Value: A Framework for Radiation Oncology

PubMed Central

Teckie, Sewit; McCloskey, Susan A.; Steinberg, Michael L.

2014-01-01

In the current health care system, high costs without proportional improvements in quality or outcome have prompted widespread calls for change in how we deliver and pay for care. Value-based health care delivery models have been proposed. Multiple impediments exist to achieving value, including misaligned patient and provider incentives, information asymmetries, convoluted and opaque cost structures, and cultural attitudes toward cancer treatment. Radiation oncology as a specialty has recently become a focus of the value discussion. Escalating costs secondary to rapidly evolving technologies, safety breaches, and variable, nonstandardized structures and processes of delivering care have garnered attention. In response, we present a framework for the value discussion in radiation oncology and identify approaches for attaining value, including economic and structural models, process improvements, outcome measurement, and cost assessment. PMID:25113759

Three Sets of Case Studies Suggest Logic and Consistency Challenges with Value Frameworks.

PubMed

Cohen, Joshua T; Anderson, Jordan E; Neumann, Peter J

2017-02-01

To assess the logic and consistency of three prominent value frameworks. We reviewed the value frameworks from three organizations: the Memorial Sloan Kettering Cancer Center (DrugAbacus), the American Society of Clinical Oncologists, and the Institute for Clinical and Economic Review. For each framework, we developed case studies to explore the degree to which the frameworks have face validity in the sense that they are consistent with four important principles: value should be proportional to a therapy's benefit; components of value should matter to framework users (patients and payers); attribute weights should reflect user preferences; and value estimates used to inform therapy prices should reflect per-person benefit. All three frameworks can aid decision making by elucidating factors not explicitly addressed by conventional evaluation techniques (in particular, cost-effectiveness analyses). Our case studies identified four challenges: 1) value is not always proportional to benefit; 2) value reflects factors that may not be relevant to framework users (patients or payers); 3) attribute weights do not necessarily reflect user preferences or relate to value in ways that are transparent; and 4) value does not reflect per-person benefit. Although the value frameworks we reviewed capture value in a way that is important to various audiences, they are not always logical or consistent. Because these frameworks may have a growing influence on therapy access, it is imperative that analytic challenges be further explored. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

StakeMeter: value-based stakeholder identification and quantification framework for value-based software systems.

PubMed

Babar, Muhammad Imran; Ghazali, Masitah; Jawawi, Dayang N A; Bin Zaheer, Kashif

2015-01-01

Value-based requirements engineering plays a vital role in the development of value-based software (VBS). Stakeholders are the key players in the requirements engineering process, and the selection of critical stakeholders for the VBS systems is highly desirable. Based on the stakeholder requirements, the innovative or value-based idea is realized. The quality of the VBS system is associated with the concrete set of valuable requirements, and the valuable requirements can only be obtained if all the relevant valuable stakeholders participate in the requirements elicitation phase. The existing value-based approaches focus on the design of the VBS systems. However, the focus on the valuable stakeholders and requirements is inadequate. The current stakeholder identification and quantification (SIQ) approaches are neither state-of-the-art nor systematic for the VBS systems. The existing approaches are time-consuming, complex and inconsistent which makes the initiation process difficult. Moreover, the main motivation of this research is that the existing SIQ approaches do not provide the low level implementation details for SIQ initiation and stakeholder metrics for quantification. Hence, keeping in view the existing SIQ problems, this research contributes in the form of a new SIQ framework called 'StakeMeter'. The StakeMeter framework is verified and validated through case studies. The proposed framework provides low-level implementation guidelines, attributes, metrics, quantification criteria and application procedure as compared to the other methods. The proposed framework solves the issues of stakeholder quantification or prioritization, higher time consumption, complexity, and process initiation. The framework helps in the selection of highly critical stakeholders for the VBS systems with less judgmental error.

StakeMeter: Value-Based Stakeholder Identification and Quantification Framework for Value-Based Software Systems

PubMed Central

Babar, Muhammad Imran; Ghazali, Masitah; Jawawi, Dayang N. A.; Zaheer, Kashif Bin

2015-01-01

Value-based requirements engineering plays a vital role in the development of value-based software (VBS). Stakeholders are the key players in the requirements engineering process, and the selection of critical stakeholders for the VBS systems is highly desirable. Based on the stakeholder requirements, the innovative or value-based idea is realized. The quality of the VBS system is associated with the concrete set of valuable requirements, and the valuable requirements can only be obtained if all the relevant valuable stakeholders participate in the requirements elicitation phase. The existing value-based approaches focus on the design of the VBS systems. However, the focus on the valuable stakeholders and requirements is inadequate. The current stakeholder identification and quantification (SIQ) approaches are neither state-of-the-art nor systematic for the VBS systems. The existing approaches are time-consuming, complex and inconsistent which makes the initiation process difficult. Moreover, the main motivation of this research is that the existing SIQ approaches do not provide the low level implementation details for SIQ initiation and stakeholder metrics for quantification. Hence, keeping in view the existing SIQ problems, this research contributes in the form of a new SIQ framework called ‘StakeMeter’. The StakeMeter framework is verified and validated through case studies. The proposed framework provides low-level implementation guidelines, attributes, metrics, quantification criteria and application procedure as compared to the other methods. The proposed framework solves the issues of stakeholder quantification or prioritization, higher time consumption, complexity, and process initiation. The framework helps in the selection of highly critical stakeholders for the VBS systems with less judgmental error. PMID:25799490

Evaluating Frameworks That Provide Value Measures for Health Care Interventions.

PubMed

Mandelblatt, Jeanne S; Ramsey, Scott D; Lieu, Tracy A; Phelps, Charles E

2017-02-01

The recent acceleration of scientific discovery has led to greater choices in health care. New technologies, diagnostic tests, and pharmaceuticals have widely varying impact on patients and populations in terms of benefits, toxicities, and costs, stimulating a resurgence of interest in the creation of frameworks intended to measure value in health. Many of these are offered by providers and/or advocacy organizations with expertise and interest in specific diseases (e.g., cancer and heart disease). To help assess the utility of and the potential biases embedded in these frameworks, we created an evaluation taxonomy with seven basic components: 1) define the purpose; 2) detail the conceptual approach, including perspectives, methods for obtaining preferences of decision makers (e.g., patients), and ability to incorporate multiple dimensions of value; 3) discuss inclusions and exclusions of elements included in the framework, and whether the framework assumes clinical intervention or offers alternatives such as palliative care or watchful waiting; 4) evaluate data sources and their scientific validity; 5) assess the intervention's effect on total costs of treating a defined population; 6) analyze how uncertainty is incorporated; and 7) illuminate possible conflicts of interest among those creating the framework. We apply the taxonomy to four representative value frameworks recently published by professional organizations focused on treatment of cancer and heart disease and on vaccine use. We conclude that each of these efforts has strengths and weaknesses when evaluated using our taxonomy, and suggest pathways to enhance the utility of value-assessing frameworks for policy and clinical decision making. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

A framework to measure the value of public health services.

PubMed

Jacobson, Peter D; Neumann, Peter J

2009-10-01

To develop a framework that public health practitioners could use to measure the value of public health services. Primary data were collected from August 2006 through March 2007. We interviewed (n=46) public health practitioners in four states, leaders of national public health organizations, and academic researchers. Using a semi-structured interview protocol, we conducted a series of qualitative interviews to define the component parts of value for public health services and identify methodologies used to measure value and data collected. The primary form of analysis is descriptive, synthesizing information across respondents as to how they measure the value of their services. Our interviews did not reveal a consensus on how to measure value or a specific framework for doing so. Nonetheless, the interviews identified some potential strategies, such as cost accounting and performance-based contracting mechanisms. The interviews noted implementation barriers, including limits to staff capacity and data availability. We developed a framework that considers four component elements to measure value: external factors that must be taken into account (i.e., mandates); key internal actions that a local health department must take (i.e., staff assessment); using appropriate quantitative measures; and communicating value to elected officials and the public.

Eliciting Values of Patients with Multiple Chronic Conditions: Evaluation of a Patient-centered Framework.

PubMed

Berry, Andrew B L; Lim, Catherine; Hartzler, Andrea L; Hirsch, Tad; Ludman, Evette; Wagner, Edward H; Ralston, James D

2017-01-01

Patients with multiple chronic conditions often face competing demands for care, and they often do not agree with physicians on priorities for care. Patients ' values shape their healthcare priorities, but existing methods for eliciting values do not necessarily meet patients ' care planning needs. We developed a patient-centered values framework based on a field study with patients and caregivers. In this paper we report on a survey to evaluate how the framework generalizes beyond field study participants, and how well the framework supports values elicitation. We found that respondents frame values in a way that is consistent with the framework, and that domains of the framework can be used to elicit a breadth of potential values individuals with MCC express. These findings demonstrate how a patient-centered perspective on values can expand on the domains considered in values clarification methods andfacilitate patient-provider communication in establishing shared care priorities.

Eliciting Values of Patients with Multiple Chronic Conditions: Evaluation of a Patient-centered Framework

PubMed Central

Berry, Andrew B.L.; Lim, Catherine; Hartzler, Andrea L.; Hirsch, Tad; Ludman, Evette; Wagner, Edward H.; Ralston, James D.

2017-01-01

Patients with multiple chronic conditions often face competing demands for care, and they often do not agree with physicians on priorities for care. Patients ’ values shape their healthcare priorities, but existing methods for eliciting values do not necessarily meet patients ’ care planning needs. We developed a patient-centered values framework based on a field study with patients and caregivers. In this paper we report on a survey to evaluate how the framework generalizes beyond field study participants, and how well the framework supports values elicitation. We found that respondents frame values in a way that is consistent with the framework, and that domains of the framework can be used to elicit a breadth of potential values individuals with MCC express. These findings demonstrate how a patient-centered perspective on values can expand on the domains considered in values clarification methods andfacilitate patient-provider communication in establishing shared care priorities. PMID:29854107

Patients Should Define Value in Health Care: A Conceptual Framework.

PubMed

Kamal, Robin N; Lindsay, Sarah E; Eppler, Sara L

2018-05-10

The main tenet of value-based health care is delivering high-quality care that is centered on the patient, improving health, and minimizing cost. Collaborative decision-making frameworks have been developed to help facilitate delivering care based on patient preferences (patient-centered care). The current value-based health care model, however, focuses on improving population health and overlooks the individuality of patients and their preferences for care. We highlight the importance of eliciting patient preferences in collaborative decision making and describe a conceptual framework that incorporates individual patients' preferences when defining value. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Implementing Value-Based Payment Reform: A Conceptual Framework and Case Examples.

PubMed

Conrad, Douglas A; Vaughn, Matthew; Grembowski, David; Marcus-Smith, Miriam

2016-08-01

This article develops a conceptual framework for implementation of value-based payment (VBP) reform and then draws on that framework to systematically examine six distinct multi-stakeholder coalition VBP initiatives in three different regions of the United States. The VBP initiatives deploy the following payment models: reference pricing, "shadow" primary care capitation, bundled payment, pay for performance, shared savings within accountable care organizations, and global payment. The conceptual framework synthesizes prior models of VBP implementation. It describes how context, project objectives, payment and care delivery strategies, and the barriers and facilitators to translating strategy into implementation affect VBP implementation and value for patients. We next apply the framework to six case examples of implementation, and conclude by discussing the implications of the case examples and the conceptual framework for future practice and research. © The Author(s) 2015.

Understanding the value of emergency care: a framework incorporating stakeholder perspectives.

PubMed

Sharp, Adam L; Cobb, Enesha M; Dresden, Scott M; Richardson, Derek K; Sabbatini, Amber K; Sauser, Kori; Kocher, Keith E

2014-09-01

In the face of escalating spending, measuring and maximizing the value of health services has become an important focus of health reform. Recent initiatives aim to incentivize high-value care through provider and hospital payment reform, but the role of the emergency department (ED) remains poorly defined. To achieve an improved understanding of the value of emergency care, we have developed a framework that incorporates the perspectives of stakeholders in the delivery of health services. A pragmatic review of the literature informed the design of this framework to standardize the definition of value in emergency care and discuss outcomes and costs from different stakeholder perspectives. The viewpoint of patient, provider, payer, health system, and society is each used to assess value for emergency medical conditions. We found that the value attributed to emergency care differs substantially by stakeholder perspective. Potential targets to improve ED value may be aimed at improving outcomes or controlling costs, depending on the acuity of the clinical condition. The value of emergency care varies by perspective, and a better understanding is achieved when specific outcomes and costs can be identified, quantified, and measured. Using this framework can help stakeholders find common ground to prioritize which costs and outcomes to target for research, quality improvement efforts, and future health policy impacting emergency care. Copyright © 2014 Elsevier Inc. All rights reserved.

The ICER Value Framework: Integrating Cost Effectiveness and Affordability in the Assessment of Health Care Value.

PubMed

Pearson, Steven D

2018-03-01

What should be the relationship between the concepts of cost effectiveness and affordability in value assessments for health care interventions? This question has received greater attention in recent years given increasing financial pressures on health systems, leading to different views on how assessment reports and decision-making processes can provide the best structure for considering both elements. In the United States, the advent of explicit value frameworks to guide drug assessments has also focused attention on this issue, driven in part by the prominent inclusion of affordability within the value framework used to guide reports from the Institute for Clinical and Economic Review. After providing a formal definition of affordability for health care systems, this article argues that, even after using empirical estimates of true health system opportunity cost, cost-effectiveness thresholds cannot by themselves be set in a way that subsumes questions about short-term affordability. The article then presents an analysis of different approaches to integrating cost effectiveness and budget impact assessments within information to guide decision making. The evolution and experience with the Institute for Clinical and Economic Review value framework are highlighted, providing lessons learned and guiding principles for future efforts to bring measures of affordability within the scope of value assessment. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

A value framework in head and neck cancer care.

PubMed

de Souza, Jonas A; Seiwert, Tanguy Y

2014-01-01

The care of head and neck squamous cell carcinoma has greatly evolved over the past 30 years. From single modality to a multidisciplinary care, there has also been a concurrent increase in treatment intensity, resulting, at many times, in more zealous regimens that patients must endure. In this article, we apply Porter's value model as a framework to balance survival, toxicities, cost, and trade-offs from a patient's perspective in head and neck cancer. This model defines value as the health outcome per dollar achieved. Domains and outcomes that are important to patients, including not only survival or short-term quality of life, but also functional outcomes, recovery, sustainability of recovery, and the lasting consequences of therapy are included in this framework. Other outcomes that are seldom measured in head and neck cancer, such as work disability and financial toxicities, are also included and further discussed. Within this value model and based on evidence, we further discuss de-escalation of care, intensity-modulated radiation therapy, newer surgical methods, and enhancements in the process of care as potential approaches to add value for patients. Finally, we argue that knowing the patient's preferences is essential in the value discussion, as the attribute that will ultimately provide the most value to the individual patient with head and neck cancer.

