation and in the entangling-gate implementation. The comparison of the two models is performed utilizing both the gate infidelity and the diamond distance as figures of merit. Our results show that in the majority of instances the sequential model outperforms the standard one in regard to a universal set of operations for quantum computation. Further investigation is made into the performance of sequential MBQC in experimental scenarios, thus setting benchmarks for possible cavity-QED implementations.

Pathologists' roles in clinical utilization management. A financing model for managed care.

PubMed

Zhao, J J; Liberman, A

2000-03-01

In ancillary or laboratory utilization management, the roles of pathologists have not been explored fully in managed care systems. Two possible reasons may account for this: pathologists' potential contributions have not been defined clearly, and effective measurement of and reasonable compensation for the pathologist's contribution remains vague. The responsibilities of pathologists in clinical practice may include clinical pathology and laboratory services (which have long been well-defined and are compensated according to a resource-based relative value system-based coding system), laboratory administration, clinical utilization management, and clinical research. Although laboratory administration services have been compensated with mechanisms such as percentage of total service revenue or fixed salary, the involvement of pathologists seems less today than in the past, owing to increased clinical workload and time constraints in an expanding managed care environment, especially in community hospital settings. The lack of financial incentives or appropriate compensation mechanisms for the services likely accounts for the current situation. Furthermore, the importance of pathologist-driven utilization management in laboratory services lacks recognition among hospital administrators, managed care executives, and pathologists themselves, despite its potential benefits for reducing cost and enhancing quality of care. We propose a financial compensation model for such services and summarize its advantages.

Weight bias internalization, core self-evaluation, and health in overweight and obese persons.

PubMed

Hilbert, Anja; Braehler, Elmar; Haeuser, Winfried; Zenger, Markus

2014-01-01

Weight bias has strong associations with psychopathology in overweight and obese individuals. However, self-evaluative processes, as conceptualized in the process model of self-stigma, and implications for other health-related outcomes, remain to be clarified. In a representative general population sample of N = 1158 overweight and obese individuals, the impact of core self-evaluation as a mediator between weight bias internalization and mental and global health outcomes as well as between weight bias internalization and health care utilization, was examined using structural equation modeling. In overweight and obese individuals, greater weight bias internalization predicted lower core self-evaluation, which in turn predicted greater depression and anxiety, lower global health, and greater health care utilization. These mediational associations were largely stable in subsample analyses and after controlling for sociodemographic variables. The results show that overweight and obese individuals with internalized weight bias are at risk for impaired health, especially if they experience low core self-evaluation, making them a group with which to target for interventions to reduce self-stigma. Weight bias internalization did not represent a barrier to health care utilization, but predicted greater health care utilization in association with greater health impairments. Copyright © 2013 The Obesity Society.

Development and Validation of a qRT-PCR Classifier for Lung Cancer Prognosis

PubMed Central

Chen, Guoan; Kim, Sinae; Taylor, Jeremy MG; Wang, Zhuwen; Lee, Oliver; Ramnath, Nithya; Reddy, Rishindra M; Lin, Jules; Chang, Andrew C; Orringer, Mark B; Beer, David G

2011-01-01

Purpose This prospective study aimed to develop a robust and clinically-applicable method to identify high-risk early stage lung cancer patients and then to validate this method for use in future translational studies. Patients and Methods Three published Affymetrix microarray data sets representing 680 primary tumors were used in the survival-related gene selection procedure using clustering, Cox model and random survival forest (RSF) analysis. A final set of 91 genes was selected and tested as a predictor of survival using a qRT-PCR-based assay utilizing an independent cohort of 101 lung adenocarcinomas. Results The RSF model built from 91 genes in the training set predicted patient survival in an independent cohort of 101 lung adenocarcinomas, with a prediction error rate of 26.6%. The mortality risk index (MRI) was significantly related to survival (Cox model p < 0.00001) and separated all patients into low, medium, and high-risk groups (HR = 1.00, 2.82, 4.42). The MRI was also related to survival in stage 1 patients (Cox model p = 0.001), separating patients into low, medium, and high-risk groups (HR = 1.00, 3.29, 3.77). Conclusions The development and validation of this robust qRT-PCR platform allows prediction of patient survival with early stage lung cancer. Utilization will now allow investigators to evaluate it prospectively by incorporation into new clinical trials with the goal of personalized treatment of lung cancer patients and improving patient survival. PMID:21792073

Zebrafish as a model for acetylcholinesterase-inhibiting organophosphorus agent exposure and oxime reactivation

PubMed Central

Koenig, Jeffrey A.; Dao, Thuy L.; Kan, Robert K.; Shih, Tsung-Ming

2016-01-01

The current research progression efforts for investigating novel treatments for exposure to organophosphorus (OP) compounds that inhibit acetylcholinesterase (AChE), including pesticides and chemical warfare nerve agents (CWNAs), rely solely on in vitro cell assays and in vivo rodent models. The zebrafish (Danio rerio) is a popular, well-established vertebrate model in biomedical research that offers high-throughput capabilities and genetic manipulation not readily available with rodents. A number of research studies have investigated the effects of subacute developmental exposure to OP pesticides in zebrafish, observing detrimental effects on gross morphology, neuronal development, and behavior. Few studies, however, have utilized this model to evaluate treatments, such as oxime reactivators, anticholinergics, or anticonvulsants, following acute exposure. Preliminary work has investigated the effects of CWNA exposure. The results clearly demonstrated relative toxicity and oxime efficacy similar to that reported for the rodent model. This review surveys the current literature utilizing zebrafish as a model for OP exposure and highlights its potential use as a high-throughput system for evaluating AChE reactivator antidotal treatments to acute pesticide and CWNA exposure. PMID:27123828

Willingness to Use Pre-Exposure Prophylaxis (PrEP): An Empirical Test of the Information-Motivation-Behavioral Skills (IMB) Model among High-Risk Drug Users in Treatment.

PubMed

Shrestha, Roman; Altice, Frederick L; Huedo-Medina, Tania B; Karki, Pramila; Copenhaver, Michael

2017-05-01

Evidence from recent pre-exposure prophylaxis (PrEP) trials has demonstrated its safety and efficacy in significantly reducing the risk of HIV acquisition for those who are at considerable risk of acquiring HIV infection. With a rapid increase in the amount of research on the efficacy of PrEP for HIV prevention, complementary research on the willingness to use PrEP has grown, especially among MSM, but limited research has been focused among people who use drugs (PWUD). As part of the formative process, we utilized the information-motivation-behavioral skills (IMB) model of health behavior change to characterize and guide intervention development for promoting willingness to use PrEP among high-risk PWUD. The analysis included 400 HIV-negative high-risk PWUD enrolled in a community-based methadone maintenance treatment who reported drug- and/or sex-related HIV risk behaviors in the past 6-months. Analyses revealed support for the IMB model as PrEP-related behavioral skills were found to mediate the influence of PrEP-related information and motivation on willingness to use PrEP. The results provide evidence as to the utility of the IMB model to increase willingness to use PrEP among high-risk PWUD. It therefore makes an important contribution to our understanding of the applicability of theoretically-grounded models of willingness to use PrEP among high-risk PWUD, who are one of the key risk populations who could benefit from the use of PrEP.

Willingness to Use Pre-Exposure Prophylaxis (PrEP): An Empirical Test of the Information-Motivation-Behavioral Skills (IMB) Model among High-Risk Drug Users in Treatment

PubMed Central

Shrestha, Roman; Altice, Frederick L.; Huedo-Medina, Tania B.; Karki, Pramila; Copenhaver, Michael

2016-01-01

Evidence from recent pre-exposure prophylaxis (PrEP) trials has demonstrated its safety and efficacy in significantly reducing the risk of HIV acquisition for those who are at considerable risk of acquiring HIV infection. With a rapid increase in the amount of research on the efficacy of PrEP for HIV prevention, complementary research on the willingness to use PrEP has grown, especially among MSM, but limited research has been focused among people who use drugs (PWUD). As part of the formative process, we utilized the Information-Motivation-Behavioral Skills (IMB) model of health behavior change to characterize and guide intervention development for promoting willingness to use PrEP among high-risk PWUD. The analysis included 400 HIV-negative high-risk PWUD enrolled in a community-based methadone maintenance treatment who reported drug- and/or sex-related HIV risk behaviors in the past 6-months. Analyses revealed support for the IMB model as PrEP-related behavioral skills were found to mediate the influence of PrEP-related information and motivation on willingness to use PrEP. The results provide evidence as to the utility of the IMB model to increase willingness to use PrEP among high-risk PWUD. It therefore makes an important contribution to our understanding of the applicability of theoretically-grounded models of willingness to use PrEP among high-risk PWUD, who are one of the key risk populations who could benefit from the use of PrEP. PMID:27990587

Impact of Three-Phase Relative Permeability and Hysteresis Models on Forecasts of Storage Associated With CO2-EOR

NASA Astrophysics Data System (ADS)

Jia, Wei; McPherson, Brian; Pan, Feng; Dai, Zhenxue; Moodie, Nathan; Xiao, Ting

2018-02-01

Geological CO2 sequestration in conjunction with enhanced oil recovery (CO2-EOR) includes complex multiphase flow processes compared to CO2 storage in deep saline aquifers. Two of the most important factors affecting multiphase flow in CO2-EOR are three-phase relative permeability and associated hysteresis, both of which are difficult to measure and are usually represented by numerical interpolation models. The purpose of this study is to improve understanding of (1) the relative impacts of different three-phase relative permeability models and hysteresis models on CO2 trapping mechanisms, and (2) uncertainty associated with these two factors. Four different three-phase relative permeability models and three hysteresis models were applied to simulations of an active CO2-EOR site, the SACROC unit located in western Texas. To eliminate possible bias of deterministic parameters, we utilized a sequential Gaussian simulation technique to generate 50 realizations to describe heterogeneity of porosity and permeability, based on data obtained from well logs and seismic survey. Simulation results of forecasted CO2 storage suggested that (1) the choice of three-phase relative permeability model and hysteresis model led to noticeable impacts on forecasted CO2 sequestration capacity; (2) impacts of three-phase relative permeability models and hysteresis models on CO2 trapping are small during the CO2-EOR injection period, and increase during the post-EOR CO2 injection period; (3) the specific choice of hysteresis model is more important relative to the choice of three-phase relative permeability model; and (4) using the recommended three-phase WAG (Water-Alternating-Gas) hysteresis model may increase the impact of three-phase relative permeability models and uncertainty due to heterogeneity.

A model for plant lighting system selection.

PubMed

Ciolkosz, D E; Albright, L D; Sager, J C; Langhans, R W

2002-01-01

A decision model is presented that compares lighting systems for a plant growth scenario and chooses the most appropriate system from a given set of possible choices. The model utilizes a Multiple Attribute Utility Theory approach, and incorporates expert input and performance simulations to calculate a utility value for each lighting system being considered. The system with the highest utility is deemed the most appropriate system. The model was applied to a greenhouse scenario, and analyses were conducted to test the model's output for validity. Parameter variation indicates that the model performed as expected. Analysis of model output indicates that differences in utility among the candidate lighting systems were sufficiently large to give confidence that the model's order of selection was valid.

Effects of selection and training on unit-level performance over time: a latent growth modeling approach.

PubMed

Van Iddekinge, Chad H; Ferris, Gerald R; Perrewé, Pamela L; Blass, Fred R; Heetderks, Thomas D; Perryman, Alexa A

2009-07-01

Surprisingly few data exist concerning whether and how utilization of job-related selection and training procedures affects different aspects of unit or organizational performance over time. The authors used longitudinal data from a large fast-food organization (N = 861 units) to examine how change in use of selection and training relates to change in unit performance. Latent growth modeling analyses revealed significant variation in both the use and the change in use of selection and training across units. Change in selection and training was related to change in 2 proximal unit outcomes: customer service performance and retention. Change in service performance, in turn, was related to change in the more distal outcome of unit financial performance (i.e., profits). Selection and training also affected financial performance, both directly and indirectly (e.g., through service performance). Finally, results of a cross-lagged panel analysis suggested the existence of a reciprocal causal relationship between the utilization of the human resources practices and unit performance. However, there was some evidence to suggest that selection and training may be associated with different causal sequences, such that use of the training procedure appeared to lead to unit performance, whereas unit performance appeared to lead to use of the selection procedure.

Environmental security control of resource utilization of shale gas' drilling cuttings containing heavy metals.

PubMed

Wang, Chao-Qiang; Lin, Xiao-Yan; Zhang, Chun; Mei, Xu-Dong

2017-09-01

The overall objective of this research project was to investigate the heavy metals environmental security control of resource utilization of shale gas' drilling cuttings. To achieve this objective, we got through theoretical calculation and testing, ultimately and preliminarily determine the content of heavy metals pollutants, and compared with related standards at domestically and abroad. The results indicated that using the second Fike's law, the theoretical model of the release amount of heavy metal can be made, and the groundwater environmental risk as main point compared with soil. This study can play a role of standard guidance on environmental security control of drilling cuttings resource utilization by the exploration and development of shale gas in our country.

Mapping the Paediatric Quality of Life Inventory (PedsQL™) Generic Core Scales onto the Child Health Utility Index-9 Dimension (CHU-9D) Score for Economic Evaluation in Children.

PubMed

Lambe, Tosin; Frew, Emma; Ives, Natalie J; Woolley, Rebecca L; Cummins, Carole; Brettell, Elizabeth A; Barsoum, Emma N; Webb, Nicholas J A

2018-04-01

The Paediatric Quality of Life Inventory (PedsQL™) questionnaire is a widely used, generic instrument designed for measuring health-related quality of life (HRQoL); however, it is not preference-based and therefore not suitable for cost-utility analysis. The Child Health Utility Index-9 Dimension (CHU-9D), however, is a preference-based instrument that has been primarily developed to support cost-utility analysis. This paper presents a method for estimating CHU-9D index scores from responses to the PedsQL™ using data from a randomised controlled trial of prednisolone therapy for treatment of childhood corticosteroid-sensitive nephrotic syndrome. HRQoL data were collected from children at randomisation, week 16, and months 12, 18, 24, 36 and 48. Observations on children aged 5 years and older were pooled across all data collection timepoints and were then randomised into an estimation (n = 279) and validation (n = 284) sample. A number of models were developed using the estimation data before internal validation. The best model was chosen using multi-stage selection criteria. Most of the models developed accurately predicted the CHU-9D mean index score. The best performing model was a generalised linear model (mean absolute error = 0.0408; mean square error = 0.0035). The proportion of index scores deviating from the observed scores by <  0.03 was 53%. The mapping algorithm provides an empirical tool for estimating CHU-9D index scores and for conducting cost-utility analyses within clinical studies that have only collected PedsQL™ data. It is valid for children aged 5 years or older. Caution should be exercised when using this with children younger than 5 years, older adolescents (>  13 years) or patient groups with particularly poor quality of life. 16645249.

Instruction-level performance modeling and characterization of multimedia applications

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

Luo, Y.; Cameron, K.W.

1999-06-01

One of the challenges for characterizing and modeling realistic multimedia applications is the lack of access to source codes. On-chip performance counters effectively resolve this problem by monitoring run-time behaviors at the instruction-level. This paper presents a novel technique of characterizing and modeling workloads at the instruction level for realistic multimedia applications using hardware performance counters. A variety of instruction counts are collected from some multimedia applications, such as RealPlayer, GSM Vocoder, MPEG encoder/decoder, and speech synthesizer. These instruction counts can be used to form a set of abstract characteristic parameters directly related to a processor`s architectural features. Based onmore » microprocessor architectural constraints and these calculated abstract parameters, the architectural performance bottleneck for a specific application can be estimated. Meanwhile, the bottleneck estimation can provide suggestions about viable architectural/functional improvement for certain workloads. The biggest advantage of this new characterization technique is a better understanding of processor utilization efficiency and architectural bottleneck for each application. This technique also provides predictive insight of future architectural enhancements and their affect on current codes. In this paper the authors also attempt to model architectural effect on processor utilization without memory influence. They derive formulas for calculating CPI{sub 0}, CPI without memory effect, and they quantify utilization of architectural parameters. These equations are architecturally diagnostic and predictive in nature. Results provide promise in code characterization, and empirical/analytical modeling.« less

Acute Stress Decreases but Chronic Stress Increases Myocardial Sensitivity to Ischemic Injury in Rodents

PubMed Central

Eisenmann, Eric D.; Rorabaugh, Boyd R.; Zoladz, Phillip R.

2016-01-01

Cardiovascular disease (CVD) is the largest cause of mortality worldwide, and stress is a significant contributor to the development of CVD. The relationship between acute and chronic stress and CVD is well evidenced. Acute stress can lead to arrhythmias and ischemic injury. However, recent evidence in rodent models suggests that acute stress can decrease sensitivity to myocardial ischemia–reperfusion injury (IRI). Conversely, chronic stress is arrhythmogenic and increases sensitivity to myocardial IRI. Few studies have examined the impact of validated animal models of stress-related psychological disorders on the ischemic heart. This review examines the work that has been completed using rat models to study the effects of stress on myocardial sensitivity to ischemic injury. Utilization of animal models of stress-related psychological disorders is critical in the prevention and treatment of cardiovascular disorders in patients experiencing stress-related psychiatric conditions. PMID:27199778

Acute Stress Decreases but Chronic Stress Increases Myocardial Sensitivity to Ischemic Injury in Rodents.

PubMed

Eisenmann, Eric D; Rorabaugh, Boyd R; Zoladz, Phillip R

2016-01-01

Cardiovascular disease (CVD) is the largest cause of mortality worldwide, and stress is a significant contributor to the development of CVD. The relationship between acute and chronic stress and CVD is well evidenced. Acute stress can lead to arrhythmias and ischemic injury. However, recent evidence in rodent models suggests that acute stress can decrease sensitivity to myocardial ischemia-reperfusion injury (IRI). Conversely, chronic stress is arrhythmogenic and increases sensitivity to myocardial IRI. Few studies have examined the impact of validated animal models of stress-related psychological disorders on the ischemic heart. This review examines the work that has been completed using rat models to study the effects of stress on myocardial sensitivity to ischemic injury. Utilization of animal models of stress-related psychological disorders is critical in the prevention and treatment of cardiovascular disorders in patients experiencing stress-related psychiatric conditions.

A Utility Model for Teaching Load Decisions in Academic Departments.

ERIC Educational Resources Information Center

Massey, William F.; Zemsky, Robert

1997-01-01

Presents a utility model for academic department decision making and describes the structural specifications for analyzing it. The model confirms the class-size utility asymmetry predicted by the authors' academic rachet theory, but shows that marginal utility associated with college teaching loads is always negative. Curricular structure and…

Computational identification of a new SelD-like family that may participate in sulfur metabolism in hyperthermophilic sulfur-reducing archaea.

PubMed

Li, Gao-Peng; Jiang, Liang; Ni, Jia-Zuan; Liu, Qiong; Zhang, Yan

2014-10-17

Selenium (Se) and sulfur (S) are closely related elements that exhibit similar chemical properties. Some genes related to S metabolism are also involved in Se utilization in many organisms. However, the evolutionary relationship between the two utilization traits is unclear. In this study, we conducted a comparative analysis of the selenophosphate synthetase (SelD) family, a key protein for all known Se utilization traits, in all sequenced archaea. Our search showed a very limited distribution of SelD and Se utilization in this kingdom. Interestingly, a SelD-like protein was detected in two orders of Crenarchaeota: Sulfolobales and Thermoproteales. Sequence and phylogenetic analyses revealed that SelD-like protein contains the same domain and conserved functional residues as those of SelD, and might be involved in S metabolism in these S-reducing organisms. Further genome-wide analysis of patterns of gene occurrence in different thermoproteales suggested that several genes, including SirA-like, Prx-like and adenylylsulfate reductase, were strongly related to SelD-like gene. Based on these findings, we proposed a simple model wherein SelD-like may play an important role in the biosynthesis of certain thiophosphate compound. Our data suggest novel genes involved in S metabolism in hyperthermophilic S-reducing archaea, and may provide a new window for understanding the complex relationship between Se and S metabolism in archaea.

Prevalence, health care utilization, and costs of fibromyalgia, irritable bowel, and chronic fatigue syndromes in the military health system, 2006-2010.

PubMed

Jeffery, Diana D; Bulathsinhala, Lakmini; Kroc, Michelle; Dorris, Joseph

2014-09-01

We compared prevalence, health care utilization, and costs over time for nonelderly adults diagnosed with fibromyalgia syndrome (FMS), irritable bowel syndrome (IBS), and chronic fatigue syndrome (CFS) in relation to timing of federal approvals for FMS drugs. We used military health care claims from October 2006 to September 2010. Retrospective, multiple-year comparisons were conducted using trend analyses, and time series regression-based generalized linear models. Over 5 years, FMS prevalence rates increased from 0.307% to 0.522%, whereas IBS and CFS prevalence rates remained stable. The largest increase in FMS prevalence occurred between 2007 and 2008. Health care utilization was higher for FMS cases compared to IBS and CFS cases. Over 5 years, the total cost for FMS-related care increased $163.2 million, whereas IBS costs increased $14.9 million and CFS cost increased $3.7 million. Between 2006 and 2010, total pharmacy cost for FMS cases increased from $55 million ($3,641/person) to $96.3 million ($3,557/person). Although cause and effect cannot be established, the advent of federally approved drugs for FMS in concert with pharmaceutical industry marketing of these drugs coincide with the observed changes in prevalence, health care utilization, and costs of FMS relative to IBS and CFS. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Measuring the impact of alcohol-related disorders on quality of life through general population preferences.

PubMed

Rodríguez-Míguez, Eva; Mosquera Nogueira, Jacinto

To estimate the intangible effects of alcohol misuse on the drinker's quality of life, based on general population preferences METHODS: The most important effects (dimensions) were identified by means of two focus groups conducted with patients and specialists. The levels of these dimensions were combined to yield different scenarios. A sample of 300 people taken from the general Spanish population evaluated a subset of these scenarios, selected by using a fractional factorial design. We used the probability lottery equivalent method to derive the utility score for the evaluated scenarios, and the random-effects regression model to estimate the relative importance of each dimension and to derive the utility score for the rest of scenarios not directly evaluated. Four main dimensions were identified (family, physical health, psychological health and social) and divided into three levels of intensity. We found a wide variation in the utilities associated with the scenarios directly evaluated (ranging from 0.09 to 0.78). The dimensions with the greatest relative importance were physical health (36.4%) and family consequences (31.3%), followed by psychological (20.5%) and social consequences (11.8%). Our findings confirm the benefits of adopting a heterogeneous approach to measure the effects of alcohol misuse. The estimated utilities could have both clinical and economic applications. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

The therapeutic potential of cell identity reprogramming for the treatment of aging-related neurodegenerative disorders

PubMed Central

Smith, Derek K.; He, Miao; Zhang, Chun-Li; Zheng, Jialin C.

2018-01-01

Neural cell identity reprogramming strategies aim to treat age-related neurodegenerative disorders with newly induced neurons that regenerate neural architecture and functional circuits in vivo. The isolation and neural differentiation of pluripotent embryonic stem cells provided the first in vitro models of human neurodegenerative disease. Investigation into the molecular mechanisms underlying stem cell pluripotency revealed that somatic cells could be reprogrammed to induced pluripotent stem cells (iPSCs) and these cells could be used to model Alzheimer disease, amyotrophic lateral sclerosis, Huntington disease, and Parkinson disease. Additional neural precursor and direct transdifferentiation strategies further enabled the induction of diverse neural linages and neuron subtypes both in vitro and in vivo. In this review, we highlight neural induction strategies that utilize stem cells, iPSCs, and lineage reprogramming to model or treat age-related neurodegenerative diseases, as well as, the clinical challenges related to neural transplantation and in vivo reprogramming strategies. PMID:26844759

Using EPA Tools and Data Services to Inform Changes to Design Storm Definitions for Wastewater Utilities based on Climate Model Projections

NASA Astrophysics Data System (ADS)

Tryby, M.; Fries, J. S.; Baranowski, C.

