76 FR 74113 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-30

... options. Rights and warrants entitle owners to purchase shares of stock at predetermined prices subject to various timing and other conditions. Like options, the price of rights and warrants are affected by the... consequence, the prices of rights and warrants may move more dramatically than the prices of the underlying...

SAHAYOG: A Testbed for Load Sharing under Failure,

DTIC Science & Technology

1987-07-01

messages, shared memory and semaphores . To communicate using messages, processes create message queues using system-provided prim- itives. The message...The size of the memory that is to be shared is decided by the process when it makes a request for memory allocation. The semaphore option of IPC can be...used to prevent two or more concurrent processes from executing their critical sections at the same time. Semaphores must be used when the processes

78 FR 7835 - Self-Regulatory Organizations; BOX Options Exchange LLC; Notice of Filing of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-04

... at $145 per share would carry a total deliverable value of $145,000, and the strike price would be... Jumbo option strike price of $145 was trading at $146 per share, the intrinsic $1 per share value would... Shares Deliverable Upon Exercise 100 shares........ 1,000 shares Strike Price if underlying is 45 45 $45...

The Role of Patients: Shared Decision-Making.

PubMed

Beers, Emily; Lee Nilsen, Marci; Johnson, Jonas T

2017-08-01

Shared decision-making affords patients and their families the autonomy to make difficult decisions after receiving comprehensive information about medical facts and treatment options. It is essential that patients' values are respected. The essential steps include first informing patients of the need for a decision, then explaining the various facts involved; after which, it is important to elicit patients' preferences and goals. Once the treatment options and outcomes important to patients are identified, an actual decision can be made. This activity is complex and requires a commitment of time and is enhanced through employment of a multidisciplinary team approach. Copyright © 2017 Elsevier Inc. All rights reserved.

Managing hydroclimatological risk to water supply with option contracts and reservoir index insurance

NASA Astrophysics Data System (ADS)

Brown, Casey; Carriquiry, Miguel

2007-11-01

This paper explores the performance of a system of economic instruments designed to facilitate the reduction of hydroclimatologic variability-induced impacts on stakeholders of shared water supply. The system is composed of bulk water option contracts between urban water suppliers and agricultural users and insurance indexed on reservoir inflows. The insurance is designed to cover the financial needs of the water supplier in situations where the option is likely to be exercised. Insurance provides the irregularly needed funds for exercising the water options. The combined option contract - reservoir index insurance system creates risk sharing between sectors that is currently lacking in many shared water situations. Contracts are designed for a shared agriculture - urban water system in Metro Manila, Philippines, using optimization and Monte Carlo analysis. Observed reservoir inflows are used to simulate contract performance. Results indicate the option - insurance design effectively smooths water supply costs of hydrologic variability for both agriculture and urban water.

75 FR 13169 - Self-Regulatory Organizations; The Options Clearing Corporation; Notice of Filing of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-18

... interpretation with respect to the treatment and clearing of options and security futures on SPDR Gold Shares.\\2... amended the interpretation to extend similar treatment to options and security futures on iShares[supreg... rule filing SR-OCC-2009-20, which extended similar treatment to options and security futures on ETFS...

26 CFR 1.1563-3 - Rules for determining stock ownership.

Code of Federal Regulations, 2010 CFR

2010-04-01

... acquire such stock. For example, assume Smith owns an option to purchase 100 shares of the outstanding stock of M Corporation. Under this subparagraph, Smith is considered to own such 100 shares. The result would be the same if Smith owned an option to acquire the option (or one of a series of options) to...

75 FR 67799 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-03

... strike, an out-of-the-money option. However, if a $0.50 strike series had been available, the investor would have been able to control 5,000 shares by purchasing 50 exercisable in-the-money $0.50 strike call... the time was $1, an in-the-money option. If a $0.50 strike series had been available, the investor...

Changing Times: The Use of Reduced Work Time Options in the United States.

ERIC Educational Resources Information Center

Olmsted, Barney

1983-01-01

This article addresses the increase in voluntary reduced work time arrangements that have developed in the United States in response to growing interest in alternatives to the standardized approach to scheduling. Permanent part-time employment, job sharing, and voluntary reduced work time plans are defined, described and, to a limited extent,…

77 FR 76132 - Self-Regulatory Organizations; BOX Options Exchange LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-26

... Rule Change To Increase the Position and Exercise Limits for Options on the iShares MSCI Emerging... exercise limits for options on the iShares MSCI Emerging Markets Index Fund (``EEM'') to 500,000 contracts... 3120 to increase the position and exercise limits for EEM options to 500,000 contracts.\\3\\ There is...

Study of the Alsys implementation of the Catalogue of Interface Features and Options for the Ada language for 80386 Unix

NASA Technical Reports Server (NTRS)

Gibson, James S.; Barnes, Michael J.; Ostermiller, Daniel L.

1993-01-01

A set of programs was written to test the functionality and performance of the Alsys Ada implementation of the Catalogue of Interface Features and Options (CIFO), a set of optional Ada packages for real-time applications. No problems were found with the task id, preemption control, or shared-data packages. Minor problems were found with the dispatching control, dynamic priority, events, non-waiting entry call, semaphore, and scheduling packages. The Alsys implementation is derived mostly from Release 2 of the CIFO standard, but includes some of the features of Release 3 and some modifications unique to Alsys. Performance measurements show that the semaphore and shared-data features are an order-of-magnitude faster than the same mechanisms using an Ada rendezvous. The non-waiting entry call is slightly faster than a standard rendezvous. The existence of errors in the implementation, the incompleteness of the documentation from the published standard impair the usefulness of this implementation. Despite those short-comings, the Alsys CIFO implementation might be of value in the development of real-time applications.

Resource Sharing and Public Education. Project Evaluation Report.

ERIC Educational Resources Information Center

Leton, Donald A.

Two exemplary projects developed to maximize student options through the sharing of facilities, programs, and options were evaluated. The Remedial-Developmental Program developed a communications network between McKinley and Roosevelt High Schools and Kapiolani Community College to share student information and use it for individual student…

Effective follow-up consultations: the importance of patient-centered communication and shared decision making.

PubMed

Brand, Paul L P; Stiggelbout, Anne M

2013-12-01

Paediatricians spend a considerable proportion of their time performing follow-up visits for children with chronic conditions, but they rarely receive specific training on how best to perform such consultations. The traditional method of running a follow-up consultation is based on the doctor's agenda, and is problem-oriented. Patients and parents, however, prefer a patient-centered, and solution-focused approach. Although many physicians now recognize the importance of addressing the patient's perspective in a follow-up consultation, a number of barriers hamper its implementation in practice, including time constraints, lack of appropriate training, and a strong tradition of the biomedical, doctor-centered approach. Addressing the patient's perspective successfully can be achieved through shared decision making, clinicians and patients making decisions together based on the best clinical evidence. Research shows that shared decision making not only increases patient, parent, and physician satisfaction with the consultation, but also may improve health outcomes. Shared decision making involves building a physician-patient-parent partnership, agreeing on the problem at hand, laying out the available options with their benefits and risks, eliciting the patient's views and preferences on these options, and agreeing on a course of action. Shared decision making requires specific communication skills, which can be learned, and should be mastered through deliberate practice. Copyright © 2013 Elsevier Ltd. All rights reserved.

Labour time required for piglet castration with isoflurane-anaesthesia using shared and stationary inhaler devices.

PubMed

Weber, Sabrina; Das, Gürbüz; Waldmann, Karl-Heinz; Gauly, Matthias

2014-01-01

Isoflurane-anaesthesia combined with an analgesic represents a welfare-friendly method of pain mitigation for castration of piglets. However, it requires an inhaler device, which is uneconomic for small farms. Sharing a device among farms may be an economical option if the shared use does not increase labour time and the resulting costs. This study aimed to investigate the amount and components of labour time required for piglet castration with isoflurane anaesthesia performed with stationary and shared devices. Piglets (N = 1579) were anaesthetised with isoflurane (using either stationary or shared devices) and castrated.The stationary devices were used in a group (n = 5) of larger farms (84 sows/farm on an average), whereas smaller farms (n = 7; 32 sows/farm on an average) shared one device. Each farm was visited four times and labour time for each process-step was recorded. The complete process included machine set-up, anaesthesia and castration by a practitioner, and preparation, collection and transport of piglets by a farmer. Labour time of the complete process was increased (P = 0.012) on farms sharing a device (266 s/piglet) compared to farms using stationary devices (177 s/ piglet), due to increased time for preparation (P = 0.055), castration (P = 0.026) and packing (P = 0.010) when sharing a device. However, components of the time budget of farms using stationary or shared devices did not differ significantly (P > 0.05). Cost arising from time spent by farmers did not differ considerably between the use of stationary (0.28 Euro per piglet) and shared (0.26 Euro) devices. It is concluded that costs arising from the increased labour time due to sharing a device can be considered marginal, since the high expenses originating from purchasing an inhaler device are shared among several farms.

77 FR 21120 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing of Proposed Rule Change to List...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-09

... Contracts Overlying 10 Shares of a Security (``Mini-Options Contracts'') and Implementing Rule Text... contracts'') and implement rule text necessary to distinguish mini-options contracts from option contracts overlying 100 shares of a security (``standard contracts''). The text of the proposed rule change is...

Supporting shared decision making using an Option Grid for osteoarthritis of the knee in an interface musculoskeletal clinic: A stepped wedge trial.

PubMed

Elwyn, Glyn; Pickles, Tim; Edwards, Adrian; Kinsey, Katharine; Brain, Kate; Newcombe, Robert G; Firth, Jill; Marrin, Katy; Nye, Alan; Wood, Fiona

2016-04-01

To evaluate whether introducing tools, specifically designed for use in clinical encounters, namely Option Grids, into a clinical practice setting leads to higher levels of shared decision making. A stepped wedge trial design where 6 physiotherapists at an interface clinic in Oldham, UK, were sequentially instructed in how to use an Option Grid for osteoarthritis of the knee. Patients with suspected or confirmed osteoarthritis of the knee were recruited, six per clinician prior to instruction, and six per clinician afterwards. We measured shared decision making, patient knowledge, and readiness to decide. A total of 72 patients were recruited; 36 were allocated to the intervention group. There was an 8.4 point (95% CI 4.4 to 12.2) increase in the Observer OPTION score (range 0-100) in the intervention group. The mean gain in knowledge was 0.9 points (score range 0-5, 95% CI, 0.3 to 1.5). There was no increase in encounter duration. Shared decision making increased when clinicians used the knee osteoarthritis Option Grid. Tools designed to support collaboration and deliberation about treatment options lead to increased levels of shared decision making. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Total Parenteral Nutrition

MedlinePlus

... Boolean useRights, FileShare share, Int32 bufferSize, FileOptions options, SECURITY_ATTRIBUTES secAttrs, String msgPath, Boolean bFromProxy) at System.IO.FileStream..ctor(String path, FileMode mode, FileAccess ...

78 FR 25502 - Self-Regulatory Organizations; Miami International Securities Exchange LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-01

... Effectiveness of Proposed Rule Change To Increase the Position and Exercise Limits for Options on iShares MSCI... filing a proposal to amend its rules to increase the position and exercise limits for options on iShares... and Policies .01 to increase position and exercise limits, respectively, for EEM options. Position...

75 FR 69058 - Request for Comment on a Proposal to Exempt, Pursuant to the Authority in Section 4(c) of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-10

... categorical Section 4(c) exemption to permit options and futures on shares of all or some precious metal commodity-based ETFs to be traded and cleared as options on securities and security futures, respectively... options and futures on shares of precious metal commodity- based ETFs. The Commission believes that...

26 CFR 1.424-1 - Definitions and special rules applicable to statutory options.

Code of Federal Regulations, 2010 CFR

2010-04-01

... in § 1.424-1(e)(4)(v)) or change in the terms or number of outstanding shares of such corporation... or price of shares purchasable under an option merely to reflect market fluctuations in the price of... of the outstanding shares of a corporation (as described in paragraph (a)(3)(ii) of this section...

14 CFR 1214.117 - Launch and orbit parameters for a standard launch.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Launch at a time, selected by NASA, from a launch window of not less than 1 hour (a more restrictive launch window may be provided as an optional service). (b) For shared flights from KSC to the standard...

Retrieval characteristics of the Bard Denali and Argon Option inferior vena cava filters.

PubMed

Dowell, Joshua D; Semaan, Dominic; Makary, Mina S; Ryu, John; Khayat, Mamdouh; Pan, Xueliang

2017-11-01

The purpose of this study was to compare the retrieval characteristics of the Option Elite (Argon Medical, Plano, Tex) and Denali (Bard, Tempe, Ariz) retrievable inferior vena cava filters (IVCFs), two filters that share a similar conical design. A single-center, retrospective study reviewed all Option and Denali IVCF removals during a 36-month period. Attempted retrievals were classified as advanced if the routine "snare and sheath" technique was initially unsuccessful despite multiple attempts or an alternative endovascular maneuver or access site was used. Patient and filter characteristics were documented. In our study, 63 Option and 45 Denali IVCFs were retrieved, with an average dwell time of 128.73 and 99.3 days, respectively. Significantly higher median fluoroscopy times were experienced in retrieving the Option filter compared with the Denali filter (12.18 vs 6.85 minutes; P = .046). Use of adjunctive techniques was also higher in comparing the Option filter with the Denali filter (19.0% vs 8.7%; P = .079). No significant difference was noted between these groups in regard to gender, age, or history of malignant disease. Option IVCF retrieval procedures required significantly longer retrieval fluoroscopy time compared with Denali IVCFs. Although procedure time was not analyzed in this study, as a surrogate, the increased fluoroscopy time may also have an impact on procedural direct costs and throughput. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Using Option Grids: steps toward shared decision-making for neonatal circumcision.

PubMed

Fay, Mary; Grande, Stuart W; Donnelly, Kyla; Elwyn, Glyn

2016-02-01

To assess the impact, acceptability and feasibility of a short encounter tool designed to enhance the process of shared decision-making and parental engagement. We analyzed video-recordings of clinical encounters, half undertaken before and half after a brief intervention that trained four clinicians how to use Option Grids, using an observer-based measure of shared decision-making. We also analyzed semi-structured interviews conducted with the clinicians four weeks after their exposure to the intervention. Observer OPTION(5) scores were higher at post-intervention, with a mean of 33.9 (SD=23.5) compared to a mean of 16.1 (SD=7.1) for pre-intervention, a significant difference of 17.8 (95% CI: 2.4, 33.2). Prior to using the intervention, clinicians used a consent document to frame circumcision as a default practice. Encounters with the Option Grid conferred agency to both parents and clinicians, and facilitated shared decision-making. Clinician reported recognizing the tool's positive effect on their communication process. Tools such as Option Grids have the potential to make it easier for clinicians to achieve shared decision-making. Encounter tools have the potential to change practice. More research is needed to test their feasibility in routine practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Working with interpreters: The challenges of introducing Option Grid patient decision aids.

PubMed

Wood, Fiona; Phillips, Katie; Edwards, Adrian; Elwyn, Glyn

2017-03-01

We aimed to observe how an Option Grid™ decision aid for clinical encounters might be used where an interpreter is present, and to assess the impact of its use on shared decision making. Data were available from three clinical consultations between patient, clinician (a physiotherapist), and interpreter about knee osteoarthritis. Clinicians were trained in the use of an Option Grid decision aid and the tool was used. Consultations were audio-recorded, transcribed, and translated by independent translators into English. Analysis revealed the difficulties with introducing a written decision aid into an interpreted consultation. The extra discussion needed between the clinician and interpreter around the principles and purpose of shared decision making and instructions regarding the Option Grid decision aid proved challenging and difficult to manage. Discussion of treatment options while using an Option Grid decision aid was predominantly done between clinician and interpreter. The patient appeared to have little involvement in discussion of treatment options. Patients were not active participants within the discussion. Further work needs to be done on how shared decision making can be achieved within interpreted consultations. Option Grid decision aids are not being used as intended in interpreted consultations. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Treatment of early onset scoliosis : How far can we go?].

PubMed

Studer, D; Hasler, C C; Schulze, A

2015-11-01

Recently, inconsistent definitions of early onset scoliosis (EOS) and a wide variety of treatment options have been observed. To clearly define the term EOS, to depict non-operative and operative treatment options, and to present the limitations of the boundaries of these techniques. Review of the literature, including conference presentations and expert opinions, in addition to personal experiences. Early onset scoliosis (EOS) refers to spine deformity that is present before 10 years of age, regardless of etiology. All existing operative treatment options share a high risk of complications. Therefore, non-operative treatment should act as a time-buying approach to postpone surgery. Awareness of treatment options and their specific indications, in addition to respecting each patient's individual needs and feasibilities, are crucial for the optimal outcome.

The essential nature of sharing in science.

PubMed

Fischer, Beth A; Zigmond, Michael J

2010-12-01

Advances in science are the combined result of the efforts of a great many scientists, and in many cases, their willingness to share the products of their research. These products include data sets, both small and large, and unique research resources not commercially available, such as cell lines and software programs. The sharing of these resources enhances both the scope and the depth of research, while making more efficient use of time and money. However, sharing is not without costs, many of which are borne by the individual who develops the research resource. Sharing, for example, reduces the uniqueness of the resources available to a scientist, potentially influencing the originator's perceived productivity and ultimately his or her competitiveness for jobs, promotions, and grants. Nevertheless, for most researchers-particularly those using public funds-sharing is no longer optional but must be considered an obligation to science, the funding agency, and ultimately society at large. Most funding agencies, journals, and professional societies now require a researcher who has published work involving a unique resource to make that resource available to other investigators. Changes could be implemented to mitigate some of the costs. The creator of the resource could explore the possibility of collaborating with those who request it. In addition, institutions that employ and fund researchers could change their policies and practices to make sharing a more attractive and viable option. For example, when evaluating an individual's productivity, institutions could provide credit for the impact a researcher has had on their field through the provision of their unique resources to other investigators, regardless of whether that impact is reflected in the researcher's list of publications. In addition, increased funding for the development and maintenance of user-friendly public repositories for data and research resources would also help to reduce barriers to sharing by minimizing the time, effort, and funding needed by individual investigators to comply with requests for their unique resource. Indeed, sharing is an imperative, but it is also essential to find ways to protect for both the original owner of the resource and those wishing to share it.

Exploring Higher Education Financing Options

ERIC Educational Resources Information Center

Nkrumah-Young, Kofi K.; Powell, Philip

2011-01-01

Higher education can be financed privately, financed by governments, or shared. Given that the benefits of education accrue to the individual and the state, many governments opt for shared financing. This article examines the underpinnings of different options for financing higher education and develops a model to compare conditions to choices and…

Assessing Option Grid® practicability and feasibility for facilitating shared decision making: An exploratory study.

PubMed

Tsulukidze, Maka; Grande, Stuart W; Gionfriddo, Michael R

2015-07-01

To assess the feasibility of Option Grids(®)for facilitating shared decision making (SDM) in simulated clinical consultations and explore clinicians' views on their practicability. We used mixed methods approach to analyze clinical consultations using the Observer OPTION instrument and thematic analysis for follow-up interviews with clinicians. Clinicians achieved high scores on information sharing and low scores on preference elicitation and integration. Four themes were identified: (1) Barriers affect practicability of Option Grids(®); (2) Option Grids(®) facilitate the SDM process; (3) Clinicians are aware of the gaps in their practice of SDM; (4) Training and ongoing feedback on the optimal use of Option Grids(®) are necessary. Use of Option Grids(®) by clinicians with background knowledge in SDM did not facilitate optimal levels of competency on the SDM core concepts of preference elicitation and integration. Future research must evaluate the impact of training on the use of Option Grids(®), and explore how best to help clinicians bridge the gap between knowledge and action. Clinicians proficiently imparting information in simulations struggled to elicit and integrate patient preferences - understanding this gap and developing strategies to close it are the next steps for implementing SDM into clinical practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Predictors of Rehabilitation Intervention Decisions in Adults with Acquired Hearing Impairment

ERIC Educational Resources Information Center

Laplante-Levesque, Ariane; Hickson, Louise; Worrall, Linda

2011-01-01

Purpose: This study investigated the predictors of rehabilitation intervention decisions in middle-age and older adults with acquired hearing impairment seeking help for the first time. Method: Using shared decision making, 139 participants were offered intervention options: hearing aids, communication programs (group or individual), and no…

Shared decision making in the safety net: where do we go from here?

PubMed

Bouma, Angelique B; Tiedje, Kristina; Poplau, Sara; Boehm, Deborah H; Shah, Nilay D; Commers, Matthew J; Linzer, Mark; Montori, Victor M

2014-01-01

Shared decision making (SDM) is an interactive process between clinicians and patients in which both share information, deliberate together, and make clinical decisions. Clinics serving safety net patients face special challenges, including fewer resources and more challenging work environments. The use of SDM within safety net institutions has not been well studied. We recruited a convenience sample of 15 safety net primary care clinicians (13 physicians, 2 nurse practitioners). Each answered a 9-item SDM questionnaire and participated in a semistructured interview. From the transcribed interviews and questionnaire data, we identified themes and suggestions for introducing SDM into a safety net environment. Clinicians reported only partially fulfilling the central components of SDM (sharing information, deliberating, and decision making). Most clinicians expressed interest in SDM by stating that they "selected a treatment option together" with patients (8 of 15 in strong or complete agreement), but only a minority (3 of 15) "thoroughly weighed the different treatment options" together with patients. Clinicians attributed this gap to many barriers, including time pressure, overwhelming visit content, patient preferences, and lack of available resources. All clinicians believed that lack of time made it difficult to practice SDM. To increase use of SDM in the safety net, efficient SDM interventions designed for this environment, team care, and patient engagement in SDM will need further development. Future studies should focus on adapting SDM to safety net settings and determine whether SDM can reduce health care disparities.

76 FR 12775 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Notice of Filing of a Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-08

... series in the pilot: (1) A time series analysis of open interest; and (2) An analysis of the distribution... times the number of shares outstanding. These are summed for all 500 stocks and divided by a... below $3.00 and $0.10 for all other series. Strike price intervals would be set no less than 5 points...

75 FR 14478 - Self-Regulatory Organizations; The Options Clearing Corporation; Notice of Filing of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-25

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-61692; File No. SR-OCC-2010-03] Self[dash]Regulatory Organizations; The Options Clearing Corporation; Notice of Filing of Proposed Rule Change Relating to ETFS Palladium Shares and ETFS Platinum Shares Correction In notice document 2010-5914 beginning...

Option Grids to facilitate shared decision making for patients with Osteoarthritis of the knee: protocol for a single site, efficacy trial.

PubMed

Marrin, Katy; Wood, Fiona; Firth, Jill; Kinsey, Katharine; Edwards, Adrian; Brain, Kate E; Newcombe, Robert G; Nye, Alan; Pickles, Timothy; Hawthorne, Kamila; Elwyn, Glyn

2014-04-07

Despite policy interest, an ethical imperative, and evidence of the benefits of patient decision support tools, the adoption of shared decision making (SDM) in day-to-day clinical practice remains slow and is inhibited by barriers that include culture and attitudes; resources and time pressures. Patient decision support tools often require high levels of health and computer literacy. Option Grids are one-page evidence-based summaries of the available condition-specific treatment options, listing patients' frequently asked questions. They are designed to be sufficiently brief and accessible enough to support a better dialogue between patients and clinicians during routine consultations. This paper describes a study to assess whether an Option Grid for osteoarthritis of the knee (OA of the knee) facilitates SDM, and explores the use of Option Grids by patients disadvantaged by language or poor health literacy. This will be a stepped wedge exploratory trial involving 72 patients with OA of the knee referred from primary medical care to a specialist musculoskeletal service in Oldham. Six physiotherapists will sequentially join the trial and consult with six patients using usual care procedures. After a period of brief training in using the Option Grid, the same six physiotherapists will consult with six further patients using an Option Grid in the consultation. The primary outcome will be efficacy of the Option Grid in facilitating SDM as measured by observational scores using the OPTION scale. Comparisons will be made between patients who have received the Option Grid and those who received usual care. A Decision Quality Measure (DQM) will assess quality of decision making. The health literacy of patients will be measured using the REALM-R instrument. Consultations will be observed and audio-recorded. Interviews will be conducted with the physiotherapists, patients and any interpreters present to explore their views of using the Option Grid. Option Grids offer a potential solution to the barriers to implementing traditional decision aids into routine clinical practice. The study will assess whether Option Grids can facilitate SDM in day-to-day clinical practice and explore their use with patients disadvantaged by language or poor health literacy. Current Controlled Trials ISRCTN94871417.

78 FR 13715 - Self-Regulatory Organizations; The Options Clearing Corporation; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-28

... Change To Provide Clarifying Language To Conform Interpretive Guidance Concerning Options Overlying Fund... providing clarifying language to conform interpretive guidance concerning options on fund shares with...

Defense Health Care: Additional Analysis of Costs and Benefits of Potential Governance Structures Is Needed

DTIC Science & Technology

2012-09-01

options, (2) a business case analysis and strategy for implementing its shared services concept, and (3) more complete analyses of the options’ strengths...and weaknesses. DoD concurred with developing a business case analysis for its shared services concept. DoD did not concur with the other two

26 CFR 1.544-4 - Options.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 7 2010-04-01 2010-04-01 true Options. 1.544-4 Section 1.544-4 Internal Revenue... (CONTINUED) Personal Holding Companies § 1.544-4 Options. The shares of stock which may be acquired by reason of an option shall be considered to be constructively owned by the individual having the option to...

Modulation of Saccade Vigor during Value-Based Decision Making.

PubMed

Reppert, Thomas R; Lempert, Karolina M; Glimcher, Paul W; Shadmehr, Reza

2015-11-18

During value-based decision-making, individuals consider the various options and select the one that provides the maximum subjective value. Although the brain integrates abstract information to compute and compare these values, the only behavioral outcome is often the decision itself. However, if the options are visual stimuli, during deliberation the brain moves the eyes from one stimulus to the other. Previous work suggests that saccade vigor, i.e., peak velocity as a function of amplitude, is greater if reward is associated with the visual stimulus. This raises the possibility that vigor during the free viewing of options may be influenced by the valuation of each option. Here, humans chose between a small, immediate monetary reward and a larger but delayed reward. As the deliberation began, vigor was similar for the saccades made to the two options but diverged 0.5 s before decision time, becoming greater for the preferred option. This difference in vigor increased as a function of the difference in the subjective values that the participant assigned to the delayed and immediate options. After the decision was made, participants continued to gaze at the options, but with reduced vigor, making it possible to infer timing of the decision from the sudden drop in vigor. Therefore, the subjective value that the brain assigned to a stimulus during decision-making affected the motor system via the vigor with which the eyes moved toward that stimulus. We find that, as individuals deliberate between two rewarding options and arrive at a decision, the vigor with which they make saccades to each option reflects a real-time evaluation of that option. With deliberation, saccade vigor diverges between the two options, becoming greater for the option that the individual will eventually choose. The results suggest a shared element between the network that assigns value to a stimulus during the process of decision-making and the network that controls vigor of movements toward that stimulus. Copyright © 2015 the authors 0270-6474/15/3515369-10$15.00/0.

Modulation of Saccade Vigor during Value-Based Decision Making

PubMed Central

Lempert, Karolina M.; Glimcher, Paul W.; Shadmehr, Reza

2015-01-01

During value-based decision-making, individuals consider the various options and select the one that provides the maximum subjective value. Although the brain integrates abstract information to compute and compare these values, the only behavioral outcome is often the decision itself. However, if the options are visual stimuli, during deliberation the brain moves the eyes from one stimulus to the other. Previous work suggests that saccade vigor, i.e., peak velocity as a function of amplitude, is greater if reward is associated with the visual stimulus. This raises the possibility that vigor during the free viewing of options may be influenced by the valuation of each option. Here, humans chose between a small, immediate monetary reward and a larger but delayed reward. As the deliberation began, vigor was similar for the saccades made to the two options but diverged 0.5 s before decision time, becoming greater for the preferred option. This difference in vigor increased as a function of the difference in the subjective values that the participant assigned to the delayed and immediate options. After the decision was made, participants continued to gaze at the options, but with reduced vigor, making it possible to infer timing of the decision from the sudden drop in vigor. Therefore, the subjective value that the brain assigned to a stimulus during decision-making affected the motor system via the vigor with which the eyes moved toward that stimulus. SIGNIFICANCE STATEMENT We find that, as individuals deliberate between two rewarding options and arrive at a decision, the vigor with which they make saccades to each option reflects a real-time evaluation of that option. With deliberation, saccade vigor diverges between the two options, becoming greater for the option that the individual will eventually choose. The results suggest a shared element between the network that assigns value to a stimulus during the process of decision-making and the network that controls vigor of movements toward that stimulus. PMID:26586823

77 FR 65917 - Self-Regulatory Organizations; The Options Clearing Corporation; Order Granting Accelerated...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-31

... Organizations; The Options Clearing Corporation; Order Granting Accelerated Approval of Proposed Rule Change To Accommodate Equity Options That Have a Unit of Trading of 10 Shares October 25, 2012. I. Introduction On September 12, 2012, the Options Clearing Corporation (``OCC'') filed with the Securities and Exchange...

Benefits and work-schedule options in hospital pharmacy practice.

PubMed

Gaither, C A; Mason, N A; Diokno, D A; Hoffman, E J

1994-03-15

Hospital pharmacy directors were surveyed to determine whether their departments offered specific family-related benefits and work-schedule options and how their attitudes about these options compared with those of female hospital pharmacists. Questionnaires were mailed to 300 randomly selected hospital pharmacy directors to collect the following information: vacancy rates and male:female ratios in hospital pharmacy positions, which of 13 selected benefits and work-schedule options were offered, barriers that prevented the other options from being offered, and attitudes about the listed options. The options included in the survey were selected because they represent ways of balancing home and work (e.g., maternity leave, job sharing, day care). The pharmacy directors' responses were compared with those from a similar survey of female hospital pharmacists. The usable response rate was 50.3%. Position vacancy rates ranged from 5.5% for directors to 35.8% for clinical supervisors. All full-time positions had an even distribution of men and women except for director and assistant or associate director positions. Of 13 options, only maternity leave, part-time schedules, and flexible schedules were offered by more than half of the hospitals. These three were also the only listed options that the respondents considered important in recruiting and retaining pharmacists. Barriers to offering other options included the perception that current benefits and work-schedule options were adequate, lack of staff coverage, lack of funds, and the perception that some positions are not compatible with alternative schedules. Respondents' ratings of the importance of the listed benefits and work-schedule options were significantly lower than ratings given by female hospital pharmacists in a separate survey.(ABSTRACT TRUNCATED AT 250 WORDS)

76 FR 74095 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-30

.... Rights and warrants entitle owners to purchase shares of stock at predetermined prices subject to various timing and other conditions. Like options, the price of rights and warrants are affected by the price of... consequence, the prices of rights and warrants may move more dramatically than the prices of the underlying...

Comparing the ability of OPTION(12) and OPTION(5) to assess shared decision-making in genetic counselling.

PubMed

Vortel, Martina A; Adam, Shelin; Port-Thompson, Ashley V; Friedman, Jan M; Grande, Stuart W; Birch, Patricia H

2016-10-01

OPTION(12) is the most widely used tool to measure shared decision-making (SDM) in health care. A newer scale, OPTION(5), has been proposed as a more parsimonious measure that better addresses core concepts of SDM. This study compares OPTION(5) to OPTION(12) in prenatal genetic counselling. Two raters independently used OPTION(12) and OPTION(5) to score 27 clinical encounters between genetic counsellors (GC) and women with pregnancies at increased risk for genetic conditions. Global and item scores on the two instruments were compared to test concurrent validity and to identify usability in this context. Inter-rater reliability was also assessed for both instruments. Mean scores for OPTION(12) were 43.8 (SD=9.7), and for OPTION(5) were=60.6 (SD=12.5). The correlation between OPTION(12) and OPTION(5) scores was r=0.70. Inter-rater reliability was 0.70 and 0.85 for OPTION(12) and OPTION(5) respectively, however mean inter-rater reliability for individual items was 0.31 and 0.63 for OPTION(12) and OPTION(5) respectively. GCs exhibit SDM as measured by both OPTION instruments. OPTION(5) exhibits improved psychometric performance relative to OPTION(12), and more specifically targets the core constructs of SDM. However, refinement of OPTION instruments or manuals is needed to improve reliability and validity in GC assessment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Shared decision making for patients living with inflammatory arthritis.

PubMed

Palmer, Deborah; El Miedany, Yasser

Providing adequate care for people with inflammatory arthritis is an ongoing challenge. In recent years significant progress has been made in the treatment of inflammatory arthritic conditions. The availability of a wide range of disease-modifying anti-rheumatic drugs as well as biologic therapies has not only improved treatment, but also made treatment decisions much more complex. This wider range of improved treatment options happened at the same time as a clear move towards patient-centred care and implementing shared decision making for both medical and surgical conditions. Implementing shared decision making has been reported to be associated with higher satisfaction and better adherence to therapy. Electronic shared decision making has more recently been suggested as a tool for clinical practice. The aim of this article is to look at further integrating shared decision making in standard rheumatology practice in view of the available evidence and the outcomes of a study looking at a recently developed patient shared decision guide.

A brief description of the Medical Information Computer System (MEDICS). [real time minicomputer system

NASA Technical Reports Server (NTRS)

Moseley, E. C.

1974-01-01

The Medical Information Computer System (MEDICS) is a time shared, disk oriented minicomputer system capable of meeting storage and retrieval needs for the space- or non-space-related applications of at least 16 simultaneous users. At the various commercially available low cost terminals, the simple command and control mechanism and the generalized communication activity of the system permit multiple form inputs, real-time updating, and instantaneous retrieval capability with a full range of options.

Reducing the Deficit: Spending and Revenue Options

DTIC Science & Technology

2011-03-01

the Conservation Reserve Program 25AgricultureOption 6 Reduce the Premium Subsidy in the Crop Insurance Program 26Option 7 Reduce by 20 Percentage...Graduate Students 31Option 11 Change the Interest Rate Structure for Student Loans 32HealthOption 12 Add a “Public Plan” to the Health Insurance Exchanges...Health Episodes Covered by Medicare 48Option 21 Reduce Medicare Costs by Changing the Cost-Sharing Structures for Medicare and Medigap Insurance 49Option

77 FR 38362 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Withdrawal of Proposed Rule Change To...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-27

... Option Contracts Overlying 10 Shares of a Security (``Mini-Options Contracts'') and Implement Rule Text... Contracts and implement rule text necessary to distinguish Mini-Options Contracts from Standard Contracts...

Acceptance and use of eight arsenic-safe drinking water options in Bangladesh.

PubMed

Inauen, Jennifer; Hossain, Mohammad Mojahidul; Johnston, Richard B; Mosler, Hans-Joachim

2013-01-01

Arsenic contamination of drinking water is a serious public health threat. In Bangladesh, eight major safe water options provide an alternative to contaminated shallow tubewells: piped water supply, deep tubewells, pond sand filters, community arsenic-removal, household arsenic removal, dug wells, well-sharing, and rainwater harvesting. However, it is uncertain how well these options are accepted and used by the at-risk population. Based on the RANAS model (risk, attitudes, norms, ability, and self-regulation) this study aimed to identify the acceptance and use of available safe water options. Cross-sectional face-to-face interviews were used to survey 1,268 households in Bangladesh in November 2009 (n = 872), and December 2010 (n = 396). The questionnaire assessed water consumption, acceptance factors from the RANAS model, and socioeconomic factors. Although all respondents had access to at least one arsenic-safe drinking water option, only 62.1% of participants were currently using these alternatives. The most regularly used options were household arsenic removal filters (92.9%) and piped water supply (85.6%). However, the former result may be positively biased due to high refusal rates of household filter owners. The least used option was household rainwater harvesting (36.6%). Those who reported not using an arsenic-safe source differed in terms of numerous acceptance factors from those who reported using arsenic-safe sources: non-users were characterized by greater vulnerability; showed less preference for the taste and temperature of alternative sources; found collecting safe water quite time-consuming; had lower levels of social norms, self-efficacy, and coping planning; and demonstrated lower levels of commitment to collecting safe water. Acceptance was particularly high for piped water supplies and deep tubewells, whereas dug wells and well-sharing were the least accepted sources. Intervention strategies were derived from the results in order to increase the acceptance and use of each arsenic-safe water option.

Acceptance and Use of Eight Arsenic-Safe Drinking Water Options in Bangladesh

PubMed Central

Inauen, Jennifer; Hossain, Mohammad Mojahidul; Johnston, Richard B.; Mosler, Hans-Joachim

2013-01-01

Arsenic contamination of drinking water is a serious public health threat. In Bangladesh, eight major safe water options provide an alternative to contaminated shallow tubewells: piped water supply, deep tubewells, pond sand filters, community arsenic-removal, household arsenic removal, dug wells, well-sharing, and rainwater harvesting. However, it is uncertain how well these options are accepted and used by the at-risk population. Based on the RANAS model (risk, attitudes, norms, ability, and self-regulation) this study aimed to identify the acceptance and use of available safe water options. Cross-sectional face-to-face interviews were used to survey 1,268 households in Bangladesh in November 2009 (n = 872), and December 2010 (n = 396). The questionnaire assessed water consumption, acceptance factors from the RANAS model, and socioeconomic factors. Although all respondents had access to at least one arsenic-safe drinking water option, only 62.1% of participants were currently using these alternatives. The most regularly used options were household arsenic removal filters (92.9%) and piped water supply (85.6%). However, the former result may be positively biased due to high refusal rates of household filter owners. The least used option was household rainwater harvesting (36.6%). Those who reported not using an arsenic-safe source differed in terms of numerous acceptance factors from those who reported using arsenic-safe sources: non-users were characterized by greater vulnerability; showed less preference for the taste and temperature of alternative sources; found collecting safe water quite time-consuming; had lower levels of social norms, self-efficacy, and coping planning; and demonstrated lower levels of commitment to collecting safe water. Acceptance was particularly high for piped water supplies and deep tubewells, whereas dug wells and well-sharing were the least accepted sources. Intervention strategies were derived from the results in order to increase the acceptance and use of each arsenic-safe water option. PMID:23326477

78 FR 785 - Self-Regulatory Organizations; NYSE Arca, Inc.; Order Granting Approval of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-04

...; securities; options on securities and indices; futures contracts; options on futures contracts; forward... options, futures, or options on futures on, Shares through ETP Holders, in connection with such ETP... pool operator with the Commodity Futures Trading Commission (``CFTC'') and is a member of the National...

42 CFR 447.52 - Cost sharing.

Code of Federal Regulations, 2014 CFR

2014-10-01

... agency imposes cost sharing under § 447.54, the process by which hospital emergency room services are... State option, cost sharing imposed for any service (other than for drugs and non-emergency services... group under § 447.56(a), and (iii) For cost sharing imposed for non-emergency services furnished in an...

75 FR 71773 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-24

... securities index options, index futures, and options on index futures to be included along with the ETF in an... hedged not only with SPY shares, but with S&P 500 options, S&P 500 futures, options on S&P 500 futures or... on a delta basis. \\9\\ ``Other units of trade'' would include, for example, options or futures...

National Centers for Environmental Prediction

Science.gov Websites

the number of threads used. HWRF group cannot access Zeus and Jet for real-time data transfers from nodes used.). All single jobs will be run on one rack and will not share with parallel jobs. No official change the group when using tag_rstprod (-g option). autotag_rstprod is a script that tags all files. It

75 FR 14236 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-24

... transactions. Currently, the First Trust ISE Water ETF (``FIW'') and the Claymore China Technology ETF (``CQQQ... options on the ProShares UltraPro Short Dow30 (``SDOW''), the ProShares UltraPro Dow30 (``UDOW''), the ProShares UltraPro Short MidCap400 (``SMDD''), the ProShares UltraPro MidCap400 (``UMDD''), the ProShares...

Dental Amalgam

MedlinePlus

... Products and Medical Procedures Dental Devices Dental Amalgam Dental Amalgam Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Dental amalgam is a dental filling material which is ...

Ambiguity Aversion in Rhesus Macaques

PubMed Central

Hayden, Benjamin Y.; Heilbronner, Sarah R.; Platt, Michael L.

2010-01-01

People generally prefer risky options, which have fully specified outcome probabilities, to ambiguous options, which have unspecified probabilities. This preference, formalized in economics, is strong enough that people will reliably prefer a risky option to an ambiguous option with a greater expected value. Explanations for ambiguity aversion often invoke uniquely human faculties like language, self-justification, or a desire to avoid public embarrassment. Challenging these ideas, here we demonstrate that a preference for unambiguous options is shared with rhesus macaques. We trained four monkeys to choose between pairs of options that both offered explicitly cued probabilities of large and small juice outcomes. We then introduced occasional trials where one of the options was obscured and examined their resulting preferences; we ran humans in a parallel experiment on a nearly identical task. We found that monkeys reliably preferred risky options to ambiguous ones, even when this bias was costly, closely matching the behavior of humans in the analogous task. Notably, ambiguity aversion varied parametrically with the extent of ambiguity. As expected, ambiguity aversion gradually declined as monkeys learned the underlying probability distribution of rewards. These data indicate that ambiguity aversion reflects fundamental cognitive biases shared with other animals rather than uniquely human factors guiding decisions. PMID:20922060

Automating the Analytical Laboratories Section, Lewis Research Center, National Aeronautics and Space Administration: A feasibility study

NASA Technical Reports Server (NTRS)

Boyle, W. G.; Barton, G. W.

1979-01-01

The feasibility of computerized automation of the Analytical Laboratories Section at NASA's Lewis Research Center was considered. Since that laboratory's duties are not routine, the automation goals were set with that in mind. Four instruments were selected as the most likely automation candidates: an atomic absorption spectrophotometer, an emission spectrometer, an X-ray fluorescence spectrometer, and an X-ray diffraction unit. Two options for computer automation were described: a time-shared central computer and a system with microcomputers for each instrument connected to a central computer. A third option, presented for future planning, expands the microcomputer version. Costs and benefits for each option were considered. It was concluded that the microcomputer version best fits the goals and duties of the laboratory and that such an automted system is needed to meet the laboratory's future requirements.

Shared decision making: what do clinicians need to know and why should they bother?

PubMed

Hoffmann, Tammy C; Légaré, France; Simmons, Magenta B; McNamara, Kevin; McCaffery, Kirsten; Trevena, Lyndal J; Hudson, Ben; Glasziou, Paul P; Del Mar, Christopher B

2014-07-07

Shared decision making enables a clinician and patient to participate jointly in making a health decision, having discussed the options and their benefits and harms, and having considered the patient's values, preferences and circumstances. It is not a single step to be added into a consultation, but a process that can be used to guide decisions about screening, investigations and treatments. The benefits of shared decision making include enabling evidence and patients' preferences to be incorporated into a consultation; improving patient knowledge, risk perception accuracy and patient-clinician communication; and reducing decisional conflict, feeling uninformed and inappropriate use of tests and treatments. Various approaches can be used to guide clinicians through the process. We elaborate on five simple questions that can be used: What will happen if the patient waits and watches? What are the test or treatment options? What are the benefits and harms of each option? How do the benefits and harms weigh up for the patient? Does the patient have enough information to make a choice? Although shared decision making can occur without tools, various types of decision support tools now exist to facilitate it. Misconceptions about shared decision making are hampering its implementation. We address the barriers, as perceived by clinicians. Despite numerous international initiatives to advance shared decision making, very little has occurred in Australia. Consequently, we are lagging behind many other countries and should act urgently.

42 CFR 447.51 - Requirements and options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Requirements and options. 447.51 Section 447.51 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES..., Premium Or Similar Cost Sharing Charge § 447.51 Requirements and options. (a) The plan must provide that...

Stochastic differential equation (SDE) model of opening gold share price of bursa saham malaysia

NASA Astrophysics Data System (ADS)

Hussin, F. N.; Rahman, H. A.; Bahar, A.

2017-09-01

Black and Scholes option pricing model is one of the most recognized stochastic differential equation model in mathematical finance. Two parameter estimation methods have been utilized for the Geometric Brownian model (GBM); historical and discrete method. The historical method is a statistical method which uses the property of independence and normality logarithmic return, giving out the simplest parameter estimation. Meanwhile, discrete method considers the function of density of transition from the process of diffusion normal log which has been derived from maximum likelihood method. These two methods are used to find the parameter estimates samples of Malaysians Gold Share Price data such as: Financial Times and Stock Exchange (FTSE) Bursa Malaysia Emas, and Financial Times and Stock Exchange (FTSE) Bursa Malaysia Emas Shariah. Modelling of gold share price is essential since fluctuation of gold affects worldwide economy nowadays, including Malaysia. It is found that discrete method gives the best parameter estimates than historical method due to the smallest Root Mean Square Error (RMSE) value.

Comparing the nine-item Shared Decision-Making Questionnaire to the OPTION Scale - an attempt to establish convergent validity.

PubMed

Scholl, Isabelle; Kriston, Levente; Dirmaier, Jörg; Härter, Martin

2015-02-01

While there has been a clear move towards shared decision-making (SDM) in the last few years, the measurement of SDM-related constructs remains challenging. There has been a call for further psychometric testing of known scales, especially regarding validity aspects. To test convergent validity of the nine-item Shared Decision-Making Questionnaire (SDM-Q-9) by comparing it to the OPTION Scale. Cross-sectional study. Data were collected in outpatient care practices. Patients suffering from chronic diseases and facing a medical decision were included in the study. Consultations were evaluated using the OPTION Scale. Patients completed the SDM-Q-9 after the consultation. First, the internal consistency of both scales and the inter-rater reliability of the OPTION Scale were calculated. To analyse the convergent validity of the SDM-Q-9, correlation between the patient (SDM-Q-9) and expert ratings (OPTION Scale) was calculated. A total of 21 physicians provided analysable data of consultations with 63 patients. Analyses revealed good internal consistency of the SDM-Q-9 and limited internal consistency of the OPTION Scale. Inter-rater reliability of the latter was less than optimal. Association between the total scores of both instruments was weak with a Spearman correlation of r = 0.19 and did not reach statistical significance. By the use of the OPTION Scale convergent validity of the SDM-Q-9 could not be established. Several possible explanations for this result are discussed. This study shows that the measurement of SDM remains challenging. © 2012 John Wiley & Sons Ltd.

Phakic Intraocular Lenses

MedlinePlus

... Implants and Prosthetics Phakic Intraocular Lenses Phakic Intraocular Lenses Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Phakic intraocular lenses are new devices used to correct nearsightedness. These ...

Community Shared Solar: Policy and Regulatory Considerations (Brochure)

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

Not Available

2014-09-01

This brochure explores the ways in which the shared solar business model interacts with existing policy and regulations, including net metering, tax credits, and securities regulation. It presents some of the barriers that shared solar projects may face, and provides options for creating a supportive policy environment.

The psychometric properties of Observer OPTION(5), an observer measure of shared decision making.

PubMed

Barr, Paul J; O'Malley, Alistair James; Tsulukidze, Maka; Gionfriddo, Michael R; Montori, Victor; Elwyn, Glyn

2015-08-01

Observer OPTION(5) was designed as a more efficient version of OPTION(12), the most commonly used measure of shared decision making (SDM). The current paper assesses the psychometric properties of OPTION(5). Two raters used OPTION(5) to rate recordings of clinical encounters from two previous patient decision aid (PDA) trials (n=201; n=110). A subsample was re-rated two weeks later. We assessed discriminative validity, inter-rater reliability, intra-rater reliability, and concurrent validity. OPTION(5) demonstrated discriminative validity, with increases in SDM between usual care and PDA arms. OPTION(5) also demonstrated concurrent validity with OPTION(12), r=0.61 (95%CI 0.54, 0.68) and intra-rater reliability, r=0.93 (0.83, 0.97). The mean difference in rater score was 8.89 (95% Credibility Interval, 7.5, 10.3), with intraclass correlation (ICC) of 0.67 (95% Credibility Interval, 0.51, 0.91) for the accuracy of rater scores and 0.70 (95% Credibility Interval, 0.56, 0.94) for the consistency of rater scores across encounters, indicating good inter-rater reliability. Raters reported lower cognitive burden when using OPTION(5) compared to OPTION(12). OPTION(5) is a brief, theoretically grounded observer measure of SDM with promising psychometric properties in this sample and low burden on raters. OPTION(5) has potential to provide reliable, valid assessment of SDM in clinical encounters. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Gluten-Free Labeling of Foods

MedlinePlus

... Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Food Home Food Guidance & Regulation Guidance Documents & Regulatory Information by Topic Allergens Gluten-Free Labeling of Foods Share Tweet Linkedin Pin it More sharing options ...

Alerts and Notices (Devices)

MedlinePlus

... Medical Devices Medical Device Safety Safety Communications Safety Communications Share Tweet Linkedin Pin it More sharing options ... Older safety communications are listed below. Older Safety Communications 2016 Safety Communications 2015 Safety Communications 2014 Safety ...

Essure Permanent Birth Control

MedlinePlus

... Prosthetics Essure Permanent Birth Control Essure Permanent Birth Control Share Tweet Linkedin Pin it More sharing options ... Print Essure is a a permanently implanted birth control device for women (female sterilization). Implantation of Essure ...

Medications for High Blood Pressure

MedlinePlus

... Consumers Home For Consumers Consumer Updates Medications for High Blood Pressure Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Hypertension tends to worsen with age and you cannot ...

Home-Use Tests - Cholesterol

MedlinePlus

... Medical Procedures In Vitro Diagnostics Home Use Tests Cholesterol Share Tweet Linkedin Pin it More sharing options ... a home-use test kit to measure total cholesterol. What cholesterol is: Cholesterol is a fat (lipid) ...

Black-Scholes finite difference modeling in forecasting of call warrant prices in Bursa Malaysia

NASA Astrophysics Data System (ADS)

Mansor, Nur Jariah; Jaffar, Maheran Mohd

2014-07-01

Call warrant is a type of structured warrant in Bursa Malaysia. It gives the holder the right to buy the underlying share at a specified price within a limited period of time. The issuer of the structured warrants usually uses European style to exercise the call warrant on the maturity date. Warrant is very similar to an option. Usually, practitioners of the financial field use Black-Scholes model to value the option. The Black-Scholes equation is hard to solve analytically. Therefore the finite difference approach is applied to approximate the value of the call warrant prices. The central in time and central in space scheme is produced to approximate the value of the call warrant prices. It allows the warrant holder to forecast the value of the call warrant prices before the expiry date.

78 FR 47041 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

... methodology developed by NationsShares, a firm that develops proprietary derivatives-based indexes and options... Organizations; International Securities Exchange, LLC; Notice of Filing of Proposed Rule Change To List Options... the Exchange of options on the Nations VolDex index, a new index that measures changes in implied...

76 FR 79748 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-22

..., confirming that ``iShares[supreg]'' is a registered trademark of BlackRock Institutional Trust Company, N.A...''), NYSEArca (``Arca''), BATS Global Markets (``BATS''), Boston Options Exchange (``BOX''), Chicago Board... to the applicable ETF option interval standards of other options markets.\\6\\ \\6\\ See, for example...

Laboratory manual: mineral X-ray diffraction data retrieval/plot computer program

USGS Publications Warehouse

Hauff, Phoebe L.; VanTrump, George

1976-01-01

The Mineral X-Ray Diffraction Data Retrieval/Plot Computer Program--XRDPLT (VanTrump and Hauff, 1976a) is used to retrieve and plot mineral X-ray diffraction data. The program operates on a file of mineral powder diffraction data (VanTrump and Hauff, 1976b) which contains two-theta or 'd' values, and intensities, chemical formula, mineral name, identification number, and mineral group code. XRDPLT is a machine-independent Fortran program which operates in time-sharing mode on a DEC System i0 computer and the Gerber plotter (Evenden, 1974). The program prompts the user to respond from a time-sharing terminal in a conversational format with the required input information. The program offers two major options: retrieval only; retrieval and plot. The first option retrieves mineral names, formulas, and groups from the file by identification number, by the mineral group code (a classification by chemistry or structure), or by searches based on the formula components. For example, it enables the user to search for minerals by major groups (i.e., feldspars, micas, amphiboles, oxides, phosphates, carbonates) by elemental composition (i.e., Fe, Cu, AI, Zn), or by a combination of these (i.e., all copper-bearing arsenates). The second option retrieves as the first, but also plots the retrieved 2-theta and intensity values as diagrammatic X-ray powder patterns on mylar sheets or overlays. These plots can be made using scale combinations compatible with chart recorder diffractograms and 114.59 mm powder camera films. The overlays are then used to separate or sieve out unrelated minerals until unknowns are matched and identified.