Best Practices Inquiry: A Multidimensional, Value-Critical Framework

ERIC Educational Resources Information Center

Petr, Christopher G.; Walter, Uta M.

2005-01-01

This article offers a multidimensional framework that broadens current approaches to "best practices" inquiry to include (1) the perspectives of both the consumers of services and professional practitioners and (2) a value-based critique. The predominant empirical approach to best practices inquiry is a necessary, but not sufficient, component of…

Innovation value chain capability in Malaysian-owned company: A theoretical framework

NASA Astrophysics Data System (ADS)

Abidin, Norkisme Zainal; Suradi, Nur Riza Mohd

2014-09-01

Good quality products or services are no longer adequate to guarantee the sustainability of a company in the present competitive business. Prior research has developed various innovation models with the hope to better understand the innovativeness of the company. Due to countless definitions, indicators, factors, parameter and approaches in the study of innovation, it is difficult to ensure which one will best suit the Malaysian-owned company innovativeness. This paper aims to provide a theoretical background to support the framework of the innovation value chain capability in Malaysian-owned Company. The theoretical framework was based on the literature reviews, expert interviews and focus group study. The framework will be used to predict and assess the innovation value chain capability in Malaysian-owned company.

Value Assessment Frameworks for HTA Agencies: The Organization of Evidence-Informed Deliberative Processes.

PubMed

Baltussen, Rob; Jansen, Maarten Paul Maria; Bijlmakers, Leon; Grutters, Janneke; Kluytmans, Anouck; Reuzel, Rob P; Tummers, Marcia; der Wilt, Gert Jan van

2017-02-01

Priority setting in health care has been long recognized as an intrinsically complex and value-laden process. Yet, health technology assessment agencies (HTAs) presently employ value assessment frameworks that are ill fitted to capture the range and diversity of stakeholder values and thereby risk compromising the legitimacy of their recommendations. We propose "evidence-informed deliberative processes" as an alternative framework with the aim to enhance this legitimacy. This framework integrates two increasingly popular and complementary frameworks for priority setting: multicriteria decision analysis and accountability for reasonableness. Evidence-informed deliberative processes are, on one hand, based on early, continued stakeholder deliberation to learn about the importance of relevant social values. On the other hand, they are based on rational decision-making through evidence-informed evaluation of the identified values. The framework has important implications for how HTA agencies should ideally organize their processes. First, HTA agencies should take the responsibility of organizing stakeholder involvement. Second, agencies are advised to integrate their assessment and appraisal phases, allowing for the timely collection of evidence on values that are considered relevant. Third, HTA agencies should subject their decision-making criteria to public scrutiny. Fourth, agencies are advised to use a checklist of potentially relevant criteria and to provide argumentation for how each criterion affected the recommendation. Fifth, HTA agencies must publish their argumentation and install options for appeal. The framework should not be considered a blueprint for HTA agencies but rather an aspirational goal-agencies can take incremental steps toward achieving this goal. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Is "Learning without Limits" a Framework of Values?

ERIC Educational Resources Information Center

Booth, Tony

2015-01-01

In this article the author connects his own work with Brian Simon's writing on IQ (intelligence quotient) testing and selection and with the Learning without Limits project. He discusses the significance he gives to a values framework in the development of education and asks whether "Learning without Limits," in part, stands for a…

VALUE - A Framework to Validate Downscaling Approaches for Climate Change Studies

NASA Astrophysics Data System (ADS)

Maraun, Douglas; Widmann, Martin; Gutiérrez, José M.; Kotlarski, Sven; Chandler, Richard E.; Hertig, Elke; Wibig, Joanna; Huth, Radan; Wilke, Renate A. I.

2015-04-01

VALUE is an open European network to validate and compare downscaling methods for climate change research. VALUE aims to foster collaboration and knowledge exchange between climatologists, impact modellers, statisticians, and stakeholders to establish an interdisciplinary downscaling community. A key deliverable of VALUE is the development of a systematic validation framework to enable the assessment and comparison of both dynamical and statistical downscaling methods. Here, we present the key ingredients of this framework. VALUE's main approach to validation is user-focused: starting from a specific user problem, a validation tree guides the selection of relevant validation indices and performance measures. Several experiments have been designed to isolate specific points in the downscaling procedure where problems may occur: what is the isolated downscaling skill? How do statistical and dynamical methods compare? How do methods perform at different spatial scales? Do methods fail in representing regional climate change? How is the overall representation of regional climate, including errors inherited from global climate models? The framework will be the basis for a comprehensive community-open downscaling intercomparison study, but is intended also to provide general guidance for other validation studies.

VALUE: A framework to validate downscaling approaches for climate change studies

NASA Astrophysics Data System (ADS)

Maraun, Douglas; Widmann, Martin; Gutiérrez, José M.; Kotlarski, Sven; Chandler, Richard E.; Hertig, Elke; Wibig, Joanna; Huth, Radan; Wilcke, Renate A. I.

2015-01-01

VALUE is an open European network to validate and compare downscaling methods for climate change research. VALUE aims to foster collaboration and knowledge exchange between climatologists, impact modellers, statisticians, and stakeholders to establish an interdisciplinary downscaling community. A key deliverable of VALUE is the development of a systematic validation framework to enable the assessment and comparison of both dynamical and statistical downscaling methods. In this paper, we present the key ingredients of this framework. VALUE's main approach to validation is user- focused: starting from a specific user problem, a validation tree guides the selection of relevant validation indices and performance measures. Several experiments have been designed to isolate specific points in the downscaling procedure where problems may occur: what is the isolated downscaling skill? How do statistical and dynamical methods compare? How do methods perform at different spatial scales? Do methods fail in representing regional climate change? How is the overall representation of regional climate, including errors inherited from global climate models? The framework will be the basis for a comprehensive community-open downscaling intercomparison study, but is intended also to provide general guidance for other validation studies.

A Framework for Assessing the Value of Investments in Nonclinical Prevention

PubMed Central

Roehrig, Charles; Russo, Pamela

2015-01-01

We present a high-level framework to show the process by which an investment in primary prevention produces value. We define primary prevention broadly to include investments in any of the determinants of health. Although it builds on previously developed frameworks, ours incorporates several additional features. It distinguishes direct and upstream determinants of health, a distinction that can help identify, describe, and track the impact of a policy or program on health and health care costs. It recognizes multiple dimensions of value, including the need to establish the nonhealth value of investments whose objectives are not limited to improvements in health (and whose costs should not be attributed solely to the health benefits). Finally, it emphasizes the need to describe value from the perspectives of the multiple stakeholders that can influence such investments. PMID:26652216

A Framework for Assessing the Value of Investments in Nonclinical Prevention.

PubMed

Miller, George; Roehrig, Charles; Russo, Pamela

2015-12-10

We present a high-level framework to show the process by which an investment in primary prevention produces value. We define primary prevention broadly to include investments in any of the determinants of health. Although it builds on previously developed frameworks, ours incorporates several additional features. It distinguishes direct and upstream determinants of health, a distinction that can help identify, describe, and track the impact of a policy or program on health and health care costs. It recognizes multiple dimensions of value, including the need to establish the nonhealth value of investments whose objectives are not limited to improvements in health (and whose costs should not be attributed solely to the health benefits). Finally, it emphasizes the need to describe value from the perspectives of the multiple stakeholders that can influence such investments.

Developing Early Place-Value Understanding: A Framework for Tens Awareness

ERIC Educational Resources Information Center

Young-Loveridge, Jenny; Bicknell, Brenda

2016-01-01

This paper outlines a framework to explain the early development of place-value understanding based on an analysis of data from 84 five- to seven-year-old children from diverse cultural and linguistic backgrounds. The children were assessed individually on number knowledge tasks (recalled facts, subitizing, counting, place-value understanding) and…

A Framework for Creating Value from Fleet Data at Ecosystem Level

NASA Astrophysics Data System (ADS)

Kinnunen, Sini-Kaisu; Hanski, Jyri; Marttonen-Arola, Salla; Kärri, Timo

2017-09-01

As companies have recently gotten more interested in utilizing the increasingly gathered data and realizing the potential of data analysis, the ability to upgrade data into value for business has been recognized as an advantage. Companies gain competitive advantage if they are able to benefit from the fleet data that is produced both in and outside the boundaries of the company. Benefits of fleet management are based on the possibility to have access to the massive amounts of asset data that can then be utilized e.g. to gain cost savings and to develop products and services. The ambition of the companies is to create value from fleet data but this requires that different actors in ecosystem are working together for a common goal - to get the most value out of fleet data for the ecosystem. In order that this could be possible, we need a framework to meet the requirements of the fleet life-cycle data utilization. This means that the different actors in the ecosystem need to understand their role in the fleet data refining process in order to promote the value creation from fleet data. The objective of this paper is to develop a framework for knowledge management in order to create value from fleet data in ecosystems. As a result, we present a conceptual framework which helps companies to develop their asset management practices related to the fleet of assets.

The total value equation: a suggested framework for understanding value creation in diagnostic radiology.

PubMed

Heller, Richard E

2014-01-01

As a result of macroeconomic forces necessitating fundamental changes in health care delivery systems, value has become a popular term in the medical industry. Much has been written recently about the idea of value as it relates to health care services in general and the practice of radiology in particular. Of course, cost, value, and cost-effectiveness are not new topics of conversation in radiology. Not only is value one of the most frequently used and complex words in management, entire classes in business school are taught around the concept of understanding and maximizing value. But what is value, and when speaking of value creation strategies, what is it exactly that is meant? For the leader of a radiology department, either private or academic, value creation is a core function. This article provides a deeper examination of what value is, what drives value creation, and how practices and departments can evaluate their own value creation efficiencies. An equation, referred to as the Total Value Equation, is presented as a framework to assess value creation activities and strategies. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

An Evaluation Framework for Lossy Compression of Genome Sequencing Quality Values.

PubMed

Alberti, Claudio; Daniels, Noah; Hernaez, Mikel; Voges, Jan; Goldfeder, Rachel L; Hernandez-Lopez, Ana A; Mattavelli, Marco; Berger, Bonnie

2016-01-01

This paper provides the specification and an initial validation of an evaluation framework for the comparison of lossy compressors of genome sequencing quality values. The goal is to define reference data, test sets, tools and metrics that shall be used to evaluate the impact of lossy compression of quality values on human genome variant calling. The functionality of the framework is validated referring to two state-of-the-art genomic compressors. This work has been spurred by the current activity within the ISO/IEC SC29/WG11 technical committee (a.k.a. MPEG), which is investigating the possibility of starting a standardization activity for genomic information representation.

Nutrient intake values (NIVs): a recommended terminology and framework for the derivation of values.

PubMed

King, Janet C; Vorster, Hester H; Tome, Daniel G

2007-03-01

Although most countries and regions around the world set recommended nutrient intake values for their populations, there is no standardized terminology or framework for establishing these standards. Different terms used for various components of a set of dietary standards are described in this paper and a common set of terminology is proposed. The recommended terminology suggests that the set of values be called nutrient intake values (NIVs) and that the set be composed of three different values. The average nutrient requirement (ANR) reflects the median requirement for a nutrient in a specific population. The individual nutrient level (INLx) is the recommended level of nutrient intake for all healthy people in the population, which is set at a certain level x above the mean requirement. For example, a value set at 2 standard deviations above the mean requirement would cover the needs of 98% of the population and would be INL98. The third component of the NIVs is an upper nutrient level (UNL), which is the highest level of daily nutrient intake that is likely to pose no risk of adverse health effects for almost all individuals in a specified life-stage group. The proposed framework for deriving a set of NIVs is based on a statistical approach for determining the midpoint of a distribution of requirements for a set of nutrients in a population (the ANR), the standard deviation of the requirements, and an individual nutrient level that assures health at some point above the mean, e.g., 2 standard deviations. Ideally, a second set of distributions of risk of excessive intakes is used as the basis for a UNL.

Cardiovascular fitness in adolescents: the influence of sexual maturation status-the AVENA and EYHS studies.

PubMed

Ortega, Francisco B; Ruiz, Jonatan R; Mesa, Jose L; Gutiérrez, Angel; Sjöström, Michael

2007-01-01

The purposes were: (1) to determine the influence of sexual maturation status and body composition by comparing cardiovascular fitness (CVF) level in two adolescent populations from the south and the north of Europe; (2) to describe the associations between CVF and sexual maturation status in adolescence. A total of 1,867 Spanish adolescents from the AVENA study and 472 from the Swedish part of the EYHS were selected for this report (aged 14-16 years). CVF (expressed by the maximal oxygen consumption) was estimated from 20 m shuttle run test in the AVENA study and from a maximal ergometer cycle test in the EYHS. Sexual maturation status was classified according to Tanner stages. Body fat percentage (BF%) was estimated from skinfold thicknesses. Expressing CVF in different ways (in absolute value and in relation to weight or fat free mass; FFM) resulted in two different results with regard to CVF interpretation and comparison between the study populations. A higher CVF, as expressed in relation to FFM, was observed in the Spanish when compared to Swedish adolescents (P = 0.001). However, after adjusting for both sexual maturation status and BF%, the difference disappeared in males, while it remained significant in females (P = 0.001). CVF was negatively associated with sexual maturation status in males (P = 0.001). However, after adjusting for BF%, the association disappeared in males, while it was significant in females (P = 0.05). These results suggest that for CVF comparisons and interpretation in adolescent populations, sexual maturation status and BF%, as well as the way to express the CVF, should be taken into account. Copyright 2007 Wiley-Liss, Inc.

A Health Economics Approach to US Value Assessment Frameworks-Introduction: An ISPOR Special Task Force Report [1].