2014-12-01

Extreme precipitation events can cause significant impacts to drinking water and wastewater utilities, including facility damage, water quality impacts, service interruptions and potential risks to human health and the environment due to localized flooding and combined sewer overflows (CSOs). These impacts will become more pronounced with the projected increases in frequency and intensity of extreme precipitation events due to climate change. To model the impacts of extreme precipitation events, wastewater utilities often develop Intensity, Duration, and Frequency (IDF) rainfall curves and "design storms" for use in the U.S. Environmental Protection Agency's (EPA) Storm Water Management Model (SWMM). Wastewater utilities use SWMM for planning, analysis, and facility design related to stormwater runoff, combined and sanitary sewers, and other drainage systems in urban and non-urban areas. SWMM tracks (1) the quantity and quality of runoff made within each sub-catchment; and (2) the flow rate, flow depth, and quality of water in each pipe and channel during a simulation period made up of multiple time steps. In its current format, EPA SWMM does not consider climate change projection data. Climate change may affect the relationship between intensity, duration, and frequency described by past rainfall events. Therefore, EPA is integrating climate projection data available in the Climate Resilience Evaluation and Awareness Tool (CREAT) into SWMM. CREAT is a climate risk assessment tool for utilities that provides downscaled climate change projection data for changes in the amount of rainfall in a 24-hour period for various extreme precipitation events (e.g., from 5-year to 100-year storm events). Incorporating climate change projections into SWMM will provide wastewater utilities with more comprehensive data they can use in planning for future storm events, thereby reducing the impacts to the utility and customers served from flooding and stormwater issues.

Trial-Based Cost-Utility Analysis of Icotinib versus Gefitinib as Second-Line Therapy for Advanced Non-Small Cell Lung Cancer in China.

PubMed

Zhang, Chunxiang; Zhang, Hongmei; Shi, Jinning; Wang, Dong; Zhang, Xiuwei; Yang, Jian; Zhai, Qizhi; Ma, Aixia

2016-01-01

Our objective is to compare the cost-utility of icotinib and gefitinib for the second-line treatment of advanced non-small cell lung cancer (NSCLC) from the perspective of the Chinese healthcare system. Model technology was applied to assess the data of randomized clinical trials and the direct medical costs from the perspective of the Chinese healthcare system. Five-year quality-adjusted life years (QALYs) and incremental cost-utility ratios (ICURs) were calculated. One-way and probabilistic sensitivity analyses (PSA) were performed. Our model suggested that the median progression-free survival (PFS) was 4.2 months in the icotinib group and 3.5 months in the gefitinib group while they were 4.6 months and 3.4 months, respectively, in the trials. The 5-year QALYs was 0.279 in the icotinib group and 0.269 in the gefitinib group, and the according medical costs were $10662.82 and $13127.57. The ICUR/QALY of icotinib versus gefitinib presented negative in this study. The most sensitive parameter to the ICUR was utility of PFS, ranging from $-1,259,991.25 to $-182,296.61; accordingly the icotinib treatment consistently represented a dominant cost-utility strategy. The icotinib strategy, as a second-line therapy for advanced NSCLC patients in China, is the preferred strategy relative to gefitinib because of the dominant cost-utility. In addition, icotinib shows a good curative effect and safety, resulting in a strong demand for the Chinese market.

Two statistics for evaluating parameter identifiability and error reduction

USGS Publications Warehouse

Doherty, John; Hunt, Randall J.

2009-01-01

Two statistics are presented that can be used to rank input parameters utilized by a model in terms of their relative identifiability based on a given or possible future calibration dataset. Identifiability is defined here as the capability of model calibration to constrain parameters used by a model. Both statistics require that the sensitivity of each model parameter be calculated for each model output for which there are actual or presumed field measurements. Singular value decomposition (SVD) of the weighted sensitivity matrix is then undertaken to quantify the relation between the parameters and observations that, in turn, allows selection of calibration solution and null spaces spanned by unit orthogonal vectors. The first statistic presented, "parameter identifiability", is quantitatively defined as the direction cosine between a parameter and its projection onto the calibration solution space. This varies between zero and one, with zero indicating complete non-identifiability and one indicating complete identifiability. The second statistic, "relative error reduction", indicates the extent to which the calibration process reduces error in estimation of a parameter from its pre-calibration level where its value must be assigned purely on the basis of prior expert knowledge. This is more sophisticated than identifiability, in that it takes greater account of the noise associated with the calibration dataset. Like identifiability, it has a maximum value of one (which can only be achieved if there is no measurement noise). Conceptually it can fall to zero; and even below zero if a calibration problem is poorly posed. An example, based on a coupled groundwater/surface-water model, is included that demonstrates the utility of the statistics. ?? 2009 Elsevier B.V.

Bayesian assessment of the expected data impact on prediction confidence in optimal sampling design

NASA Astrophysics Data System (ADS)

Leube, P. C.; Geiges, A.; Nowak, W.

2012-02-01

Incorporating hydro(geo)logical data, such as head and tracer data, into stochastic models of (subsurface) flow and transport helps to reduce prediction uncertainty. Because of financial limitations for investigation campaigns, information needs toward modeling or prediction goals should be satisfied efficiently and rationally. Optimal design techniques find the best one among a set of investigation strategies. They optimize the expected impact of data on prediction confidence or related objectives prior to data collection. We introduce a new optimal design method, called PreDIA(gnosis) (Preposterior Data Impact Assessor). PreDIA derives the relevant probability distributions and measures of data utility within a fully Bayesian, generalized, flexible, and accurate framework. It extends the bootstrap filter (BF) and related frameworks to optimal design by marginalizing utility measures over the yet unknown data values. PreDIA is a strictly formal information-processing scheme free of linearizations. It works with arbitrary simulation tools, provides full flexibility concerning measurement types (linear, nonlinear, direct, indirect), allows for any desired task-driven formulations, and can account for various sources of uncertainty (e.g., heterogeneity, geostatistical assumptions, boundary conditions, measurement values, model structure uncertainty, a large class of model errors) via Bayesian geostatistics and model averaging. Existing methods fail to simultaneously provide these crucial advantages, which our method buys at relatively higher-computational costs. We demonstrate the applicability and advantages of PreDIA over conventional linearized methods in a synthetic example of subsurface transport. In the example, we show that informative data is often invisible for linearized methods that confuse zero correlation with statistical independence. Hence, PreDIA will often lead to substantially better sampling designs. Finally, we extend our example to specifically highlight the consideration of conceptual model uncertainty.

A model of adaptive decision-making from representation of information environment by quantum fields.

PubMed

Bagarello, F; Haven, E; Khrennikov, A

2017-11-13

We present the mathematical model of decision-making (DM) of agents acting in a complex and uncertain environment (combining huge variety of economical, financial, behavioural and geopolitical factors). To describe interaction of agents with it, we apply the formalism of quantum field theory (QTF). Quantum fields are a purely informational nature. The QFT model can be treated as a far relative of the expected utility theory, where the role of utility is played by adaptivity to an environment (bath). However, this sort of utility-adaptivity cannot be represented simply as a numerical function. The operator representation in Hilbert space is used and adaptivity is described as in quantum dynamics. We are especially interested in stabilization of solutions for sufficiently large time. The outputs of this stabilization process, probabilities for possible choices, are treated in the framework of classical DM. To connect classical and quantum DM, we appeal to Quantum Bayesianism. We demonstrate the quantum-like interference effect in DM, which is exhibited as a violation of the formula of total probability, and hence the classical Bayesian inference scheme.This article is part of the themed issue 'Second quantum revolution: foundational questions'. © 2017 The Author(s).

A model of adaptive decision-making from representation of information environment by quantum fields

NASA Astrophysics Data System (ADS)

Bagarello, F.; Haven, E.; Khrennikov, A.

2017-10-01

We present the mathematical model of decision-making (DM) of agents acting in a complex and uncertain environment (combining huge variety of economical, financial, behavioural and geopolitical factors). To describe interaction of agents with it, we apply the formalism of quantum field theory (QTF). Quantum fields are a purely informational nature. The QFT model can be treated as a far relative of the expected utility theory, where the role of utility is played by adaptivity to an environment (bath). However, this sort of utility-adaptivity cannot be represented simply as a numerical function. The operator representation in Hilbert space is used and adaptivity is described as in quantum dynamics. We are especially interested in stabilization of solutions for sufficiently large time. The outputs of this stabilization process, probabilities for possible choices, are treated in the framework of classical DM. To connect classical and quantum DM, we appeal to Quantum Bayesianism. We demonstrate the quantum-like interference effect in DM, which is exhibited as a violation of the formula of total probability, and hence the classical Bayesian inference scheme. This article is part of the themed issue `Second quantum revolution: foundational questions'.

Prescriptive models to support decision making in genetics.

PubMed

Pauker, S G; Pauker, S P

1987-01-01

Formal prescriptive models can help patients and clinicians better understand the risks and uncertainties they face and better formulate well-reasoned decisions. Using Bayes rule, the clinician can interpret pedigrees, historical data, physical findings and laboratory data, providing individualized probabilities of various diagnoses and outcomes of pregnancy. With the advent of screening programs for genetic disease, it becomes increasingly important to consider the prior probabilities of disease when interpreting an abnormal screening test result. Decision trees provide a convenient formalism for structuring diagnostic, therapeutic and reproductive decisions; such trees can also enhance communication between clinicians and patients. Utility theory provides a mechanism for patients to understand the choices they face and to communicate their attitudes about potential reproductive outcomes in a manner which encourages the integration of those attitudes into appropriate decisions. Using a decision tree, the relevant probabilities and the patients' utilities, physicians can estimate the relative worth of various medical and reproductive options by calculating the expected utility of each. By performing relevant sensitivity analyses, clinicians and patients can understand the impact of various soft data, including the patients' attitudes toward various health outcomes, on the decision making process. Formal clinical decision analytic models can provide deeper understanding and improved decision making in clinical genetics.

The use of information theory for the evaluation of biomarkers of aging and physiological age.

PubMed

Blokh, David; Stambler, Ilia

2017-04-01

The present work explores the application of information theoretical measures, such as entropy and normalized mutual information, for research of biomarkers of aging. The use of information theory affords unique methodological advantages for the study of aging processes, as it allows evaluating non-linear relations between biological parameters, providing the precise quantitative strength of those relations, both for individual and multiple parameters, showing cumulative or synergistic effect. Here we illustrate those capabilities utilizing a dataset on heart disease, including diagnostic parameters routinely available to physicians. The use of information-theoretical methods, utilizing normalized mutual information, revealed the exact amount of information that various diagnostic parameters or their combinations contained about the persons' age. Based on those exact informative values for the correlation of measured parameters with age, we constructed a diagnostic rule (a decision tree) to evaluate physiological age, as compared to chronological age. The present data illustrated that younger subjects suffering from heart disease showed characteristics of people of higher age (higher physiological age). Utilizing information-theoretical measures, with additional data, it may be possible to create further clinically applicable information-theory-based markers and models for the evaluation of physiological age, its relation to age-related diseases and its potential modifications by therapeutic interventions. Copyright © 2017 Elsevier B.V. All rights reserved.

Enhanced risk prediction model for emergency department use and hospitalizations in patients in a primary care medical home.

PubMed

Takahashi, Paul Y; Heien, Herbert C; Sangaralingham, Lindsey R; Shah, Nilay D; Naessens, James M

2016-07-01

With the advent of healthcare payment reform, identifying high-risk populations has become more important to providers. Existing risk-prediction models often focus on chronic conditions. This study sought to better understand other factors to improve identification of the highest risk population. A retrospective cohort study of a paneled primary care population utilizing 2010 data to calibrate a risk prediction model of hospital and emergency department (ED) use in 2011. Data were randomly split into development and validation data sets. We compared the enhanced model containing the additional risk predictors with the Minnesota medical tiering model. The study was conducted in the primary care practice of an integrated delivery system at an academic medical center in Rochester, Minnesota. The study focus was primary care medical home patients in 2010 and 2011 (n = 84,752), with the primary outcome of subsequent hospitalization or ED visit. A total of 42,384 individuals derived the enhanced risk-prediction model and 42,368 individuals validated the model. Predictors included Adjusted Clinical Groups-based Minnesota medical tiering, patient demographics, insurance status, and prior year healthcare utilization. Additional variables included specific mental and medical conditions, use of high-risk medications, and body mass index. The area under the curve in the enhanced model was 0.705 (95% CI, 0.698-0.712) compared with 0.662 (95% CI, 0.656-0.669) in the Minnesota medical tiering-only model. New high-risk patients in the enhanced model were more likely to have lack of health insurance, presence of Medicaid, diagnosed depression, and prior ED utilization. An enhanced model including additional healthcare-related factors improved the prediction of risk of hospitalization or ED visit.

Variation in Place of Publication: A Model for Cataloging Simplification.

ERIC Educational Resources Information Center

Marker, Rhonda J.; Reagor, Melinda Ann

1994-01-01

Discussion of the revision of cataloging rules to simplify catalog records focuses on the information relating to publication, formerly called the imprint. Highlights include a review of cataloging codes; Library of Congress rules interpretations; the impact on bibliographic utilities; implications for technical and public services; and publishing…

Hybrid Teacher Leaders and the New Professional Development Ecology

ERIC Educational Resources Information Center

Margolis, Jason

2012-01-01

This two-year study examines an emergent model for promoting classroom change amidst systemic professional development efforts--the hybrid teacher leader (HTL). Utilizing ecological and teacher social network frameworks, the relative strengths and weaknesses of educators who both teach and lead teachers are explored. In-depth qualitative data from…

African Cultural Traditions and Modernization: A Reaffirmation.

ERIC Educational Resources Information Center

Boateng, Felix A.

1978-01-01

The viability of African cultural traditions and their role in modernization and nation-building in Africa are examined. Social and political organization and formal education are discussed in relation to the process of modernization. Although Africa may utilize Western models of development, Westernization and modernization are not synonymous.…

Feminist Identity and Theories as Correlates of Feminist Supervision Practices. Conference

ERIC Educational Resources Information Center

Szymanski, Dawn M.

2005-01-01

Although feminist supervision approaches have been advanced in the literature as alternatives or adjuncts to traditional supervision models, little is known about those who utilize feminist supervision practices. This study was designed to examine if feminist supervision practices were related to one's own feminist identity and various beliefs…

Adding Personality to Gifted Identification: Relationships among Traditional and Personality-Based Constructs

ERIC Educational Resources Information Center

Carman, Carol A.

2011-01-01

One of the underutilized tools in gifted identification is personality-based measures. A multiple confirmatory factor analysis was utilized to examine the relationships between traditional identification methods and personality-based measures. The pattern of correlations indicated this model could be measuring two constructs, one related to…

The Utilization of Edge-of-Field Monitoring of Agricultural Runoff in Addressing Nonpoint Source Pollution

USDA-ARS?s Scientific Manuscript database

While basin-scale studies and modeling are important tools in relating land uses to water quality concerns, edge-of-field monitoring (EOFM) provides the necessary resolution to spatially target, design, and evaluate in-field conservation practices for reducing nutrient and sediment loading from agri...

Situational and Demographic Influences on Transfer System Characteristics in Organizations

ERIC Educational Resources Information Center

Chen, Hsin-Chih; Holton, Elwood F., III; Bates, Reid A.

2006-01-01

Transfer theories, which are closely related to evaluation theory, have been developed from a holistic perspective, but most of empirical transfer research has not effectively utilized holistic models to investigate transfer of learning until the late 1990s. Additionally, little has been done in examining the relationship between situational…

An Adaptive Model of Student Performance Using Inverse Bayes

ERIC Educational Resources Information Center

Lang, Charles

2014-01-01

This article proposes a coherent framework for the use of Inverse Bayesian estimation to summarize and make predictions about student behaviour in adaptive educational settings. The Inverse Bayes Filter utilizes Bayes theorem to estimate the relative impact of contextual factors and internal student factors on student performance using time series…

Caregiver Life Satisfaction: Relationship to Youth Symptom Severity through Treatment

ERIC Educational Resources Information Center

Athay, M. Michele

2012-01-01

This study utilized the Satisfaction with Life Scale to investigate the life satisfaction of caregivers for youth receiving mental health services (N = 383). Specifically, this study assessed how caregiver life satisfaction relates to youth symptom severity throughout treatment. Hierarchical linear modeling with a time-varying covariate was used…

Modeling and testing of reactive contaminant transport in drinking water pipes: Chlorine response and implications for online contaminant detection

EPA Science Inventory

Reactive contaminants introduced to chlorinated drinking water can cause water quality change directly related to their reactivity and other physiochemical properties. This general principle is further developed and utilized in a proposed real-time event adaptive detection, iden...

Utility of computer simulations in landscape genetics

Treesearch

Bryan K. Epperson; Brad H. McRae; Kim Scribner; Samuel A. Cushman; Michael S. Rosenberg; Marie-Josee Fortin; Patrick M. A. James; Melanie Murphy; Stephanie Manel; Pierre Legendre; Mark R. T. Dale

2010-01-01

Population genetics theory is primarily based on mathematical models in which spatial complexity and temporal variability are largely ignored. In contrast, the field of landscape genetics expressly focuses on how population genetic processes are affected by complex spatial and temporal environmental heterogeneity. It is spatially explicit and relates patterns to...

MODIA: Vol. 4. The Resource Utilization Model. A Project AIR FORCE Report.

ERIC Educational Resources Information Center

Gallegos, Margaret

MODIA (Method of Designing Instructional Alternatives) was developed to help the Air Force manage resources for formal training by systematically and explicitly relating quantitative requirements for training resources to the details of course design and course operation during the planning stage. This report describes the Resource Utilization…

The Efficacy of Multidimensional Constraint Keys in Database Query Performance

ERIC Educational Resources Information Center

Cardwell, Leslie K.

2012-01-01

This work is intended to introduce a database design method to resolve the two-dimensional complexities inherent in the relational data model and its resulting performance challenges through abstract multidimensional constructs. A multidimensional constraint is derived and utilized to implement an indexed Multidimensional Key (MK) to abstract a…

Influence of Joint Angle on EMG-Torque Model During Constant-Posture, Torque-Varying Contractions.

PubMed

Liu, Pu; Liu, Lukai; Clancy, Edward A

2015-11-01

Relating the electromyogram (EMG) to joint torque is useful in various application areas, including prosthesis control, ergonomics and clinical biomechanics. Limited study has related EMG to torque across varied joint angles, particularly when subjects performed force-varying contractions or when optimized modeling methods were utilized. We related the biceps-triceps surface EMG of 22 subjects to elbow torque at six joint angles (spanning 60° to 135°) during constant-posture, torque-varying contractions. Three nonlinear EMG σ -torque models, advanced EMG amplitude (EMG σ ) estimation processors (i.e., whitened, multiple-channel) and the duration of data used to train models were investigated. When EMG-torque models were formed separately for each of the six distinct joint angles, a minimum "gold standard" error of 4.01±1.2% MVC(F90) resulted (i.e., error relative to maximum voluntary contraction at 90° flexion). This model structure, however, did not directly facilitate interpolation across angles. The best model which did so achieved a statistically equivalent error of 4.06±1.2% MVC(F90). Results demonstrated that advanced EMG σ processors lead to improved joint torque estimation as do longer model training durations.

Cost-utility analysis of duloxetine in osteoarthritis: a US private payer perspective.

PubMed

Wielage, Ronald C; Bansal, Megha; Andrews, J Scott; Klein, Robert W; Happich, Michael

2013-06-01

Duloxetine has recently been approved in the USA for chronic musculoskeletal pain, including osteoarthritis and chronic low back pain. The cost effectiveness of duloxetine in osteoarthritis has not previously been assessed. Duloxetine is targeted as post first-line (after acetaminophen) treatment of moderate to severe pain. The objective of this study was to estimate the cost effectiveness of duloxetine in the treatment of osteoarthritis from a US private payer perspective compared with other post first-line oral treatments, including nonsteroidal anti-inflammatory drugs (NSAIDs), and both strong and weak opioids. A cost-utility analysis was performed using a discrete-state, time-dependent semi-Markov model based on the National Institute for Health and Clinical Excellence (NICE) model documented in its 2008 osteoarthritis guidelines. The model was extended for opioids by adding titration, discontinuation and additional adverse events (AEs). A life-long time horizon was adopted to capture the full consequences of NSAID-induced AEs. Fourteen health states comprised the structure of the model: treatment without persistent AE, six during-AE states, six post-AE states and death. Treatment-specific utilities were calculated using the transfer-to-utility method and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total scores from a meta-analysis of osteoarthritis clinical trials of 12 weeks and longer. Costs for 2011 were estimated using Red Book, The Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project database, the literature and, sparingly, expert opinion. One-way and probabilistic sensitivity analyses were undertaken, as well as subgroup analyses of patients over 65 years old and a population at greater risk of NSAID-related AEs. In the base case the model estimated naproxen to be the lowest total-cost treatment, tapentadol the highest cost, and duloxetine the most effective after considering AEs. Duloxetine accumulated 0.027 discounted quality-adjusted life-years (QALYs) more than naproxen and 0.013 more than oxycodone. Celecoxib was dominated by naproxen, tramadol was subject to extended dominance, and strong opioids were dominated by duloxetine. The model estimated an incremental cost-effectiveness ratio (ICER) of US$47,678 per QALY for duloxetine versus naproxen. One-way sensitivity analysis identified the probabilities of NSAID-related cardiovascular AEs as the inputs to which the ICER was most sensitive when duloxetine was compared with an NSAID. When compared with a strong opioid, duloxetine dominated the opioid under nearly all sensitivity analysis scenarios. When compared with tramadol, the ICER was most sensitive to the costs of duloxetine and tramadol. In subgroup analysis, the cost per QALY for duloxetine versus naproxen fell to US$24,125 for patients over 65 years and to US$18,472 for a population at high risk of cardiovascular and gastrointestinal AEs. The model estimated that duloxetine was potentially cost effective in the base-case population and more cost effective for subgroups over 65 years or at high risk of NSAID-related AEs. In sensitivity analysis, duloxetine dominated all strong opioids in nearly all scenarios.

Impact of HMO ownership on management processes and utilization outcomes.

PubMed

Ahern, M; Molinari, C

2001-05-01

To examine the effects of health maintenance organization (HMO) ownership characteristics on selected utilization outcomes and management processes affecting utilization. We used 1995 HMO data from the American Association of Health Plans. Using regression analysis, we examined the relation between HMO utilization (hospital discharges, days, and average length of stay; cardiac catheterization procedures; and average cost of outpatient prescriptions) and the structural characteristics of HMOs: ownership type (insurance company, hospital, physician, independent, and national managed care company), HMO size, for-profit status, model type, geographic region, and payer mix. HMO ownership type is significantly associated with medical management processes, including risk sharing by providers, risk sharing by consumers, and other management strategies. Relative to hospital-owned HMOs, insurance company-owned HMOs have fewer hospital discharges, fewer hospital days, and longer lengths of stay. National managed care organization-owned HMOs have fewer cardiac catheterizations and lower average outpatient prescription costs. Independently owned HMOs have more cardiac catheterizations. For-profit HMOs have lower prescription costs. Relative to hospital-owned HMOs, insurance company-owned HMOs are more likely to use hospital risk sharing and provider capitation and less likely to use out-of-pocket payments for hospital use and a closed formulary. National managed care organization-owned HMOs are less likely to use provider capitation, out-of-pocket payments for hospital use, catastrophic case management, and hospital risk sharing. Physician-hospital-owned HMOs are less likely to use catastrophic case management. For-profit HMOs are more likely to use hospital risk sharing and catastrophic case management. HMO ownership type affects utilization outcomes and management strategies.