Dyadic OPTION: Measuring perceptions of shared decision-making in practice.

PubMed

Melbourne, Emma; Roberts, Stephen; Durand, Marie-Anne; Newcombe, Robert; Légaré, France; Elwyn, Glyn

2011-04-01

Current models of the medical consultation emphasize shared decision-making (SDM), whereby the expertise of both the doctor and the patient are recognised and seen to equally contribute to the consultation. The evidence regarding the desirability and effectiveness of the SDM approach is often conflicting. It is proposed that the conflicts are due to the nature of assessment, with current assessments from the perspective of an outside observer. To empirically assess perceived involvement in the medical consultation using the dyadic OPTION instrument. 36 simulated medical consultations were organised between general practitioners and standardized- patients, using the observer OPTION and the newly developed dyadic OPTION instruments. SDM behaviours observed in the consultations were seen to depend on both members of the doctor and patient dyad, rather than each in isolation. Thus a dyadic approach to measurement is supported. This current study highlights the necessity for a dyadic approach to assessment and introduces a novel research instrument: the dyadic OPTION instrument. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Job Sharing--A New Way to Work

ERIC Educational Resources Information Center

Olmsted, Barney

1977-01-01

Describes the concept of job sharing, discusses the advantages and disadvantages to employees and employers, examines how widespread the practice is, and suggests ways that interested employers can implement this option. (SH)

Silicone Gel-Filled Breast Implants

MedlinePlus

... and Medical Procedures Implants and Prosthetics Breast Implants Silicone Gel-Filled Breast Implants Share Tweet Linkedin Pin ... sharing options Linkedin Pin it Email Print Description: Silicone gel-filled breast implants have a silicone outer ...

Treating Cushing's Disease in Dogs

MedlinePlus

... For Consumers Consumer Updates Treating Cushing's Disease in Dogs Share Tweet Linkedin Pin it More sharing options ... FDA Consumer Health Information Your 9-year old dog has been drinking a lot more lately and ...

True Friends: Tough Times and a New Generation of Donors Are Causing Institutions to Rethink Donor Friendships

ERIC Educational Resources Information Center

Jarrell, Andrea

2009-01-01

Ralph Waldo Emerson said, "The only way to have a friend is to be one." But what it means to be a good friend from a donor's perspective is changing. Today's donors have more options for their philanthropic interests than ever before, and they want deep connections with institutions that matter to them and share their values. If an institution is…

Applications of GIFTS III to Structural Engineering Problems.

DTIC Science & Technology

The paper describes the latest version of the GIFTS SYSTEM (Graphics Oriented Interactive Finite Element Package for Time-Sharing), due for release...at the end of March 1976. The paper gives a description of the program modules available in the GIFTS library and the options available within its...framework. Examples are given to demonstrate the use of GIFTS in design-oriented applications. Some performance measurements are included. Amongst the

Arctic Region Policy: Information Sharing Model Options

DTIC Science & Technology

2010-09-01

8 Figure 5. 2004 Arctic Maritime Activity (From Treadwell, 2009, p. 48) .............. 10 Figure 6. Explorer Stuck in the Antarctic (From New...been a Titanic situation, such as what happened to the cruise ship EXPLORER in the Antarctic in November 2007 as shown in Figure 6 (Browley & 11...without detection. Figure 6. Explorer Stuck in the Antarctic (From New York Times, 2007) The EXPLORER story and different scenarios presented

Defense Acquisition: Overview, Issues, and Options for Congress

DTIC Science & Technology

2007-06-04

Unified Combatant Commands ( UCCs ); the Defense Agencies; and DOD field activities. The PPBES process consists of four stages; planning, programming...thorough market research is performed for a procurement action. But, opponents could argue that the cost and time necessary to perform the analysis may...they sought, on the other, that the industrialists in their own states and districts got their fair share , or more, of the military contracts there

Beware of Fraudulent 'Dietary Supplements'

MedlinePlus

... Home For Consumers Consumer Updates Beware of Fraudulent Dietary Supplements Share Tweet Linkedin Pin it More sharing options ... phone at 1-800-FDA-1088 or online . Dietary Supplements and FDA Dietary supplements, in general, are not ...

Antibiotics and Antibiotic Resistance

MedlinePlus

... Medicine Safely Antibiotics and Antibiotic Resistance Antibiotics and Antibiotic Resistance Share Tweet Linkedin Pin it More sharing options ... throughout the world are becoming resistant to antibiotics. Antibiotic resistance has been called one of the world's most ...

Biosimilars: More Treatment Choices and Innovation

MedlinePlus

... Consumers Consumer Updates Biosimilars: More Treatment Choices and Innovation Share Tweet Linkedin Pin it More sharing options ... developing biologics generally is a far more difficult process than manufacturing conventional drugs. A biosimilar is a ...

Outsmarting Poison Ivy and Other Poisonous Plants

MedlinePlus

... Consumer Updates Outsmarting Poison Ivy and Other Poisonous Plants Share Tweet Linkedin Pin it More sharing options ... whitish-green fruits hang in loose clusters. Poison Plant Rashes Aren’t Contagious Poison ivy and other ...

Cost-effective and low-technology options for simulation and training in neonatology.

PubMed

Bruno, Christie J; Glass, Kristen M

2016-11-01

The purpose of this review is to explore low-cost options for simulation and training in neonatology. Numerous cost-effective options exist for simulation and training in neonatology. Lower cost options are available for teaching clinical skills and procedural training in neonatal intubation, chest tube insertion, and pericardiocentesis, among others. Cost-effective, low-cost options for simulation-based education can be developed and shared in order to optimize the neonatal simulation training experience. Copyright © 2016 Elsevier Inc. All rights reserved.

A Review of Shared Decision-Making and Patient Decision Aids in Radiation Oncology.

PubMed

Woodhouse, Kristina Demas; Tremont, Katie; Vachani, Anil; Schapira, Marilyn M; Vapiwala, Neha; Simone, Charles B; Berman, Abigail T

2017-06-01

Cancer treatment decisions are complex and may be challenging for patients, as multiple treatment options can often be reasonably considered. As a result, decisional support tools have been developed to assist patients in the decision-making process. A commonly used intervention to facilitate shared decision-making is a decision aid, which provides evidence-based outcomes information and guides patients towards choosing the treatment option that best aligns with their preferences and values. To ensure high quality, systematic frameworks and standards have been proposed for the development of an optimal aid for decision making. Studies have examined the impact of these tools on facilitating treatment decisions and improving decision-related outcomes. In radiation oncology, randomized controlled trials have demonstrated that decision aids have the potential to improve patient outcomes, including increased knowledge about treatment options and decreased decisional conflict with decision-making. This article provides an overview of the shared-decision making process and summarizes the development, validation, and implementation of decision aids as patient educational tools in radiation oncology. Finally, this article reviews the findings from decision aid studies in radiation oncology and offers various strategies to effectively implement shared decision-making into clinical practice.

75 FR 80557 - Self-Regulatory Organizations; NYSE Amex LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-22

..., or options on currencies or currency futures or other currency derivatives or Currency Trust Shares... futures or options or derivatives on the foregoing in this subparagraph (b); or (c) CBOE Volatility Index...; (b) interest rate futures or options or derivatives on the foregoing; or (c) CBOE VIX futures. NYSE...

77 FR 74700 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-17

... Rule Change To Increase Position and Exercise Limits in EEM Options December 11, 2012. Pursuant to... exercise limits for options on the iShares MSCI Emerging Markets Index Fund (``EEM''). The text of the... Material .01 of ISE Rule 414 to increase position and exercise limits, respectively, for EEM options. This...

What to Ask Your Doctor Before Taking Opioids

MedlinePlus

... Updates What to Ask Your Doctor Before Taking Opioids Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Bring this opioid questions checklist to your doctor’s office (PDF 34 ...

42 CFR 447.52 - Minimum and maximum income-related charges.

Code of Federal Regulations, 2013 CFR

2013-10-01

... agency imposes cost sharing under § 447.54, the process by which hospital emergency room services are... option, cost sharing imposed for any service (other than for drugs and non-emergency services furnished... group under § 447.56(a), and (iii) For cost sharing imposed for non-emergency services furnished in an...

For the last time: stock options are an expense.

PubMed

Bodie, Zvi; Kaplan, Robert S; Merton, Robert C

2003-03-01

Should stock options be recorded as an expense on a company's income statement and balance sheet, or should they remain where they are, relegated to footnotes? The extraordinary boom in share prices during the Internet bubble made critics of option expensing look like spoilsports. But since the crash, the debate has returned with a vengeance. And no wonder: The authors believe the case for expensing options is overwhelming. In this article, Nobel Iaureate Robert Merton, one of the inventors of the Black-Scholes option-pricing model; his coauthor on the classic textbook Finance, Zvi Bodie; and Robert Kaplan, creator of the Balanced Scorecard, examine and dismiss the principal claims put forward by those who continue to oppose options expensing. They demonstrate that stock-option grants do indeed have real cash-flow implications that need to be reported. They show that effective ways certainly exist to quantify those implications. They detail the distortions that relegating stock-option accounting to footnotes creates. And they show why reporting option costs should in no way hamper young companies in their efforts to provide incentives. Options are indeed a powerful incentive, the authors agree, and failing to record a transaction that creates such powerful effects is economically indefensible. Worse, it encourages companies to favor options over alternative incentive systems. It is not the proper role of accounting standards, the authors argue, to distort executive and employee compensation by subsidizing one particular form of compensation and no other. Companies should choose compensation methods according to their economic benefits--not the way they are reported.

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

Zoberi, J.

Brachytherapy has proven to be an effective treatment option for prostate cancer. Initially, prostate brachytherapy was delivered through permanently implanted low dose rate (LDR) radioactive sources; however, high dose rate (HDR) temporary brachytherapy for prostate cancer is gaining popularity. Needle insertion during prostate brachytherapy is most commonly performed under ultrasound (U/S) guidance; however, treatment planning may be performed utilizing several imaging modalities either in an intra- or post-operative setting. During intra-operative prostate HDR, the needles are imaged during implantation, and planning may be performed in real time. At present, the most common imaging modality utilized for intra-operative prostate HDR ismore » U/S. Alternatively, in the post-operative setting, following needle implantation, patients may be simulated with computed tomography (CT) or magnetic resonance imaging (MRI). Each imaging modality and workflow provides its share of benefits and limitations. Prostate HDR has been adopted in a number of cancer centers across the nation. In this educational session, we will explore the role of U/S, CT, and MRI in HDR prostate brachytherapy. Example workflows and operational details will be shared, and we will discuss how to establish a prostate HDR program in a clinical setting. Learning Objectives: Review prostate HDR techniques based on the imaging modality Discuss the challenges and pitfalls introduced by the three imagebased options for prostate HDR brachytherapy Review the QA process and learn about the development of clinical workflows for these imaging options at different institutions.« less

High Blood Pressure (Hypertension)

MedlinePlus

... For Consumers Consumer Information by Audience For Women High Blood Pressure (Hypertension) Share Tweet Linkedin Pin it More sharing options ... En Español Who is at risk? How is high blood pressure treated? Understanding your blood pressure: What do the ...

Navy Littoral Combat Ship (LCS) Program: Background, Issues, and Options for Congress

DTIC Science & Technology

2011-01-20

response, including the time for reviewing instructions, searching existing data sources , gathering and maintaining the data needed, and completing and...Congressional Research Service 3 Figure 1. Lockheed LCS Design (Top) and General Dynamics LCS Design (Bottom) Source : Source : U.S. Navy file photo...according to an agreed apportionment (i.e., a “share line”). Any cost growth above the ceiling cost would be borne entirely by the contractor. The Navy

The Human Response to the Gander Military Air Disaster: A Summary Report

DTIC Science & Technology

1987-12-01

should be asserted by leaders in that it refocuses thinking toward the future. Training Strategies oo Formal classes on grief leadership should be...2. Family support group members should be given the option to volunteer their assistance to the formal death notification teams. This includes...chaplains avoided burnout by trusting others in helping roles to take over for them, scheduling time for rest, and sharing feelings and experiences with

The Right Tools for the Job--Technology Options for Adult Online Learning and Collaboration

ERIC Educational Resources Information Center

Regional Educational Laboratory, 2014

2014-01-01

Many options exist for using technology as a tool for adult learning, and each day, it becomes easier to share information online than it ever has been. Online learning technology has grown from one-sided communications to numerous options for audience engagement and interactivity. This guide introduces a variety of tools, online platforms, and…

Medication decision making and patient outcomes in GP, nurse and pharmacist prescriber consultations.

PubMed

Weiss, Marjorie C; Platt, Jo; Riley, Ruth; Chewning, Betty; Taylor, Gordon; Horrocks, Susan; Taylor, Andrea

2015-09-01

Aim The aims of this study were twofold: (a) to explore whether specific components of shared decision making were present in consultations involving nurse prescribers (NPs), pharmacist prescribers (PPs) and general practitioners (GPs) and (b) to relate these to self-reported patient outcomes including satisfaction, adherence and patient perceptions of practitioner empathy. There are a range of ways for defining and measuring the process of concordance, or shared decision making as it relates to decisions about medicines. As a result, demonstrating a convincing link between shared decision making and patient benefit is challenging. In the United Kingdom, nurses and pharmacists can now take on a prescribing role, engaging in shared decision making. Given the different professional backgrounds of GPs, NPs and PPs, this study sought to explore the process of shared decision making across these three prescriber groups. Analysis of audio-recordings of consultations in primary care in South England between patients and GPs, NPs and PPs. Analysis of patient questionnaires completed post consultation. Findings A total of 532 consultations were audio-recorded with 20 GPs, 19 NPs and 12 PPs. Prescribing decisions occurred in 421 (79%). Patients were given treatment options in 21% (102/482) of decisions, the prescriber elicited the patient's treatment preference in 18% (88/482) and the patient expressed a treatment preference in 24% (118/482) of decisions. PPs were more likely to ask for the patient's preference about their treatment regimen (χ 2=6.6, P=0.036, Cramer's V=0.12) than either NPs or GPs. Of the 275 patient questionnaires, 192(70%) could be matched with a prescribing decision. NP patients had higher satisfaction levels than patients of GPs or PPs. More time describing treatment options was associated with increased satisfaction, adherence and greater perceived practitioner empathy. While defining, measuring and enabling the process of shared decision making remains challenging, it may have patient benefit.

Paying for Cures: How Can We Afford It? Managed Care Pharmacy Stakeholder Perceptions of Policy Options to Address Affordability of Prescription Drugs.

PubMed

Yeung, Kai; Suh, Kangho; Basu, Anirban; Garrison, Louis P; Bansal, Aasthaa; Carlson, Josh J

2017-10-01

High-priced medications with curative potential, such as the newer hepatitis C therapies, have contributed to the recent growth in pharmaceutical expenditure. Despite the obvious benefits, health care decision makers are just beginning to grapple with questions of how to value and pay for curative therapies that may feature large upfront cost, followed by health benefits that are reaped over a patient's lifespan. Alternative policy options have been proposed to promote high value and financially sustainable use of these therapies. It is unclear which policy options would be most acceptable to health care payer and biomedical manufacturer stakeholders. To (a) briefly review pharmaceutical policy options to address health system affordability and (b) assess the acceptability of alternative policy options to health care payers and biomedical manufacturers before and after an Academy of Managed Care Pharmacy (AMCP) continuing pharmacy education (CPE) session. We searched MEDLINE and Cochran databases for pharmaceutical policy options addressing affordability. With input from a focus group of managed care professionals, we developed CPE session content and an 8-question survey focusing on the most promising policy options. We fielded the survey before and after the CPE session, which occurred as part of the 2016 AMCP Annual Meeting. We first conducted a chi-squared goodness-of-fit test to assess response distributions. Next, we tested how responses differed before and after by using an ordered logit and a multinomial logit to model Likert scale and unordered responses, respectively. Although risk-sharing payments over time remained the most favorable choice before (37%) and after (35%) the CPE session, this choice was closely followed by HealthCoin after the session, which increased in favorability from 4% to 33% of responses (P = 0.001). About half of the respondents (54%) indicated that legislative change is the most significant barrier to the implementation of any policy. As high-cost curative drugs reach the market, managed care stakeholders need information from a balanced education source regarding alternative policies to address affordability. We found that after the AMCP CPE session, risk-sharing payments over time and HealthCoin were the most favorable options. No funding was provided for this research. Carlson reports consulting fees from Genentech, Pfizer, and Seattle Genetics. The other authors have nothing to disclose. Study concept and design were contributed by Yeung, Garrison, and Carlson. Yeung collected the data, which were interpreted by Yeung and Basu. The manuscript was written by Yeung, Suh, and Bansal and revised by Yeung. A portion of this research was presented at the Academy of Managed Care & Specialty Pharmacy Annual Meeting as a continuing education session entitled "Paying for Cures: How Can We Afford It?" on April 20, 2016, in San Francisco, California.

The Evolving Market Structure of the U.S. Residential Solar PV Installation Industry, 2000-2016

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

OShaughnessy, Eric J

Market structure refers to the number of firms and the distribution of market shares among firms within an industry. In The Evolving Market Structure of the U.S. Residential Solar PV Installation Industry, 2000-2016, we examine market structure in the context of residential solar PV. We find that over 8,000 companies have installed at least one residential PV system, with about 2,900 companies active in 2016. The majority of residential PV installers are relatively small companies, with about half of installers installing fewer than five systems. At the same time, a subset of high-volume installers accumulated market share, especially beginning aroundmore » 2010 with the emergence of alternative customer financing options.« less

Navy Littoral Combat Ship (LCS) Program: Background, Issues, and Options for Congress

DTIC Science & Technology

2011-01-11

response, including the time for reviewing instructions, searching existing data sources , gathering and maintaining the data needed, and completing and... Source : Source : U.S. Navy file photo accessed by CRS at http://www.navy.mil/list_all.asp?id=57917 on January 6, 2010. Navy Littoral Combat Ship...above the target cost and up to the ceiling cost would be shared between the contractor and the Navy according to an agreed apportionment (i.e., a

Housing Options for Older Adults: A Guide for Making Housing Decisions

MedlinePlus

... from house sharing may have on eligibility for public benefits. ■ The effect of receiving Medicaid services on the ... facilities and whether the facility accepts individuals whose costs are paid by Medicaid. Benefits: Group housing options offer a wide range of ...

Dual career and job sharing - two careers or half a career?

NASA Astrophysics Data System (ADS)

Heilbronner, Renée; Stünitz, Holger

2017-04-01

One option for a dual career that is often considered is job sharing. After 20 years of job sharing during the most competitive years of our careers we would like to share a few thoughts on some of the problems we came across. The typical job sharing situation is one of a young couple about to found a family. However, this need not be the case, many alternative models are thinkable, few are actually liveable. The list of problems we came across includes: 1 - The hiring age for professors keeps dropping. This adds extra stress to the competitive post doc time 2 - Postdoc positions are not designed for dual career. ... and much less for job sharing. 3 - The higher the academic position the less likely it is offered for job sharing. - because it is claimed that leadership and responsibility cannot be shared. - because two half positions do indeed cost more than one whole (what hiring institutions fail to see is that they get two instead of one fully qualified scientists in return) - because they are difficult to plan: what happens if one partner leaves the department? 4 - Age difference of dual career partners Partners of different age have different qualifications and experiences. Usually the career of the more advanced partners is promoted more, the career of the second partner falls behind.

Genital surgery for disorders of sex development: implementing a shared decision-making approach.

PubMed

Karkazis, Katrina; Tamar-Mattis, Anne; Kon, Alexander A

2010-08-01

Ongoing controversy surrounds early genital surgery for children with disorders of sex development, making decisions about these procedures extraordinarily complex. Professional organizations have encouraged healthcare providers to adopt shared decision-making due to its broad potential to improve the decision-making process, perhaps most so when data are lacking, when there is no clear "best-choice" treatment, when decisions involve more than one choice, where each choice has both advantages and disadvantages, and where the ranking of options depends heavily on the decision-maker's values. We present a 6-step model for shared decision-making in decisions about genital surgery for disorders of sex development: (1) Set the stage and develop an appropriate team; (2) Establish preferences for information and roles in decision-making; (3) Perceive and address emotions; (4) Define concerns and values; (5) Identify options and present evidence; and (6) Share responsibility for making a decision. As long as controversy persists regarding surgery for DSD, an SDM process can facilitate the increased sharing of relevant information essential for making important health care decisions.

Decision-making in multiple sclerosis consultations in Italy: third observer and patient assessments.

PubMed

Pietrolongo, Erika; Giordano, Andrea; Kleinefeld, Monica; Confalonieri, Paolo; Lugaresi, Alessandra; Tortorella, Carla; Pugliatti, Maura; Radice, Davide; Goss, Claudia; Heesen, Christoph; Solari, Alessandra

2013-01-01

To assess decision-making in multiple sclerosis (MS) from third observer and patient perspectives. Audio recordings of first-ever consultations with a participating physician (88 outpatients, 10 physicians) at four tertiary MS care clinics in Italy, were rated by a third observer using the Observing Patient Involvement in Shared Decision Making (OPTION) and by patients using the Perceived Involvement in Care Scale (PICS). Mean patient age was 37.5, 66% were women, 72% had MS, and 28% had possible MS or other disease. Mean PICS subscale scores (range 0 poor, 100 best possible) were 71.9 (SD 24.3) for "physician facilitation" (PICS-F); 74.6 (SD 22.9) for "patient information exchange" (PICS-I); and only 22.5 (SD 16.2) for "patient decision making" (PICS-DM). Mean OPTION total score (0 poor, 100 best possible) was 29.6 (SD 10.3). Poorest OPTION scores were found for items assessing "preferred patient approach to receiving information" and "preferred patient level of involvement." Highest scores were for "clinician drawing attention to identified problem", "indicating need for decision making," and "need to review the decision." Consultation time, woman physician, patient-physician gender concordance and PICS-F were associated with higher OPTION total score; older physician and second opinion consultation were associated with lower OPTION score. In line with findings in other settings, our third observer findings indicated limited patient involvement abilities of MS physicians during first consultations. Patient perceptions of physician skills were better than third observers', although they correlated. Consultations with women physicians, and younger physicians, were associated with higher third observer and patient-based scores. Our findings reveal a need to empower Italian MS physicians with better communication and shared decision-making skills, and show in particular that attention to MS patient preferences for reception of information and involvement in health decisions, need to be improved.

Have a Baby or Young Child With a Cold? Most Don't Need Medicines

MedlinePlus

... With a Cough or Cold Don't Need Medicines Share Tweet Linkedin Pin it More sharing options ... the correct dose. Giving the Right Dose of Medicine “It’s easy to make errors with liquid medications. ...

Bad Reaction to Cosmetics?

MedlinePlus

... Yourself Health Fraud Bad Reactions to Cosmetics? Tell FDA! Share Tweet Linkedin Pin it More sharing options ... 日本語 | فارسی | English FDA Accessibility Careers FDA Basics FOIA No FEAR Act ...

MO-B-BRC-01: Introduction [Brachytherapy

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

Prisciandaro, J.

2016-06-15

Brachytherapy has proven to be an effective treatment option for prostate cancer. Initially, prostate brachytherapy was delivered through permanently implanted low dose rate (LDR) radioactive sources; however, high dose rate (HDR) temporary brachytherapy for prostate cancer is gaining popularity. Needle insertion during prostate brachytherapy is most commonly performed under ultrasound (U/S) guidance; however, treatment planning may be performed utilizing several imaging modalities either in an intra- or post-operative setting. During intra-operative prostate HDR, the needles are imaged during implantation, and planning may be performed in real time. At present, the most common imaging modality utilized for intra-operative prostate HDR ismore » U/S. Alternatively, in the post-operative setting, following needle implantation, patients may be simulated with computed tomography (CT) or magnetic resonance imaging (MRI). Each imaging modality and workflow provides its share of benefits and limitations. Prostate HDR has been adopted in a number of cancer centers across the nation. In this educational session, we will explore the role of U/S, CT, and MRI in HDR prostate brachytherapy. Example workflows and operational details will be shared, and we will discuss how to establish a prostate HDR program in a clinical setting. Learning Objectives: Review prostate HDR techniques based on the imaging modality Discuss the challenges and pitfalls introduced by the three imagebased options for prostate HDR brachytherapy Review the QA process and learn about the development of clinical workflows for these imaging options at different institutions.« less

Cooperative Drought Adaptation: Integrating Infrastructure Development, Conservation, and Water Transfers into Adaptive Policy Pathways

NASA Astrophysics Data System (ADS)

Zeff, H. B.; Characklis, G. W.; Reed, P. M.; Herman, J. D.

2015-12-01

Water supply policies that integrate portfolios of short-term management decisions with long-term infrastructure development enable utilities to adapt to a range of future scenarios. An effective mix of short-term management actions can augment existing infrastructure, potentially forestalling new development. Likewise, coordinated expansion of infrastructure such as regional interconnections and shared treatment capacity can increase the effectiveness of some management actions like water transfers. Highly adaptable decision pathways that mix long-term infrastructure options and short-term management actions require decision triggers capable of incorporating the impact of these time-evolving decisions on growing water supply needs. Here, we adapt risk-based triggers to sequence a set of potential infrastructure options in combination with utility-specific conservation actions and inter-utility water transfers. Individual infrastructure pathways can be augmented with conservation or water transfers to reduce the cost of meeting utility objectives, but they can also include cooperatively developed, shared infrastructure that expands regional capacity to transfer water. This analysis explores the role of cooperation among four water utilities in the 'Research Triangle' region of North Carolina by formulating three distinct categories of adaptive policy pathways: independent action (utility-specific conservation and supply infrastructure only), weak cooperation (utility-specific conservation and infrastructure development with regional transfers), and strong cooperation (utility specific conservation and jointly developed of regional infrastructure that supports transfers). Results suggest that strong cooperation aids the utilities in meeting their individual objections at substantially lower costs and with fewer irreversible infrastructure options.

MO-B-BRC-04: MRI-Based Prostate HDR

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

Mourtada, F.

2016-06-15

Brachytherapy has proven to be an effective treatment option for prostate cancer. Initially, prostate brachytherapy was delivered through permanently implanted low dose rate (LDR) radioactive sources; however, high dose rate (HDR) temporary brachytherapy for prostate cancer is gaining popularity. Needle insertion during prostate brachytherapy is most commonly performed under ultrasound (U/S) guidance; however, treatment planning may be performed utilizing several imaging modalities either in an intra- or post-operative setting. During intra-operative prostate HDR, the needles are imaged during implantation, and planning may be performed in real time. At present, the most common imaging modality utilized for intra-operative prostate HDR ismore » U/S. Alternatively, in the post-operative setting, following needle implantation, patients may be simulated with computed tomography (CT) or magnetic resonance imaging (MRI). Each imaging modality and workflow provides its share of benefits and limitations. Prostate HDR has been adopted in a number of cancer centers across the nation. In this educational session, we will explore the role of U/S, CT, and MRI in HDR prostate brachytherapy. Example workflows and operational details will be shared, and we will discuss how to establish a prostate HDR program in a clinical setting. Learning Objectives: Review prostate HDR techniques based on the imaging modality Discuss the challenges and pitfalls introduced by the three imagebased options for prostate HDR brachytherapy Review the QA process and learn about the development of clinical workflows for these imaging options at different institutions.« less

MO-B-BRC-00: Prostate HDR Treatment Planning - Considering Different Imaging Modalities

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

NONE

2016-06-15

Brachytherapy has proven to be an effective treatment option for prostate cancer. Initially, prostate brachytherapy was delivered through permanently implanted low dose rate (LDR) radioactive sources; however, high dose rate (HDR) temporary brachytherapy for prostate cancer is gaining popularity. Needle insertion during prostate brachytherapy is most commonly performed under ultrasound (U/S) guidance; however, treatment planning may be performed utilizing several imaging modalities either in an intra- or post-operative setting. During intra-operative prostate HDR, the needles are imaged during implantation, and planning may be performed in real time. At present, the most common imaging modality utilized for intra-operative prostate HDR ismore » U/S. Alternatively, in the post-operative setting, following needle implantation, patients may be simulated with computed tomography (CT) or magnetic resonance imaging (MRI). Each imaging modality and workflow provides its share of benefits and limitations. Prostate HDR has been adopted in a number of cancer centers across the nation. In this educational session, we will explore the role of U/S, CT, and MRI in HDR prostate brachytherapy. Example workflows and operational details will be shared, and we will discuss how to establish a prostate HDR program in a clinical setting. Learning Objectives: Review prostate HDR techniques based on the imaging modality Discuss the challenges and pitfalls introduced by the three imagebased options for prostate HDR brachytherapy Review the QA process and learn about the development of clinical workflows for these imaging options at different institutions.« less

MO-B-BRC-02: Ultrasound Based Prostate HDR

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

Chang, Z.

2016-06-15

Brachytherapy has proven to be an effective treatment option for prostate cancer. Initially, prostate brachytherapy was delivered through permanently implanted low dose rate (LDR) radioactive sources; however, high dose rate (HDR) temporary brachytherapy for prostate cancer is gaining popularity. Needle insertion during prostate brachytherapy is most commonly performed under ultrasound (U/S) guidance; however, treatment planning may be performed utilizing several imaging modalities either in an intra- or post-operative setting. During intra-operative prostate HDR, the needles are imaged during implantation, and planning may be performed in real time. At present, the most common imaging modality utilized for intra-operative prostate HDR ismore » U/S. Alternatively, in the post-operative setting, following needle implantation, patients may be simulated with computed tomography (CT) or magnetic resonance imaging (MRI). Each imaging modality and workflow provides its share of benefits and limitations. Prostate HDR has been adopted in a number of cancer centers across the nation. In this educational session, we will explore the role of U/S, CT, and MRI in HDR prostate brachytherapy. Example workflows and operational details will be shared, and we will discuss how to establish a prostate HDR program in a clinical setting. Learning Objectives: Review prostate HDR techniques based on the imaging modality Discuss the challenges and pitfalls introduced by the three imagebased options for prostate HDR brachytherapy Review the QA process and learn about the development of clinical workflows for these imaging options at different institutions.« less

The Distributional Impact of Social Security Policy Options.

PubMed

Couch, Kenneth A; Reznik, Gayle L; Tamborini, Christopher R; Iams, Howard M

2017-01-01

Using microsimulation, we estimate the effects of three policy proposals that would alter Social Security's eligibility rules or benefit structure to reflect changes in women's labor force activity, marital patterns, and differential mortality among the aged. First, we estimate a set of options related to the duration of marriage required to receive divorced spouse and survivor benefits. Second, we estimate the effects of an earnings sharing proposal with survivor benefits, in which benefits are based entirely on earned benefits with spouses sharing their earnings during years of marriage. Third, we estimate the effects of adjusting benefits to reflect the increasing differential life expectancy by lifetime earnings. The results advance our understanding of the distributional effects of these alternative policy options on projected benefits and retirement income, including poverty and supplemental poverty status, of divorced and widowed women aged 60 or older in 2030.

The High Cost of Saving Energy Dollars.

ERIC Educational Resources Information Center

Rose, Patricia

1985-01-01

In alternative financing a private company provides the capital and expertise for improving school energy efficiency. Savings are split between the school system and the company. Options for municipal leasing, cost sharing, and shared savings are explained along with financial, procedural, and legal considerations. (MLF)

Can streamlined multi-criteria decision analysis be used to implement shared decision making for colorectal cancer screening?

PubMed Central

Dolan, James G.; Boohaker, Emily; Allison, Jeroan; Imperiale, Thomas F.

2013-01-01

Background Current US colorectal cancer screening guidelines that call for shared decision making regarding the choice among several recommended screening options are difficult to implement. Multi-criteria decision analysis (MCDA) is an established methodology well suited for supporting shared decision making. Our study goal was to determine if a streamlined form of MCDA using rank order based judgments can accurately assess patients’ colorectal cancer screening priorities. Methods We converted priorities for four decision criteria and three sub-criteria regarding colorectal cancer screening obtained from 484 average risk patients using the Analytic Hierarchy Process (AHP) in a prior study into rank order-based priorities using rank order centroids. We compared the two sets of priorities using Spearman rank correlation and non-parametric Bland-Altman limits of agreement analysis. We assessed the differential impact of using the rank order-based versus the AHP-based priorities on the results of a full MCDA comparing three currently recommended colorectal cancer screening strategies. Generalizability of the results was assessed using Monte Carlo simulation. Results Correlations between the two sets of priorities for the seven criteria ranged from 0.55 to 0.92. The proportions of absolute differences between rank order-based and AHP-based priorities that were more than ± 0.15 ranged from 1% to 16%. Differences in the full MCDA results were minimal and the relative rankings of the three screening options were identical more than 88% of the time. The Monte Carlo simulation results were similar. Conclusion Rank order-based MCDA could be a simple, practical way to guide individual decisions and assess population decision priorities regarding colorectal cancer screening strategies. Additional research is warranted to further explore the use of these methods for promoting shared decision making. PMID:24300851

Shared decision making in endocrinology: present and future directions.

PubMed

Rodriguez-Gutierrez, Rene; Gionfriddo, Michael R; Ospina, Naykky Singh; Maraka, Spyridoula; Tamhane, Shrikant; Montori, Victor M; Brito, Juan P

2016-08-01

In medicine and endocrinology, there are few clinical circumstances in which clinicians can accurately predict what is best for their patients. As a result, patients and clinicians frequently have to make decisions about which there is uncertainty. Uncertainty results from limitations in the research evidence, unclear patient preferences, or an inability to predict how treatments will fit into patients' daily lives. The work that patients and clinicians do together to address the patient's situation and engage in a deliberative dialogue about reasonable treatment options is often called shared decision making. Decision aids are evidence-based tools that facilitate this process. Shared decision making is a patient-centred approach in which clinicians share information about the benefits, harms, and burden of different reasonable diagnostic and treatment options, and patients explain what matters to them in view of their particular values, preferences, and personal context. Beyond the ethical argument in support of this approach, decision aids have been shown to improve patients' knowledge about the available options, accuracy of risk estimates, and decisional comfort. Decision aids also promote patient participation in the decision-making process. Despite accumulating evidence from clinical trials, policy support, and expert recommendations in endocrinology practice guidelines, shared decision making is still not routinely implemented in endocrine practice. Additional work is needed to enrich the number of available tools and to implement them in practice workflows. Also, although the evidence from randomised controlled trials favours the use of this shared decision making in other settings, populations, and illnesses, the effect of this approach has been studied in a few endocrine disorders. Future pragmatic trials are needed to explore the effect and feasibility of shared decision making implementation into routine endocrinology and primary care practice. With the available evidence, however, endocrinologists can now start to practice shared decision making, partner with their patients, and use their expertise to formulate treatment plans that reflect patient preferences and are more likely to fit into the context of patients' lives. In this Personal View, we describe shared decision making, the evidence behind the approach, and why and how both endocrinologists and their patients could benefit from this approach. Copyright © 2016 Elsevier Ltd. All rights reserved.

Expensing options solves nothing.

PubMed

Sahlman, William A

2002-12-01

The use of stock options for executive compensation has become a lightning rod for public anger, and it's easy to see why. Many top executives grew hugely rich on the back of the gains they made on their options, profits they've been able to keep even as the value they were supposed to create disappeared. The supposed scam works like this: Current accounting regulations let companies ignore the cost of option grants on their income statements, so they can award valuable option packages without affecting reported earnings. Not charging the cost of the grants supposedly leads to overstated earnings, which purportedly translate into unrealistically high share prices, permitting top executives to realize big gains when they exercise their options. If an accounting anomaly is the problem, then the solution seems obvious: Write off executive share options against the current year's revenues. The trouble is, Sahlman writes, expensing option grants won't give us a more accurate view of earnings, won't add any information not already included in the financial statements, and won't even lead to equal treatment of different forms of executive pay. Far worse, expensing evades the real issue, which is whether compensation (options and other-wise) does what it's supposed to do--namely, help a company recruit, retain, and provide the right people with appropriate performance incentives. Any performance-based compensation system has the potential to encourage cheating. Only ethical management, sensible governance, adequate internal control systems, and comprehensive disclosure will save the investor from disaster. If, Sahlman warns, we pass laws that require the expensing of options, thinking that's fixed the fundamental flaws in corporate America's accounting, we will have missed a golden opportunity to focus on the much more extensive defects in the present system.

Feasibility and acceptability of shared decision-making to promote alcohol behavior change among women Veterans: Results from focus groups.

PubMed

Abraham, Traci H; Wright, Patricia; White, Penny; Booth, Brenda M; Cucciare, Michael A

2017-01-01

Although rates of unhealthy drinking are high among women Veterans with mental health comorbidities, most women Veterans with mental comorbidities who present to primary care with unhealthy drinking do not receive alcohol-related care. Barriers to alcohol-related treatment could be reduced through patient-centered approaches to care, such as shared decision-making. We assessed the feasibility and acceptability of a telephone-delivered shared decision-making intervention for promoting alcohol behavior change in women Veterans with unhealthy drinking and co-morbid depression and/or probable post-traumatic stress disorder. We used 3, 2-hour focus group discussions with 19 women Veterans to identify barriers and solicit recommendations for using the intervention with women Veterans who present to primary care with unhealthy drinking and mental health comorbidities. Transcripts from the focus groups were qualitatively analyzed using template analysis. Although participants perceived that the intervention was feasible and acceptable for the targeted patient population, they identified the treatment delivery modality, length of telephone sessions, and some of the option grid content as potential barriers. Facilitators included strategies for enhancing the telephone-delivered shared decision-making sessions and diversifying the treatment options contained in the option grids. Focus group feedback resulted in preliminary adaptations to the intervention that are mindful of women Veterans' individual preferences for care and realistic in the everyday context of their busy lives.

Computer conferencing: Choices and strategies

NASA Technical Reports Server (NTRS)

Smith, Jill Y.

1991-01-01

Computer conferencing permits meeting through the computer while sharing a common file. The primary advantages of computer conferencing are that participants may (1) meet simultaneously or nonsimultaneously, and (2) contribute across geographic distance and time zones. Due to these features, computer conferencing offers a viable meeting option for distributed business teams. Past research and practice is summarized denoting practical uses of computer conferencing as well as types of meeting activities ill suited to the medium. Additionally, effective team strategies are outlined which maximize the benefits of computer conferencing.

Maniac Talk- Ralph Kahn

NASA Image and Video Library

2016-02-01

Ralph Kahn Maniac Lecture, February 1, 2016 NASA climate scientist Ralph Kahn presented a Maniac lecture entitled, "The Stories Data Tell." At an early age, Ralph found that separating causality from coincidence can be the lynchpin of understanding, and at times can help identify prerogatives or highlight the path toward the better options. Ralph shared his experiences, professional, personal, and at the intersection of the two, where the difference seemed to matter. And how data can help address this challenge, providing evidence one way or the other - sometimes!

Improving team information sharing with a structured call-out in anaesthetic emergencies: a randomized controlled trial.

PubMed

Weller, J M; Torrie, J; Boyd, M; Frengley, R; Garden, A; Ng, W L; Frampton, C

2014-06-01

Sharing information with the team is critical in developing a shared mental model in an emergency, and fundamental to effective teamwork. We developed a structured call-out tool, encapsulated in the acronym 'SNAPPI': Stop; Notify; Assessment; Plan; Priorities; Invite ideas. We explored whether a video-based intervention could improve structured call-outs during simulated crises and if this would improve information sharing and medical management. In a simulation-based randomized, blinded study, we evaluated the effect of the video-intervention teaching SNAPPI on scores for SNAPPI, information sharing, and medical management using baseline and follow-up crisis simulations. We assessed information sharing using a probe technique where nurses and technicians received unique, clinically relevant information probes before the simulation. Shared knowledge of probes was measured in a written, post-simulation test. We also scored sharing of diagnostic options with the team and medical management. Anaesthetists' scores for SNAPPI were significantly improved, as was the number of diagnostic options they shared. We found a non-significant trend to improve information-probe sharing and medical management in the intervention group, and across all simulations, a significant correlation between SNAPPI and information-probe sharing. Of note, only 27% of the clinically relevant information about the patient provided to the nurse and technician in the pre-simulation information probes was subsequently learnt by the anaesthetist. We developed a structured communication tool, SNAPPI, to improve information sharing between anaesthetists and their team, taught it using a video-based intervention, and provide initial evidence to support its value for improving communication in a crisis. © The Author [2014]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Prostate Cancer: A Contemporary Approach to Treatment and Outcomes.

PubMed

Weiner, Adam B; Kundu, Shilajit D

2018-03-01

Given the high incidence of prostate cancer and the need for shared decision-making before screening, it is imperative that primary care providers understand treatment options and treatment adverse effects. In this review article, the treatment options for the localized and metastatic prostate cancer are discussed, including the different modalities and their indications, adverse effects, oncologic outcomes, posttreatment monitoring, and potential treatment options following cancer recurrence. Copyright © 2017 Elsevier Inc. All rights reserved.

Risk-prone individuals prefer the wrong options on a rat version of the Iowa Gambling Task.

PubMed

Rivalan, Marion; Ahmed, Serge H; Dellu-Hagedorn, Françoise

2009-10-15

Decision making in complex and conflicting situations, as measured in the widely used Iowa Gambling Task (IGT), can be profoundly impaired in psychiatric disorders, such as attention-deficit/hyperactivity disorder, drug addiction, and also in healthy individuals for whom immediate gratification prevails over long-term gain. The cognitive processes underlying these deficits are poorly understood, in part due to a lack of suitable animal models assessing complex decision making with good construct validity. We developed a rat gambling task analogous to the IGT that tracks, for the first time, the ongoing decision process within a single session in an operant cage. Rats could choose between various options. Disadvantageous options, as opposed to advantageous ones, offered bigger immediate food reward but were followed by longer, unpredictable penalties (time-out). The majority of rats can evaluate and deduce favorable options more or less rapidly according to task complexity, whereas others systematically choose disadvantageously. These interindividual differences are stable over time and do not depend on task difficulty or on the level of food restriction. We find that poor decision making does not result from a failure to acquire relevant information but from hypersensitivity to reward and higher risk taking in anxiogenic situations. These results suggest that rats, as well as human poor performers, share similar traits to those observed in decision-making related psychiatric disorders. These traits could constitute risk factors of developing such disorders. The rapid identification of poor decision makers using the rat gambling task should promote the discovery of the specific brain dysfunctions that cause maladapted decision making.

78 FR 4955 - Self-Regulatory Organizations; NYSE Arca, Inc.; Order Granting Approval of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-23

... of the $2 per share premium, so the net loss to the Index's value would be $5.50 per share on the ABC... strike price, then the option expires worthless and the entire amount of the premium payment is retained... for a premium of $2 per share: Settlement at or above the strike price: If at the end of 60 days the...

The impact of public transportation strikes on use of a bicycle share program in London: interrupted time series design.

PubMed

Fuller, Daniel; Sahlqvist, Shannon; Cummins, Steven; Ogilvie, David

2012-01-01

To investigate the immediate and sustained effects of two London Underground strikes on use of a public bicycle share program. An interrupted time series design was used to examine the impact of two 24 hour strikes on the total number of trips per day and mean trip duration per day on the London public bicycle share program. The strikes occurred on September 6th and October 4th 2010 and limited service on the London Underground. The mean total number of trips per day over the whole study period was 14,699 (SD=5390) while the mean trip duration was 18.5 minutes (SD=3.7). Significant increases in daily trip count were observed following strike 1 (3864: 95% CI 125 to 7604) and strike 2 (11,293: 95% CI 5169 to 17,416). Events that greatly constrain the primary motorised mode of transportation for a population may have unintended short-term effects on travel behaviour. These findings suggest that limiting transportation options may have the potential to increase population levels of physical activity by promoting the use of cycling. Copyright © 2011 Elsevier Inc. All rights reserved.

Self-Esteem and Sharing in Fourth-Grade Children.

ERIC Educational Resources Information Center

Miller, Shirley M.; And Others

1981-01-01

Children (N=64) in a fourth-grade class were given 20 tokens for drawing a picture and then had the option of donating any or all of the tokens to either "needy children" or for "a class prize." Sharing with needy children was positively correlated with self-esteem. (Author)

On a learning curve for shared decision making: Interviews with clinicians using the knee osteoarthritis Option Grid.

PubMed

Elwyn, Glyn; Rasmussen, Julie; Kinsey, Katharine; Firth, Jill; Marrin, Katy; Edwards, Adrian; Wood, Fiona

2018-02-01

Tools used in clinical encounters to illustrate to patients the risks and benefits of treatment options have been shown to increase shared decision making. However, we do not have good information about how these tools are viewed by clinicians and how clinicians think patients would react to their use. Our aim was to examine clinicians' views about the possible and actual use of tools designed to support patients and clinicians to collaborate and deliberate about treatment options, namely, Option Grid decision aids. We conducted a thematic analysis of qualitative interviews embedded in the intervention phase of a trial of an Option Grid decision aid for osteoarthritis of the knee. Interviews were conducted with 6 participating clinicians before they used the tool and again after clinicians had used the tool with 6 patients. In the first interview, clinicians voiced concerns that the tool would lead to an increase in encounter duration, patient resistance regarding involvement in decision making, and potential information overload. At the second interview, after minimal training, the clinicians reported that the tool had changed their usual way of communicating, and it was generally acceptable and helpful to integrate it into practice. After experiencing the use of Option Grids, clinicians became more willing to use the tools in their clinical encounters with patients. How best to introduce Option Grids to clinicians and adopt their use into practice will need careful consideration of context, workflow, and clinical pathways. © 2016 John Wiley & Sons, Ltd.

IT Research Services: Powerful Tools to Track a Fast Moving Industry

NASA Technical Reports Server (NTRS)

Hunter, Paul

2010-01-01

Research services change and evolve over time, sometimes suddenly, in their focus, topics, formats, service model, etc. You have to check in often. Some offer products that you can customize to your environment, others not so much. You will find a variation in customer management practices (e.g., when and how they share information) ...can sometimes be annoying. Assess your needs carefully. Each research service has a very different service model. Explore ways to share or lower the cost. Someone out there may share the expense when that is an option. Make sure you read the small print. It can work for you as well as against you. When in doubt, ask your Vendor's POC. Set up Research Service "gurus or SME's." Not to violate the copyright agreement of course, just have someone who knows what's there. After you subscribe, reassess.Get the most out of your investment. Some early enthusiasts will fade, and there will be others who don't know it's there and can use it.

How can clinical practice guidelines be adapted to facilitate shared decision making? A qualitative key-informant study.

PubMed

van der Weijden, Trudy; Pieterse, Arwen H; Koelewijn-van Loon, Marije S; Knaapen, Loes; Légaré, France; Boivin, Antoine; Burgers, Jako S; Stiggelbout, Anne M; Faber, Marjan; Elwyn, Glyn

2013-10-01

To explore how clinical practice guidelines can be adapted to facilitate shared decision making. This was a qualitative key-informant study with group discussions and semi-structured interviews. First, 75 experts in guideline development or shared decision making participated in group discussions at two international conferences. Next, health professionals known as experts in depression or breast cancer, experts on clinical practice guidelines and/or shared decision making, and patient representatives were interviewed (N=20). Using illustrative treatment decisions on depression or breast cancer, we asked the interviewees to indicate as specifically as they could how guidelines could be used to facilitate shared decision making. Interviewees suggested some generic strategies, namely to include a separate chapter on the importance of shared decision making, to use language that encourages patient involvement, and to develop patient versions of guidelines. Recommendation-specific strategies, related to specific decision points in the guideline, were also suggested: These include structuring the presentation of healthcare options to increase professionals' option awareness; structuring the deliberation process between professionals and patients; and providing relevant patient support tools embedded at important decision points in the guideline. This study resulted in an overview of strategies to adapt clinical practice guidelines to facilitate shared decision making. Some strategies seemed more contentious than others. Future research should assess the feasibility and impact of these strategies to make clinical practice guidelines more conducive to facilitate shared decision making.

78 FR 6382 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-30

... shares other than 100.\\8\\ Moreover, the concept of listing and trading parallel options products of... terms of the Options Disclosure Document. With regard to the impact of this proposal on system capacity... Authority (``OPRA'') have the necessary systems capacity to handle the potential additional traffic...

78 FR 6391 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-30

... shares other than 100.\\8\\ Moreover, the concept of listing and trading parallel options products of... system capacity, the Exchange has analyzed its capacity and represents that it and the Options Price Reporting Authority (``OPRA'') have the necessary systems capacity to handle the potential additional...

26 CFR 1.422-1 - Incentive stock options; general rules.

Code of Federal Regulations, 2010 CFR

2010-04-01

... an option ceased employment because of permanent and total disability, within the meaning of section... from the inclusion of that amount in A's gross income as compensation attributable to the exercise of... $225 (the $100 paid for the share plus the $125 increase in basis resulting from the inclusion of that...

Counseling women with early pregnancy failure: utilizing evidence, preserving preference.

PubMed

Wallace, Robin R; Goodman, Suzan; Freedman, Lori R; Dalton, Vanessa K; Harris, Lisa H

2010-12-01

To apply principles of shared decision-making to EPF management counseling. To present a patient treatment priority checklist developed from review of available literature on patient priorities for EPF management. Review of evidence for patient preferences; personal, emotional, physical and clinical factors that may influence patient priorities for EPF management; and the clinical factors, resources, and provider bias that may influence current practice. Women have strong and diverse preferences for EPF management and report higher satisfaction when treated according to these preferences. However, estimates of actual treatment patterns suggest that current practice does not reflect the evidence for safety and acceptability of all options, or patient preferences. Multiple practice barriers and biases exist that may be influencing provider counseling about options for EPF management. Choosing management for EPF is a preference-sensitive decision. A patient-centered approach to EPF management should incorporate counseling about all treatment options. Providers can integrate a counseling model into EPF management practice that utilizes principles of shared decision-making and an organized method for eliciting patient preferences, priorities, and concerns about treatment options. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Defense Health Care: Department of Defense Needs a Strategic Approach to Contracting for Health Care Professionals

DTIC Science & Technology

2013-05-01

DOD identify, develop, and implement joint medical personnel standards for shared services .22 While DOD concurred with our recommendation, as of...a defense health agency in part to assume the responsibility for creating and managing shared services , and leave the military chain of command...intact with the military departments in control of their military treatment facilities. This option would include a shared services concept to

Decision making in pediatric oncology: Views of parents and physicians in two European countries.

PubMed

Badarau, Domnita O; Ruhe, Katharina; Kühne, Thomas; De Clercq, Eva; Colita, Anca; Elger, Bernice S; Wangmo, Tenzin

2017-01-01

Decision making is a highly complex task when providing care for seriously ill children. Physicians, parents, and children face many challenges when identifying and selecting from available treatment options. This qualitative interview study explored decision-making processes for children with cancer at different stages in their treatment in Switzerland and Romania. Thematic analysis of interviews conducted with parents and oncologists identified decision making as a heterogeneous process in both countries. Various decisions were made based on availability and reasonableness of care options. In most cases, at the time of diagnosis, parents were confronted with a "choiceless choice"-that is, there was only one viable option (a standard protocol), and physicians took the lead in making decisions significant for health outcomes. Parents' and sometimes children's role increased during treatment when they had to make decisions regarding research participation and aggressive therapy or palliative care. Framing these results within the previously described Decisional Priority in Pediatric Oncology Model (DPM) highlights family's more prominent position when making elective decisions regarding quality-of-life or medical procedures, which had little effect on health outcomes. The interdependency between oncologists, parents, and children is always present. Communication, sharing of information, and engaging in discussions about preferences, values, and ultimately care goals should be decision making's foundation. Patient participation in these processes was reported as sometimes limited, but parents and oncologists should continue to probe patients' abilities and desire to be involved in decision making. Future research should expand the DPM and explore how decisional priority and authority can be shared by oncologists with parents and even patients.