PubMed

Neumann, Peter J; Willke, Richard J; Garrison, Louis P

2018-02-01

Concerns about rising spending on prescription drugs and other areas of health care have led to multiple initiatives in the United States designed to measure and communicate the value of pharmaceuticals and other technologies for decision making. In this section we introduce the work of the International Society for Pharmacoeconomics and Outcomes Research Special Task Force on US Value Assessment Frameworks formed to review relevant perspectives and appropriate approaches and methods to support the definition and use of high-quality value frameworks. The Special Task Force was part of the International Society for Pharmacoeconomics and Outcomes Research Initiative on US Value Assessment Frameworks, which enlisted the expertise of leading health economists, concentrating on what the field of health economics can provide to help inform the development and use of value assessment frameworks. We focus on five value framework initiatives: the American College of Cardiology/American Heart Association, the American Society of Clinical Oncology, the Institute for Clinical and Economic Review, the Memorial Sloan Kettering Cancer Center, and the National Comprehensive Cancer Network. These entities differ in their missions, scope of activities, and methodological approaches. Because they are gaining visibility and some traction in the United States, it is essential to scrutinize whether the frameworks use approaches that are transparent as well as conceptually and methodologically sound. Our objectives were to describe the conceptual bases for value and its use in decision making, critically examine existing value frameworks, discuss the importance of sound conceptual underpinning, identify key elements of value relevant to specific decision contexts, and recommend good practice in value definition and implementation as well as areas for further research. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc

Interpersonal Communication Behaviors and Self-Actualizing Values: A Conceptual Framework.

ERIC Educational Resources Information Center

Macklin, Thomas

This report addresses the relationship between self-actualizing values and interpersonal communication behaviors. After a discussion of behavioristic and humanistic frameworks for social science research, the paper explains Abraham Maslow's and Carl Roger's concepts of self-actualization as the tendency toward completing and perfecting one's…

Relativism, Values and Morals in the New Zealand Curriculum Framework

ERIC Educational Resources Information Center

Jorgensen, Lone Morris; Ryan, SueAnn

2004-01-01

"The New Zealand Curriculum Framework", 1993, is the official document for teaching, learning and assessment in New Zealand schools. It consists of a set of curriculum statements, which define the learning principles, achievement aims and essential skills for seven learning areas. It also indicates the place of attitudes and values in…

Using frameworks to diagram value in complex policy and environmental interventions to prevent childhood obesity.

PubMed

Swank, Melissa Farrell; Brennan, Laura K; Gentry, Daniel; Kemner, Allison L

2015-01-01

To date, few tools assist policy makers and practitioners in understanding and conveying the implementation costs, potential impacts, and value of policy and environmental changes to address healthy eating, active living, and childhood obesity. For the Evaluation of Healthy Kids, Healthy Communities (HKHC), evaluators considered inputs (resources and investments) that generate costs and savings as well as benefits and harms related to social, economic, environmental, and health-related outcomes in their assessment of 49 HKHC community partnerships funded from 2009 to 2014. Using data collected through individual and group interviews and an online performance monitoring system, evaluators created a socioecological framework to assess investments, resources, costs, savings, benefits, and harms at the individual, organizational, community, and societal levels. Evaluators customized frameworks for 6 focal strategies: active transportation, parks and play spaces, child care physical activity standards, corner stores, farmers' markets, and child care nutrition standards. To illustrate the Value Frameworks, this brief highlights the 38 HKHC communities implementing at least 1 active transportation strategy. Evaluators populated this conceptual Value Framework with themes from the strategy-specific inputs and outputs. The range of factors corresponding to the implementation and impact of the HKHC community partnerships are highlighted along with the inputs and outputs. The Value Frameworks helped evaluators identify gaps in current analysis models (ie, benefit-cost analysis, cost-effectiveness analysis) as well as paint a more complete picture of value for potential obesity prevention strategies. These frameworks provide a comprehensive understanding of investments needed, proposed costs and savings, and potential benefits and harms associated with economic, social, environmental, and health outcomes. This framing also allowed evaluators to demonstrate the interdependence

Evaluation of the ASCO Value Framework for Anticancer Drugs at an Academic Medical Center.

PubMed

Wilson, Leslie; Lin, Tracy; Wang, Ling; Patel, Tanuja; Tran, Denise; Kim, Sarah; Dacey, Katie; Yuen, Courtney; Kroon, Lisa; Brodowy, Bret; Rodondi, Kevin

2017-02-01

Anticancer drug prices have increased by an average of 12% each year from 1996 to 2014. A major concern is that the increasing cost and responsibility of evaluating treatment options are being shifted to patients. This research compared 2 value-based pricing models that were being considered for use at the University of California, San Francisco (UCSF) Medical Center to address the growing burden of high-cost cancer drugs while improving patient-centered care. The Medication Outcomes Center (MOC) in the Department of Clinical Pharmacy, University of California, San Francisco (UCSF), School of Pharmacy focuses on assessing the value of medication-related health care interventions and disseminating findings to the UCSF Medical Center. The High Cost Oncology Drug Initiative at the MOC aims to assess and adopt tools for the critical assessment and amelioration of high-cost cancer drugs. The American Society of Clinical Oncology (ASCO) Value Framework (2016 update) and a cost-effectiveness analysis (CEA) framework were identified as potential tools for adoption. To assess 1 prominent value framework, the study investigators (a) asked 8 clinicians to complete the ASCO Value Framework for 11 anticancer medications selected by the MOC; (b) reviewed CEAs assessing the drugs; (c) generated descriptive statistics; and (d) analyzed inter-rater reliability, convergence validity, and ranking consistency. On the scale of -20 to 180, the mean ASCO net health benefit (NHB) total score across 11 drugs ranged from 7.6 (SD = 7.8) to 53 (SD = 9.8). The Kappa coefficient (κ) for NHB scores across raters was 0.11, which is categorized as "slightly reliable." The combined κ score was 0.22, which is interpreted as low to fair inter-rater reliability. Convergent validity indicates that the correlation between NHB scores and CEA-based incremental cost-effectiveness ratios (ICERs) was low (-0.215). Ranking of ICERs, ASCO scores, and wholesale acquisition costs indicated different results

A geostatistical extreme-value framework for fast simulation of natural hazard events

PubMed Central

Stephenson, David B.

2016-01-01

We develop a statistical framework for simulating natural hazard events that combines extreme value theory and geostatistics. Robust generalized additive model forms represent generalized Pareto marginal distribution parameters while a Student’s t-process captures spatial dependence and gives a continuous-space framework for natural hazard event simulations. Efficiency of the simulation method allows many years of data (typically over 10 000) to be obtained at relatively little computational cost. This makes the model viable for forming the hazard module of a catastrophe model. We illustrate the framework by simulating maximum wind gusts for European windstorms, which are found to have realistic marginal and spatial properties, and validate well against wind gust measurements. PMID:27279768

Tandem vaginoscopy with colonoscopy: a diagnostic technique for the assessment of colovaginal fistula.

PubMed

Alkhatib, A A; Santoro, G A; Gorgun, E; Abbas, M A

2016-05-01

Colovaginal fistula (CVF) has a negative impact on quality of life. Identifying the fistula track is a critical step in its management. In a subset of patients, localizing the fistula preoperatively can be difficult. The purpose of this report is to describe the technique and results of tandem vaginoscopy with colonoscopy (TVC). A retrospective analysis was conducted of all patients referred to a tertiary centre with symptoms suggestive of CVF but no prior successful localization of a fistula. TVC was performed by one colorectal surgeon in the endoscopy suite under intravenous sedation. Between 2003 and 2013, 18 patients (median age 58 years) underwent TVC. CVF was ruled out in three patients. In the remaining 15 patients, TVC documented the fistula in 13. In eight cases a wire was passed through the fistulous track from the vagina to the colon, in three the track was large enough to be traversed with the endoscope and in two a fistulous opening was noted on the vaginal side but passage of a wire to localize the opening on the colonic side was not possible due to extensive scarring. No TVC-related complications were recorded. The sensitivity, specificity, positive predictive value and negative predictive value for TVC in detecting CVF were 86.7%, 100%, 100% and 60%, respectively. TVC is a useful technique that can localize the fistulous track in most patients with CVF. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

Measuring the Value of New Drugs: Validity and Reliability of 4 Value Assessment Frameworks in the Oncology Setting.

PubMed

Bentley, Tanya G K; Cohen, Joshua T; Elkin, Elena B; Huynh, Julie; Mukherjea, Arnab; Neville, Thanh H; Mei, Matthew; Copher, Ronda; Knoth, Russell; Popescu, Ioana; Lee, Jackie; Zambrano, Jenelle M; Broder, Michael S

2017-06-01

Several organizations have developed frameworks to systematically assess the value of new drugs. To evaluate the convergent validity and interrater reliability of 4 value frameworks to understand the extent to which these tools can facilitate value-based treatment decisions in oncology. Eight panelists used the American Society of Clinical Oncology (ASCO), European Society for Medical Oncology (ESMO), Institute for Clinical and Economic Review (ICER), and National Comprehensive Cancer Network (NCCN) frameworks to conduct value assessments of 15 drugs for advanced lung and breast cancers and castration-refractory prostate cancer. Panelists received instructions and published clinical data required to complete the assessments, assigning each drug a numeric or letter score. Kendall's Coefficient of Concordance for Ranks (Kendall's W) was used to measure convergent validity by cancer type among the 4 frameworks. Intraclass correlation coefficients (ICCs) were used to measure interrater reliability for each framework across cancers. Panelists were surveyed on their experiences. Kendall's W across all 4 frameworks for breast, lung, and prostate cancer drugs was 0.560 (P= 0.010), 0.562 (P = 0.010), and 0.920 (P < 0.001), respectively. Pairwise, Kendall's W for breast cancer drugs was highest for ESMO-ICER and ICER-NCCN (W = 0.950, P = 0.019 for both pairs) and lowest for ASCO-NCCN (W = 0.300, P = 0.748). For lung cancer drugs, W was highest pairwise for ESMO-ICER (W = 0.974, P = 0.007) and lowest for ASCO-NCCN (W = 0.218, P = 0.839); for prostate cancer drugs, pairwise W was highest for ICER-NCCN (W = 1.000, P < 0.001) and lowest for ESMO-ICER and ESMO-NCCN (W = 0.900, P = 0.052 for both pairs). When ranking drugs on distinct framework subdomains, Kendall's W among breast cancer drugs was highest for certainty (ICER, NCCN: W = 0.908, P = 0.046) and lowest for clinical benefit (ASCO, ESMO, NCCN: W = 0.345, P = 0.436). Among lung cancer drugs, W was highest for toxicity

Ethical Frameworks in Public Health Decision-Making: Defending a Value-Based and Pluralist Approach.

PubMed

Grill, Kalle; Dawson, Angus

2017-12-01

A number of ethical frameworks have been proposed to support decision-making in public health and the evaluation of public health policy and practice. This is encouraging, since ethical considerations are of paramount importance in health policy. However, these frameworks have various deficiencies, in part because they incorporate substantial ethical positions. In this article, we discuss and criticise a framework developed by James Childress and Ruth Bernheim, which we consider to be the state of the art in the field. Their framework distinguishes aims, such as the promotion of public health, from constraints on the pursuit of those aims, such as the requirement to avoid limitations to liberty, or the requirement to be impartial. We show how this structure creates both theoretical and practical problems. We then go on to present and defend a more practical framework, one that is neutral in avoiding precommitment to particular values and how they ought to be weighted. We believe ethics is at the very heart of such weightings and our framework is developed to reflect this belief. It is therefore both pluralist and value-based. We compare our new framework to Childress and Bernheim's and outline its advantages. It is justified by its impetus to consider a wide range of alternatives and its tendency to direct decisions towards the best alternatives, as well as by the information provided by the ranking of alternatives and transparent explication of the judgements that motivate this ranking. The new framework presented should be useful to decision-makers in public health, as well as being a means to stimulate further reflection on the role of ethics in public health.

Review of Recent US Value Frameworks-A Health Economics Approach: An ISPOR Special Task Force Report [6].

PubMed

Willke, Richard J; Neumann, Peter J; Garrison, Louis P; Ramsey, Scott D

2018-02-01

The sixth section of our Special Task Force (STF) report reviews and comments on recent US-oriented value assessment frameworks, specifically those published by the American College of Cardiology/American Heart Association, the Institute for Clinical and Economic Research, the American Society of Clinical Oncology, the National Comprehensive Cancer Network, and the Memorial Sloan Kettering Cancer Center. We review published commentaries that address the validity, reliability, and conceptual underpinnings of these frameworks. We find common themes of critique regarding the strengths and limitations across frameworks. Particular shortcomings of some frameworks pose greater threats to their face validity and utility compared with others. The most significant limitations include lack of clear perspective (e.g., patient vs. health plan) and poor transparency in accounting for costs and benefits. We then review how each framework adheres to core STF recommendations, with particular emphasis on whether the framework can be used to support coverage decisions by health insurers, and whether it adheres to core principles of cost-effectiveness analysis. The Institute for Clinical and Economic Research framework most closely adheres to core STF recommendations. Others have significant limitations that vary widely from framework to framework. We also review how the frameworks follow STF recommendations for addressing potentially relevant issues beyond cost-effectiveness analysis - for example, equity in resource allocation and patient heterogeneity. Finally, we review whether and how each framework uses value thresholds and addresses affordability concerns. We conclude with suggestions for further research, particularly in the areas of testing the measurement and use of novel elements of value and deliberative processes. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Action, outcome, and value: a dual-system framework for morality.

PubMed

Cushman, Fiery

2013-08-01

Dual-system approaches to psychology explain the fundamental properties of human judgment, decision making, and behavior across diverse domains. Yet, the appropriate characterization of each system is a source of debate. For instance, a large body of research on moral psychology makes use of the contrast between "emotional" and "rational/cognitive" processes, yet even the chief proponents of this division recognize its shortcomings. Largely independently, research in the computational neurosciences has identified a broad division between two algorithms for learning and choice derived from formal models of reinforcement learning. One assigns value to actions intrinsically based on past experience, while another derives representations of value from an internally represented causal model of the world. This division between action- and outcome-based value representation provides an ideal framework for a dual-system theory in the moral domain.

The knowledge-value chain: A conceptual framework for knowledge translation in health.

PubMed

Landry, Réjean; Amara, Nabil; Pablos-Mendes, Ariel; Shademani, Ramesh; Gold, Irving

2006-08-01

This article briefly discusses knowledge translation and lists the problems associated with it. Then it uses knowledge-management literature to develop and propose a knowledge-value chain framework in order to provide an integrated conceptual model of knowledge management and application in public health organizations. The knowledge-value chain is a non-linear concept and is based on the management of five dyadic capabilities: mapping and acquisition, creation and destruction, integration and sharing/transfer, replication and protection, and performance and innovation.