Radar detectability studies of slow and small Zodiacal Dust Cloud Particles: I. The case of Arecibo 430 MHz meteor head echo observations

PubMed Central

Janches, D.; Plane, J.M.C.; Nesvorný, D.; Feng, W.; Vokrouhlický, D.; Nicolls, M.J.

2016-01-01

Recent model development of the Zodiacal Dust Cloud (ZDC) model (Nesvorný et al. 2010, 2011b) argue that the incoming flux of meteoric material into the Earth’s upper atmosphere is mostly undetected by radars because they cannot detect small extraterrestrial particles entering the atmosphere at low velocities due to the relatively small production of electrons. In this paper we present a new methodology utilizing meteor head echo radar observations that aims to constrain the ZDC physical model by ground-based measurements. In particular, for this work, we focus on Arecibo 430 MHz observations since this is the most sensitive radar utilized for this type of observations to date. For this, we integrate and employ existing comprehensive models of meteoroid ablation, ionization and radar detection to enable accurate interpretation of radar observations and show that reasonable agreement in the hourly rates is found between model predictions and Arecibo observations when: 1) we invoke the lower limit of the model predicted flux (~16 t/d) and 2) we estimate the ionization probability of ablating metal atoms using laboratory measurements of the ionization cross sections of high speed metal atom beams, resulting in values up to two orders of magnitude lower than the extensively utilized figure reported by Jones (1997) for low speeds meteors. However, even at this lower limit the model over predicts the slow portion of the Arecibo radial velocity distributions by a factor of 3, suggesting the model requires some revision. PMID:27642186

Radar Detectability Studies of Slow and Small Zodiacal Dust Cloud Particles: I. The Case of Arecibo 430 MHz Meteor Head Echo Observations

NASA Technical Reports Server (NTRS)

Janches, D.; Plane, J. M. C.; Nesvorny, D.; Feng, W.; Vokrouhlicky, D.; Nicolls, M. J.

2014-01-01

Recent model development of the Zodiacal Dust Cloud (ZDC) model (Nesvorny et al. 2010, 2011b) argue that the incoming flux of meteoric material into the Earth's upper atmosphere is mostly undetected by radars because they cannot detect small extraterrestrial particles entering the atmosphere at low velocities due to the relatively small production of electrons. In this paper we present a new methodology utilizing meteor head echo radar observations that aims to constrain the ZDC physical model by ground-based measurements. In particular, for this work, we focus on Arecibo 430 MHz observations since this is the most sensitive radar utilized for this type of observations to date. For this, we integrate and employ existing comprehensive models of meteoroid ablation, ionization and radar detection to enable accurate interpretation of radar observations and show that reasonable agreement in the hourly rates is found between model predictions and Arecibo observations when: 1) we invoke the lower limit of the model predicted flux (approximately 16 t/d) and 2) we estimate the ionization probability of ablating metal atoms using laboratory measurements of the ionization cross sections of high speed metal atom beams, resulting in values up to two orders of magnitude lower than the extensively utilized figure reported by Jones (1997) for low speeds meteors. However, even at this lower limit the model over predicts the slow portion of the Arecibo radial velocity distributions by a factor of 3, suggesting the model requires some revision.

Use of an administrative data set to determine optimal scheduling of an alcohol intervention worker.

PubMed

Peterson, Timothy A; Desmond, Jeffrey S; Cunningham, Rebecca

2012-06-01

Brief alcohol interventions are efficacious in reducing alcohol-related consequences among emergency department (ED) patients. Use of non-clinical staff may increase alcohol screening and intervention; however, optimal scheduling of an alcohol intervention worker (AIW) is unknown. Determine optimal scheduling of an AIW based on peak discharge time of alcohol-related ED visits. Discharge times for consecutive patients with an alcohol-related diagnosis were abstracted from an urban ED's administrative data set from September 2005 through August 2007. Queuing theory was used to identify optimal scheduling. Data for weekends and weekdays were analyzed separately. Stationary independent period-by-period analysis was performed for hourly periods. An M/M/s queuing model, for Markovian inter-arrival time/Markovian service time/and potentially more than one server, was developed for each hour assuming: 1) a single unlimited queue; 2) 75% of patients waited no longer than 30 min for intervention; 3) AIW spent an average 20 min/patient. Estimated average utilization/hour was calculated; if utilization/hour exceeded 25%, AIW staff was considered necessary. There were 2282 patient visits (mean age 38 years, range 11-84 years). Weekdays accounted for 45% of visits; weekends 55%. On weekdays, one AIW from 6:00 a.m.-9:00 a.m. (max utilization 42%/hour) would accommodate 28% of weekday alcohol-related patients. On weekends, 5:00 a.m.-11:00 a.m. (max utilization 50%), one AIW would cover 54% of all weekend alcohol-related visits. During other hours the utilization rate falls below 25%/hour. Evaluating 2 years of discharge data revealed that 30 h of dedicated AIW time--18 weekend hours (5:00 a.m.-11:00 a.m.), 12 weekday hours (6:00 a.m.-9:00 a.m.)--would allow maximal patient alcohol screening and intervention with minimal additional burden to clinical staff. Copyright © 2012 Elsevier Inc. All rights reserved.

Quantifying tobacco related health care expenditures in the Republic of the Marshall Islands: a case study in determining health costs in a developing US associated island nation.

PubMed

Palafox, N A; Ou, A C; Haberle, H; Chen, T H

2001-01-01

This case study examines the advantages, disadvantages, and utility of three research methods to measure the medical costs of tobacco use in the Republic of the Marshall Islands (RMI). The authors used the morbidity-based models, models based on the difference in utilization of medical facilities between smokers and non-smokers, and models of inter-country comparisons. In the RMI, morbidity models would have a propensity to grossly under-estimate the medical costs of tobacco use. Models that measure the difference in medical service utilization between smokers and non-smokers can be confounded by cultural factors and by the level of health care that is provided. The RMI population structure affected the sampling methods. The external validity of the survey instrument may be increased through measuring more parameters with greater precision. Inter-country comparisons may be used to approximate and set upper and lower limits of costs for past medical costs, and may be the only method to determine future health care costs from tobacco use. Determining medical costs of tobacco use in an US Associated island nation with an under-developed health care infrastructure has not been previously attempted. There were significant methodological challenges that were encountered. Health, economic, cultural, and research environments in the RMI are unique and require innovative methods to determine medical costs associated with tobacco use. Direct application of the methodologies utilized in the United States to determine medical costs of tobacco use may grossly under-estimate the medical cost of tobacco use in the RMI. The research challenges can be addressed.

Data Mining Methods for Omics and Knowledge of Crude Medicinal Plants toward Big Data Biology

PubMed Central

Afendi, Farit M.; Ono, Naoaki; Nakamura, Yukiko; Nakamura, Kensuke; Darusman, Latifah K.; Kibinge, Nelson; Morita, Aki Hirai; Tanaka, Ken; Horai, Hisayuki; Altaf-Ul-Amin, Md.; Kanaya, Shigehiko

2013-01-01

Molecular biological data has rapidly increased with the recent progress of the Omics fields, e.g., genomics, transcriptomics, proteomics and metabolomics that necessitates the development of databases and methods for efficient storage, retrieval, integration and analysis of massive data. The present study reviews the usage of KNApSAcK Family DB in metabolomics and related area, discusses several statistical methods for handling multivariate data and shows their application on Indonesian blended herbal medicines (Jamu) as a case study. Exploration using Biplot reveals many plants are rarely utilized while some plants are highly utilized toward specific efficacy. Furthermore, the ingredients of Jamu formulas are modeled using Partial Least Squares Discriminant Analysis (PLS-DA) in order to predict their efficacy. The plants used in each Jamu medicine served as the predictors, whereas the efficacy of each Jamu provided the responses. This model produces 71.6% correct classification in predicting efficacy. Permutation test then is used to determine plants that serve as main ingredients in Jamu formula by evaluating the significance of the PLS-DA coefficients. Next, in order to explain the role of plants that serve as main ingredients in Jamu medicines, information of pharmacological activity of the plants is added to the predictor block. Then N-PLS-DA model, multiway version of PLS-DA, is utilized to handle the three-dimensional array of the predictor block. The resulting N-PLS-DA model reveals that the effects of some pharmacological activities are specific for certain efficacy and the other activities are diverse toward many efficacies. Mathematical modeling introduced in the present study can be utilized in global analysis of big data targeting to reveal the underlying biology. PMID:24688691

Cumulative Weighing of Time in Intertemporal Tradeoffs

PubMed Central

2016-01-01

We examine preferences for sequences of delayed monetary gains. In the experimental literature, two prominent models have been advanced as psychological descriptions of preferences for sequences. In one model, the instantaneous utilities of the outcomes in a sequence are discounted as a function of their delays, and assembled into a discounted utility of the sequence. In the other model, the accumulated utility of the outcomes in a sequence is considered along with utility or disutility from improvement in outcome utilities and utility or disutility from the spreading of outcome utilities. Drawing on three threads of evidence concerning preferences for sequences of monetary gains, we propose that the accumulated utility of the outcomes in a sequence is traded off against the duration of utility accumulation. In our first experiment, aggregate choice behavior provides qualitative support for the tradeoff model. In three subsequent experiments, one of which incentivized, disaggregate choice behavior provides quantitative support for the tradeoff model in Bayesian model contests. One thread of evidence motivating the tradeoff model is that, when, in the choice between two single dated outcomes, it is conveyed that receiving less sooner means receiving nothing later, preference for receiving more later increases, but when it is conveyed that receiving more later means receiving nothing sooner, preference is left unchanged. Our results show that this asymmetric hidden-zero effect is indeed driven by those supporting the tradeoff model. The tradeoff model also accommodates all remaining evidence on preferences for sequences of monetary gains. PMID:27560853

Validation of the conceptual research utilization scale: an application of the standards for educational and psychological testing in healthcare

PubMed Central

2011-01-01

Background There is a lack of acceptable, reliable, and valid survey instruments to measure conceptual research utilization (CRU). In this study, we investigated the psychometric properties of a newly developed scale (the CRU Scale). Methods We used the Standards for Educational and Psychological Testing as a validation framework to assess four sources of validity evidence: content, response processes, internal structure, and relations to other variables. A panel of nine international research utilization experts performed a formal content validity assessment. To determine response process validity, we conducted a series of one-on-one scale administration sessions with 10 healthcare aides. Internal structure and relations to other variables validity was examined using CRU Scale response data from a sample of 707 healthcare aides working in 30 urban Canadian nursing homes. Principal components analysis and confirmatory factor analyses were conducted to determine internal structure. Relations to other variables were examined using: (1) bivariate correlations; (2) change in mean values of CRU with increasing levels of other kinds of research utilization; and (3) multivariate linear regression. Results Content validity index scores for the five items ranged from 0.55 to 1.00. The principal components analysis predicted a 5-item 1-factor model. This was inconsistent with the findings from the confirmatory factor analysis, which showed best fit for a 4-item 1-factor model. Bivariate associations between CRU and other kinds of research utilization were statistically significant (p < 0.01) for the latent CRU scale score and all five CRU items. The CRU scale score was also shown to be significant predictor of overall research utilization in multivariate linear regression. Conclusions The CRU scale showed acceptable initial psychometric properties with respect to responses from healthcare aides in nursing homes. Based on our validity, reliability, and acceptability analyses, we recommend using a reduced (four-item) version of the CRU scale to yield sound assessments of CRU by healthcare aides. Refinement to the wording of one item is also needed. Planned future research will include: latent scale scoring, identification of variables that predict and are outcomes to conceptual research use, and longitudinal work to determine CRU Scale sensitivity to change. PMID:21595888

EQ-5D™-derived utility values for different levels of migraine severity from a UK sample of migraineurs

PubMed Central

2012-01-01

Background To estimate utility values for different levels of migraine pain severity from a United Kingdom (UK) sample of migraineurs. Methods One hundred and six migraineurs completed the EQ-5D to evaluate their health status for mild, moderate and severe levels of migraine pain severity for a recent migraine attack, and for current health defined as health status within seven days post-migraine attack. Statistical tests were used to evaluate differences in mean utility scores by migraine severity. Results Utility scores for each health state were significantly different from 1.0 (no problems on any EQ-5D dimension) (p < 0.0001) and one another (p < 0.0001). The lowest mean utility, − 0.20 (95% confidence interval [CI]: -0.27 – -0.13), was for severe migraine pain. The smallest difference in mean utility was between mild and moderate migraine pain (0.13) and the largest difference in mean utility was between current health (without migraine) and severe migraine pain (1.07). Conclusions Results indicate that all levels of migraine pain are associated with significantly reduced utility values. As severity worsened, utility decreased and severe migraine pain was considered a health state worse than death. Results can be used in cost-utility models examining the relative economic value of therapeutic strategies for migraine in the UK. PMID:22691697

'Drug adherence levels are falling down again': health worker perceptions of women's service utilization before and after integration of HIV/AIDS services into general care in India.

PubMed

Shukla, Shrivridhi; Muchomba, Felix M; McCoyd, Judith L M

2018-06-01

Integrated models of HIV/AIDS service delivery are believed to have advantages over stand-alone models of care from health planners' and providers' perspectives. Integration models differ, yet there is little information about the influence of differing models on workers' beliefs about models' efficacy. Here, we examine the effect of integration of HIV care into the general health system in India. In 2014, India replaced its stand-alone model of HIV service delivery-Community Care Centers (CCCs)-with a purported integrated model that delivers HIV medical services at general hospitals and HIV psychosocial services at nearby Care and Support Centers (CSCs). We examine 15 health workers' perceptions of how change from the earlier stand-alone model to the current model impacted women's care in a district in Uttar Pradesh, India. Results indicate that (1) Women's antiretroviral (ART) adherence and utilization of psychosocial support service for HIV/AIDS suffered when services were not provided at one site; (2) Provision of inpatient care in the CCC model offered women living in poverty personal safety in accessing HIV health services and promoted chances of competent ART usage and repeat service utilization; and (3) Although integration of HIV services with the general health system was perceived to improve patient anonymity and decrease chances of HIV-related stigma and discrimination, resource shortages continued to plague the integrated system while shifting costs of time and money to the patients. Findings suggest that integration efforts need to consider the context of service provision and the gendered nature of access to HIV care.

Out-of-pocket medication costs, medication utilization, and use of healthcare services among children with asthma

PubMed Central

Karaca-Mandic, Pinar; Jena, Anupam B.; Joyce, Geoffrey F.; Goldman, Dana P.

2013-01-01

Context Health plans have implemented policies to restrain prescription medication spending by shifting costs towards patients. It is unknown how these policies have affected children with chronic illness. Objective To analyze the association of medication cost-sharing with medication utilization and use of hospital services among children with asthma, the most prevalent chronic disease of childhood. Design, Setting, and Patients Retrospective study of insurance claims for 8834 children with asthma who initiated asthma control therapy between 1997 and 2007. Using variation in out-of-pocket (OOP) costs for a fixed ‘basket’ of asthma medications across 37 employers, we estimated multivariate models of asthma medication utilization, asthma-related hospitalization, and emergency department (ED) visits with respect to OOP costs and child and family characteristics. Main Outcome Measures Asthma medication utilization, asthma-related hospitalizations and ED visits in 365-day follow-up Results The mean annual OOP asthma medication cost was $154 (standard deviation, $71). Among 5913 children ages 5 to 18, filled asthma prescriptions covered a mean of 40.9% of days (95% CI 40.2–41.5). In 1-year follow-up, 121 children (2.1%) had an asthma-related hospitalization and 220 (3.7%) an ED visit. Among 2921 children under age 5, mean utilization was 46.2% of days (95% CI 45.2–47.1); 136 children(4. 7%) had an asthma-related hospitalization and 231 (7.9%) an ED visit. An increase in OOP medication costs from the 25th to the 75th percentile was associated with a reduction in adjusted medication utilization among children ages 5 to 18 (41.7% of days vs 40. 3%, p = 0.02), but no change among younger children. Adjusted rates of asthma-related hospitalization were higher for children ages 5 to 18 in the top quartile of OOP costs (2.4 hospitalizations per 100 children vs 1.7 in bottom quartile, p = 0.004), but not for children under 5. Annual, adjusted rates of ED use did not vary across OOP quartiles for either age group. Conclusions Greater cost-sharing for asthma medications was associated with a slight reduction in medication utilization and higher rates of asthma hospitalization among children 5 years and above. PMID:22453569

Coupling hydrodynamic modeling and empirical measures of bed mobility to assess the risk of redd scour on a large regulated river

Treesearch

Christine L. May; Bonnie S. Pryor; Thomas E. Lisle; Margaret M. Lang

2009-01-01

n order to assess the risk of scour and fill of spawning redds during floods, an understanding of the relations among river discharge, bed mobility, and scour and fill depths in areas of the streambed heavily utilized by spawning salmon is needed. Our approach coupled numerical flow modeling and empirical data from the Trinity River, California, to quantify spatially...

Study of High Temperature Failure Mechanisms in Ceramics

DTIC Science & Technology

1988-06-01

The major experimental 4 techniques employed in the program are the use of small- angle neutron scattering to characterize cavity nucleation and growth...creep crackgrowth. Of particular interest are the development of a stochastic model of grainboundary sliding and a micromechanical model that relates...Accession For NTIS GF.A&I DTIC T,’ IDi st ribut Ion’ ;i Avillii~diii l l= (~~ I. RESEARCH OBJECTIVES I. Utilize small- angle neutron scattering to

Connected Equipment Maturity Model Version 1.0

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

Butzbaugh, Joshua B.; Mayhorn, Ebony T.; Sullivan, Greg

2017-05-01

The Connected Equipment Maturity Model (CEMM) evaluates the high-level functionality and characteristics that enable equipment to provide the four categories of energy-related services through communication with other entities (e.g., equipment, third parties, utilities, and users). The CEMM will help the U.S. Department of Energy, industry, energy efficiency organizations, and research institutions benchmark the current state of connected equipment and identify capabilities that may be attained to reach a more advanced, future state.

Bridging the Gap: Towards a Cell-Type Specific Understanding of Neural Circuits Underlying Fear Behaviors

PubMed Central

McCullough, KM; Morrison, FG; Ressler, KJ

2016-01-01

Fear and anxiety-related disorders are remarkably common and debilitating, and are often characterized by dysregulated fear responses. Rodent models of fear learning and memory have taken great strides towards elucidating the specific neuronal circuitries underlying the learning of fear responses. The present review addresses recent research utilizing optogenetic approaches to parse circuitries underlying fear behaviors. It also highlights the powerful advances made when optogenetic techniques are utilized in a genetically defined, cell-type specific, manner. The application of next-generation genetic and sequencing approaches in a cell-type specific context will be essential for a mechanistic understanding of the neural circuitry underlying fear behavior and for the rational design of targeted, circuit specific, pharmacologic interventions for the treatment and prevention of fear-related disorders. PMID:27470092

MoCog1: A computer simulation of recognition-primed human decision making

NASA Technical Reports Server (NTRS)

Gevarter, William B.

1991-01-01

This report describes the successful results of the first stage of a research effort to develop a 'sophisticated' computer model of human cognitive behavior. Most human decision-making is of the experience-based, relatively straight-forward, largely automatic, type of response to internal goals and drives, utilizing cues and opportunities perceived from the current environment. This report describes the development of the architecture and computer program associated with such 'recognition-primed' decision-making. The resultant computer program was successfully utilized as a vehicle to simulate findings that relate how an individual's implicit theories orient them toward particular goals, with resultant cognitions, affects, and behavior in response to their environment. The present work is an expanded version and is based on research reported while the author was an employee of NASA ARC.

Big Data Provenance: Challenges, State of the Art and Opportunities

PubMed Central

Wang, Jianwu; Crawl, Daniel; Purawat, Shweta; Nguyen, Mai; Altintas, Ilkay

2017-01-01

Ability to track provenance is a key feature of scientific workflows to support data lineage and reproducibility. The challenges that are introduced by the volume, variety and velocity of Big Data, also pose related challenges for provenance and quality of Big Data, defined as veracity. The increasing size and variety of distributed Big Data provenance information bring new technical challenges and opportunities throughout the provenance lifecycle including recording, querying, sharing and utilization. This paper discusses the challenges and opportunities of Big Data provenance related to the veracity of the datasets themselves and the provenance of the analytical processes that analyze these datasets. It also explains our current efforts towards tracking and utilizing Big Data provenance using workflows as a programming model to analyze Big Data. PMID:29399671

Therapeutic Utility of Non-Peptidic CRF1 Receptor Antagonists in Anxiety, Depression, and Stress-Related Disorders: Evidence from Animal Models

PubMed Central

Kehne, John H.; Cain, Christopher K.

2012-01-01

Adaptive responding to threatening stressors is of fundamental importance for survival. Dysfunctional hyperactivation of corticotropin releasing factor type-1 (CRF1) receptors in stress response system pathways is linked to stress-related psychopathology and CRF1 receptor antagonists (CRAs) have been proposed as novel therapeutic agents. CRA effects in diverse animal models of stress that detect anxiolytics and/or antidepressants are reviewed, with the goal of evaluating their potential therapeutic utility in depression, anxiety, and other stress-related disorders. CRAs have a distinct phenotype in animals that has similarities to, and differences from, those of classic antidepressants and anxiolytics. CRAs are generally behaviorally silent, indicating that CRF1 receptors are normally in a state of low basal activation. CRAs reduce stressor-induced HPA axis activation by blocking pituitary and possibly brain CRF1 receptors which may ameliorate chronic stress-induced pathology. In animal models sensitive to anxiolytics and/or antidepressants, CRAs are generally more active in those with high stress levels, conditions which may maximize CRF1 receptor hyperactivation. Clinically, CRAs have demonstrated good tolerability and safety, but have thus far lacked compelling efficacy in major depressive disorder, generalized anxiety disorder, or irritable bowel syndrome. CRAs may be best suited for disorders in which stressors clearly contribute to the underlying pathology (e.g. posttraumatic stress disorder, early life trauma, withdrawal/abstinence from addictive substances), though much work is needed to explore these possibilities. An evolving literature exploring the genetic, developmental and environmental factors linking CRF1 receptor dysfunction to stress-related psychopathology is discussed in the context of improving the translational value of current animal models. PMID:20826181

Comparative effectiveness and cost-effectiveness of the implantable miniature telescope.

PubMed

Brown, Gary C; Brown, Melissa M; Lieske, Heidi B; Lieske, Philip A; Brown, Kathryn S; Lane, Stephen S

2011-09-01

To assess the preference-based comparative effectiveness (human value gain) and the cost-utility (cost-effectiveness) of a telescope prosthesis (implantable miniature telescope) for the treatment of end-stage, age-related macular degeneration (AMD). A value-based medicine, second-eye model, cost-utility analysis was performed to quantify the comparative effectiveness and cost-effectiveness of therapy with the telescope prosthesis. Published, evidence-based data from the IMT002 Study Group clinical trial. Ophthalmic utilities were obtained from a validated cohort of >1000 patients with ocular diseases. Comparative effectiveness data were converted from visual acuity to utility (value-based) format. The incremental costs (Medicare) of therapy versus no therapy were integrated with the value gain conferred by the telescope prosthesis to assess its average cost-utility. The incremental value gains and incremental costs of therapy referent to (1) a fellow eye cohort and (2) a fellow eye cohort of those who underwent intra-study cataract surgery were integrated in incremental cost-utility analyses. All value outcomes and costs were discounted at a 3% annual rate, as per the Panel on Cost-Effectiveness in Health and Medicine. Comparative effectiveness was quantified using the (1) quality-adjusted life-year (QALY) gain and (2) percent human value gain (improvement in quality of life). The QALY gain was integrated with incremental costs into the cost-utility ratio ($/QALY, or US dollars expended per QALY gained). The mean, discounted QALY gain associated with use of the telescope prosthesis over 12 years was 0.7577. When the QALY loss of 0.0004 attributable to the adverse events was factored into the model, the final QALY gain was 0.7573. This resulted in a 12.5% quality of life gain for the average patient during the 12 years of the model. The average cost-utility versus no therapy for use of the telescope prosthesis was $14389/QALY. The incremental cost-utility referent to control fellow eyes was $14063/QALY, whereas the incremental cost-utility referent to fellow eyes that underwent intra-study cataract surgery was $11805/QALY. Therapy with the telescope prosthesis considerably improves quality of life and at the same time is cost-effective by conventional standards. Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Comparison of telemedicine with in-person care for follow-up after elective neurosurgery: results of a cost-effectiveness analysis of 1200 patients using patient-perceived utility scores.