Challenges in shared decision making in advanced cancer care: a qualitative longitudinal observational and interview study.

PubMed

Brom, Linda; De Snoo-Trimp, Janine C; Onwuteaka-Philipsen, Bregje D; Widdershoven, Guy A M; Stiggelbout, Anne M; Pasman, H Roeline W

2017-02-01

Patients' preferences and expectations should be taken into account in treatment decision making in the last phase of life. Shared decision making (SDM) is regarded as a way to give the patient a central role in decision making. Little is known about how SDM is used in clinical practice in advanced cancer care. To examine whether and how the steps of SDM can be recognized in decision making about second- and third-line chemotherapy. Fourteen advanced cancer patients were followed over time using face-to-face in-depth interviews and observations of the patients' out-clinic visits. Interviews and outpatient clinic visits in which treatment options were discussed or decisions made were transcribed verbatim and analysed using open coding. Patients were satisfied with the decision-making process, but the steps of SDM were barely seen in daily practice. The creation of awareness about available treatment options by physicians was limited and not discussed in an equal way. Patients' wishes and concerns were not explicitly assessed, which led to different expectations about improved survival from subsequent lines of chemotherapy. To reach SDM in daily practice, physicians should create awareness of all treatment options, including forgoing treatment, and communicate the risk of benefit and harm. Open and honest communication is needed in which patients' expectations and concerns are discussed. Through this, the difficult process of decision making in the last phase of life can be facilitated and the focus on the best care for the specific patient is strengthened. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Shared decision-making to improve attention-deficit hyperactivity disorder care.

PubMed

Brinkman, William B; Hartl Majcher, Jessica; Poling, Lauren M; Shi, Gaoyan; Zender, Mike; Sucharew, Heidi; Britto, Maria T; Epstein, Jeffery N

2013-10-01

To examine the effect of a shared decision-making intervention with parents of children newly diagnosed with attention-deficit/hyperactivity disorder. Seven pediatricians participated in a pre/post open trial of decision aids for use before and during the office visit to discuss diagnosis and develop a treatment plan. Encounters pre- (n=21, control group) and post-intervention implementation (n=33, intervention group) were compared. We video-recorded encounters and surveyed parents. Compared to controls, intervention group parents were more involved in shared decision-making (31.2 vs. 43.8 on OPTION score, p<0.01), more knowledgeable (6.4 vs. 8.1 questions correct, p<0.01), and less conflicted about treatment options (16.2 vs. 10.7 on decisional conflict total score, p=0.06). Visit duration was unchanged (41.0 vs. 41.6min, p=0.75). There were no significant differences in the median number of follow-up visits (0 vs. 1 visits, p=0.08), or the proportion of children with medication titration (62% vs. 76%, p=0.28), or parent-completed behavior rating scale to assess treatment response (24% vs. 39%, p=0.36). Our intervention increased shared decision-making with parents. Parents were better informed about treatment options without increasing visit duration. Interventions are available to prepare parents for visits and enable physicians to elicit parent preferences and involvement in decision-making. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Sharing the Wealth: Factors Influencing Resource Allocation in the Sharing Game

ERIC Educational Resources Information Center

Fantino, Edmund; Kennelly, Arthur

2009-01-01

Students chose between two allocation options, one that gave the allocator more and another participant still more (the "optimal" choice) and one which gave the allocator less and the other participant still less (the "competitive" choice). In a within-subjects design, students' behavior patterns were significantly correlated across the two rounds…

75 FR 81977 - Order Exempting the Trading and Clearing of Certain Products Related to the CBOE Gold ETF...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

... derivatives transaction execution facility for transactions for future delivery in any commodity under section... categorical Section 4(c) exemption to permit options and futures on shares of all or some precious metal commodity-based ETFs to be traded and cleared as options on securities and security futures, respectively...

75 FR 14646 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-26

... Organizations; International Securities Exchange, LLC; Notice of Filing of Proposed Rule Change To List and... ``Commission'') authorized ISE to list and trade options on the SPDR Gold Trust,\\3\\ the iShares COMEX Gold... Exchange proposes to list and trade options on the ETFS Palladium Trust and the ETFS Platinum Trust. \\3...

Applying Marketing in the Public School Setting

ERIC Educational Resources Information Center

Pettinga, Deidre M.; Angelov, Azure D. S.; Bateman, David F.

2015-01-01

Traditional public schools no longer have a guaranteed market share of students, or tax dollars, based on geographic location. Families with little to no options in the past about where their child would attend school, now have many. In response to the expanding options available to them--in the form of charter schools and vouchers--families today…

77 FR 6160 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Order Granting Approval of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-07

... SLV and USO strike price intervals. \\4\\ The Exchange also proposed certain non-substantive changes to... Strike Price Intervals for SLV and USO Options February 1, 2012. I. Introduction On December 7, 2011...-4 thereunder,\\2\\ a proposed rule change regarding strike price intervals for options on iShares[reg...

A structured multi-stakeholder learning process for Sustainable Land Management.

PubMed

Schwilch, Gudrun; Bachmann, Felicitas; Valente, Sandra; Coelho, Celeste; Moreira, Jorge; Laouina, Abdellah; Chaker, Miloud; Aderghal, Mohamed; Santos, Patricia; Reed, Mark S

2012-09-30

There are many, often competing, options for Sustainable Land Management (SLM). Each must be assessed - and sometimes negotiated - prior to implementation. Participatory, multi-stakeholder approaches to identification and selection of SLM options are increasingly popular, often motivated by social learning and empowerment goals. Yet there are few practical tools for facilitating processes in which land managers may share, select, and decide on the most appropriate SLM options. The research presented here aims to close the gap between the theory and the practice of stakeholder participation/learning in SLM decision-making processes. The paper describes a three-part participatory methodology for selecting SLM options that was tested in 14 desertification-prone study sites within the EU-DESIRE project. Cross-site analysis and in-depth evaluation of the Moroccan and Portuguese sites were used to evaluate how well the proposed process facilitated stakeholder learning and selection of appropriate SLM options for local implementation. The structured nature of the process - starting with SLM goal setting - was found to facilitate mutual understanding and collaboration between stakeholders. The deliberation process led to a high degree of consensus over the outcome and, though not an initial aim, it fostered social learning in many cases. This solution-oriented methodology is applicable in a wide range of contexts and may be implemented with limited time and resources. Copyright © 2012 Elsevier Ltd. All rights reserved.

Can't get no satisfaction? Will pay for performance help?: toward an economic framework for understanding performance-based risk-sharing agreements for innovative medical products.

PubMed

Towse, Adrian; Garrison, Louis P

2010-01-01

This article examines performance-based risk-sharing agreements for pharmaceuticals from a theoretical economic perspective. We position these agreements as a form of coverage with evidence development. New performance-based risk sharing could produce a more efficient market equilibrium, achieved by adjustment of the price post-launch to reflect outcomes combined with a new approach to the post-launch costs of evidence collection. For this to happen, the party best able to manage or to bear specific risks must do so. Willingness to bear risk will depend not only on ability to manage it, but on the degree of risk aversion. We identify three related frameworks that provide relevant insights: value of information, real option theory and money-back guarantees. We identify four categories of risk sharing: budget impact, price discounting, outcomes uncertainty and subgroup uncertainty. We conclude that a value of information/real option framework is likely to be the most helpful approach for understanding the costs and benefits of risk sharing. There are a number of factors that are likely to be crucial in determining if performance-based or risk-sharing agreements are efficient and likely to become more important in the future: (i) the cost and practicality of post-launch evidence collection relative to pre-launch; (ii) the feasibility of coverage with evidence development without a pre-agreed contract as to how the evidence will be used to adjust price, revenues or use, in which uncertainty around the pay-off to additional research will reduce the incentive for the manufacturer to collect the information; (iii) the difficulty of writing and policing risk-sharing agreements; (iv) the degree of risk aversion (and therefore opportunity to trade) on the part of payers and manufacturers; and (v) the extent of transferability of data from one country setting to another to support coverage with evidence development in a risk-sharing framework. There is no doubt that--in principle--risk sharing can provide manufacturers and payers additional real options that increase overall efficiency. Given the lack of empirical evidence on the success of schemes already agreed and on the issues we set out above, it is too early to tell if the recent surge of interest in these arrangements is likely to be a trend or only a fad.

Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2018; Amendments to Special Enrollment Periods and the Consumer Operated and Oriented Plan Program. Final rule.

PubMed

2016-12-22

This final rule sets forth payment parameters and provisions related to the risk adjustment program; cost-sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges and State-based Exchanges on the Federal platform. It also provides additional guidance relating to standardized options; qualified health plans; consumer assistance tools; network adequacy; the Small Business Health Options Programs; stand-alone dental plans; fair health insurance premiums; guaranteed availability and guaranteed renewability; the medical loss ratio program; eligibility and enrollment; appeals; consumer-operated and oriented plans; special enrollment periods; and other related topics.

Trying to optimise the German version of the OPTION scale regarding the dyadic aspect of shared decision making.

PubMed

Keller, H; Hirsch, O; Müller-Engelmann, M; Heinzel-Gutenbrunner, M; Krones, T; Donner-Banzhoff, N

2013-01-01

The OPTION scale ("observing patient involvement in decision making") assesses the extent to which clinicians involve patients in decisions across a range of situations in clinical practice. It so far just covers physician behavior. We intended to modify the scoring of the OPTION scale to incorporate active patient behavior in consultations. Modification was done on scoring level, attempting a dyadic, relationship-centred approach in that high ratings can be evoked also by the behaviour of active patients. The German version of the OPTION scale was compared with a modified version by analysing video recordings of primary care consultations dealing with cardiovascular prevention. Fifteen general practitioners provided 40 videotaped consultations. Videos were analysed by two rater pairs and two experts in shared decision making (SDM). Reliability measures of the modified version were lower than those of the original scale. Significant associations of the dichotomised scale with the expert SDM rating as well as with physicians' expertise in SDM were only found for the modified OPTION scale. Receiver Operating Characteristic (ROC) analyses confirmed a valid differentiation between the presence of SDM (yes/no) on total score level, even though the cut-off point was quite low. Standard deviations of the single items in the modified version were higher compared to the original OPTION scale, while the means of total scores were similar. The original OPTION scale is physician-centered and neglects the activity and a possible self-involvement of the patient. Our modified instruction was able to capture the dyadic element partially. The development of a separate dyadic instrument might be more promising.

The logic of job-sharing in the provision and delivery of health care.

PubMed

Branine, M

1998-01-01

By definition the practice of job-sharing starts from the premiss that there is a full-time job to be shared by those who want to balance their work with other commitments. In a public sector institution, such as the National Health Service (NHS), where most employees are female, it seems logical to believe that a job-sharing policy would be able to promote equal opportunities, to increase employee job satisfaction and to reduce labour costs. Hence, this paper attempts to discuss the advantages and disadvantages of having a job-sharing policy, and to analyse the reasons for the limited number of job-sharers in the NHS despite the apparent benefits of job-sharing to both the employees and the employer. This study was carried out in 15 NHS Trusts in northern England and Scotland, by the use of questionnaires and interviews, and found that most NHS managers did not see the practice of job-sharing as a major cost-saving opportunity or as a working pattern that would enhance employee satisfaction and commitment. They saw job-sharing as just a routine equal opportunities request which did not deserve such managerial attention or long-term strategic thinking. It is argued in this paper that job-sharing is a potentially useful option against a background of demographic and other social and economic changes which require the development and use of long-term strategic policies. Therefore it is concluded that, in the NHS, there is a need for a more active and creative approach to job-sharing rather than the reactive and passive approach that has dominated the practice so far.

The logic of job-sharing in the provision and delivery of health care.

PubMed

Branine, M

1998-01-01

By definition the practice of job-sharing starts from the premiss that there is a full-time job to be shared by those who want to balance their work with other commitments. In a public sector institution, such as the National Health Service (NHS), where most employees are female, it seems logical to believe that a job-sharing policy would be able to promote equal opportunities, to increase employee job satisfaction and to reduce labour costs. Hence, this paper attempts to discuss the advantages and disadvantages of having a job-sharing policy, and to analyse the reasons for the limited number of job-sharers in the NHS despite the apparent benefits of job-sharing to both the employees and the employer. This study was carried out in 15 NHS Trusts in northern England and Scotland, by the use of questionnaires and interviews, and found that most NHS managers did not see the practice of job-sharing as a major cost-saving opportunity or as a working pattern that would enhance employee satisfaction and commitment. They saw job-sharing as just a routine equal opportunities request which did not deserve such managerial attention or long-term strategic thinking. It is argued in this paper that job-sharing is a potentially useful option against a background of demographic and other social and economic changes which require the development and use of long-term strategic policies. Therefore, it is concluded that, in the NHS, there is a need for a more active and creative approach to job-sharing, rather than the reactive and passive approach that has dominated the practice so far.

How Do Astronomers Share Data? Reliability and Persistence of Datasets Linked in AAS Publications and a Qualitative Study of Data Practices among US Astronomers

PubMed Central

Pepe, Alberto; Goodman, Alyssa; Muench, August; Crosas, Merce; Erdmann, Christopher

2014-01-01

We analyze data sharing practices of astronomers over the past fifteen years. An analysis of URL links embedded in papers published by the American Astronomical Society reveals that the total number of links included in the literature rose dramatically from 1997 until 2005, when it leveled off at around 1500 per year. The analysis also shows that the availability of linked material decays with time: in 2011, 44% of links published a decade earlier, in 2001, were broken. A rough analysis of link types reveals that links to data hosted on astronomers' personal websites become unreachable much faster than links to datasets on curated institutional sites. To gauge astronomers' current data sharing practices and preferences further, we performed in-depth interviews with 12 scientists and online surveys with 173 scientists, all at a large astrophysical research institute in the United States: the Harvard-Smithsonian Center for Astrophysics, in Cambridge, MA. Both the in-depth interviews and the online survey indicate that, in principle, there is no philosophical objection to data-sharing among astronomers at this institution. Key reasons that more data are not presently shared more efficiently in astronomy include: the difficulty of sharing large data sets; over reliance on non-robust, non-reproducible mechanisms for sharing data (e.g. emailing it); unfamiliarity with options that make data-sharing easier (faster) and/or more robust; and, lastly, a sense that other researchers would not want the data to be shared. We conclude with a short discussion of a new effort to implement an easy-to-use, robust, system for data sharing in astronomy, at theastrodata.org, and we analyze the uptake of that system to-date. PMID:25165807

How do astronomers share data? Reliability and persistence of datasets linked in AAS publications and a qualitative study of data practices among US astronomers.

PubMed

Pepe, Alberto; Goodman, Alyssa; Muench, August; Crosas, Merce; Erdmann, Christopher

2014-01-01

We analyze data sharing practices of astronomers over the past fifteen years. An analysis of URL links embedded in papers published by the American Astronomical Society reveals that the total number of links included in the literature rose dramatically from 1997 until 2005, when it leveled off at around 1500 per year. The analysis also shows that the availability of linked material decays with time: in 2011, 44% of links published a decade earlier, in 2001, were broken. A rough analysis of link types reveals that links to data hosted on astronomers' personal websites become unreachable much faster than links to datasets on curated institutional sites. To gauge astronomers' current data sharing practices and preferences further, we performed in-depth interviews with 12 scientists and online surveys with 173 scientists, all at a large astrophysical research institute in the United States: the Harvard-Smithsonian Center for Astrophysics, in Cambridge, MA. Both the in-depth interviews and the online survey indicate that, in principle, there is no philosophical objection to data-sharing among astronomers at this institution. Key reasons that more data are not presently shared more efficiently in astronomy include: the difficulty of sharing large data sets; over reliance on non-robust, non-reproducible mechanisms for sharing data (e.g. emailing it); unfamiliarity with options that make data-sharing easier (faster) and/or more robust; and, lastly, a sense that other researchers would not want the data to be shared. We conclude with a short discussion of a new effort to implement an easy-to-use, robust, system for data sharing in astronomy, at theastrodata.org, and we analyze the uptake of that system to-date.

How Do Astronomers Share Data? Reliability and Persistence of Datasets Linked in AAS Publications and a Qualitative Study of Data Practices among US Astronomers

NASA Astrophysics Data System (ADS)

Pepe, Alberto; Goodman, Alyssa; Muench, August; Crosas, Merce; Erdmann, Christopher

2014-08-01

We analyze data sharing practices of astronomers over the past fifteen years. An analysis of URL links embedded in papers published by the American Astronomical Society reveals that the total number of links included in the literature rose dramatically from 1997 until 2005, when it leveled off at around 1500 per year. The analysis also shows that the availability of linked material decays with time: in 2011, 44% of links published a decade earlier, in 2001, were broken. A rough analysis of link types reveals that links to data hosted on astronomers' personal websites become unreachable much faster than links to datasets on curated institutional sites. To gauge astronomers' current data sharing practices and preferences further, we performed in-depth interviews with 12 scientists and online surveys with 173 scientists, all at a large astrophysical research institute in the United States: the Harvard-Smithsonian Center for Astrophysics, in Cambridge, MA. Both the in-depth interviews and the online survey indicate that, in principle, there is no philosophical objection to data-sharing among astronomers at this institution. Key reasons that more data are not presently shared more efficiently in astronomy include: the difficulty of sharing large data sets; over reliance on non-robust, non-reproducible mechanisms for sharing data (e.g. emailing it); unfamiliarity with options that make data-sharing easier (faster) and/or more robust; and, lastly, a sense that other researchers would not want the data to be shared. We conclude with a short discussion of a new effort to implement an easy-to-use, robust, system for data sharing in astronomy, at theastrodata.org, and we analyze the uptake of that system to-date.

The Evolving Market Structure of the U.S. Residential Solar PV Installation Industry, 2000-2016

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

OShaughnessy, Eric J.

This study uses data on over 900,000 solar PV installations to summarize the evolving market structure of the U.S. residential solar PV installation industry. Over 8,000 companies have installed residential PV systems in the United States. The vast majority of these installers are small local companies. At the same time, a subset of national-scale high-volume PV installation companies hold high market shares. This study examines the factors behind these trends in market concentration, including the role of customer financing options.

Follicular unit extraction hair transplant automation: options in overcoming challenges of the latest technology in hair restoration with the goal of avoiding the line scar.

PubMed

Rashid, Rashid M; Morgan Bicknell, Lindsay T

2012-09-15

Follicular unit extraction (FUE) provides many advantages over the strip surgical method of harvesting hair grafts for hair restoration. However, FUE also has its shortcomings because it is a more time intensive approach that results in increased costs and is technically a more challenging technique of hair transplantation. In this manuscript, we seek to share approaches used at our center to help minimize and/or improve on some of the challenges of FUE.

Sustainability of UK shale gas in comparison with other electricity options: Current situation and future scenarios.

PubMed

Cooper, Jasmin; Stamford, Laurence; Azapagic, Adisa

2018-04-01

Many countries are considering exploitation of shale gas but its overall sustainability is currently unclear. Previous studies focused mainly on environmental aspects of shale gas, largely in the US, with scant information on socio-economic aspects. To address this knowledge gap, this paper integrates for the first time environmental, economic and social aspects of shale gas to evaluate its overall sustainability. The focus is on the UK which is on the cusp of developing a shale gas industry. Shale gas is compared to other electricity options for the current situation and future scenarios up to the year 2030 to investigate whether it can contribute towards a more sustainable electricity mix in the UK. The results obtained through multi-criteria decision analysis suggest that, when equal importance is assumed for each of the three sustainability aspects shale gas ranks seventh out of nine electricity options, with wind and solar PV being the best and coal the worst options. However, it outranks biomass and hydropower. Changing the importance of the sustainability aspects widely, the ranking of shale gas ranges between fourth and eighth. For shale gas to become the most sustainable option of those assessed, large improvements would be needed, including a 329-fold reduction in environmental impacts and 16 times higher employment, along with simultaneous large changes (up to 10,000 times) in the importance assigned to each criterion. Similar changes would be needed if it were to be comparable to conventional or liquefied natural gas, biomass, nuclear or hydropower. The results also suggest that a future electricity mix (2030) would be more sustainable with a lower rather than a higher share of shale gas. These results serve to inform UK policy makers, industry and non-governmental organisations. They will also be of interest to other countries considering exploitation of shale gas. Copyright © 2017 Elsevier B.V. All rights reserved.

The Shifting Spaces of Teacher Relationships: Complementary Methods in Examinations of Teachers' Digital Practices

ERIC Educational Resources Information Center

Homan, Elizabeth C.

2014-01-01

Today's teachers are faced with a number of options when it comes to sharing knowledge about their professions. In the digital age, teachers use social media, online professional networks, email listservs, and blogging connections to share knowledge and resources. Here, I describe how one teacher engages with social media to develop networks that…

75 FR 57310 - American Capital, Ltd.; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-20

... markets for the common stock, the Fair Market Value will be determined in good faith by the Board, but in.... Under the Plan, a maximum of 750,000 shares of applicant's common stock, in the aggregate, may be issued to Non-employee Directors and options to purchase 93,750 shares of applicant's common stock may be...

Characterizing Impacts of Online Professional Development on Teachers' Beliefs and Perspectives about Teaching Statistics

ERIC Educational Resources Information Center

Lee, Hollylynne S.; Lovett, Jennifer N.; Mojica, Gemma M.

2017-01-01

With online learning becoming a more viable option for teachers to develop their expertise, our report shares one such effort focused on improving the teaching of statistics. We share design principles and learning opportunities, as well as discuss specific impacts evident in classroom teachers' course activity concerning changes to their beliefs…

Mayo Clinic employees responded to new requirements for cost sharing by reducing possibly unneeded health services use.

PubMed

Shah, Nilay D; Naessens, James M; Wood, Douglas L; Stroebel, Robert J; Litchy, William; Wagie, Amy; Fan, Jiaquan; Nesse, Robert

2011-11-01

Some health plans have experimented with increasing consumer cost sharing, on the theory that consumers will use less unnecessary health care if they are expected to bear some of the financial responsibility for it. However, it is unclear whether the resulting decrease in use is sustained beyond one or two years. In 2004 Mayo Clinic's self-funded health plan increased cost sharing for its employees and their dependents for specialty care visits (adding a $25 copayment to the high-premium option) and other services such as imaging, testing, and outpatient procedures (adding 10 or 20 percent coinsurance, depending on the option). The plan also removed all cost sharing for visits to primary care providers and for preventive services such as colorectal screening and mammography. The result was large decreases in the use of diagnostic testing and outpatient procedures that were sustained for four years, and an immediate decrease in the use of imaging that later rebounded (possibly to levels below the expected trend). Beneficiaries decreased visits to specialists but did not make greater use of primary care services. These results suggest that implementing relatively low levels of cost sharing can lead to a long-term decrease in utilization.

77 FR 71644 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-03

... exercise limits for options on the iShares MSCI Emerging Markets Index Fund (``EEM'') to 500,000 contracts... exercise limits for EEM options to 500,000 contracts.\\3\\ There is precedent for establishing position...\\ \\3\\ By virtue of Rule 1002, which is not being amended by this filing, the exercise limit for EEM...

77 FR 73708 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-11

... Amending Commentary .07 to Exchange Rule 904 To Increase the Position and Exercise Limits for Options on... exercise limits for options on the iShares MSCI Emerging Markets Index Fund (``EEM'') to 500,000 contracts... change is to amend Exchange Rule 904, Commentary .07 to increase the position and exercise limits for EEM...

76 FR 5848 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-02

... component is the underlying stock or ETF to the functionality on its electronic trading platform for options... or sell a stated number of units of an underlying stock or ETF coupled with the purchase or sale of... underlying stock or Exchange Traded Fund Share (``ETF'') is also referred to as a stock-option order. 2...

Shared decision making in chronic care in the context of evidence based practice in nursing.

PubMed

Friesen-Storms, Jolanda H H M; Bours, Gerrie J J W; van der Weijden, Trudy; Beurskens, Anna J H M

2015-01-01

In the decision-making environment of evidence-based practice, the following three sources of information must be integrated: research evidence of the intervention, clinical expertise, and the patient's values. In reality, evidence-based practice usually focuses on research evidence (which may be translated into clinical practice guidelines) and clinical expertise without considering the individual patient's values. The shared decision-making model seems to be helpful in the integration of the individual patient's values in evidence-based practice. We aim to discuss the relevance of shared decision making in chronic care and to suggest how it can be integrated with evidence-based practice in nursing. We start by describing the following three possible approaches to guide the decision-making process: the paternalistic approach, the informed approach, and the shared decision-making approach. Implementation of shared decision making has gained considerable interest in cases lacking a strong best-treatment recommendation, and when the available treatment options are equivalent to some extent. We discuss that in chronic care it is important to always invite the patient to participate in the decision-making process. We delineate the following six attributes of health care interventions in chronic care that influence the degree of shared decision making: the level of research evidence, the number of available intervention options, the burden of side effects, the impact on lifestyle, the patient group values, and the impact on resources. Furthermore, the patient's willingness to participate in shared decision making, the clinical expertise of the nurse, and the context in which the decision making takes place affect the shared decision-making process. A knowledgeable and skilled nurse with a positive attitude towards shared decision making—integrated with evidence-based practice—can facilitate the shared decision-making process. We conclude that nurses as well as other health care professionals in chronic care should integrate shared decision making with evidence-based practice to deliver patient-centred care. Copyright © 2014 Elsevier Ltd. All rights reserved.

A three-talk model for shared decision making: multistage consultation process

PubMed Central

Durand, Marie Anne; Song, Julia; Aarts, Johanna; Barr, Paul J; Berger, Zackary; Cochran, Nan; Frosch, Dominick; Galasiński, Dariusz; Gulbrandsen, Pål; Han, Paul K J; Härter, Martin; Kinnersley, Paul; Lloyd, Amy; Mishra, Manish; Perestelo-Perez, Lilisbeth; Scholl, Isabelle; Tomori, Kounosuke; Trevena, Lyndal; Witteman, Holly O; Van der Weijden, Trudy

2017-01-01

Objectives To revise an existing three-talk model for learning how to achieve shared decision making, and to consult with relevant stakeholders to update and obtain wider engagement. Design Multistage consultation process. Setting Key informant group, communities of interest, and survey of clinical specialties. Participants 19 key informants, 153 member responses from multiple communities of interest, and 316 responses to an online survey from medically qualified clinicians from six specialties. Results After extended consultation over three iterations, we revised the three-talk model by making changes to one talk category, adding the need to elicit patient goals, providing a clear set of tasks for each talk category, and adding suggested scripts to illustrate each step. A new three-talk model of shared decision making is proposed, based on “team talk,” “option talk,” and “decision talk,” to depict a process of collaboration and deliberation. Team talk places emphasis on the need to provide support to patients when they are made aware of choices, and to elicit their goals as a means of guiding decision making processes. Option talk refers to the task of comparing alternatives, using risk communication principles. Decision talk refers to the task of arriving at decisions that reflect the informed preferences of patients, guided by the experience and expertise of health professionals. Conclusions The revised three-talk model of shared decision making depicts conversational steps, initiated by providing support when introducing options, followed by strategies to compare and discuss trade-offs, before deliberation based on informed preferences. PMID:29109079

Theory and ontology for sharing temporal knowledge

NASA Technical Reports Server (NTRS)

Loganantharaj, Rasiah

1996-01-01

Using current technology, the sharing or re-using of knowledge-bases is very difficult, if not impossible. ARPA has correctly recognized the problem and funded a knowledge sharing initiative. One of the outcomes of this project is a formal language called Knowledge Interchange Format (KIF) for representing knowledge that could be translated into other languages. Capturing and representing design knowledge and reasoning with them have become very important for NASA who is a pioneer of innovative design of unique products. For upgrading an existing design for changing technology, needs, or requirements, it is essential to understand the design rationale, design choices, options and other relevant information associated with the design. Capturing such information and presenting them in the appropriate form are part of the ongoing Design Knowledge Capture project of NASA. The behavior of an object and various other aspects related to time are captured by the appropriate temporal knowledge. The captured design knowledge will be represented in such a way that various groups of NASA who are interested in various aspects of the design cycle should be able to access and use the design knowledge effectively. To facilitate knowledge sharing among these groups, one has to develop a very well defined ontology. Ontology is a specification of conceptualization. In the literature several specific domains were studied and some well defined ontologies were developed for such domains. However, very little, or no work has been done in the area of representing temporal knowledge to facilitate sharing. During the ASEE summer program, I have investigated several temporal models and have proposed a theory for time that is flexible to accommodate the time elements, such as, points and intervals, and is capable of handling the qualitative and quantitative temporal constraints. I have also proposed a primitive temporal ontology using which other relevant temporal ontologies can be built. I have investigated various issues of sharing knowledge and have proposed a formal framework for modeling the concept of knowledge sharing. This work may be implemented and tested in the software environment supplied by Knowledge Based System, Inc.

Emotional/Mental Challenges Pre-, In-, and Post-Flight

NASA Technical Reports Server (NTRS)

Voss, Janice

2001-01-01

Dr. Voss has flown aboard the Space Shuttle five times. She knows well her inner concerns, emotions, and mental challenges attending such highly demanding and risky adventures. And she has shared those ideas with her colleagues. She notes that their busy training schedules and fully committed on orbit time allow little time for dwelling on most of these issues. However, they are nonetheless real and may not be ignored with impunity. She thinks that perhaps they are more striking for rookie space farers, but all spacecrew members share them and can profit by assuring proper support and unique solutions for their own specific situation, which could vary with the mission. In her own experience, she found notable benefit from sharing with close members of her family, both before flight and during. The latter has proved of great value to all crew persons in the form of their personal ground contact time with family and friends. In addition, how one arranges and what one provides in the on board personal space and time goes far toward keeping a confident and upbeat view of the big picture. The type and amount of off duty diversions (e.g., music, reading material) are important, as are how one participates in group time. And it is universally agreed that viewing time at the spacecraft windows offers great joy and calm. Dr. Voss conjectures that there could be a difference in how people deal with these matters on busy, short-duration (Shuttle type) missions versus those of longer ones, particularly out of low earth orbit, where the options in the advent of mishap are fewer. Her final opinion is one of optimism and assurance that the human person will do well in coping with this new environment.

Pediatric Traumatic Brain Injury and Autism: Elucidating Shared Mechanisms

PubMed Central

Singh, Rahul; Nguyen, Linda; Motwani, Kartik; Swatek, Michelle

2016-01-01

Pediatric traumatic brain injury (TBI) and autism spectrum disorder (ASD) are two serious conditions that affect youth. Recent data, both preclinical and clinical, show that pediatric TBI and ASD share not only similar symptoms but also some of the same biologic mechanisms that cause these symptoms. Prominent symptoms for both disorders include gastrointestinal problems, learning difficulties, seizures, and sensory processing disruption. In this review, we highlight some of these shared mechanisms in order to discuss potential treatment options that might be applied for each condition. We discuss potential therapeutic and pharmacologic options as well as potential novel drug targets. Furthermore, we highlight advances in understanding of brain circuitry that is being propelled by improved imaging modalities. Going forward, advanced imaging will help in diagnosis and treatment planning strategies for pediatric patients. Lessons from each field can be applied to design better and more rigorous trials that can be used to improve guidelines for pediatric patients suffering from TBI or ASD. PMID:28074078

a Standardized Approach to Topographic Data Processing and Workflow Management

NASA Astrophysics Data System (ADS)

Wheaton, J. M.; Bailey, P.; Glenn, N. F.; Hensleigh, J.; Hudak, A. T.; Shrestha, R.; Spaete, L.

2013-12-01

An ever-increasing list of options exist for collecting high resolution topographic data, including airborne LIDAR, terrestrial laser scanners, bathymetric SONAR and structure-from-motion. An equally rich, arguably overwhelming, variety of tools exists with which to organize, quality control, filter, analyze and summarize these data. However, scientists are often left to cobble together their analysis as a series of ad hoc steps, often using custom scripts and one-time processes that are poorly documented and rarely shared with the community. Even when literature-cited software tools are used, the input and output parameters differ from tool to tool. These parameters are rarely archived and the steps performed lost, making the analysis virtually impossible to replicate precisely. What is missing is a coherent, robust, framework for combining reliable, well-documented topographic data-processing steps into a workflow that can be repeated and even shared with others. We have taken several popular topographic data processing tools - including point cloud filtering and decimation as well as DEM differencing - and defined a common protocol for passing inputs and outputs between them. This presentation describes a free, public online portal that enables scientists to create custom workflows for processing topographic data using a number of popular topographic processing tools. Users provide the inputs required for each tool and in what sequence they want to combine them. This information is then stored for future reuse (and optionally sharing with others) before the user then downloads a single package that contains all the input and output specifications together with the software tools themselves. The user then launches the included batch file that executes the workflow on their local computer against their topographic data. This ZCloudTools architecture helps standardize, automate and archive topographic data processing. It also represents a forum for discovering and sharing effective topographic processing workflows.

Key stakeholders' perceptions of the acceptability and usefulness of a tablet-based tool to improve communication and shared decision making in ICUs.

PubMed

Ernecoff, Natalie C; Witteman, Holly O; Chon, Kristen; Chen, Yanquan Iris; Buddadhumaruk, Praewpannarai; Chiarchiaro, Jared; Shotsberger, Kaitlin J; Shields, Anne-Marie; Myers, Brad A; Hough, Catherine L; Carson, Shannon S; Lo, Bernard; Matthay, Michael A; Anderson, Wendy G; Peterson, Michael W; Steingrub, Jay S; Arnold, Robert M; White, Douglas B

2016-06-01

Although barriers to shared decision making in intensive care units are well documented, there are currently no easily scaled interventions to overcome these problems. We sought to assess stakeholders' perceptions of the acceptability, usefulness, and design suggestions for a tablet-based tool to support communication and shared decision making in ICUs. We conducted in-depth semi-structured interviews with 58 key stakeholders (30 surrogates and 28 ICU care providers). Interviews explored stakeholders' perceptions about the acceptability of a tablet-based tool to support communication and shared decision making, including the usefulness of modules focused on orienting families to the ICU, educating them about the surrogate's role, completing a question prompt list, eliciting patient values, educating about treatment options, eliciting perceptions about prognosis, and providing psychosocial support resources. The interviewer also elicited stakeholders' design suggestions for such a tool. We used constant comparative methods to identify key themes that arose during the interviews. Overall, 95% (55/58) of participants perceived the proposed tool to be acceptable, with 98% (57/58) of interviewees finding six or more of the seven content domains acceptable. Stakeholders identified several potential benefits of the tool including that it would help families prepare for the surrogate role and for family meetings as well as give surrogates time and a framework to think about the patient's values and treatment options. Key design suggestions included: conceptualize the tool as a supplement to rather than a substitute for surrogate-clinician communication; make the tool flexible with respect to how, where, and when surrogates can access the tool; incorporate interactive exercises; use video and narration to minimize the cognitive load of the intervention; and build an extremely simple user interface to maximize usefulness for individuals with low computer literacy. There is broad support among stakeholders for the use of a tablet-based tool to improve communication and shared decision making in ICUs. Eliciting the perspectives of key stakeholders early in the design process yielded important insights to create a tool tailored to the needs of surrogates and care providers in ICUs. Copyright © 2016 Elsevier Inc. All rights reserved.

Empowering Oncology Nurses to Lead Change Through a Shared Governance Project.

PubMed

Gordon, Jeanine N

2016-11-01

Nurses at the bed- or chairside are knowledgeable about clinical and operational concerns that need improvement and, consequently, are in the best position to generate and evaluate practical options and potential solutions to improve efficacy and care processes. Implementation of a shared governance model is effective in engaging staff nurses to make meaningful and sustainable change in patient care processes.

26 CFR 1.936-6 - Intangible property income when an election out is made: Cost sharing and profit split options...

Code of Federal Regulations, 2010 CFR

2010-04-01

... answer 12. (iii) The principles contained in questions and answers 11, 12, 13, and 14 are illustrated by... treated as the owner, for purposes of obtaining a return thereon, of any marketing intangibles except... corporation. Q. 6: How is income attributable to marketing intangibles treated under the cost sharing method...

Sharing AIS Related Anomalies (SARA)

DTIC Science & Technology

2016-03-01

Maritime Integrated Command, Control and Communications IMO International Maritime Organization IQ Information Quality ISI Information Sharing...way to summarize level 1 anomalies, an Information Quality ( IQ ) approach was selected. One of the reasons to favour this approach is the option to...Ray [31], but with slightly different IQ dimensions. Six dimensions of IQ have been selected to describe level 2 anomalies (described in Table 3.1

26 CFR 1.421-2 - General rules.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 100 shares of X stock at $10 per share. On August 1, 2006, A exercises the option when the fair market... compensation income A must include in income is $1,000 ($2,000, the fair market value of X stock on transfer... in income is $2,000 ($3,000, the fair market value of Y stock on transfer, less $1,000, the exercise...

76 FR 56824 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated: Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-14

... Exchange is proposing to eliminate the PULSe non-standard services fee. All of these changes, which are.... Currently the fee is set at $0.05 per executed contract or share equivalent. The Exchange is proposing to reduce the fee to $0.02 per contract or share equivalent. The second purpose of this proposed rule change...

75 FR 8774 - Self-Regulatory Organizations; NYSE Amex LLC; Notice of Filing of Proposed Rule Change Amending...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-25

... limits were introduced as a means of forestalling the potential manipulation of an equity's price by... significantly reduced concerns of market manipulation or disruption in the underlying markets. Shares in these... values on a per-share basis, the option strike prices result in being equal to \\1/ 100\\th of the...

26 CFR 1.936-6 - Intangible property income when an election out is made: Cost sharing and profit split options...

Code of Federal Regulations, 2014 CFR

2014-04-01

... right to use, a patent, invention, formula, process, design, pattern or know-how; and a proper allowance... affiliated possessions corporation. Q. 5: Are pre-TEFRA sales included in the cost sharing fraction? A. 5: No. Pre-TEFRA sales are sales of products produced by the possessions corporation and transferred to an...

26 CFR 1.936-6 - Intangible property income when an election out is made: Cost sharing and profit split options...

Code of Federal Regulations, 2011 CFR

2011-04-01

... right to use, a patent, invention, formula, process, design, pattern or know-how; and a proper allowance... affiliated possessions corporation. Q. 5: Are pre-TEFRA sales included in the cost sharing fraction? A. 5: No. Pre-TEFRA sales are sales of products produced by the possessions corporation and transferred to an...

26 CFR 1.936-6 - Intangible property income when an election out is made: Cost sharing and profit split options...

Code of Federal Regulations, 2013 CFR

2013-04-01

... right to use, a patent, invention, formula, process, design, pattern or know-how; and a proper allowance... affiliated possessions corporation. Q. 5: Are pre-TEFRA sales included in the cost sharing fraction? A. 5: No. Pre-TEFRA sales are sales of products produced by the possessions corporation and transferred to an...

26 CFR 1.936-6 - Intangible property income when an election out is made: Cost sharing and profit split options...

Code of Federal Regulations, 2012 CFR

2012-04-01

... right to use, a patent, invention, formula, process, design, pattern or know-how; and a proper allowance... affiliated possessions corporation. Q. 5: Are pre-TEFRA sales included in the cost sharing fraction? A. 5: No. Pre-TEFRA sales are sales of products produced by the possessions corporation and transferred to an...

Parental Preference Assessment for Vesicoureteral Reflux Management in Children.

PubMed

Tran, Geraldine N; Bodapati, Anand V; Routh, Jonathan C; Saigal, Christopher S; Copp, Hillary L

2017-03-01

Parents of children with vesicoureteral reflux are presented with a variety of management options, which in many cases offer a similar risk-benefit ratio. To facilitate shared decision making, parental preferences regarding vesicoureteral reflux treatment options need to be acknowledged. We aimed to characterize the clinical experience of parents and elicit core themes affecting decision making in regard to managing vesicoureteral reflux in their child. A semistructured, qualitative interview script was developed and vetted by 25 pediatric urologists to discuss treatment options for vesicoureteral reflux. Additional patient interviews were conducted until new themes failed to arise. Content analysis was performed to extract all statements that described treatment options. Similar statements were combined until a final list of unique themes emerged. A total of 26 interviews were performed, yielding 689 statements about overall parent experiences with managing vesicoureteral reflux in the child and 450 statements (65%) pertaining to treatment options. Of the 13 themes that emerged, those most commonly considered were the prevention of future urinary tract infections by 85% of parents, the efficacy rate of treatment options by 85%, the burden of daily maintenance or compliance by 77%, antibiotic resistance by 69%, chronic kidney damage by 62% and invasiveness by 58%. Our study emphasizes that when choosing a treatment option for vesicoureteral reflux in their child, parent preferences regarding risks and benefits are variable. However, their chief concerns include whether a method decreases the risk of urinary tract infections, has an acceptable efficacy rate and aligns itself with the capabilities of the family. These themes help frame discussions between families and clinicians regarding vesicoureteral reflux management, and they can facilitate shared decision making. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Sharing up, down, and Sideways: Alliance Is a Driving Force in Reshaping New Jersey Vocational School

ERIC Educational Resources Information Center

von Frank, Valerie

2011-01-01

In Essex County, New Jersey, whose county seat is Newark, students have the option of attending one of four vocational high schools. The Essex County Vocational School District draws students from the county seeking instruction in a multitude of career and technical areas. North 13th Street Technical School is one of the four vocational options.…

Information findability: An informal study to explore options for improving information findability for the systems analysis group

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

Stoecker, Nora Kathleen

2014-03-01

A Systems Analysis Group has existed at Sandia National Laboratories since at least the mid-1950s. Much of the groups work output (reports, briefing documents, and other materials) has been retained, along with large numbers of related documents. Over time the collection has grown to hundreds of thousands of unstructured documents in many formats contained in one or more of several different shared drives or SharePoint sites, with perhaps five percent of the collection still existing in print format. This presents a challenge. How can the group effectively find, manage, and build on information contained somewhere within such a large setmore » of unstructured documents? In response, a project was initiated to identify tools that would be able to meet this challenge. This report documents the results found and recommendations made as of August 2013.« less

Effect of premium, copayments, and health status on the choice of health plans.

PubMed

Naessens, James M; Khan, Mahmud; Shah, Nilay D; Wagie, Amy; Pautz, Rebecca A; Campbell, Claudia R

2008-10-01

Explore effects of comorbidity and prior health care utilization on choice of employee health plans with different levels of cost sharing. Mayo Clinic employees in Rochester, Minnesota (MCR) under age 65 in January 2004; N = 20,379. Assessment of a natural experiment where self-funded medical care benefit options were changed to contain costs within a large medical group practice. Before the change, most employees were enrolled in a plan with first dollar coverage, while 18% had a plan with copays and deductibles. In 2004, 3 existing plans were replaced by 2 new options, one with lower premiums and higher out-of-pocket costs and the other with higher premiums, a lower coinsurance rate, and lower out-of-pocket maximums. Data on employees were merged across insurance claims, medical records, eligibility files, and employment files for 2003 and 2004. As the number of chronic comorbidities among family members increased, the probability of choosing high-premium option also increased. Seventy-two percent of employees with at least 1 family member with comorbidity chose the high-cost option versus 54.7% of employees with no comorbidities. High-premium and low-premium plans seem to subdivide population into discrete risk categories, which may adversely affect the future stability of the insurance plan options. Various factors affect decision making of employees regarding the choice of plan with different levels of cost-sharing. In a natural experiment setting where all options were redesigned, the health status of employees and their dependents played a very significant role in plan choice.

Planning in context: A situated view of children's management of science projects

NASA Astrophysics Data System (ADS)

Marshall, Susan Katharine

This study investigated children's collaborative planning of a complex, long-term software design project. Using sociocultural methods, it examined over time the development of design teams' planning negotiations and tools to document the coconstruction of cultural frameworks to organize teams' shared understanding of what and how to plan. Results indicated that student teams developed frameworks to address a set of common planning functions that included design planning, project metaplanning (things such as division of labor or sharing of computer resources) and team collaboration management planning. There were also some between-team variations in planning frameworks, within a bandwidth of options. Teams engaged in opportunistic planning, which reflected shifts in strategies in response to new circumstances over time. Team members with past design project experience ("oldtimers") demonstrated the transfer of their planning framework to the current design task, and they supported the developing participation of "newcomers." Teams constructed physical tools (e.g. planning boards) that acted as visual representations of teams' planning frameworks, and inscriptions of team thinking. The assigned functions of the tools also shifted over time with changing project circumstances. The discussion reexamines current approaches to the study of planning and discusses their educational implications.

MOIL-opt: Energy-Conserving Molecular Dynamics on a GPU/CPU system

PubMed Central

Ruymgaart, A. Peter; Cardenas, Alfredo E.; Elber, Ron

2011-01-01

We report an optimized version of the molecular dynamics program MOIL that runs on a shared memory system with OpenMP and exploits the power of a Graphics Processing Unit (GPU). The model is of heterogeneous computing system on a single node with several cores sharing the same memory and a GPU. This is a typical laboratory tool, which provides excellent performance at minimal cost. Besides performance, emphasis is made on accuracy and stability of the algorithm probed by energy conservation for explicit-solvent atomically-detailed-models. Especially for long simulations energy conservation is critical due to the phenomenon known as “energy drift” in which energy errors accumulate linearly as a function of simulation time. To achieve long time dynamics with acceptable accuracy the drift must be particularly small. We identify several means of controlling long-time numerical accuracy while maintaining excellent speedup. To maintain a high level of energy conservation SHAKE and the Ewald reciprocal summation are run in double precision. Double precision summation of real-space non-bonded interactions improves energy conservation. In our best option, the energy drift using 1fs for a time step while constraining the distances of all bonds, is undetectable in 10ns simulation of solvated DHFR (Dihydrofolate reductase). Faster options, shaking only bonds with hydrogen atoms, are also very well behaved and have drifts of less than 1kcal/mol per nanosecond of the same system. CPU/GPU implementations require changes in programming models. We consider the use of a list of neighbors and quadratic versus linear interpolation in lookup tables of different sizes. Quadratic interpolation with a smaller number of grid points is faster than linear lookup tables (with finer representation) without loss of accuracy. Atomic neighbor lists were found most efficient. Typical speedups are about a factor of 10 compared to a single-core single-precision code. PMID:22328867

Exploring the use of Option Grid™ patient decision aids in a sample of clinics in Poland.

PubMed

Scalia, Peter; Elwyn, Glyn; Barr, Paul; Song, Julia; Zisman-Ilani, Yaara; Lesniak, Monika; Mullin, Sarah; Kurek, Krzysztof; Bushell, Matt; Durand, Marie-Anne

2018-05-29

Research on the implementation of patient decision aids to facilitate shared decision making in clinical settings has steadily increased across Western countries. A study which implements decision aids and measures their impact on shared decision making has yet to be conducted in the Eastern part of Europe. To study the use of Option Grid TM patient decision aids in a sample of Grupa LUX MED clinics in Warsaw, Poland, and measure their impact on shared decision making. We conducted a pre-post interventional study. Following a three-month period of usual care, clinicians from three Grupa LUX MED clinics received a one-hour training session on how to use three Option Grid TM decision aids and were provided with copies for use for four months. Throughout the study, all eligible patients were asked to complete the three-item CollaboRATE patient-reported measure of shared decision making after their clinical encounter. CollaboRATE enables patients to assess the efforts clinicians make to: (i) inform them about their health issues; (ii) listen to 'what matters most'; (iii) integrate their treatment preference in future plans. A Hierarchical Logistic Regression model was performed to understand which variables had an effect on CollaboRATE. 2,048 patients participated in the baseline phase; 1,889 patients participated in the intervention phase. Five of the thirteen study clinicians had a statistically significant increase in their CollaboRATE scores (p<.05) when comparing baseline phase to intervention phase. All five clinicians were located at the same clinic, the only clinic where an overall increase (non-significant) in the mean CollaboRATE top score percentage occurred from baseline phase (M=60 %, SD=0.49; 95 % CI [57-63 %]) to intervention phase (M=62 %, SD=0.49; 95% CI [59-65%]). Only three of those five clinicians who had a statistically significant increase had a clinically significant difference. The implementation of Option Grid TM helped some clinicians practice shared decision making as reflected in CollaboRATE scores, but most clinicians did not have a significant increase in their scores. Our study indicates that the effect of these interventions may be dependent on clinic contexts and clinician engagement. Copyright © 2018. Published by Elsevier GmbH.

Milk marketing policy options for the dairy industry in New England.

PubMed

Doyon, M; Criner, G; Bragg, L A

2008-03-01

New England dairy farmers are under intense price pressure resulting from important growth in milk production from lower cost of production Southwest states as well as by retailers' market power. Agricultural officials and legislative bodies in New England and in other Northeast US states are aware of these pressures and have been reacting with emergency dairy farm aid, following a very low 2006 milk price, and with state legislations in an attempt to address perceived excess retailing margins for fluid milk. In this paper, we suggest that a sigmoid demand relationship exists for fluid milk. This demand relationship would explain fluid milk asymmetric price transmission, high-low pricing, and the creation of a large retailing margin (chain surplus) often observed for fluid milk. It is also argued that a sigmoid demand relationship offers an opportunity for state legislators to help Northeast dairy farmers capturing a larger share of the dollar of the consumers through various policy options. Therefore, 5 milk market channel regulatory mechanisms (status quo, price gouging, supply control, fair share policy, and chain surplus return) are discussed and compared. The supply control mechanism was found the most effective at redistributing the chain surplus, associated with the sigmoid demand relationship for fluid milk, to dairy farmers. However, this option is unlikely to be politically acceptable in the United States. Second-best options for increasing dairy farmers' share of the consumers' dollar are the fair price policy and the chain surplus return. The former mechanism would distribute the chain surplus between retailers, processors, and farmers, whereas the latter would distribute it between consumers, retailers, and farmers. Remaining mechanisms would either transfer the chain surplus to retailers (status quo) or to consumers (price gouging).

Extensions to Multivariate Space Time Mixture Modeling of Small Area Cancer Data.

PubMed

Carroll, Rachel; Lawson, Andrew B; Faes, Christel; Kirby, Russell S; Aregay, Mehreteab; Watjou, Kevin

2017-05-09

Oral cavity and pharynx cancer, even when considered together, is a fairly rare disease. Implementation of multivariate modeling with lung and bronchus cancer, as well as melanoma cancer of the skin, could lead to better inference for oral cavity and pharynx cancer. The multivariate structure of these models is accomplished via the use of shared random effects, as well as other multivariate prior distributions. The results in this paper indicate that care should be taken when executing these types of models, and that multivariate mixture models may not always be the ideal option, depending on the data of interest.

FBI Intelligence Reform Since September 11, 2001: Issues and Options for Congress

DTIC Science & Technology

2004-08-04

manner for failing to focus on the domestic terrorist threat; collect useful intelligence; analyze strategic intelligence; and to share intelligence...cited as JIC Inquiry) 7 An analyst conducts counterterrorism strategic intelligence analysis in order to develop a national and international...intelligence; strategically analyze intelligence,7 and to share intelligence internally, and with the rest of the IC. According to the congressional

75 FR 30078 - Self-Regulatory Organizations; Notice of Filing of Proposed Rule Change by NASDAQ OMX PHLX, Inc...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-28

... example: Sanofi Aventis (SNY), which has recently traded at a low of about $33 per share, is not currently in the $1 Strike Program. This means that options on Sanofi Aventis are offered at strike price intervals of $2.50. If an investor desired to protect 100 shares of Sanofi Aventis in the event of a 10...