The knowledge-value chain: A conceptual framework for knowledge translation in health.

PubMed Central

Landry, Réjean; Amara, Nabil; Pablos-Mendes, Ariel; Shademani, Ramesh; Gold, Irving

2006-01-01

This article briefly discusses knowledge translation and lists the problems associated with it. Then it uses knowledge-management literature to develop and propose a knowledge-value chain framework in order to provide an integrated conceptual model of knowledge management and application in public health organizations. The knowledge-value chain is a non-linear concept and is based on the management of five dyadic capabilities: mapping and acquisition, creation and destruction, integration and sharing/transfer, replication and protection, and performance and innovation. PMID:16917645

Value Driven Outcomes (VDO): a pragmatic, modular, and extensible software framework for understanding and improving health care costs and outcomes

PubMed Central

Kawamoto, Kensaku; Martin, Cary J; Williams, Kip; Tu, Ming-Chieh; Park, Charlton G; Hunter, Cheri; Staes, Catherine J; Bray, Bruce E; Deshmukh, Vikrant G; Holbrook, Reid A; Morris, Scott J; Fedderson, Matthew B; Sletta, Amy; Turnbull, James; Mulvihill, Sean J; Crabtree, Gordon L; Entwistle, David E; McKenna, Quinn L; Strong, Michael B; Pendleton, Robert C; Lee, Vivian S

2015-01-01

Objective To develop expeditiously a pragmatic, modular, and extensible software framework for understanding and improving healthcare value (costs relative to outcomes). Materials and methods In 2012, a multidisciplinary team was assembled by the leadership of the University of Utah Health Sciences Center and charged with rapidly developing a pragmatic and actionable analytics framework for understanding and enhancing healthcare value. Based on an analysis of relevant prior work, a value analytics framework known as Value Driven Outcomes (VDO) was developed using an agile methodology. Evaluation consisted of measurement against project objectives, including implementation timeliness, system performance, completeness, accuracy, extensibility, adoption, satisfaction, and the ability to support value improvement. Results A modular, extensible framework was developed to allocate clinical care costs to individual patient encounters. For example, labor costs in a hospital unit are allocated to patients based on the hours they spent in the unit; actual medication acquisition costs are allocated to patients based on utilization; and radiology costs are allocated based on the minutes required for study performance. Relevant process and outcome measures are also available. A visualization layer facilitates the identification of value improvement opportunities, such as high-volume, high-cost case types with high variability in costs across providers. Initial implementation was completed within 6 months, and all project objectives were fulfilled. The framework has been improved iteratively and is now a foundational tool for delivering high-value care. Conclusions The framework described can be expeditiously implemented to provide a pragmatic, modular, and extensible approach to understanding and improving healthcare value. PMID:25324556

Multiple Criteria Decision Analysis (MCDA) for evaluating new medicines in Health Technology Assessment and beyond: The Advance Value Framework.

PubMed

Angelis, Aris; Kanavos, Panos

2017-09-01

Escalating drug prices have catalysed the generation of numerous "value frameworks" with the aim of informing payers, clinicians and patients on the assessment and appraisal process of new medicines for the purpose of coverage and treatment selection decisions. Although this is an important step towards a more inclusive Value Based Assessment (VBA) approach, aspects of these frameworks are based on weak methodologies and could potentially result in misleading recommendations or decisions. In this paper, a Multiple Criteria Decision Analysis (MCDA) methodological process, based on Multi Attribute Value Theory (MAVT), is adopted for building a multi-criteria evaluation model. A five-stage model-building process is followed, using a top-down "value-focused thinking" approach, involving literature reviews and expert consultations. A generic value tree is structured capturing decision-makers' concerns for assessing the value of new medicines in the context of Health Technology Assessment (HTA) and in alignment with decision theory. The resulting value tree (Advance Value Tree) consists of three levels of criteria (top level criteria clusters, mid-level criteria, bottom level sub-criteria or attributes) relating to five key domains that can be explicitly measured and assessed: (a) burden of disease, (b) therapeutic impact, (c) safety profile (d) innovation level and (e) socioeconomic impact. A number of MAVT modelling techniques are introduced for operationalising (i.e. estimating) the model, for scoring the alternative treatment options, assigning relative weights of importance to the criteria, and combining scores and weights. Overall, the combination of these MCDA modelling techniques for the elicitation and construction of value preferences across the generic value tree provides a new value framework (Advance Value Framework) enabling the comprehensive measurement of value in a structured and transparent way. Given its flexibility to meet diverse requirements and

Value Driven Outcomes (VDO): a pragmatic, modular, and extensible software framework for understanding and improving health care costs and outcomes.

PubMed

Kawamoto, Kensaku; Martin, Cary J; Williams, Kip; Tu, Ming-Chieh; Park, Charlton G; Hunter, Cheri; Staes, Catherine J; Bray, Bruce E; Deshmukh, Vikrant G; Holbrook, Reid A; Morris, Scott J; Fedderson, Matthew B; Sletta, Amy; Turnbull, James; Mulvihill, Sean J; Crabtree, Gordon L; Entwistle, David E; McKenna, Quinn L; Strong, Michael B; Pendleton, Robert C; Lee, Vivian S

2015-01-01

To develop expeditiously a pragmatic, modular, and extensible software framework for understanding and improving healthcare value (costs relative to outcomes). In 2012, a multidisciplinary team was assembled by the leadership of the University of Utah Health Sciences Center and charged with rapidly developing a pragmatic and actionable analytics framework for understanding and enhancing healthcare value. Based on an analysis of relevant prior work, a value analytics framework known as Value Driven Outcomes (VDO) was developed using an agile methodology. Evaluation consisted of measurement against project objectives, including implementation timeliness, system performance, completeness, accuracy, extensibility, adoption, satisfaction, and the ability to support value improvement. A modular, extensible framework was developed to allocate clinical care costs to individual patient encounters. For example, labor costs in a hospital unit are allocated to patients based on the hours they spent in the unit; actual medication acquisition costs are allocated to patients based on utilization; and radiology costs are allocated based on the minutes required for study performance. Relevant process and outcome measures are also available. A visualization layer facilitates the identification of value improvement opportunities, such as high-volume, high-cost case types with high variability in costs across providers. Initial implementation was completed within 6 months, and all project objectives were fulfilled. The framework has been improved iteratively and is now a foundational tool for delivering high-value care. The framework described can be expeditiously implemented to provide a pragmatic, modular, and extensible approach to understanding and improving healthcare value. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association.

The Importance of Economic Perspective and Quantitative Approaches in Oncology Value Frameworks of Drug Selection and Shared Decision Making.

PubMed

Waldeck, A Reginald; Botteman, Marc F; White, Richard E; van Hout, Ben A

2017-06-01

The debate around value in oncology drug selection has been prominent in recent years, and several professional bodies have furthered this debate by advocating for so-called value frameworks. Herein, we provide a viewpoint on these value frameworks, emphasizing the need to consider 4 key aspects: (1) the economic underpinnings of value; (2) the importance of the perspective adopted in the valuation; (3) the importance of the difference between absolute and relative measures of risk and measuring patient preferences; and (4) the recognition of multiple quality-of-life (QoL) domains, and the aggregation and valuation of those domains, through utilities within a multicriteria decision analysis, may allow prioritization of QoL above the tallying of safety events, particularly in a value framework focusing on the individual patient. While several frameworks exist, they incorporate different attributes and-importantly-assess value from alternative perspectives, including those of patients, regulators, payers, and society. The various perspectives necessarily lead to potentially different, if not sometimes divergent, conclusions about the valuation. We show that the perspective of the valuation affects the framing of the risk/benefit question and the methodology to measure the individual patient choice, or preference, as opposed to the collective, or population, choice. We focus specifically on the American Society of Clinical Oncology (ASCO) Value Framework. We argue that its laudable intent to assist in shared clinician-patient decision making can be augmented by more formally adopting methodology underpinned by micro- and health economic concepts, as well as application of formal quantitative approaches. Our recommendations for value frameworks focusing on the individual patient, such as the ASCO Value Framework, are 3-fold: (1) ensure that stakeholders understand the importance of the adopted (economic) perspective; (2) consider using exclusively absolute measures of

Relativism, Values and Morals in the New Zealand Curriculum Framework

NASA Astrophysics Data System (ADS)

Jorgensen, Lone Morris; Ryan, Sueann

The New Zealand Curriculum Framework, 1993, is the official document for teaching, learning and assessment in New Zealand schools. It consists of a set of curriculum statements, which define the learning principles, achievement aims and essential skills for seven learning areas. It also indicates the place of attitudes and values in the school curriculum. This paper investigates the requirements for teaching attitudes, values and ethics in the curriculum statements for Science, Biology and Technology. The question is raised whether the teaching of skills for resolving moral and ethical dilemmas are required by the official education standards in New Zealand, and internationally. The paper reports on a survey done on pre-service teacher trainees of their understanding of these requirements. Implications for courses that might need to be provided in future pre-service teacher education programmes are briefly discussed.

Do Clouds Compute? A Framework for Estimating the Value of Cloud Computing

NASA Astrophysics Data System (ADS)

Klems, Markus; Nimis, Jens; Tai, Stefan

On-demand provisioning of scalable and reliable compute services, along with a cost model that charges consumers based on actual service usage, has been an objective in distributed computing research and industry for a while. Cloud Computing promises to deliver on this objective: consumers are able to rent infrastructure in the Cloud as needed, deploy applications and store data, and access them via Web protocols on a pay-per-use basis. The acceptance of Cloud Computing, however, depends on the ability for Cloud Computing providers and consumers to implement a model for business value co-creation. Therefore, a systematic approach to measure costs and benefits of Cloud Computing is needed. In this paper, we discuss the need for valuation of Cloud Computing, identify key components, and structure these components in a framework. The framework assists decision makers in estimating Cloud Computing costs and to compare these costs to conventional IT solutions. We demonstrate by means of representative use cases how our framework can be applied to real world scenarios.

Portfolio Decision Analysis Framework for Value-Focused Ecosystem Management

PubMed Central

Convertino, Matteo; Valverde, L. James

2013-01-01

Management of natural resources in coastal ecosystems is a complex process that is made more challenging by the need for stakeholders to confront the prospect of sea level rise and a host of other environmental stressors. This situation is especially true for coastal military installations, where resource managers need to balance conflicting objectives of environmental conservation against military mission. The development of restoration plans will necessitate incorporating stakeholder preferences, and will, moreover, require compliance with applicable federal/state laws and regulations. To promote the efficient allocation of scarce resources in space and time, we develop a portfolio decision analytic (PDA) framework that integrates models yielding policy-dependent predictions for changes in land cover and species metapopulations in response to restoration plans, under different climate change scenarios. In a manner that is somewhat analogous to financial portfolios, infrastructure and natural resources are classified as human and natural assets requiring management. The predictions serve as inputs to a Multi Criteria Decision Analysis model (MCDA) that is used to measure the benefits of restoration plans, as well as to construct Pareto frontiers that represent optimal portfolio allocations of restoration actions and resources. Optimal plans allow managers to maintain or increase asset values by contrasting the overall degradation of the habitat and possible increased risk of species decline against the benefits of mission success. The optimal combination of restoration actions that emerge from the PDA framework allows decision-makers to achieve higher environmental benefits, with equal or lower costs, than those achievable by adopting the myopic prescriptions of the MCDA model. The analytic framework presented here is generalizable for the selection of optimal management plans in any ecosystem where human use of the environment conflicts with the needs of

Portfolio Decision Analysis Framework for Value-Focused Ecosystem Management.

PubMed

Convertino, Matteo; Valverde, L James

2013-01-01

Management of natural resources in coastal ecosystems is a complex process that is made more challenging by the need for stakeholders to confront the prospect of sea level rise and a host of other environmental stressors. This situation is especially true for coastal military installations, where resource managers need to balance conflicting objectives of environmental conservation against military mission. The development of restoration plans will necessitate incorporating stakeholder preferences, and will, moreover, require compliance with applicable federal/state laws and regulations. To promote the efficient allocation of scarce resources in space and time, we develop a portfolio decision analytic (PDA) framework that integrates models yielding policy-dependent predictions for changes in land cover and species metapopulations in response to restoration plans, under different climate change scenarios. In a manner that is somewhat analogous to financial portfolios, infrastructure and natural resources are classified as human and natural assets requiring management. The predictions serve as inputs to a Multi Criteria Decision Analysis model (MCDA) that is used to measure the benefits of restoration plans, as well as to construct Pareto frontiers that represent optimal portfolio allocations of restoration actions and resources. Optimal plans allow managers to maintain or increase asset values by contrasting the overall degradation of the habitat and possible increased risk of species decline against the benefits of mission success. The optimal combination of restoration actions that emerge from the PDA framework allows decision-makers to achieve higher environmental benefits, with equal or lower costs, than those achievable by adopting the myopic prescriptions of the MCDA model. The analytic framework presented here is generalizable for the selection of optimal management plans in any ecosystem where human use of the environment conflicts with the needs of

Detection of microbial invasion of the amniotic cavity by analysis of cervicovaginal proteins in women with preterm labor and intact membranes.