PubMed

Thakar, Sumit; Rajagopal, Niranjana; Mani, Subramaniyan; Shyam, Maya; Aryan, Saritha; Rao, Arun S; Srinivasa, Rakshith; Mohan, Dilip; Hegde, Alangar S

2018-05-01

OBJECTIVE The utility of telemedicine (TM) in neurosurgery is underexplored, with most of the studies relating to teletrauma or telestroke programs. In this study, the authors evaluate the cost-effectiveness of TM consultations for follow-up care of a large population of patients who underwent neurosurgical procedures. METHODS A decision-analytical model was used to assess the cost-effectiveness of TM for elective post-neurosurgical care patients from a predominantly nonurban cohort in West Bengal, India. The model compared TM care via a nodal center in West Bengal to routine, in-person, per-episode care at the provider site in Bangalore, India. Cost and effectiveness data relating to 1200 patients were collected for a 52-month period. The effectiveness of TM care was calculated using efficiency in terms of the percentage of successful TM consultations, as well as patient-perceived utility values for overall experience of the type of health care access that they received. Incremental cost-effectiveness ratio (ICER) analysis was done using the 4-quadrant charting of the cost-effectiveness plane. One-way sensitivity and tornado analyses were performed to identify thresholds where the care strategy would change. RESULTS The overall utility for the 3 TM scenarios was found to be higher (89%) than for the utility of routine care (80%). TM was found to be more cost-effective (Indian rupee [INR] 2630 per patient) compared to routine care (INR 6848 per patient). The TM strategy "dominates" that of routine care by being more effective and less expensive (ICER value of -39,400 INR/unit of effectiveness). Sensitivity analysis revealed that cost-effectiveness of TM was most sensitive to changes in the number of TM patients, utility and success rate of TM, and travel distance to the TM center. CONCLUSIONS TM care dominates the in-person care strategy by providing more effective and less expensive follow-up care for a remote post-neurosurgical care population in India. In the authors' setting, this benefit of TM is sustainable even if half the TM consultations turn out to be unsuccessful. The viability of TM as a cost-effective care protocol is attributed to a combination of factors, like an adequate patient volume utilizing TM, patient utility, success rate of TM, and the patient travel distance.

Utilization of and Adherence to Oral Contraceptive Pills and Associated Disparities in the United States: A Baseline Assessment for the Impact of the Affordable Care Act of 2010.

PubMed

Lin, Hsien-Chang; Lee, Hsiao-Yun

2015-01-01

This study investigated sociological factors that may influence women's utilization of and adherence to oral contraceptive pills. This was a retrospective cross-sectional study using the 2010-2012 Medical Expenditure Panel Survey. Female adults aged 18-50 years were included. Logistic regression was performed to discern women's decisions to use oral contraceptive pills or not. Ordinary least squares and Poisson regressions were conducted to examine the number of oral contraceptive pills received, refill frequency, and annual out-of-pocket expenditure on oral contraceptive pills. Covariates were based on the Andersen model of health care utilization. Among the study sample (weighted n = 207,007,531), 14.8% were oral contraceptive pill users. Factors positively related to oral contraceptive pill use included non-Hispanic white ethnicity, younger age, not currently married, having private insurance, residing in the Midwest, higher education level, and higher annual family income. Being non-Hispanic white and having a higher education level were positively related to oral contraceptive pill adherence. Our findings therefore demonstrate disparities in oral contraceptive pill utilization and adherence, especially according to women's race/ethnicity and educational level. This study serves as a baseline assessment for the impact of the Affordable Care Act on oral contraceptive pill utilization and adherence for future studies. © The Author(s) 2015.

3D biomaterial matrix to support long term, full thickness, immuno-competent human skin equivalents with nervous system components.

PubMed

Vidal, Sarah E Lightfoot; Tamamoto, Kasey A; Nguyen, Hanh; Abbott, Rosalyn D; Cairns, Dana M; Kaplan, David L

2018-04-24

Current commercially available human skin equivalents (HSEs) are used for relatively short term studies (∼1 week) due in part to the time-dependent contraction of the collagen gel-based matrix and the limited cell types and skin tissue components utilized. In contrast, here we describe a new matrix consisting of a silk-collagen composite system that provides long term, stable cultivation with reduced contraction and degradation over time. This matrix supports full thickness skin equivalents which include nerves. The unique silk-collagen composite system preserves cell-binding domains of collagen while maintaining the stability and mechanics of the skin system for long-term culture with silk. The utility of this new composite protein-based biomaterial was demonstrated by bioengineering full thickness human skin systems using primary cells, including nerves and immune cells to establish an HSE with a neuro-immuno-cutaneous system. The HSEs with neurons and hypodermis, compared to in vitro skin-only HSEs controls, demonstrated higher secretion of pro-inflammatory cytokines. Proteomics analysis confirmed the presence of several proteins associated with inflammation across all sample groups, but HSEs with neurons had the highest amount of detected protein due to the complexity of the model. This improved, in vitro full thickness HSE model system utilizes cross-linked silk-collagen as the biomaterial and allows reduced reliance on animal models and provides a new in vitro tissue system for the assessment of chronic responses related to skin diseases and drug discovery. Copyright © 2018 Elsevier Ltd. All rights reserved.

Theoretical models for application in school health education research.

PubMed

Parcel, G S

1984-01-01

Theoretical models that may be useful to research studies in school health education are reviewed. Selected, well-defined theories include social learning theory, problem-behavior theory, theory of reasoned action, communications theory, coping theory, social competence, and social and family theories. Also reviewed are multiple theory models including models of health related-behavior, the PRECEDE Framework, social-psychological approaches and the Activated Health Education Model. Two major reviews of teaching models are also discussed. The paper concludes with a brief outline of the general applications of theory to the field of school health education including applications to basic research, development and design of interventions, program evaluation, and program utilization.

Initial investigations into the damping characteristics of wire rope vibration isolators

NASA Technical Reports Server (NTRS)

Cutchins, M. A.; Cochran, J. E., Jr.; Kumar, K.; Fitz-Coy, N. G.; Tinker, M. L.

1987-01-01

Passive dampers composed of coils of multi-strand wire rope are investigated. Analytical results range from those produced by complex NASTRAN models to those of a Coulomb damping model with variable friction force. The latter agrees well with experiment. The Coulomb model is also utilized to generate hysteresis loops. Various other models related to early experimental investigations are described. Significant closed-form static solutions for physical properties of single-and multi-strand wire ropes are developed for certain specific geometries and loading conditions. NASTRAN models concentrate on model generation and mode shapes of 2-strand and 7-strand straight wire ropes with interfacial forces.

Measuring Model-Based High School Science Instruction: Development and Application of a Student Survey

NASA Astrophysics Data System (ADS)

Fulmer, Gavin W.; Liang, Ling L.

2013-02-01

This study tested a student survey to detect differences in instruction between teachers in a modeling-based science program and comparison group teachers. The Instructional Activities Survey measured teachers' frequency of modeling, inquiry, and lecture instruction. Factor analysis and Rasch modeling identified three subscales, Modeling and Reflecting, Communicating and Relating, and Investigative Inquiry. As predicted, treatment group teachers engaged in modeling and inquiry instruction more than comparison teachers, with effect sizes between 0.55 and 1.25. This study demonstrates the utility of student report data in measuring teachers' classroom practices and in evaluating outcomes of a professional development program.

Annotated Bibliography of the Air Force Human Resources Laboratory Technical Reports - 1978

DTIC Science & Technology

1980-06-01

selection of incentives for classroom use. Grade-related and non -grade-related incentives were described in this experiment in a manner designed to...information monitoring- feedback. The current piractice= materials and methods are an outgroiuth of experimental aJpproache-s to the design . dev...operated in a stand- alone mode, the R & M model can be utilized to analyze the impact of various avionics design configurations on system support

Managing Objects in a Relational Framework

DTIC Science & Technology

1989-01-01

Database Week, San Jose CA, May.1983, pp.107-113. [Stonebraker 85] Stonebraker,M. and Rowe,L.: "The Design of POSTGRES " Tech.Report UC Berkeley, Nov...latter is equivalent to the definition of an attribute in a POSTGRES relation using the generic Quel facility. Recently, recursive query languages have...utilize rewrite rules. OSQL [Lynl 88] provides a language for associative access. 2. The POSTGRES model [Sto 86] allows Quel and C-procedures as the

Assessment of corneal properties based on statistical modeling of OCT speckle.

PubMed

Jesus, Danilo A; Iskander, D Robert

2017-01-01

A new approach to assess the properties of the corneal micro-structure in vivo based on the statistical modeling of speckle obtained from Optical Coherence Tomography (OCT) is presented. A number of statistical models were proposed to fit the corneal speckle data obtained from OCT raw image. Short-term changes in corneal properties were studied by inducing corneal swelling whereas age-related changes were observed analyzing data of sixty-five subjects aged between twenty-four and seventy-three years. Generalized Gamma distribution has shown to be the best model, in terms of the Akaike's Information Criterion, to fit the OCT corneal speckle. Its parameters have shown statistically significant differences (Kruskal-Wallis, p < 0.001) for short and age-related corneal changes. In addition, it was observed that age-related changes influence the corneal biomechanical behaviour when corneal swelling is induced. This study shows that Generalized Gamma distribution can be utilized to modeling corneal speckle in OCT in vivo providing complementary quantified information where micro-structure of corneal tissue is of essence.

The use of multi-criteria decision making models in evaluating anesthesia method options in circumcision surgery.

PubMed

Hancerliogullari, Gulsah; Hancerliogullari, Kadir Oymen; Koksalmis, Emrah

2017-01-23

Determining the most suitable anesthesia method for circumcision surgery plays a fundamental role in pediatric surgery. This study is aimed to present pediatric surgeons' perspective on the relative importance of the criteria for selecting anesthesia method for circumcision surgery by utilizing the multi-criteria decision making methods. Fuzzy set theory offers a useful tool for transforming linguistic terms into numerical assessments. Since the evaluation of anesthesia methods requires linguistic terms, we utilize the fuzzy Analytic Hierarchy Process (AHP) and fuzzy Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). Both mathematical decision-making methods are originated from individual judgements for qualitative factors utilizing the pair-wise comparison matrix. Our model uses four main criteria, eight sub-criteria as well as three alternatives. To assess the relative priorities, an online questionnaire was completed by three experts, pediatric surgeons, who had experience with circumcision surgery. Discussion of the results with the experts indicates that time-related factors are the most important criteria, followed by psychology, convenience and duration. Moreover, general anesthesia with penile block for circumcision surgery is the preferred choice of anesthesia compared to general anesthesia without penile block, which has a greater priority compared to local anesthesia under the discussed main-criteria and sub-criteria. The results presented in this study highlight the need to integrate surgeons' criteria into the decision making process for selecting anesthesia methods. This is the first study in which multi-criteria decision making tools, specifically fuzzy AHP and fuzzy TOPSIS, are used to evaluate anesthesia methods for a pediatric surgical procedure.

Research on Storm-Tide Disaster Losses in China Using a New Grey Relational Analysis Model with the Dispersion of Panel Data.

PubMed

Yin, Kedong; Zhang, Ya; Li, Xuemei

2017-11-01

Owing to the difference of the sequences' orders and the surface structure in the current panel grey relational models, research results will not be unique. In addition, individual measurement of indicators and objects and the subjectivity of combined weight would significantly weaken the effective information of panel data and reduce the reliability and accuracy of research results. Therefore, we propose the concept and calculation method of dispersion of panel data, establish the grey relational model based on dispersion of panel data (DPGRA), and prove that DPGRA exhibits the effective properties of uniqueness, symmetry, and normality. To demonstrate its applicability, the proposed DPGRA model is used to research on storm-tide disaster losses in China's coastal areas. Comparing research results of three models, which are DPGRA, Euclidean distance grey relational model, and grey grid relational model, it was shown that DPGRA is more effective, feasible, and stable. It is indicated that DPGRA can entirely utilize the effective information of panel data; what's more, it can not only handle the non-uniqueness of the grey relational model's results but also improve the reliability and accuracy of research results. The research results are of great significance for coastal areas to focus on monitoring storm-tide disasters hazards, strengthen the protection measures of natural disasters, and improve the ability of disaster prevention and reduction.

Combining wet and dry research: experience with model development for cardiac mechano-electric structure-function studies

PubMed Central

Quinn, T. Alexander; Kohl, Peter

2013-01-01

Since the development of the first mathematical cardiac cell model 50 years ago, computational modelling has become an increasingly powerful tool for the analysis of data and for the integration of information related to complex cardiac behaviour. Current models build on decades of iteration between experiment and theory, representing a collective understanding of cardiac function. All models, whether computational, experimental, or conceptual, are simplified representations of reality and, like tools in a toolbox, suitable for specific applications. Their range of applicability can be explored (and expanded) by iterative combination of ‘wet’ and ‘dry’ investigation, where experimental or clinical data are used to first build and then validate computational models (allowing integration of previous findings, quantitative assessment of conceptual models, and projection across relevant spatial and temporal scales), while computational simulations are utilized for plausibility assessment, hypotheses-generation, and prediction (thereby defining further experimental research targets). When implemented effectively, this combined wet/dry research approach can support the development of a more complete and cohesive understanding of integrated biological function. This review illustrates the utility of such an approach, based on recent examples of multi-scale studies of cardiac structure and mechano-electric function. PMID:23334215

Single-Prolonged Stress: A Review of Two Decades of Progress in a Rodent Model of Post-traumatic Stress Disorder

PubMed Central

Lisieski, Michael J.; Eagle, Andrew L.; Conti, Alana C.; Liberzon, Israel; Perrine, Shane A.

2018-01-01

Post-traumatic stress disorder (PTSD) is a common, costly, and often debilitating psychiatric condition. However, the biological mechanisms underlying this disease are still largely unknown or poorly understood. Considerable evidence indicates that PTSD results from dysfunction in highly-conserved brain systems involved in stress, anxiety, fear, and reward. Pre-clinical models of traumatic stress exposure are critical in defining the neurobiological mechanisms of PTSD, which will ultimately aid in the development of new treatments for PTSD. Single prolonged stress (SPS) is a pre-clinical model that displays behavioral, molecular, and physiological alterations that recapitulate many of the same alterations observed in PTSD, illustrating its validity and giving it utility as a model for investigating post-traumatic adaptations and pre-trauma risk and protective factors. In this manuscript, we review the present state of research using the SPS model, with the goals of (1) describing the utility of the SPS model as a tool for investigating post-trauma adaptations, (2) relating findings using the SPS model to findings in patients with PTSD, and (3) indicating research gaps and strategies to address them in order to improve our understanding of the pathophysiology of PTSD. PMID:29867615

A composite model for a class of electric-discharge shock tubes

NASA Technical Reports Server (NTRS)

Elkins, R. T.; Baganoff, D.

1973-01-01

A gasdynamic model is presented and analyzed for a class of shock tubes that utilize both Joule heating and electromagnetic forces to produce high-speed shock waves. The model consists of several stages of acceleration in which acceleration to sonic conditions is achieved principally through heating, and further acceleration of the supersonic flow is obtained principally through use of electromagnetic forces. The utility of the model results from the fact that it predicts a quasi-steady flow process, mathematical analysis is straightforward, and it is even possible to remove one or more component stages and still have the model related to a possible shock-tube flow. Initial experiments have been performed where the electrical discharge configuration and current level were such that Joule heating was the dominant form of energy addition present. These experiments indicate that the predictions of the model dealing with heat addition correspond quite closely to reality. The experimental data together with the theory show that heat addition to the flowing driver gas after diaphragm rupture (approach used in the model) is much more effective in producing high-speed shock waves than heating the gas in the driver before diaphragm rupture, as in the case of the arc-driven shock tube.

Stress and coping in HIV-positive former plasma/blood donors in China: A test of cognitive appraisal theory

PubMed Central

Meade, Christina S.; Wang, Jianping; Lin, Xiuyun; Wu, Hao; Poppen, Paul J.

2013-01-01

Throughout the 1990s, many villagers in rural China were infected with HIV through commercial plasma/blood donation. These former plasma/blood donors (FPDs) experienced many HIV-related stressors. This study tested a cognitive appraisal model of stress and coping in a sample of HIV-positive adult FPDs. Participants (N = 207) from multiple villages completed a battery of questionnaires assessing HIV-related stress, HIV symptoms, cognitive appraisal, coping behaviors, and psychological distress. Participants reported high levels of HIV-related stress, depression, and anxiety. In a structural equation model, greater HIV-related stress, HIV symptoms, and threat appraisal were directly associated with psychological distress. HIV-related stress was also indirectly associated with psychological distress through threat appraisal. In a second model, coping was found to mediate the relationship between challenge appraisal and psychological distress. Results support the utility of cognitive appraisal theory. Stress management interventions targeting HIV-positive FPDs in China are indicated. PMID:19127424

Distress Associated with Dementia-Related Psychosis and Agitation in Relation to Healthcare Utilization and Costs.

PubMed

Maust, Donovan T; Kales, Helen C; McCammon, Ryan J; Blow, Frederic C; Leggett, Amanda; Langa, Kenneth M

2017-10-01

Explore the relationship between behavioral and psychological symptoms of dementia (BPSD; specifically, delusions, hallucinations, and agitation/aggression) and associated caregiver distress with emergency department (ED) utilization, inpatient hospitalization, and expenditures for direct medical care. Retrospective cross-sectional cohort of participants with dementia (N = 332) and informants from the Aging, Demographics, and Memory Study, a nationally representative survey of U.S. adults >70 years old. BPSD of interest and associated informant distress (trichotomized as none/low/high) were assessed using the Neuropsychiatric Inventory (NPI). Outcomes were determined from one year of Medicare claims and examined according to presence of BPSD and associated informant distress, adjusting for participant demographics, dementia severity, and comorbidity. Fifty-eight (15%) participants with dementia had clinically significant delusions, hallucinations, or agitation/aggression. ED visits, inpatient admissions, and costs were not significantly higher among the group with significant BPSD. In fully adjusted models, a high level of informant distress was associated with all outcomes: ED visit incident rate ratio (IRR) 3.03 (95% CI: 1.98-4.63; p < 0.001), hospitalization IRR 2.78 (95% CI: 1.73-4.46; p < 0.001), and relative cost ratio 2.00 (95% CI: 1.12-3.59; p = 0.02). A high level of informant distress related to participant BPSD, rather than the symptoms themselves, was associated with increased healthcare utilization and costs. Effectively identifying, educating, and supporting distressed caregivers may help reduce excess healthcare utilization for the growing number of older adults with dementia. Copyright © 2017 American Association for Geriatric Psychiatry. All rights reserved.

Utility of a sports medicine model in military combat concussion and musculoskeletal restoration care.

PubMed

Spooner, Shawn P; Tyner, Stuart D; Sowers, Christopher; Tsao, Jack; Stuessi, Keith

2014-11-01

Combat-related concussions are significant sources of injury and morbidity among deployed military service members. Musculoskeletal injury also is one of the most prevalent battle and nonbattle-related deployed injury types. Both injuries threaten the service member's physical condition as well as unit and mission readiness due to reduced duty status or evacuation from military theater of operations. In August 2010, the Concussion Restoration Care Center (CRCC) was established at Camp Leatherneck, Afghanistan, to address the need for consistent and specialized evaluation and care of concussion and musculoskeletal injury. This performance improvement effort examined evaluation and treatment of concussion and musculoskeletal injury at the CRCC. Among 4,947 military personnel evaluated at the CRCC between August 2010 and May 2013, 97.9% were returned to duty and retained in theater. Members averaged 10 to 12 days of limited duty status to achieve complete recovery. Concussion injury was secondary to blast injury in 90% of cases. Sport/recreation, occupational, and other accidental injuries each represented 30% of the musculoskeletal injuries with only 10% reported as result of combat. The utilization patterns and outcome measures demonstrate the success and utility of a multidisciplinary clinical model of care for these two types of injuries in the far-forward deployed setting. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

A Multi-Attribute-Utility-Theory Model that Minimizes Interview-Data Requirements: A Consolidation of Space Launch Decisions.

DTIC Science & Technology

1994-12-01

satel~ lites on th" .gruunu" U, .U,- orbit affects the priority given to a new launch. Table 3.9 Launch Priorities Level Level Title Description 0.00 No...value of a satellite’s mission(s) relative to the misston(s) of other sate• lites As such the rating given may reflect an endre class of satellites for...Expected Remaining Lifetime 0 Years Assign a number between 0 and I that best describes the utility of a sate; lite ’,th Vh,,V- ,ta .=.... ,. A at these

Radar detectability studies of slow and small zodiacal dust cloud particles. I. The case of Arecibo 430 MHz meteor head echo observations

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

Janches, D.; Plane, J. M. C.; Feng, W.

2014-11-20

Recent model development of the Zodiacal Dust Cloud (ZDC) argues that the incoming flux of meteoric material into the Earth's upper atmosphere is mostly undetected by radars because they cannot detect small extraterrestrial particles entering the atmosphere at low velocities due to the relatively small production of electrons. In this paper, we present a new methodology utilizing meteor head echo radar observations that aims to constrain the ZDC physical model by ground-based measurements. In particular, for this work, we focus on Arecibo 430 MHz observations since this is the most sensitive radar utilized for this type of observations to date.more » For this, we integrate and employ existing comprehensive models of meteoroid ablation, ionization, and radar detection to enable accurate interpretation of radar observations and show that reasonable agreement in the hourly rates is found between model predictions and Arecibo observations when (1) we invoke the lower limit of the model predicted flux (∼16 t d{sup –1}) and (2) we estimate the ionization probability of ablating metal atoms using laboratory measurements of the ionization cross sections of high-speed metal atom beams, resulting in values up to two orders of magnitude lower than the extensively utilized figure reported by Jones for low-speed meteors. However, even at this lower limit, the model overpredicts the slow portion of the Arecibo radial velocity distributions by a factor of three, suggesting that the model requires some revision.« less

Negative impact of oral health conditions on oral health related quality of life of community dwelling elders in Mexico city, a population based study.