A three-talk model for shared decision making: multistage consultation process.

PubMed

Elwyn, Glyn; Durand, Marie Anne; Song, Julia; Aarts, Johanna; Barr, Paul J; Berger, Zackary; Cochran, Nan; Frosch, Dominick; Galasiński, Dariusz; Gulbrandsen, Pål; Han, Paul K J; Härter, Martin; Kinnersley, Paul; Lloyd, Amy; Mishra, Manish; Perestelo-Perez, Lilisbeth; Scholl, Isabelle; Tomori, Kounosuke; Trevena, Lyndal; Witteman, Holly O; Van der Weijden, Trudy

2017-11-06

Objectives  To revise an existing three-talk model for learning how to achieve shared decision making, and to consult with relevant stakeholders to update and obtain wider engagement. Design  Multistage consultation process. Setting  Key informant group, communities of interest, and survey of clinical specialties. Participants  19 key informants, 153 member responses from multiple communities of interest, and 316 responses to an online survey from medically qualified clinicians from six specialties. Results  After extended consultation over three iterations, we revised the three-talk model by making changes to one talk category, adding the need to elicit patient goals, providing a clear set of tasks for each talk category, and adding suggested scripts to illustrate each step. A new three-talk model of shared decision making is proposed, based on "team talk," "option talk," and "decision talk," to depict a process of collaboration and deliberation. Team talk places emphasis on the need to provide support to patients when they are made aware of choices, and to elicit their goals as a means of guiding decision making processes. Option talk refers to the task of comparing alternatives, using risk communication principles. Decision talk refers to the task of arriving at decisions that reflect the informed preferences of patients, guided by the experience and expertise of health professionals. Conclusions  The revised three-talk model of shared decision making depicts conversational steps, initiated by providing support when introducing options, followed by strategies to compare and discuss trade-offs, before deliberation based on informed preferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Do physicians’ recommendations pull patients away from their preferred treatment options?

PubMed Central

Mendel, Rosmarie; Traut‐Mattausch, Eva; Frey, Dieter; Bühner, Markus; Berthele, Achim; Kissling, Werner; Hamann, Johannes

2011-01-01

Abstract Context and objective  Shared decision making is especially advocated for preference‐sensitive decisions. We investigated whether physicians’ recommendations pull patients away from their preferred treatment option when making a preference‐sensitive decision. Design, participants and methods  Inpatients (N = 102 with schizophrenia, N = 101 with multiple sclerosis) were presented with a hypothetical scenario (the choice between two drugs). They were first asked about their preferences concerning the two drugs and then they received a (fictitious) clinician’s recommendation that was contrary to their preferences. Subsequently they made a final choice between the two drugs. Main outcome measures  The main outcome measure was whether the patient followed the physician’s advice in the hypothetical scenario. Thereby patient’s (pre‐recommendation) preferences served as a baseline. Results  In the decision scenario, about 48% of the patients with schizophrenia and 26% of the patients with multiple sclerosis followed the advice of their physician and thus chose the treatment option that went against their initial preferences. Patients who followed their physician’s advice were less satisfied with their decision than patients not following their physician’s advice (schizophrenia: t = 2.61, P = 0.01; multiple sclerosis: t = 2.67, P = 0.009). Discussion and conclusions  When sharing decisions with patients, physicians should be aware that their advice might influence patients’ decisions away from their preferred treatment option. They should encourage their patients to identify their own preferences and help to find the treatment option most consistent with them. PMID:21323824

Sharing data for public health research by members of an international online diabetes social network.

PubMed

Weitzman, Elissa R; Adida, Ben; Kelemen, Skyler; Mandl, Kenneth D

2011-04-27

Surveillance and response to diabetes may be accelerated through engaging online diabetes social networks (SNs) in consented research. We tested the willingness of an online diabetes community to share data for public health research by providing members with a privacy-preserving social networking software application for rapid temporal-geographic surveillance of glycemic control. SN-mediated collection of cross-sectional, member-reported data from an international online diabetes SN entered into a software application we made available in a "Facebook-like" environment to enable reporting, charting and optional sharing of recent hemoglobin A1c values through a geographic display. Self-enrollment by 17% (n = 1,136) of n = 6,500 active members representing 32 countries and 50 US states. Data were current with 83.1% of most recent A1c values reported obtained within the past 90 days. Sharing was high with 81.4% of users permitting data donation to the community display. 34.1% of users also displayed their A1cs on their SN profile page. Users selecting the most permissive sharing options had a lower average A1c (6.8%) than users not sharing with the community (7.1%, p = .038). 95% of users permitted re-contact. Unadjusted aggregate A1c reported by US users closely resembled aggregate 2007-2008 NHANES estimates (respectively, 6.9% and 6.9%, p = 0.85). Success within an early adopter community demonstrates that online SNs may comprise efficient platforms for bidirectional communication with and data acquisition from disease populations. Advancing this model for cohort and translational science and for use as a complementary surveillance approach will require understanding of inherent selection and publication (sharing) biases in the data and a technology model that supports autonomy, anonymity and privacy.

Development of shared decision-making resources to help inform difficult healthcare decisions: An example focused on dysvascular partial foot and transtibial amputations.

PubMed

Quigley, Matthew; Dillon, Michael P; Fatone, Stefania

2018-02-01

Shared decision making is a consultative process designed to encourage patient participation in decision making by providing accurate information about the treatment options and supporting deliberation with the clinicians about treatment options. The process can be supported by resources such as decision aids and discussion guides designed to inform and facilitate often difficult conversations. As this process increases in use, there is opportunity to raise awareness of shared decision making and the international standards used to guide the development of quality resources for use in areas of prosthetic/orthotic care. To describe the process used to develop shared decision-making resources, using an illustrative example focused on decisions about the level of dysvascular partial foot amputation or transtibial amputation. Development process: The International Patient Decision Aid Standards were used to guide the development of the decision aid and discussion guide focused on decisions about the level of dysvascular partial foot amputation or transtibial amputation. Examples from these shared decision-making resources help illuminate the stages of development including scoping and design, research synthesis, iterative development of a prototype, and preliminary testing with patients and clinicians not involved in the development process. Lessons learnt through the process, such as using the International Patient Decision Aid Standards checklist and development guidelines, may help inform others wanting to develop similar shared decision-making resources given the applicability of shared decision making to many areas of prosthetic-/orthotic-related practice. Clinical relevance Shared decision making is a process designed to guide conversations that help patients make an informed decision about their healthcare. Raising awareness of shared decision making and the international standards for development of high-quality decision aids and discussion guides is important as the approach is introduced in prosthetic-/orthotic-related practice.

Shared decision-making in epilepsy management.

PubMed

Pickrell, W O; Elwyn, G; Smith, P E M

2015-06-01

Policy makers, clinicians, and patients increasingly recognize the need for greater patient involvement in clinical decision-making. Shared decision-making helps address these concerns by providing a framework for clinicians and patients to make decisions together using the best evidence. Shared decision-making is applicable to situations where several acceptable options exist (clinical equipoise). Such situations occur commonly in epilepsy, for example, in decisions regarding the choice of medication, treatment in pregnancy, and medication withdrawal. A talk model is a way of implementing shared decision-making during consultations, and decision aids are useful tools to assist in the process. Although there is limited evidence available for shared decision-making in epilepsy, there are several benefits of shared decision-making in general including improved decision quality, more informed choices, and better treatment concordance. Copyright © 2015 Elsevier Inc. All rights reserved.

TRI Pollution Prevention Reporting Tipsheet

EPA Pesticide Factsheets

TRI Pollution Prevention Reporting Tipsheet is provided to encourage and assist TRI facilities with reporting optional P2 information on their TRI reporting forms, and to facilitate information sharing within and across organizations.

Consumer satisfaction with psychiatric services: The role of shared decision making and the therapeutic relationship.

PubMed

Klingaman, Elizabeth A; Medoff, Deborah R; Park, Stephanie G; Brown, Clayton H; Fang, Lijuan; Dixon, Lisa B; Hack, Samantha M; Tapscott, Stephanie L; Walsh, Mary Brighid; Kreyenbuhl, Julie A

2015-09-01

Although dissatisfaction is a primary reason for disengagement from outpatient psychiatric care among consumers with serious mental illnesses, little is known about predictors of their satisfaction with medication management visits. The primary purpose of this study was to explore how dimensions of consumer preferences for shared decision making (i.e., preferences for obtaining knowledge about one's mental illness, being offered and asked one's opinion about treatment options, and involvement in treatment decisions) and the therapeutic relationship (i.e., positive collaboration and type of clinician input) were related to visit satisfaction. Participants were 228 Veterans with serious mental illnesses who completed a 19-item self-report questionnaire assessing satisfaction with visits to prescribers (524 assessments) immediately after visits. In this correlational design, a 3-level mixed model with the restricted maximum likelihood estimation procedure was used to examine shared decision-making preferences and therapeutic alliance as predictors of visit satisfaction. Preferences for involvement in treatment decisions was the unique component of shared decision making associated with satisfaction, such that the more consumers desired involvement, the less satisfied they were. Positive collaboration and prescriber input were associated with greater visit satisfaction. When consumers with serious mental illnesses express preferences to be involved in shared decision making, it may not be sufficient to only provide information and treatment options; prescribers should attend to consumers' interest in involvement in actual treatment decisions. Assessment and tailoring of treatment approaches to consumer preferences for shared decision making should occur within the context of a strong therapeutic relationship. (c) 2015 APA, all rights reserved).

Adoption of alternative financing strategies to increase the diffusion of picture archiving and communication systems into the radiology marketplace.

PubMed

Reiner, B; Siegel, E; McKay, P

2000-05-01

The objective of the study was to evaluate current marketplace conditions and strategies employed by major picture archiving and communication systems (PACS) vendors in the creation of alternative financing strategies, to enhance the diffusion of filmless imaging. Data were collected from the major PACS vendors in the forms of survey questionnaires and review of existing leases. Topics evaluated in the survey included current financing options available, foreseeable changes in PACS financing, role of third-party financiers, and creation of risk-sharing arrangements. Generic leases were also reviewed evaluating the presence or absence of several key variables including technology obsolescence protection, hardware/software upgrades, end-of-term options, determination of fair market value, functionality/acceptance testing, uptime guarantees, and workflow management consulting. Eight of the 10 PACS vendors surveyed participated in the data collection. The vast majority of current PACS implementations (60% to 90%) occur through direct purchase, with conventional leasing (operating or capital) accounting for only 5% to 30% of PACS installations. The majority of respondents view fee-for-lease arrangements and other forms of risk sharing as increasing importance for future PACS financing. The specific targets for such risk-sharing arrangements consist of small hospital and privately owned imaging centers. Leases currently offered range in duration from 3 to 5 years and frequently offer technology obsolescence protection with upgrades, multiple end-of-term options, and some form of acceptance testing. A number of important variables frequently omitted from leases include uptime guarantees, flexibility in changing financing or vendors, and incorporation of expected productivity/operational efficiency gains. As vendors strive to increase the penetration of PACS into the radiology marketplace, there will be a shift from conventional financing (loan or purchase) to leasing. Fee-for-use leasing and other forms of risk sharing have the greatest potential in smaller hospitals, which do not have the financial resources to pursue conventional financing options. Potential PACS customers must be cautious when entering into these alternative financing strategies, to ensure that appropriate safeguards are incorporated, in order to minimize downside risk.

Freshwater Choices in China: Options That Will Impact South and Southeast Asia

DTIC Science & Technology

2014-12-04

engineering infrastructure upstream on shared international river basins within its borders, and will be able to effectively use the threat of...constructing hydro-engineering infrastructure upstream on shared international river basins within its borders, and will be able to effectively use the...international river basins within its borders, China will be able to effectively use the threat of restricting freshwater flows as a political weapon to

Biodiversity Hotspots, Climate Change, and Agricultural Development: Global Limits of Adaptation

NASA Astrophysics Data System (ADS)

Schneider, U. A.; Rasche, L.; Schmid, E.; Habel, J. C.

2017-12-01

Terrestrial ecosystems are threatened by climate and land management change. These changes result from complex and heterogeneous interactions of human activities and natural processes. Here, we study the potential change in pristine area in 33 global biodiversity hotspots within this century under four climate projections (representative concentration pathways) and associated population and income developments (shared socio-economic pathways). A coupled modelling framework computes the regional net expansion of crop and pasture lands as result of changes in food production and consumption. We use a biophysical crop simulation model to quantify climate change impacts on agricultural productivity, water, and nutrient emissions for alternative crop management systems in more than 100 thousand agricultural land polygons (homogeneous response units) and for each climate projection. The crop simulation model depicts detailed soil, weather, and management information and operates with a daily time step. We use time series of livestock statistics to link livestock production to feed and pasture requirements. On the food consumption side, we estimate national demand shifts in all countries by processing population and income growth projections through econometrically estimated Engel curves. Finally, we use a global agricultural sector optimization model to quantify the net change in pristine area in all biodiversity hotspots under different adaptation options. These options include full-scale global implementation of i) crop yield maximizing management without additional irrigation, ii) crop yield maximizing management with additional irrigation, iii) food yield maximizing crop mix adjustments, iv) food supply maximizing trade flow adjustments, v) healthy diets, and vi) combinations of the individual options above. Results quantify the regional potentials and limits of major agricultural producer and consumer adaptation options for the preservation of pristine areas in biodiversity hotspots. Results also quantify the conflicts between food and water security, biodiversity protection, and climate change mitigation.

NREL Develops OpenEI.org, a Public Website Where Energy Data can be Generated, Shared, and Compared (Fact Sheet)

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

Not Available

2013-12-01

The National Renewable Energy Laboratory (NREL) has developed OpenEI.org, a public, open, data-sharing platform where consumers, analysts, industry experts, and energy decision makers can go to boost their energy IQs, search for energy data, share data, and get access to energy applications. The free site blends elements of social media, linked open-data practices, and MediaWiki-based technology to build a collaborative environment for creating and sharing energy data with the world. The result is a powerful platform that is helping government and industry leaders around the world define policy options, make informed investment decisions, and create new businesses.

Lectin Affinity Plasmapheresis for Middle East Respiratory Syndrome-Coronavirus and Marburg Virus Glycoprotein Elimination.

PubMed

Koch, Benjamin; Schult-Dietrich, Patricia; Büttner, Stefan; Dilmaghani, Bijan; Lohmann, Dario; Baer, Patrick C; Dietrich, Ursula; Geiger, Helmut

2018-04-26

Middle East respiratory syndrome coronavirus (MERS-CoV) and Marburg virus (MARV) are among the World Health Organization's top 8 emerging pathogens. Both zoonoses share nonspecific early symptoms, a high lethality rate, and a reduced number of specific treatment options. Therefore, we evaluated extracorporeal virus and glycoprotein (GP) elimination by lectin affinity plasmapheresis (LAP). For both MERS-CoV (pseudovirus) as well as MARV (GPs), 4 LAP devices (Mini Hemopurifiers, Aethlon Medical, San Diego, CA, USA) and 4 negative controls were tested. Samples were collected every 30 min and analyzed for reduction in virus infectivity by a flow cytometry-based infectivity assay (MERS-CoV) and in soluble GP content (MARV) by an immunoassay. The experiments show a time-dependent clearance of MERS-CoV of up to 80% within 3 h (pseudovirus). Up to 70% of MARV-soluble GPs were eliminated at the same time. Substantial saturation of the binding resins was detected within the first treatment hour. MERS-CoV (pseudovirus) and MARV soluble GPs are eliminated by LAP in vitro. Considering the high lethality and missing established treatment options, LAP should be evaluated in vivo. Especially early initiation, continuous therapy, and timed cartridge exchanges could be of importance. The Author(s). Published by S. Karger AG, Basel.

The Fremont complex: A behavioral perspective

USGS Publications Warehouse

Madsen, D.B.; Simms, S.R.

1998-01-01

The Fremont complex is composed of farmers and foragers who occupied the Colorado Plateau and Great Basin region of western North America from about 2100 to 500 years ago. These people included both immigrants and indigenes who shared some material culture and symbolic attributes, but also varied in ways not captured by definitions of the Fremont as a shared cultural tradition. The complex reflects a mosaic of behaviors including full-time farmers, full-time foragers, part-time farmer/foragers who seasonally switched modes of production, farmers who switched to full-time foraging, and foragers who switched to full-time farming. Farming defines the Fremont, but only in the sense that it altered the matrix in which both farmers and foragers lived, a matrix which provided a variety of behavioral options to people pursuing an array of adaptive strategies. The mix of symbiotic and competitive relationships among farmers and between farmers and foragers presents challenges to detection in the archaeological record. Greater clarity results from use of a behavioral model which recognizes differing contexts of selection favoring one adaptive strategy over another. The Fremont is a case where the transition from foraging to farming is followed by a millennium of adaptive diversity and terminates with the abandonment of farming. As such, it serves as a potential comparison to other cases in the world during the early phases of the food producing transition.

Options for Online Undergraduate Courses in Biology at American Colleges and Universities.

PubMed

Varty, Alison K

I aimed to document the online undergraduate course supply in biology to evaluate how well biology educators are serving the diverse and growing population of online students. I documented online biology course offerings in the 2015-2016 academic year at 96 American colleges and universities. I quantified differences in variety, extent, and availability of courses offered by different kinds of academic institutions and characterized 149 online biology courses offered. Although there was no relationship between an institution's enrollment size and any measure of its online biology offerings, I found significantly more online biology course options at 2-year public compared with 4-year public and 4-year private schools. Courses offered for nonmajors, including students pursuing healthcare-related degrees, were three times as common as those intended for biology majors, who were more likely to be offered hybrid courses with face-to-face laboratories. These data indicate some deficiencies in online biology course options; options for students majoring in biology are limited at all types of institutions examined with a minority of 4-year institutions having any online options in biology. Significant investment of institutional resources in faculty training and technological support are necessary to develop online biology courses that will benefit a larger student population. © 2016 A. K. Varty. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Advanced Demonstration and Test Reactor Options Study

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

Petti, David Andrew; Hill, R.; Gehin, J.

Global efforts to address climate change will require large-scale decarbonization of energy production in the United States and elsewhere. Nuclear power already provides 20% of electricity production in the United States (U.S.) and is increasing in countries undergoing rapid growth around the world. Because reliable, grid-stabilizing, low emission electricity generation, energy security, and energy resource diversity will be increasingly valued, nuclear power’s share of electricity production has a potential to grow. In addition, there are non electricity applications (e.g., process heat, desalination, hydrogen production) that could be better served by advanced nuclear systems. Thus, the timely development, demonstration, and commercializationmore » of advanced nuclear reactors could diversify the nuclear technologies available and offer attractive technology options to expand the impact of nuclear energy for electricity generation and non-electricity missions. The purpose of this planning study is to provide transparent and defensible technology options for a test and/or demonstration reactor(s) to be built to support public policy, innovation and long term commercialization within the context of the Department of Energy’s (DOE’s) broader commitment to pursuing an “all of the above” clean energy strategy and associated time lines. This planning study includes identification of the key features and timing needed for advanced test or demonstration reactors to support research, development, and technology demonstration leading to the commercialization of power plants built upon these advanced reactor platforms. This planning study is consistent with the Congressional language contained within the fiscal year 2015 appropriation that directed the DOE to conduct a planning study to evaluate “advanced reactor technology options, capabilities, and requirements within the context of national needs and public policy to support innovation in nuclear energy”. Advanced reactors are defined in this study as reactors that use coolants other than water. Advanced reactor technologies have the potential to expand the energy applications, enhance the competitiveness, and improve the sustainability of nuclear energy.« less

Is watching television a realistic leisure option for people with dementia?

PubMed

Gústafsdóttir, Margrét

2015-01-01

Watching television is a common leisure activity, not least among older people. However, watching television may become difficult when it is disturbed by symptoms of dementia. A total of 284 questionnaires were handed out to relatives of people with dementia in Iceland, in the Memory Clinic of the University Hospital and in specialized units for people with dementia (6 day-care units and 8 units within nursing homes). The response rate was just below 58%. Watching television was shown to play a less important role in the course of the daily life of people with dementia as soon as the symptoms of the disease became evident, and it increasingly became less relevant. So, this previous leisure activity left an ever-growing void of time to fill. However, watching television may provide an important social context for contact and togetherness during the progress of the disease, as watching television with someone close to them was important for the individuals with dementia. It is not a viable option for people with dementia to watch television on their own, but they may enjoy watching television while sharing this activity with a person close to them. This may even provide quality time.

Prizes for innovation of new medicines and vaccines.

PubMed

Love, James; Hubbard, Tim

2009-01-01

This article argues that prizes can help stimulate medical innovation, control costs and ensure greater access to new medicines and vaccines. The authors explore four increasingly ambitious prize options to reward medical innovation, each addressing flaws in the current patent system. The first option promotes innovation through a large prize fund linked to the impact on health outcomes; the second option rewards the sharing of knowledge, data, and technology with open source dividends; the third option awards prizes for interim benchmarks and discrete technical problems; and the final option removes the exclusive right to use patented inventions in upstream research in favor of prizes. The authors conclude that a system of prizes to reward drug development would break the link between R&D incentives and product prices, and that such a reform is needed to improve innovation and access to new medicines and vaccines.

ARC-VM: An architecture real options complexity-based valuation methodology for military systems-of-systems acquisitions

NASA Astrophysics Data System (ADS)

Domercant, Jean Charles

The combination of today's national security environment and mandated acquisition policies makes it necessary for military systems to interoperate with each other to greater degrees. This growing interdependency results in complex Systems-of-Systems (SoS) that only continue to grow in complexity to meet evolving capability needs. Thus, timely and affordable acquisition becomes more difficult, especially in the face of mounting budgetary pressures. To counter this, architecting principles must be applied to SoS design. The research objective is to develop an Architecture Real Options Complexity-Based Valuation Methodology (ARC-VM) suitable for acquisition-level decision making, where there is a stated desire for more informed tradeoffs between cost, schedule, and performance during the early phases of design. First, a framework is introduced to measure architecture complexity as it directly relates to military SoS. Development of the framework draws upon a diverse set of disciplines, including Complexity Science, software architecting, measurement theory, and utility theory. Next, a Real Options based valuation strategy is developed using techniques established for financial stock options that have recently been adapted for use in business and engineering decisions. The derived complexity measure provides architects with an objective measure of complexity that focuses on relevant complex system attributes. These attributes are related to the organization and distribution of SoS functionality and the sharing and processing of resources. The use of Real Options provides the necessary conceptual and visual framework to quantifiably and traceably combine measured architecture complexity, time-valued performance levels, as well as programmatic risks and uncertainties. An example suppression of enemy air defenses (SEAD) capability demonstrates the development and usefulness of the resulting architecture complexity & Real Options based valuation methodology. Different portfolios of candidate system types are used to generate an array of architecture alternatives that are then evaluated using an engagement model. This performance data is combined with both measured architecture complexity and programmatic data to assign an acquisition value to each alternative. This proves useful when selecting alternatives most likely to meet current and future capability needs.

Da Vincis Children Take Flight: Unmanned Aircraft Systems in the Homeland

DTIC Science & Technology

2014-03-01

corporate self-regulation, consistent with a laissez - faire tradition. B. TOWARD A POLICY OPTION TO PROTECT PRIVACY WHILE MAINTAINING TRANSPARENCY Over...take this journey and shared many a conversation over 4 a.m. coffee; who has borne more than his fair share of the responsibility for our home; and...alternate routes to meet consumer demand.  Public interest is considered, as expressed through political leadership . Public interest will be assumed to

Hazardous Environment Robotics

NASA Technical Reports Server (NTRS)

1996-01-01

Jet Propulsion Laboratory (JPL) developed video overlay calibration and demonstration techniques for ground-based telerobotics. Through a technology sharing agreement with JPL, Deneb Robotics added this as an option to its robotics software, TELEGRIP. The software is used for remotely operating robots in nuclear and hazardous environments in industries including automotive and medical. The option allows the operator to utilize video to calibrate 3-D computer models with the actual environment, and thus plan and optimize robot trajectories before the program is automatically generated.

Food Safety and Nutrition Information for Kids and Teens

MedlinePlus

... Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Food Home Food Resources for You Consumers Kids & Teens ... More sharing options Linkedin Pin it Email Print Food Safety & Nutrition Information for Kids and Teens Fun & ...

Sterilization surgery - making a decision

MedlinePlus

... medlineplus.gov/ency/article/002138.htm Sterilization surgery - making a decision To use the sharing features on this page, ... about all the options available to you before making the decision to have a sterilization procedure. Alternative Names Deciding ...

Consumer Satisfaction with Psychiatric Services: The Role of Shared Decision-Making and the Therapeutic Relationship

PubMed Central

Klingaman, Elizabeth A.; Medoff, Deborah R.; Park, Stephanie G.; Brown, Clayton H.; Fang, Lijuan; Dixon, Lisa B.; Hack, Samantha M.; Tapscott, Stephanie L.; Walsh, Mary Brighid; Kreyenbuhl, Julie A.

2017-01-01

Objective Although dissatisfaction is a primary reason for disengagement from outpatient psychiatric care among consumers with serious mental illnesses, little is known about predictors of their satisfaction with medication management visits. The primary purpose of the present study was to explore how dimensions of consumer preferences for shared decision-making (i.e., preferences for obtaining knowledge about one’s mental illness, being offered and asked one’s opinion about treatment options, and involvement in treatment decisions) and the therapeutic relationship (i.e., positive collaboration and type of clinician input) were related to visit satisfaction. Methods Participants were 228 Veterans with serious mental illnesses who completed a 19-item self-report questionnaire assessing satisfaction with visits to prescribers (n=524 assessments) immediately after visits. In this correlational design, a 3-level mixed model with the restricted maximum likelihood estimation procedure was used to examine shared decision-making preferences and therapeutic alliance as predictors of visit satisfaction. Results Preferences for involvement in treatment decisions was the unique component of shared decision-making associated with satisfaction, such that the more consumers desired involvement, the less satisfied they were. Positive collaboration and prescriber input were associated with greater visit satisfaction. Conclusions and Implications for Practice When consumers with serious mental illnesses express preferences to be involved in shared decision-making, it may not be sufficient to only provide information and treatment options; prescribers should attend to consumers’ interest in involvement in actual treatment decisions. Assessment and tailoring of treatment approaches to consumer preferences for shared decision-making should occur within the context of a strong therapeutic relationship. PMID:25664755

Primum Non Nocere: is shared decision-making the answer?

PubMed

Santhirapala, Ramai; Moonesinghe, Ramani

2016-01-01

Surgical ambition is rising, with the Royal College of Surgeons reporting an increase in the number of procedures by a million over the past decade (Royal College of Surgeons. Surgery and the NHS in Numbers. Available from https://www.rcseng.ac.uk). Underpinning, this is a rapidly growing population, especially those in the over 85 age group, coupled with rising perioperative expertise; options for surgery are now present where conditions were once managed conservatively. Matching the right patient to the right procedure has never been so pertinent (Bader, Am Soc Anesthesiol 78(6), 2014). At the heart of these increasingly complex decisions, which may prove fatal or result in serious morbidity, lies the aspiration of shared decision-making (SDM) (Glance et al., N Engl J Med 370:1379-81, 2014). Shared decision-making is a patient-centred approach taking into account the beliefs, preferences and views of the patient as an expert in what is right for them, supported by clinicians who are the experts in diagnostics and valid therapeutic options (Coulter and Collins, Making shared decision-making a reality: no decision about me, without me, 2011). It has been described as the pinnacle of patient-centred care (Barry et al., N Engl J Med 366:780-1, 2012). In this commentary, we explore further the concept of shared decision-making, supported by a recent article which highlights critical deficits in current perioperative practice (Ankuda et al., Patient Educ Couns 94(3):328-33, 2014). This article was chosen for the purposes of this commentary as it is a large study across several surgical specialties investigating preoperative shared decision-making, and to our knowledge, the only of this kind.

Implementing shared-decision-making for diabetes care across country settings: What really matters to people?

PubMed

Tinelli, Michela; Petrou, Panagiotis; Samoutis, George; Traynor, Vivie; Olympios, George; McGuire, Alistair

2017-07-01

Growing evidence of improved clinical outcomes and patient/professional satisfaction supports shared-decision-making (SDM) services as an effective primary care interventions for diabetes. However, only a few countries have actually adopted them (e.g. England). In other European countries (e.g. Cyprus) there is awareness that patients play a crucial role in decision-making, and SDM services could be considered as innovative strategies to promote the actual implementation of patient rights legislation and strengthen primary care. to understand preferences of people with diabetes when choosing their care, and how they value alternative SDM services compared to their 'current' option. Preferences were collected from patients based in England, where SDM is already in place at national level, and Cyprus, where people are new to it, using a discrete-choice-experiment (DCE) survey. Cypriots valued choosing alternative SDM services compared to their 'current' option, whereas the English preferred their status quo to other services. Having the primary-care-physician as healthcare provider, receiving compassionate care, receiving detailed and accurate information about their care, continuity of care, choosing their care management and treatment, and reduced waiting time were the SDM characteristics that Cypriots valued; the English preferred similar factors, apart from information/continuity of care. People with diabetes do value SDM and different SDM models may fit different groups according to their personal experience and country specific settings. Copyright © 2017 Elsevier B.V. All rights reserved.

Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making.

PubMed

Schroy, Paul C; Mylvaganam, Shamini; Davidson, Peter

2014-02-01

Decision aids for colorectal cancer (CRC) screening have been shown to enable patients to identify a preferred screening option, but the extent to which such tools facilitate shared decision making (SDM) from the perspective of the provider is less well established. Our goal was to elicit provider feedback regarding the impact of a CRC screening decision aid on SDM in the primary care setting. Cross-sectional survey. Primary care providers participating in a clinical trial evaluating the impact of a novel CRC screening decision aid on SDM and adherence. Perceptions of the impact of the tool on decision-making and implementation issues. Twenty-nine of 42 (71%) eligible providers responded, including 27 internists and two nurse practitioners. The majority (>60%) felt that use of the tool complimented their usual approach, increased patient knowledge, helped patients identify a preferred screening option, improved the quality of decision making, saved time and increased patients' desire to get screened. Respondents were more neutral is their assessment of whether the tool improved the overall quality of the patient visit or patient satisfaction. Fewer than 50% felt that the tool would be easy to implement into their practices or that it would be widely used by their colleagues. Decision aids for CRC screening can improve the quality and efficiency of SDM from the provider perspective but future use is likely to depend on the extent to which barriers to implementation can be addressed. © 2011 John Wiley & Sons Ltd.

Patients' views on the use of an Option Grid for knee osteoarthritis in physiotherapy clinical encounters: An interview study.

PubMed

Kinsey, Katharine; Firth, Jill; Elwyn, Glyn; Edwards, Adrian; Brain, Katherine; Marrin, Katy; Nye, Alan; Wood, Fiona

2017-12-01

Patient decision support tools have been developed as a means of providing accurate and accessible information in order for patients to make informed decisions about their care. Option Grids ™ are a type of decision support tool specifically designed to be used during clinical encounters. To explore patients' views of the Option Grid encounter tool used in clinical consultations with physiotherapists, in comparison with usual care, within a patient population who are likely to be disadvantaged by age and low health literacy. Semi-structured interviews with 72 patients (36 who had been given an Option Grid in their consultation and 36 who had not). Thematic analysis explored patients' understanding of treatment options, perceptions of involvement, and readability and utility of the Option Grid. Interviews suggested that the Option Grid facilitated more detailed discussion about the risks and benefits of a wider range of treatment options for osteoarthritis of the knee. Participants indicated that the Option Grid was clear and aided their understanding of a structured progression of the options as their condition advanced, although it was not clear whether the Option Grid facilitated greater engagement in shared decision making. The Option Grid for osteoarthritis of the knee was well received by patient participants who reported that it helped them to understand their options, and made the notion of choice explicit. Use of Option Grids should be considered within routine consultations. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

75 FR 50015 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-16

... Solar, Inc. (``FSLR''), Market Vectors ETF Gold Miners (``GDX''), SPDR Gold Trust (``GLD''), iShares DJ... still lower than fees charged by other options exchanges. PHLX, For example, currently charges Broker...

Know the Risks of Feeding Raw Food to Your Pets

MedlinePlus

... More sharing options Linkedin Pin it Email Print Dogs and cats aren’t exempt from the dangers ... food to contain organisms that can make your dog or cat sick, says William J. Burkholder, DVM, ...

Via Dialogue or Messaging: How Air Force Public Affairs Is Leveraging Social Media

DTIC Science & Technology

2010-12-01

or “blogs”; (2) content-sharing sites (e.g., YouTube, Flickr, Wikis); (3) Micro-blogs (Twitter, Google Buzz); and (4) Social networking sites (e.g...aforementioned categories of social media (blogs, content sharing, micro-blogs, social networking sites , and the optional “other”) are to the overall PA...The results indicate that social networking sites (e.g., Facebook, LinkedIn) were clearly the most utilized by respondents, in terms of posting and

The true invariant of an arbitrage free portfolio

NASA Astrophysics Data System (ADS)

Schmidt, Anatoly B.

2003-03-01

It is shown that the arbitrage free portfolio paradigm being applied to a portfolio with an arbitrary number of shares N allows for the extended solution in which the option price F depends on N. However the resulting stock hedging expense Q= MF (where M is the number of options in the portfolio) does not depend on whether N is treated as an independent variable or as a parameter. Therefore the stock hedging expense is the true invariant of the arbitrage free portfolio paradigm.

Sharing programming resources between Bio* projects through remote procedure call and native call stack strategies.

PubMed

Prins, Pjotr; Goto, Naohisa; Yates, Andrew; Gautier, Laurent; Willis, Scooter; Fields, Christopher; Katayama, Toshiaki

2012-01-01

Open-source software (OSS) encourages computer programmers to reuse software components written by others. In evolutionary bioinformatics, OSS comes in a broad range of programming languages, including C/C++, Perl, Python, Ruby, Java, and R. To avoid writing the same functionality multiple times for different languages, it is possible to share components by bridging computer languages and Bio* projects, such as BioPerl, Biopython, BioRuby, BioJava, and R/Bioconductor. In this chapter, we compare the two principal approaches for sharing software between different programming languages: either by remote procedure call (RPC) or by sharing a local call stack. RPC provides a language-independent protocol over a network interface; examples are RSOAP and Rserve. The local call stack provides a between-language mapping not over the network interface, but directly in computer memory; examples are R bindings, RPy, and languages sharing the Java Virtual Machine stack. This functionality provides strategies for sharing of software between Bio* projects, which can be exploited more often. Here, we present cross-language examples for sequence translation, and measure throughput of the different options. We compare calling into R through native R, RSOAP, Rserve, and RPy interfaces, with the performance of native BioPerl, Biopython, BioJava, and BioRuby implementations, and with call stack bindings to BioJava and the European Molecular Biology Open Software Suite. In general, call stack approaches outperform native Bio* implementations and these, in turn, outperform RPC-based approaches. To test and compare strategies, we provide a downloadable BioNode image with all examples, tools, and libraries included. The BioNode image can be run on VirtualBox-supported operating systems, including Windows, OSX, and Linux.

An empirical analysis of the corporate call decision

NASA Astrophysics Data System (ADS)

Carlson, Murray Dean

1998-12-01

In this thesis we provide insights into the behavior of financial managers of utility companies by studying their decisions to redeem callable preferred shares. In particular, we investigate whether or not an option pricing based model of the call decision, with managers who maximize shareholder value, does a better job of explaining callable preferred share prices and call decisions than do other models of the decision. In order to perform these tests, we extend an empirical technique introduced by Rust (1987) to include the use of information from preferred share prices in addition to the call decisions. The model we develop to value the option embedded in a callable preferred share differs from standard models in two ways. First, as suggested in Kraus (1983), we explicitly account for transaction costs associated with a redemption. Second, we account for state variables that are observed by the decision makers but not by the preferred shareholders. We interpret these unobservable state variables as the benefits and costs associated with a change in capital structure that can accompany a call decision. When we add this variable, our empirical model changes from one which predicts exactly when a share should be called to one which predicts the probability of a call as the function of the observable state. These two modifications of the standard model result in predictions of calls, and therefore of callable preferred share prices, that are consistent with several previously unexplained features of the data; we show that the predictive power of the model is improved in a statistical sense by adding these features to the model. The pricing and call probability functions from our model do a good job of describing call decisions and preferred share prices for several utilities. Using data from shares of the Pacific Gas and Electric Co. (PGE) we obtain reasonable estimates for the transaction costs associated with a call. Using a formal empirical test, we are able to conclude that the managers of the Pacific Gas and Electric Company clearly take into account the value of the option to delay the call when making their call decisions. Overall, the model seems to be robust to tests of its specification and does a better job of describing the data than do simpler models of the decision making process. Limitations in the data do not allow us to perform the same tests in a larger cross-section of utility companies. However, we are able to estimate transaction cost parameters for many firms and these do not seem to vary significantly from those of PGE. This evidence does not cause us to reject our hypothesis that managerial behavior is consistent with a model in which managers maximize shareholder value.

Optimisation of the Management of Higher Activity Waste in the UK - 13537

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

Walsh, Ciara; Buckley, Matthew

2013-07-01

The Upstream Optioneering project was created in the Nuclear Decommissioning Authority (UK) to support the development and implementation of significant opportunities to optimise activities across all the phases of the Higher Activity Waste management life cycle (i.e. retrieval, characterisation, conditioning, packaging, storage, transport and disposal). The objective of the Upstream Optioneering project is to work in conjunction with other functions within NDA and the waste producers to identify and deliver solutions to optimise the management of higher activity waste. Historically, optimisation may have occurred on aspects of the waste life cycle (considered here to include retrieval, conditioning, treatment, packaging, interimmore » storage, transport to final end state, which may be geological disposal). By considering the waste life cycle as a whole, critical analysis of assumed constraints may lead to cost savings for the UK Tax Payer. For example, it may be possible to challenge the requirements for packaging wastes for disposal to deliver an optimised waste life cycle. It is likely that the challenges faced in the UK are shared in other countries. It is therefore likely that the opportunities identified may also apply elsewhere, with the potential for sharing information to enable value to be shared. (authors)« less

Patients' and observers' perceptions of involvement differ. Validation study on inter-relating measures for shared decision making.

PubMed

Kasper, Jürgen; Heesen, Christoph; Köpke, Sascha; Fulcher, Gary; Geiger, Friedemann

2011-01-01

Patient involvement into medical decisions as conceived in the shared decision making method (SDM) is essential in evidence based medicine. However, it is not conclusively evident how best to define, realize and evaluate involvement to enable patients making informed choices. We aimed at investigating the ability of four measures to indicate patient involvement. While use and reporting of these instruments might imply wide overlap regarding the addressed constructs this assumption seems questionable with respect to the diversity of the perspectives from which the assessments are administered. The study investigated a nested cohort (N = 79) of a randomized trial evaluating a patient decision aid on immunotherapy for multiple sclerosis. Convergent validities were calculated between observer ratings of videotaped physician-patient consultations (OPTION) and patients' perceptions of the communication (Shared Decision Making Questionnaire, Control Preference Scale & Decisional Conflict Scale). OPTION reliability was high to excellent. Communication performance was low according to OPTION and high according to the three patient administered measures. No correlations were found between observer and patient judges, neither for means nor for single items. Patient report measures showed some moderate correlations. Existing SDM measures do not refer to a single construct. A gold standard is missing to decide whether any of these measures has the potential to indicate patient involvement. Pronounced heterogeneity of the underpinning constructs implies difficulties regarding the interpretation of existing evidence on the efficacy of SDM. Consideration of communication theory and basic definitions of SDM would recommend an inter-subjective focus of measurement. Controlled-Trials.com ISRCTN25267500.

Acceptance of shared decision making with reference to an electronic library of decision aids (arriba-lib) and its association to decision making in patients: an evaluation study.

PubMed

Hirsch, Oliver; Keller, Heidemarie; Krones, Tanja; Donner-Banzhoff, Norbert

2011-07-07

Decision aids based on the philosophy of shared decision making are designed to help patients make informed choices among diagnostic or treatment options by delivering evidence-based information on options and outcomes. A patient decision aid can be regarded as a complex intervention because it consists of several presumably relevant components. Decision aids have rarely been field tested to assess patients' and physicians' attitudes towards them. It is also unclear what effect decision aids have on the adherence to chosen options. The electronic library of decision aids (arriba-lib) to be used within the clinical encounter has a modular structure and contains evidence-based decision aids for the following topics: cardiovascular prevention, atrial fibrillation, coronary heart disease, oral antidiabetics, conventional and intensified insulin therapy, and unipolar depression. We conducted an evaluation study in which 29 primary care physicians included 192 patients. After the consultation, patients filled in questionnaires and were interviewed via telephone two months later. We used generalised estimation equations to measure associations within patient variables and traditional crosstab analyses. Patients were highly satisfied with arriba-lib and the process of shared decision making. Two-thirds of patients reached in the telephone interview wanted to be counselled again with arriba-lib. There was a high congruence between preferred and perceived decision making. Of those patients reached in the telephone interview, 80.7% said that they implemented the decision, independent of gender and education. Elderly patients were more likely to say that they implemented the decision. Shared decision making with our multi-modular electronic library of decision aids (arriba-lib) was accepted by a high number of patients. It has positive associations to general aspects of decision making in patients. It can be used for patient groups with a wide range of individual characteristics.

Evidence-based dentistry: fundamentals for the dentist.

PubMed

Bauer, Janet; Chiappelli, Francesco; Spackman, Sue; Prolo, Paolo; Stevenson, Richard

2006-06-01

This article explains the fundamentals of evidence-based dentistry for the dentist. Evidence-based dentistry is a discipline whose primary participant is the translational researcher. Recent developments have emphasized the importance of this discipline (clinical and translational research) for improving health care. The process of evidence-based dentistry is the reciprocation of new and existing evidence between dentists and quantitative and qualitative researchers, facilitated by the translational researcher. The product of this reciprocation is the clinical practice guideline, or best evidence, that provides the patient options in choosing treatments or services. These options are quantified and qualified by decision, utility, and cost data. Using shared decision-making, the dentist and patient arrive at a mutual understanding of which option best meets an acceptable and preferred treatment course that is cost effective. This option becomes the clinical decision.

Roles, processes, and outcomes of interprofessional shared decision-making in a neonatal intensive care unit: A qualitative study.

PubMed

Dunn, Sandra I; Cragg, Betty; Graham, Ian D; Medves, Jennifer; Gaboury, Isabelle

2018-05-01

Shared decision-making provides an opportunity for the knowledge and skills of care providers to synergistically influence patient care. Little is known about interprofessional shared decision-making processes in critical care settings. The aim of this study was to explore interprofessional team members' perspectives about the nature of interprofessional shared decision-making in a neonatal intensive care unit (NICU) and to determine if there are any differences in perspectives across professional groups. An exploratory qualitative approach was used consisting of semi-structured interviews with 22 members of an interprofessional team working in a tertiary care NICU in Canada. Participants identified four key roles involved in interprofessional shared decision-making: leader, clinical experts, parents, and synthesizer. Participants perceived that interprofessional shared decision-making happens through collaboration, sharing, and weighing the options, the evidence and the credibility of opinions put forward. The process of interprofessional shared decision-making leads to a well-informed decision and participants feeling valued. Findings from this study identified key concepts of interprofessional shared decision-making, increased awareness of differing professional perspectives about this process of shared decision-making, and clarified understanding of the different roles involved in the decision-making process in an NICU.

Declining average daily census. Part 1: Implications and options.

PubMed

Weil, T P

1985-12-01

A national trend toward declining average daily (inpatient) census (ADC) started in late 1982 even before the Medicare prospective payment system began. The decrease in total days will continue despite an increasing number of aged persons in the U.S. population. This decline could have been predicted from trends during 1978 to 1983, such as increasing available beds but decreasing occupancy, 100 percent increases in hospital expenses, and declining lengths of stay. Assuming that health care costs will remain as a relatively fixed part of the gross national product and no major medical advances will occur in the next five years, certain implications and options exist for facilities experiencing a declining ADC. This article discusses several considerations: Attempts to improve market share; Reduction of full-time equivalent employees; Impact of greater acuity of illness among remaining inpatients; Implications of increasing the number of physicians on medical staffs; Option of a closed medical staff by clinical specialty; Unbundling with not-for-profit and profit-making corporations; Review of mergers, consolidations, and multihospital systems to decide when this option is most appropriate; Sale of a not-for-profit hospital to an investor-owned chain, with implications facing Catholic hospitals choosing this option; Impact and difficulty of developing meaningful alternative health care systems with the hospital's medical staff; Special problems of teaching hospitals; The social issue of the hospital shifting from the community's health center to a cost center; Increased turnover of hospital CEOs; With these in mind, institutions can then focus on solutions that can sometimes be used in tandem to resolve this problem's impact. The second part of this article will discuss some of them.

Transitivity of Preferences

ERIC Educational Resources Information Center

Regenwetter, Michel; Dana, Jason; Davis-Stober, Clintin P.

2011-01-01

Transitivity of preferences is a fundamental principle shared by most major contemporary rational, prescriptive, and descriptive models of decision making. To have transitive preferences, a person, group, or society that prefers choice option "x" to "y" and "y" to "z" must prefer "x" to…

Clinical Equipoise and Shared Decision-making in Pulmonary Nodule Management. A Survey of American Thoracic Society Clinicians.

PubMed

Iaccarino, Jonathan M; Simmons, James; Gould, Michael K; Slatore, Christopher G; Woloshin, Steven; Schwartz, Lisa M; Wiener, Renda Soylemez

2017-06-01

Guidelines for pulmonary nodule evaluation suggest a variety of strategies, reflecting the lack of high-quality evidence demonstrating the superiority of any one approach. It is unclear whether clinicians agree that multiple management options are appropriate at different levels of risk and whether this impacts their decision-making approaches with patients. To assess clinicians' perceptions of the appropriateness of various diagnostic strategies, approach to decision-making, and perceived clinical equipoise in pulmonary nodule evaluation. We developed and administered a web-based survey in March and April, 2014 to clinician members of the American Thoracic Society. The primary outcome was perceived appropriateness of pulmonary nodule evaluation strategies in three clinical vignettes with different malignancy risk. We compared responses to guideline recommendations and analyzed clinician characteristics associated with a reported shared decision-making approach. We also assessed clinicians' likelihood to enroll patients in hypothetical randomized trials comparing nodule evaluation strategies. Of 5,872 American Thoracic Society members e-mailed, 1,444 opened the e-mail and 428 eligible clinicians participated in the survey (response rate, 30.0% among those who opened the invitation; 7% overall). The mean number of options considered appropriate increased with pretest probability of cancer, ranging from 1.8 (SD, 1.2) for the low-risk case to 3.5 (1.1) for the high-risk case (P < 0.0001). As recommended by guidelines, the proportion that deemed surgical resection as an appropriate option also increased with cancer risk (P < 0.0001). One-half of clinicians (50.4%) reported engaging in shared decision-making with patients for pulmonary nodule management; this was more commonly reported by clinicians with more years of experience (P = 0.01) and those who reported greater comfort in managing pulmonary nodules (P = 0.005). Although one-half (49.9%) deemed the evidence for pulmonary nodule evaluation to be strong, most clinicians were willing to enroll patients in randomized trials to compare nodule management strategies in all risk categories (low risk, 87.6%; moderate risk, 89.7%; high risk, 63.0%). Consistent with guideline recommendations, clinicians embrace multiple options for pulmonary nodule evaluation and many are open to shared decision-making. Clinicians support the need for randomized clinical trials to strengthen the evidence for nodule evaluation, which will further improve decision-making.

Study protocol for 'we DECide': implementation of advance care planning for nursing home residents with dementia.

PubMed

Ampe, Sophie; Sevenants, Aline; Coppens, Evelien; Spruytte, Nele; Smets, Tinne; Declercq, Anja; van Audenhove, Chantal

2015-05-01

To evaluate the effects of 'we DECide', an educational intervention for nursing home staff on shared decision-making in the context of advance care planning for residents with dementia. Advance care planning (preparing care choices for when persons no longer have decision-making capacity) is of utmost importance for nursing home residents with dementia, but is mostly not realized for this group. Advance care planning consists of discussing care choices and making decisions and corresponds to shared decision-making (the involvement of persons and their families in care and treatment decisions). This quasi-experimental pre-test-post-test study is conducted in 19 nursing homes (Belgium). Participants are nursing home staff. 'We DECide' focuses on three crucial moments for discussing advance care planning: the time of admission, crisis situations and everyday conversations. The 'ACP-audit' assesses participants' views on the organization of advance care planning (organizational level), the 'OPTION scale' evaluates the degree of shared decision-making in individual conversations (clinical level) and the 'IFC-SDM Questionnaire' assesses participants' views on Importance, Frequency and Competence of realizing shared decision-making (clinical level). (Project funded: July 2010). The study hypothesis is that 'we DECide' results in a higher realization of shared decision-making in individual conversations on advance care planning. A better implementation of advance care planning will lead to a higher quality of end-of-life care and more person-centred care. We believe our study will be of interest to researchers and to professional nursing home caregivers and policy-makers. © 2014 John Wiley & Sons Ltd.

Patient and physician views of shared decision making in cancer.

PubMed

Tamirisa, Nina P; Goodwin, James S; Kandalam, Arti; Linder, Suzanne K; Weller, Susan; Turrubiate, Stella; Silva, Colleen; Riall, Taylor S

2017-12-01

Engaging patients in shared decision making involves patient knowledge of treatment options and physician elicitation of patient preferences. Our aim was to explore patient and physician perceptions of shared decision making in clinical encounters for cancer care. Patients and physicians were asked open-ended questions regarding their perceptions of shared decision making throughout their cancer care. Transcripts of interviews were coded and analysed for shared decision-making themes. At an academic medical centre, 20 cancer patients with a range of cancer diagnoses, stages of cancer and time from diagnosis, and eight physicians involved in cancer care were individually interviewed. Most physicians reported providing patients with written information. However, most patients reported that written information was too detailed and felt that the physicians did not assess the level of information they wished to receive. Most patients wanted to play an active role in the treatment decision, but also wanted the physician's recommendation, such as what their physician would choose for him/herself or a family member in a similar situation. While physicians stated that they incorporated patient autonomy in decision making, most provided data without making treatment recommendations in the format preferred by most patients. We identified several communication gaps in cancer care. While patients want to be involved in the decision-making process, they also want physicians to provide evidence-based recommendations in the context of their individual preferences. However, physicians often are reluctant to provide a recommendation that will bias the patient. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

How Will the Affordable Care Act's Cost-Sharing Reductions Affect Consumers' Out-of-Pocket Costs in 2016?

PubMed

Collins, Sara R; Gunja, Munira; Beutel, Sophie

2016-03-01

Health insurers selling plans in the Affordable Care Act's market­places are required to reduce cost-sharing in silver plans for low- and moderate-income people earning between 100 percent and 250 percent of the federal pov­erty level. In 2016, as many as 7 million Americans may have plans with these cost-sharing reductions. In the largest markets in the 38 states using the federal website for marketplace enrollment, the cost-sharing reductions substantially lower projected out-of-pocket costs for people who qualify for them. However, the degree to which consumers' out-of-pocket spending will fall varies by plan and how much health care they use. This is because insurers use deductibles, out-of-pocket limits, and copayments in different combinations to lower cost-sharing for eligible enrollees. In 2017, marketplace insurers will have the option of offering standard plans, which may help simplify consumers' choices and lead to more equal cost-sharing.

Job sharing in clinical nutrition management: a plan for successful implementation.