PubMed

Combs, C Andrew; Garite, Thomas J; Lapidus, Jodi A; Lapointe, Jerome P; Gravett, Michael; Rael, Julie; Amon, Erol; Baxter, Jason K; Brady, Kim; Clewell, William; Eddleman, Keith A; Fortunato, Stephen; Franco, Albert; Haas, David M; Heyborne, Kent; Hickok, Durlin E; How, Helen Y; Luthy, David; Miller, Hugh; Nageotte, Michael; Pereira, Leonardo; Porreco, Richard; Robilio, Peter A; Simhan, Hyagriv; Sullivan, Scott A; Trofatter, Kenneth; Westover, Thomas

2015-04-01

Microbial invasion of the amniotic cavity (MIAC) is common in early preterm labor and is associated with maternal and neonatal infectious morbidity. MIAC is usually occult and is reliably detected only with amniocentesis. We sought to develop a noninvasive test to predict MIAC based on protein biomarkers in cervicovaginal fluid (CVF) in a cohort of women with preterm labor (phase 1) and to validate the test in an independent cohort (phase 2). This was a prospective study of women with preterm labor who had amniocentesis to screen for MIAC. MIAC was defined by positive culture and/or 16S ribosomal DNA results. Nine candidate CVF proteins were analyzed by enzyme-linked immunosorbent assay. Logistic regression was used to identify combinations of up to 3 proteins that could accurately classify the phase 1 cohort (N = 108) into those with or without MIAC. The best models, selected by area under the curve (AUC) of the receiver operating characteristic curve in phase 1, included various combinations of interleukin (IL)-6, chemokine (C-X-C motif) ligand 1 (CXCL1), alpha fetoprotein, and insulin-like growth factor binding protein-1. Model performance was then tested in the phase 2 cohort (N = 306). MIAC was present in 15% of cases in phase 1 and 9% in phase 2. A 3-marker CVF model using IL-6 plus CXCL1 plus insulin-like growth factor binding protein-1 had AUC 0.87 in phase 1 and 0.78 in phase 2. Two-marker models using IL-6 plus CXCL1 or alpha fetoprotein plus CXCL1 performed similarly in phase 2 (AUC 0.78 and 0.75, respectively), but were not superior to CVF IL-6 alone (AUC 0.80). A cutoff value of CVF IL-6 ≥463 pg/mL (which had 81% sensitivity in phase 1) predicted MIAC in phase 2 with sensitivity 79%, specificity 78%, positive predictive value 38%, and negative predictive value 97%. High levels of IL-6 in CVF are strongly associated with MIAC. If developed into a bedside test or rapid laboratory assay, cervicovaginal IL-6 might be useful in selecting patients in

Which health technologies should be funded? A prioritization framework based explicitly on value for money.

PubMed

Golan, Ofra; Hansen, Paul

2012-11-26

Deciding which health technologies to fund involves confronting some of the most difficult choices in medicine. As for other countries, the Israeli health system is faced each year with having to make these difficult decisions. The Public National Advisory Committee, known as 'the Basket Committee', selects new technologies for the basic list of health care that all Israelis are entitled to access, known as the 'health basket'. We introduce a framework for health technology prioritization based explicitly on value for money that enables the main variables considered by decision-makers to be explicitly included. Although the framework's exposition is in terms of the Basket Committee selecting new technologies for Israel's health basket, we believe that the framework would also work well for other countries. Our proposed prioritization framework involves comparing four main variables for each technology: 1. Incremental benefits, including 'equity benefits', to Israel's population; 2. Incremental total cost to Israel's health system; 3. Quality of evidence; and 4. Any additional 'X-factors' not elsewhere included, such as strategic or legal factors, etc. Applying methodology from multi-criteria decision analysis, the multiple dimensions comprising the first variable are aggregated via a points system. The four variables are combined for each technology and compared across the technologies in the 'Value for Money (VfM) Chart'. The VfM Chart can be used to identify technologies that are good value for money, and, given a budget constraint, to select technologies that should be funded. This is demonstrated using 18 illustrative technologies. The VfM Chart is an intuitively appealing decision-support tool for helping decision-makers to focus on the inherent tradeoffs involved in health technology prioritization. Such deliberations can be performed in a systematic and transparent fashion that can also be easily communicated to stakeholders, including the general public

Geocapabilities: Toward an International Framework for Researching the Purposes and Values of Geography Education

ERIC Educational Resources Information Center

Solem, Michael; Lambert, David; Tani, Sirpa

2013-01-01

GeoCapabilities is a transatlantic collaborative project for researching the purposes and values of geography education through a "capabilities approach." Inspired by the writings of philosopher Amartya Sen and economist Martha Nussbaum, the capabilities approach provides a normative framework for understanding the broader aims of…

A Parallel Framework with Block Matrices of a Discrete Fourier Transform for Vector-Valued Discrete-Time Signals.

PubMed

Soto-Quiros, Pablo

2015-01-01

This paper presents a parallel implementation of a kind of discrete Fourier transform (DFT): the vector-valued DFT. The vector-valued DFT is a novel tool to analyze the spectra of vector-valued discrete-time signals. This parallel implementation is developed in terms of a mathematical framework with a set of block matrix operations. These block matrix operations contribute to analysis, design, and implementation of parallel algorithms in multicore processors. In this work, an implementation and experimental investigation of the mathematical framework are performed using MATLAB with the Parallel Computing Toolbox. We found that there is advantage to use multicore processors and a parallel computing environment to minimize the high execution time. Additionally, speedup increases when the number of logical processors and length of the signal increase.

A Framework for Enhancing the Value of Research for Dissemination and Implementation

PubMed Central

Glasgow, Russell E.; Carpenter, Christopher R.; Grimshaw, Jeremy M.; Rabin, Borsika A.; Fernandez, Maria E.; Brownson, Ross C.

2015-01-01

A comprehensive guide that identifies critical evaluation and reporting elements necessary to move research into practice is needed. We propose a framework that highlights the domains required to enhance the value of dissemination and implementation research for end users. We emphasize the importance of transparent reporting on the planning phase of research in addition to delivery, evaluation, and long-term outcomes. We highlight key topics for which well-established reporting and assessment tools are underused (e.g., cost of intervention, implementation strategy, adoption) and where such tools are inadequate or lacking (e.g., context, sustainability, evolution) within the context of existing reporting guidelines. Consistent evaluation of and reporting on these issues with standardized approaches would enhance the value of research for practitioners and decision-makers. PMID:25393182

Embracing value co-creation in primary care services research: a framework for success.

PubMed

Janamian, Tina; Crossland, Lisa; Jackson, Claire L

2016-04-18

Value co-creation redresses a key criticism of researcher-driven approaches to research - that researchers may lack insight into the end users' needs and values across the research journey. Value co-creation creates, in a step-wise way, value with, and for, multiple stakeholders through regular, ongoing interactions leading to innovation, increased productivity and co-created outcomes of value to all parties - thus creating a "win more-win more" environment. The Centre of Research Excellence (CRE) in Building Primary Care Quality, Performance and Sustainability has co-created outcomes of value that have included robust and enduring partnerships, research findings that have value to end users (such as the Primary Care Practice Improvement Tool and the best-practice governance framework), an International Implementation Research Network in Primary Care and the International Primary Health Reform Conference. Key lessons learned in applying the strategies of value co-creation have included the recognition that partnership development requires an investment of time and effort to ensure meaningful interactions and enriched end user experiences, that research management systems including governance, leadership and communication also need to be "co-creative", and that openness and understanding is needed to work across different sectors and cultures with flexibility, fairness and transparency being essential to the value co-creation process.

Value to Whom? The Patient Voice in the Value Discussion.

PubMed

Perfetto, Eleanor M; Oehrlein, Elisabeth M; Boutin, Marc; Reid, Sarah; Gascho, Eric

2017-02-01

Professional societies and other organizations have recently taken a visible role trying to define treatment value via value frameworks and assessments, providing payer or provider recommendations, and potentially impacting patient access. Patient perspectives routinely differ from those of other stakeholders. Yet, it is not always apparent that patients were engaged in value framework development or assessment. To describe the development and content of the National Health Council's (NHC's) Rubric, a tool that includes criteria for evaluation of value frameworks specifically with regard to patient-centeredness and meaningful patient engagement. The NHC held a multistakeholder, invitational roundtable in Washington, DC, in 2016. Participants reviewed existing patient-engagement rubrics, discussed experiences with value frameworks, debated and thematically grouped hallmark patient-centeredness characteristics, and developed illustrative examples of the characteristics. These materials were organized into the rubric, and subsequently vetted via multistakeholder peer review. The resulting rubric describes six domains of patient-centered value frameworks: partnership, transparency, inclusiveness, diversity, outcomes, and data sources. Each domain includes specific examples illustrating how patient engagement and patient-centeredness can be operationalized in value framework processes. The NHC multistakeholder roundtable's recommendations are captured in the NHC's Rubric to assess value framework and model patient-centeredness and patient engagement. The Rubric is a tool that will be refined over time on the basis of feedback from patient, patient group, framework developer, and other stakeholder-use experiences. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The sociocultural appraisals, values, and emotions (SAVE) framework of prosociality: core processes from gene to meme.

PubMed

Keltner, Dacher; Kogan, Aleksandr; Piff, Paul K; Saturn, Sarina R

2014-01-01

The study of prosocial behavior--altruism, cooperation, trust, and the related moral emotions--has matured enough to produce general scholarly consensus that prosociality is widespread, intuitive, and rooted deeply within our biological makeup. Several evolutionary frameworks model the conditions under which prosocial behavior is evolutionarily viable, yet no unifying treatment exists of the psychological decision-making processes that result in prosociality. Here, we provide such a perspective in the form of the sociocultural appraisals, values, and emotions (SAVE) framework of prosociality. We review evidence for the components of our framework at four levels of analysis: intrapsychic, dyadic, group, and cultural. Within these levels, we consider how phenomena such as altruistic punishment, prosocial contagion, self-other similarity, and numerous others give rise to prosocial behavior. We then extend our reasoning to chart the biological underpinnings of prosociality and apply our framework to understand the role of social class in prosociality.

Near-infrared CVF spectrophotometry of Saturn in 1992.

NASA Astrophysics Data System (ADS)

Molina, A.; Moreno, F.; Kidger, M.; Ortiz, J. L.

1995-06-01

Absolutely calibrated measurements of the reflectivity of Saturn in 1992 are presented. The observations were carried out using a Circular Variable Filter in combination with a photometer with a single element InSb detector at the 1.54m Carlos Sanchez infrared telescope of the Observatorio del Teide in the Canary Islands (Spain). The spectral ranges covered were 1.4-2.4μm and 2.6-4.5μm. Besides the measurements at the disk, values of the reflectance of the Saturn's rings in the West Ansa were obtained. A comparison with the few related published works is made, and the significant spectral features in this wavelength region are discussed. A spectrum of Jupiter obtained in 1993 is also presented and compared with spectra obtained by us in 1991 using the same instrumental configuration.

A proposed ethical framework for vaccine mandates: competing values and the case of HPV.

PubMed

Field, Robert I; Caplan, Arthur L

2008-06-01

Debates over vaccine mandates raise intense emotions, as reflected in the current controversy over whether to mandate the vaccine against human papilloma virus (HPV), the virus that can cause cervical cancer. Public health ethics so far has failed to facilitate meaningful dialogue between the opposing sides. When stripped of its emotional charge, the debate can be framed as a contest between competing ethical values. This framework can be conceptualized graphically as a conflict between autonomy on the one hand, which militates against government intrusion, and beneficence, utilitarianism, justice, and nonmaleficence on the other, which may lend support to intervention. When applied to the HPV vaccine, this framework would support a mandate based on utilitarianism, if certain conditions are met and if herd immunity is a realistic objective.

Incorporating the Cultural Value of Respeto Into a Framework of Latino Parenting

PubMed Central

Calzada, Esther J.; Fernandez, Yenny; Cortes, Dharma E.

2015-01-01

Latino families face multiple stressors associated with adjusting to United States mainstream culture that, along with poverty and residence in inner-city communities, may further predispose their children to risk for negative developmental outcomes. Evidence-based mental health treatments may require culturally informed modifications to best address the unique needs of the Latino population, yet few empirical studies have assessed these cultural elements. The current study examined cultural values of 48 Dominican and Mexican mothers of preschoolers through focus groups in which they described their core values as related to their parenting role. Results showed that respeto, family and religion were the most important values that mothers sought to transmit to their children. Respeto is manifested in several domains, including obedience to authority, deference, decorum, and public behavior. The authors describe the socialization messages that Latina mothers use to teach their children respeto and present a culturally derived framework of how these messages may relate to child development. The authors discuss how findings may inform the cultural adaptation of evidence-based mental health treatments such as parent training programs. PMID:20099967

The economic value of water use: implications for implementing the Water Framework Directive in Scotland.

PubMed

Moran, Dominic; Dann, Sabrina

2008-05-01

The European Union Water Framework Directive (WFD) enshrines several economic principles in pursuit of 'good ecological status' for Europe's waters and rationalising water use in society. The implicit principle of maximising the social value from use of a scarce resource is reminiscent of the debate about treating water as an economic good, which has competing uses in society. This paper locates the debate about the economic value of water in the requirements of WFD. Specifically, we consider the implications of national reporting requirements for the economic characterisation report that stress the identification of relative value derived from use. As part of the Scottish contribution to the UK reporting exercise, we use a range of secondary data sources to derive economic values for water on a sector basis. We suggest whether the implications of different water values can be followed through in the WFD.

The value of heterogeneity for cost-effectiveness subgroup analysis: conceptual framework and application.

PubMed

Espinoza, Manuel A; Manca, Andrea; Claxton, Karl; Sculpher, Mark J

2014-11-01

This article develops a general framework to guide the use of subgroup cost-effectiveness analysis for decision making in a collectively funded health system. In doing so, it addresses 2 key policy questions, namely, the identification and selection of subgroups, while distinguishing 2 sources of potential value associated with heterogeneity. These are 1) the value of revealing the factors associated with heterogeneity in costs and outcomes using existing evidence (static value) and 2) the value of acquiring further subgroup-related evidence to resolve the uncertainty given the current understanding of heterogeneity (dynamic value). Consideration of these 2 sources of value can guide subgroup-specific treatment decisions and inform whether further research should be conducted to resolve uncertainty to explain variability in costs and outcomes. We apply the proposed methods to a cost-effectiveness analysis for the management of patients with acute coronary syndrome. This study presents the expected net benefits under current and perfect information when subgroups are defined based on the use and combination of 6 binary covariates. The results of the case study confirm the theoretical expectations. As more subgroups are considered, the marginal net benefit gains obtained under the current information show diminishing marginal returns, and the expected value of perfect information shows a decreasing trend. We present a suggested algorithm that synthesizes the results to guide policy. © The Author(s) 2014.