PubMed

Castrejón-Pérez, Roberto Carlos; Borges-Yáñez, S Aída; Irigoyen-Camacho, Ma Esther; Cruz-Hervert, Luis Pablo

2017-05-01

Oral health in old persons is frequently poor; non-functional prostheses are common and negatively affect quality of life. The objective of this study was to estimate the impact of oral health problems on oral health related quality of life in a sample of home dwelling Mexican elders. Household survey in 655 persons 70 years old and over residing in one county in Mexico City. Oral Health Related Quality of Life (Short version of the Oral Health Impact Profile validated in Mexico-OHIP-14-sp), self-perception of general and oral health, xerostomia, utilization of dental services, utilization and functionality of removable dental prostheses, dental and periodontal conditions, age, gender, marital status, schooling, depression, cognitive impairment and independence in activities of daily living (ADL). A negative binomial regression model was fitted. Mean age was 79.2 ± 7.1 years; 54.2% were women. Mean OHIP-14-Sp score was 6.8 ± 8.7, median was 4. The final model showed that men (RR = 1.30); persons with xerostomia (RR = 1.41); no utilization of removable prostheses (RR = 1.55); utilization of non-functional removable prostheses (RR = 1.69); fair self-perception of general health (RR = 1.34); equal (RR = 1.43) or worse (RR = 2.32) self-perception of oral health compared with persons of the same age; and being dependent for at least one ADL (RR = 1.71) increased the probability of higher scores of the OHIP-14-sp. Age, schooling, depression, cognitive impairment and periodontal conditions showed no association. Oral rehabilitation can improve quality of life, health education and health promotion for the elder and their caregivers may reduce the risk of dental problems. Geriatr Gerontol Int 2017; 17: 744-752. © 2016 Japan Geriatrics Society.

Do Zero-Cost Workers’ Compensation Medical Claims Really Have Zero Costs?

PubMed Central

Asfaw, Abay; Rosa, Roger; Mao, Rebecca

2015-01-01

Objective Previous research suggests that non–workers’ compensation (WC) insurance systems, such as group health insurance (GHI), Medicare, or Medicaid, at least partially cover work-related injury and illness costs. This study further examined GHI utilization and costs. Methods Using two-part model, we compared those outcomes immediately after injuries for which accepted WC medical claims made zero or positive medical payments. Results Controlling for pre-injury GHI utilization and costs and other covariates, our results indicated that post-injury GHI utilization and costs increased regardless of whether a WC medical claim was zero or positive. The increases were highest for zero-cost WC medical claims. Conclusion Our national estimates showed that zero-cost WC medical claims alone could cost the GHI $212 million per year. PMID:24316724

Response latencies are alive and well for identifying fakers on a self-report personality inventory: A reconsideration of van Hooft and Born (2012).

PubMed

Holden, Ronald R; Lambert, Christine E

2015-12-01

Van Hooft and Born (Journal of Applied Psychology 97:301-316, 2012) presented data challenging both the correctness of a congruence model of faking on personality test items and the relative merit (i.e., effect size) of response latencies for identifying fakers. We suggest that their analysis of response times was suboptimal, and that it followed neither from a congruence model of faking nor from published protocols on appropriately filtering the noise in personality test item answering times. Using new data and following recommended analytic procedures, we confirmed the relative utility of response times for identifying personality test fakers, and our obtained results, again, reinforce a congruence model of faking.

Risks associated with antiretroviral treatment for human immunodeficiency virus (HIV): qualitative analysis of social media data and health state utility valuation.

PubMed

Matza, Louis S; Chung, Karen C; Kim, Katherine J; Paulus, Trena M; Davies, Evan W; Stewart, Katie D; McComsey, Grace A; Fordyce, Marshall W

2017-07-01

Despite benefits of antiretroviral therapies (ART), people with HIV infection have increased risk of cardiovascular disease, kidney disease, and low bone mineral density. Some ARTs increase risk of these events. The purpose of this study was to examine patients' perspectives of these risks and estimate health state utilities associated with these risks for use in cost-utility models. Qualitative thematic analysis was conducted to examine messages posted to the POZ/AIDSmeds Internet community forums, focusing on bone, kidney, and cardiovascular side effects and risks of HIV/AIDS medications. Then, health state vignettes were drafted based on this qualitative analysis, literature review, and clinician interviews. The health states (representing HIV, plus treatment-related risks) were valued in time trade-off interviews with general population participants in the UK. Qualitative analysis of the Internet forums documented patient concerns about ART risks, as well as treatment decisions made because of these risks. A total of 208 participants completed utility interviews (51.4% female; mean age 44.6 years). The mean utility of the HIV health state (virologically suppressed, treated with ART) was 0.86. Adding a description of risk resulted in statistically significant disutility (i.e., utility decreases): renal risk (disutility = -0.02), bone risk (-0.03), and myocardial infarction risk (-0.05). Patient concerns and treatment decisions were documented via qualitative analysis of Internet forum discussions, and the impact of these concerns was quantified in terms of health state utilities. The resulting disutilities may be useful for differentiating among ARTs in economic modeling of treatment for patients with HIV.

Mean Field Games for Stochastic Growth with Relative Utility

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

Huang, Minyi, E-mail: mhuang@math.carleton.ca; Nguyen, Son Luu, E-mail: sonluu.nguyen@upr.edu

This paper considers continuous time stochastic growth-consumption optimization in a mean field game setting. The individual capital stock evolution is determined by a Cobb–Douglas production function, consumption and stochastic depreciation. The individual utility functional combines an own utility and a relative utility with respect to the population. The use of the relative utility reflects human psychology, leading to a natural pattern of mean field interaction. The fixed point equation of the mean field game is derived with the aid of some ordinary differential equations. Due to the relative utility interaction, our performance analysis depends on some ratio based approximation errormore » estimate.« less

Sensitivity Training and Group Encounter, an Introduction.

ERIC Educational Resources Information Center

Siroka, Robert W., Ed.; And Others

"Sensitivity Training and Group Encounter" attempts to explore group interaction on many levels--verbal, sensory, and physical. It can be utilized as a model for dealing with various forms of interpersonal relations, from ongoing social issues to the isolation, alienation, and distrust felt by the members of a group. Presented as a guide to this…

Examining Success Factors Related to ERP Implementations in Higher Education Shared Services Projects

ERIC Educational Resources Information Center

Stoyanoff, Dawn Galadriel Pfeiffer

2012-01-01

This study examined the enterprise resource planning (ERP) implementations that utilized a shared services model in higher education. The purpose of this research was to examine the critical success factors which were perceived to contribute to project success. This research employed a quantitative non-experimental correlational design and the…

The elusive constellations of poverty.

PubMed

Breugelmans, Seger M; Plantinga, Arnoud; Zeelenberg, Marcel; Poluektova, Olga; Efremova, Maria

2017-01-01

Pepper & Nettle describe possible processes underlying what they call a behavioral constellation of deprivation (BCD). Although we are certain about the application of evolutionary models to our understanding of poverty, we are less certain about the utility of behavioral constellations. The empirical record on poverty-related behaviors is much more divergent and broad than such constellations suggest.

Business Candidate Reactions to Community College Recruitment Practices: Effects of Instructional Programs and Job Attributes.

ERIC Educational Resources Information Center

Winter, Paul A.

This paper draws on the literatures of educational administration, management, and marketing to address, empirically, two issues related to community college faculty recruitment: (a) factors influencing faculty application decisions, and (b) the utility of an existing model for recruiting community college faculty. It examines factors influencing…

A Skylab program for the International Hydrological Decade (IHD). [Lake Ontario Basin

NASA Technical Reports Server (NTRS)

Polcyn, F. C. (Principal Investigator); Rebel, D. L.

1975-01-01

The author has identified the following significant results. Demonstration of the procedure for utilizing the model relating red and IR reflectance to surface soil moisture over regions of variable vegetation cover indicates that remote sensing may be able to make direct inputs into determination of this hydrologic parameter.

Innovative Peer Review Model for Rural Physicians: System Design and Implementation

ERIC Educational Resources Information Center

Williams, Josie R.; Mechler, Kathy; Akins, Ralitsa B.

2008-01-01

Context: The peer review process in small rural hospitals is complicated by limited numbers of physicians, conflict of interest, issues related to appropriate utilization of new technology, possibility for conflicting recommendations, and need for external expertise. Purpose: The purpose of this project was to design, test, and implement a virtual…

Development of Mastery during Adolescence: The Role of Family Problem-Solving

ERIC Educational Resources Information Center

Conger, Katherine Jewsbury; Williams, Shannon Tierney; Little, Wendy M.; Masyn, Katherine E.; Shebloski, Barbara

2009-01-01

A sense of mastery is an important component of psychological health and wellbeing across the life-span; however, relatively little is known about the development of mastery during childhood and adolescence. Utilizing prospective, longitudinal data from 444 adolescent sibling pairs and their parents, our conceptual model proposes that family…

Alcohol, Consent, Sex: Reducing College Students' Risky Behaviors Utilizing an Integrated Orientation Model

ERIC Educational Resources Information Center

Smith, Diane Dani

2013-01-01

College students are at high risk of experiencing serious problems related to physical and social health issues that include binge drinking, sexual assault, and contracting a sexually transmitted disease. Despite research reporting that many of these incidents co-occur on campuses, university prevention programs have failed to present the…

Reciprocal Associations between Boys' Externalizing Problems and Mothers' Depressive Symptoms

ERIC Educational Resources Information Center

Gross, Heather E.; Shaw, Daniel S.; Moilanen, Kristin L.

2008-01-01

Although much has been written about the utility of applying transactional models to the study of parenting practices, relatively few researchers have used such an approach to examine how children influence maternal well-being throughout their development. Using a sample of males from predominantly low-income families, the current study explored…

Interating the History of Mathematics in Educational Praxis

ERIC Educational Resources Information Center

Farmaki, Vassiliki; Klaudatos, Nikos; Paschos, Theodorus

2004-01-01

The integration of History in the educational practice can lead to the development of a series of activities exploiting genetic "moments" of the history of Mathematics. Utilizing genetic ideas that developed during the 14th century (Merton College, N. Oresme), activities are developed and mathematical models for solving problems related to uniform…

Parenting and Adolescent Self-Regulation Mediate between Family Socioeconomic Status and Adolescent Adjustment

ERIC Educational Resources Information Center

Farley, Julee P.; Kim-Spoon, Jungmeen

2017-01-01

Using two waves of longitudinal data, we utilized the family stress model of economic hardship to test whether family socioeconomic status is related to adolescent adjustment (substance use and academic achievement) through parental knowledge and adolescent self-regulation (behavioral self-control and delay discounting). Participants included 220…

Oral Language and Reading Success: A Structural Equation Modeling Approach

ERIC Educational Resources Information Center

Beron, Kurt J.; Farkas, George

2004-01-01

Oral language skills and habits may serve as important resources for success or failure in school-related tasks such as learning to read. This article tests this hypothesis utilizing a unique data set, the original Woodcock-Johnson Psycho-Educational Battery-Revised norming sample. This article assesses the importance of oral language by focusing…

A critical evaluation of validity and utility of translational imaging in pain and analgesia: Utilizing functional imaging to enhance the process.

PubMed

Upadhyay, Jaymin; Geber, Christian; Hargreaves, Richard; Birklein, Frank; Borsook, David

2018-01-01

Assessing clinical pain and metrics related to function or quality of life predominantly relies on patient reported subjective measures. These outcome measures are generally not applicable to the preclinical setting where early signs pointing to analgesic value of a therapy are sought, thus introducing difficulties in animal to human translation in pain research. Evaluating brain function in patients and respective animal model(s) has the potential to characterize mechanisms associated with pain or pain-related phenotypes and thereby provide a means of laboratory to clinic translation. This review summarizes the progress made towards understanding of brain function in clinical and preclinical pain states elucidated using an imaging approach as well as the current level of validity of translational pain imaging. We hypothesize that neuroimaging can describe the central representation of pain or pain phenotypes and yields a basis for the development and selection of clinically relevant animal assays. This approach may increase the probability of finding meaningful new analgesics that can help satisfy the significant unmet medical needs of patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Implementation of Gravity Model to Estimation of Transportation Market Shares

NASA Astrophysics Data System (ADS)

Krata, Przemysław

2010-03-01

The theoretical consideration presented in the paper is inspired by market gravity models, as an interesting attitude towards operations research on a market. The transportation market issues are emphasized. The mathematical model of relations, taking place between transportation companies and their customers on the market, which is applied in the course of the research is based on continuous functions characteristics. This attitude enables the use of the field theory notions. The resultant vector-type utility function facilitates obtaining of competitive advantage areas for all transportation companies located on the considered transportation market.

Mapping health outcome measures from a stroke registry to EQ-5D weights

PubMed Central

2013-01-01

Purpose To map health outcome related variables from a national register, not part of any validated instrument, with EQ-5D weights among stroke patients. Methods We used two cross-sectional data sets including patient characteristics, outcome variables and EQ-5D weights from the national Swedish stroke register. Three regression techniques were used on the estimation set (n = 272): ordinary least squares (OLS), Tobit, and censored least absolute deviation (CLAD). The regression coefficients for “dressing“, “toileting“, “mobility”, “mood”, “general health” and “proxy-responders” were applied to the validation set (n = 272), and the performance was analysed with mean absolute error (MAE) and mean square error (MSE). Results The number of statistically significant coefficients varied by model, but all models generated consistent coefficients in terms of sign. Mean utility was underestimated in all models (least in OLS) and with lower variation (least in OLS) compared to the observed. The maximum attainable EQ-5D weight ranged from 0.90 (OLS) to 1.00 (Tobit and CLAD). Health states with utility weights <0.5 had greater errors than those with weights ≥0.5 (P < 0.01). Conclusion This study indicates that it is possible to map non-validated health outcome measures from a stroke register into preference-based utilities to study the development of stroke care over time, and to compare with other conditions in terms of utility. PMID:23496957

Communication Skills Training in Pediatric Oncology: Moving Beyond Role Modeling

PubMed Central

Feraco, Angela M.; Brand, Sarah R.; Mack, Jennifer W.; Kesselheim, Jennifer C.; Block, Susan D.; Wolfe, Joanne

2018-01-01

Communication is central to pediatric oncology care. Pediatric oncologists disclose life-threatening diagnoses, explain complicated treatment options, and endeavor to give honest prognoses, to maintain hope, to describe treatment complications, and to support families in difficult circumstances ranging from loss of function and fertility to treatment-related or disease-related death. However, parents, patients, and providers report substantial communication deficits. Poor communication outcomes may stem, in part, from insufficient communication skills training, overreliance on role modeling, and failure to utilize best practices. This review summarizes evidence for existing methods to enhance communication skills and calls for revitalizing communication skills training within pediatric oncology. PMID:26822066

Communication Skills Training in Pediatric Oncology: Moving Beyond Role Modeling.

PubMed

Feraco, Angela M; Brand, Sarah R; Mack, Jennifer W; Kesselheim, Jennifer C; Block, Susan D; Wolfe, Joanne

2016-06-01

Communication is central to pediatric oncology care. Pediatric oncologists disclose life-threatening diagnoses, explain complicated treatment options, and endeavor to give honest prognoses, to maintain hope, to describe treatment complications, and to support families in difficult circumstances ranging from loss of function and fertility to treatment-related or disease-related death. However, parents, patients, and providers report substantial communication deficits. Poor communication outcomes may stem, in part, from insufficient communication skills training, overreliance on role modeling, and failure to utilize best practices. This review summarizes evidence for existing methods to enhance communication skills and calls for revitalizing communication skills training within pediatric oncology. © 2016 Wiley Periodicals, Inc.

Geophysics of Martian Periglacial Processes

NASA Technical Reports Server (NTRS)

Mellon, Michael T.

2004-01-01

Through the examination of small-scale geologic features potentially related to water and ice in the martian subsurface (specifically small-scale polygonal ground and young gully-like features), determine the state, distribution and recent history of subsurface water and ice on Mars. To refine existing models and develop new models of near-surface water and ice, and develop new insights about the nature of water on Mars as manifested by these geologic features. Through an improved understanding of potentially water-related geologic features, utilize these features in addressing questions about where to best search for present day water and what space craft may encounter that might facilitate or inhibit the search for water.

Deriving the expected utility of a predictive model when the utilities are uncertain.

PubMed

Cooper, Gregory F; Visweswaran, Shyam

2005-01-01

Predictive models are often constructed from clinical databases with the goal of eventually helping make better clinical decisions. Evaluating models using decision theory is therefore natural. When constructing a model using statistical and machine learning methods, however, we are often uncertain about precisely how the model will be used. Thus, decision-independent measures of classification performance, such as the area under an ROC curve, are popular. As a complementary method of evaluation, we investigate techniques for deriving the expected utility of a model under uncertainty about the model's utilities. We demonstrate an example of the application of this approach to the evaluation of two models that diagnose coronary artery disease.

Model-based Utility Functions

NASA Astrophysics Data System (ADS)

Hibbard, Bill

2012-05-01

Orseau and Ring, as well as Dewey, have recently described problems, including self-delusion, with the behavior of agents using various definitions of utility functions. An agent's utility function is defined in terms of the agent's history of interactions with its environment. This paper argues, via two examples, that the behavior problems can be avoided by formulating the utility function in two steps: 1) inferring a model of the environment from interactions, and 2) computing utility as a function of the environment model. Basing a utility function on a model that the agent must learn implies that the utility function must initially be expressed in terms of specifications to be matched to structures in the learned model. These specifications constitute prior assumptions about the environment so this approach will not work with arbitrary environments. But the approach should work for agents designed by humans to act in the physical world. The paper also addresses the issue of self-modifying agents and shows that if provided with the possibility to modify their utility functions agents will not choose to do so, under some usual assumptions.

Non-animal models of epithelial barriers (skin, intestine and lung) in research, industrial applications and regulatory toxicology.

PubMed

Gordon, Sarah; Daneshian, Mardas; Bouwstra, Joke; Caloni, Francesca; Constant, Samuel; Davies, Donna E; Dandekar, Gudrun; Guzman, Carlos A; Fabian, Eric; Haltner, Eleonore; Hartung, Thomas; Hasiwa, Nina; Hayden, Patrick; Kandarova, Helena; Khare, Sangeeta; Krug, Harald F; Kneuer, Carsten; Leist, Marcel; Lian, Guoping; Marx, Uwe; Metzger, Marco; Ott, Katharina; Prieto, Pilar; Roberts, Michael S; Roggen, Erwin L; Tralau, Tewes; van den Braak, Claudia; Walles, Heike; Lehr, Claus-Michael

2015-01-01

Models of the outer epithelia of the human body - namely the skin, the intestine and the lung - have found valid applications in both research and industrial settings as attractive alternatives to animal testing. A variety of approaches to model these barriers are currently employed in such fields, ranging from the utilization of ex vivo tissue to reconstructed in vitro models, and further to chip-based technologies, synthetic membrane systems and, of increasing current interest, in silico modeling approaches. An international group of experts in the field of epithelial barriers was convened from academia, industry and regulatory bodies to present both the current state of the art of non-animal models of the skin, intestinal and pulmonary barriers in their various fields of application, and to discuss research-based, industry-driven and regulatory-relevant future directions for both the development of new models and the refinement of existing test methods. Issues of model relevance and preference, validation and standardization, acceptance, and the need for simplicity versus complexity were focal themes of the discussions. The outcomes of workshop presentations and discussions, in relation to both current status and future directions in the utilization and development of epithelial barrier models, are presented by the attending experts in the current report.

Do claim factors predict health care utilization after transport accidents?

PubMed

Elbers, Nieke A; Cuijpers, Pim; Akkermans, Arno J; Collie, Alex; Ruseckaite, Rasa; Bruinvels, David J

2013-04-01

Injured people who are involved in compensation processes have less recovery and less well-being compared to those not involved in claims settlement procedures. This study investigated whether claim factors, such as no-fault versus common law claims, the number of independent medical assessments, and legal disputes, predict health care utilization after transport accidents. The sample consisted of 68,911 claimants who lodged a compensation claim at the Transport Accident Commission (TAC) in Victoria, Australia, between 2000 and 2005. The main outcome measure was health care utilization, which was defined as the number of visits to health care providers (e.g. general practitioners, physiotherapists, psychologists) during the 5 year period post-accident. After correction for gender, age, role in accident, injury type, and severity of injury, it was found that independent medical assessments were associated with greater health care utilization (β=.36, p<.001). Involvement in common law claims and legal disputes were both significantly related to health care utilization (respectively β=.05, p<.001 and β=-.02, p<.001), however, the standardized betas were negligible, therefore the effect is not clinically relevant. A model including claim factors predicted the number of health care visits significantly better (ΔR(2)=.08, p<.001) than a model including only gender, age, role in accident, injury type, and severity of injury. The positive association between the number of independent medical assessments and health care utilization after transport accidents may imply that numerous medical assessments have a negative effect on claimants' health. However, further research is needed to determine a causal relationship. Copyright © 2013 Elsevier Ltd. All rights reserved.

Greater healthcare utilization and costs among Black persons compared to White persons with aphasia in the North Carolina stroke belt.

PubMed

Ellis, Charles; Hardy, Rose Y; Lindrooth, Richard C

2017-05-15

To examine racial differences in healthcare utilization and costs for persons with aphasia (PWA) being treated in acute care hospitals in North Carolina (NC). NC Healthcare Cost and Utilization Project State Inpatient Database (HCUP-SID) data from 2011-2012 were analyzed to examine healthcare utilization and costs of care for stroke patients with aphasia. Analyses emphasized length of stay, charges and cost of general hospital services. Generalized linear models (GLM) were constructed to determine the impact of demographic characteristics, stroke/illness severity, and observed hospital characteristics on utilization and costs. Hospital fixed effects were included to yield within-hospital estimates of disparities. GLM models demonstrated that Blacks with aphasia experienced 1.9days longer lengths of stay compared to Whites with aphasia after controlling for demographic characteristics, 1.4days controlling for stroke/illness severity, 1.2days controlling for observed hospital characteristics, and ~1 extra day controlling for unobserved hospital characteristics. Similarly, Blacks accrued ~$2047 greater total costs compared to Whites after controlling for demographic characteristics, $1659 controlling for stroke/illness severity, $1338 controlling for observed hospital characteristics, and ~$1311 greater total costs after controlling for unobserved hospital characteristics. In the acute hospital setting, Blacks with aphasia utilize greater hospital services during longer hospitalizations and at substantially higher costs in the state of NC. A substantial portion of the adjusted difference was related to the hospital treating the patient. However, even after controlling for the hospital, the differences remained clinically and statistically significant. Copyright © 2017 Elsevier B.V. All rights reserved.

Trial-Based Cost-Utility Analysis of Icotinib versus Gefitinib as Second-Line Therapy for Advanced Non-Small Cell Lung Cancer in China

PubMed Central

Zhang, Chunxiang; Zhang, Hongmei; Shi, Jinning; Wang, Dong; Zhang, Xiuwei; Yang, Jian; Zhai, Qizhi; Ma, Aixia

2016-01-01

Background Our objective is to compare the cost-utility of icotinib and gefitinib for the second-line treatment of advanced non-small cell lung cancer (NSCLC) from the perspective of the Chinese healthcare system. Methods Model technology was applied to assess the data of randomized clinical trials and the direct medical costs from the perspective of the Chinese healthcare system. Five-year quality-adjusted life years (QALYs) and incremental cost-utility ratios (ICURs) were calculated. One-way and probabilistic sensitivity analyses (PSA) were performed. Results Our model suggested that the median progression-free survival (PFS) was 4.2 months in the icotinib group and 3.5 months in the gefitinib group while they were 4.6 months and 3.4 months, respectively, in the trials. The 5-year QALYs was 0.279 in the icotinib group and 0.269 in the gefitinib group, and the according medical costs were $10662.82 and $13127.57. The ICUR/QALY of icotinib versus gefitinib presented negative in this study. The most sensitive parameter to the ICUR was utility of PFS, ranging from $-1,259,991.25 to $-182,296.61; accordingly the icotinib treatment consistently represented a dominant cost-utility strategy. Conclusions The icotinib strategy, as a second-line therapy for advanced NSCLC patients in China, is the preferred strategy relative to gefitinib because of the dominant cost-utility. In addition, icotinib shows a good curative effect and safety, resulting in a strong demand for the Chinese market. PMID:27015267

AskIT Service Desk Support Value Model

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

Ashcraft, Phillip Lynn; Cummings, Susan M.; Fogle, Blythe G.