PubMed

Visocan, B J; Herold, L S; Mulcahy, M J; Schlosser, M F

1993-10-01

While women continue to enter the American work force in record numbers; many experience difficulty in juggling career and family obligations. Flexible scheduling is one option used to ease work and family pressures. Women's changing work roles have potentially noteworthy implications for clinical nutrition management, a traditionally female-dominated profession where the recruitment and retention of valued, experienced registered dietitians can prove to be a human resources challenge. Job sharing, one type of flexible scheduling, is applicable to the nutrition management arena. This article describes and offers a plan for overcoming obstacles to job sharing, including determining feasibility, gaining support of top management, establishing program design, announcing the job share program, and using implementation, monitoring, and fine-tuning strategies. Benefits that can be derived from a successful job share are reduced absenteeism, decreased turnover, enhanced recruitment, improved morale, increased productivity, improved job coverage, and enhanced skills and knowledge base. A case study illustrates one method for achieving job sharing success in clinical nutrition management.

Downsizing: Fat Reduction or Fool's Gold?

ERIC Educational Resources Information Center

Teece, Phil

1999-01-01

Discussion of downsizing in organizations focuses on Australian libraries. Topics include rationales behind downsizing; negative results in terms of equity and efficiency; guidelines and other options for responsible restructuring, including skills training, continuous learning programs, information sharing, and employee participation; jobs for…

76 FR 62877 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-11

.... This lower rate will be calculated on a daily basis. Market participants who share a trading acronym or... require that a market participant appropriately indicate his trading acronym and/or MPID in the...

Economic viability of Stratified Medicine concepts: An investor perspective on drivers and conditions that favour using Stratified Medicine approaches in a cost-contained healthcare environment.

PubMed

Fugel, Hans-Joerg; Nuijten, Mark; Postma, Maarten

2016-12-25

Stratified Medicine (SM) is becoming a natural result of advances in biomedical science and a promising path for the innovation-based biopharmaceutical industry to create new investment opportunities. While the use of biomarkers to improve R&D efficiency and productivity is very much acknowledged by industry, much work remains to be done to understand the drivers and conditions that favour using a stratified approach to create economically viable products and to justify the investment in SM interventions as a stratification option. In this paper we apply a decision analytical methodology to address the economic attractiveness of different SM development options in a cost-contained healthcare environment. For this purpose, a hypothetical business case in the oncology market has been developed considering four feasible development scenarios. The article outlines the effects of development time and time to peak sales as key economic value drivers influencing profitability of SM interventions under specific conditions. If regulatory and reimbursement challenges can be solved, decreasing development time and enhancing early market penetration would most directly improve the economic attractiveness of SM interventions. Appropriate tailoring of highly differentiated patient subgroups is the prerequisite to leverage potential efficiency gains in the R&D process. Also, offering a better targeted and hence ultimately more cost-effective therapy at reimbursable prices will facilitate time to market access and allow increasing market share gains within the targeted populations. Copyright © 2016 Elsevier B.V. All rights reserved.

Modeling and Improving Information Flows in the Development of Large Business Applications

NASA Astrophysics Data System (ADS)

Schneider, Kurt; Lübke, Daniel

Designing a good architecture for an application is a wicked problem. Therefore, experience and knowledge are considered crucial for informing work in software architecture. However, many organizations do not pay sufficient attention to experience exploitation and architectural learning. Many users of information systems are not aware of the options and the needs to report problems and requirements. They often do not have time to describe a problem encountered in sufficient detail for developers to remove it. And there may be a lengthy process for providing feedback. Hence, the knowledge about problems and potential solutions is not shared effectively. Architectural knowledge needs to include evaluative feedback as well as decisions and their reasons (rationale).

Strategies to mitigate nitrous oxide emissions from herbivore production systems.

PubMed

Schils, R L M; Eriksen, J; Ledgard, S F; Vellinga, Th V; Kuikman, P J; Luo, J; Petersen, S O; Velthof, G L

2013-03-01

Herbivores are a significant source of nitrous oxide (N(2)O) emissions. They account for a large share of manure-related N(2)O emissions, as well as soil-related N(2)O emissions through the use of grazing land, and land for feed and forage production. It is widely acknowledged that mitigation measures are necessary to avoid an increase in N(2)O emissions while meeting the growing global food demand. The production and emissions of N(2)O are closely linked to the efficiency of nitrogen (N) transfer between the major components of a livestock system, that is, animal, manure, soil and crop. Therefore, mitigation options in this paper have been structured along these N pathways. Mitigation technologies involving diet-based intervention include lowering the CP content or increasing the condensed tannin content of the diet. Animal-related mitigation options also include breeding for improved N conversion and high animal productivity. The main soil-based mitigation measures include efficient use of fertilizer and manure, including the use of nitrification inhibitors. In pasture-based systems with animal housing facilities, reducing grazing time is an effective option to reduce N(2)O losses. Crop-based options comprise breeding efforts for increased N-use efficiency and the use of pastures with N(2)-fixing clover. It is important to recognize that all N(2)O mitigation options affect the N and carbon cycles of livestock systems. Therefore, care should be taken that reductions in N(2)O emissions are not offset by unwanted increases in ammonia, methane or carbon dioxide emissions. Despite the abundant availability of mitigation options, implementation in practice is still lagging. Actual implementation will only follow after increased awareness among farmers and greenhouse gases targeted policies. So far, reductions in N(2)O emissions that have been achieved are mostly a positive side effect of other N-targeted policies.

iAnn: an event sharing platform for the life sciences.

PubMed

Jimenez, Rafael C; Albar, Juan P; Bhak, Jong; Blatter, Marie-Claude; Blicher, Thomas; Brazas, Michelle D; Brooksbank, Cath; Budd, Aidan; De Las Rivas, Javier; Dreyer, Jacqueline; van Driel, Marc A; Dunn, Michael J; Fernandes, Pedro L; van Gelder, Celia W G; Hermjakob, Henning; Ioannidis, Vassilios; Judge, David P; Kahlem, Pascal; Korpelainen, Eija; Kraus, Hans-Joachim; Loveland, Jane; Mayer, Christine; McDowall, Jennifer; Moran, Federico; Mulder, Nicola; Nyronen, Tommi; Rother, Kristian; Salazar, Gustavo A; Schneider, Reinhard; Via, Allegra; Villaveces, Jose M; Yu, Ping; Schneider, Maria V; Attwood, Teresa K; Corpas, Manuel

2013-08-01

We present iAnn, an open source community-driven platform for dissemination of life science events, such as courses, conferences and workshops. iAnn allows automatic visualisation and integration of customised event reports. A central repository lies at the core of the platform: curators add submitted events, and these are subsequently accessed via web services. Thus, once an iAnn widget is incorporated into a website, it permanently shows timely relevant information as if it were native to the remote site. At the same time, announcements submitted to the repository are automatically disseminated to all portals that query the system. To facilitate the visualization of announcements, iAnn provides powerful filtering options and views, integrated in Google Maps and Google Calendar. All iAnn widgets are freely available. http://iann.pro/iannviewer manuel.corpas@tgac.ac.uk.

Patient Protection and Affordable Care Act; HHS notice of benefit and payment parameters for 2015. Final rule.

PubMed

2014-03-11

This final rule sets forth payment parameters and oversight provisions related to the risk adjustment, reinsurance, and risk corridors programs; cost sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges. It also provides additional standards with respect to composite premiums, privacy and security of personally identifiable information, the annual open enrollment period for 2015, the actuarial value calculator, the annual limitation in cost sharing for stand-alone dental plans, the meaningful difference standard for qualified health plans offered through a Federally-facilitated Exchange, patient safety standards for issuers of qualified health plans, and the Small Business Health Options Program.

Excluded Facility Financial Status and Options for Payment System Modification

PubMed Central

Schneider, John E.; Cromwell, Jerry; McGuire, Thomas P.

1993-01-01

Psychiatric, rehabilitation, long-term care, and children's facilities have remained under the reimbursement system established under the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 (Public Law 97-248). The number of TEFRA facilities and discharges has been increasing while their average profit rates have been steadily declining. Modifying TEFRA would require either rebasing the target amount or adjusting cost sharing for facilities exceeding their cost target. Based on our simulations of alternative payment systems, we recommend rebasing facilities' target amounts using a 50/50 blend of own costs and national average costs. Cost sharing above the target amount could be increased to include more government sharing of losses. PMID:10135345

The Caspian Sea Negotiation Support System 2.0

NASA Astrophysics Data System (ADS)

Rouhani, O. M.; Madani, K.

2012-12-01

The Caspian Sea is one of the most resourceful (both in energy and biological resources) areas of the world. The share allocation of Caspian Sea has been the subject of many disputes. Up to now, the negotiations to reach an agreement regarding the ownership status of the sea have not been completely successful. To facilitate reaching an agreement among littoral countries, research studies can provide valuable information. Researchers should examine different options for dividing the sea closely and determine the benefits of each of the options for the parties involved. Following an earlier effort, Caspian Sea Negotiation Support System is further developed in this regard. The model estimates countries' areal and utility shares under different legal methods/scenarios, attempting to minimize transportation costs of exploiting the resource. The applied model is more efficient than the earlier model and the used data includes more variables/attributes such as depth, the differentiation between gas and oil, and various fish resources than the previously employed data. Consequently, the estimates are calculated in more details than are calculated in the earlier study. The results still show a high sensitivity of outputs to the proposed division rules, suggesting a need to clarify the countries' utility and areal shares under any suggested legal regime. Compared to the previous results, the new results confirm the significant effect of the addition of the more variables/attributes to the analysis, in terms of the areal shares and allocations, valuation of resources, and asset management.

5 CFR 6801.102 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

...; any interests convertible into debt or equity interests; and any options, rights, warrants, puts, calls, straddles, and derivatives with respect thereto. (2) Debt or equity interest does not include deposits; credit union shares; any future interest created by someone other than the employee, his or her...

EPA'S PHOTOVOLTAIC DEMAND-SIDE MANAGEMENT COST-SHARED DEMONSTRATIONS

EPA Science Inventory

The paper discusses an investigation of how photovoltaics (PV) may be used as both a pollution-mitigating energy replacement for fossil fuels and a demand-side management (DSM) option to reduce peak electrical demands of commercial and residential buildings. leven electric utilit...

42 CFR 423.882 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... qualifying covered retiree under the plan. Benefit option means a particular benefit design, category of benefits, or cost-sharing arrangement offered within a group health plan. Employment-based retiree health... the foregoing, including a health benefits plan offered under chapter 89 of Title 5, United States...

Container-based sanitation: assessing costs and effectiveness of excreta management in Cap Haitien, Haiti

PubMed Central

Tilmans, Sebastien; Russel, Kory; Sklar, Rachel; Page, Leah; Kramer, Sasha

2015-01-01

Container-based sanitation (CBS) – in which wastes are captured in sealable containers that are then transported to treatment facilities – is an alternative sanitation option in urban areas where on-site sanitation and sewerage are infeasible. This paper presents the results of a pilot household CBS service in Cap Haitien, Haiti. We quantify the excreta generated weekly in a dense urban slum,(1) the proportion safely removed via container-based public and household toilets, and the costs associated with these systems. The CBS service yielded an approximately 3.5-fold decrease in the unmanaged share of faeces produced, and nearly eliminated the reported use of open defecation and “flying toilets” among service recipients. The costs of this pilot small-scale service were higher than those of large-scale waterborne sewerage, but economies of scale have the potential to reduce CBS costs over time. The paper concludes with a discussion of planning and policy implications of incorporating CBS into the menu of sanitation options for rapidly growing cities. PMID:26097288

Failure to protect: why the individual insurance market is not a viable option for most U.S. families: findings from the Commonwealth Fund Biennial Health Insurance Survey, 2007.

PubMed

Doty, Michelle M; Collins, Sara R; Nicholson, Jennifer L; Rustgi, Sheila D

2009-07-01

Between 2001 and 2007, an increasing share of adults with private insurance--whether employer-based coverage or individual market plans--spent a large amount of their income on premiums and out-of-pocket medical costs, were underinsured, and/or avoided needed health care because of costs. Those with coverage obtained in the individual market were the most affected. Over the last three years, nearly three-quarters of people who tried to buy coverage in this market never actually purchased a plan, either because they could not find one that fit their needs or that they could afford, or because they were turned down due to a preexisting condition. Even people enrolled in employer-based plans are spending larger amounts of their income on health care and curtailing their use of needed services to save money. The findings underscore the need for an expansion of affordable health insurance options, particularly during a time of mounting job losses.

Patient adherence and effective communication.

PubMed

Bukstein, Don A

2016-12-01

Poor adherence to inhaled corticosteroid medication is a critical problem for asthma because it contributes to morbidity and mortality through poor asthma control, frequent asthma exacerbations, acute care visits, and oral corticosteroid use. To discuss evidence-based, time-efficient strategies that can be adopted by most practitioners to try to increase patient adherence. Asthma management guidelines and other key publications are used to enhance discussion. Establishing patient-centered, collaborative care that permits effective patient-practitioner communication can improve adherence, thus leading to improved asthma outcomes. One critical strategy is shared decision making, in which the patient and the practitioner share relevant information, discuss risks vs benefits of various treatment options, express treatment preferences, deliberate the options, and agree on treatment. Asthma self-management education, which emphasizes self-efficacy, is also essential. The education necessary to provide those skills depends in part on consideration of the patient's health literacy. Practitioners also have at their disposal a variety of tips and techniques to improve communication and gather information not only at the patient-practitioner level but also at the practitioner-practitioner level, such as within a group practice or within a health care system. To improve patient adherence, clinicians need to consider a variety of factors and implement strategies that directly target underlying issues. Strategies may include customizing and simplifying learning and intervention regimens, identifying barriers to adherence and addressing them, ensuring patient support structures are in place, and improving self-efficacy and health literacy. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Global socioeconomic carbon stocks in long-lived products 1900-2008

NASA Astrophysics Data System (ADS)

Lauk, Christian; Haberl, Helmut; Erb, Karl-Heinz; Gingrich, Simone; Krausmann, Fridolin

2012-09-01

A better understanding of the global carbon cycle as well as of climate change mitigation options such as carbon sequestration requires the quantification of natural and socioeconomic stocks and flows of carbon. A so-far under-researched aspect of the global carbon budget is the accumulation of carbon in long-lived products such as buildings and furniture. We present a comprehensive assessment of global socioeconomic carbon stocks and the corresponding in- and outflows during the period 1900-2008. These data allowed calculation of the annual carbon sink in socioeconomic stocks during this period. The study covers the most important socioeconomic carbon fractions, i.e. wood, bitumen, plastic and cereals. Our assessment was mainly based on production and consumption data for plastic, bitumen and wood products and the respective fractions remaining in stocks in any given year. Global socioeconomic carbon stocks were 2.3 GtC in 1900 and increased to 11.5 GtC in 2008. The share of wood in total C stocks fell from 97% in 1900 to 60% in 2008, while the shares of plastic and bitumen increased to 16% and 22%, respectively. The rate of gross carbon sequestration in socioeconomic stocks increased from 17 MtC yr-1 in 1900 to a maximum of 247 MtC yr-1 in 2007, corresponding to 2.2%-3.4% of global fossil-fuel-related carbon emissions. We conclude that while socioeconomic carbon stocks are not negligible, their growth over time is not a major climate change mitigation option and there is an only modest potential to mitigate climate change by the increase of socioeconomic carbon stocks.

Shared decision making: prostate cancer patients' appraisal of treatment alternatives and oncologists' eliciting and responding behavior, an explorative study.

PubMed

Pieterse, Arwen H; Henselmans, Inge; de Haes, Hanneke C J M; Koning, Caro C E; Geijsen, Elisabeth D; Smets, Ellen M A

2011-12-01

To assess clinicians' use of shared decision making (SDM) skills, enabling patient treatment evaluations (appraisals); and varieties of patient appraisals and clinicians' preceding and following utterances. Two coders rated videotaped initial visits of 25 early-stage prostate cancer patients to their radiation oncologist. SDM skills were assessed using the Decision Analysis System for Oncology (DAS-O); appraisals and clinicians' utterances were labeled using qualitative methodology. Clinicians offered a treatment choice to 10 patients. They informed 15/25 about pros and 20/25 about cons of options. Patients expressed 67 appraisals (median/visit=2; range, 0-12). Half of appraisals were favorable and one-fourth was unfavorable toward treatment options. One-fifth referred to explicit tradeoffs. One-third of appraisals followed clinician requests; 58% followed clinician information. Clinicians approved almost half of appraisals. They contested, ignored or highlighted a minority. Clinicians infrequently offered patients a choice or explored appraisals. Most appraisals supported rather than challenged treatment options. Clinicians most often legitimized appraisals, thereby helping patients to feel good about the decision. Exploring appraisals may help patients in forming more stable preferences, thus benefiting patients in the long run. Clinicians should request patient appraisals and ascertain whether these seem well-informed before making treatment recommendations. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Development of a Framework Based on Reflective MCDA to Support Patient-Clinician Shared Decision-Making: The Case of the Management of Gastroenteropancreatic Neuroendocrine Tumors (GEP-NET) in the United States.

PubMed

Wagner, Monika; Samaha, Dima; Khoury, Hanane; O'Neil, William M; Lavoie, Louis; Bennetts, Liga; Badgley, Danielle; Gabriel, Sylvie; Berthon, Anthony; Dolan, James; Kulke, Matthew H; Goetghebeur, Mireille

2018-01-01

Well- or moderately differentiated gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are often slow-growing, and some patients with unresectable, asymptomatic, non-functioning tumors may face the choice between watchful waiting (WW), or somatostatin analogues (SSA) to delay progression. We developed a comprehensive multi-criteria decision analysis (MCDA) framework to help patients and physicians clarify their values and preferences, consider each decision criterion, and support communication and shared decision-making. The framework was adapted from a generic MCDA framework (EVIDEM) with patient and clinician input. During a workshop, patients and clinicians expressed their individual values and preferences (criteria weights) and, on the basis of two scenarios (treatment vs WW; SSA-1 [lanreotide] vs SSA-2 [octreotide]) with evidence from a literature review, expressed how consideration of each criterion would impact their decision in favor of either option (score), and shared their knowledge and insights verbally and in writing. The framework included benefit-risk criteria and modulating factors, such as disease severity, quality of evidence, costs, and constraints. Overall and progression-free survival being most important, criteria weights ranged widely, highlighting variations in individual values and the need to share them. Scoring and considering each criterion prompted a rich exchange of perspectives and uncovered individual assumptions and interpretations. At the group level, type of benefit, disease severity, effectiveness, and quality of evidence favored treatment; cost aspects favored WW (scenario 1). For scenario 2, most criteria did not favor either option. Patients and clinicians consider many aspects in decision-making. The MCDA framework provided a common interpretive frame to structure this complexity, support individual reflection, and share perspectives. Ipsen Pharma.

Treating childhood intermittent distance exotropia: a qualitative study of decision making.

PubMed

Lecouturier, Jan; Clarke, Michael P; Errington, Gail; Hallowell, Nina; Murtagh, Madeleine J; Thomson, Richard

2015-08-22

Engaging patients (parents/families) in treatment decisions is increasingly recognised as important and beneficial. Yet where the evidence base for treatment options is limited, as with intermittent distance exotropia (X(T)), this presents a challenge for families and clinicians. The purpose of this study was to explore how decisions are made in the management and treatment of X(T) and what can be done to support decision-making for clinicians, parents and children. This was a qualitative study using face to face interviews with consultant ophthalmologists and orthoptists, and parents of children with X(T). Interview data were analysed using the constant comparative method. The drivers for clinicians in treatment decision-making for X(T) were the proportion of time the strabismus is manifest and parents' views. For parents, decisions were influenced by: fear of bullying and, to a lesser degree, concerns around the impact of the strabismus on their child's vision. Uncertainty around the effectiveness of treatment options caused difficulties for some clinicians when communicating with parents. Parental understanding of the nature of X(T) and rationale for treatment often differed from that of the clinicians, and this affected their involvement in decision-making. Though there were good examples of shared decision-making and parent and child engagement some parents said the process felt rushed and they felt excluded. Parents reported that clinicians provided sufficient information in consultations but they had difficulties in retaining verbal information to convey to other family members. Overall parents were happy with the care their child received but there is scope for better parent and (where appropriate) child engagement in decision-making. There was an expressed need for written information about X(T) to reinforce what was given verbally in consultations and to share with other family members. Access could be via the hospital website, along with videos or blogs from parents and children who have undergone the various management options. A method of assisting clinicians to explain the treatment options, together with the uncertainties, in a clear and concise way could be of particular benefit to orthoptists who have the most regular contact with parents and children, and are more likely to suggest conservative treatments such as occlusion and minus lenses.

The LINC-NIRVANA fringe and flexure tracker: Linux real-time solutions

NASA Astrophysics Data System (ADS)

Wang, Yeping; Bertram, Thomas; Straubmeier, Christian; Rost, Steffen; Eckart, Andreas

2006-06-01

The correction of atmospheric differential piston and instrumental flexure effects is mandatory for optimum interferometric performance of the LBT NIR interferometric imaging camera LINC-NIRVANA. The task of the Fringe and Flexure Tracking System (FFTS) is to detect and correct these effects in a real-time closed loop. On a timescale of milliseconds, image data of the order of 4K bytes has to be retrieved from the FFTS detector, analyzed, and the results have to be sent to the control system. The need for a reliable communication between several processes within a confined period of time calls for solutions with good real-time performance. We investigated two soft real-time options for the Linux platform. The design we present takes advantage of several features that follow the POSIX standard with improved real-time performance, which were implemented in the new Linux kernel (2.6.12). Several concepts, such as synchronization, shared memory, and preemptive scheduling are considered and the performance of the most time-critical parts of the FFTS software is tested.

33 CFR 279.5 - Policy.

Code of Federal Regulations, 2012 CFR

2012-07-01

... served (social option) and will be in keeping with the capabilities of the natural and man-made resources... administrative cost-sharing policy. Preparation of regional studies and establishment of these objectives will... public be fully involved in the regional studies and development of resource use objectives and...

33 CFR 279.5 - Policy.

Code of Federal Regulations, 2011 CFR

2011-07-01

... served (social option) and will be in keeping with the capabilities of the natural and man-made resources... administrative cost-sharing policy. Preparation of regional studies and establishment of these objectives will... public be fully involved in the regional studies and development of resource use objectives and...

33 CFR 279.5 - Policy.

Code of Federal Regulations, 2014 CFR

2014-07-01

... served (social option) and will be in keeping with the capabilities of the natural and man-made resources... administrative cost-sharing policy. Preparation of regional studies and establishment of these objectives will... public be fully involved in the regional studies and development of resource use objectives and...

33 CFR 279.5 - Policy.

Code of Federal Regulations, 2013 CFR

2013-07-01

... served (social option) and will be in keeping with the capabilities of the natural and man-made resources... administrative cost-sharing policy. Preparation of regional studies and establishment of these objectives will... public be fully involved in the regional studies and development of resource use objectives and...

Contributions of Participatory Modeling to Development and Support of Coastal and Marine Management Plans

EPA Science Inventory

The role of participatory modeling- at various scales- to assist in developing shared visions, understanding the decision landscape, identifying and selecting management options, and monitoring outcomes will be explored in the context of coastal and marine planning, ecosystem ser...

Engaging Adolescents to Inform the Development of a Mobile Gaming App to Incentivize Physical Activity

PubMed Central

Dibble, Marguerite

2017-01-01

Background Involving youth in the development of a mobile game designed to increase physical activity may increase relevancy and adoption. Objective To share the development process used to create a gaming app aimed at incentivizing physical activity in high school students. Methods Five focus groups were conducted with high school students (N=50) to understand gaming behaviors. A subset of students from the focus groups chose to complete a Web-based survey (N=10). Four different versions of gaming artwork and concept design based on student input were pilot tested (N=35), and group consensus building determined the direction of the game. The 4 game versions differed in their artwork style and gaming concept with some requiring competition versus cooperation, or being more individual versus team based. Group consensus building meant that all artwork and game concept options were displayed at the front of a classroom. Students could then vote for their top artwork and concept choices by putting stickers on the top 1 or 2 artwork and concept options that they liked best. Once all votes were cast, investigators discussed the voting results with students, and brainstormed ways to incorporate popular aspects of the 3 “losing” artwork and game concepts into the winning ideas. Results Focus group transcripts were analyzed for common themes. Artwork and gaming concept-voting data was tallied at the time of voting to share with students in real time. Focus groups and survey results revealed important themes for a successful gaming app: (1) competition, (2) balanced in-game rewards, (3) accessibility, and (4) aesthetic features. Consensus voting indicated the popularity of a collaborative competitive content design (35/66, 53%) and playful art (27/71, 38%). Conclusions To ensure saliency and effectiveness of game-based physical activity interventions, youth need to be included in design and implementation. Furthermore, the unique preferences and social constructs of high school students need to be considered during intervention development. PMID:28851676

[Informed Treatment Consent and Refusal in Advanced Endonasal Surgery: The Ethical Dilemma of Olfaction Sacrifice in Surgery for Chronic Rhinosinusitis with Polyposis].

PubMed

Subtil, João; Araújo, João Pedro; Saraiva, José; Santos, Alberto; Vera-Cruz, Paulo; Paço, João; Pais, Diogo

2015-01-01

Olfaction is frequently affected in chronic rhino-sinusitis with polyposis and has been recognised to have important impact on quality of life. Surgical resolution on cases of maximal medical therapy failure is an option to relieve symptoms, with debates as to how extensive surgery should be. A more radical approach will achieve better disease control with less relapse, but can also compromise olfaction. This decision about a more radical surgical approach should be shared with the patient. Thorough informed consent regarding disease control and hyposmia should be taken. Literature review and consultation with a board of experts. We propose some elements to be included in the informed consent discussion, in order to broadly address the surgical limitations regarding anosmia as a frequent complaint, as well as the different options and their associated consequences. Radical surgery decision making should be shared with the patient and the informed consent should be as thorough as possible regarding disease control and hyposmia resolution.

Field testing of tele-operation versus shared and traded control for military assets: an evaluation involving real-time embedded simulation and soldier assessment

NASA Astrophysics Data System (ADS)

Metcalfe, Jason S.; Alban, Jillyn; Cosenzo, Keryl; Johnson, Tony; Capstick, Erin

2010-04-01

Those applying autonomous technologies to military systems strive to enhance human-robot and robot-robot performance. Beyond performance, the military must be concerned with local area security. Characterized as "secure mobility", military systems must enable safe and effective terrain traversal concurrent with maintenance of situational awareness (SA). One approach to interleaving these objectives is supervisory control, with popular options being shared and traded control. Yet, with the scale and expense of military assets, common technical issues such as transition time and safeguarding become critical; especially as they interact with Soldier capabilities. Study is required to enable selection of control methods that optimize Soldier-system performance while safeguarding both individually. The current report describes a study utilizing experimental military vehicles and simulation systems enabling teleoperation and supervisory control. Automated triggering of SA demands was interspersed with a set of challenging driving maneuvers in a 'teleoperation-like' context to examine the influence of supervisory control on Soldier-system performance. Results indicated that direct application of supervisory control, while beneficial under particular demands, requires continued development to be perceived by Soldiers as useful. Future efforts should more tightly couple the information exchanged between the Soldier and system to overcome current challenges not addressed by standard control methods.

Application of multiobjective optimization to scheduling capacity expansion of urban water resource systems

NASA Astrophysics Data System (ADS)

Mortazavi-Naeini, Mohammad; Kuczera, George; Cui, Lijie

2014-06-01

Significant population increase in urban areas is likely to result in a deterioration of drought security and level of service provided by urban water resource systems. One way to cope with this is to optimally schedule the expansion of system resources. However, the high capital costs and environmental impacts associated with expanding or building major water infrastructure warrant the investigation of scheduling system operational options such as reservoir operating rules, demand reduction policies, and drought contingency plans, as a way of delaying or avoiding the expansion of water supply infrastructure. Traditionally, minimizing cost has been considered the primary objective in scheduling capacity expansion problems. In this paper, we consider some of the drawbacks of this approach. It is shown that there is no guarantee that the social burden of coping with drought emergencies is shared equitably across planning stages. In addition, it is shown that previous approaches do not adequately exploit the benefits of joint optimization of operational and infrastructure options and do not adequately address the need for the high level of drought security expected for urban systems. To address these shortcomings, a new multiobjective optimization approach to scheduling capacity expansion in an urban water resource system is presented and illustrated in a case study involving the bulk water supply system for Canberra. The results show that the multiobjective approach can address the temporal equity issue of sharing the burden of drought emergencies and that joint optimization of operational and infrastructure options can provide solutions superior to those just involving infrastructure options.

Shared decision-making.

PubMed

Godolphin, William

2009-01-01

Shared decision-making has been called the crux of patient-centred care and identified as a key part of change for improved quality and safety in healthcare. However, it rarely happens, is hard to do and is not taught - for many reasons. Talking with patients about options is not embedded in the attitudes or communication skills training of most healthcare professionals. Information tools such as patient decision aids, personal health records and the Internet will help to shift this state, as will policy that drives patient and public involvement in healthcare delivery and training.

Collaborative Data Publication Utilizing the Open Data Repository's Data Publisher

NASA Technical Reports Server (NTRS)

Stone, N.; Lafuente, B.; Bristow, T.; Keller, R. M.; Downs, R. T.; Blake, D.; Fonda, M.; Dateo, C.; Pires, A.

2017-01-01

For small communities in multidisciplinary fields such as astrobiology, publishing and sharing data can be challenging. While large, homogenous fields often have repositories and existing data standards, small groups of independent researchers have few options for publishing data that can be utilized within their community. In conjunction with teams at NASA Ames and the University of Arizona, a number of pilot studies are being conducted to assess the needs of these research groups and to guide the software development so that it allows them to publish and share their data collaboratively.

Thread mapping using system-level model for shared memory multicores

NASA Astrophysics Data System (ADS)

Mitra, Reshmi

Exploring thread-to-core mapping options for a parallel application on a multicore architecture is computationally very expensive. For the same algorithm, the mapping strategy (MS) with the best response time may change with data size and thread counts. The primary challenge is to design a fast, accurate and automatic framework for exploring these MSs for large data-intensive applications. This is to ensure that the users can explore the design space within reasonable machine hours, without thorough understanding on how the code interacts with the platform. Response time is related to the cycles per instructions retired (CPI), taking into account both active and sleep states of the pipeline. This work establishes a hybrid approach, based on Markov Chain Model (MCM) and Model Tree (MT) for system-level steady state CPI prediction. It is designed for shared memory multicore processors with coarse-grained multithreading. The thread status is represented by the MCM states. The program characteristics are modeled as the transition probabilities, representing the system moving between active and suspended thread states. The MT model extrapolates these probabilities for the actual application size (AS) from the smaller AS performance. This aspect of the framework, along with, the use of mathematical expressions for the actual AS performance information, results in a tremendous reduction in the CPI prediction time. The framework is validated using an electromagnetics application. The average performance prediction error for steady state CPI results with 12 different MSs is less than 1%. The total run time of model is of the order of minutes, whereas the actual application execution time is in terms of days.

Value-based cost sharing in the United States and elsewhere can increase patients' use of high-value goods and services.

PubMed

Thomson, Sarah; Schang, Laura; Chernew, Michael E

2013-04-01

This article reviews efforts in the United States and several other member countries of the Organization for Economic Cooperation and Development to encourage patients, through cost sharing, to use goods such as medications, services, and providers that offer better value than other options--an approach known as value-based cost sharing. Among the countries we reviewed, we found that value-based approaches were most commonly applied to drug cost sharing. A few countries, including the United States, employed financial incentives, such as lower copayments, to encourage use of preferred providers or preventive services. Evidence suggests that these efforts can increase patients' use of high-value services--although they may also be associated with high administrative costs and could exacerbate health inequalities among various groups. With careful design, implementation, and evaluation, value-based cost sharing can be an important tool for aligning patient and provider incentives to pursue high-value care.

Big data from small data: data-sharing in the ‘long tail’ of neuroscience

PubMed Central

Ferguson, Adam R; Nielson, Jessica L; Cragin, Melissa H; Bandrowski, Anita E; Martone, Maryann E

2016-01-01

The launch of the US BRAIN and European Human Brain Projects coincides with growing international efforts toward transparency and increased access to publicly funded research in the neurosciences. The need for data-sharing standards and neuroinformatics infrastructure is more pressing than ever. However, ‘big science’ efforts are not the only drivers of data-sharing needs, as neuroscientists across the full spectrum of research grapple with the overwhelming volume of data being generated daily and a scientific environment that is increasingly focused on collaboration. In this commentary, we consider the issue of sharing of the richly diverse and heterogeneous small data sets produced by individual neuroscientists, so-called long-tail data. We consider the utility of these data, the diversity of repositories and options available for sharing such data, and emerging best practices. We provide use cases in which aggregating and mining diverse long-tail data convert numerous small data sources into big data for improved knowledge about neuroscience-related disorders. PMID:25349910

The Annuity Option.

ERIC Educational Resources Information Center

Demsey, Brian R.

1991-01-01

For school executives, annuities have become the preferred retirement vehicle, because other private-sector investments (some deferred compensation and profit-sharing plans) are closed to public employees. This article explains Internal Revenue Code sections 403 (b) and 457 and 1986 Tax Reform Act provisions related to tax-sheltered annuity plans.…

Timetabling: A Shared Services Model

ERIC Educational Resources Information Center

O'Regan, Carmel

2012-01-01

This paper identifies common timetabling issues and options as experienced in Australian universities, and develops a rationale to inform management decisions on a suitable system and the associated policies, procedures, management structure and resources at the University of Newcastle, to enable more effective timetabling in line with the needs…

Design and analysis of simple choice surveys for natural resource management

USGS Publications Warehouse

Fieberg, John; Cornicelli, Louis; Fulton, David C.; Grund, Marrett D.

2010-01-01

We used a simple yet powerful method for judging public support for management actions from randomized surveys. We asked respondents to rank choices (representing management regulations under consideration) according to their preference, and we then used discrete choice models to estimate probability of choosing among options (conditional on the set of options presented to respondents). Because choices may share similar unmodeled characteristics, the multinomial logit model, commonly applied to discrete choice data, may not be appropriate. We introduced the nested logit model, which offers a simple approach for incorporating correlation among choices. This forced choice survey approach provides a useful method of gathering public input; it is relatively easy to apply in practice, and the data are likely to be more informative than asking constituents to rate attractiveness of each option separately.

A Framework to Improve Surgeon Communication in High-Stakes Surgical Decisions: Best Case/Worst Case.

PubMed

Taylor, Lauren J; Nabozny, Michael J; Steffens, Nicole M; Tucholka, Jennifer L; Brasel, Karen J; Johnson, Sara K; Zelenski, Amy; Rathouz, Paul J; Zhao, Qianqian; Kwekkeboom, Kristine L; Campbell, Toby C; Schwarze, Margaret L

2017-06-01

Although many older adults prefer to avoid burdensome interventions with limited ability to preserve their functional status, aggressive treatments, including surgery, are common near the end of life. Shared decision making is critical to achieve value-concordant treatment decisions and minimize unwanted care. However, communication in the acute inpatient setting is challenging. To evaluate the proof of concept of an intervention to teach surgeons to use the Best Case/Worst Case framework as a strategy to change surgeon communication and promote shared decision making during high-stakes surgical decisions. Our prospective pre-post study was conducted from June 2014 to August 2015, and data were analyzed using a mixed methods approach. The data were drawn from decision-making conversations between 32 older inpatients with an acute nonemergent surgical problem, 30 family members, and 25 surgeons at 1 tertiary care hospital in Madison, Wisconsin. A 2-hour training session to teach each study-enrolled surgeon to use the Best Case/Worst Case communication framework. We scored conversation transcripts using OPTION 5, an observer measure of shared decision making, and used qualitative content analysis to characterize patterns in conversation structure, description of outcomes, and deliberation over treatment alternatives. The study participants were patients aged 68 to 95 years (n = 32), 44% of whom had 5 or more comorbid conditions; family members of patients (n = 30); and surgeons (n = 17). The median OPTION 5 score improved from 41 preintervention (interquartile range, 26-66) to 74 after Best Case/Worst Case training (interquartile range, 60-81). Before training, surgeons described the patient's problem in conjunction with an operative solution, directed deliberation over options, listed discrete procedural risks, and did not integrate preferences into a treatment recommendation. After training, surgeons using Best Case/Worst Case clearly presented a choice between treatments, described a range of postoperative trajectories including functional decline, and involved patients and families in deliberation. Using the Best Case/Worst Case framework changed surgeon communication by shifting the focus of decision-making conversations from an isolated surgical problem to a discussion about treatment alternatives and outcomes. This intervention can help surgeons structure challenging conversations to promote shared decision making in the acute setting.

Shared Decision-Making and Patient Empowerment in Preventive Cardiology.

PubMed

Kambhampati, Swetha; Ashvetiya, Tamara; Stone, Neil J; Blumenthal, Roger S; Martin, Seth S

2016-05-01

Shared decision-making, central to evidence-based medicine and good patient care, begins and ends with the patient. It is the process by which a clinician and a patient jointly make a health decision after discussing options, potential benefits and harms, and considering the patient's values and preferences. Patient empowerment is crucial to shared decision-making and occurs when a patient accepts responsibility for his or her health. They can then learn to solve their own problems with information and support from professionals. Patient empowerment begins with the provider acknowledging that patients are ultimately in control of their care and aims to increase a patient's capacity to think critically and make autonomous, informed decisions about their health. This article explores the various components of shared decision-making in scenarios such as hypertension and hyperlipidemia, heart failure, and diabetes. It explores barriers and the potential for improving medication adherence, disease awareness, and self-management of chronic disease.

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

Duro, Francisco Rodrigo; Garcia Blas, Javier; Isaila, Florin

This paper explores novel techniques for improving the performance of many-task workflows based on the Swift scripting language. We propose novel programmer options for automated distributed data placement and task scheduling. These options trigger a data placement mechanism used for distributing intermediate workflow data over the servers of Hercules, a distributed key-value store that can be used to cache file system data. We demonstrate that these new mechanisms can significantly improve the aggregated throughput of many-task workflows with up to 86x, reduce the contention on the shared file system, exploit the data locality, and trade off locality and load balance.

Advance care planning and proxy decision making for patients with advanced Parkinson disease.

PubMed

Kwak, Jung; Wallendal, Maggie S; Fritsch, Thomas; Leo, Gary; Hyde, Trevor

2014-03-01

To examine advance care planning practices and proxy decision making by family healthcare proxies for patients with advanced Parkinson disease (PD). Sixty-four spouses and adult children, self-designated as a/the healthcare proxy for advanced patients with PD, participated in a cross-sectional survey study. Sixty patients with PD (95%) had completed a living will, but only 38% had shared the document with a physician. Among three life-support treatments--cardiopulmonary resuscitation (CPR), ventilator, and feeding tube--47% of patients opted for CPR, 16% for ventilator, and 20% for feeding tube. Forty-two percent of proxies did not know patients' preferences for one or more of the three life-support treatments. Only 28% of proxies reported that patients wanted hospice. Patients who shared advance directives with a physician were significantly less likely to choose CPR and a feeding tube and they were more likely to choose hospice. In a hypothetical end-of-life (EOL) scenario, the majority of proxies chose comfort care as the EOL goal of care (53%) and pain and symptom management only as the course of treatment option (72%); these proxy choices for patients, however, were not associated with patients' preferences for life support. Patients' proxies preferred a form of shared decision making with other family members and physicians. Advance care planning is effective when patients, families, and healthcare professionals together consider future needs for EOL care decisions. Further efforts are needed by healthcare professionals to provide evidence-based education about care options and facilitate advanced discussion and shared decision making by the patient and families.

The Importance and Satisfaction of Collaborative Innovation for Strategic Entrepreneurship

ERIC Educational Resources Information Center

Tsai, I-Chang; Lei, Han-Sheng

2016-01-01

Building on network, learning, resource-based and real options theories, collaborative innovation through the sharing of ideas, knowledge, expertise, and opportunities can enable both small and large firms to successfully engage in strategic entrepreneurship. We use the real case of a research-oriented organization and its incubator for analysis…

Sensitive But Unclassified Information and Other Controls: Policy and Options for Scientific and Technical Information

DTIC Science & Technology

2006-11-14

could be used to develop and deliver with greater efficiency new bioweapons, perhaps even selectively targeting certain racial or ethnic groups.”160 To...shared within and between government agencies; by decriminalizing actions of legitimate whistleblowers who might use such information; and by not

Exploration of options for publishing databases and supplemental material in society journals

USDA-ARS?s Scientific Manuscript database

As scientific information becomes increasingly more abundant, there is increasing interest among members of our societies to share databases. These databases have great value, for example, in providing long-term perspectives of various scientific problems and for use by modelers to extend the inform...

14 CFR 1214.806 - Premature termination of Spacelab flights.

Code of Federal Regulations, 2011 CFR

2011-01-01

... dedicated-Shuttle Spacelab flight, a dedicated-pallet flight, or dedicated-FMDM/MPESS flight is prematurely terminated, NASA shall refund the optional services charges for planned, but unused, extra days on orbit. If a complete-pallet or shared-element flight is prematurely terminated, NASA shall refund a pro rata...

14 CFR 1214.806 - Premature termination of Spacelab flights.

Code of Federal Regulations, 2013 CFR

2013-01-01

... dedicated-Shuttle Spacelab flight, a dedicated-pallet flight, or dedicated-FMDM/MPESS flight is prematurely terminated, NASA shall refund the optional services charges for planned, but unused, extra days on orbit. If a complete-pallet or shared-element flight is prematurely terminated, NASA shall refund a pro rata...

14 CFR 1214.806 - Premature termination of Spacelab flights.

Code of Federal Regulations, 2012 CFR

2012-01-01

... dedicated-Shuttle Spacelab flight, a dedicated-pallet flight, or dedicated-FMDM/MPESS flight is prematurely terminated, NASA shall refund the optional services charges for planned, but unused, extra days on orbit. If a complete-pallet or shared-element flight is prematurely terminated, NASA shall refund a pro rata...

14 CFR 1214.806 - Premature termination of Spacelab flights.

Code of Federal Regulations, 2010 CFR

2010-01-01

... dedicated-Shuttle Spacelab flight, a dedicated-pallet flight, or dedicated-FMDM/MPESS flight is prematurely terminated, NASA shall refund the optional services charges for planned, but unused, extra days on orbit. If a complete-pallet or shared-element flight is prematurely terminated, NASA shall refund a pro rata...

14 CFR § 1214.806 - Premature termination of Spacelab flights.

Code of Federal Regulations, 2014 CFR

2014-01-01

.... If a dedicated-Shuttle Spacelab flight, a dedicated-pallet flight, or dedicated-FMDM/MPESS flight is prematurely terminated, NASA shall refund the optional services charges for planned, but unused, extra days on orbit. If a complete-pallet or shared-element flight is prematurely terminated, NASA shall refund a pro...

A Tale of English Polytechnic Lecturers' Decision Making

ERIC Educational Resources Information Center

Abdullah, Suhaily; Majid, Faizah Abd

2016-01-01

Teacher decision making involves a selection of options that leads to thinking processes, underlying teaching in language classroom contexts. Due to this, as a small part of an on-going postgraduate research, this exploratory case study shares the initial findings on the lecturers' decision-making effects on their classroom orientation. Four…

Circuit Riding: A Method for Providing Reference Services.

ERIC Educational Resources Information Center

Plunket, Linda; And Others

1983-01-01

Discussion of the design and implementation of the Circuit Rider Librarian Program, a shared services project for delivering reference services to eight hospitals in Maine, includes a cost analysis of services and description of user evaluation survey. Five references, composite results of the survey, and postgrant options proposal are appended.…

31 CFR 352.7 - Issues on exchange.

Code of Federal Regulations, 2014 CFR

2014-07-01

... redemption value exceeded, but was not an even multiple of $500, the owner had the option either: (1) To add... United States Savings Notes (Freedom Shares) at their current redemption values for Series HH bonds...) Computation of issue price. The total current redemption value of the eligible securities submitted for...

Geoexchange: Getting it Right

ERIC Educational Resources Information Center

Johnson, William C.; Ormond, Paul

2013-01-01

If properly installed, optimized geoexchange systems can be one of the most cost effective, powerful options to accomplish the goal of improved energy efficiency and reduced carbon emissions. Accurately quantifying field performance is an important step in designing a system that is the proper size and capacity. The authors share the real life…

Microbiological Difference of Eggs From Traditional Cage and Free Range Production

USDA-ARS?s Scientific Manuscript database

Eggs from alternative production systems are a growing market share in the US. Meeting consumer requests for greater diversity in retail egg options has resulted in some unique challenges such as understanding the food safety implications of eggs from alternative housing practices. A study was con...

Technology-Driven Resource Sharing: Paying for Improvement.

ERIC Educational Resources Information Center

Rush, James E.

1993-01-01

Addresses the inadequacies of traditional methods of library financing and proposes a strategy to be implemented in an environment supported by automation and networks. Publisher pricing of data rather than publications, options for charging library users with debit cards, and the role of regional library networks are discussed. (EAM)

Impact Factor: Early Career Research & Digital Scholarship

ERIC Educational Resources Information Center

Pasquini, Laura A.; Wakefield, Jenny S.; Roman, Tiffany

2014-01-01

It is becoming increasingly vital to publish and share research as well as get citations for the purpose of researcher visibility. The publishing options available for research distribution seem endless. It really is an academic jungle out there! This article reviews why early career researchers and graduate scholars should consider their research…

Policy Options for Sharing Activities between the Department of Veterans Affairs and the Department of Defense

DTIC Science & Technology

2007-06-14

evidence - based medicine (Guideline [medicall, 2006). Those who adopt and execute the guidelines and operate within their requirements are said to...the populations of both Departments continues to rise. Similarly, as more evidence - based medicine is transformed into clinical practice guidelines and

Implementation and design of a teleoperation system based on a VMEBUS/68020 pipelined architecture

NASA Technical Reports Server (NTRS)

Lee, Thomas S.

1989-01-01

A pipelined control design and architecture for a force-feedback teleoperation system that is being implemented at the Jet Propulsion Laboratory and which will be integrated with the autonomous portion of the testbed to achieve share control is described. At the local site, the operator sees real-time force/torque displays and moves two 6-degree of freedom (dof) force-reflecting hand-controllers as his hands feel the contact force/torques generated at the remote site where the robots interact with the environment. He also uses a graphical user menu to monitor robot states and specify system options. The teleoperation software is written in the C language and runs on MC68020-based processor boards in the VME chassis, which utilizes a real-time operating system; the hardware is configured to realize a four-stage pipeline configuration. The environment is very flexible, such that the system can easily be configured as a stand-alone facility for performing independent research in human factors, force control, and time-delayed systems.

Eyes on the Mind: Investigating the Influence of Gaze Dynamics on the Perception of Others in Real-Time Social Interaction

PubMed Central

Pfeiffer, Ulrich J.; Schilbach, Leonhard; Jording, Mathis; Timmermans, Bert; Bente, Gary; Vogeley, Kai

2012-01-01

Social gaze provides a window into the interests and intentions of others and allows us to actively point out our own. It enables us to engage in triadic interactions involving human actors and physical objects and to build an indispensable basis for coordinated action and collaborative efforts. The object-related aspect of gaze in combination with the fact that any motor act of looking encompasses both input and output of the minds involved makes this non-verbal cue system particularly interesting for research in embodied social cognition. Social gaze comprises several core components, such as gaze-following or gaze aversion. Gaze-following can result in situations of either “joint attention” or “shared attention.” The former describes situations in which the gaze-follower is aware of sharing a joint visual focus with the gazer. The latter refers to a situation in which gazer and gaze-follower focus on the same object and both are aware of their reciprocal awareness of this joint focus. Here, a novel interactive eye-tracking paradigm suited for studying triadic interactions was used to explore two aspects of social gaze. Experiments 1a and 1b assessed how the latency of another person’s gaze reactions (i.e., gaze-following or gaze version) affected participants’ sense of agency, which was measured by their experience of relatedness of these reactions. Results demonstrate that both timing and congruency of a gaze reaction as well as the other’s action options influence the sense of agency. Experiment 2 explored differences in gaze dynamics when participants were asked to establish either joint or shared attention. Findings indicate that establishing shared attention takes longer and requires a larger number of gaze shifts as compared to joint attention, which more closely seems to resemble simple visual detection. Taken together, novel insights into the sense of agency and the awareness of others in gaze-based interaction are provided. PMID:23227017

Communication about absent entities in great apes and human infants.

PubMed

Bohn, Manuel; Call, Josep; Tomasello, Michael

2015-12-01

There is currently debate about the extent to which non-linguistic beings such as human infants and great apes are capable of absent reference. In a series of experiments we investigated the flexibility and specificity of great apes' (N=36) and 12 month-old infants' (N=40) requests for absent entities. Subjects had the choice between requesting visible objects directly and using the former location of a depleted option to request more of these now-absent entities. Importantly, we systematically varied the quality of the present and absent options. We found that great apes as well as human infants flexibly adjusted their requests for absent entities to these contextual variations and only requested absent entities when the visible option was of lower quality than the absent option. These results suggest that the most basic cognitive capacities for absent reference do not depend on language and are shared by humans and their closest living relatives. Copyright © 2015 Elsevier B.V. All rights reserved.

The potential for shared decision-making and decision aids in rehabilitation medicine.

PubMed

van Til, Janine A; Drossaert, Constance H C; Punter, R Annemiek; Ijzerman, Maarten J

2010-06-01

Shared decision-making and the use of decision aids are increasingly promoted in various healthcare settings. The extent of their current use and potential in rehabilitation medicine is unknown. The aim of the present study was to explore the barriers to and facilitators of shared decision-making and use of decision aids in daily practice, and to explore the perceptions of physical and rehabilitation medicine (PRM) physicians toward them. A cross-sectional survey of 408 PRM physicians was performed (response rate 31%). PRM physicians expressed the highest levels of comfort with shared decision-making as opposed to paternalistic and informed decision-making. The majority reported that shared decision-making constituted their usual approach. The most important barriers to shared decision-making were cases in which the patient received conflicting recommendations and when the patient had difficulty accepting the disease. Key facilitators were the patient's trust in the PRM physician and the patient being knowledgeable about the disease and about treatment options. PRM physicians' attitudes towards the use of decision aids to inform patients were moderately positive. Shared decision-making appears to have great potential in the rehabilitation setting. Increasing the use of decision aids may contribute to the further implementation of shared decision-making.

Informed Decision Making: Assessment of the Quality of Physician Communication about Prostate Cancer Diagnosis and Treatment.

PubMed

Holmes-Rovner, Margaret; Montgomery, Jeffrey S; Rovner, David R; Scherer, Laura D; Whitfield, Jesse; Kahn, Valerie C; Merkle, Edgar C; Ubel, Peter A; Fagerlin, Angela

2015-11-01

Little is known about how physicians present diagnosis and treatment planning in routine practice in preference-sensitive treatment decisions. We evaluated completeness and quality of informed decision making in localized prostate cancer post biopsy encounters. We analyzed audio-recorded office visits of 252 men with presumed localized prostate cancer (Gleason 6 and Gleason 7 scores) who were seeing 45 physicians at 4 Veterans Affairs Medical Centers. Data were collected between September 2008 and May 2012 in a trial of 2 decision aids (DAs). Braddock's previously validated Informed Decision Making (IDM) system was used to measure quality. Latent variable models for ordinal data examined the relationship of IDM score to treatment received. Mean IDM score showed modest quality (7.61±2.45 out of 18) and high variability. Treatment choice and risks and benefits were discussed in approximately 95% of encounters. However, in more than one-third of encounters, physicians provided a partial set of treatment options and omitted surveillance as a choice. Informing quality was greater in patients treated with surveillance (β = 1.1, p = .04). Gleason score (7 vs 6) and lower age were often cited as reasons to exclude surveillance. Patient preferences were elicited in the majority of cases, but not used to guide treatment planning. Encounter time was modestly correlated with IDM score (r = 0.237, p = .01). DA type was not associated with IDM score. Physicians informed patients of options and risks and benefits, but infrequently engaged patients in core shared decision-making processes. Despite patients having received DAs, physicians rarely provided an opportunity for preference-driven decision making. More attention to the underused patient decision-making and engagement elements could result in improved shared decision making. © The Author(s) 2015.