Which health technologies should be funded? A prioritization framework based explicitly on value for money

PubMed Central

2012-01-01

Background Deciding which health technologies to fund involves confronting some of the most difficult choices in medicine. As for other countries, the Israeli health system is faced each year with having to make these difficult decisions. The Public National Advisory Committee, known as ‘the Basket Committee’, selects new technologies for the basic list of health care that all Israelis are entitled to access, known as the ‘health basket’. We introduce a framework for health technology prioritization based explicitly on value for money that enables the main variables considered by decision-makers to be explicitly included. Although the framework’s exposition is in terms of the Basket Committee selecting new technologies for Israel’s health basket, we believe that the framework would also work well for other countries. Methods Our proposed prioritization framework involves comparing four main variables for each technology: 1. Incremental benefits, including ‘equity benefits’, to Israel’s population; 2. Incremental total cost to Israel’s health system; 3. Quality of evidence; and 4. Any additional ‘X-factors’ not elsewhere included, such as strategic or legal factors, etc. Applying methodology from multi-criteria decision analysis, the multiple dimensions comprising the first variable are aggregated via a points system. Results The four variables are combined for each technology and compared across the technologies in the ‘Value for Money (VfM) Chart’. The VfM Chart can be used to identify technologies that are good value for money, and, given a budget constraint, to select technologies that should be funded. This is demonstrated using 18 illustrative technologies. Conclusions The VfM Chart is an intuitively appealing decision-support tool for helping decision-makers to focus on the inherent tradeoffs involved in health technology prioritization. Such deliberations can be performed in a systematic and transparent fashion that can also be

Using Expectancy Value Theory as a Framework to Reduce Student Resistance to Active Learning: A Proof of Concept.

PubMed

Cooper, Katelyn M; Ashley, Michael; Brownell, Sara E

2017-01-01

There has been a national movement to transition college science courses from passive lectures to active learning environments. Active learning has been shown to be a more effective way for students to learn, yet there is concern that some students are resistant to active learning approaches. Although there is much discussion about student resistance to active learning, few studies have explored this topic. Furthermore, a limited number of studies have applied theoretical frameworks to student engagement in active learning. We propose using a theoretical lens of expectancy value theory to understand student resistance to active learning. In this study, we examined student perceptions of active learning after participating in 40 hours of active learning. We used the principal components of expectancy value theory to probe student experience in active learning: student perceived self-efficacy in active learning, value of active learning, and potential cost of participating in active learning. We found that students showed positive changes in the components of expectancy value theory and reported high levels of engagement in active learning, which provide proof of concept that expectancy value theory can be used to boost student perceptions of active learning and their engagement in active learning classrooms. From these findings, we have built a theoretical framework of expectancy value theory applied to active learning.

Buffalo cervico-vaginal fluid proteomics with special reference to estrous cycle: heat shock protein (HSP)-70 appears to be an estrus indicator.

PubMed

Muthukumar, Subramanian; Rajkumar, Ramalingam; Karthikeyan, Kandasamy; Liao, Chen-Chung; Singh, Dheer; Akbarsha, Mohammad Abdulkader; Archunan, Govindaraju

2014-05-01

Cervico-vaginal fluid (CVF) plays significant roles in coitus, sperm transport, and implantation. It is believed to be a good noninvasive biomarker for various diagnostic purposes. In this study, a comprehensive proteomic analysis of buffalo CVF was performed during the estrous cycle in order to document the protein expressions, utilizing SDS-PAGE, mass spectrometry, and immunoblot. The main objective was to screen the CVF of buffalo for one or more estrus-specific proteins. A total of 416 proteins were identified in the CVF of both estrus and diestrus phases. Out of these proteins, 68 estrus-specific proteins have been extensively reviewed in the protein database. The major physiological functions of estrus CVF proteins appeared to be stress response, immune response, and metabolic. Eventually, the expression level of heat shock protein-70 in the CVF during the estrus phase, as revealed in SDS-PAGE analysis, was higher than during diestrus. The identity of the protein was confirmed by immunoblot analysis as heat shock protein-70. The findings provide a potential lead for the evaluation of these proteins for estrus detection in buffalo because CVF biomarker detection is a noninvasive technique. The mass spectrometric data of identified proteins have been deposited at the ProteomeXchange with the identifier PXD000620.

A Framework for Valuing Investments in a Nurturing Society: Opportunities for Prevention Research

PubMed Central

Crowley, Max; Jones, Damon

2017-01-01

Investing in strategies that aim to build a more nurturing society offers tremendous opportunities for the field of prevention science. Yet, scientists struggle to consistently take their research beyond effectiveness evaluations and actually value the impact of preventive strategies. Ultimately, it is clear that convincing policymakers to make meaningful investments in children and youth will require estimates of the fiscal impact of such strategies across public service systems. The framework offered here values such investments. First, we review current public spending on children and families. Then, we describe how to quantify and monetize the impact of preventive interventions. This includes a new measurement strategy for assessing multi-system service utilization and a price list for key service provision from public education, social services, criminal justice, healthcare, and tax systems. PMID:28247294

A framework for quantifying and optimizing the value of seismic monitoring of infrastructure

NASA Astrophysics Data System (ADS)

Omenzetter, Piotr

2017-04-01

This paper outlines a framework for quantifying and optimizing the value of information from structural health monitoring (SHM) technology deployed on large infrastructure, which may sustain damage in a series of earthquakes (the main and the aftershocks). The evolution of the damage state of the infrastructure without or with SHM is presented as a time-dependent, stochastic, discrete-state, observable and controllable nonlinear dynamical system. The pre-posterior Bayesian analysis and the decision tree are used for quantifying and optimizing the value of SHM information. An optimality problem is then formulated how to decide on the adoption of SHM and how to manage optimally the usage and operations of the possibly damaged infrastructure and its repair schedule using the information from SHM. The objective function to minimize is the expected total cost or risk.

A Framework for Valuing Investments in a Nurturing Society: Opportunities for Prevention Research.

PubMed

Crowley, Max; Jones, Damon

2017-03-01

Investing in strategies that aim to build a more nurturing society offers tremendous opportunities for the field of prevention science. Yet, scientists struggle to consistently take their research beyond effectiveness evaluations and actually value the impact of preventive strategies. Ultimately, it is clear that convincing policymakers to make meaningful investments in children and youth will require estimates of the fiscal impact of such strategies across public service systems. The framework offered here values such investments. First, we review current public spending on children and families. Then, we describe how to quantify and monetize the impact of preventive interventions. This includes a new measurement strategy for assessing multisystem service utilization and a price list for key service provision from public education, social services, criminal justice, health care and tax systems.

Incorporating the cultural value of respeto into a framework of Latino parenting.

PubMed

Calzada, Esther J; Fernandez, Yenny; Cortes, Dharma E

2010-01-01

Latino families face multiple stressors associated with adjusting to United States mainstream culture that, along with poverty and residence in inner-city communities, may further predispose their children to risk for negative developmental outcomes. Evidence-based mental health treatments may require culturally informed modifications to best address the unique needs of the Latino population, yet few empirical studies have assessed these cultural elements. The current study examined cultural values of 48 Dominican and Mexican mothers of preschoolers through focus groups in which they described their core values as related to their parenting role. Results showed that respeto, family and religion were the most important values that mothers sought to transmit to their children. Respeto is manifested in several domains, including obedience to authority, deference, decorum, and public behavior. The authors describe the socialization messages that Latina mothers use to teach their children respeto and present a culturally derived framework of how these messages may relate to child development. The authors discuss how findings may inform the cultural adaptation of evidence-based mental health treatments such as parent training programs. (c) 2009 APA, all rights reserved.

Adjusting Estimates of the Expected Value of Information for Implementation: Theoretical Framework and Practical Application.

PubMed

Andronis, Lazaros; Barton, Pelham M

2016-04-01

Value of information (VoI) calculations give the expected benefits of decision making under perfect information (EVPI) or sample information (EVSI), typically on the premise that any treatment recommendations made in light of this information will be implemented instantly and fully. This assumption is unlikely to hold in health care; evidence shows that obtaining further information typically leads to "improved" rather than "perfect" implementation. To present a method of calculating the expected value of further research that accounts for the reality of improved implementation. This work extends an existing conceptual framework by introducing additional states of the world regarding information (sample information, in addition to current and perfect information) and implementation (improved implementation, in addition to current and optimal implementation). The extension allows calculating the "implementation-adjusted" EVSI (IA-EVSI), a measure that accounts for different degrees of implementation. Calculations of implementation-adjusted estimates are illustrated under different scenarios through a stylized case study in non-small cell lung cancer. In the particular case study, the population values for EVSI and IA-EVSI were £ 25 million and £ 8 million, respectively; thus, a decision assuming perfect implementation would have overestimated the expected value of research by about £ 17 million. IA-EVSI was driven by the assumed time horizon and, importantly, the specified rate of change in implementation: the higher the rate, the greater the IA-EVSI and the lower the difference between IA-EVSI and EVSI. Traditionally calculated measures of population VoI rely on unrealistic assumptions about implementation. This article provides a simple framework that accounts for improved, rather than perfect, implementation and offers more realistic estimates of the expected value of research. © The Author(s) 2015.

Using Expectancy Value Theory as a Framework to Reduce Student Resistance to Active Learning: A Proof of Concept

PubMed Central

Cooper, Katelyn M.; Ashley, Michael; Brownell, Sara E.

2017-01-01

There has been a national movement to transition college science courses from passive lectures to active learning environments. Active learning has been shown to be a more effective way for students to learn, yet there is concern that some students are resistant to active learning approaches. Although there is much discussion about student resistance to active learning, few studies have explored this topic. Furthermore, a limited number of studies have applied theoretical frameworks to student engagement in active learning. We propose using a theoretical lens of expectancy value theory to understand student resistance to active learning. In this study, we examined student perceptions of active learning after participating in 40 hours of active learning. We used the principal components of expectancy value theory to probe student experience in active learning: student perceived self-efficacy in active learning, value of active learning, and potential cost of participating in active learning. We found that students showed positive changes in the components of expectancy value theory and reported high levels of engagement in active learning, which provide proof of concept that expectancy value theory can be used to boost student perceptions of active learning and their engagement in active learning classrooms. From these findings, we have built a theoretical framework of expectancy value theory applied to active learning. PMID:28861130

Defining the value framework for prostate brachytherapy using patient-centered outcome metrics and time-driven activity-based costing.

PubMed

Thaker, Nikhil G; Pugh, Thomas J; Mahmood, Usama; Choi, Seungtaek; Spinks, Tracy E; Martin, Neil E; Sio, Terence T; Kudchadker, Rajat J; Kaplan, Robert S; Kuban, Deborah A; Swanson, David A; Orio, Peter F; Zelefsky, Michael J; Cox, Brett W; Potters, Louis; Buchholz, Thomas A; Feeley, Thomas W; Frank, Steven J

2016-01-01

Value, defined as outcomes over costs, has been proposed as a measure to evaluate prostate cancer (PCa) treatments. We analyzed standardized outcomes and time-driven activity-based costing (TDABC) for prostate brachytherapy (PBT) to define a value framework. Patients with low-risk PCa treated with low-dose-rate PBT between 1998 and 2009 were included. Outcomes were recorded according to the International Consortium for Health Outcomes Measurement standard set, which includes acute toxicity, patient-reported outcomes, and recurrence and survival outcomes. Patient-level costs to 1 year after PBT were collected using TDABC. Process mapping and radar chart analyses were conducted to visualize this value framework. A total of 238 men were eligible for analysis. Median age was 64 (range, 46-81). Median followup was 5 years (0.5-12.1). There were no acute Grade 3-5 complications. Expanded Prostate Cancer Index Composite 50 scores were favorable, with no clinically significant changes from baseline to last followup at 48 months for urinary incontinence/bother, bowel bother, sexual function, and vitality. Ten-year outcomes were favorable, including biochemical failure-free survival of 84.1%, metastasis-free survival 99.6%, PCa-specific survival 100%, and overall survival 88.6%. TDABC analysis demonstrated low resource utilization for PBT, with 41% and 10% of costs occurring in the operating room and with the MRI scan, respectively. The radar chart allowed direct visualization of outcomes and costs. We successfully created a visual framework to define the value of PBT using the International Consortium for Health Outcomes Measurement standard set and TDABC costs. PBT is associated with excellent outcomes and low costs. Widespread adoption of this methodology will enable value comparisons across providers, institutions, and treatment modalities. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Defining the Value Framework for Prostate Brachytherapy using Patient-Centered Outcome Metrics and Time-Driven Activity-Based Costing

PubMed Central

Thaker, Nikhil G.; Pugh, Thomas J.; Mahmood, Usama; Choi, Seungtaek; Spinks, Tracy E.; Martin, Neil E.; Sio, Terence T.; Kudchadker, Rajat J.; Kaplan, Robert S.; Kuban, Deborah A.; Swanson, David A.; Orio, Peter F.; Zelefsky, Michael J.; Cox, Brett W.; Potters, Louis; Buchholz, Thomas A.; Feeley, Thomas W.; Frank, Steven J.

2017-01-01

PURPOSE Value, defined as outcomes over costs, has been proposed as a measure to evaluate prostate cancer (PCa) treatments. We analyzed standardized outcomes and time-driven activity-based costing (TDABC) for prostate brachytherapy (PBT) to define a value framework. METHODS AND MATERIALS Patients with low-risk PCa treated with low-dose rate PBT between 1998 and 2009 were included. Outcomes were recorded according to the International Consortium for Health Outcomes Measurement (ICHOM) standard set, which includes acute toxicity, patient-reported outcomes, and recurrence and survival outcomes. Patient-level costs to one year after PBT were collected using TDABC. Process mapping and radar chart analyses were conducted to visualize this value framework. RESULTS A total of 238 men were eligible for analysis. Median age was 64 (range, 46–81). Median follow-up was 5 years (0.5–12.1). There were no acute grade 3–5 complications. EPIC-50 scores were favorable, with no clinically significant changes from baseline to last follow-up at 48 months for urinary incontinence/bother, bowel bother, sexual function, and vitality. Ten-year outcomes were favorable, including biochemical failure-free survival of 84.1%, metastasis-free survival 99.6%, PCa-specific survival 100%, and overall survival 88.6%. TDABC analysis demonstrated low resource utilization for PBT, with 41% and 10% of costs occurring in the operating room and with the MRI scan, respectively. The radar chart allowed direct visualization of outcomes and costs. CONCLUSIONS We successfully created a visual framework to define the value of PBT using the ICHOM standard set and TDABC costs. PBT is associated with excellent outcomes and low costs. Widespread adoption of this methodology will enable value comparisons across providers, institutions, and treatment modalities. PMID:26916105

A Framework for Enhancing Bird Habitat Value of Urban Greenspaces in the Woonasquatucket Watershed, Rhode Island, USA

EPA Science Inventory

Modifying greenspaces to enhance habitat value has been proposed as a means towards protecting or restoring biodiversity in urban landscapes. In this report, we provide a framework for developing low-cost, low-impact enhancements that can be incorporated during the restoration of...