The value model discussed herein provides an accurate and simple calculation of the funding required to adequately staff the AskIT Service Desk (SD).  The model is incremental – only technical labor cost is considered.  All other costs, such as management, equipment, buildings, HVAC, and training are considered common elements of providing any labor related IT Service. Depending on the amount of productivity loss and the number of hours the defect was unresolved, the value of resolving work from the SD is unquestionably an economic winner; the average cost of $16 per SD resolution can commonly translate to cost avoidance exceeding well overmore » $100. Attempting to extract too much from the SD will likely create a significant downside. The analysis used to develop the value model indicates that the utilization of the SD is very high (approximately 90%).  As a benchmark, consider a comment from a manager at Vitalyst (a commercial IT service desk) that their utilization target is approximately 60%.  While high SD utilization is impressive, over the long term it is likely to cause unwanted consequences to staff such as higher turnover, illness, or burnout.  A better solution is to staff the SD so that analysts have time to improve skills through training, develop knowledge, improve processes, collaborate with peers, and improve customer relationship skills.« less

Experiments with metallic and ceramic porous media

NASA Technical Reports Server (NTRS)

Frederking, T. H. K.; Abbassi, P.; Khandhar, P. K.; Luna, Jack

1988-01-01

Work in the area of mechano-caloric phenomena was initiated during 1988 with startup in the Summer 1988 period. The ideal system utilizing He-II super-phenomena is modeled readily, within the frame of thermodynamics energetics, using the concept of an ideal superleak. The real system however uses porous media of non-ideal pore-grain ingredients. The early phase of experimental and related modeling studies is outlined for the time period from Summer 1988 to the end of 1988.

Thermal control of high energy nuclear waste, space option. [mathematical models

NASA Technical Reports Server (NTRS)

Peoples, J. A.

1979-01-01

Problems related to the temperature and packaging of nuclear waste material for disposal in space are explored. An approach is suggested for solving both problems with emphasis on high energy density waste material. A passive cooling concept is presented which utilized conduction rods that penetrate the inner core. Data are presented to illustrate the effectiveness of the rods and the limit of their capability. A computerized thermal model is discussed and developed for the cooling concept.

Research on Storm-Tide Disaster Losses in China Using a New Grey Relational Analysis Model with the Dispersion of Panel Data

PubMed Central

Yin, Kedong; Zhang, Ya; Li, Xuemei

2017-01-01

Owing to the difference of the sequences’ orders and the surface structure in the current panel grey relational models, research results will not be unique. In addition, individual measurement of indicators and objects and the subjectivity of combined weight would significantly weaken the effective information of panel data and reduce the reliability and accuracy of research results. Therefore, we propose the concept and calculation method of dispersion of panel data, establish the grey relational model based on dispersion of panel data (DPGRA), and prove that DPGRA exhibits the effective properties of uniqueness, symmetry, and normality. To demonstrate its applicability, the proposed DPGRA model is used to research on storm-tide disaster losses in China’s coastal areas. Comparing research results of three models, which are DPGRA, Euclidean distance grey relational model, and grey grid relational model, it was shown that DPGRA is more effective, feasible, and stable. It is indicated that DPGRA can entirely utilize the effective information of panel data; what’s more, it can not only handle the non-uniqueness of the grey relational model’s results but also improve the reliability and accuracy of research results. The research results are of great significance for coastal areas to focus on monitoring storm–tide disasters hazards, strengthen the protection measures of natural disasters, and improve the ability of disaster prevention and reduction. PMID:29104262

Utility usage forecasting

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

Hosking, Jonathan R. M.; Natarajan, Ramesh

The computer creates a utility demand forecast model for weather parameters by receiving a plurality of utility parameter values, wherein each received utility parameter value corresponds to a weather parameter value. Determining that a range of weather parameter values lacks a sufficient amount of corresponding received utility parameter values. Determining one or more utility parameter values that corresponds to the range of weather parameter values. Creating a model which correlates the received and the determined utility parameter values with the corresponding weather parameters values.

Robust Microplate-Based Methods for Culturing and in Vivo Phenotypic Screening of Chlamydomonas reinhardtii

PubMed Central

Haire, Timothy C.; Bell, Cody; Cutshaw, Kirstin; Swiger, Brendan; Winkelmann, Kurt; Palmer, Andrew G.

2018-01-01

Chlamydomonas reinhardtii (Cr), a unicellular alga, is routinely utilized to study photosynthetic biochemistry, ciliary motility, and cellular reproduction. Its minimal culture requirements, unicellular morphology, and ease of transformation have made it a popular model system. Despite its relatively slow doubling time, compared with many bacteria, it is an ideal eukaryotic system for microplate-based studies utilizing either, or both, absorbance as well as fluorescence assays. Such microplate assays are powerful tools for researchers in the areas of toxicology, pharmacology, chemical genetics, biotechnology, and more. However, while microplate-based assays are valuable tools for screening biological systems, these methodologies can significantly alter the conditions in which the organisms are cultured and their subsequent physiology or morphology. Herein we describe a novel method for the microplate culture and in vivo phenotypic analysis of growth, viability, and photosynthetic pigments of C. reinhardtii. We evaluated the utility of our assay by screening silver nanoparticles for their effects on growth and viability. These methods are amenable to a wide assortment of studies and present a significant advancement in the methodologies available for research involving this model organism. PMID:29623083

Robust Microplate-Based Methods for Culturing and in Vivo Phenotypic Screening of Chlamydomonas reinhardtii.

PubMed

Haire, Timothy C; Bell, Cody; Cutshaw, Kirstin; Swiger, Brendan; Winkelmann, Kurt; Palmer, Andrew G

2018-01-01

Chlamydomonas reinhardtii (Cr), a unicellular alga, is routinely utilized to study photosynthetic biochemistry, ciliary motility, and cellular reproduction. Its minimal culture requirements, unicellular morphology, and ease of transformation have made it a popular model system. Despite its relatively slow doubling time, compared with many bacteria, it is an ideal eukaryotic system for microplate-based studies utilizing either, or both, absorbance as well as fluorescence assays. Such microplate assays are powerful tools for researchers in the areas of toxicology, pharmacology, chemical genetics, biotechnology, and more. However, while microplate-based assays are valuable tools for screening biological systems, these methodologies can significantly alter the conditions in which the organisms are cultured and their subsequent physiology or morphology. Herein we describe a novel method for the microplate culture and in vivo phenotypic analysis of growth, viability, and photosynthetic pigments of C. reinhardtii . We evaluated the utility of our assay by screening silver nanoparticles for their effects on growth and viability. These methods are amenable to a wide assortment of studies and present a significant advancement in the methodologies available for research involving this model organism.

POLUTE. Forest Air Pollutant Uptake Model

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

Murphy, C.E. Jr.; Sinclair, T.R.

1992-02-13

POLUTE is a computer model designed to estimate the uptake of air pollutants by forests. The model utilizes submodels to describe atmospheric diffusion immediately above and within the canopy, and into the sink areas within or on the trees. The program implementing the model is general and can be used, with only minor changes, for any gaseous pollutant. The model provides an estimate describing the response of the vegetarian-atmosphere system to the environment as related to three types of processes: atmospheric diffusion, diffusion near and inside the absorbing plant, and the physical and chemical processes at the sink on ormore » within the plant.« less

Exploring SMBH assembly with semi-analytic modelling

NASA Astrophysics Data System (ADS)

Ricarte, Angelo; Natarajan, Priyamvada

2018-02-01

We develop a semi-analytic model to explore different prescriptions of supermassive black hole (SMBH) fuelling. This model utilizes a merger-triggered burst mode in concert with two possible implementations of a long-lived steady mode for assembling the mass of the black hole in a galactic nucleus. We improve modelling of the galaxy-halo connection in order to more realistically determine the evolution of a halo's velocity dispersion. We use four model variants to explore a suite of observables: the M•-σ relation, mass functions of both the overall and broad-line quasar population, and luminosity functions as a function of redshift. We find that `downsizing' is a natural consequence of our improved velocity dispersion mappings, and that high-mass SMBHs assemble earlier than low-mass SMBHs. The burst mode of fuelling is sufficient to explain the assembly of SMBHs to z = 2, but an additional steady mode is required to both assemble low-mass SMBHs and reproduce the low-redshift luminosity function. We discuss in detail the trade-offs in matching various observables and the interconnected modelling components that govern them. As a result, we demonstrate the utility as well as the limitations of these semi-analytic techniques.

Immunology and Homeopathy. 3. Experimental Studies on Animal Models

PubMed Central

Bellavite, Paolo; Ortolani, Riccardo; Conforti, Anita

2006-01-01

A search of the literature and the experiments carried out by the authors of this review show that there are a number of animal models where the effect of homeopathic dilutions or the principles of homeopathic medicine have been tested. The results relate to the immunostimulation by ultralow doses of antigens, the immunological models of the ‘simile’, the regulation of acute or chronic inflammatory processes and the use of homeopathic medicines in farming. The models utilized by different research groups are extremely etherogeneous and differ as the test medicines, the dilutions and the outcomes are concerned. Some experimental lines, particularly those utilizing mice models of immunomodulation and anti-inflammatory effects of homeopathic complex formulations, give support to a real effect of homeopathic high dilutions in animals, but often these data are of preliminary nature and have not been independently replicated. The evidence emerging from animal models is supporting the traditional ‘simile’ rule, according to which ultralow doses of compounds, that in high doses are pathogenic, may have paradoxically a protective or curative effect. Despite a few encouraging observational studies, the effectiveness of the homeopathic prevention or therapy of infections in veterinary medicine is not sufficiently supported by randomized and controlled trials. PMID:16786046

Modeling resident error-making patterns in detection of mammographic masses using computer-extracted image features: preliminary experiments

NASA Astrophysics Data System (ADS)

Mazurowski, Maciej A.; Zhang, Jing; Lo, Joseph Y.; Kuzmiak, Cherie M.; Ghate, Sujata V.; Yoon, Sora

2014-03-01

Providing high quality mammography education to radiology trainees is essential, as good interpretation skills potentially ensure the highest benefit of screening mammography for patients. We have previously proposed a computer-aided education system that utilizes trainee models, which relate human-assessed image characteristics to interpretation error. We proposed that these models be used to identify the most difficult and therefore the most educationally useful cases for each trainee. In this study, as a next step in our research, we propose to build trainee models that utilize features that are automatically extracted from images using computer vision algorithms. To predict error, we used a logistic regression which accepts imaging features as input and returns error as output. Reader data from 3 experts and 3 trainees were used. Receiver operating characteristic analysis was applied to evaluate the proposed trainee models. Our experiments showed that, for three trainees, our models were able to predict error better than chance. This is an important step in the development of adaptive computer-aided education systems since computer-extracted features will allow for faster and more extensive search of imaging databases in order to identify the most educationally beneficial cases.

Implications of workforce and financing changes for primary care practice utilization, revenue, and cost: a generalizable mathematical model for practice management.

PubMed

Basu, Sanjay; Landon, Bruce E; Song, Zirui; Bitton, Asaf; Phillips, Russell S

2015-02-01

Primary care practice transformations require tools for policymakers and practice managers to understand the financial implications of workforce and reimbursement changes. To create a simulation model to understand how practice utilization, revenues, and expenses may change in the context of workforce and financing changes. We created a simulation model estimating clinic-level utilization, revenues, and expenses using user-specified or public input data detailing practice staffing levels, salaries and overhead expenditures, patient characteristics, clinic workload, and reimbursements. We assessed whether the model could accurately estimate clinic utilization, revenues, and expenses across the nation using labor compensation, medical expenditure, and reimbursements databases, as well as cost and revenue data from independent practices of varying size. We demonstrated the model's utility in a simulation of how utilization, revenue, and expenses would change after hiring a nurse practitioner (NP) compared with hiring a part-time physician. Modeled practice utilization and revenue closely matched independent national utilization and reimbursement data, disaggregated by patient age, sex, race/ethnicity, insurance status, and ICD diagnostic group; the model was able to estimate independent revenue and cost estimates, with highest accuracy among larger practices. A demonstration analysis revealed that hiring an NP to work independently with a subset of patients diagnosed with diabetes or hypertension could increase net revenues, if NP visits involve limited MD consultation or if NP reimbursement rates increase. A model of utilization, revenue, and expenses in primary care practices may help policymakers and managers understand the implications of workforce and financing changes.

Preventive care utilization: Association with individual- and workgroup-level policy and practice perceptions.

PubMed

Sabbath, Erika L; Sparer, Emily H; Boden, Leslie I; Wagner, Gregory R; Hashimoto, Dean M; Hopcia, Karen; Sorensen, Glorian

2018-06-01

Preventive medical care may reduce downstream medical costs and reduce population burden of disease. However, although social, demographic, and geographic determinants of preventive care have been studied, there is little information about how the workplace affects preventive care utilization. This study examines how four types of organizational policies and practices (OPPs) are associated with individual workers' preventive care utilization. We used data collected in 2012 from 838 hospital patient care workers, grouped in 84 patient care units at two hospitals in Boston. Via survey, we assessed individuals' perceptions of four types of OPPs on their work units. We linked the survey data to a database containing detailed information on medical expenditures. Using multilevel models, we tested whether individual-level perceptions, workgroup-average perceptions, and their combination were associated with individual workers' preventive care utilization (measured by number of preventive care encounters over a two-year period). Adjusting for worker characteristics, higher individual-level perceptions of workplace flexibility were associated with greater preventive care utilization. Higher average unit-level perceptions of people-oriented culture, ergonomic practices, and flexibility were associated with greater preventive care utilization. Overall, we find that workplace policies and practices supporting flexibility, ergonomics, and people-oriented culture are associated with positive preventive care-seeking behavior among workers, with some policies and practices operating at the individual level and some at the group level. Improving the work environment could impact employers' health-related expenditures and improve workers' health-related quality of life. Copyright © 2018 Elsevier Inc. All rights reserved.

Language-related values, reading amount, and reading comprehension in students with migration backgrounds.

PubMed

El-Khechen, Wahiba; Ferdinand, Hanna D; Steinmayr, Ricarda; McElvany, Nele

2016-06-01

Although various studies on general language performance have investigated determinants of students' reading comprehension (e.g., reading amount), they have paid insufficient attention to how students perceive parental values influence their language-related values and behaviour - and, as a consequence, their performance. This is particularly the case for bilingual students with a migration background. The present study aims to examine the impact of how students perceive parental values regarding German (attainment, utility, and cost), students' (utility) value of German/Turkish, and students' reading amount in German/Turkish on German reading comprehension. A total of 118 Grade 4 students in Germany with Turkish as their family language. Reading comprehension was measured with a 15-item standardized test. Whereas students' reading amount (German/Turkish) was assessed through students' self-reports on three questions, students' utility value (German/Turkish) and perceived parental values regarding German (attainment, utility, and cost) were each measured with two items. Results of path modelling supported the hypotheses that students' utility value regarding German and their reading amount in German would positively predict their German reading comprehension, whereas their utility value regarding Turkish and their reading amount in Turkish would negatively predict their German reading comprehension. Data also confirmed a direct effect of the negatively perceived parental cost value of German on German reading comprehension. The new evidence is of practical relevance for teachers, educational scientists, and psychologists who are striving to improve the educational outcomes of bilingual students. Further research needs and the significance of the results for educational practice and home environment are discussed. © 2015 The British Psychological Society.

Selected winglet and mixed flow long duct nacelle development for DC-10 derivative aircraft

NASA Technical Reports Server (NTRS)

Taylor, A. B.

1980-01-01

The high speed cruise drag effects of the installation of winglets and a wing tip extension and a mixed flow long duct nacelle are investigated. The winglet program utilized a 4.7 percent semispan model in an eight foot transonic wind tunnel. Winglets provided approximately twice the cruise drag reduction of wing tip extensions for about the same increase in bending moment at the wing-fuselage juncture. The long duct nacelle interference drag program utilized the same model, without the winglets, in the 11 foot transonic wind tunnel. The long duct nacelle, installed in the same position as the current short duct nacelle and with the current production symmetric pylon, was a relatively low risk installation. A pylon with an addition small rearward fairing was also tested and showed some drag reduction potential over the current pylon.

Vermont's Community-Oriented All-Payer Medical Home Model Reduces Expenditures and Utilization While Delivering High-Quality Care

PubMed Central

Jones, Craig; Finison, Karl; McGraves-Lloyd, Katharine; Tremblay, Timothy; Tanzman, Beth; Hazard, Miki; Maier, Steven; Samuelson, Jenney

2016-01-01

Abstract Patient-centered medical home programs using different design and implementation strategies are being tested across the United States, and the impact of these programs on outcomes for a general population remains unclear. Vermont has pursued a statewide all-payer program wherein medical home practices are supported with additional staffing from a locally organized shared resource, the community health team. Using a 6-year, sequential, cross-sectional methodology, this study reviewed annual cost, utilization, and quality outcomes for patients attributed to 123 practices participating in the program as of December 2013 versus a comparison population from each year attributed to nonparticipating practices. Populations are grouped based on their practices' stage of participation in a calendar year (Pre-Year, Implementation Year, Scoring Year, Post-Year 1, Post-Year 2). Annual risk-adjusted total expenditures per capita at Pre-Year for the participant group and comparison group were not significantly different. The difference-in-differences change from Pre-Year to Post-Year 2 indicated that the participant group's expenditures were reduced by −$482 relative to the comparison (95% CI, −$573 to −$391; P < .001). The lower costs were driven primarily by inpatient (−$218; P < .001) and outpatient hospital expenditures (−$154; P < .001), with associated changes in inpatient and outpatient hospital utilization. Medicaid participants also had a relative increase in expenditures for dental, social, and community-based support services ($57; P < .001). Participants maintained higher rates on 9 of 11 effective and preventive care measures. These results suggest that Vermont's community-oriented medical home model is associated with improved outcomes for a general population at lower expenditures and utilization. (Population Health Management 2016;19:196–205) PMID:26348492

Relationship of self-reported asthma severity and urgent health care utilization to psychological sequelae of the September 11, 2001 terrorist attacks on the World Trade Center among New York City area residents.

PubMed

Fagan, Joanne; Galea, Sandro; Ahern, Jennifer; Bonner, Sebastian; Vlahov, David

2003-01-01

Posttraumatic psychological stress may be associated with increases in somatic illness, including asthma, but the impact of the psychological sequelae of the September 11, 2001 terrorist attacks on physical illness has not been well documented. The authors assessed the relationship between the psychological sequelae of the attacks and asthma symptom severity and the utilization of urgent health care services for asthma since September 11. The authors performed a random digit dial telephone survey of adults in the New York City (NYC) metropolitan area 6 to 9 months after September 11, 2001. Two thousand seven hundred fifty-five demographically representative adults including 364 asthmatics were recruited. The authors assessed self-reported asthma symptom severity, emergency room (ER) visits, and unscheduled physician office visits for asthma since September 11. After adjustment for asthma measures before September 11, demographics, and event exposure in multivariate models posttraumatic stress disorder (PTSD) were a significant predictor of self-reported moderate-to-severe asthma symptoms (OR = 3.4; CI = 1.2-9.4), seeking care for asthma at an ER since September 11 (OR = 6.6; CI = 1.6-28.0), and unscheduled physician visits for asthma since September 11 (OR = 3.6; CI = 1.1-11.5). The number of PTSD symptoms was also significantly related to moderate-to-severe asthma symptoms and unscheduled physician visits since September 11. Neither a panic attack on September 11 nor depression since September 11 was an independent predictor of asthma severity or utilization in multivariate models after September 11. PTSD related to the September 11 terrorist attacks contributed to symptom severity and the utilization of urgent health care services among asthmatics in the NYC metropolitan area.

Effect of Streamflow Forecast Uncertainty on Real-Time Reservoir Operation

NASA Astrophysics Data System (ADS)

Zhao, T.; Cai, X.; Yang, D.

2010-12-01

Various hydrological forecast products have been applied to real-time reservoir operation, including deterministic streamflow forecast (DSF), DSF-based probabilistic streamflow forecast (DPSF), and ensemble streamflow forecast (ESF), which represent forecast uncertainty in the form of deterministic forecast error, deterministic forecast error-based uncertainty distribution, and ensemble forecast errors, respectively. Compared to previous studies that treat these forecast products as ad hoc inputs for reservoir operation models, this paper attempts to model the uncertainties involved in the various forecast products and explores their effect on real-time reservoir operation decisions. In hydrology, there are various indices reflecting the magnitude of streamflow forecast uncertainty; meanwhile, few models illustrate the forecast uncertainty evolution process. This research introduces Martingale Model of Forecast Evolution (MMFE) from supply chain management and justifies its assumptions for quantifying the evolution of uncertainty in streamflow forecast as time progresses. Based on MMFE, this research simulates the evolution of forecast uncertainty in DSF, DPSF, and ESF, and applies the reservoir operation models (dynamic programming, DP; stochastic dynamic programming, SDP; and standard operation policy, SOP) to assess the effect of different forms of forecast uncertainty on real-time reservoir operation. Through a hypothetical single-objective real-time reservoir operation model, the results illustrate that forecast uncertainty exerts significant effects. Reservoir operation efficiency, as measured by a utility function, decreases as the forecast uncertainty increases. Meanwhile, these effects also depend on the type of forecast product being used. In general, the utility of reservoir operation with ESF is nearly as high as the utility obtained with a perfect forecast; the utilities of DSF and DPSF are similar to each other but not as efficient as ESF. Moreover, streamflow variability and reservoir capacity can change the magnitude of the effects of forecast uncertainty, but not the relative merit of DSF, DPSF, and ESF. Schematic diagram of the increase in forecast uncertainty with forecast lead-time and the dynamic updating property of real-time streamflow forecast

Health inequality and community-based health insurance: a case study of rural Rwanda with repeated cross-sectional data.

PubMed

Liu, Kai; Cook, Benjamin; Lu, Chunling

2018-06-08

To investigate the inequality in medical care utilization and household catastrophic health spending (HCHS) between the poverty and non-poverty residents in rural Rwanda and their links with community-based health insurance (Mutuelles). We used the 2005 and 2010 nationally representative Integrated Living Conditions Surveys. We estimated multilevel logistic regression models to obtain the adjusted levels and trends of both absolute and relative inequalities and examined associations between Mutuelles status and these inequalities. Significant inequality between the two income groups, in both absolute and relative measures of medical care utilization and HCHS remained unchanged in 2005 and 2010. Significant reduction in adjusted absolute inequality in percentage of HCHS between the two years was not associated with Mutuelles status. While Mutuelles promoted medical care utilization and reduced HCHS, it did not play a significant role in reducing their inequalities by poverty status between 2005 and 2010. Future studies should assess the impact of additional strategies (e.g., the exemption of Mutuelles premiums and copayments for households living in poverty), on reducing inequality by poverty status.

Health Services Utilization in Older Adults with Dementia Receiving Care Coordination: The MIND at Home Trial.

PubMed

Amjad, Halima; Wong, Stephanie K; Roth, David L; Huang, Jin; Willink, Amber; Black, Betty S; Johnston, Deirdre; Rabins, Peter V; Gitlin, Laura N; Lyketsos, Constantine G; Samus, Quincy M

2018-02-01

To investigate effects of a novel dementia care coordination program on health services utilization. A total of 303 community-dwelling adults aged ≥70 with a cognitive disorder in Baltimore, Maryland (2008-2011). Single-blind RCT evaluating efficacy of an 18-month care coordination intervention delivered through community-based nonclinical care coordinators, supported by an interdisciplinary clinical team. Study partners reported acute care/inpatient, outpatient, and home- and community-based service utilization at baseline, 9, and 18 months. From baseline to 18 months, there were no significant group differences in acute care/inpatient or total outpatient services use, although intervention participants had significantly increased outpatient dementia/mental health visits from 9 to 18 months (p = .04) relative to controls. Home and community-based support service use significantly increased from baseline to 18 months in the intervention compared to control (p = .005). While this dementia care coordination program did not impact acute care/inpatient services utilization, it increased use of dementia-related outpatient medical care and nonmedical supportive community services, a combination that may have helped participants remain at home longer. Future care model modifications that emphasize delirium, falls prevention, and behavior management may be needed to influence inpatient service use. © Health Research and Educational Trust.