Knowledge and decision-making for labour analgesia of Australian primiparous women.

PubMed

Raynes-Greenow, Camille H; Roberts, Christine L; McCaffery, Kirsten; Clarke, Judith

2007-06-01

to assess and investigate knowledge of labour pain management options and decision-making among primiparous women. a semi-structured guide was used in focus groups to gather pregnant women's knowledge concerning labour analgesia. Attitudes to labour and pain relief, knowledge of pain relief, trustworthiness of knowledge sources, and plans and expectations for labour pain relief were investigated. a major tertiary obstetric hospital in metropolitan Sydney, Australia. twenty five primiparous women, who were 25 weeks or more gestation, and planning a vaginal birth. although women considered themselves knowledgeable, they were unable to describe labour analgesic risks or benefits. There was a large discrepancy between perception and actual knowledge. The main source of knowledge was anecdotal information. Late in pregnancy was considered the ideal time to be given information about labour analgesia. Women described their labour pain relief plans as flexible in relation to their labour circumstances; however, most women wanted to take an active role in decision-making. the large discrepancy between perceived knowledge and actual knowledge of the likely consequences of labour analgesia suggests that women rely too heavily on anecdotal information. clinicians should be aware that some women overestimate their knowledge and understanding of analgesic options, which is often based on anecdotal information. Standardised labour analgesia information at an appropriate time in their pregnancy may benefit some women and assist health-care providers and women to practice shared decision-making.

Denali, Tulip, and Option Inferior Vena Cava Filter Retrieval: A Single Center Experience.

PubMed

Ramaswamy, Raja S; Jun, Emily; van Beek, Darren; Mani, Naganathan; Salter, Amber; Kim, Seung K; Akinwande, Olaguoke

2018-04-01

To compare the technical success of filter retrieval in Denali, Tulip, and Option inferior vena cava filters. A retrospective analysis of Denali, Gunther Tulip, and Option IVC filters was conducted. Retrieval failure rates, fluoroscopy time, sedation time, use of advanced retrieval techniques, and filter-related complications that led to retrieval failure were recorded. There were 107 Denali, 43 Option, and 39 Tulip filters deployed and removed with average dwell times of 93.5, 86.0, and 131 days, respectively. Retrieval failure rates were 0.9% for Denali, 11.6% for Option, and 5.1% for Tulip filters (Denali vs. Option p = 0.018; Denali vs. Tulip p = 0.159; Tulip vs. Option p = 0.045). Median fluoroscopy time for filter retrieval was 3.2 min for the Denali filter, 6.75 min for the Option filter, and 4.95 min for the Tulip filter (Denali vs. Option p < 0.01; Denali vs. Tulip p < 0.01; Tulip vs. Option p = 0.67). Advanced retrieval techniques were used in 0.9% of Denali filters, 21.1% in Option filters, and 10.8% in Tulip filters (Denali vs. Option p < 0.01; Denali vs. Tulip p < 0.01; Tulip vs. Option p < 0.01). Filter retrieval failure rates were significantly higher for the Option filter when compared to both the Denali and Tulip filters. Retrieval of the Denali filter required significantly less amount of fluoroscopy time and use of advanced retrieval techniques when compared to both the Option and Tulip filters. The findings of this study indicate easier retrieval of the Denali and Tulip IVC filters when compared to the Option filter.

Shared Decision Making in Vascular Surgery: An Exploratory Study.

PubMed

Santema, T B; Stubenrouch, F E; Koelemay, M J W; Vahl, A C; Vermeulen, C F W; Visser, M J T; Ubbink, D T

2016-04-01

Shared decision making (SDM) is a process in which patients and their doctors collaborate in choosing a suitable treatment option by incorporating patient values and preferences, as well as the best available evidence. Particularly in vascular surgery, several conditions seem suitable for SDM because there are multiple treatment options. The objective of this study was to assess the degree of SDM behaviour in vascular surgery. Vascular surgeons of four Dutch hospitals selected consultations with patients who were facing a treatment decision. Immediately after the consultation, patients and surgeons completed the (subjective) SDM Q-9 and SDM Q-doc questionnaires respectively, to appreciate the perceived level of SDM behaviour. Two evaluators independently and objectively rated SDM behaviour in the audiotaped consultations, using the Observing Patient Involvement (OPTION-12) scale. Nine vascular surgeons and three vascular surgeons in training conducted 54 consultations. The patients' median SDM Q-9 score was high, 93% (IQR 79-100%), and 16/54 (29.6%) of them gave the maximum score. The surgeons' median score was also high, 84% (IQR 73-92%), while 4/54 (7.4%) gave the maximum score. In contrast, mean OPTION score was 31% (SD 11%). Surgeons hardly ever asked the patients for their preferred approach to receive information, whether they had understood the provided information, and how they would like to be involved in SDM. Currently, objective SDM behaviour among vascular surgeons is limited, even though the presented disorders allow for SDM. Hence, SDM in vascular surgical consultations could be improved by increasing the patients' and surgeons' awareness and knowledge about the concept of SDM. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Patient Protection and Affordable Care Act; HHS notice of benefit and payment parameters for 2016. Final rule.

PubMed

2015-02-27

This final rule sets forth payment parameters and provisions related to the risk adjustment, reinsurance, and risk corridors programs; cost sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges. It also finalizes additional standards for the individual market annual open enrollment period for the 2016 benefit year, essential health benefits, qualified health plans, network adequacy, quality improvement strategies, the Small Business Health Options Program, guaranteed availability, guaranteed renewability, minimum essential coverage, the rate review program, the medical loss ratio program, and other related topics.

A moving target: financing Medicare for the future.

PubMed

Moon, M; Segal, M; Weiss, R

Since 1997, there has been a steady downward trend in projected Medicare spending as a share of the gross domestic product (GDP), substantially improving the long-run outlook for Medicare. But even with improvements in outlook, the required share of GDP will rise by more than 70%, and the question remains as to who will pay for Medicare in the future. This report examines a limited set of tax options and a flat beneficiary premium to illustrate the size of contributions necessary to achieve several different goals, and to explore the difference that multiple years of projections can make on these requirements.

Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017. Final rule.

PubMed

2016-03-08

This final rule sets forth payment parameters and provisions related to the risk adjustment, reinsurance, and risk corridors programs; cost-sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges. It also provides additional amendments regarding the annual open enrollment period for the individual market for the 2017 and 2018 benefit years; essential health benefits; cost sharing; qualified health plans; Exchange consumer assistance programs; network adequacy; patient safety; the Small Business Health Options Program; stand-alone dental plans; third-party payments to qualified health plans; the definitions of large employer and small employer; fair health insurance premiums; student health insurance coverage; the rate review program; the medical loss ratio program; eligibility and enrollment; exemptions and appeals; and other related topics.

Communication networks for the tactical edge

NASA Astrophysics Data System (ADS)

Evans, Joseph B.; Pennington, Steven G.; Ewy, Benjamin J.

2017-04-01

Information at the tactical level is increasingly critical in today's conflicts. The proliferation of commercial tablets and smart phones has created the ability for extensive information sharing at the tactical edge, beyond the traditional tactical voice communications and location information. This is particularly the case in Gray Zone conflicts, in which tactical decision making and actions are intertwined with information sharing and exploitation. Networking of tactical devices is the key to this information sharing. In this work, we detail and analyze two network models at different parts of the Gray Zone spectrum, and explore a number of networking options including Named Data Networking. We also compare networking approaches in a variety of realistic operating environments. Our results show that Named Data Networking is a good match for the disrupted networking environments found in many tactical situations

A comparative review of the options for treatment of erectile dysfunction: which treatment for which patient?

PubMed

Hatzimouratidis, Konstantinos; Hatzichristou, Dimitrios G

2005-01-01

The field of erectile dysfunction (ED) has been revolutionised over the last two decades. Several treatment options are available today, most of which are associated with high efficacy rates and favourable safety profiles. A MEDLINE search was undertaken in order to evaluate all currently available data on treatment modalities for ED. Phosphodiesterase type 5 (PDE5) inhibitors (sildenafil, tadalafil, vardenafil) are currently the first-choice of most physicians and patients for the treatment of ED. PDE5 inhibitors have differences in their pharmacological profiles, the most obvious being the long duration of action of tadalafil, but there are no data supporting superiority for any one of them in terms of efficacy or safety. Sublingual apomorphine has limited efficacy compared with the PDE5 inhibitors, and its use is limited to patients with mild ED. Treatment failures with oral drugs may be due to medication, clinician and patient issues. The physician needs to address all of these issues in order to identify true treatment failures. Patients who are truly unresponsive to oral drugs may be offered other treatment options.Intracavernous injections of alprostadil alone, or in combination with other vasoactive agents (papaverine and phentolamine), remain an excellent treatment option, with proven efficacy and safety over time. Topical pharmacotherapy is appealing in nature, but currently available formulations have limited efficacy. Vacuum constriction devices may be offered mainly to elderly patients with occasional intercourse attempts, as younger patients show limited preference because of the unnatural erection that is associated with this treatment modality. Penile prostheses are generally the last treatment option offered, because of invasiveness, cost and non-reversibility; however, they are associated with high satisfaction rates in properly selected patients. All treatment options are associated with particular strengths and weaknesses. A patient-centred approach based on patient needs and expectations is necessary for the management of ED. The clinician must educate the patient and provide a supportive environment for shared decision making. The management strategy must be supplemented by careful follow-up in order to identify changes in patient health and relationship/emotional status that may necessitate treatment optimisation.

78 FR 15385 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Notice of Filing of Proposed Rule Change To...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-11

... Series, any adjusted option series, and any option series until the time to expiration for such series is... existing requirement may at times discourage liquidity in particular options series because a market maker... the option is subject to the Price/Time execution algorithm, the Directed Market Maker shall receive...

Perceptions of shared decision making and decision aids among rural primary care clinicians.

PubMed

King, Valerie J; Davis, Melinda M; Gorman, Paul N; Rugge, J Bruin; Fagnan, L J

2012-01-01

Shared decision making (SDM) and decision aids (DAs) increase patients' involvement in health care decisions and enhance satisfaction with their choices. Studies of SDM and DAs have primarily occurred in academic centers and large health systems, but most primary care is delivered in smaller practices, and over 20% of Americans live in rural areas, where poverty, disease prevalence, and limited access to care may increase the need for SDM and DAs. To explore perceptions and practices of rural primary care clinicians regarding SDM and DAs. Cross-sectional survey. Setting and Participants Primary care clinicians affiliated with the Oregon Rural Practice-based Research Network. Surveys were returned by 181 of 231 eligible participants (78%); 174 could be analyzed. Two-thirds of participants were physicians, 84% practiced family medicine, and 55% were male. Sixty-five percent of respondents were unfamiliar with the term shared decision making, but following definition, 97% reported that they found the approach useful for conditions with multiple treatment options. Over 90% of clinicians perceived helping patients make decisions regarding chronic pain and health behavior change as moderate/hard in difficulty. Although 69% of respondents preferred that patients play an equal role in making decisions, they estimate that this happens only 35% of the time. Time was reported as the largest barrier to engaging in SDM (63%). Respondents were receptive to using DAs to facilitate SDM in print- (95%) or web-based formats (72%), and topic preference varied by clinician specialty and decision difficulty. Rural clinicians recognized the value of SDM and were receptive to using DAs in multiple formats. Integration of DAs to facilitate SDM in routine patient care may require addressing practice operation and reimbursement.

Opinion and Special Articles: Amateur fundus photography with various new devices: Our experience as neurology residents.

PubMed

Zafar, Saman; Cardenas, Ylec Mariana; Leishangthem, Lakshmi; Yaddanapudi, Sridhara

2018-05-08

Times are changing in the way we secure and share patient fundus photographs to enhance our diagnostic skills in neurology. At the recent American Academy of Neurology meeting, the use of a fundus camera and smartphones to secure good-quality fundus photographs of patients presenting with headache to the emergency department (ED) was presented. We were enthusiastic to replicate the success of the Fundus Photography vs Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) study in our neurology department, but encountered problems in terms of cost, setup, feasibility, and portability of the device. As neurology residents, we came up with 3 easier options. We present these 3 options as our personal experience, and hope to reignite enthusiasm among neurology trainees to find their own means of performing ophthalmoscopy routinely in the hospital, as it appears that the Internet market is now thriving with many other devices to make this examination easier and more rewarding. Of the options explored above, the Handheld Fundus Camera was a clear favorite among the residents, and we have placed one in our call room for routine use. It travels to the clinic, floor, intensive care unit, and ED when needed. It has enhanced the way we approach the fundus examination and been a fun skill to acquire. We look forward to further advances that will make it possible to carry such a device in a physician's pocket. © 2018 American Academy of Neurology.

Justifying Clinical Nudges.

PubMed

Gorin, Moti; Joffe, Steven; Dickert, Neal; Halpern, Scott

2017-03-01

The shift away from paternalistic decision-making and toward patient-centered, shared decision-making has stemmed from the recognition that in order to practice medicine ethically, health care professionals must take seriously the values and preferences of their patients. At the same time, there is growing recognition that minor and seemingly irrelevant features of how choices are presented can substantially influence the decisions people make. Behavioral economists have identified striking ways in which trivial differences in the presentation of options can powerfully and predictably affect people's choices. Choice-affecting features of the decision environment that do not restrict the range of choices or significantly alter the incentives have come to be known as "nudges." Although some have criticized conscious efforts to influence choice, we believe that clinical nudges may often be morally justified. The most straightforward justification for nudge interventions is that they help people bypass their cognitive limitations-for example, the tendency to choose the first option presented even when that option is not the best for them-thereby allowing people to make choices that best align with their rational preferences or deeply held values. However, we argue that this justification is problematic. We argue that, if physicians wish to use nudges to shape their patients' choices, the justification for doing so must appeal to an ethical and professional standard, not to patients' preferences. We demonstrate how a standard with which clinicians and bioethicists already are quite familiar-the best-interest standard-offers a robust justification for the use of nudges. © 2017 The Hastings Center.

Phosphorus Import Dependency and Recycling Potential in the Global Phosphorus Mosaic

NASA Astrophysics Data System (ADS)

Powers, S. M.

2017-12-01

Nations differ widely in terms of recent P consumption trends and fertilizer trade dependencies, reflecting dynamic and globally uneven P fertilizer production, consumption, export, and import. Recovered P from urban and agricultural wastes can provide renewable sources that supplant the need to import P fertilizer, but to date, research on P recycling potential has been highly spatially segregated. Understanding of the global distribution of P recycling potential and options, and how these intersect with P import dependencies, could be used to guide long-term, spatially-prioritized planning for P, food, and water security. We integrated recent data on national P fertilizer flows, subnational P use, and landscape features within a global grid to understand how these constraints on future options for P use are distributed worldwide. This analysis illustrates several regions where combinations of high population density, cropland extent, and manure P production provide islands of opportunity for P recycling in mixed crop-livestock and populous agricultural areas. At the same time, nations with lower import ratios (net P import:consumption) contained a disproportionately large share of manure-rich croplands and populous croplands. As a further demonstration of the kinds of integrated comparisons that are possible using global land use data sets in combination with P, worldwide similarities and distinctions for P emerged from a cluster analysis. These kinds of socioeconomic-geographic patterns may foretell distinct P futures as societies address spatially uneven options for P, food, and water security.

Community Solar Scenario Tool | Integrated Energy Solutions | NREL

Science.gov Websites

Community Solar Scenario Tool Community Solar Scenario Tool The Community Solar Scenario Tool (CSST ) provides a "first cut" analysis of different community or shared solar program options. NREL sponsoring utility. Community Solar Scenario Tool -Beta Version Available as a Microsoft Excel file, which

New Choices Facing College and University Pension Funds.

ERIC Educational Resources Information Center

Bernstein, Melvin H., Ed.

This publication presents a collection of essays from top investment thinkers and financial commentators who share their views on the revolutionary retirement plan options now available to college and university employees. The essays were prepared for a conference that was convened by the New England Board of Higher Education in Boston to help…

Leadership through Fellowship: Distributed Leadership in a Professional Recognition Scheme for University Educators

ERIC Educational Resources Information Center

Beckmann, Elizabeth A.

2017-01-01

Researchers in the field of teaching and learning in higher education have identified concerns with top-down leadership models. Distributed (or shared) leadership approaches may provide more successful engagement with institutional change agendas, and provide more options to reward and recognise staff leading teaching and learning initiatives.…

78 FR 33068 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-03

... affecting New England fisheries in the exclusive economic zone (EEZ). DATES: The meeting will be held on... Guidance Committee will discuss options for trading quota under the provisions of the U.S./Canada Resource Sharing Understanding and may ask the Council to develop U.S./Canada trading mechanisms. The Enforcement...

Distance Education in the United States: From Correspondence Courses to the Internet

ERIC Educational Resources Information Center

Caruth, Gail D.; Caruth, Donald L.

2013-01-01

Online learning is a descendant of distance education. Online education has a shared history with correspondence learning. In 1873, Anna Eliot Ticknor founded the Society to Encourage Studies at Home. Ticknor's Society established one of America's first correspondence schools, a distance learning option conducted through the mail. This Society was…

Configuration and Management of a Cluster Computing Facility in Undergraduate Student Computer Laboratories

ERIC Educational Resources Information Center

Cornforth, David; Atkinson, John; Spennemann, Dirk H. R.

2006-01-01

Purpose: Many researchers require access to computer facilities beyond those offered by desktop workstations. Traditionally, these are offered either through partnerships, to share the cost of supercomputing facilities, or through purpose-built cluster facilities. However, funds are not always available to satisfy either of these options, and…

Stay the Course: Managing Online Presence

ERIC Educational Resources Information Center

Fredrick, Kathy

2009-01-01

How can a school librarian share instruction and information with students and colleagues in the virtual world? Library Web pages make resources available 24/7. New tools available to schools can also give new options in making a Web presence known. This article suggests a plan for school librarians on how they can manage their libraries' online…

Disagreement over the Best Way to Use the Word "Validity" and Options for Reaching Consensus

ERIC Educational Resources Information Center

Newton, Paul E.; Shaw, Stuart D.

2016-01-01

The ability to convey shared meaning with minimal ambiguity is highly desirable for technical terms within disciplines and professions. Unfortunately, there is no widespread professional consensus over the meaning of the word "validity" as it pertains to educational and psychological testing. After illustrating the nature and extent of…

The Military Health System: Redefining the Role of Employers and Improving Cost-Share Parity Among Retirees

DTIC Science & Technology

2014-02-13

program and optional dental plans. Active-duty military members are automatically enrolled into TRICARE Prime and are assigned to a military treatment...registers as a cost consideration in the calculus of the majority of employers in the U.S. who provide health insurance to their employees. Military

76 FR 27114 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-10

... CRD Processing Fee, the NASD Annual System Processing Fee, and the NYSE Arca Transfer/Re-license... Fees, the NASD Annual System Processing Fee, and the NYSE Arca Transfer/Re-license Individual Fee. Fees... Options Regulatory Surveillance Authority (``ORSA'') national market system plan and in doing so shares...

77 FR 24543 - Beverly Hills Bancorp Inc.; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

... on the pink sheets. As of September 30, 2011, BHBC had 78 holders of record. 3. BHBC has options...-1/P-1, shares of registered money market funds, and any instruments that are eligible for investment by money market funds consistent with rule 2a-7 under the Act (collectively, ``Permitted Securities...

Linking Literacy and Technology: A Guide for K-8 Classrooms.

ERIC Educational Resources Information Center

Wepner, Shelley B., Ed.; Valmont, William J., Ed.; Thurlow, Richard, Ed.

Based on the idea that instruction should drive technology, and not vice versa, this book shares ideas, options, and opportunities for using technology in the classroom. Vignettes and examples of classroom uses of technology are presented throughout the book to highlight concepts and help teachers support literacy goals. The essays in the book…

24 CFR 982.627 - Homeownership option: Eligibility requirements for families.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SECTION 8 TENANT BASED ASSISTANCE: HOUSING CHOICE VOUCHER PROGRAM... the Section 8 Housing Choice Voucher program, in accordance with subpart E of this part. (2) The... individual living alone (or paying his or her share of food and housing costs) multiplied by twelve; or (ii...

77 FR 49044 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Designation of a...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-15

... Organizations; International Securities Exchange, LLC; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change To List and Trade Option Contracts Overlying 10 Shares of a Security August 9, 2012. On June 20, 2012, the International Securities Exchange, LLC (``Exchange'') filed with...

From Affinity and Beyond: A Study of Online Literacy Conversations and Communities

ERIC Educational Resources Information Center

Albers, Peggy; Pace, Christi L.; Odo, Dennis Murphy

2016-01-01

Digital technologies make possible new avenues for sharing and accessing literacy research and practices worldwide. Among the myriad of options available, web seminars have become popular online learning venues. The current investigation is part of Global Conversations in Literacy Research (GCLR), a longitudinal and qualitative study now in its…

Preschool Adequacy and Efficiency in California: Issues, Policy Options, and Recommendations. Monograph

ERIC Educational Resources Information Center

Karoly, Lynn A.

2009-01-01

Facing mounting evidence that California has fallen behind on many key indicators of educational performance, policymakers and the public share considerable interest in exploring whether California should expand public funding for preschool education. This expanded funding will be most effective if resources can be directed to their most efficient…

78 FR 53646 - Shared Responsibility Payment for Not Maintaining Minimum Essential Coverage

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-30

... disabled child who requires an institutional level of care (such as that provided in a nursing facility... because their income is too high. Children eligible for Medicaid under this option are entitled to the... eligibility to individuals with high medical expenses who would otherwise be eligible for Medicaid but for...

Concierge: Personal Database Software for Managing Digital Research Resources

PubMed Central

Sakai, Hiroyuki; Aoyama, Toshihiro; Yamaji, Kazutsuna; Usui, Shiro

2007-01-01

This article introduces a desktop application, named Concierge, for managing personal digital research resources. Using simple operations, it enables storage of various types of files and indexes them based on content descriptions. A key feature of the software is a high level of extensibility. By installing optional plug-ins, users can customize and extend the usability of the software based on their needs. In this paper, we also introduce a few optional plug-ins: literature management, electronic laboratory notebook, and XooNlps client plug-ins. XooNIps is a content management system developed to share digital research resources among neuroscience communities. It has been adopted as the standard database system in Japanese neuroinformatics projects. Concierge, therefore, offers comprehensive support from management of personal digital research resources to their sharing in open-access neuroinformatics databases such as XooNIps. This interaction between personal and open-access neuroinformatics databases is expected to enhance the dissemination of digital research resources. Concierge is developed as an open source project; Mac OS X and Windows XP versions have been released at the official site (http://concierge.sourceforge.jp). PMID:18974800

A shared decision-making tool for obstructive sleep apnea without tonsillar hypertrophy: A randomized controlled trial.

PubMed

Bergeron, Mathieu; Duggins, Angela L; Cohen, Aliza P; Tiemeyer, Karin; Mullen, Lisa; Crisalli, Joseph; McArthur, Angela; Ishman, Stacey L

2018-04-01

Shared decision-making is a process whereby patients and clinicians jointly establish a treatment plan integrating clinical evidence and patient values and preferences. Although this approach has been successfully employed in numerous medical disciplines, often using shared decision-making tools, otolaryngologic research assessing its use is scant. Our primary objective was therefore to determine if the tools we developed reduced decisional conflict for children with obstructive sleep apnea without tonsillar hypertrophy. Prospective, single-blind, randomized controlled trial. We enrolled consecutive patients meeting inclusion criteria who were referred to our multidisciplinary upper airway center. Study patients used a shared decision-making tool whereas controls did not. Measures of decisional conflict (SURE [Sure of myself, Understanding information, Risk benefit ratio, Encouragement], CollaboRATE, and the Decisional Conflict Scale [DCS]) were obtained pre- and postvisit. We assessed 50 families (study group = 24, controls = 26). The mean age was 8.8 ± 6.6 years, 44% were female, 86% were white, and the mean obstructive apnea-hypopnea index was 12.7 ± 15.6 events/hour. The previsit mean DCS score was similar for controls (42.7) and study patients (40.8) (P = .38). The postvisit mean DCS score for controls was 13.3 and for study patients 6.1 (P = .034). Improvement in this score was greater in the study group (P = .03). At previsit evaluation, 63% of controls and 58% of study patients were unsure about their options. Postvisit, this improved to 4.1% and 0%, respectively. Families counseled regarding treatment options using shared decision-making tools had significantly less decisional conflict than those who did not use these tools. These positive outcomes suggest that clinicians should consider integrating this approach into clinical practice. 1b. Laryngoscope, 128:1007-1015, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Federal privacy regulations and the provision of Early Hearing Detection and Intervention programs.

PubMed

Houston, K Todd; Behl, Diane D; White, Karl R; Forsman, Irene

2010-08-01

To be successful, Early Hearing Detection and Intervention (EHDI) programs require individually identifiable information about children to be shared among people who are responsible for screening, diagnosis, early intervention, family support, and medical home services. Pediatricians and other stakeholders in the EHDI process often point to federal laws that were passed to ensure privacy and confidentiality in health care and educational programs as major obstacles to achieving efficient and effective EHDI programs. In this article we summarize the provisions of 3 federal laws (the Health Insurance Portability and Accountability Act [HIPAA], the Family Education Rights and Privacy Act [FERPA], and Part C privacy regulations of the Individuals With Disabilities Education Act [IDEA]) that most directly affect information-sharing in EHDI programs. We suggest strategies for sharing the information needed to operate successful EHDI programs while remaining in compliance with these laws, including obtaining signed parental consent to share information between providers, including an option on the individual family services plan for parents to permit sharing of the plan with pediatricians and other providers, and giving copies of all relevant test results to parents to share with providers as they wish.

Complex Care Options for Patients With Advanced Heart Failure Approaching End of Life.

PubMed

Wordingham, Sara E; McIlvennan, Colleen K; Dionne-Odom, J Nicholas; Swetz, Keith M

2016-02-01

Care for patients with advanced cardiac disease continues to evolve in a complex milieu of therapeutic options, advanced technological interventions, and efforts at improving patient-centered care and shared decision-making. Despite improvements in quality of life and survival with these interventions, optimal supportive care across the advanced illness trajectory remains diverse and heterogeneous. Herein, we outline challenges in prognostication, communication, and caregiving in advanced heart failure and review the unique needs of patients who experience frequent hospitalizations, require chronic home inotropic support, and who have implantable cardioverter-defibrillators and mechanical circulatory support in situ, to name a few.

Incentives for new antibiotics: the Options Market for Antibiotics (OMA) model.

PubMed

Brogan, David M; Mossialos, Elias

2013-11-07

Antimicrobial resistance is a growing threat resulting from the convergence of biological, economic and political pressures. Investment in research and development of new antimicrobials has suffered secondary to these pressures, leading to an emerging crisis in antibiotic resistance. Current policies to stimulate antibiotic development have proven inadequate to overcome market failures. Therefore innovative ideas utilizing market forces are necessary to stimulate new investment efforts. Employing the benefits of both the previously described Advanced Market Commitment and a refined Call Options for Vaccines model, we describe herein a novel incentive mechanism, the Options Market for Antibiotics. This model applies the benefits of a financial call option to the investment in and purchase of new antibiotics. The goal of this new model is to provide an effective mechanism for early investment and risk sharing while maintaining a credible purchase commitment and incentives for companies to ultimately bring new antibiotics to market. We believe that the Options Market for Antibiotics (OMA) may help to overcome some of the traditional market failures associated with the development of new antibiotics. Additional work must be done to develop a more robust mathematical model to pave the way for practical implementation.

Incentives for new antibiotics: the Options Market for Antibiotics (OMA) model

PubMed Central

2013-01-01

Background Antimicrobial resistance is a growing threat resulting from the convergence of biological, economic and political pressures. Investment in research and development of new antimicrobials has suffered secondary to these pressures, leading to an emerging crisis in antibiotic resistance. Methods Current policies to stimulate antibiotic development have proven inadequate to overcome market failures. Therefore innovative ideas utilizing market forces are necessary to stimulate new investment efforts. Employing the benefits of both the previously described Advanced Market Commitment and a refined Call Options for Vaccines model, we describe herein a novel incentive mechanism, the Options Market for Antibiotics. Results This model applies the benefits of a financial call option to the investment in and purchase of new antibiotics. The goal of this new model is to provide an effective mechanism for early investment and risk sharing while maintaining a credible purchase commitment and incentives for companies to ultimately bring new antibiotics to market. Conclusions We believe that the Options Market for Antibiotics (OMA) may help to overcome some of the traditional market failures associated with the development of new antibiotics. Additional work must be done to develop a more robust mathematical model to pave the way for practical implementation. PMID:24199835

Bridging the Gap - Networking Educators using Real-Time Seismic Data

NASA Astrophysics Data System (ADS)

Ortiz, A. M.; Renwald, M. D.; Baldwin, T. K.; Hall, M. K.

2004-12-01

After nearly a decade, the seismology community has made critical advances in identifying what is effective and what is needed for success in incorporating real-time seismic data in the classroom. Today's K-16 classroom teachers have many options and opportunities for incorporating short- and long-term inquiry activities for monitoring earthquakes and analyzing seismic data in their daily instruction. Through the SpiNet program, we are providing web-based tools that support educators working with real-time seismic data (http://www.scieds.com/spinet/). Our site includes a Recent Seismicity section, which allows users to share seismic data in real-time, and provides near real-time information about global seismicity. Our Activities section provides data and lessons to assist educators who wish to integrate seismology into their classroom. The Research section, currently under development, will allow educators to share general information about how they teach seismology in their classroom through a discussion board and by posting lesson plans. In addition, we are developing a user-friendly tool for students to post results of their research projects. Designing a website which targets a range of users requires a working knowledge of both user needs and website programming and design. User needs include providing a logical navigational structure and accounting for differences in browser functionality, internet access, and users' abilities. Using website development tools, such as PHP, MySQL, RDF feeds, and specialized geoscience applications, we are automating site maintenance; incorporating databases for information storage and retrieval; and providing accessibility for users with a range of skills and physical limitations. By incorporating these features, we have built a dynamic interface for a broad range of users interested in educational seismology.

Shared decision-making in an intercultural context. Barriers in the interaction between physicians and immigrant patients.

PubMed

Suurmond, Jeanine; Seeleman, Conny

2006-02-01

The objective of this exploratory paper is to describe several barriers in shared decision-making in an intercultural context. Based on the prevailing literature on intercultural communication in medical settings, four conceptual barriers were described. When the conceptual barriers were described, they were compared with the results from semi-structured interviews with purposively selected physicians (n = 18) and immigrant patients (n = 13). Physicians differed in medical discipline (GPs, company doctors, an internist, a cardiologist, a gynaecologist, and an intern) and patients had different ethnic and immigration backgrounds. The following barriers were found: (1) physician and patient may not share the same linguistic background; (2) physician and patient may not share similar values about health and illness; (3) physician and patient may not have similar role expectations; and (4) physician and patient may have prejudices and do not speak to each other in an unbiased manner. We conclude that due to these barriers, the transfer of information, the formulation of the diagnosis, and the discussion of treatment options are at stake and the shared decision-making process is impeded. Improving physician's skills to recognize the communication limitations during shared decision-making as well as improving the skills to deal with the barriers may help to ameliorate shared decision-making in an intercultural setting.

XDS-I Gateway Development for HIE Connectivity with Legacy PACS at Gil Hospital.

PubMed

Simalango, Mikael Fernandus; Kim, Youngchul; Seo, Young Tae; Choi, Young Hwan; Cho, Yong Kyun

2013-12-01

The ability to support healthcare document sharing is imperative in a health information exchange (HIE). Sharing imaging documents or images, however, can be challenging, especially when they are stored in a picture archiving and communication system (PACS) archive that does not support document sharing via standard HIE protocols. This research proposes a standard-compliant imaging gateway that enables connectivity between a legacy PACS and the entire HIE. Investigation of the PACS solutions used at Gil Hospital was conducted. An imaging gateway application was then developed using a Java technology stack. Imaging document sharing capability enabled by the gateway was tested by integrating it into Gil Hospital's order communication system and its HIE infrastructure. The gateway can acquire radiology images from a PACS storage system, provide and register the images to Gil Hospital's HIE for document sharing purposes, and make the images retrievable by a cross-enterprise document sharing document viewer. Development of an imaging gateway that mediates communication between a PACS and an HIE can be considered a viable option when the PACS does not support the standard protocol for cross-enterprise document sharing for imaging. Furthermore, the availability of common HIE standards expedites the development and integration of the imaging gateway with an HIE.

XDS-I Gateway Development for HIE Connectivity with Legacy PACS at Gil Hospital

PubMed Central

Simalango, Mikael Fernandus; Kim, Youngchul; Seo, Young Tae; Cho, Yong Kyun

2013-01-01

Objectives The ability to support healthcare document sharing is imperative in a health information exchange (HIE). Sharing imaging documents or images, however, can be challenging, especially when they are stored in a picture archiving and communication system (PACS) archive that does not support document sharing via standard HIE protocols. This research proposes a standard-compliant imaging gateway that enables connectivity between a legacy PACS and the entire HIE. Methods Investigation of the PACS solutions used at Gil Hospital was conducted. An imaging gateway application was then developed using a Java technology stack. Imaging document sharing capability enabled by the gateway was tested by integrating it into Gil Hospital's order communication system and its HIE infrastructure. Results The gateway can acquire radiology images from a PACS storage system, provide and register the images to Gil Hospital's HIE for document sharing purposes, and make the images retrievable by a cross-enterprise document sharing document viewer. Conclusions Development of an imaging gateway that mediates communication between a PACS and an HIE can be considered a viable option when the PACS does not support the standard protocol for cross-enterprise document sharing for imaging. Furthermore, the availability of common HIE standards expedites the development and integration of the imaging gateway with an HIE. PMID:24523994

Multitasking the three-dimensional transport code TORT on CRAY platforms

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

Azmy, Y.Y.; Barnett, D.A.; Burre, C.A.

1996-04-01

The multitasking options in the three-dimensional neutral particle transport code TORT originally implemented for Cray`s CTSS operating system are revived and extended to run on Cray Y/MP and C90 computers using the UNICOS operating system. These include two coarse-grained domain decompositions; across octants, and across directions within an octant, termed Octant Parallel (OP), and Direction Parallel (DP), respectively. Parallel performance of the DP is significantly enhanced by increasing the task grain size and reducing load imbalance via dynamic scheduling of the discrete angles among the participating tasks. Substantial Wall Clock speedup factors, approaching 4.5 using 8 tasks, have been measuredmore » in a time-sharing environment, and generally depend on the test problem specifications, number of tasks, and machine loading during execution.« less

Human-centric sensing.

PubMed

Srivastava, Mani; Abdelzaher, Tarek; Szymanski, Boleslaw

2012-01-13

The first decade of the century witnessed a proliferation of devices with sensing and communication capabilities in the possession of the average individual. Examples range from camera phones and wireless global positioning system units to sensor-equipped, networked fitness devices and entertainment platforms (such as Wii). Social networking platforms emerged, such as Twitter, that allow sharing information in real time. The unprecedented deployment scale of such sensors and connectivity options ushers in an era of novel data-driven applications that rely on inputs collected by networks of humans or measured by sensors acting on their behalf. These applications will impact domains as diverse as health, transportation, energy, disaster recovery, intelligence and warfare. This paper surveys the important opportunities in human-centric sensing, identifies challenges brought about by such opportunities and describes emerging solutions to these challenges.

Comparison between three option, four option and five option multiple choice question tests for quality parameters: A randomized study.

PubMed

Vegada, Bhavisha; Shukla, Apexa; Khilnani, Ajeetkumar; Charan, Jaykaran; Desai, Chetna

2016-01-01

Most of the academic teachers use four or five options per item of multiple choice question (MCQ) test as formative and summative assessment. Optimal number of options in MCQ item is a matter of considerable debate among academic teachers of various educational fields. There is a scarcity of the published literature regarding the optimum number of option in each item of MCQ in the field of medical education. To compare three options, four options, and five options MCQs test for the quality parameters - reliability, validity, item analysis, distracter analysis, and time analysis. Participants were 3 rd semester M.B.B.S. students. Students were divided randomly into three groups. Each group was given one set of MCQ test out of three options, four options, and five option randomly. Following the marking of the multiple choice tests, the participants' option selections were analyzed and comparisons were conducted of the mean marks, mean time, validity, reliability and facility value, discrimination index, point biserial value, distracter analysis of three different option formats. Students score more ( P = 0.000) and took less time ( P = 0.009) for the completion of three options as compared to four options and five options groups. Facility value was more ( P = 0.004) in three options group as compared to four and five options groups. There was no significant difference between three groups for the validity, reliability, and item discrimination. Nonfunctioning distracters were more in the four and five options group as compared to three option group. Assessment based on three option MCQs is can be preferred over four option and five option MCQs.

Using videos, apps and hands-on experience in undergraduate hydrology teaching

NASA Astrophysics Data System (ADS)

Van Loon, Anne

2016-04-01

Hydrological sciences teaching always needs to make a link between the classroom and the outside world. This can be done with fieldwork and excursions, but the increasing availability of open educational resources gives more-and-more other options to make theory more understandable and applicable. In the undergraduate teaching of hydrology at the University of Birmingham we make use of a number of tools to enhance the hydrology 'experience' of students. Firstly, we add hydrological science videos available in the public domain to our explanations of theory. These are both visualisations of concepts and recorded demonstrations in the field or the lab. One example is the concept of catchments and travel times which has been excellently visualised by MetEd. Secondly, we use a number of mobile phone apps, which provide virtual reality information and real-time monitoring information. We use the MySoil App (by Natural Environment Research Council (NERC), British Geological Survey (BGS) and Centre for Ecology & Hydrology (CEH)) and iGeology / iGeology3D (by BGS) to let students explore soil properties and hydrogeology of an area of interest. And we use the River Levels App (by OGL based on Environment Agency real time data) for exploring real time river levels and investigating spatial variability. Finally, we developed small hands-on projects for students to apply the theory outside the classroom. We for instance let them do simple infiltration experiments and ask them to them design a measurement plan. Evaluations have shown that students enjoy these activities and that it helps their learning. In this presentation we hope to share our experience so that the options for using open (educational) resources for hydrology teaching become more used in linking the classroom to the outside world.

Group Health's participation in a shared decision-making demonstration yielded lessons, such as role of culture change.

PubMed

King, Jaime; Moulton, Benjamin

2013-02-01

In 2007 Washington State became the first state to enact legislation encouraging the use of shared decision making and decision aids to address deficiencies in the informed-consent process. Group Health volunteered to fulfill a legislated mandate to study the costs and benefits of integrating these shared decision-making processes into clinical practice across a range of conditions for which multiple treatment options are available. The Group Health Demonstration Project, conducted during 2009-11, yielded five key lessons for successful implementation, including the synergy between efforts to reduce practice variation and increase shared decision making; the need to support modifications in practice with changes in physician training and culture; and the value of identifying best implementation methods through constant evaluation and iterative improvement. These lessons, and the legislated provisions that supported successful implementation, can guide other states and health care institutions moving toward informed patient choice as the standard of care for medical decision making.

Multirole cargo aircraft options and configurations. [economic analysis

NASA Technical Reports Server (NTRS)

Conner, D. W.; Vaughan, J. C., III

1979-01-01

A future requirements and advanced market evaluation study indicates derivatives of current wide-body aircraft, using 1980 advanced technology, would be economically attractive through 2008, but new dedicated airfreighters incorporating 1990 technology, would offer little or no economic incentive. They would be economically attractive for all payload sizes, however, if RD and T costs could be shared in a joint civil/military arrangement. For the 1994-2008 cargo market, option studies indicate Mach 0.7 propfans would be economically attractive in trip cost, aircraft price and airline ROI. Spanloaders would have an even lower price and higher ROI but would have a relatively high trip cost because of aerodynamic inefficiencies. Dedicated airfreighters using propfans at Mach 0.8 cruise, laminar flow control, or cryofuels, would not provide any great economic benefits. Air cushion landing gear configurations are identified as an option for avoiding runway constraints on airport requirements and/or operational constraints are noted.

Decision aids: when 'nudging' patients to make a particular choice is more ethical than balanced, nondirective content.

PubMed

Blumenthal-Barby, J S; Cantor, Scott B; Russell, Heidi Voelker; Naik, Aanand D; Volk, Robert J

2013-02-01

Patient decision aids, such as instructional leaflets describing treatment options for prostate cancer, are designed to help educate patients so that they can share in decisions about their care. Developers of these decision aids strive for balance, aiming to be as neutral, unbiased, and nondirective as possible. We argue that balance should not always be a goal, and we identify three situations where it should not be. For example, men diagnosed with early-stage prostate cancer frequently are not advised by their physicians that active surveillance is a reasonable alternative to immediate surgery or radiation. It may be desirable to design decision aids that promote active surveillance as an option. We recognize that the arguments put forth in this article are controversial. But they are also justified. We challenge medical decision makers and decision aid developers to determine if and when patients should be "nudged" toward one option or another.

[Shared medical decision making in gynaecology].

PubMed

This, P; Panel, P

2010-02-01

When two options or more can be chosen in medical care, the final decision implies two steps: facts analysis, and patient evaluation of preferences. Shared Medical Decision-Making is a rational conceptual frame that can be used in such cases. In this paper, we describe the concept, its practical modalities, and the questions raised by its use. In gynaecology, many medical situations involve "sensitive preferences choice": for example, contraceptive choice, menorrhagia treatment, and approach of menopause. Some tools from the "Shared Medical Decision Making" concept are useful to structure medical consultations, to convey information, and to reveal patients preferences. Decision aid are used in clinical research settings, but some of them may also be easily used in usual practice, and help physicians to improve both quality and traceability of the decisional process. Copyright 2009 Elsevier Masson SAS. All rights reserved.

Alberta's Pluriform School System: Beyond the "Public-Secular" versus "Private-Religious" Divide

ERIC Educational Resources Information Center

Hiemstra, John

2017-01-01

The Canadian province of Alberta runs a unique school system that offers ten options for school plurality and choice, nine of which provide some form of faith-based schooling. This article argues that Alberta has created a pragmatic version of a "pluriform school system." This system breaks with the assumption, shared by many Christian…

47 CFR 90.1430 - Local public safety build-out and operation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the NSA, to build out by a certain date, a public safety entity may, with the pre-approval of the... the NSA. (1) Options for early build-out in areas with a build-out commitment. In order to obtain... network into the Shared Wireless Broadband Network constructed pursuant to the NSA; or (ii) To, in...

47 CFR 27.1330 - Local public safety build-out and operation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... the NSA, to build out by a certain date, a public safety entity may, with the pre-approval of the... the NSA. (1) Options for early build-out in areas with a build-out commitment. In order to obtain... network into the Shared Wireless Broadband Network constructed pursuant to the NSA; or (ii) To, in...

47 CFR 27.1330 - Local public safety build-out and operation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the NSA, to build out by a certain date, a public safety entity may, with the pre-approval of the... the NSA. (1) Options for early build-out in areas with a build-out commitment. In order to obtain... network into the Shared Wireless Broadband Network constructed pursuant to the NSA; or (ii) To, in...

47 CFR 90.1430 - Local public safety build-out and operation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the NSA, to build out by a certain date, a public safety entity may, with the pre-approval of the... the NSA. (1) Options for early build-out in areas with a build-out commitment. In order to obtain... network into the Shared Wireless Broadband Network constructed pursuant to the NSA; or (ii) To, in...

47 CFR 90.1430 - Local public safety build-out and operation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... the NSA, to build out by a certain date, a public safety entity may, with the pre-approval of the... the NSA. (1) Options for early build-out in areas with a build-out commitment. In order to obtain... network into the Shared Wireless Broadband Network constructed pursuant to the NSA; or (ii) To, in...

47 CFR 27.1330 - Local public safety build-out and operation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the NSA, to build out by a certain date, a public safety entity may, with the pre-approval of the... the NSA. (1) Options for early build-out in areas with a build-out commitment. In order to obtain... network into the Shared Wireless Broadband Network constructed pursuant to the NSA; or (ii) To, in...

76 FR 20779 - Self-Regulatory Organizations; The Options Clearing Corporation; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-13

... Change To Provide Legal Certainty for the Trading of Futures on the CBOE Gold ETF Volatility Index April... CBOE Gold ETF Volatility Index (``GVZ Index''). II. Self-Regulatory Organization's Statement of the..., LLC (``CFE'') as an up-to-the-minute market estimate of the expected volatility of SPDR Gold Shares...

ExplaNet: A Collaborative Learning Tool and Hybrid Recommender System for Student-Authored Explanations

ERIC Educational Resources Information Center

Masters, Jessica; Madhyastha, Tara; Shakouri, Ali

2008-01-01

ExplaNet is a web-based, anonymous, asynchronous explanation-sharing network. Instructors post questions to the network and students submit explanatory answers. Students then view and rank the explanations submitted by their peers before optionally resubmitting a final and revised answer. Three classroom evaluations of ExplaNet showed that by…

Open Source Meets Virtual Reality--An Instructor's Journey Unearths New Opportunities for Learning, Community, and Academia

ERIC Educational Resources Information Center

O'Connor, Eileen A.

2015-01-01

Opening with the history, recent advances, and emerging ways to use avatar-based virtual reality, an instructor who has used virtual environments since 2007 shares how these environments bring more options to community building, teaching, and education. With the open-source movement, where the source code for virtual environments was made…

77 FR 58429 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Filing of Proposed Rule Change Amending...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-20

... series of individual stock options and Exchange-Traded Fund Shares until the beginning of the month in... participants' risk management needs in a stock. In these situations, the Exchange has the ability to add... tailor their investment decisions and hedging decisions prior to expiration. The Exchange also believes...

75 FR 36724 - Self-Regulatory Organizations; The Options Clearing Corporation; Notice of Filing of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-28

... futures any futures contracts on Sprott Physical Gold Shares. II. Self-Regulatory Organization's Statement... C below, of the most significant aspects of such statements. A. Self-Regulatory Organization's...-Laws and Rules of OCC. \\5\\ 15 U.S.C. 78q-1. B. Self-Regulatory Organization's Statement on Burden on...

76 FR 28251 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-16

... establish pricing for customers who are not co-located in the Exchange's data center, but require shared cabinet space and power for optional routers, switches, or modems to support their direct circuit...'' space and a maximum power of 125 Watts per U space. Currently, non co-located customers are assessed...

77 FR 33794 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Designation of a...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-07

... Organizations; International Securities Exchange, LLC; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change To List and Trade Option Contracts Overlying 10 Shares of a Security June... Act of 1934 (``Act'') \\1\\ and Rule 19b-4 thereunder,\\2\\ a proposed rule change to list and trade...

77 FR 38361 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Withdrawal of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-27

... Organizations; International Securities Exchange, LLC; Notice of Withdrawal of Proposed Rule Change To List and... proposed rule change to list and trade option contracts overlying 10 shares of a security. Notice of the proposed rule change was published in the Federal Register on April 24, 2012.\\3\\ The Commission received...

An Unexpected Ally: Using Microsoft's SharePoint to Create a Departmental Intranet

ERIC Educational Resources Information Center

Dahl, David

2010-01-01

In September 2008, the Albert S. Cook Library at Towson University implemented an intranet to support the various functions of the library's Reference Department. This intranet is called the RefPortal. After exploring open source options and other Web 2.0 tools, the department (under the guidance of the library technology coordinator) chose…

When Pictures Aren't Pretty: Deconstructing Punitive Literacy Practices

ERIC Educational Resources Information Center

Fisher, Teresa R.; Albers, Peggy; Frederick, Temmy G.

2014-01-01

Young children frequently tell visual stories, drawing pictures to record and share their thoughts, feelings and understanding. How and what young children describe through art, especially when written language is not an option, is the focus of this interpretive analysis. A series of pictures by John, a 6-year-old boy, were drawn across the…

Flexible Work Strategies | Climate Neutral Research Campuses | NREL

Science.gov Websites

physical resources through shared offices and hotelling. Employees take turns using physical office and lab , telecommuting, and similar strategies make the most of limited physical space and, in some cases, avoid new construction. Hotelling is a popular option under which employees take turns using physical office and lab

76 FR 56838 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated: Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-14

... addition, the Exchange is proposing to eliminate the PULSe non-standard services fee. Finally, the Exchange is proposing to make a non-substantive numbering correction to its Fees Schedule. All of these... executed contract or share equivalent. The Exchange is proposing to reduce the fee to $0.02 per contract or...

30 CFR 204.202 - What is the cumulative royalty reports and payments relief option?

Code of Federal Regulations, 2010 CFR

2010-07-01

... OF THE INTERIOR MINERALS REVENUE MANAGEMENT ALTERNATIVES FOR MARGINAL PROPERTIES Accounting and... produced from the marginal property (not just your share of the production) is 1,000 BOE or less during the... allowances on Form MMS-2014 on the same annual basis as the royalties for your marginal property production...

Optimal health insurance: the case of observable, severe illness.

PubMed

Chernew, M E; Encinosa, W E; Hirth, R A

2000-09-01

We explore optimal cost-sharing provisions for insurance contracts when individuals have observable, severe diseases with a discrete number of medically appropriate treatment options. Variation in preferences for alternative treatments is unobserved by the insurer and non-contractible. Interest in such situations is increasingly common, exemplified by disease carve-out programs and shared decision-making (SDM) tools. We demonstrate that optimal insurance charges a copay to patients choosing the high-cost treatment and provides consumers of the low-cost treatment a cash payment. A simulation of the effect of such a policy, based on prostate cancer, indicates a substantial reduction in moral hazard.

Assessments of the extent to which health-care providers involve patients in decision making: a systematic review of studies using the OPTION instrument.

PubMed

Couët, Nicolas; Desroches, Sophie; Robitaille, Hubert; Vaillancourt, Hugues; Leblanc, Annie; Turcotte, Stéphane; Elwyn, Glyn; Légaré, France

2015-08-01

We have no clear overview of the extent to which health-care providers involve patients in the decision-making process during consultations. The Observing Patient Involvement in Decision Making instrument (OPTION) was designed to assess this. To systematically review studies that used the OPTION instrument to observe the extent to which health-care providers involve patients in decision making across a range of clinical contexts, including different health professions and lengths of consultation. We conducted online literature searches in multiple databases (2001-12) and gathered further data through networking. (i) OPTION scores as reported outcomes and (ii) health-care providers and patients as study participants. For analysis, we only included studies using the revised scale. Extracted data included: (i) study and participant characteristics and (ii) OPTION outcomes (scores, statistical associations and reported psychometric results). We also assessed the quality of OPTION outcomes reporting. We found 33 eligible studies, 29 of which used the revised scale. Overall, we found low levels of patient-involving behaviours: in cases where no intervention was used to implement shared decision making (SDM), the mean OPTION score was 23 ± 14 (0-100 scale). When assessed, the variables most consistently associated with higher OPTION scores were interventions to implement SDM (n = 8/9) and duration of consultations (n = 8/15). Whatever the clinical context, few health-care providers consistently attempt to facilitate patient involvement, and even fewer adjust care to patient preferences. However, both SDM interventions and longer consultations could improve this. © 2013 John Wiley & Sons Ltd.

Two executives, one career.

PubMed

Cunningham, Cynthia R; Murray, Shelley S

2005-02-01

For six years, Cynthia Cunningham and Shelley Murray shared an executive job at Fleet Bank. One desk, one chair, one computer, one telephone, and one voice-mail account. To their clients and colleagues, they were effectively one person, though one person with the strengths and ideas of two, seamlessly handing projects back and forth. Although their department was dissolved after the bank merged with Bank of America, the two continue to consider themselves a package-they have one resume, and they are seeking their next opportunity together. Their choice to share a job was not only a quality-of-life decision but one intended to keep their careers on course: "Taking two separate part-time jobs would have thrown us completely off track" they write in this first-person account."We're both ambitious people, and neither of us wanted just a job. We wanted careers" In this article, the two highly motivated women reveal their determination to manage the demands of both family and career. Flextime,telecommuting, and compressed workweeks are just some of the options open to executives seeking greater work/ life balance, and the job share, as described by Cunningham and Murray, could well be the next solution for those wishing to avoid major trade-offs between their personal and professional lives. Cunningham and Murray describe in vivid detail how they structured their unusual arrangement, how they sold themselves to management, and the hurdles they faced along the way. Theirs is a win-win story, for the company and for them.