Valuing Groundwater Resources in Arid Watersheds under Climate Change: A Framework and Estimates for the Upper Rio Grande

NASA Astrophysics Data System (ADS)

Hurd, B. H.; Coonrod, J.

2008-12-01

Climate change is expected to alter surface hydrology throughout the arid Western United States, in most cases compressing the period of peak snowmelt and runoff, and in some cases, for example, the Rio Grande, limiting total runoff. As such, climate change is widely expected to further stress arid watersheds, particularly in regions where trends in population growth, economic development and environmental regulation are current challenges. Strategies to adapt to such changes are evolving at various institutional levels including conjunctive management of surface and ground waters. Groundwater resources remain one of the key components of water management strategies aimed at accommodating continued population growth and mitigating the potential for water supply disruptions under climate change. By developing a framework for valuing these resources and for value improvements in the information pertaining to their characteristics, this research can assist in prioritizing infrastructure and investment to change and enhance water resource management. The key objective of this paper is to 1) develop a framework for estimating the value of groundwater resources and improved information, and 2) provide some preliminary estimates of this value and how it responds to plausible scenarios of climate change.

Challenges in the Clinical Application of the American Society of Clinical Oncology Value Framework: A Medicare Cost-Benefit Analysis in Chronic Lymphocytic Leukemia.

PubMed

Seymour, Erlene K; Schiffer, Charles A; de Souza, Jonas A

2017-12-01

The ASCO Value Framework calculates the value of cancer therapies. Given costly novel therapeutics for chronic lymphocytic leukemia, we used the framework to compare net health benefit (NHB) and cost within Medicare of all regimens listed in the National Comprehensive Cancer Network (NCCN) guidelines. The current NCCN guidelines for chronic lymphocytic leukemia were reviewed. All referenced studies were screened, and only randomized controlled prospective trials were included. The revised ASCO Value Framework was used to calculate NHB. Medicare drug pricing was used to calculate the cost of therapies. Forty-nine studies were screened. The following observations were made: only 10 studies (20%) could be evaluated; when comparing regimens studied against the same control arm, ranking NHB scores were comparable to their preference in guidelines; NHB scores varied depending on which variables were used, and there were no clinically validated thresholds for low or high values; treatment-related deaths were not weighted in the toxicity scores; and six of the 10 studies used less potent control arms, ranked as the least-preferred NCCN-recommended regimens. The ASCO Value Framework is an important initial step to quantify value of therapies. Essential limitations include the lack of clinically relevant validated thresholds for NHB scores and lack of incorporation of grade 5 toxicities/treatment-related mortality into its methodology. To optimize its application for clinical practice, we urge investigators/sponsors to incorporate and report the required variables to calculate the NHB of regimens and encourage trials with stronger comparator arms to properly quantify the relative value of therapies.

Replacing missing values using trustworthy data values from web data sources

NASA Astrophysics Data System (ADS)

Izham Jaya, M.; Sidi, Fatimah; Mat Yusof, Sharmila; Suriani Affendey, Lilly; Ishak, Iskandar; Jabar, Marzanah A.

2017-09-01

In practice, collected data usually are incomplete and contains missing value. Existing approaches in managing missing values overlook the importance of trustworthy data values in replacing missing values. In view that trusted completed data is very important in data analysis, we proposed a framework of missing value replacement using trustworthy data values from web data sources. The proposed framework adopted ontology to map data values from web data sources to the incomplete dataset. As data from web is conflicting with each other, we proposed a trust score measurement based on data accuracy and data reliability. Trust score is then used to select trustworthy data values from web data sources for missing values replacement. We successfully implemented the proposed framework using financial dataset and presented the findings in this paper. From our experiment, we manage to show that replacing missing values with trustworthy data values is important especially in a case of conflicting data to solve missing values problem.

The HTA Core Model®-10 Years of Developing an International Framework to Share Multidimensional Value Assessment.

PubMed

Kristensen, Finn Børlum; Lampe, Kristian; Wild, Claudia; Cerbo, Marina; Goettsch, Wim; Becla, Lidia

2017-02-01

The HTA Core Model ® as a science-based framework for assessing dimensions of value was developed as a part of the European network for Health Technology Assessment project in the period 2006 to 2008 to facilitate production and sharing of health technology assessment (HTA) information, such as evidence on efficacy and effectiveness and patient aspects, to inform decisions. It covers clinical value as well as organizational, economic, and patient aspects of technologies and has been field-tested in two consecutive joint actions in the period 2010 to 2016. A large number of HTA institutions were involved in the work. The model has undergone revisions and improvement after iterations of piloting and can be used in a local, national, or international context to produce structured HTA information that can be taken forward by users into their own frameworks to fit their specific needs when informing decisions on technology. The model has a broad scope and offers a common ground to various stakeholders through offering a standard structure and a transparent set of proposed HTA questions. It consists of three main components: 1) the HTA ontology, 2) methodological guidance, and 3) a common reporting structure. It covers domains such as effectiveness, safety, and economics, and also includes domains covering organizational, patient, social, and legal aspects. There is a full model and a focused rapid relative effectiveness assessment model, and a third joint action is to continue till 2020. The HTA Core Model is now available for everyone around the world as a framework for assessing value. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Developing a Value Framework: The Need to Reflect the Opportunity Costs of Funding Decisions.

PubMed

Sculpher, Mark; Claxton, Karl; Pearson, Steven D

2017-02-01

A growing number of health care systems internationally use formal economic evaluation methods to support health care funding decisions. Recently, a range of organizations have been advocating forms of analysis that have been termed "value frameworks." There has also been a push for analytical methods to reflect a fuller range of benefits of interventions through multicriteria decision analysis. A key principle that is invariably neglected in current and proposed frameworks is the need to reflect evidence on the opportunity costs that health systems face when making funding decisions. The mechanisms by which opportunity costs are realized vary depending on the system's financial arrangements, but they always mean that a decision to fund a specific intervention for a particular patient group has the potential to impose costs on others in terms of forgone benefits. These opportunity costs are rarely explicitly reflected in analysis to support decisions, but recent developments to quantify benefits forgone make more appropriate analyses feasible. Opportunity costs also need to be reflected in decisions if a broader range of attributes of benefit is considered, and opportunity costs are a key consideration in determining the appropriate level of total expenditure in a system. The principles by which opportunity costs can be reflected in analysis are illustrated in this article by using the example of the proposed methods for value-based pricing in the United Kingdom. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

A framework for interval-valued information system

NASA Astrophysics Data System (ADS)

Yin, Yunfei; Gong, Guanghong; Han, Liang

2012-09-01

Interval-valued information system is used to transform the conventional dataset into the interval-valued form. To conduct the interval-valued data mining, we conduct two investigations: (1) construct the interval-valued information system, and (2) conduct the interval-valued knowledge discovery. In constructing the interval-valued information system, we first make the paired attributes in the database discovered, and then, make them stored in the neighbour locations in a common database and regard them as 'one' new field. In conducting the interval-valued knowledge discovery, we utilise some related priori knowledge and regard the priori knowledge as the control objectives; and design an approximate closed-loop control mining system. On the implemented experimental platform (prototype), we conduct the corresponding experiments and compare the proposed algorithms with several typical algorithms, such as the Apriori algorithm, the FP-growth algorithm and the CLOSE+ algorithm. The experimental results show that the interval-valued information system method is more effective than the conventional algorithms in discovering interval-valued patterns.

The Instrumental Value of Conceptual Frameworks in Educational Technology Research

ERIC Educational Resources Information Center

Antonenko, Pavlo D.

2015-01-01

Scholars from diverse fields and research traditions agree that the conceptual framework is a critically important component of disciplined inquiry. Yet, there is a pronounced lack of shared understanding regarding the definition and functions of conceptual frameworks, which impedes our ability to design effective research and mentor novice…

Value-focused framework for defining landscape-scale conservation targets

USGS Publications Warehouse

Romañach, Stephanie; Benscoter, Allison M.; Brandt, Laura A.

2016-01-01

Conservation of natural resources can be challenging in a rapidly changing world and require collaborative efforts for success. Conservation planning is the process of deciding how to protect, conserve, and enhance or minimize loss of natural and cultural resources. Establishing conservation targets (also called indicators or endpoints), the measurable expressions of desired resource conditions, can help with site-specific up to landscape-scale conservation planning. Using conservation targets and tracking them through time can deliver benefits such as insight into ecosystem health and providing early warnings about undesirable trends. We describe an approach using value-focused thinking to develop statewide conservation targets for Florida. Using such an approach allowed us to first identify stakeholder objectives and then define conservation targets to meet those objectives. Stakeholders were able to see how their shared efforts fit into the broader conservation context, and also anticipate the benefits of multi-agency and -organization collaboration. We developed an iterative process for large-scale conservation planning that included defining a shared framework for the process, defining the conservation targets themselves, as well as developing management and monitoring strategies for evaluation of their effectiveness. The process we describe is applicable to other geographies where multiple parties are seeking to implement collaborative, large-scale biological planning.

Looking Under the Streetlight? A Framework for Differentiating Performance Measures by Level of Care in a Value-Based Payment Environment

PubMed Central

Van Such, Monica B.; Nesse, Robert E.; Dilling, James A.; Swensen, Stephen J.; Thompson, Kristine M.; Orlowski, Janis M.; Santrach, Paula J.

2017-01-01

The majority of quality measures used to assess providers and hospitals are based on easily obtained data, focused on a few dimensions of quality, and developed mainly for primary/community care and population health. While this approach supports efforts focused on addressing the triple aim of health care, many current quality report cards and assessments do not reflect the breadth or complexity of many referral center practices. In this article, the authors highlight the differences between population health efforts and referral care and address issues related to value measurement and performance assessment. They discuss why measures may need to differ across the three levels of care (primary/community care, secondary care, complex care) and illustrate the need for further risk adjustment to eliminate referral bias. With continued movement toward value-based purchasing, performance measures and reimbursement schemes need to reflect the increased level of intensity required to provide complex care. The authors propose a framework to operationalize value measurement and payment for specialty care, and they make specific recommendations to improve performance measurement for complex patients. Implementing such a framework to differentiate performance measures by level of care involves coordinated efforts to change both policy and operational platforms. An essential component of this framework is a new model that defines the characteristics of patients who require complex care and standardizes metrics that incorporate those definitions. PMID:28353502

Looking Under the Streetlight? A Framework for Differentiating Performance Measures by Level of Care in a Value-Based Payment Environment.

PubMed

Naessens, James M; Van Such, Monica B; Nesse, Robert E; Dilling, James A; Swensen, Stephen J; Thompson, Kristine M; Orlowski, Janis M; Santrach, Paula J

2017-07-01

The majority of quality measures used to assess providers and hospitals are based on easily obtained data, focused on a few dimensions of quality, and developed mainly for primary/community care and population health. While this approach supports efforts focused on addressing the triple aim of health care, many current quality report cards and assessments do not reflect the breadth or complexity of many referral center practices.In this article, the authors highlight the differences between population health efforts and referral care and address issues related to value measurement and performance assessment. They discuss why measures may need to differ across the three levels of care (primary/community care, secondary care, complex care) and illustrate the need for further risk adjustment to eliminate referral bias.With continued movement toward value-based purchasing, performance measures and reimbursement schemes need to reflect the increased level of intensity required to provide complex care. The authors propose a framework to operationalize value measurement and payment for specialty care, and they make specific recommendations to improve performance measurement for complex patients. Implementing such a framework to differentiate performance measures by level of care involves coordinated efforts to change both policy and operational platforms. An essential component of this framework is a new model that defines the characteristics of patients who require complex care and standardizes metrics that incorporate those definitions.

Developing a framework to guide the de-adoption of low-value clinical practices in acute care medicine: a study protocol.

PubMed

Parsons Leigh, Jeanna; Niven, Daniel J; Boyd, Jamie M; Stelfox, Henry T

2017-01-19

Healthcare systems have difficulty incorporating scientific evidence into clinical practice, especially when science suggests that existing clinical practices are of low-value (e.g. ineffective or harmful to patients). While a number of lists outlining low-value practices in acute care medicine currently exist, less is known about how best to initiate and sustain the removal of low-value clinical practices (i.e. de-adoption). This study will develop a comprehensive list of barriers and facilitators to the de-adoption of low-value clinical practices in acute care facilities to inform the development of a framework to guide the de-adoption process. The proposed project is a multi-stage mixed methods study to develop a framework to guide the de-adoption of low-value clinical practices in acute care medicine that will be tested in a representative sample of acute care settings in Alberta, Canada. Specifically, we will: 1) conduct a systematic review of the de-adoption literature to identify published barriers and facilitators to the de-adoption of low-value clinical practices in acute care medicine and any associated interventions proposed (Phase one); 2) conduct focus groups with acute care stakeholders to identify important themes not published in the literature and obtain a comprehensive appreciation of stakeholder perspectives (Phase two); 3) extend the generalizability of focus group findings by conducting individual stakeholder surveys with a representative sample of acute care providers throughout the province to determine which barriers and facilitators identified in Phases one and two are most relevant in their clinical setting (Phase three). Identified barriers and facilitators will be catalogued and integrated with targeted interventions in a framework to guide the process of de-adoption in each of four targeted areas of acute care medicine (Emergency Medicine, Cardiovascular Health and Stroke, Surgery and Critical Care Medicine). Analyses will be

The Crystal Structure of Cobra Venom Factor, a Cofactor for C3- and C5-Convertase CVFBb

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

Krishnan, Vengadesan; Ponnuraj, Karthe; Xu, Yuanyuan

2009-05-26

Cobra venom factor (CVF) is a functional analog of human complement component C3b, the active fragment of C3. Similar to C3b, in human and mammalian serum, CVF binds factor B, which is then cleaved by factor D, giving rise to the CVFBb complex that targets the same scissile bond in C3 as the authentic complement convertases C4bC2a and C3bBb. Unlike the latter, CVFBb is a stable complex and an efficient C5 convertase. We solved the crystal structure of CVF, isolated from Naja naja kouthia venom, at 2.6 {angstrom} resolution. The CVF crystal structure, an intermediate between C3b and C3c, lacksmore » the TED domain and has the CUB domain in an identical position to that seen in C3b. The similarly positioned CUB and slightly displaced C345c domains of CVF could play a vital role in the formation of C3 convertases by providing important primary binding sites for factor B.« less

The crystal structure of cobra venom factor, a cofactor for C3- and C5-convertase CVFBb.