Equity in health care utilization in Chile.

PubMed

Núñez, Alicia; Chi, Chunhuei

2013-08-12

One of the most extensive Chilean health care reforms occurred in July 2005, when the Regime of Explicit Health Guarantees (AUGE) became effective. This reform guarantees coverage for a specific set of health conditions. Thus, the purpose of this study is to provide timely evidence for policy makers to understand the current distribution and equity of health care utilization in Chile.The authors analyzed secondary data from the National Socioeconomic Survey (CASEN) for the years 1992-2009 and the 2006 Satisfaction and Out-of-Pocket Payment Survey to assess equity in health care utilization using two different approaches. First, we used a two-part model to estimate factors associated with the utilization of health care. Second, we decomposed income-related inequalities in medical care use into contributions of need and non-need factors and estimated a horizontal inequity index.Findings of this empirical study include evidence of inequities in the Chilean health care system that are beneficial to the better-off. We also identified some key factors, including education and health care payment, which affect the utilization of health care services. Results of this study could help researchers and policy makers identify targets for improving equity in health care utilization and strengthening availability of health care services accordingly.

Reliability and cost evaluation of small isolated power systems containing photovoltaic and wind energy

NASA Astrophysics Data System (ADS)

Karki, Rajesh

Renewable energy application in electric power systems is growing rapidly worldwide due to enhanced public concerns for adverse environmental impacts and escalation in energy costs associated with the use of conventional energy sources. Photovoltaics and wind energy sources are being increasingly recognized as cost effective generation sources. A comprehensive evaluation of reliability and cost is required to analyze the actual benefits of utilizing these energy sources. The reliability aspects of utilizing renewable energy sources have largely been ignored in the past due the relatively insignificant contribution of these sources in major power systems, and consequently due to the lack of appropriate techniques. Renewable energy sources have the potential to play a significant role in the electrical energy requirements of small isolated power systems which are primarily supplied by costly diesel fuel. A relatively high renewable energy penetration can significantly reduce the system fuel costs but can also have considerable impact on the system reliability. Small isolated systems routinely plan their generating facilities using deterministic adequacy methods that cannot incorporate the highly erratic behavior of renewable energy sources. The utilization of a single probabilistic risk index has not been generally accepted in small isolated system evaluation despite its utilization in most large power utilities. Deterministic and probabilistic techniques are combined in this thesis using a system well-being approach to provide useful adequacy indices for small isolated systems that include renewable energy. This thesis presents an evaluation model for small isolated systems containing renewable energy sources by integrating simulation models that generate appropriate atmospheric data, evaluate chronological renewable power outputs and combine total available energy and load to provide useful system indices. A software tool SIPSREL+ has been developed which generates risk, well-being and energy based indices to provide realistic cost/reliability measures of utilizing renewable energy. The concepts presented and the examples illustrated in this thesis will help system planners to decide on appropriate installation sites, the types and mix of different energy generating sources, the optimum operating policies, and the optimum generation expansion plans required to meet increasing load demands in small isolated power systems containing photovoltaic and wind energy sources.

Relational systems change: implementing a model of change in integrating services for women with substance abuse and mental health disorders and histories of trauma.

PubMed

Markoff, Laurie S; Finkelstein, Norma; Kammerer, Nina; Kreiner, Peter; Prost, Carol A

2005-01-01

This article describes the "relational systems change" model developed by the Institute for Health and Recovery, and the implementation of the model in Massachusetts from 1998-2002 to facilitate systems change to support the delivery of integrated and trauma-informed services for women with co-occurring substance abuse and mental health disorders and histories of violence and empirical evidence of resulting systems changes. The federally funded Women Embracing Life and Living (WELL) Project utilized relational strategies to facilitate systems change within and across 3 systems levels: local treatment providers, community (or region), and state. The WELL Project demonstrates that a highly collaborative, inclusive, and facilitated change process can effect services integration within agencies (intra-agency), strengthen integration within a regional network of agencies (interagency), and foster state support for services integration.

CW dipolar broadening EPR spectroscopy and mechanically aligned bilayers used to measure distance and relative orientation between two TOAC spin labels on an antimicrobial peptide

NASA Astrophysics Data System (ADS)

Sahu, Indra D.; Hustedt, Eric J.; Ghimire, Harishchandra; Inbaraj, Johnson J.; McCarrick, Robert M.; Lorigan, Gary A.

2014-12-01

An EPR membrane alignment technique was applied to measure distance and relative orientations between two spin labels on a protein oriented along the surface of the membrane. Previously we demonstrated an EPR membrane alignment technique for measuring distances and relative orientations between two spin labels using a dual TOAC-labeled integral transmembrane peptide (M2δ segment of Acetylcholine receptor) as a test system. In this study we further utilized this technique and successfully measured the distance and relative orientations between two spin labels on a membrane peripheral peptide (antimicrobial peptide magainin-2). The TOAC-labeled magainin-2 peptides were mechanically aligned using DMPC lipids on a planar quartz support, and CW-EPR spectra were recorded at specific orientations. Global analysis in combination with rigorous spectral simulation was used to simultaneously analyze data from two different sample orientations for both single- and double-labeled peptides. We measured an internitroxide distance of 15.3 Å from a dual TOAC-labeled magainin-2 peptide at positions 8 and 14 that closely matches with the 13.3 Å distance obtained from a model of the labeled magainin peptide. In addition, the angles determining the relative orientations of the two nitroxides have been determined, and the results compare favorably with molecular modeling. This study demonstrates the utility of the technique for proteins oriented along the surface of the membrane in addition to the previous results for proteins situated within the membrane bilayer.

Deciphering the crowd: modeling and identification of pedestrian group motion.

PubMed

Yücel, Zeynep; Zanlungo, Francesco; Ikeda, Tetsushi; Miyashita, Takahiro; Hagita, Norihiro

2013-01-14

Associating attributes to pedestrians in a crowd is relevant for various areas like surveillance, customer profiling and service providing. The attributes of interest greatly depend on the application domain and might involve such social relations as friends or family as well as the hierarchy of the group including the leader or subordinates. Nevertheless, the complex social setting inherently complicates this task. We attack this problem by exploiting the small group structures in the crowd. The relations among individuals and their peers within a social group are reliable indicators of social attributes. To that end, this paper identifies social groups based on explicit motion models integrated through a hypothesis testing scheme. We develop two models relating positional and directional relations. A pair of pedestrians is identified as belonging to the same group or not by utilizing the two models in parallel, which defines a compound hypothesis testing scheme. By testing the proposed approach on three datasets with different environmental properties and group characteristics, it is demonstrated that we achieve an identification accuracy of 87% to 99%. The contribution of this study lies in its definition of positional and directional relation models, its description of compound evaluations, and the resolution of ambiguities with our proposed uncertainty measure based on the local and global indicators of group relation.

Deciphering the Crowd: Modeling and Identification of Pedestrian Group Motion

PubMed Central

Yücel, Zeynep; Zanlungo, Francesco; Ikeda, Tetsushi; Miyashita, Takahiro; Hagita, Norihiro

2013-01-01

Associating attributes to pedestrians in a crowd is relevant for various areas like surveillance, customer profiling and service providing. The attributes of interest greatly depend on the application domain and might involve such social relations as friends or family as well as the hierarchy of the group including the leader or subordinates. Nevertheless, the complex social setting inherently complicates this task. We attack this problem by exploiting the small group structures in the crowd. The relations among individuals and their peers within a social group are reliable indicators of social attributes. To that end, this paper identifies social groups based on explicit motion models integrated through a hypothesis testing scheme. We develop two models relating positional and directional relations. A pair of pedestrians is identified as belonging to the same group or not by utilizing the two models in parallel, which defines a compound hypothesis testing scheme. By testing the proposed approach on three datasets with different environmental properties and group characteristics, it is demonstrated that we achieve an identification accuracy of 87% to 99%. The contribution of this study lies in its definition of positional and directional relation models, its description of compound evaluations, and the resolution of ambiguities with our proposed uncertainty measure based on the local and global indicators of group relation. PMID:23344382

Practical strategies for developing the business case for hospital glycemic control teams.

PubMed

Magee, Michelle F; Beck, Adam

2008-09-01

Many business models may be used to make the business case for support of a multidisciplinary team to implement targeted glucose control in the hospital. Models may be hospital-supported or self-supporting. In the former, the hospital provides financial support based on improved documentation opportunities, reduction in length of stay, and improved resource utilization. In the latter, clinical revenues for diabetes management offsets costs of salary, fringe benefits, and overheads. A combination of these strategies may also be used. The business plan presented to administration must justify return on investment. It is imperative to involve hospital administration, particularly representatives from coding, billing, and finance, in the development of the business plan. The business case for hospital support will be based on opportunities related to improving accuracy of documentation and coding for diabetes-related diagnoses, including level of control and complications present, on reduction in length of stay and on optimization of resource utilization through reduction in morbidity and mortality (cost aversion). The case for revenue generation through billing for clinical services will be based on opportunities to increase the provision of glycemic management services in the hospital. Examples from the literature and of analyses to support each of these models are presented. (c) 2008 Society of Hospital Medicine.

Computer simulation of the mathematical modeling involved in constitutive equation development: Via symbolic computations

NASA Technical Reports Server (NTRS)

Arnold, S. M.; Tan, H. Q.; Dong, X.

1989-01-01

Development of new material models for describing the high temperature constitutive behavior of real materials represents an important area of research in engineering disciplines. Derivation of mathematical expressions (constitutive equations) which describe this high temperature material behavior can be quite time consuming, involved and error prone; thus intelligent application of symbolic systems to facilitate this tedious process can be of significant benefit. A computerized procedure (SDICE) capable of efficiently deriving potential based constitutive models, in analytical form is presented. This package, running under MACSYMA, has the following features: partial differentiation, tensor computations, automatic grouping and labeling of common factors, expression substitution and simplification, back substitution of invariant and tensorial relations and a relational data base. Also limited aspects of invariant theory were incorporated into SDICE due to the utilization of potentials as a starting point and the desire for these potentials to be frame invariant (objective). Finally not only calculation of flow and/or evolutionary laws were accomplished but also the determination of history independent nonphysical coefficients in terms of physically measurable parameters, e.g., Young's modulus, was achieved. The uniqueness of SDICE resides in its ability to manipulate expressions in a general yet predefined order and simplify expressions so as to limit expression growth. Results are displayed when applicable utilizing index notation.

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

Elliott, C.J.; McVey, B.; Quimby, D.C.

The level of field errors in an FEL is an important determinant of its performance. We have computed 3D performance of a large laser subsystem subjected to field errors of various types. These calculations have been guided by simple models such as SWOOP. The technique of choice is utilization of the FELEX free electron laser code that now possesses extensive engineering capabilities. Modeling includes the ability to establish tolerances of various types: fast and slow scale field bowing, field error level, beam position monitor error level, gap errors, defocusing errors, energy slew, displacement and pointing errors. Many effects of thesemore » errors on relative gain and relative power extraction are displayed and are the essential elements of determining an error budget. The random errors also depend on the particular random number seed used in the calculation. The simultaneous display of the performance versus error level of cases with multiple seeds illustrates the variations attributable to stochasticity of this model. All these errors are evaluated numerically for comprehensive engineering of the system. In particular, gap errors are found to place requirements beyond mechanical tolerances of {plus minus}25{mu}m, and amelioration of these may occur by a procedure utilizing direct measurement of the magnetic fields at assembly time. 4 refs., 12 figs.« less

Exploitation of Digital Surface Models Generated from WORLDVIEW-2 Data for SAR Simulation Techniques

NASA Astrophysics Data System (ADS)

Ilehag, R.; Auer, S.; d'Angelo, P.

2017-05-01

GeoRaySAR, an automated SAR simulator developed at DLR, identifies buildings in high resolution SAR data by utilizing geometric knowledge extracted from digital surface models (DSMs). Hitherto, the simulator has utilized DSMs generated from LiDAR data from airborne sensors with pre-filtered vegetation. Discarding the need for pre-optimized model input, DSMs generated from high resolution optical data (acquired with WorldView-2) are used for the extraction of building-related SAR image parts in this work. An automatic preprocessing of the DSMs has been developed for separating buildings from elevated vegetation (trees, bushes) and reducing the noise level. Based on that, automated simulations are triggered considering the properties of real SAR images. Locations in three cities, Munich, London and Istanbul, were chosen as study areas to determine advantages and limitations related to WorldView-2 DSMs as input for GeoRaySAR. Beyond, the impact of the quality of the DSM in terms of building extraction is evaluated as well as evaluation of building DSM, a DSM only containing buildings. The results indicate that building extents can be detected with DSMs from optical satellite data with various success, dependent on the quality of the DSM as well as on the SAR imaging perspective.

Evaluating the Utility of Remotely-Sensed Soil Moisture Retrievals for Operational Agricultural Drought Monitoring

NASA Technical Reports Server (NTRS)

Bolten, John D.; Crow, Wade T.; Zhan, Xiwu; Jackson, Thomas J.; Reynolds,Curt

2010-01-01

Soil moisture is a fundamental data source used by the United States Department of Agriculture (USDA) International Production Assessment Division (IPAD) to monitor crop growth stage and condition and subsequently, globally forecast agricultural yields. Currently, the USDA IPAD estimates surface and root-zone soil moisture using a two-layer modified Palmer soil moisture model forced by global precipitation and temperature measurements. However, this approach suffers from well-known errors arising from uncertainty in model forcing data and highly simplified model physics. Here we attempt to correct for these errors by designing and applying an Ensemble Kalman filter (EnKF) data assimilation system to integrate surface soil moisture retrievals from the NASA Advanced Microwave Scanning Radiometer (AMSR-E) into the USDA modified Palmer soil moisture model. An assessment of soil moisture analysis products produced from this assimilation has been completed for a five-year (2002 to 2007) period over the North American continent between 23degN - 50degN and 128degW - 65degW. In particular, a data denial experimental approach is utilized to isolate the added utility of integrating remotely-sensed soil moisture by comparing EnKF soil moisture results obtained using (relatively) low-quality precipitation products obtained from real-time satellite imagery to baseline Palmer model runs forced with higher quality rainfall. An analysis of root-zone anomalies for each model simulation suggests that the assimilation of AMSR-E surface soil moisture retrievals can add significant value to USDA root-zone predictions derived from real-time satellite precipitation products.

Electric utilities, fiscal illusion and the provision of local public services

NASA Astrophysics Data System (ADS)

Dowell, Paula Elizabeth Kay

2000-10-01

Restructuring activity in the electric utility industry is threatening a once stable and significant source of revenue for local governments. Potentially declining revenues from electric utilities leaves local policymakers with the unpopular decision of raising taxes or reducing the level of public services provided. This has led to pressure on state governments to introduce legislation aimed at mitigating potential revenue loss for local government due to restructuring activity. However, before imposing such legislation, a better understanding of the potential distortionary effects of internal subsidization by electric utilities is needed. Two models of the demand for local public services--a structural model using the Stone-Geary utility framework and a reduced form model--are developed in an attempt to model the behavioral responses of local public expenditures to revenue contributions from electric utilities. Empirical analysis of both models is conducted using a panel data set for 242 municipalities in Tennessee from 1988 to 1998. Aggregate spending and expenditures on four specific service functions are examined. The results provide evidence of a positive flypaper effect. Furthermore, the source of the flypaper effect is attributed to fiscal illusion caused by price distortions. The stimulative effect of electric utility revenue contributions on the level of local public services indicate that a 1.00 change in electric utility subsidies results in a change in local expenditures ranging from 0.22 to 1.32 for the structural model and 1.97 to 2.51 for the reduced form model. The amount of the marginal effect directly attributed to price illusion is estimated to range from 0.04 to $0.85. In addition, the elasticities of electric utility revenue contributions are estimated to range from 0.05 to 0.90. The results raise a number of interesting issues regarding municipal ownership of utilities and legislation regarding tax treatment of utilities after restructuring. The fact that the current study suggests that electric utility subsidies give rise to fiscal illusion raises new questions regarding the justification of safeguarding the exclusive franchise of municipally-owned utilities and revenues from electric utilities in the era of restructuring.

Health service utilization before and after evidence-based treatment for PTSD.

PubMed

Tuerk, Peter W; Wangelin, Bethany; Rauch, Sheila A M; Dismuke, Clara E; Yoder, Matthew; Myrick, Hugh; Eftekhari, Afsoon; Acierno, Ron

2013-11-01

Posttraumatic stress disorder (PTSD) is associated with functional impairment, co-occurring diagnoses, and increased health care utilization. Associated high demand for health care services is an important contributor to the large public-health cost of PTSD. Treatments incorporating exposure therapy are efficacious in ameliorating or eliminating PTSD symptoms. Accordingly, the Veterans Health Administration has made significant investments toward nationwide dissemination of a manualized exposure therapy protocol, prolonged exposure (PE). PE is effective with veterans; however, the relationship between PE and mental health service utilization is unknown. The current study investigates PE as it relates to actual tracked mental health service utilization in an urban VA medical center. A sample of 60 veterans with a diagnosis of PTSD was used to examine mental health service utilization in the 12-months prior to and 12-months after being offered PE. Hierarchical Linear Models and traditional repeated-measures ANOVA were used to estimate R²- and d-type effect sizes for service utilization. Associated estimated cost saving are reported. PE was associated with large reductions in symptoms and diagnosis remission. Treatment was also associated with statistically significant, large reductions in mental health service utilization for veterans who completed treatment. Findings suggest that expanding access to PE can increase access to mental health services in general by decreasing ongoing demand for specialty care clinical services.

Evaluation of markers and risk prediction models: Overview of relationships between NRI and decision-analytic measures

PubMed Central

Calster, Ben Van; Vickers, Andrew J; Pencina, Michael J; Baker, Stuart G; Timmerman, Dirk; Steyerberg, Ewout W

2014-01-01

BACKGROUND For the evaluation and comparison of markers and risk prediction models, various novel measures have recently been introduced as alternatives to the commonly used difference in the area under the ROC curve (ΔAUC). The Net Reclassification Improvement (NRI) is increasingly popular to compare predictions with one or more risk thresholds, but decision-analytic approaches have also been proposed. OBJECTIVE We aimed to identify the mathematical relationships between novel performance measures for the situation that a single risk threshold T is used to classify patients as having the outcome or not. METHODS We considered the NRI and three utility-based measures that take misclassification costs into account: difference in Net Benefit (ΔNB), difference in Relative Utility (ΔRU), and weighted NRI (wNRI). We illustrate the behavior of these measures in 1938 women suspect of ovarian cancer (prevalence 28%). RESULTS The three utility-based measures appear transformations of each other, and hence always lead to consistent conclusions. On the other hand, conclusions may differ when using the standard NRI, depending on the adopted risk threshold T, prevalence P and the obtained differences in sensitivity and specificity of the two models that are compared. In the case study, adding the CA-125 tumor marker to a baseline set of covariates yielded a negative NRI yet a positive value for the utility-based measures. CONCLUSIONS The decision-analytic measures are each appropriate to indicate the clinical usefulness of an added marker or compare prediction models, since these measures each reflect misclassification costs. This is of practical importance as these measures may thus adjust conclusions based on purely statistical measures. A range of risk thresholds should be considered in applying these measures. PMID:23313931

Automated method for relating regional pulmonary structure and function: integration of dynamic multislice CT and thin-slice high-resolution CT

NASA Astrophysics Data System (ADS)

Tajik, Jehangir K.; Kugelmass, Steven D.; Hoffman, Eric A.

1993-07-01

We have developed a method utilizing x-ray CT for relating pulmonary perfusion to global and regional anatomy, allowing for detailed study of structure to function relationships. A thick slice, high temporal resolution mode is used to follow a bolus contrast agent for blood flow evaluation and is fused with a high spatial resolution, thin slice mode to obtain structure- function detail. To aid analysis of blood flow, we have developed a software module, for our image analysis package (VIDA), to produce the combined structure-function image. Color coded images representing blood flow, mean transit time, regional tissue content, regional blood volume, regional air content, etc. are generated and imbedded in the high resolution volume image. A text file containing these values along with a voxel's 3-D coordinates is also generated. User input can be minimized to identifying the location of the pulmonary artery from which the input function to a blood flow model is derived. Any flow model utilizing one input and one output function can be easily added to a user selectable list. We present examples from our physiologic based research findings to demonstrate the strengths of combining dynamic CT and HRCT relative to other scanning modalities to uniquely characterize pulmonary normal and pathophysiology.

NETMARK: A Schema-less Extension for Relational Databases for Managing Semi-structured Data Dynamically

NASA Technical Reports Server (NTRS)

Maluf, David A.; Tran, Peter B.

2003-01-01

Object-Relational database management system is an integrated hybrid cooperative approach to combine the best practices of both the relational model utilizing SQL queries and the object-oriented, semantic paradigm for supporting complex data creation. In this paper, a highly scalable, information on demand database framework, called NETMARK, is introduced. NETMARK takes advantages of the Oracle 8i object-relational database using physical addresses data types for very efficient keyword search of records spanning across both context and content. NETMARK was originally developed in early 2000 as a research and development prototype to solve the vast amounts of unstructured and semi-structured documents existing within NASA enterprises. Today, NETMARK is a flexible, high-throughput open database framework for managing, storing, and searching unstructured or semi-structured arbitrary hierarchal models, such as XML and HTML.

Cellular automata and its applications in protein bioinformatics.

PubMed

Xiao, Xuan; Wang, Pu; Chou, Kuo-Chen

2011-09-01

With the explosion of protein sequences generated in the postgenomic era, it is highly desirable to develop high-throughput tools for rapidly and reliably identifying various attributes of uncharacterized proteins based on their sequence information alone. The knowledge thus obtained can help us timely utilize these newly found protein sequences for both basic research and drug discovery. Many bioinformatics tools have been developed by means of machine learning methods. This review is focused on the applications of a new kind of science (cellular automata) in protein bioinformatics. A cellular automaton (CA) is an open, flexible and discrete dynamic model that holds enormous potentials in modeling complex systems, in spite of the simplicity of the model itself. Researchers, scientists and practitioners from different fields have utilized cellular automata for visualizing protein sequences, investigating their evolution processes, and predicting their various attributes. Owing to its impressive power, intuitiveness and relative simplicity, the CA approach has great potential for use as a tool for bioinformatics.

Intelligent Systems: Terrestrial Observation and Prediction Using Remote Sensing Data

NASA Technical Reports Server (NTRS)

Coughlan, Joseph C.

2005-01-01

NASA has made science and technology investments to better utilize its large space-borne remote sensing data holdings of the Earth. With the launch of Terra, NASA created a data-rich environment where the challenge is to fully utilize the data collected from EOS however, despite unprecedented amounts of observed data, there is a need for increasing the frequency, resolution, and diversity of observations. Current terrestrial models that use remote sensing data were constructed in a relatively data and compute limited era and do not take full advantage of on-line learning methods and assimilation techniques that can exploit these data. NASA has invested in visualization, data mining and knowledge discovery methods which have facilitated data exploitation, but these methods are insufficient for improving Earth science models that have extensive background knowledge nor do these methods refine understanding of complex processes. Investing in interdisciplinary teams that include computational scientists can lead to new models and systems for online operation and analysis of data that can autonomously improve in prediction skill over time.