Country watch: Central African Republic (CAR).

PubMed

Aubel, J; Sobela, F; Voga, P

1997-01-01

This article describes the activities of the Community Peer AIDS Education Project, initiated in 1995 in the Central African Republic (CAR). The CAR project was created by the National AIDS Committee (NAC) and the US Peace Corps. A 4-day workshop was held at the onset for project staff and consultants. Staff developed a simple monitoring and evaluation (M&E) system that emphasizes "learning." M&E schemes measure project outputs, expenditures, and other measures of program implementation in order to help staff gradually improve implementation. M&E helps staff document activities, share information, and learn from the implementation process. Project activities are documented by maintaining community logbooks, taking photos of significant aspects of the educational activities, and leading informal discussion groups. The CAR project engaged in sharing and learning activities by holding meetings with peer leaders, team meetings, meetings with project managers, and meetings with the NAC. Once a month, peer field coordinators conducted a structured exercise with peer leaders. One aim was to gain their feedback on the successes and constraints of activities. Another was to make suggestions on how to improve activities. These structured exercises are recorded as lessons learned in a project book. Team meetings are held periodically. During meetings, staff review project books and photos and discuss successes and problems encountered. Project manager meetings provide time to share lessons learned and to suggest project strengthening options. NAC meetings between the project manager and field coordinators allow for a bottom-up learning process. CAR project staff were receptive to M&E efforts.

Engaging Adolescents to Inform the Development of a Mobile Gaming App to Incentivize Physical Activity.

PubMed

Pope, Lizzy; Garnett, Bernice; Dibble, Marguerite

2017-08-29

Involving youth in the development of a mobile game designed to increase physical activity may increase relevancy and adoption. To share the development process used to create a gaming app aimed at incentivizing physical activity in high school students. Five focus groups were conducted with high school students (N=50) to understand gaming behaviors. A subset of students from the focus groups chose to complete a Web-based survey (N=10). Four different versions of gaming artwork and concept design based on student input were pilot tested (N=35), and group consensus building determined the direction of the game. The 4 game versions differed in their artwork style and gaming concept with some requiring competition versus cooperation, or being more individual versus team based. Group consensus building meant that all artwork and game concept options were displayed at the front of a classroom. Students could then vote for their top artwork and concept choices by putting stickers on the top 1 or 2 artwork and concept options that they liked best. Once all votes were cast, investigators discussed the voting results with students, and brainstormed ways to incorporate popular aspects of the 3 "losing" artwork and game concepts into the winning ideas. Focus group transcripts were analyzed for common themes. Artwork and gaming concept-voting data was tallied at the time of voting to share with students in real time. Focus groups and survey results revealed important themes for a successful gaming app: (1) competition, (2) balanced in-game rewards, (3) accessibility, and (4) aesthetic features. Consensus voting indicated the popularity of a collaborative competitive content design (35/66, 53%) and playful art (27/71, 38%). To ensure saliency and effectiveness of game-based physical activity interventions, youth need to be included in design and implementation. Furthermore, the unique preferences and social constructs of high school students need to be considered during intervention development. ©Lizzy Pope, Bernice Garnett, Marguerite Dibble. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 29.08.2017.

Time-changed geometric fractional Brownian motion and option pricing with transaction costs

NASA Astrophysics Data System (ADS)

Gu, Hui; Liang, Jin-Rong; Zhang, Yun-Xiu

2012-08-01

This paper deals with the problem of discrete time option pricing by a fractional subdiffusive Black-Scholes model. The price of the underlying stock follows a time-changed geometric fractional Brownian motion. By a mean self-financing delta-hedging argument, the pricing formula for the European call option in discrete time setting is obtained.

47 CFR 73.561 - Operating schedule; time sharing.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 4 2011-10-01 2011-10-01 false Operating schedule; time sharing. 73.561...; time sharing. (a) All noncommercial educational FM stations will be licensed for unlimited time operation except those stations operating under a time sharing arrangement. All noncommercial educational FM...

Five shared decision-making tools in 5 months: use of rapid reviews to develop decision boxes for seniors living with dementia and their caregivers.

PubMed

Lawani, Moulikatou Adouni; Valéra, Béatriz; Fortier-Brochu, Émilie; Légaré, France; Carmichael, Pierre-Hugues; Côté, Luc; Voyer, Philippe; Kröger, Edeltraut; Witteman, Holly; Rodriguez, Charo; Giguere, Anik M C

2017-03-15

Decision support tools build upon comprehensive and timely syntheses of literature. Rapid reviews may allow supporting their development by omitting certain components of traditional systematic reviews. We thus aimed to describe a rapid review approach underlying the development of decision support tools, i.e., five decision boxes (DB) for shared decision-making between seniors living with dementia, their caregivers, and healthcare providers. We included studies based on PICO questions (Participant, Intervention, Comparison, Outcome) describing each of the five specific decision. We gave priority to higher quality evidence (e.g., systematic reviews). For each DB, we first identified secondary sources of literature, namely, clinical summaries, clinical practice guidelines, and systematic reviews. After an initial extraction, we searched for primary studies in academic databases and grey literature to fill gaps in evidence. We extracted study designs, sample sizes, populations, and probabilities of benefits/harms of the health options. A single reviewer conducted the literature search and study selection. The data extracted by one reviewer was verified by a second experienced reviewer. Two reviewers assessed the quality of the evidence. We converted all probabilities into absolute risks for ease of understanding. Two to five experts validated the content of each DB. We conducted descriptive statistical analyses on the review processes and resources required. The approach allowed screening of a limited number of references (range: 104 to 406/review). For each review, we included 15 to 26 studies, 2 to 10 health options, 11 to 62 health outcomes and we conducted 9 to 47 quality assessments. A team of ten reviewers with varying levels of expertise was supported at specific steps by an information specialist, a biostatistician, and a graphic designer. The time required to complete a rapid review varied from 7 to 31 weeks per review (mean ± SD, 19 ± 10 weeks). Data extraction required the most time (8 ± 6.8 weeks). The average estimated cost of a rapid review was C$11,646 (SD = C$10,914). This approach enabled the development of clinical tools more rapidly than with a traditional systematic review. Future studies should evaluate the applicability of this approach to other teams/tools.

Mutual influence in shared decision making: a collaborative study of patients and physicians.

PubMed

Lown, Beth A; Clark, William D; Hanson, Janice L

2009-06-01

To explore how patients and physicians describe attitudes and behaviours that facilitate shared decision making. Background Studies have described physician behaviours in shared decision making, explored decision aids for informing patients and queried whether patients and physicians want to share decisions. Little attention has been paid to patients' behaviors that facilitate shared decision making or to the influence of patients and physicians on each other during this process. Qualitative analysis of data from four research work groups, each composed of patients with chronic conditions and primary care physicians. Eighty-five patients and physicians identified six categories of paired physician/patient themes, including act in a relational way; explore/express patient's feelings and preferences; discuss information and options; seek information, support and advice; share control and negotiate a decision; and patients act on their own behalf and physicians act on behalf of the patient. Similar attitudes and behaviours were described for both patients and physicians. Participants described a dynamic process in which patients and physicians influence each other throughout shared decision making. This study is unique in that clinicians and patients collaboratively defined and described attitudes and behaviours that facilitate shared decision making and expand previous descriptions, particularly of patient attitudes and behaviours that facilitate shared decision making. Study participants described relational, contextual and affective behaviours and attitudes for both patients and physicians, and explicitly discussed sharing control and negotiation. The complementary, interactive behaviours described in the themes for both patients and physicians illustrate mutual influence of patients and physicians on each other.

POD experiments using real and simulated time-sharing observations for GEO satellites in C-band transfer ranging system

NASA Astrophysics Data System (ADS)

Fen, Cao; XuHai, Yang; ZhiGang, Li; ChuGang, Feng

2016-08-01

The normal consecutive observing model in Chinese Area Positioning System (CAPS) can only supply observations of one GEO satellite in 1 day from one station. However, this can't satisfy the project need for observing many GEO satellites in 1 day. In order to obtain observations of several GEO satellites in 1 day like GPS/GLONASS/Galileo/BeiDou, the time-sharing observing model for GEO satellites in CAPS needs research. The principle of time-sharing observing model is illuminated with subsequent Precise Orbit Determination (POD) experiments using simulated time-sharing observations in 2005 and the real time-sharing observations in 2015. From time-sharing simulation experiments before 2014, the time-sharing observing 6 GEO satellites every 2 h has nearly the same orbit precision with the consecutive observing model. From POD experiments using the real time-sharing observations, POD precision for ZX12# and Yatai7# are about 3.234 m and 2.570 m, respectively, which indicates the time-sharing observing model is appropriate for CBTR system and can realize observing many GEO satellites in 1 day.

The nurse's lived experience of becoming an interprofessional leader.

PubMed

Stiles, Kim A; Horton-Deutsch, Sara L; Andrews, Catherine A

2014-11-01

In the current complex health care environment, nurses in all practice settings are called on to be leaders in advocating for a healthier future. Health care reform, the rise of the evidence-based practice movement, and the proliferation of new educational options are opening opportunities as never before for nurses to expand their leadership capacity to an interprofessional level. This interpretive phenomenological study conducted with eight nurse participants describes their experience of becoming an interprofessional leader. A team of three nurse researchers interpreted the texts individually and collectively. Interview texts were analyzed hermeneutically to uncover the common shared experience of moving toward common ground with interprofessional leadership as a process, one that not only took time, but also called for self-reflection, deliberate actions, and a new mind-set. This study develops the evidence base for leadership preparation at a time when there is a strong need for interprofessional leaders and educators in health care. Copyright 2014, SLACK Incorporated.

Truncated Lévy walks and an emerging market economic index

NASA Astrophysics Data System (ADS)

Miranda, L. Couto; Riera, R.

2001-08-01

In this paper, we perform a statistical analysis of the major stock index in Latin America, the São Paulo Stock Exchange Index in Brazil (IBOVESPA). Database contains daily records for the 15-year period 1986-2000. We find that the time evolution of the index of share prices is well described by an Exponentially Truncated Lévy Flight (ETLF) characterized by a Lévy exponent α≃1.6-1.7 and a cutoff exponent λ≃1.7. The ETLF statistics accounts for the observed short-term large fluctuations of the financial data time series and describes the long-term convergence to the Gaussian regime. We derive the characteristic crossover time scale Nc dependence on α and λ according to this model as well as the volatility dependence on α, λ and Nc. We find an uncorrelated behaviour of the historical data and Nc≃20 trading days which are in numerical agreement with the analytical results. This dynamic model provides a framework within which it is possible to develop an efficient risk management and option pricing practice for emerging economies.

Shared Decision-Making as the Future of Emergency Cardiology.

PubMed

Probst, Marc A; Noseworthy, Peter A; Brito, Juan P; Hess, Erik P

2018-02-01

Shared decision-making is playing an increasingly large role in emergency cardiovascular care. Although there are many challenges to successfully performing shared decision-making in the emergency department, there are numerous clinical scenarios in which it should be used. In this article, we explore new research and emerging decision aids in the following emergency care scenarios: (1) low-risk chest pain; (2) new-onset atrial fibrillation; and (3) moderate-risk syncope. These decision aids are designed to engage patients and facilitate shared decision-making for specific treatment and disposition (admit vs discharge) decisions. We then offer a 3-step, practical approach to performing shared decision-making in the acute care setting, on the basis of broad stakeholder input and previous conceptual work. Step 1 involves simply acknowledging that a clinical decision needs to be made. Step 2 involves a shared discussion about the working diagnosis and the options for care in the context of the patient's values, preferences, and circumstances. The third and final step requires the patient and provider to agree on a plan of action regarding further medical care. The implementation of shared decision-making in emergency cardiology has the potential to shift the paradigm of clinical practice from paternalism toward mutualism and improve the quality and experience of care for our patients. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Feynman path integral application on deriving black-scholes diffusion equation for european option pricing

NASA Astrophysics Data System (ADS)

Utama, Briandhika; Purqon, Acep

2016-08-01

Path Integral is a method to transform a function from its initial condition to final condition through multiplying its initial condition with the transition probability function, known as propagator. At the early development, several studies focused to apply this method for solving problems only in Quantum Mechanics. Nevertheless, Path Integral could also apply to other subjects with some modifications in the propagator function. In this study, we investigate the application of Path Integral method in financial derivatives, stock options. Black-Scholes Model (Nobel 1997) was a beginning anchor in Option Pricing study. Though this model did not successfully predict option price perfectly, especially because its sensitivity for the major changing on market, Black-Scholes Model still is a legitimate equation in pricing an option. The derivation of Black-Scholes has a high difficulty level because it is a stochastic partial differential equation. Black-Scholes equation has a similar principle with Path Integral, where in Black-Scholes the share's initial price is transformed to its final price. The Black-Scholes propagator function then derived by introducing a modified Lagrange based on Black-Scholes equation. Furthermore, we study the correlation between path integral analytical solution and Monte-Carlo numeric solution to find the similarity between this two methods.

Understanding Preferences for Treatment After Hypothetical First-Time Anterior Shoulder Dislocation: Surveying an Online Panel Utilizing a Novel Shared Decision-Making Tool.

PubMed

Streufert, Ben; Reed, Shelby D; Orlando, Lori A; Taylor, Dean C; Huber, Joel C; Mather, Richard C

2017-03-01

Although surgical management of a first-time anterior shoulder dislocation (FTASD) can reduce the risk of recurrent dislocation, other treatment characteristics, costs, and outcomes are important to patients considering treatment options. While patient preferences, such as those elicited by conjoint analysis, have been shown to be important in medical decision-making, the magnitudes or effects of patient preferences in treating an FTASD are unknown. To test a novel shared decision-making tool after sustained FTASD. Specifically measured were the following: (1) importance of aspects of operative versus nonoperative treatment, (2) respondents' agreement with results generated by the tool, (3) willingness to share these results with physicians, and (4) association of results with choice of treatment after FTASD. Cross-sectional study; Level of evidence, 3. A tool was designed and tested using members of Amazon Mechanical Turk, an online panel. The tool included an adaptive conjoint analysis exercise, a method to understand individuals' perceived importance of the following attributes of treatment: (1) chance of recurrent dislocation, (2) cost, (3) short-term limits on shoulder motion, (4) limits on participation in high-risk activities, and (5) duration of physical therapy. Respondents then chose between operative and nonoperative treatment for hypothetical shoulder dislocation. Overall, 374 of 501 (75%) respondents met the inclusion criteria, of which most were young, active males; one-third reported prior dislocation. From the conjoint analysis, the importance of recurrent dislocation and cost of treatment were the most important attributes. A substantial majority agreed with the tool's ability to generate representative preferences and indicated that they would share these preferences with their physician. Importance of recurrence proved significantly predictive of respondents' treatment choices, independent of sex or age; however, activity level was important to previous dislocators. A total of 125 (55%) males and 33 (23%) females chose surgery after FTASD, as did 37% of previous dislocators compared with 45% of nondislocators. When given thorough information about the risks and benefits, respondents had strong preferences for operative treatment after an FTASD. Respondents agreed with the survey results and wanted to share the information with providers. Recurrence was the most important attribute and played a role in decisions about treatment.

Security Concerns in Accessing Naval e-Learning with Personal Mobile Devices

DTIC Science & Technology

2014-12-01

if it was not for God, I know not where I would be. I would like to thank Mom and Dad for their love and understanding and raising me to believe...option inside container applications. Sharing of container contacts to outside contacts. 5 64 s.ua.WI!i .~ (~~oitb &! sex l .lQ Coafi~a T~o. V

Social Change and Family Policies. Free Papers, Part 4. International CFR Seminar (20th, Melbourne, Australia, August 19-24, 1984).

ERIC Educational Resources Information Center

Baum, Frances E.; And Others

These free papers presented at an International Committee on Family Research (CFR) seminar include (1) Frances E. Baum's "There's No Room in the Nuclear Family: Sharing As an Alternative Housing Option"; (2) Paula W. Dail's "Parental Role Perceptions among Young, Dual Parent Families in America: Family Policy Implications for the…

77 FR 73716 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-11

... Change Amending Commentary .06 to Exchange Rule 6.8 To Increase the Position and Exercise Limits for... position and exercise limits for options on the iShares MSCI Emerging Markets Index Fund (``EEM'') to 500... change is to amend Exchange Rule 6.8, Commentary .06 to increase the position and exercise limits for EEM...

The Decolonial Option in English Teaching: Can the Subaltern Act?

ERIC Educational Resources Information Center

Kumaravadivelu, B.

2016-01-01

In this reflective article that straddles the personal and the professional, the author shares his critical thoughts on the impact of the steady stream of discourse on the native speaker/nonnative speaker (NS/NNS) inequity in the field of TESOL. His contention is that more than a quarter century of the discoursal output has not in any significant…

26 CFR 1.936-4 - Intangible property income in the absence of an election out.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 1, 1983, to use the cost-plus method of pricing without reflecting a return from intangibles, but... and its affiliates do not make an election under either the cost sharing or 50/50 profit split option... disposition of any product or from the rendering of a service which is in excess of the reasonable costs it...

75 FR 2908 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-19

... proposes to adopt in both Rule 8.91 and Rule 8.93 a limited exception for integrated market making in broad... established a new category of market-making participant called e-DPMs, who are member organizations appointed... potential for the sharing of material non-public information between a DPM's market making activities and...

CAD Instructor Designs Eco-Friendly Shed

ERIC Educational Resources Information Center

Schwendau, Mark

2013-01-01

Dissatisfied with the options offered by big box stores--and wanting to save some money and go as green as possible--the author puts his design and construction skills to good use. In this article, he shares how he designed and built an eco-friendly shed. He says he is very pleased with the results of working with his own design, reducing waste,…

"What If Students Revolt?"--Considering Student Resistance: Origins, Options, and Opportunities for Investigation

ERIC Educational Resources Information Center

Siedel, Shannon B.; Tanner, Kimberly D.

2013-01-01

In this article, the author's attempt to provide an overview of the types of student resistance one might encounter in a classroom, as well as share hypotheses from other disciplines about the potential origins of student resistance. In addition, they offer examples of classroom strategies that have been proposed as potentially useful for…

77 FR 31783 - Property Transferred in Connection With the Performance of Services Under Section 83

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-30

... the IRS do not believe that such a condition was intended to defer the taxation of the stock transfer... provision of the securities law that would delay taxation under section 83 is section 16(b) of the Exchange... preclude taxation under section 83 when the shares resulting from exercise of the option are transferred to...

Getting from Facts to Policy: A California Education Policy Convening (Sacramento, California, October 19, 2007). Policy Briefs and Materials

ERIC Educational Resources Information Center

EdSource, 2007

2007-01-01

EdSource hosted an unprecedented forum on October 19, 2007 in Sacramento, California for the presentation and sharing of research-based education policy options offered by a range of K-12 organization and opinion leaders in California with diverse perspectives. Invitees included highly respected state policymakers, education leaders, researchers,…

Dispensing behaviour of pharmacies in prescription drug markets.

PubMed

Guhl, Dennis; Stargardt, Tom; Schneider, Udo; Fischer, Katharina E

2016-02-01

We aim to investigate pharmacies' dispensing behaviour under the existing dispensing regulations in Germany. Using administrative data, we performed a cross-sectional retrospective study to analyse whether the competitive environment and pharmacy characteristics, i.e., organisation, lead to dispensing choices aimed at by third-party payers. We specified generalised linear models with the share of imported pharmaceuticals, generic share, and share of preferred brands as dependent variables. The final dataset contained 49,260,902 prescriptions from 16,797 pharmacies. The average share of imported pharmaceuticals across the pharmacies was 18.4% (standard deviation (SD) 8.8), the average generic share was 92.8% (SD 2.1), and compliance with preferred brands was 81.3% (SD 5.9). Pharmacies with little competition used fewer imported pharmaceuticals (p<0.001), generics (p<0.001) and preferred brands (p<0.001); less organised pharmacies yielded similar results. The difference in outcomes between pharmacies in the first and 4th quartiles of the pharmacy organisation variable is 17.4% vs. 17.0% for share of imported pharmaceuticals, 92.8% vs. 92.7% for generic share and 81.9% vs. 81.1% for compliance with preferred brands. We show that pharmacies' dispensing choices meet the aims of payers at high levels. However, dispensing behaviour varies between pharmacies. Increasing competition among pharmacies and targeting pharmacies with high shares of bill auditing seem viable options to improving dispensing behaviour as defined by payers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Sharing Experimental Animal Resources, Coordinating Holdings (SEARCH) Framework: Encouraging Reduction, Replacement, and Refinement in Animal Research.

PubMed

Morrissey, Bethny; Blyth, Karen; Carter, Phil; Chelala, Claude; Jones, Louise; Holen, Ingunn; Speirs, Valerie

2017-01-01

While significant medical breakthroughs have been achieved through using animal models, our experience shows that often there is surplus material remaining that is frequently never revisited but could be put to good use by other scientists. Recognising that most scientists are willing to share this material on a collaborative basis, it makes economic, ethical, and academic sense to explore the option to utilise this precious resource before generating new/additional animal models and associated samples. To bring together those requiring animal tissue and those holding this type of archival material, we have devised a framework called Sharing Experimental Animal Resources, Coordinating Holdings (SEARCH) with the aim of making remaining material derived from animal studies in biomedical research more visible and accessible to the scientific community. We encourage journals, funding bodies, and scientists to unite in promoting a new way of approaching animal research by adopting the SEARCH framework.

The Sharing Experimental Animal Resources, Coordinating Holdings (SEARCH) Framework: Encouraging Reduction, Replacement, and Refinement in Animal Research

PubMed Central

Morrissey, Bethny; Blyth, Karen; Carter, Phil; Chelala, Claude; Jones, Louise; Holen, Ingunn; Speirs, Valerie

2017-01-01

While significant medical breakthroughs have been achieved through using animal models, our experience shows that often there is surplus material remaining that is frequently never revisited but could be put to good use by other scientists. Recognising that most scientists are willing to share this material on a collaborative basis, it makes economic, ethical, and academic sense to explore the option to utilise this precious resource before generating new/additional animal models and associated samples. To bring together those requiring animal tissue and those holding this type of archival material, we have devised a framework called Sharing Experimental Animal Resources, Coordinating Holdings (SEARCH) with the aim of making remaining material derived from animal studies in biomedical research more visible and accessible to the scientific community. We encourage journals, funding bodies, and scientists to unite in promoting a new way of approaching animal research by adopting the SEARCH framework. PMID:28081116

Shared decision making in the management of children with newly diagnosed immune thrombocytopenia.

PubMed

Beck, Carolyn E; Boydell, Katherine M; Stasiulis, Elaine; Blanchette, Victor S; Llewellyn-Thomas, Hilary; Birken, Catherine S; Breakey, Vicky R; Parkin, Patricia C

2014-10-01

This study aimed to examine the treatment decision-making process for children hospitalized with newly diagnosed immune thrombocytopenia (ITP). Using focus groups, we studied children with ITP, parents of children with ITP, and health care professionals, inquiring about participants' experience with decision support and decision making in newly diagnosed ITP. Data were examined using thematic analysis. Themes that emerged from children were feelings of "anxiety, fear, and confusion"; the need to "understand information"; and "treatment choice," the experience of which was age dependent. For parents, "anxiety, fear, and confusion" was a dominant theme; "treatment choice" revealed that participants felt directed toward intravenous immune globulin (IVIG) for initial treatment. For health care professionals, "comfort level" highlighted factors contributing to professionals' comfort with offering options; "assumptions" were made about parental desire for participation in shared decision making (SDM) and parental acceptance of treatment options; "providing information" was informative regarding modes of facilitating SDM; and "treatment choice" revealed a discrepancy between current practice (directed toward IVIG) and the ideal of SDM. At our center, families of children with newly diagnosed ITP are not experiencing SDM. Our findings support the implementation of SDM to facilitate patient-centered care for the management of pediatric ITP.

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

Myers, C.W.; Giraud, K.M.

Newcomer countries expected to develop new nuclear power programs by 2030 are being encouraged by the International Atomic Energy Agency to explore the use of shared facilities for spent fuel storage and geologic disposal. Multinational underground nuclear parks (M-UNPs) are an option for sharing such facilities. Newcomer countries with suitable bedrock conditions could volunteer to host M-UNPs. M-UNPs would include back-end fuel cycle facilities, in open or closed fuel cycle configurations, with sufficient capacity to enable M-UNP host countries to provide for-fee waste management services to partner countries, and to manage waste from the M-UNP power reactors. M-UNP potential advantagesmore » include: the option for decades of spent fuel storage; fuel-cycle policy flexibility; increased proliferation resistance; high margin of physical security against attack; and high margin of containment capability in the event of beyond-design-basis accidents, thereby reducing the risk of Fukushima-like radiological contamination of surface lands. A hypothetical M-UNP in crystalline rock with facilities for small modular reactors, spent fuel storage, reprocessing, and geologic disposal is described using a room-and-pillar reference-design cavern. Underground construction cost is judged tractable through use of modern excavation technology and careful site selection. (authors)« less

Job Hunting in Tougher Times.

ERIC Educational Resources Information Center

Ross, Steven S.

1985-01-01

Several resources to consider are offered to ease the squeeze created by the computer market downturn. Areas addressed include: job-shop option; other-industries option; overseas option; graduate school option; entrepreneurial option; military option; job fairs; and weighing locations. Notes that colleges are looking for engineering teachers,…

Secure password-based authenticated key exchange for web services

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

Liang, Fang; Meder, Samuel; Chevassut, Olivier

This paper discusses an implementation of an authenticated key-exchange method rendered on message primitives defined in the WS-Trust and WS-SecureConversation specifications. This IEEE-specified cryptographic method (AuthA) is proven-secure for password-based authentication and key exchange, while the WS-Trust and WS-Secure Conversation are emerging Web Services Security specifications that extend the WS-Security specification. A prototype of the presented protocol is integrated in the WSRF-compliant Globus Toolkit V4. Further hardening of the implementation is expected to result in a version that will be shipped with future Globus Toolkit releases. This could help to address the current unavailability of decent shared-secret-based authentication options inmore » the Web Services and Grid world. Future work will be to integrate One-Time-Password (OTP) features in the authentication protocol.« less

78 FR 15073 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-08

... will not apply to such long-term options series until the time to expiration is less than nine months... trading on the Exchange, the Exchange shall from time to time open for trading series of options therein... not apply to options series until the time to expiration is less than nine months (that is, until such...

Implementing a virtual community of practice for family physician training: a mixed-methods case study.

PubMed

Barnett, Stephen; Jones, Sandra C; Caton, Tim; Iverson, Don; Bennett, Sue; Robinson, Laura

2014-03-12

GP training in Australia can be professionally isolating, with trainees spread across large geographic areas, leading to problems with rural workforce retention. Virtual communities of practice (VCoPs) may provide a way of improving knowledge sharing and thus reducing professional isolation. The goal of our study was to review the usefulness of a 7-step framework for implementing a VCoP for general practitioner (GP) training and then evaluated the usefulness of the resulting VCoP in facilitating knowledge sharing and reducing professional isolation. The case was set in an Australian general practice training region involving 55 first-term trainees (GPT1s), from January to July 2012. ConnectGPR was a secure, online community site that included standard community options such as discussion forums, blogs, newsletter broadcasts, webchats, and photo sharing. A mixed-methods case study methodology was used. Results are presented and interpreted for each step of the VCoP 7-step framework and then in terms of the outcomes of knowledge sharing and overcoming isolation. Step 1, Facilitation: Regular, personal facilitation by a group of GP trainers with a co-ordinating facilitator was an important factor in the success of ConnectGPR. Step 2, Champion and Support: Leadership and stakeholder engagement were vital. Further benefits are possible if the site is recognized as contributing to training time. Step 3, Clear Goals: Clear goals of facilitating knowledge sharing and improving connectedness helped to keep the site discussions focused. Step 4, A Broad Church: The ConnectGPR community was too narrow, focusing only on first-term trainees (GPT1s). Ideally there should be more involvement of senior trainees, trainers, and specialists. Step 5, A Supportive Environment: Facilitators maintained community standards and encouraged participation. Step 6, Measurement Benchmarking and Feedback: Site activity was primarily driven by centrally generated newsletter feedback. Viewing comments by other participants helped users benchmark their own knowledge, particularly around applying guidelines. Step 7, Technology and Community: All the community tools were useful, but chat was limited and users suggested webinars in future. A larger user base and more training may also be helpful. Time is a common barrier. Trust can be built online, which may have benefit for trainees that cannot attend face-to-face workshops. Knowledge sharing and isolation outcomes: 28/34 (82%) of the eligible GPT1s enrolled on ConnectGPR. Trainees shared knowledge through online chat, forums, and shared photos. In terms of knowledge needs, GPT1s rated their need for cardiovascular knowledge more highly than supervisors. Isolation was a common theme among interview respondents, and ConnectGPR users felt more supported in their general practice (13/14, 92.9%). The 7-step framework for implementation of an online community was useful. Overcoming isolation and improving connectedness through an online knowledge sharing community shows promise in GP training. Time and technology are barriers that may be overcome by training, technology, and valuable content. In a VCoP, trust can be built online. This has implications for course delivery, particularly in regional areas. VCoPs may also have a specific role assisting overseas trained doctors to interpret their medical knowledge in a new context.

Role of telehealth in renal replacement therapy education.

PubMed

Malkina, Anna; Tuot, Delphine S

2018-03-01

The prevalence of end-stage renal disease is rising in the United States, which bears high financial and public health burden. The most common modality of renal replacement therapy (RRT) in the United States is in-center hemodialysis. Many patients report lack of comprehensive and timely education about their treatment options, which may preclude them from participating in home-based dialysis therapies and kidney transplantation evaluation. While RRT education has traditionally been provided in-person, the rise of telehealth has afforded new opportunities to improve upon the status quo. For example, technology-augmented RRT education has recently been implemented into telehealth nephrology clinics, informational websites and mobile applications maintained by professional organizations, patient-driven forums on social media, and multimodality programs. The benefits of technology in RRT education are increased access for geographically isolated and/or medically frail patients, versatility of content delivery, information repetition to enhance knowledge retention, and interpersonal connection for educational content and emotional support. Challenges center around privacy and accuracy of information sharing, in addition to differential access to technology due to age and socioeconomic status. A review of available scholarly and social media resources suggests that technology-aided delivery of education about treatment options for end-stage renal disease provides an important alternative and/or supplemental resource for patients and families. © 2018 Wiley Periodicals, Inc.

Is different better?: models of teaching and their influence on the net financial outcome for general practice teaching posts.

PubMed

Laurence, Caroline O; Black, Linda E; Cheah, Carolyn; Karnon, Jonathan

2011-07-12

In Australia, training for general practice (GP) occurs within private practices and their involvement in teaching can have significant financial costs. At the same time there are growing demands for clinical places for all disciplines and for GP there is concern that there are insufficient teaching practices to meet the demand at the medical student, prevocational and vocational training levels. One option to address this may be to change how teaching occurs in the practice. A question that arises in posing such an option is whether different models of teaching change the costs for a teaching practice. The aim of this study is to determine the net financial outcome of teaching models in private GP. Modelling the financial implications for a range of teaching options using a costing framework developed from a survey of teaching practices in South Australia. Each option was compared with the traditional model of teaching where one GP supervisor is singularly responsible for one learner. The main outcome measure was net financial outcome per week. Decisions on the model cost parameters were made by the study's Steering Group which comprised of experienced GP supervisors. Four teaching models are presented. Model 1 investigates the gains from teaching multiple same level learners, Models 2 and 3, the benefits of vertically integrated teaching using different permutations, and Model 4 the concept of a GP teacher who undertakes all the teaching. There was a significant increase in net benefits of Aus$547 per week (95% confidence intervals $459, $668) to the practice when a GP taught two same level learners (Model 1) and when a senior registrar participated in teaching a prevocational doctor (Model 3, Aus$263, 95% confidence intervals $80, $570). For Model 2, a practice could significantly reduce the loss if a registrar was involved in vertically integrated teaching which included the training of a medical student (Aus$551, 95% confidence intervals $419, $718). The GP teacher model resulted in a net remuneration of Aus$207,335 per year, sourced predominantly from the GP teacher activities, with no loss to the practice. Our study costed teaching options that can maximise the financial outcomes from teaching. The inclusion of GP registrars in the teaching model or the supervisor teaching more than one same level learner results in a greater financial benefit. This gain was achieved through a reduction in supervisor teaching time and the sharing of administrative and teaching activities with GP registrars. We also show that a GP teacher who carries a minimal patient load can be a sustainable option for a practice. Further, the costing framework used for the teaching models presented in this study has the ability to be applied to any number of teaching model permutations.

TerraFERMA: The Transparent Finite Element Rapid Model Assembler for multiphysics problems in Earth sciences

NASA Astrophysics Data System (ADS)

Wilson, Cian R.; Spiegelman, Marc; van Keken, Peter E.

2017-02-01

We introduce and describe a new software infrastructure TerraFERMA, the Transparent Finite Element Rapid Model Assembler, for the rapid and reproducible description and solution of coupled multiphysics problems. The design of TerraFERMA is driven by two computational needs in Earth sciences. The first is the need for increased flexibility in both problem description and solution strategies for coupled problems where small changes in model assumptions can lead to dramatic changes in physical behavior. The second is the need for software and models that are more transparent so that results can be verified, reproduced, and modified in a manner such that the best ideas in computation and Earth science can be more easily shared and reused. TerraFERMA leverages three advanced open-source libraries for scientific computation that provide high-level problem description (FEniCS), composable solvers for coupled multiphysics problems (PETSc), and an options handling system (SPuD) that allows the hierarchical management of all model options. TerraFERMA integrates these libraries into an interface that organizes the scientific and computational choices required in a model into a single options file from which a custom compiled application is generated and run. Because all models share the same infrastructure, models become more reusable and reproducible, while still permitting the individual researcher considerable latitude in model construction. TerraFERMA solves partial differential equations using the finite element method. It is particularly well suited for nonlinear problems with complex coupling between components. TerraFERMA is open-source and available at http://terraferma.github.io, which includes links to documentation and example input files.

Enterprise systems security management: a framework for breakthrough protection

NASA Astrophysics Data System (ADS)

Farroha, Bassam S.; Farroha, Deborah L.

2010-04-01

Securing the DoD information network is a tremendous task due to its size, access locations and the amount of network intrusion attempts on a daily basis. This analysis investigates methods/architecture options to deliver capabilities for secure information sharing environment. Crypto-binding and intelligent access controls are basic requirements for secure information sharing in a net-centric environment. We introduce many of the new technology components to secure the enterprise. The cooperative mission requirements lead to developing automatic data discovery and data stewards granting access to Cross Domain (CD) data repositories or live streaming data. Multiple architecture models are investigated to determine best-of-breed approaches including SOA and Private/Public Clouds.

47 CFR 73.1715 - Share time.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Share time. 73.1715 Section 73.1715... Rules Applicable to All Broadcast Stations § 73.1715 Share time. Operation is permitted by two or more... considered part of their licenses. (a) If the licenses of stations authorized to share time do not specify...

47 CFR 73.1715 - Share time.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 4 2014-10-01 2014-10-01 false Share time. 73.1715 Section 73.1715... Rules Applicable to All Broadcast Stations § 73.1715 Share time. Operation is permitted by two or more... considered part of their licenses. (a) If the licenses of stations authorized to share time do not specify...

47 CFR 73.1715 - Share time.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 4 2012-10-01 2012-10-01 false Share time. 73.1715 Section 73.1715... Rules Applicable to All Broadcast Stations § 73.1715 Share time. Operation is permitted by two or more... considered part of their licenses. (a) If the licenses of stations authorized to share time do not specify...

47 CFR 73.1715 - Share time.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 4 2011-10-01 2011-10-01 false Share time. 73.1715 Section 73.1715... Rules Applicable to All Broadcast Stations § 73.1715 Share time. Operation is permitted by two or more... considered part of their licenses. (a) If the licenses of stations authorized to share time do not specify...

76 FR 14111 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-15

... Options Series, adjusted option series and any options series until the time to expiration for such series... time to expiration for such series is less than nine months be treated differently. Specifically, under... until the time to expiration for such series is less than nine months. Accordingly, the requirement to...

Current warming will reduce yields unless maize breeding and seed systems adapt immediately

NASA Astrophysics Data System (ADS)

Challinor, A. J.; Koehler, A.-K.; Ramirez-Villegas, J.; Whitfield, S.; Das, B.

2016-10-01

The development of crop varieties that are better suited to new climatic conditions is vital for future food production. Increases in mean temperature accelerate crop development, resulting in shorter crop durations and reduced time to accumulate biomass and yield. The process of breeding, delivery and adoption (BDA) of new maize varieties can take up to 30 years. Here, we assess for the first time the implications of warming during the BDA process by using five bias-corrected global climate models and four representative concentration pathways with realistic scenarios of maize BDA times in Africa. The results show that the projected difference in temperature between the start and end of the maize BDA cycle results in shorter crop durations that are outside current variability. Both adaptation and mitigation can reduce duration loss. In particular, climate projections have the potential to provide target elevated temperatures for breeding. Whilst options for reducing BDA time are highly context dependent, common threads include improved recording and sharing of data across regions for the whole BDA cycle, streamlining of regulation, and capacity building. Finally, we show that the results have implications for maize across the tropics, where similar shortening of duration is projected.

Corporate Social Responsibility: A Real Options Approach to the Challenge of Financial Sustainability

PubMed Central

2015-01-01

Background In contemporary complex societies, social values like ethics, corporate social responsibility, and being respectful with the environment, among others, are becoming social requirements. Corporations are expected to fulfill them and, according to empirical evidence, an overwhelming majority aspires to good social valuation. At the same time, the maximization of market share value in the long run continues to be the central corporate goal. Making environmental and social expenses compatible with value creation is a central challenge for corporations since it implies the financial sustainability of Corporate Social Responsibility (CSR). Methods and Results The value creation capacity of CSR projects, mainly through innovation, is widely acknowledged in economic literature and corporate practice. This fact arouses the need of having a quantitative framework capable of summarizing the value creation capacity of the variables involved in CSR projects. With this aim we build up a sensitivity analysis of real option ratios that studies and quantifies the value creation capacity of CSR projects connected with innovation. Ratio analysis has the advantage of being scale independent. Hence, it furnishes a homogeneous framework to express the interaction of value creation variables and, thus, supports strategic thinking quantitatively. Often, CSR expenses can be regarded as preliminary projects that create the opportunity to undertake a full future project. For them, we obtain the minimum expectations scenario that makes financially sustainable a preliminary project that can be interpreted as a call option. We propose a classification of CSR projects from the decision analysis perspective following a two-fold approach: Their relationship with value creation and their links with existing corporate activities. This classification of CSR projects aims at contributing to choose the best capital budgeting method to study the financial sustainability of the project and identifying those CSR projects that fulfill the required features to be studied from the real options perspective. PMID:25938410

Corporate social responsibility: a real options approach to the challenge of financial sustainability.

PubMed

Bosch-Badia, Maria-Teresa; Montllor-Serrats, Joan; Tarrazon-Rodon, Maria-Antonia

2015-01-01

In contemporary complex societies, social values like ethics, corporate social responsibility, and being respectful with the environment, among others, are becoming social requirements. Corporations are expected to fulfill them and, according to empirical evidence, an overwhelming majority aspires to good social valuation. At the same time, the maximization of market share value in the long run continues to be the central corporate goal. Making environmental and social expenses compatible with value creation is a central challenge for corporations since it implies the financial sustainability of Corporate Social Responsibility (CSR). The value creation capacity of CSR projects, mainly through innovation, is widely acknowledged in economic literature and corporate practice. This fact arouses the need of having a quantitative framework capable of summarizing the value creation capacity of the variables involved in CSR projects. With this aim we build up a sensitivity analysis of real option ratios that studies and quantifies the value creation capacity of CSR projects connected with innovation. Ratio analysis has the advantage of being scale independent. Hence, it furnishes a homogeneous framework to express the interaction of value creation variables and, thus, supports strategic thinking quantitatively. Often, CSR expenses can be regarded as preliminary projects that create the opportunity to undertake a full future project. For them, we obtain the minimum expectations scenario that makes financially sustainable a preliminary project that can be interpreted as a call option. We propose a classification of CSR projects from the decision analysis perspective following a two-fold approach: Their relationship with value creation and their links with existing corporate activities. This classification of CSR projects aims at contributing to choose the best capital budgeting method to study the financial sustainability of the project and identifying those CSR projects that fulfill the required features to be studied from the real options perspective.

17 CFR 230.153b - Definition of “preceded by a prospectus”, as used in section 5(b)(2), in connection with certain...

Code of Federal Regulations, 2010 CFR

2010-04-01

... customer making a request thereof; and (b) The issuer shall have furnished such options market with such..., prior to any transactions, of copies of such prospectus to each options market upon which the options...) Such options market shall thereto have requested of the issuer, from time to time, such number of...

17 CFR 230.153b - Definition of “preceded by a prospectus”, as used in section 5(b)(2), in connection with certain...

Code of Federal Regulations, 2012 CFR

2012-04-01

... customer making a request thereof; and (b) The issuer shall have furnished such options market with such..., prior to any transactions, of copies of such prospectus to each options market upon which the options...) Such options market shall thereto have requested of the issuer, from time to time, such number of...

17 CFR 230.153b - Definition of “preceded by a prospectus”, as used in section 5(b)(2), in connection with certain...

Code of Federal Regulations, 2011 CFR

2011-04-01

... customer making a request thereof; and (b) The issuer shall have furnished such options market with such..., prior to any transactions, of copies of such prospectus to each options market upon which the options...) Such options market shall thereto have requested of the issuer, from time to time, such number of...

17 CFR 230.153b - Definition of “preceded by a prospectus”, as used in section 5(b)(2), in connection with certain...

Code of Federal Regulations, 2014 CFR

2014-04-01

... customer making a request thereof; and (b) The issuer shall have furnished such options market with such..., prior to any transactions, of copies of such prospectus to each options market upon which the options...) Such options market shall thereto have requested of the issuer, from time to time, such number of...

17 CFR 230.153b - Definition of “preceded by a prospectus”, as used in section 5(b)(2), in connection with certain...

Code of Federal Regulations, 2013 CFR

2013-04-01

... customer making a request thereof; and (b) The issuer shall have furnished such options market with such..., prior to any transactions, of copies of such prospectus to each options market upon which the options...) Such options market shall thereto have requested of the issuer, from time to time, such number of...

78 FR 36002 - Self-Regulatory Organizations; The Options Clearing Corporation; Notice of Filing of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-14

... models underlying STANS, time series of proportional changes in implied volatilities for a range of.... OCC has proposed at this time to clear only OTC Options on the S&P 500 index and only such options...

Automatic page composition with nested sub-layouts

NASA Astrophysics Data System (ADS)

Hunter, Andrew

2013-03-01

This paper provides an overview of a system for the automatic composition of publications. The system first composes nested hierarchies of contents, then applies layout engines at branch points in the hierarchies to explore layout options, and finally selects the best overall options for the finished publications. Although the system has been developed as a general platform for automated publishing, this paper describes its application to the composition and layout of a magazine-like publication for social content from Facebook. The composition process works by assembling design fragments that have been populated with text and images from the Facebook social network. The fragments constitute a design language for a publication. Each design fragment is a nested mutable sub-layout that has no specific size or shape until after it has been laid-out. The layout process balances the space requirements of the fragment's internal contents with its external context in the publication. The mutability of sub-layouts requires that their layout options must be kept open until all the other contents that share the same space have been considered. Coping with large numbers of options is one of the greatest challenges in layout automation. Most existing layout methods work by rapidly elimination design options rather than by keeping options open. A further goal of this publishing system is to confirm that a custom publication can be generated quickly by the described methods. In general, the faster that publications can be created, the greater the opportunities for the technology.

Groups have a larger cognitive capacity than individuals.

PubMed

Sasaki, Takao; Pratt, Stephen C

2012-10-09

Increasing the number of options can paradoxically lead to worse decisions, a phenomenon known as cognitive overload [1]. This happens when an individual decision-maker attempts to digest information exceeding its processing capacity. Highly integrated groups, such as social insect colonies, make consensus decisions that combine the efforts of many members, suggesting that these groups can overcome individual limitations [2-4]. Here we report that an ant colony choosing a new nest site is less vulnerable to cognitive overload than an isolated ant making this decision on her own. We traced this improvement to differences in individual behavior. In whole colonies, each ant assesses only a small subset of available sites, and the colony combines their efforts to thoroughly explore all options. An isolated ant, on the other hand, must personally assess a larger number of sites to approach the same level of option coverage. By sharing the burden of assessment, the colony avoids overtaxing the abilities of its members. Copyright © 2012 Elsevier Ltd. All rights reserved.

Contemporary best practice in the evaluation and management of stuttering priapism.

PubMed

Kousournas, Georgios; Muneer, Asif; Ralph, David; Zacharakis, Evangelos

2017-01-01

Stuttering priapism is rare and under-investigated clinical entity. Although it shares similarities with ischaemic priapism, by definition, stuttering priapism has distinct characteristics that advocate for a different management in the clinical setting. Therefore, the management of stuttering priapism aims primarily to prevent recurrence rather than the resolution of spontaneous attacks. A multimodal approach and the individualization of each case are essential because of the diversity of the condition and the plethora of proposed therapeutic strategies. Understanding the underlying pathophysiology and familiarity with contemporary, past and emerging future agents and therapeutic options are required in order to provide an optimal solution for each patient. In addition, patient counselling and the option to combine therapeutic strategies and challenge second-line therapies are essential weapons in the armament of the urologist. Although further clinical trials and studies are mandatory in order to obtain solid data and provide recommendations, all therapeutic options are analysed, with specific interest in the potential advantages and disadvantages. A structured evaluation procedure is also described.

Bonobos and chimpanzees exhibit human-like framing effects

PubMed Central

Krupenye, Christopher; Rosati, Alexandra G.; Hare, Brian

2015-01-01

Humans exhibit framing effects when making choices, appraising decisions involving losses differently from those involving gains. To directly test for the evolutionary origin of this bias, we examined decision-making in humans' closest living relatives: bonobos (Pan paniscus) and chimpanzees (Pan troglodytes). We presented the largest sample of non-humans to date (n = 40) with a simple task requiring minimal experience. Apes made choices between a ‘framed’ option that provided preferred food, and an alternative option that provided a constant amount of intermediately preferred food. In the gain condition, apes experienced a positive ‘gain’ event in which the framed option was initially presented as one piece of food but sometimes was augmented to two. In the loss condition, apes experienced a negative ‘loss' event in which they initially saw two pieces but sometimes received only one. Both conditions provided equal pay-offs, but apes chose the framed option more often in the positive ‘gain’ frame. Moreover, male apes were more susceptible to framing than were females. These results suggest that some human economic biases are shared through common descent with other apes and highlight the importance of comparative work in understanding the origins of individual differences in human choice. PMID:25672997

Eco-efficiency improvements in industrial water-service systems: assessing options with stakeholders.

PubMed

Levidow, Les; Lindgaard-Jørgensen, Palle; Nilsson, Asa; Skenhall, Sara Alongi; Assimacopoulos, Dionysis

2014-01-01

The well-known eco-efficiency concept helps to assess the economic value and resource burdens of potential improvements by comparison with the baseline situation. But eco-efficiency assessments have generally focused on a specific site, while neglecting wider effects, for example, through interactions between water users and wastewater treatment (WWT) providers. To address the methodological gap, the EcoWater project has developed a method and online tools for meso-level analysis of the entire water-service value chain. This study investigated improvement options in two large manufacturing companies which have significant potential for eco-efficiency gains. They have been considering investment in extra processes which can lower resource burdens from inputs and wastewater, as well as internalising WWT processes. In developing its methodology, the EcoWater project obtained the necessary information from many agents, involved them in the meso-level assessment and facilitated their discussion on alternative options. Prior discussions with stakeholders stimulated their attendance at a workshop to discuss a comparative eco-efficiency assessment for whole-system improvement. Stakeholders expressed interest in jointly extending the EcoWater method to more options and in discussing investment strategies. In such ways, optimal solutions will depend on stakeholders overcoming fragmentation by sharing responsibility and knowledge.

Counseling for personal care options at neonatal end of life: a quantitative and qualitative parent survey.

PubMed

Shelkowitz, Emily; Vessella, Sharon L; O'Reilly, Patricia; Tucker, Richard; Lechner, Beatrice E

2015-12-02

The death of a newborn is a traumatic life changing event in the lives of parents. We hypothesized that bereaved parents of newborn infants want to have choices in the personal care of their infant at the end of life. Parents who had suffered a perinatal or neonatal loss between 1 and 6 years before the survey in a regional level IV neonatal intensive care unit (NICU) and associated labor and delivery room were invited to participate. Parents chose between an online survey, paper survey or telephone interview. The survey included multiple choice and open ended questions. Parents prefer multiple options for the personal care of their infant at the end of life. Emergent themes were need for guidance by the medical team, memory making, feeling cared for and respected by staff, and regrets related to missed opportunities. While parents differ in their preferences in utilizing specific personal care options for their infant's end of life, they share a common preference for being presented with multiple options to choose from and in being guided and supported by healthcare providers, while being afforded the opportunity to make memories with their infant by bonding with and parenting them.

School Partners in ILLINET. Automation Options for School Library Resource Sharing in Illinois. Final Report [and] Partners in ILLINET. Special Report.

ERIC Educational Resources Information Center

Howrey, Mary M.

This study was funded by the Library Services and Construction Act (LSCA) to enable the Illinois School Library Media Association (ISLMA) to plan the automation of the state's school libraries. The research was intended to identify current national programs of interest to ISLMA, identify current automation programs within Illinois library systems,…

78 FR 62838 - Self-Regulatory Organizations; Topaz Exchange, LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

... SPDR S&P 500 Exchange Traded Fund (``SPY'') and the iShares Russell 2000 Index Fund (``IWM''), is $0.01... $3 per contract or greater. QQQQ, SPY and IWM are traded in $0.01 increments for all options series... Securities Exchange Act of 1934 (the ``Act''),\\1\\ and Rule 19b-4 thereunder,\\2\\ notice is hereby given that...

Talk Is Cheap: Skype Can Make VoIP a Very Real Communication Option for Your School

ERIC Educational Resources Information Center

Branzburg, Jeffrey

2007-01-01

There have been many tools that people can use to get connected with each other worldwide. Cell phones, blogs, wikis, podcasts, e-mail--the world hinges upon people's ability to connect, share, collaborate, and communicate. Voice over Internet Protocol (VoIP) is another tool schools can use to help their students get connected with the world. One…

Humans and Autonomy: Implications of Shared Decision Making for Military Operations

DTIC Science & Technology

2017-01-01

and machine learning transparency are identified as future research opportunities. 15. SUBJECT TERMS autonomy, human factors, intelligent agents...network as either the mission changes or an agent becomes disabled (DSB 2012). Fig. 2 Control structures for human agent teams. Robots without tools... learning (ML) algorithms monitor progress. However, operators have final executive authority; they are able to tweak the plan or choose an option

Recent activities in flame retardancy of wood-plastic composites at the Forest Products Laboratory

Treesearch

Robert H. White; Nicole M. Stark; Nadir Ayrilmis

2011-01-01

For a variety of reasons, wood-plastic composite (WPC) products are widely available for some building applications. In applications such as outdoor decking, WPCs have gained a significant share of the market. As an option to improve the efficient use of wood fiber, the USDA Forest Service, Forest Products Laboratory (FPL), has an extensive research program on WPCs....