E-Commerce and Business Models

NASA Astrophysics Data System (ADS)

Ogasawara, Yasushi

The development of IT will lead to the integration of computers and networks, and IT will become more function oriented service and result in an indispensable part of the social infrastructure. This means that the critical point will shift from prioritizing “ownership of IS (Information Systems) before anything else” to “how IT will be utilized.” By reaching this technology level, Western origin non-discretion oriented management concept where IT is used as an enabler and IT-based business tools can be flexible enough to accommodate highly discretion oriented practices in Japanese organizations. In other words, IT can finally be utilized in a Japanese way. Taking account of the technological development trend, there is a need to take a macro look at the meaning of the concept of business models, something that has become viewed in the “micro” as patent-related issues. Under such trends, the greater freedom in business design the multipurpose use of IT functions is providing, the more critical a capability in the design of an elaborate business model is becoming.

Health courts: an alternative to traditional tort law.

PubMed

Miller, Lisa A

2011-01-01

The current adversarial tort-based system of adjudicating malpractice claims is flawed. Alternate methods of compensation for birth injuries related to oxygen deprivation or mechanical injury are being utilized in Virginia and Florida. Although utilization of both of these schemes is limited, and they are not without problems in application, both have been successful in reducing the number of malpractice claims in the tort system and in reducing malpractice premiums. While the Florida and Virginia programs are primarily focused on compensation, other models outside the US focus include compensation as well as enhanced dispute resolution and potential for clinical practice change through peer review. Experts in the fields of law and public policy in the United States have evaluated a variety of approaches and have proposed models for administrative health courts that would provide both compensation and dispute resolution for medical and nursing malpractice claims. These alternative models are based on transparency and disclosure, with just compensation for injuries, and opportunities for improvements in patient safety.

Analysis of changes in the association of income and the utilization of curative health services in Mexico between 2000 and 2006

PubMed Central

2011-01-01

Background A common characteristic of health systems in most developing countries is unequal access to health services. As a result, members of the poorest population groups often do not receive formal attention for health services, because they cannot afford it. In 2001 in Mexico, to address income-related differences in the use of health services, the government launched a major healthcare reform, which includes a health insurance program called Seguro Popular, aimed at improving healthcare access among poor, uninsured residents. This paper analyzes the before and after changes in the demand for curative ambulatory health services focusing on the association of income-related characteristics and the utilization of formal healthcare providers vs. no healthcare service utilization. Methods By using two nationally representative health surveys (ENSA-2000 and ENSANUT-2006), we modeled an individual's decision when experiencing an illness to use services provided by the (1) Ministry of Health (MoH), (2) social security, (3) private entities, or (4) to not use formal services (no healthcare service utilization). Results Poorer individuals were more likely in 2006 than in 2000 to respond to an illness by using formal healthcare providers. Trends in provider selection differed, however. The probability of using public services from the MoH increased among the poorest population, while the findings indicated an increase in utilization of private health services among members of low- and middle-income groups. No significant change was seen among formal workers -covered by social security services-, regardless of socioeconomic status. Conclusions Overall, for 2006 the Mexican population appears less differentiated in using healthcare across economic groups than in 2000. This may be related, in part, to the implementation of Seguro Popular, which seems to be stimulating healthcare demand among the poorest and previously uninsured segment of the population. Still, public health authorities need to address the remaining income-related healthcare utilization differences, the differences in quality between public and private health services, and the general perception that MoH facilities offer inferior services. PMID:21978183

Analysis of changes in the association of income and the utilization of curative health services in Mexico between 2000 and 2006.

PubMed

Danese-Dlsantos, Laura G; Sosa-Rubí, Sandra G; Valencia-Mendoza, Atanacio

2011-10-07

A common characteristic of health systems in most developing countries is unequal access to health services. As a result, members of the poorest population groups often do not receive formal attention for health services, because they cannot afford it. In 2001 in Mexico, to address income-related differences in the use of health services, the government launched a major healthcare reform, which includes a health insurance program called Seguro Popular, aimed at improving healthcare access among poor, uninsured residents. This paper analyzes the before and after changes in the demand for curative ambulatory health services focusing on the association of income-related characteristics and the utilization of formal healthcare providers vs. no healthcare service utilization. By using two nationally representative health surveys (ENSA-2000 and ENSANUT-2006), we modeled an individual's decision when experiencing an illness to use services provided by the (1) Ministry of Health (MoH), (2) social security, (3) private entities, or (4) to not use formal services (no healthcare service utilization). Poorer individuals were more likely in 2006 than in 2000 to respond to an illness by using formal healthcare providers. Trends in provider selection differed, however. The probability of using public services from the MoH increased among the poorest population, while the findings indicated an increase in utilization of private health services among members of low- and middle-income groups. No significant change was seen among formal workers -covered by social security services-, regardless of socioeconomic status. Overall, for 2006 the Mexican population appears less differentiated in using healthcare across economic groups than in 2000. This may be related, in part, to the implementation of Seguro Popular, which seems to be stimulating healthcare demand among the poorest and previously uninsured segment of the population. Still, public health authorities need to address the remaining income-related healthcare utilization differences, the differences in quality between public and private health services, and the general perception that MoH facilities offer inferior services.

Utilization of a state run public private emergency transportation service exclusively for childbirth: the Janani (maternal) Express program in Madhya Pradesh, India.

PubMed

Sidney, Kristi; Ryan, Kayleigh; Diwan, Vishal; De Costa, Ayesha

2014-01-01

In 2009 the state government of Madhya Pradesh, India launched an emergency obstetric transportation service, Janani Express Yojana (JEY), to support the cash transfer program that promotes institutional delivery. JEY, a large scale public private partnership, lowers geographical access barriers to facility based care. The state contracts and pays private agencies to provide emergency transportation at no cost to the user. The objective was to study (a) the utilization of JEY among women delivering in health facilities, (b) factors associated with usage, (c) the timeliness of the service. A cross sectional facility based study was conducted in facilities that carried out > ten deliveries a month. Researchers who spent five days in each facility administered a questionnaire to all women who gave birth there to elicit socio-demographic characteristics and transport related details. 35% of women utilised JEY to reach a facility, however utilization varied between study districts. Uptake was highest among women from rural areas (44%), scheduled tribes (55%), and poorly educated women (40%). Living in rural areas and belonging to scheduled tribes were significant predictors for JEY usage. Almost 1/3 of JEY users (n = 104) experienced a transport related delay. The JEY service model complements the cash transfer program by providing transport to a facility to give birth. A study of the distribution of utilization in population subgroups suggests the intervention was successful in reaching the most vulnerable population, promoting equity in access. While 1/3 of women utilized the service and it saved them money; 30% experienced significant transport related delays in reaching a facility, which is comparable to women using public transportation. Further research is needed to understand why utilization is low, to explore if there is a need for service expansion at the community level and to improve the overall time efficiency of JEY.

Increased Burden of Healthcare Utilization and Cost Associated with Opioid-Related Constipation Among Patients with Noncancer Pain

PubMed Central

Fernandes, Ancilla W.; Kern, David M.; Datto, Catherine; Chen, Yen-Wen; McLeskey, Charles; Tunceli, Ozgur

2016-01-01

Background Opioids are widely accepted as treatment for moderate to severe pain, and opioid-induced constipation is one of the most common side effects of opioids. This side effect negatively affects pain management and patients’ quality of life, which could result in increased healthcare utilization and costs. Objective To assess healthcare utilization and costs (all-cause, constipation-related, and pain-related) for individuals with and without opioid-induced constipation during the 12 months after initiation of opioid therapy for noncancer pain. Methods This retrospective cohort study was conducted using administrative claims data from HealthCore Integrated Research Environment between January 1, 2006, and June 30, 2014. The analysis was limited to patients aged ≥18 years who filled a prescription for continuous opioid treatment (≥28 days) for noncancer pain. Propensity scores were used to match opioid users with constipation (cohort 1) and opioid users without constipation (cohort 2), using a 1:1 ratio. Generalized linear models were used to estimate all-cause, constipation-related, and pain-related healthcare utilization and costs during the 12 months after the initiation of opioid therapy. Results After matching and balancing for all prespecified variables, 17,384 patients were retained in each cohort (mean age, 56 years; 63% female). Opioid users with constipation were twice as likely as those without constipation to have ≥1 inpatient hospitalizations (odds ratio, 2.28; 95% confidence interval [CI], 2.17–2.39) during the 12 months. The total mean adjusted overall costs per patient during the study period were $12,413 higher for patients with constipation versus those without it (95% CI, $11,726–$13,116). The total mean adjusted overall pain-related costs per patient were $6778 (95% CI, $6293–$7279) higher for the patients with constipation than those without. Among patients using opioids for noncancer pain, the annual mean constipation-related costs per patient totaled $4646 (total average plan-paid costs, $4424; total patient-paid costs, $222). Conclusions Patients using opioids with newly diagnosed constipation had significantly greater healthcare utilization and costs than patients without constipation; these costs accounted for approximately 16% of the total healthcare costs per patient during the 12-month study period. Recognition and effective treatment of opioid-induced constipation may decrease healthcare utilization for patients with chronic noncancer pain and may reduce the economic burden of pain therapy. PMID:27606040

Optimal foraging on the roof of the world: Himalayan langurs and the classical prey model

PubMed Central

Sayers, Ken; Norconk, Marilyn A.; Conklin-Brittain, Nancy L.

2009-01-01

Optimal foraging theory has only been sporadically applied to nonhuman primates. The classical prey model, modified for patch choice, predicts a sliding “profitability threshold” for dropping patch types from the diet, preference for profitable foods, dietary niche breadth reduction as encounter rates increase, and that exploitation of a patch type is unrelated to its own abundance. We present results from a one-year study testing these predictions with Himalayan langurs (Semnopithecus entellus) at Langtang National Park, Nepal. Behavioral data included continuous recording of feeding bouts and between-patch travel times. Encounter rates were estimated for 55 food types, which were analyzed for crude protein, lipid, free simple sugar, and fibers. Patch types were entered into the prey model algorithm for eight seasonal time periods and differing age-sex classes and nutritional currencies. Although the model consistently underestimated diet breadth, the majority of non-predicted patch types represented rare foods. Profitability was positively related to annual/seasonal dietary contribution by organic matter estimates, while time estimates provided weaker relationships. Patch types utilized did not decrease with increasing encounter rates involving profitable foods, although low-ranking foods available year-round were taken predominantly when high-ranking foods were scarce. High-ranking foods were taken in close relation to encounter rates, while low-ranking foods were not. The utilization of an energetic currency generally resulted in closest conformation to model predictions, and it performed best when assumptions were most closely approximated. These results suggest that even simple models from foraging theory can provide a useful framework for the study of primate feeding behavior. PMID:19844998

A qualitative case study of the legislative process of the hygienist-therapist bill in a large Midwestern state.

PubMed

Dollins, Haley E; Bray, Kimberly Krust; Gadbury-Amyot, Cynthia C

2013-10-01

Inequitable access to dental care contributes to oral health disparities. Midlevel dental provider models are utilized across the globe as a way to bridge the gap between preventive and restorative dental professionals and increase access to dental care. The purpose of this study was threefold: to examine lessons learned from the state legislative process related to creation of the hygienist-therapist in a Midwestern state, to improve understanding of the relationship between alternative oral health delivery models and public policy and to inform the development and passage of future policies aimed at addressing the unmet dental needs of the public. This research investigation utilized a qualitative research methodology to examine the process of legislation relating to an alternative oral health delivery model (hygienist-therapist) through the eyes of key stakeholders. Interview data was analyzed and then triangulated with 3 data sources: interviews with key stakeholders, documents and researcher participant field notes. Data analysis resulted in consensus on 3 emergent themes with accompanying categories. The themes that emerged included social justice, partnerships and coalitions, and the legislative process. This qualitative case study suggests that the creation of a new oral health workforce model was a long and arduous process involving multiple stakeholders and negotiation between the parties involved. The creation of this new workforce model was recognized as a necessary step to increasing access to dental care at the state and national level. The research in this case study may serve to inform advocates of access to oral health care as other states pursue their own workforce models.

Determination of Uncertainties for the New SSME Model

NASA Technical Reports Server (NTRS)

Coleman, Hugh W.; Hawk, Clark W.

1996-01-01

This report discusses the uncertainty analysis performed in support of a new test analysis and performance prediction model for the Space Shuttle Main Engine. The new model utilizes uncertainty estimates for experimental data and for the analytical model to obtain the most plausible operating condition for the engine system. This report discusses the development of the data sets and uncertainty estimates to be used in the development of the new model. It also presents the application of uncertainty analysis to analytical models and the uncertainty analysis for the conservation of mass and energy balance relations is presented. A new methodology for the assessment of the uncertainty associated with linear regressions is presented.

FEQinput—An editor for the full equations (FEQ) hydraulic modeling system

USGS Publications Warehouse

Ancalle, David S.; Ancalle, Pablo J.; Domanski, Marian M.

2017-10-30

IntroductionThe Full Equations Model (FEQ) is a computer program that solves the full, dynamic equations of motion for one-dimensional unsteady hydraulic flow in open channels and through control structures. As a result, hydrologists have used FEQ to design and operate flood-control structures, delineate inundation maps, and analyze peak-flow impacts. To aid in fighting floods, hydrologists are using the software to develop a system that uses flood-plain models to simulate real-time streamflow.Input files for FEQ are composed of text files that contain large amounts of parameters, data, and instructions that are written in a format exclusive to FEQ. Although documentation exists that can aid in the creation and editing of these input files, new users face a steep learning curve in order to understand the specific format and language of the files.FEQinput provides a set of tools to help a new user overcome the steep learning curve associated with creating and modifying input files for the FEQ hydraulic model and the related utility tool, Full Equations Utilities (FEQUTL).

Assessing the utility of the willingness/prototype model in predicting help-seeking decisions.

PubMed

Hammer, Joseph H; Vogel, David L

2013-01-01

Prior research on professional psychological help-seeking behavior has operated on the assumption that the decision to seek help is based on intentional and reasoned processes. However, research on the dual-process prototype/willingness model (PWM; Gerrard, Gibbons, Houlihan, Stock, & Pomery, 2008) suggests health-related decisions may also involve social reaction processes that influence one's spontaneous willingness (rather than planned intention) to seek help, given conducive circumstances. The present study used structural equation modeling to evaluate the ability of these 2 information-processing pathways (i.e., the reasoned pathway and the social reaction pathway) to predict help-seeking decisions among 182 college students currently experiencing clinical levels of psychological distress. Results indicated that when both pathways were modeled simultaneously, only the social reaction pathway independently accounted for significant variance in help-seeking decisions. These findings argue for the utility of the PWM framework in the context of professional psychological help seeking and hold implications for future counseling psychology research, prevention, and practice. PsycINFO Database Record (c) 2013 APA, all rights reserved.

The therapeutic potential of cell identity reprogramming for the treatment of aging-related neurodegenerative disorders.

PubMed

Smith, Derek K; He, Miao; Zhang, Chun-Li; Zheng, Jialin C

2017-10-01

Neural cell identity reprogramming strategies aim to treat age-related neurodegenerative disorders with newly induced neurons that regenerate neural architecture and functional circuits in vivo. The isolation and neural differentiation of pluripotent embryonic stem cells provided the first in vitro models of human neurodegenerative disease. Investigation into the molecular mechanisms underlying stem cell pluripotency revealed that somatic cells could be reprogrammed to induced pluripotent stem cells (iPSCs) and these cells could be used to model Alzheimer disease, amyotrophic lateral sclerosis, Huntington disease, and Parkinson disease. Additional neural precursor and direct transdifferentiation strategies further enabled the induction of diverse neural linages and neuron subtypes both in vitro and in vivo. In this review, we highlight neural induction strategies that utilize stem cells, iPSCs, and lineage reprogramming to model or treat age-related neurodegenerative diseases, as well as, the clinical challenges related to neural transplantation and in vivo reprogramming strategies. Copyright © 2016. Published by Elsevier Ltd.

Adding Hierarchical Objects to Relational Database General-Purpose XML-Based Information Managements

NASA Technical Reports Server (NTRS)

Lin, Shu-Chun; Knight, Chris; La, Tracy; Maluf, David; Bell, David; Tran, Khai Peter; Gawdiak, Yuri

2006-01-01

NETMARK is a flexible, high-throughput software system for managing, storing, and rapid searching of unstructured and semi-structured documents. NETMARK transforms such documents from their original highly complex, constantly changing, heterogeneous data formats into well-structured, common data formats in using Hypertext Markup Language (HTML) and/or Extensible Markup Language (XML). The software implements an object-relational database system that combines the best practices of the relational model utilizing Structured Query Language (SQL) with those of the object-oriented, semantic database model for creating complex data. In particular, NETMARK takes advantage of the Oracle 8i object-relational database model using physical-address data types for very efficient keyword searches of records across both context and content. NETMARK also supports multiple international standards such as WEBDAV for drag-and-drop file management and SOAP for integrated information management using Web services. The document-organization and -searching capabilities afforded by NETMARK are likely to make this software attractive for use in disciplines as diverse as science, auditing, and law enforcement.

Differential Relations of Depression and Social Anxiety Symptoms to the Facets of Extraversion/Positive Emotionality

PubMed Central

Naragon-Gainey, Kristin; Watson, David; Markon, Kristian E.

2009-01-01

Previous research has shown that depression and social anxiety—two “facets” of internalizing psychopathology— both are characterized by low levels of extraversion/positive emotionality (E/PE). However, little is known about the relations of the facets of E/PE with symptoms of depression and social anxiety. This study utilized multiple measures of each facet of E/PE, as well as depression and social anxiety symptoms. Self-report data were collected from large samples of college students and psychiatric outpatients. Separate factor analyses in each sample revealed a four-factor structure of E/PE, consisting of Sociability, Positive Emotionality, Ascendance, and Fun-Seeking. Structural equation modeling revealed that, after controlling for the higher-order internalizing factor and the overlap among the E/PE facets, social anxiety was broadly related to all four facets of E/PE, whereas depression was strongly related only to low positive emotionality. Implications for hierarchical models of personality and psychopathology, assessment and treatment, and etiological models are discussed. PMID:19413405

Systematic review of the impact of urinary tract infections on health-related quality of life.

PubMed

Bermingham, Sarah L; Ashe, Joanna F

2012-12-01

What's known on the subject? and What does the study add? Values for equivalent health states can vary substantially depending on the measure used and method of valuation; this has a direct impact on the results of economic analyses. To date, the majority of existing economic evaluations that include UTI as a health state refer to an analysis in which the Index of Well Being was used to estimate the quality of life experienced by young women with UTIs. Currently, there are no validated methods or filters for systematically searching for the type of generic quality of life data required for decision analytic models. This study is the only systematic review of quality of life in people with UTI in the literature. Twelve studies were identified which report quality of life using a variety of generic methods; the results of these papers were summarized in a way that is useful for a health researcher seeking to populate a decision model, design a clinical study or assess the effect of UTI on quality of life relative to other conditions. One research group provided previously unpublished data from a large cohort study; these scores were mapped to EuroQol 5-Dimension values using published algorithms and probabilistic simulations. The aim of this review was to identify studies that have evaluated the impact of symptomatic urinary tract infection (UTI) and UTI-associated bacteraemia on quality of life, and to summarize these data in a way that is useful for a health researcher seeking to populate a cost-utility model, design a clinical study or assess the effect of UTIs on quality of life relative to other conditions. We conducted a systematic search of the literature using MEDLINE, EMBASE, the NHS Economic Evaluations database, Health Technology Assessment database, Health Economics Evaluations database, Cost-Effectiveness Analysis Registry and EuroQol website. Studies that reported utility values for symptomatic UTI or UTI-associated bacteraemia derived from a generic QoL measurement tool or expert opinion were included. Studies using disease-specific instruments were excluded. Twelve studies were identified that included a generic measure of health-related quality of life for patients with UTIs. These measures included: the short-form (SF)-36 and SF-12 questionnaires; the Health Utilities Index Mark 2; Quality of Well Being; the Index of Well Being, standard gamble; the Health and Activity Limitation Index; and expert opinion. The authors of studies using either of the SF questionnaires were contacted for additional data. One research group provided previously unpublished data from a large cohort study; these scores were mapped to EuroQol 5-Dimension (EQ-5D) values using published algorithms and probabilistic simulations. The present review provides health researchers with several sources from which to select utility values to populate cost-utility models. It also shows that very few studies have measured quality of life in patients with UTI using generic preference-based measures of health and none have evaluated the impact of this health state on quality of life in children. Future studies ought to consider the inclusion of commonly used preference-based measures of health, such as the EQ-5D, in all patient populations experiencing symptomatic UTI or UTI-related complications. © 2012 NATIONAL CLINICAL GUIDELINE CENTRE OF ROYAL COLLEGE OF PHYSICIANS.

Medical care transition planning and dental care use for youth with special health care needs during the transition from adolescence to young adulthood: a preliminary explanatory model

PubMed Central

Chi, Donald L.

2013-01-01

Objectives To test the hypotheses that youth with special health care needs (YSHCN) with a medical care transition plan are more likely to use dental care during the transition from adolescence to young adulthood and that different factors are associated with dental utilization for YSHCN with and YSHCN without functional limitations. Methods National Survey of CSHCN (2001) and Survey of Adult Transition and Health (2007) data were analyzed (N=1,746). The main predictor variable was having a medical care transition plan, defined as having discussed with a doctor how health care needs might change with age and having developed a transition plan. The outcome variable was dental care use in 2001 (adolescence) and 2007 (young adulthood). Multiple variable Poisson regression models with robust standard errors were used to estimate covariate-adjusted relative risks (RR). Results About 63% of YSHCN had a medical care transition plan and 73.5% utilized dental care. YSHCN with a medical care transition plan had a 9% greater relative risk (RR) of utilizing dental care than YSHCN without a medical care transition plan (RR:1.09; 95% CI:1.03–1.16). In the models stratified by functional limitation status, having a medical care transition plan was significantly associated with dental care use, but only for YSHCN without functional limitations (RR:1.11; 95% CI:1.04–1.18). Conclusions Having a medical care transition plan is significantly associated with dental care use, but only for YSHCN with no functional limitation. Dental care should be an integral part of the comprehensive health care transition planning process for all YSHCN. PMID:23812799

Surrogate analysis and index developer (SAID) tool and real-time data dissemination utilities

USGS Publications Warehouse

Domanski, Marian M.; Straub, Timothy D.; Wood, Molly S.; Landers, Mark N.; Wall, Gary R.; Brady, Steven J.

2015-01-01

The use of acoustic and other parameters as surrogates for suspended-sediment concentrations (SSC) in rivers has been successful in multiple applications across the Nation. Critical to advancing the operational use of surrogates are tools to process and evaluate the data along with the subsequent development of regression models from which real-time sediment concentrations can be made available to the public. Recent developments in both areas are having an immediate impact on surrogate research, and on surrogate monitoring sites currently in operation. The Surrogate Analysis and Index Developer (SAID) standalone tool, under development by the U.S. Geological Survey (USGS), assists in the creation of regression models that relate response and explanatory variables by providing visual and quantitative diagnostics to the user. SAID also processes acoustic parameters to be used as explanatory variables for suspended-sediment concentrations. The sediment acoustic method utilizes acoustic parameters from fixed-mount stationary equipment. The background theory and method used by the tool have been described in recent publications, and the tool also serves to support sediment-acoustic-index methods being drafted by the multi-agency Sediment Acoustic Leadership Team (SALT), and other surrogate guidelines like USGS Techniques and Methods 3-C4 for turbidity and SSC. The regression models in SAID can be used in utilities that have been developed to work with the USGS National Water Information System (NWIS) and for the USGS National Real-Time Water Quality (NRTWQ) Web site. The real-time dissemination of predicted SSC and prediction intervals for each time step has substantial potential to improve understanding of sediment-related water-quality and associated engineering and ecological management decisions.