Issues in electric power in India: Challenges and opportunities

NASA Astrophysics Data System (ADS)

Tongia, Rahul

This dissertation provides an examination of three facets of the Indian power program. The first issue we analyze is the current regulatory environment and guidelines in place for independent power producers and other generators, focusing on possible tradeoffs between prices and investor returns. The analysis shows that investor rates of return are significantly higher than the nominal 16% as stipulated by the Central Electricity Authority guidelines, and an uncertainty analysis reveals the relative importance of various input and project parameters. We discuss problems with the existing guidelines, and provide options for changes in policy. Adoption of modified guidelines that are more transparent and do not focus on project capital structures are likely to result in more affordable tariffs, less delays in project completion and yet provide adequate rates of return for investors. India's nuclear power program is based on indigenous materials and technology, with the potential for providing energy security for many decades. We examine the technical validity of this plan, especially the role of fast breeder reactors for extending the domestic uranium supplies. The analysis shows that breeding is unlikely to occur at anywhere near the rates envisioned, leading to a slow growth of fast breeder reactors. In addition, domestic uranium reserves restrict growth of Pressurized Heavy Water Reactors, which are likely to be the main contributors to nuclear capacity in the short term. To increase the share of nuclear power in the coming decades, India should consider the construction of a number of large thermal reactors based on indigenous and imported uranium. We also present policy options for such changes to India's nuclear power program. This dissertation examines in detail the policy, technology, and economics of an overland pipeline supplying natural gas to India and Pakistan. Such a pipeline would be shared by both countries, and would be a strong confidence building measure, offering a unique opportunity for cooperation. As natural gas pipelines exhibit significant economies of scale, a shared pipeline would also offer the lowest price natural gas for both countries. This study addresses some of the potential concerns, suggesting options for overcoming security of supply worries. (Abstract shortened by UMI.)

Economic Impact of Harvesting Corn Stover under Time Constraint: The Case of North Dakota

DOE PAGES

Maung, Thein A.; Gustafson, Cole R.

2013-01-01

This study examines the impact of stochastic harvest field time on profit maximizing potential of corn cob/stover collection in North Dakota. Three harvest options are analyzed using mathematical programming models. Our findings show that under the first corn grain only harvest option, farmers are able to complete harvesting corn grain and achieve maximum net income in a fairly short amount of time with existing combine technology. However, under the second simultaneous corn grain and cob (one-pass) harvest option, farmers generate lower net income compared to the net income of the first option. This is due to the slowdown in combinemore » harvest capacity as a consequence of harvesting corn cobs. Under the third option of separate corn grain and stover (two-pass) harvest option, time allocation is the main challenge and our evidence shows that with limited harvest field time available, farmers find it optimal to allocate most of their time harvesting grain and then proceed to harvest and bale stover if time permits at the end of harvest season. The overall findings suggest is that it would be more economically efficient to allow a firm that is specialized in collecting biomass feedstock to participate in cob/stover harvest business.« less

Economic Impact of Harvesting Corn Stover under Time Constraint: The Case of North Dakota

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

Maung, Thein A.; Gustafson, Cole R.

This study examines the impact of stochastic harvest field time on profit maximizing potential of corn cob/stover collection in North Dakota. Three harvest options are analyzed using mathematical programming models. Our findings show that under the first corn grain only harvest option, farmers are able to complete harvesting corn grain and achieve maximum net income in a fairly short amount of time with existing combine technology. However, under the second simultaneous corn grain and cob (one-pass) harvest option, farmers generate lower net income compared to the net income of the first option. This is due to the slowdown in combinemore » harvest capacity as a consequence of harvesting corn cobs. Under the third option of separate corn grain and stover (two-pass) harvest option, time allocation is the main challenge and our evidence shows that with limited harvest field time available, farmers find it optimal to allocate most of their time harvesting grain and then proceed to harvest and bale stover if time permits at the end of harvest season. The overall findings suggest is that it would be more economically efficient to allow a firm that is specialized in collecting biomass feedstock to participate in cob/stover harvest business.« less

Association between prescription cost sharing and adherence to initial combination antiretroviral therapy in commercially insured antiretroviral-naïve patients with HIV.

PubMed

Johnston, Stephen S; Juday, Timothy; Seekins, Daniel; Espindle, Derek; Chu, Bong-Chul

2012-03-01

In treatment of human immunodeficiency virus (HIV), high levels of adherence to combination antiretroviral therapy (cART) are required to prevent failure of virologic suppression, development of drug resistance, and permanent loss of therapeutic options. No published research has assessed the association between cART prescription cost sharing and adherence to cART. To analyze the association between cART prescription cost sharing and adherence to initial cART in commercially insured antiretroviral (ARV)-naïve patients with HIV. This retrospective observational cohort study used 2002-2008 data from a large U.S. claims database of more than 56 million commercially insured individuals. Study subjects were patients aged 18 years or older who initiated cART during the period January 1, 2003, to December 31, 2007, had no ARV claims during the 6-month period prior to the initiation date, and had at least 1 ICD-9-CM diagnosis code for HIV infection (042, 795.71, V08) from 12 months before to 12 months after cART initiation. A minimum 12-month period of continuous enrollment after cART initiation was used to construct a patient-quarter repeated measures panel dataset in which each quarter of data that a patient contributed represented an observation. The evaluation period extended from cART initiation until the occurrence of 1 of the following events: addition of an ARV that was not part of the initial cART regimen, 30-day gap in possession of an ARV within the initiated cART regimen, hospitalization of 30 or more days, loss to follow-up due to study end (December 31, 2008), or disenrollment. The study's outcome was quarterly adherence to cART, defined as the number of days within the quarter that a patient possessed all components of the initial cART regimen. Each patient's cART cost-sharing amount was calculated per 30-day supply of the entire cART regimen. Adherence was dichotomized for analysis at the clinically meaningful thresholds of 95% and 78%. The dichotomized adherence outcomes were separately modeled using population-averaged generalized estimating equations (GEEs) with time-varying and time-constant covariates and an exchangeable working correlation structure. Independent variables included cost-sharing amount; sequential quarter number after cART initiation; interaction between cost-sharing amount and sequential quarter number (to capture any changes in the association of cost sharing with adherence that may occur over time after initiation of cART); and patient demographic, clinical, and insurance characteristics. For each sequential quarter after cART initiation, the GEE models were used to generate average predicted probabilities of adherence reaching each threshold (95% and 78%) at cost-sharing levels of $25, $75, and $144, which represented the 25th, 75th, and 90th percentiles of the cost-sharing distribution, respectively. The study sample included 19,199 patient-quarters and 3,731 patients: mean age 41.1 years; 83.2% male; mean (SD) duration of post-index period 5.1 (4.2) quarters; mean (SD) daily cART pill count 3.2 (2.2); mean (median) cost sharing per 30-day supply of the entire cART regimen $67 ($40). In the unadjusted analyses of patient-quarters, mean adherence ranged from 97.2% for cost-sharing levels within the 0-20th percentiles (from $0 to $20 per 30-day cART supply) to 94.0% for cost-sharing levels exceeding the 80th percentile (from $84 to $3,832 per 30-day cART supply). In the adjusted analyses for the second quarter (25th percentile of follow-up duration, n = 3,117 cases still under observation) at the cost-sharing levels of $25, $75, and $144, the predicted probabilities of at least 95% adherence were 0.782, 0.770, and 0.752, respectively, and the predicted probabilities of at least 78% adherence were 0.936, 0.931, and 0.924, respectively. The differences in the predicted probabilities of adherence grew over time. By the seventh quarter (the 75th percentile of follow-up duration, n = 1,096 cases still under observation), the predicted probabilities were 0.773, 0.746, and 0.707 for 95% adherence and 0.933, 0.922, and 0.904 for 78% adherence at cost-sharing levels of $25, $75, and $144, respectively. Increasing cART prescription cost sharing was associated with modestly decreased probability of maintaining clinically meaningful levels of cART adherence.

EC power management and NTM control in ITER

NASA Astrophysics Data System (ADS)

Poli, Francesca; Fredrickson, E.; Henderson, M.; Bertelli, N.; Farina, D.; Figini, L.; Nowak, S.; Poli, E.; Sauter, O.

2016-10-01

The suppression of Neoclassical Tearing Modes (NTMs) is an essential requirement for the achievement of the demonstration baseline in ITER. The Electron Cyclotron upper launcher is specifically designed to provide highly localized heating and current drive for NTM stabilization. In order to assess the power management for shared applications, we have performed time-dependent simulations for ITER scenarios covering operation from half to full field. The free-boundary TRANSP simulations evolve the magnetic equilibrium and the pressure profiles in response to the heating and current drive sources and are interfaced with a GRE for the evolution of size and frequency of the magnetic islands. Combined with a feedback control of the EC power and the steering angle, these simulations are used to model the plasma response to NTM control, accounting for the misalignment of the EC deposition with the resonant surfaces, uncertainties in the magnetic equilibrium reconstruction and in the magnetic island detection threshold. Simulations indicate that the threshold for detection of the island should not exceed 2-3cm, that pre-emptive control is a preferable option, and that for safe operation the power needed for NTM control should be reserved, rather than shared with other applications. Work supported by ITER under IO/RFQ/13/9550/JTR and by DOE under DE-AC02-09CH11466.

The anatomical placode in reptile scale morphogenesis indicates shared ancestry among skin appendages in amniotes

PubMed Central

Di-Poï, Nicolas; Milinkovitch, Michel C.

2016-01-01

Most mammals, birds, and reptiles are readily recognized by their hairs, feathers, and scales, respectively. However, the lack of fossil intermediate forms between scales and hairs and substantial differences in their morphogenesis and protein composition have fueled the controversy pertaining to their potential common ancestry for decades. Central to this debate is the apparent lack of an “anatomical placode” (that is, a local epidermal thickening characteristic of feathers’ and hairs’ early morphogenesis) in reptile scale development. Hence, scenarios have been proposed for the independent development of the anatomical placode in birds and mammals and parallel co-option of similar signaling pathways for their morphogenesis. Using histological and molecular techniques on developmental series of crocodiles and snakes, as well as of unique wild-type and EDA (ectodysplasin A)–deficient scaleless mutant lizards, we show for the first time that reptiles, including crocodiles and squamates, develop all the characteristics of an anatomical placode: columnar cells with reduced proliferation rate, as well as canonical spatial expression of placode and underlying dermal molecular markers. These results reveal a new evolutionary scenario where hairs, feathers, and scales of extant species are homologous structures inherited, with modification, from their shared reptilian ancestor’s skin appendages already characterized by an anatomical placode and associated signaling molecules. PMID:28439533

The anatomical placode in reptile scale morphogenesis indicates shared ancestry among skin appendages in amniotes.

PubMed

Di-Poï, Nicolas; Milinkovitch, Michel C

2016-06-01

Most mammals, birds, and reptiles are readily recognized by their hairs, feathers, and scales, respectively. However, the lack of fossil intermediate forms between scales and hairs and substantial differences in their morphogenesis and protein composition have fueled the controversy pertaining to their potential common ancestry for decades. Central to this debate is the apparent lack of an "anatomical placode" (that is, a local epidermal thickening characteristic of feathers' and hairs' early morphogenesis) in reptile scale development. Hence, scenarios have been proposed for the independent development of the anatomical placode in birds and mammals and parallel co-option of similar signaling pathways for their morphogenesis. Using histological and molecular techniques on developmental series of crocodiles and snakes, as well as of unique wild-type and EDA (ectodysplasin A)-deficient scaleless mutant lizards, we show for the first time that reptiles, including crocodiles and squamates, develop all the characteristics of an anatomical placode: columnar cells with reduced proliferation rate, as well as canonical spatial expression of placode and underlying dermal molecular markers. These results reveal a new evolutionary scenario where hairs, feathers, and scales of extant species are homologous structures inherited, with modification, from their shared reptilian ancestor's skin appendages already characterized by an anatomical placode and associated signaling molecules.

Pricing European option with transaction costs under the fractional long memory stochastic volatility model

NASA Astrophysics Data System (ADS)

Wang, Xiao-Tian; Wu, Min; Zhou, Ze-Min; Jing, Wei-Shu

2012-02-01

This paper deals with the problem of discrete time option pricing using the fractional long memory stochastic volatility model with transaction costs. Through the 'anchoring and adjustment' argument in a discrete time setting, a European call option pricing formula is obtained.

Patient and Clinician Openness to Including a Broader Range of Healing Options in Primary Care

PubMed Central

Hsu, Clarissa; Cherkin, Daniel C.; Hoffmeyer, Sylvia; Sherman, Karen J.; Phillips, William R.

2011-01-01

PURPOSE We studied the openness of patients and clinicians to introducing a broader range of healing options into primary care. METHODS Focus groups were conducted with primary care patients (4 groups) and clinicians (3 groups) from an integrated medical care system in 2008. Transcripts of discussions were analyzed using an immersion/crystallization approach. RESULTS Both patients (n = 44) and clinicians (n = 32) were open to including a wider variety of healing options in primary care. Patients desired some evidence of effectiveness, although there was wide variation in the type of evidence required. Many patients believed that the clinician’s personal and practice experience was an important form of evidence. Patients wanted to share in the decision to refer and the choice of options. Clinicians were most concerned with safety of specific treatments, including some of the herbs and dietary supplements. They also believed they lacked adequate information about the nature, benefits, and risks of many alternatives, and they were not aware of local practitioners and resources to whom they could confidently refer their patients. Both patients and clinicians were concerned that services recommended be covered by insurance or be affordable to patients. CONCLUSIONS Integrating additional healing options into primary care may be feasible and desirable, as well as help meet the needs of patients with conditions that have not been responsive to standard medical treatments. PMID:21911764

Paradoxical choice in rats: Subjective valuation and mechanism of choice.

PubMed

Ojeda, Andrés; Murphy, Robin A; Kacelnik, Alex

2018-07-01

Decision-makers benefit from information only when they can use it to guide behavior. However, recent experiments found that pigeons and starlings value information that they cannot use. Here we show that this paradox is also present in rats, and explore the underlying decision process. Subjects chose between two options that delivered food probabilistically after a fixed delay. In one option ("info"), outcomes (food/no-food) were signaled immediately after choice, whereas in the alternative ("non-info") the outcome was uncertain until the delay lapsed. Rats sacrificed up to 20% potential rewards by preferring the info option, but reversed preference when the cost was 60%. This reversal contrasts with the results found with pigeons and starlings and may reflect species' differences worth of further investigation. Results are consistent with predictions of the Sequential Choice Model (SCM), that proposes that choices are driven by the mechanisms that control action in sequential encounters. As expected from the SCM, latencies to respond in single-option trials predicted preferences in choice trials, and latencies in choice trials were the same or shorter than in single-option trials. We argue that the congruence of results in distant vertebrates probably reflects evolved adaptations to shared fundamental challenges in nature, and that the apparently paradoxical overvaluing of information is not sub-optimal as has been claimed, even though its functional significance is not yet understood. Copyright © 2018 Elsevier B.V. All rights reserved.

Collaboration in natural resource governance: reconciling stakeholder expectations in deer management in Scotland.

PubMed

Davies, Althea L; White, Rehema M

2012-12-15

The challenges of integrated, adaptive and ecosystem management are leading government agencies to adopt participatory modes of engagement. Collaborative governance is a form of participation in which stakeholders co-produce goals and strategies and share responsibilities and resources. We assess the potential and challenges of collaborative governance as a mechanism to provide an integrated, ecosystem approach to natural resource management, using red deer in Scotland as a case study. Collaborative Deer Management Groups offer a well-established example of a 'bridging organisation', intended to reduce costs and facilitate decision making and learning across institutions and scales. We examine who initiates collaborative processes and why, what roles different actors adopt and how these factors influence the outcomes, particularly at a time of changing values, management and legislative priorities. Our findings demonstrate the need for careful consideration of where and how shared responsibility might be best implemented and sustained as state agencies often remain key to the process, despite the partnership intention. Differing interpretations between agencies and landowners of the degree of autonomy and division of responsibilities involved in 'collaboration' can create tension, while the diversity of landowner priorities brings additional challenges for defining shared goals in red deer management and in other cases. Effective maintenance depends on appropriate role allocation and adoption of responsibilities, definition of convergent values and goals, and establishing communication and trust in institutional networks. Options that may help private stakeholders offset the costs of accepting responsibility for delivering public benefits need to be explicitly addressed to build capacity and support adaptation. This study indicates that collaborative governance has the potential to help reconcile statutory obligations with stakeholder empowerment. The potential of collaboration to reduce the costs of sustainable management remains contentious and, in times of increasing resource constraints, the potential mismatch between resource investment and anticipated goals is likely to become a critical issue, which may challenge the goals and capacity of the state and existing managers. Copyright © 2012 Elsevier Ltd. All rights reserved.

Job Sharing in the Public Sector.

ERIC Educational Resources Information Center

Olmsted, Barney; And Others

Job sharing is defined as "two people sharing the responsibilities of one full-time position with salary and benefits prorated"; the concept focuses on positions usually offered only as full-time jobs, often in professional and managerial categories. This book presents an overview of current job sharing and permanent part-time employment…

The Psychosocial and Independent Living Donor Advocate Evaluation and Post-surgery Care of Living Donors.

PubMed

Rudow, Dianne LaPointe; Swartz, Kathleen; Phillips, Chelsea; Hollenberger, Jennifer; Smith, Taylor; Steel, Jennifer L

2015-09-01

Solid organ transplantation as a treatment for end stage organ failure has been an accepted treatment option for decades. Despite advances in medicine and technology, and increased awareness of organ donation and transplantation, the gap between supply and demand continues to widen. Living donation has been an option that has increased the number of transplants despite the continued shortage of deceased organs. In the early 2000s live donor transplantation reached an all-time high in the United States. As a result, a consensus meeting was convened in 2000 to increase the oversight of living donor transplantation. Both the Centers for Medicare and Medicaid Services and the United Network for Organ Sharing developed regulations that transplant programs performing live donor transplantation. These regulations and guidelines involve the education, evaluation, informed consent process and living donor follow-up care. Two areas in which had significant changes included the psychosocial and the independent living donor advocate (ILDA) evaluation. The purpose of this paper was to outline the current regulations and guidelines associated with the psychosocial and ILDA evaluation as well as provide further recommendations for the administration of a high quality evaluation of living donors. The goals and timing of the evaluation and education of donors; qualifications of the health care providers performing the evaluation; components of the evaluation; education provided to donors; documentation of the evaluation; participation in the selection committee meeting; post-decline and post-donation care of donors is described. Caveats including the paired donor exchange programs and non-directed and directed donation are also considered.

Refinement of a Conceptual Model for Adolescent Readiness to Engage in End-of-Life Discussions.

PubMed

Bell, Cynthia J; Zimet, Gregory D; Hinds, Pamela S; Broome, Marion E; McDaniel, Anna M; Mays, Rose M; Champion, Victoria L

Adolescents living with incurable cancer require ongoing support to process grief, emotions, and information as disease progresses including treatment options (phase 1 clinical trials and/or hospice/palliative care). Little is known about how adolescents become ready for such discussions. The purpose of this study was to explore the process of adolescent readiness for end-of-life preparedness discussions, generating a theoretical understanding for guiding clinical conversations when curative options are limited. We explored 2 in-depth cases across time using case-study methodology. An à priori conceptual model based on current end-of-life research guided data collection and analysis. Multiple sources including in-depth adolescent interviews generated data collection on model constructs. Analysis followed a logical sequence establishing a chain of evidence linking raw data to study conclusions. Synthesis and data triangulation across cases and time led to theoretical generalizations. Initially, we proposed a linear process of readiness with 3 domains: a cognitive domain (awareness), an emotional domain (acceptance), and a behavioral domain (willingness), which preceded preparedness. Findings led to conceptual model refinement showing readiness is a dynamic internal process that interacts with preparedness. Current awareness context facilitates the type of preparedness discussions (cognitive or emotional). Furthermore, social constraint inhibits discussions. Data support theoretical understanding of the dynamism of readiness. Future research that validates adolescent conceptualization will ensure age-appropriate readiness representation. Understanding the dynamic process of readiness for engaging in end-of-life preparedness provides clinician insight for guiding discussions that facilitate shared decision making and promote quality of life for adolescents and their families.

48 CFR 536.270 - Exercise of options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Exercise of options. 536... Construction 536.270 Exercise of options. (a) If exercising an option, notify the contractor, in writing, within the time period specified in the contract. (b) Exercise options only after determining that all...

48 CFR 536.270 - Exercise of options.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 4 2013-10-01 2013-10-01 false Exercise of options. 536... Construction 536.270 Exercise of options. (a) If exercising an option, notify the contractor, in writing, within the time period specified in the contract. (b) Exercise options only after determining that all...

48 CFR 536.270 - Exercise of options.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Exercise of options. 536... Construction 536.270 Exercise of options. (a) If exercising an option, notify the contractor, in writing, within the time period specified in the contract. (b) Exercise options only after determining that all...

48 CFR 536.270 - Exercise of options.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 4 2012-10-01 2012-10-01 false Exercise of options. 536... Construction 536.270 Exercise of options. (a) If exercising an option, notify the contractor, in writing, within the time period specified in the contract. (b) Exercise options only after determining that all...

48 CFR 536.270 - Exercise of options.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 4 2014-10-01 2014-10-01 false Exercise of options. 536... Construction 536.270 Exercise of options. (a) If exercising an option, notify the contractor, in writing, within the time period specified in the contract. (b) Exercise options only after determining that all...

Incorporating simulation into gynecologic surgical training.

PubMed

Wohlrab, Kyle; Jelovsek, J Eric; Myers, Deborah

2017-11-01

Today's educational environment has made it more difficult to rely on the Halstedian model of "see one, do one, teach one" in gynecologic surgical training. There is decreased surgical volume, but an increased number of surgical modalities. Fortunately, surgical simulation has evolved to fill the educational void. Whether it is through skill generalization or skill transfer, surgical simulation has shifted learning from the operating room back to the classroom. This article explores the principles of surgical education and ways to introduce simulation as an adjunct to residency training. We review high- and low-fidelity surgical simulators, discuss the progression of surgical skills, and provide options for skills competency assessment. Time and money are major hurdles when designing a simulation curriculum, but low-fidelity models, intradepartmental cost sharing, and utilizing local experts for simulation proctoring can aid in developing a simulation program. Copyright © 2017 Elsevier Inc. All rights reserved.

Participatory and evidence-based recommendations for urban redevelopment following natural disasters: older adults as policy advisers.

PubMed

Annear, Michael; Keeling, Sally; Wilkinson, Tim

2014-03-01

To develop community-generated recommendations to inform urban environmental remediation following earthquakes in Christchurch, New Zealand, and share these with local decision-makers during a participatory action research process. This study employed three focus group discussions to critique mixed-methods and multiphase results and develop evidence-based recommendations. Participants included 30 volunteers and 8 knowledgeable advisers aged 65 years and older. Participant recommendations addressed the remediation of earthquake-affected suburbs, access to transportation, age-friendly design, safer communities, resilient support agencies, and restoration of resources for social and cultural activities. Older collaborators identified salient barriers to active ageing and options for post-earthquake redevelopment that had not previously been considered in research or policy. Independently living older adults are well placed to work with researchers to develop recommendations to improve the urban environment following natural disasters as well as in times of relative stability. © 2013 ACOTA.

The Role of Nuclear Power in Reducing Risk of the Fossil Fuel Prices and Diversity of Electricity Generation in Tunisia: A Portfolio Approach

NASA Astrophysics Data System (ADS)

Abdelhamid, Mohamed Ben; Aloui, Chaker; Chaton, Corinne; Souissi, Jomâa

2010-04-01

This paper applies real options and mean-variance portfolio theories to analyze the electricity generation planning into presence of nuclear power plant for the Tunisian case. First, we analyze the choice between fossil fuel and nuclear production. A dynamic model is presented to illustrate the impact of fossil fuel cost uncertainty on the optimal timing to switch from gas to nuclear. Next, we use the portfolio theory to manage risk of the electricity generation portfolio and to determine the optimal fuel mix with the nuclear alternative. Based on portfolio theory, the results show that there is other optimal mix than the mix fixed for the Tunisian mix for the horizon 2010-2020, with lower cost for the same risk degree. In the presence of nuclear technology, we found that the optimal generating portfolio must include 13% of nuclear power technology share.

High-Temperature Oxidation of Plutonium Surrogate Metals and Alloys

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

Sparks, Joshua C.; Krantz, Kelsie E.; Christian, Jonathan H.

The Plutonium Management and Disposition Agreement (PMDA) is a nuclear non-proliferation agreement designed to remove 34 tons of weapons-grade plutonium from Russia and the United States. While several removal options have been proposed since the agreement was first signed in 2000, processing the weapons-grade plutonium to mixed-oxide (MOX) fuel has remained the leading candidate for achieving the goals of the PMDA. However, the MOX program has received its share of criticisms, which causes its future to be uncertain. One alternative pathway for plutonium disposition would involve oxidizing the metal followed by impurity down blending and burial in the Waste Isolationmore » Pilot Plant (WIPP) in Carlsbad, New Mexico. This pathway was investigated by use of a hybrid microwave and a muffle furnace with Fe and Al as surrogate materials. Oxidation occurred similarly in the microwave and muffle furnace; however, the microwave process time was significantly faster.« less

Unlocking the potential of smart grid technologies with behavioral science

PubMed Central

Sintov, Nicole D.; Schultz, P. Wesley

2015-01-01

Smart grid systems aim to provide a more stable and adaptable electricity infrastructure, and to maximize energy efficiency. Grid-linked technologies vary widely in form and function, but generally share common potentials: to reduce energy consumption via efficiency and/or curtailment, to shift use to off-peak times of day, and to enable distributed storage and generation options. Although end users are central players in these systems, they are sometimes not central considerations in technology or program design, and in some cases, their motivations for participating in such systems are not fully appreciated. Behavioral science can be instrumental in engaging end-users and maximizing the impact of smart grid technologies. In this paper, we present emerging technologies made possible by a smart grid infrastructure, and for each we highlight ways in which behavioral science can be applied to enhance their impact on energy savings. PMID:25914666

[Innovative teleradiology network: concept and experience report].

PubMed

Kämmerer, M; Bethge, O T; Antoch, G

2014-04-01

(DICOM E-MAIL provides a standardized way for exchanging DICOM objects (Digital Imaging and Communications in Medicine) and further relevant patient data for the treatment context reliably and securely via encrypted e-mails. The current version of the DICOM E-MAIL standard recommendations of the"Deutsche Röntgengesellschaft" (DRG, German Röntgen Society) defines for the first time options for setting up a special directory service for the provision and distribution of communication data of all participants in a network. By using such"telephone books", networks of any size can be operated independent of the provider. Compared to a Cross-Enterprise Document Sharing (XDS) scenario, the required infrastructure is considerably less complex and quicker to realize. Critical success factors are, in addition to the technology and an effective support, that the participants themselves contribute to the further development of the network and in this way, the network approach can be practiced.

Computer graphics for management: An abstract of capabilities and applications of the EIS system

NASA Technical Reports Server (NTRS)

Solem, B. J.

1975-01-01

The Executive Information Services (EIS) system, developed as a computer-based, time-sharing tool for making and implementing management decisions, and including computer graphics capabilities, was described. The following resources are available through the EIS languages: centralized corporate/gov't data base, customized and working data bases, report writing, general computational capability, specialized routines, modeling/programming capability, and graphics. Nearly all EIS graphs can be created by a single, on-line instruction. A large number of options are available, such as selection of graphic form, line control, shading, placement on the page, multiple images on a page, control of scaling and labeling, plotting of cum data sets, optical grid lines, and stack charts. The following are examples of areas in which the EIS system may be used: research, estimating services, planning, budgeting, and performance measurement, national computer hook-up negotiations.

Unlocking the potential of smart grid technologies with behavioral science.

PubMed

Sintov, Nicole D; Schultz, P Wesley

2015-01-01

Smart grid systems aim to provide a more stable and adaptable electricity infrastructure, and to maximize energy efficiency. Grid-linked technologies vary widely in form and function, but generally share common potentials: to reduce energy consumption via efficiency and/or curtailment, to shift use to off-peak times of day, and to enable distributed storage and generation options. Although end users are central players in these systems, they are sometimes not central considerations in technology or program design, and in some cases, their motivations for participating in such systems are not fully appreciated. Behavioral science can be instrumental in engaging end-users and maximizing the impact of smart grid technologies. In this paper, we present emerging technologies made possible by a smart grid infrastructure, and for each we highlight ways in which behavioral science can be applied to enhance their impact on energy savings.

Impact of socioeconomic factors on informed decision making and treatment choice in patients with hip and knee OA.

PubMed

Youm, Jiwon; Chan, Vanessa; Belkora, Jeffrey; Bozic, Kevin J

2015-02-01

It is unclear how socioeconomic (SES) status influences the effectiveness of shared decision making (SDM) tools. The purpose of this study was to assess the impact of SES on the utility of SDM tools among patients with hip and knee osteoarthritis (OA). We performed a secondary analysis of data from a randomized controlled trial of 123 patients with hip or knee OA. Higher education and higher income were independently associated with higher knowledge survey scores. Patients with private insurance were 2.7 times more likely than patients with Medicare to arrive at a decision after the initial office visit. Higher education was associated with lower odds of choosing surgery, even after adjusting for knowledge. Patient knowledge of their medical condition and treatment options varies with SES. Copyright © 2014 Elsevier Inc. All rights reserved.

Unlocking the potential of smart grid technologies with behavioral science

DOE PAGES

Sintov, Nicole D.; Schultz, P. Wesley

2015-04-09

Smart grid systems aim to provide a more stable and adaptable electricity infrastructure, and to maximize energy efficiency. Grid-linked technologies vary widely in form and function, but generally share common potentials: to reduce energy consumption via efficiency and/or curtailment, to shift use to off-peak times of day, and to enable distributed storage and generation options. Although end users are central players in these systems, they are sometimes not central considerations in technology or program design, and in some cases, their motivations for participating in such systems are not fully appreciated. Behavioral science can be instrumental in engaging end-users and maximizingmore » the impact of smart grid technologies. In this study, we present emerging technologies made possible by a smart grid infrastructure, and for each we highlight ways in which behavioral science can be applied to enhance their impact on energy savings.« less

Unlocking the potential of smart grid technologies with behavioral science

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

Sintov, Nicole D.; Schultz, P. Wesley

Smart grid systems aim to provide a more stable and adaptable electricity infrastructure, and to maximize energy efficiency. Grid-linked technologies vary widely in form and function, but generally share common potentials: to reduce energy consumption via efficiency and/or curtailment, to shift use to off-peak times of day, and to enable distributed storage and generation options. Although end users are central players in these systems, they are sometimes not central considerations in technology or program design, and in some cases, their motivations for participating in such systems are not fully appreciated. Behavioral science can be instrumental in engaging end-users and maximizingmore » the impact of smart grid technologies. In this study, we present emerging technologies made possible by a smart grid infrastructure, and for each we highlight ways in which behavioral science can be applied to enhance their impact on energy savings.« less

Technical options for the mitigation of direct methane and nitrous oxide emissions from livestock: a review.

PubMed

Gerber, P J; Hristov, A N; Henderson, B; Makkar, H; Oh, J; Lee, C; Meinen, R; Montes, F; Ott, T; Firkins, J; Rotz, A; Dell, C; Adesogan, A T; Yang, W Z; Tricarico, J M; Kebreab, E; Waghorn, G; Dijkstra, J; Oosting, S

2013-06-01

Although livestock production accounts for a sizeable share of global greenhouse gas emissions, numerous technical options have been identified to mitigate these emissions. In this review, a subset of these options, which have proven to be effective, are discussed. These include measures to reduce CH4 emissions from enteric fermentation by ruminants, the largest single emission source from the global livestock sector, and for reducing CH4 and N2O emissions from manure. A unique feature of this review is the high level of attention given to interactions between mitigation options and productivity. Among the feed supplement options for lowering enteric emissions, dietary lipids, nitrates and ionophores are identified as the most effective. Forage quality, feed processing and precision feeding have the best prospects among the various available feed and feed management measures. With regard to manure, dietary measures that reduce the amount of N excreted (e.g. better matching of dietary protein to animal needs), shift N excretion from urine to faeces (e.g. tannin inclusion at low levels) and reduce the amount of fermentable organic matter excreted are recommended. Among the many 'end-of-pipe' measures available for manure management, approaches that capture and/or process CH4 emissions during storage (e.g. anaerobic digestion, biofiltration, composting), as well as subsurface injection of manure, are among the most encouraging options flagged in this section of the review. The importance of a multiple gas perspective is critical when assessing mitigation potentials, because most of the options reviewed show strong interactions among sources of greenhouse gas (GHG) emissions. The paper reviews current knowledge on potential pollution swapping, whereby the reduction of one GHG or emission source leads to unintended increases in another.

Point Positioning Service for Natural Hazard Monitoring

NASA Astrophysics Data System (ADS)

Bar-Sever, Y. E.

2014-12-01

In an effort to improve natural hazard monitoring, JPL has invested in updating and enlarging its global real-time GNSS tracking network, and has launched a unique service - real-time precise positioning for natural hazard monitoring, entitled GREAT Alert (GNSS Real-Time Earthquake and Tsunami Alert). GREAT Alert leverages the full technological and operational capability of the JPL's Global Differential GPS System [www.gdgps.net] to offer owners of real-time dual-frequency GNSS receivers: Sub-5 cm (3D RMS) real-time, absolute positioning in ITRF08, regardless of location Under 5 seconds turnaround time Full covariance information Estimates of ancillary parameters (such as troposphere) optionally provided This service enables GNSS networks operators to instantly have access to the most accurate and reliable real-time positioning solutions for their sites, and also to the hundreds of participating sites globally, assuring inter-consistency and uniformity across all solutions. Local authorities with limited technical and financial resources can now access to the best technology, and share environmental data to the benefit of the entire pacific region. We will describe the specialized precise point positioning techniques employed by the GREAT Alert service optimized for natural hazard monitoring, and in particular Earthquake monitoring. We address three fundamental aspects of these applications: 1) small and infrequent motion, 2) the availability of data at a central location, and 3) the need for refined solutions at several time scales

Alzheimer disease and pre-emptive suicide.

PubMed

Davis, Dena S

2014-08-01

There is a flood of papers being published on new ways to diagnose Alzheimer disease (AD) before it is symptomatic, involving a combination of invasive tests (eg, spinal tap), and pen and paper tests. This changes the landscape with respect to genetic tests for risk of AD, making rational suicide a much more feasible option. Before the availability of these presymptomatic tests, even someone with a high risk of developing AD could not know if and when the disease was approaching. One could lose years of good life by committing suicide too soon, or risk waiting until it was too late and dementia had already sapped one of the ability to form and carry out a plan. One can now put together what one knows about one's risk, with continuing surveillance via these clinical tests, and have a good strategy for planning one's suicide before one becomes demented. This has implications for how these genetic and clinical tests are marketed and deployed, and the language one uses to speak about them. The phrase 'there is nothing one can do' is insulting and disrespectful of the planned suicide option, as is the language of the Risk Evaluation and Education for Alzheimer's Disease (REVEAL) studies and others that conclude that it is 'safe' to tell subjects their risk status for AD. Further, the argument put forward by some researchers that presymptomatic testing should remain within research protocols, and the results not shared with subjects until such time as treatments become available, disrespects the autonomy of people at high risk who consider suicide an option. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

78 FR 5544 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-25

... 1.1(ccc)) in at least the lesser of 99% of the non- adjusted option series that have a time to expiration of less than nine months or 100% of the non-adjusted option series that have a time to expiration... electronic quotes in series that have a time to expiration of nine months or more in the classes for which it...

Network approach for decision making under risk-How do we choose among probabilistic options with the same expected value?

PubMed

Pan, Wei; Chen, Yi-Shin

2018-01-01

Conventional decision theory suggests that under risk, people choose option(s) by maximizing the expected utility. However, theories deal ambiguously with different options that have the same expected utility. A network approach is proposed by introducing 'goal' and 'time' factors to reduce the ambiguity in strategies for calculating the time-dependent probability of reaching a goal. As such, a mathematical foundation that explains the irrational behavior of choosing an option with a lower expected utility is revealed, which could imply that humans possess rationality in foresight.

Scaling and long-range dependence in option pricing V: Multiscaling hedging and implied volatility smiles under the fractional Black-Scholes model with transaction costs

NASA Astrophysics Data System (ADS)

Wang, Xiao-Tian

2011-05-01

This paper deals with the problem of discrete time option pricing using the fractional Black-Scholes model with transaction costs. Through the ‘anchoring and adjustment’ argument in a discrete time setting, a European call option pricing formula is obtained. The minimal price of an option under transaction costs is obtained. In addition, the relation between scaling and implied volatility smiles is discussed.

Help a Brother Out: A Case Study in Multinational Intelligence Sharing, NATO SOF

DTIC Science & Technology

2011-12-01

increases the likelihood of operational failure and further risks the personal safety of the operators. NATO (and many of the individual member states... personalities in a region. The more 33 Lucien S. Vandenbroucke, Perilous Options: Special Operations as an...ICBMs, tank armies -- they were actually relatively easy to find , but they were very hard to kill. Intelligence was important, don’t get me wrong, but

Social Networking Technologies

DTIC Science & Technology

2015-01-01

that an invasion of privacy can occur where the user has created a password protected, private account and limits those who can view it. The question...increasingly add new options for more intimate sharing of information. For example, sites like FourSquare and Instagram , as well as some of the more...her account while a supervisor looked on. The supervisor then copied the post and forwarded it on to the state paramedic licensing board alleging

Combat Identification with Sequential Observations, Rejection Option, and Out-of-Library Targets

DTIC Science & Technology

2005-09-01

nature of the entities sharing the battlespace is unknown. Here CID characterizes those entities using information from a variety of sources. The goal...producing high-resolution returns with signif - icantly enhanced target to clutter (and noise) ratios through Doppler filtering and clutter...treat the subject from a natural science perspective. The following 43 subsections on the various model selection techniques are derived from these

Defense Acquisition: Overview, Issues, and Options for Congress

DTIC Science & Technology

2007-06-20

Joint Staff; the Unified Combatant Commands ( UCCs ); the Defense Agencies; and DOD field activities. planning stage results in the production of the Joint...through the use of such procurement actions. Supporters could also argue that this requirement will help ensure that thorough market research is...high prices for shoddy weapons. Yet they sought, on the other, that the industrialists in their own states and districts got their fair share , or more

Sell your practice to grow and compete--the synergism of vertical integration.

PubMed

Robison, D L

1988-01-01

There are many advantages for selling a group practice to achieve vertical integration with a larger entity, including shared medical and management services, and greater efficiency, which results in greater profits. Health care in the 1990s will have a more formalized, structured system, greatly reducing freedoms enjoyed by both physicians and patients. An attractive option for smaller groups or solo practitioners is vertical integration.

5 CFR 892.211 - What options are available to me if I go on a period of leave without pay (LWOP) or other types...

Code of Federal Regulations, 2010 CFR

2010-01-01

... will continue FEHB coverage while on LWOP; your employer will advance your share of your FEHB premium during your LWOP period; and you will repay the advanced amounts when you return from LWOP. (Described in... you now waive). (b)(1) You may continue your FEHB coverage by agreeing in advance of LWOP to one of...

The neglected topic: presentation of cost information in patient decision AIDS.

PubMed

Blumenthal-Barby, J S; Robinson, Emily; Cantor, Scott B; Naik, Aanand D; Russell, Heidi Voelker; Volk, Robert J

2015-05-01

Costs are an important component of patients' decision making, but a comparatively underemphasized aspect of formal shared decision making. We hypothesized that decision aids also avoid discussion of costs, despite their being tools designed to facilitate shared decision making about patient-centered outcomes. We sought to define the frequency of cost-related information and identify the common modes of presenting cost and cost-related information in the 290 decision aids catalogued in the Ottawa Hospital Research Institute's Decision Aid Library Inventory (DALI) system. We found that 56% (n = 161) of the decision aids mentioned cost in some way, but only 13% (n = 37) gave a specific price or range of prices. We identified 9 different ways in which cost was mentioned. The most common approach was as a "pro" of one of the treatment options (e.g., "you avoid the cost of medication"). Of the 37 decision aids that gave specific prices or ranges of prices for treatment options, only 2 were about surgery decisions despite the fact that surgery decision aids were the most common. Our findings suggest that presentation of cost information in decision aids is highly variable. Evidence-based guidelines should be developed by the International Patient Decision Aid Standards (IPDAS) Collaboration. © The Author(s) 2015.

The Impact of Multifaceted Osteoporosis Group Education on Patients' Decision-Making regarding Treatment Options and Lifestyle Changes.

PubMed

Jensen, Annesofie L; Wind, Gitte; Langdahl, Bente Lomholt; Lomborg, Kirsten

2018-01-01

Patients with chronic diseases like osteoporosis constantly have to make decisions related to their disease. Multifaceted osteoporosis group education (GE) may support patients' decision-making. This study investigated multifaceted osteoporosis GE focusing on the impact of GE on patients' decision-making related to treatment options and lifestyle. An interpretive description design using ethnographic methods was utilized with 14 women and three men diagnosed with osteoporosis who attended multifaceted GE. Data consisted of participant observation during GE and individual interviews. Attending GE had an impact on the patients' decision-making in all educational themes. Patients decided on new ways to manage osteoporosis and made decisions regarding bone health and how to implement a lifestyle ensuring bone health. During GE, teachers and patients shared evidence-based knowledge and personal experiences and preferences, respectively, leading to a two-way exchange of information and deliberation about recommendations. Though teachers and patients explored the implications of the decisions and shared their preferences, teachers stressed that the patients ultimately had to make the decision. Teachers therefore refrained from participating in the final step of the decision-making process. Attending GE has an impact on the patients' decision-making as it can initiate patient reflection and support decision-making.

Case Studies in Describing Scientific Research Efforts as Linked Data

NASA Astrophysics Data System (ADS)

Gandara, A.; Villanueva-Rosales, N.; Gates, A.

2013-12-01

The Web is growing with numerous scientific resources, prompting increased efforts in information management to consider integration and exchange of scientific resources. Scientists have many options to share scientific resources on the Web; however, existing options provide limited support to scientists in annotating and relating research resources resulting from a scientific research effort. Moreover, there is no systematic approach to documenting scientific research and sharing it on the Web. This research proposes the Collect-Annotate-Refine-Publish (CARP) Methodology as an approach for guiding documentation of scientific research on the Semantic Web as scientific collections. Scientific collections are structured descriptions about scientific research that make scientific results accessible based on context. In addition, scientific collections enhance the Linked Data data space and can be queried by machines. Three case studies were conducted on research efforts at the Cyber-ShARE Research Center of Excellence in order to assess the effectiveness of the methodology to create scientific collections. The case studies exposed the challenges and benefits of leveraging the Semantic Web and Linked Data data space to facilitate access, integration and processing of Web-accessible scientific resources and research documentation. As such, we present the case study findings and lessons learned in documenting scientific research using CARP.

Attitudes towards Prosthodontic Clinical Decision-Making for Edentulous Patients among South West Deanery Dental Foundation Year One Dentists

PubMed Central

Barber, Andrew; Puryer, James; Leary, Sam; McNally, Lisa; O’Sullivan, Dominic

2016-01-01

The aim of this study was to describe Dental Foundation year one dentists’ attitudes towards prosthodontic decision making for edentulous patients, and identify whether there are gender differences in these attitudes. All South West Deanery trainees were invited to take part in the study between May and June 2011 and a previously piloted questionnaire was administered to the trainees by their training programme directors. The questionnaire posed questions based upon a clinical scenario of discussing treatment options with patients. Seventy-two questionnaires were used in the analysis (91% overall response rate). Trainees perceived their own values to be less important than the patient’s values (p < 0.001) in decision making, but similar to the patient’s friend’s/relative’s values (p = 0.1). In addition, the trainees perceived the patient’s values to be less important than their friend’s/relatives (p < 0.001). Sixty-six per cent of trainees acknowledged an influence from their own personal values on their presentation of material to patients who are in the process of choosing among different treatment options, and 87% thought their edentulous patients were satisfied with the decision making process when choosing among different treatment options. Fifty-eight per cent of trainees supported a strategy of negotiation between patients and clinicians (shared decision making). There was no strong evidence to suggest gender had an influence on the attitudes towards decision making. The finding of a consensus towards shared decision making in the attitudes of trainees, and no gender differences is encouraging and is supportive of UK dental schools’ ability to foster ethical and professional values among dentists. PMID:29563454

Impact of Broader Sharing on Transport Time for Deceased Donor Livers

PubMed Central

Gentry, Sommer E; Chow, Eric KH; Wickliffe, Corey E; Massie, Allan B; Leighton, Tabitha; Segev, Dorry L

2014-01-01

Recent allocation policy changes have increased sharing of deceased donor livers across local boundaries, and sharing even broader than this has been proposed as a remedy for persistent geographic disparities in liver transplantation. It is possible that broader sharing might increase cold ischemia time (CIT) and thus harm recipients. We constructed a detailed model of transport modes (driving, helicopter, or fixed-wing) and transport times between all hospitals, and investigated the relationship between transport time and CIT for deceased donor liver transplants. Median estimated transport time for regionally shared livers was 2.0 hours compared with 1.0 hours for locally allocated livers. Model-predicted transport mode was flying for 90% of regionally shared livers but only 22% of locally allocated livers. Median CIT was 7.0 hours for regionally shared livers compared with 6.0 hours for locally allocated livers. Variation in transport time accounted for only 14.7% of the variation in CIT and, on average, transport time comprised only 21% of CIT. In conclusion, non-transport factors play a substantially larger role in CIT than does transport time. Broader sharing will have only a marginal impact on CIT but will significantly increase the fraction of transplants that are transported by flying rather than driving. PMID:24975028

EU-AIMS Longitudinal European Autism Project (LEAP): the autism twin cohort.

PubMed

Isaksson, Johan; Tammimies, Kristiina; Neufeld, Janina; Cauvet, Élodie; Lundin, Karl; Buitelaar, Jan K; Loth, Eva; Murphy, Declan G M; Spooren, Will; Bölte, Sven

2018-01-01

EU-AIMS is the largest European research program aiming to identify stratification biomarkers and novel interventions for autism spectrum disorder (ASD). Within the program, the Longitudinal European Autism Project (LEAP) has recruited and comprehensively phenotyped a rare sample of 76 monozygotic and dizygotic twins, discordant, or concordant for ASD plus 30 typically developing twins. The aim of this letter is to complete previous descriptions of the LEAP case-control sample, clinically characterize, and investigate the suitability of the sample for ASD twin-control analyses purposes and share some 'lessons learnt.' Among the twins, a diagnosis of ASD is associated with increased symptom levels of ADHD, higher rates of intellectual disability, and lower family income. For the future, we conclude that the LEAP twin cohort offers multiple options for analyses of genetic and shared and non-shared environmental factors to generate new hypotheses for the larger cohort of LEAP singletons, but particularly cross-validate and refine evidence from it.

Time Out with Half-Time: Job Sharing in the Nineties.

ERIC Educational Resources Information Center

Turner, Linda

1996-01-01

Job sharing is a form of employment often overlooked by the average worker. Eight women were interviewed for this qualitative research study on the benefits and drawbacks of job sharing. Rather than simply allowing more time for them to spend with their children or on domestic chores, job sharing provided unanticipated opportunities to enjoy a…

11 CFR 100.93 - Travel by aircraft or other means of transportation.

Code of Federal Regulations, 2014 CFR

2014-01-01

... traveled or within seven (7) calendar days thereof. The payment rate must be determined by the time the... travel on an aircraft that is owned or leased under a shared-ownership or other time-share arrangement... travel on an aircraft that is owned or leased under a shared-ownership or other time-share arrangement...

Design of the transfer line from booster to storage ring at 3 GeV

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

Bayar, C., E-mail: cafer.bayar@cern.ch; Ciftci, A. K., E-mail: abbas.kenan.ciftci@cern.ch

The Synchrotron Booster Ring accelerates the e-beam up to 3 GeV and particles are transported from booster to storage ring by transfer line. In this study, two options are considered, the first one is a long booster which shares the same tunnel with storage ring and the second one is a compact booster. As a result, two transfer line are designed based on booster options. The optical design is constrained by the e-beam Twiss parameters entering and leaving the transfer line. Twiss parameters in the extraction point of booster are used for the entrance of transfer line and are matchedmore » in the exit of transfer line to the injection point of the storage ring.« less

Emerging Options and Opportunities in Civilian Aeronautics

NASA Technical Reports Server (NTRS)

Bushnell, Dennis M.

2012-01-01

This paper addresses the major problems/issues with civilian aeronautics going forward, the contextual ongoing technology revolutions, the several emerging civilian aeronautical "Big Ideas" and associated enabling technological approaches. The ongoing IT Revolution is increasingly providing, as 5 senses virtual presence/reality becomes available, along with Nano/Molecular Manufacturing, virtual alternatives to Physical transportation for both people and goods. Paper examines the potential options available to aeronautics to maintain and perhaps grow "market share" in the context of this evolving competition. Many of these concepts are not new, but the emerging technology landscape is enhancing their viability and marketability. The concepts vary from the "interesting" to the truly revolutionary and all require considerable research. Paper considers the speed range from personal/general aviation to supersonic transports and technologies from energetics to fabrication.

Teaching and Learning Communities through Online Annotation

NASA Astrophysics Data System (ADS)

van der Pluijm, B.

2016-12-01

What do colleagues do with your assigned textbook? What they say or think about the material? Want students to be more engaged in their learning experience? If so, online materials that complement standard lecture format provide new opportunity through managed, online group annotation that leverages the ubiquity of internet access, while personalizing learning. The concept is illustrated with the new online textbook "Processes in Structural Geology and Tectonics", by Ben van der Pluijm and Stephen Marshak, which offers a platform for sharing of experiences, supplementary materials and approaches, including readings, mathematical applications, exercises, challenge questions, quizzes, alternative explanations, and more. The annotation framework used is Hypothes.is, which offers a free, open platform markup environment for annotation of websites and PDF postings. The annotations can be public, grouped or individualized, as desired, including export access and download of annotations. A teacher group, hosted by a moderator/owner, limits access to members of a user group of teachers, so that its members can use, copy or transcribe annotations for their own lesson material. Likewise, an instructor can host a student group that encourages sharing of observations, questions and answers among students and instructor. Also, the instructor can create one or more closed groups that offers study help and hints to students. Options galore, all of which aim to engage students and to promote greater responsibility for their learning experience. Beyond new capacity, the ability to analyze student annotation supports individual learners and their needs. For example, student notes can be analyzed for key phrases and concepts, and identify misunderstandings, omissions and problems. Also, example annotations can be shared to enhance notetaking skills and to help with studying. Lastly, online annotation allows active application to lecture posted slides, supporting real-time notetaking during lecture presentation. Sharing of experiences and practices of annotation could benefit teachers and learners alike, and does not require complicated software, coding skills or special hardware environments.

The first shall be last: Selection-driven minority becomes majority

NASA Astrophysics Data System (ADS)

Crokidakis, Nuno; de Oliveira, Paulo Murilo Castro

2014-09-01

Street demonstrations occur across the world. In Rio de Janeiro, in June/July 2013, they reach beyond one million people. A wrathful reader of O Globo, a leading newspaper in the same city, published a letter (Ferreira (2011) [10]) where many social questions are stated and answered Yes or No. These million people of street demonstrations share opinion consensus about a similar set of social issues. But they did not reach this consensus within such a huge numbered meeting. Earlier, they have met in diverse small groups where some of them could be convinced to change their mind by other few fellows. Suddenly, a macroscopic consensus emerges. Many other big manifestations are widespread all over the world in recent times, and are supposed to remain in the future. The interesting questions are: (1) How a binary-option opinion distributed among some population evolves in time, through local changes that occurred within small-group meetings? and (2) Is there some natural selection rule acting upon? Here, we address these questions through an agent-based model.