PubMed

Krishnan, Vengadesan; Ponnuraj, Karthe; Xu, Yuanyuan; Macon, Kevin; Volanakis, John E; Narayana, Sthanam V L

2009-04-15

Cobra venom factor (CVF) is a functional analog of human complement component C3b, the active fragment of C3. Similar to C3b, in human and mammalian serum, CVF binds factor B, which is then cleaved by factor D, giving rise to the CVFBb complex that targets the same scissile bond in C3 as the authentic complement convertases C4bC2a and C3bBb. Unlike the latter, CVFBb is a stable complex and an efficient C5 convertase. We solved the crystal structure of CVF, isolated from Naja naja kouthia venom, at 2.6 A resolution. The CVF crystal structure, an intermediate between C3b and C3c, lacks the TED domain and has the CUB domain in an identical position to that seen in C3b. The similarly positioned CUB and slightly displaced C345c domains of CVF could play a vital role in the formation of C3 convertases by providing important primary binding sites for factor B.

Team Attributes, Processes, and Values: A Pedagogical Framework

ERIC Educational Resources Information Center

Keyton, Joann; Beck, Stephenson J.

2008-01-01

This article proposes a pedagogical framework to help students analyze their group and team interactions. Intersecting five fundamental group attributes (group size, group goal, group member interdependence, group structure, and group identity) with three overarching group processes (leadership, decision making, and conflict management) creates an…

Human cervicovaginal fluid biomarkers to predict term and preterm labor

PubMed Central

Heng, Yujing J.; Liong, Stella; Permezel, Michael; Rice, Gregory E.; Di Quinzio, Megan K. W.; Georgiou, Harry M.

2015-01-01

Preterm birth (PTB; birth before 37 completed weeks of gestation) remains the major cause of neonatal morbidity and mortality. The current generation of biomarkers predictive of PTB have limited utility. In pregnancy, the human cervicovaginal fluid (CVF) proteome is a reflection of the local biochemical milieu and is influenced by the physical changes occurring in the vagina, cervix and adjacent overlying fetal membranes. Term and preterm labor (PTL) share common pathways of cervical ripening, myometrial activation and fetal membranes rupture leading to birth. We therefore hypothesize that CVF biomarkers predictive of labor may be similar in both the term and preterm labor setting. In this review, we summarize some of the existing published literature as well as our team's breadth of work utilizing the CVF for the discovery and validation of putative CVF biomarkers predictive of human labor. Our team established an efficient method for collecting serial CVF samples for optimal 2-dimensional gel electrophoresis resolution and analysis. We first embarked on CVF biomarker discovery for the prediction of spontaneous onset of term labor using 2D-electrophoresis and solution array multiple analyte profiling. 2D-electrophoretic analyses were subsequently performed on CVF samples associated with PTB. Several proteins have been successfully validated and demonstrate that these biomarkers are associated with term and PTL and may be predictive of both term and PTL. In addition, the measurement of these putative biomarkers was found to be robust to the influences of vaginal microflora and/or semen. The future development of a multiple biomarker bed-side test would help improve the prediction of PTB and the clinical management of patients. PMID:26029118

A single competency-based education and training and competency-based career framework for the Australian health workforce: discussing the potential value add.

PubMed

Brownie, Sharon Mary; Thomas, Janelle

2014-09-01

This brief discusses the policy implications of a research study commissioned by Health Workforce Australia (HWA) within its health workforce innovation and reform work program. The project explored conceptually complex and operationally problematic concepts related to developing a whole-of-workforce competency-based education and training and competency-based career framework for the Australian health workforce and culminated with the production of three reports published by HWA. The project raised important queries as to whether such a concept is desirable, feasible or implementable - in short what is the potential value add and is it achievable? In setting the scene for discussion, the foundation of the project's genesis and focus of the study are highlighted. A summary of key definitions related to competency-based education and training frameworks and competency-based career frameworks are provided to further readers' commonality of understanding. The nature of the problem to be solved is explored and the potential value-add for the Australian health workforce and its key constituents proposed. The paper concludes by discussing relevance and feasibility issues within Australia's current and changing healthcare context along with the essential steps and implementation realities that would need to be considered and actioned if whole-of-workforce frameworks were to be developed and implemented.

A single competency-based education and training and competency-based career framework for the Australian health workforce: discussing the potential value add

PubMed Central

Brownie, Sharon Mary; Thomas, Janelle

2014-01-01

This brief discusses the policy implications of a research study commissioned by Health Workforce Australia (HWA) within its health workforce innovation and reform work program. The project explored conceptually complex and operationally problematic concepts related to developing a whole-of-workforce competency-based education and training and competency-based career framework for the Australian health workforce and culminated with the production of three reports published by HWA. The project raised important queries as to whether such a concept is desirable, feasible or implementable – in short what is the potential value add and is it achievable? In setting the scene for discussion, the foundation of the project’s genesis and focus of the study are highlighted. A summary of key definitions related to competency-based education and training frameworks and competency-based career frameworks are provided to further readers’ commonality of understanding. The nature of the problem to be solved is explored and the potential value-add for the Australian health workforce and its key constituents proposed. The paper concludes by discussing relevance and feasibility issues within Australia’s current and changing healthcare context along with the essential steps and implementation realities that would need to be considered and actioned if whole-of-workforce frameworks were to be developed and implemented. PMID:25279384

Effect of complement depletion by cobra venom factor on fowlpox virus infection in chickens and chicken embryos.

PubMed Central

Ohta, H; Yoshikawa, Y; Kai, C; Yamanouchi, K; Taniguchi, H; Komine, K; Ishijima, Y; Okada, H

1986-01-01

The course of infection with an attenuated strain of fowlpox virus (FPV), which is known to induce antibody-independent activation of complement via the alternative pathway, was investigated in 1- to 3-day-old chickens and 14-day-old chicken embryos by treatment with cobra venom factor (CVF). CVF was found to inhibit complement activity transiently via the alternative pathway but not via the classical pathway. In chickens treated with CVF, virus growth in the skin was enhanced, and pock lesions tended to disseminate, leading to fatal infection in some birds. Histologically, an acute inflammation at an early stage of infection (within 3 days) was inhibited, and virus content in the pock lesion was increased. In chicken embryos with immature immune capacities, CVF treatment caused changes in pock morphology from clear pocks to diffuse ones, an increase in virus content in the pock, and inhibition of cell infiltration. Thus, FPV infection was aggravated in both CVF-treated chickens and chicken embryos. These results are discussed in relation to roles of complement in the elimination of virus at an early stage of FPV infection. Images PMID:3003397

Individual performance review in hospital practice: the development of a framework and evaluation of doctors' attitudes to its value and implementation.

PubMed

Trebble, T M; Cruickshank, L; Hockey, P M; Heyworth, N; Powell, T; Clarke, N

2013-11-01

Appraisal, or independent performance review (IPR) is used in human resources management in the commercial and public sectors to evaluate the performance of an employee against agreed local organisational expectations and objectives, and to identify their requirements for development and effective management. IPR for NHS consultants may provide essential information for job planning, contribute towards medical appraisal for revalidation, and facilitate productivity and quality improvement. To develop a framework for IPR for consultants, and to determine attitudes on its value, process and content. Information from commercial, public and voluntary sector models and published and other literature sources were used to develop an IPR framework. This was assessed through a three-cycle action research methodology involving qualitative interviews with 22 consultants (predominantly with medical management roles). The domains of the IPR framework included: (1) performance against objectives; (2) behaviour and leadership; (3) talent management; (4) agreed future objectives. A number of themes were identified from the consultant interviews including: ineffective current appraisal systems reflecting a lack of valid performance data and allotted time; a lack of empowerment of medical managers to address performance issues; IPR as a more explicit system, offering value in evaluating doctors performance; and the dependence of successful implementation on the engagement of the Trust executive. IPR may have value for performance evaluation of consultants, contributing toward job planning and complementing medical appraisal. Support by their employing organisation and engagement with medical managers in design and implementation is likely to be essential.

Shared Values, Particular Values, and Education for a Multicultural Society.

ERIC Educational Resources Information Center

Singh, Basil R.

1995-01-01

Within the framework of liberal democratic values are shared (universal) values and particular cultural values. Social harmony depends on integrating these two sets of values. The role of multicultural education is to stress cultural development rather than cultural maintenance while adhering to principles of inclusion. (SK)

Examining the Value of a Scaffolded Critique Framework to Promote Argumentative and Explanatory Writings within an Argument-Based Inquiry Approach

ERIC Educational Resources Information Center

Jang, Jeong-yoon; Hand, Brian

2017-01-01

This study investigated the value of using a scaffolded critique framework to promote two different types of writing--argumentative writing and explanatory writing--with different purposes within an argument-based inquiry approach known as the Science Writing Heuristic (SWH) approach. A quasi-experimental design with sixth and seventh grade…

Emerging Good Practices for Transforming Value Assessment: Patients' Voices, Patients' Values.

PubMed

Perfetto, Eleanor M; Harris, Jason; Mullins, C Daniel; dosReis, Susan

2018-04-01

Patient engagement is a transformative strategy for improving value assessment. US value framework developers have increased engagement activities, but more needs to be learned about how to best achieve meaningful patient engagement in value assessment. The objective was to glean good practices in patient engagement emerging from patient community experiences, to be used in value assessment. The National Health Council Value Workgroup conducted a survey and held a focus group with its member advocacy organizations to gather experiences with value framework developers and views on emerging good practices. Ten of 13 organizations completed the survey; reporting 13 interactions with four framework developers. Most rated experiences as "good" to "very good." Emerging good practices included (1) engage early; (2) engage a range of patients; (3) leverage patient-provided information, data resources, and outreach mechanisms; (4) be transparent; and (5) appreciate and accommodate resource constraints. Twelve of 13 organizations participated in the focus group, and this produced 30 emerging good practices in four areas: (1) timing; (2) methodology and data; (3) partnering; and (4) characterizing engagement. Patient engagement was limited in early development of value frameworks but has increased in the past few years. Patient groups report positive experiences that can serve as emerging good practices. These groups also reported experienced challenges in their interactions and recommended good practices to mitigate those challenges. The growing pool of patient engagement experiences can be translated into good practices to advance a patient-centered, value-driven health care ecosystem. Lessons learned from these early experiences can help establish recommend emerging good practices that can eventually result in best practices and standards in the field. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc

Leading Change, Adding Value.

PubMed

Evans, Nick

2016-07-01

Essential facts Leading Change, Adding Value is NHS England's new nursing and midwifery framework. It builds on Compassion in Practice (CiP), which set out the 6Cs. While CiP established the values of nursing and midwifery, the new framework explains how staff can help transform the health and care sectors to meet the aims of NHS England's Five Year Forward View.

Educational Goods and Values: A Framework for Decision Makers

ERIC Educational Resources Information Center

Brighouse, Harry; Ladd, Helen F.; Loeb, Susanna; Swift, Adam

2016-01-01

This article articulates a framework suitable for use when making decisions about education policy. Decision makers should establish what the feasible options are and evaluate them in terms of their contribution to the development, and distribution, of educational goods in children, balanced against the negative effect of policies on important…

A Dynamic Simulation Model of Organizational Culture and Business Strategy Effects on Performance

NASA Astrophysics Data System (ADS)

Trivellas, Panagiotis; Reklitis, Panagiotis; Konstantopoulos, Nikolaos

2007-12-01

In the past two decades, organizational culture literature has gained tremendous interest for both academic and practitioners. This is based not only on the suggestion that culture is related to performance, but also on the view that it is subject of direct managerial control and manipulation to the desired direction. In the present paper, we adopt Competing Values Framework (CVF) to operationalise organizational culture and Porter's typology to conceptualize business strategy (cost leadership, innovative and marketing differentiation, and focus). Although simulation of social events is a quite difficult task, since there are so many considerations (not all well understood) involved, in the present study we developed a dynamic model to simulate the organizational culture and strategy effects on financial performance. Data obtained from a six-year survey in the banking sector of a European developing economy was used for the proposed dynamic model development.

42 CFR 23.25 - How will interest rates for loans be determined?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false How will interest rates for loans be determined? 23... will interest rates for loans be determined? Interest will be charged at the Treasury Current Value of Funds (CVF) rate in effect on April 1 immediately preceding the date on which the loan is approved and...

Leading Change, Adding Value.

PubMed

Evans, Nick

2016-07-06

Essential facts Leading Change, Adding Value is NHS England's new nursing and midwifery framework. It builds on Compassion in Practice (CiP), which set out the 6Cs. While CiP established the values of nursing and midwifery, the new framework explains how staff can help transform the health and care sectors to meet the aims of the NHS England's Five Year Forward View.

Values based practice: a framework for thinking with.

PubMed

Mohanna, Kay

2017-07-01

Values are those principles that govern behaviours, and values-based practice has been described as a theory and skills base for effective healthcare decision-making where different (and hence potentially conflicting) values are in play. The emphasis is on good process rather than pre-set right outcomes, aiming to achieve balanced decision-making. In this article we will consider the utility of this model by looking at leadership development, a current area of much interest and investment in healthcare. Copeland points out that 'values based leadership behaviors are styles with a moral, authentic and ethical dimension', important qualities in healthcare decision-making.

How to Invest in Getting Cost-effective Technologies into Practice? A Framework for Value of Implementation Analysis Applied to Novel Oral Anticoagulants.

PubMed

Faria, Rita; Walker, Simon; Whyte, Sophie; Dixon, Simon; Palmer, Stephen; Sculpher, Mark

2017-02-01

Cost-effective interventions are often implemented slowly and suboptimally in clinical practice. In such situations, a range of implementation activities may be considered to increase uptake. A framework is proposed to use cost-effectiveness analysis to inform decisions on how best to invest in implementation activities. This framework addresses 2 key issues: 1) how to account for changes in utilization in the future in the absence of implementation activities; and 2) how to prioritize implementation efforts between subgroups. A case study demonstrates the framework's application: novel oral anticoagulants (NOACs) for the prevention of stroke in the National Health Service in England and Wales. The results suggest that there is value in additional implementation activities to improve uptake of NOACs, particularly in targeting patients with average or poor warfarin control. At a cost-effectiveness threshold of £20,000 per quality-adjusted life-year (QALY) gained, additional investment in an educational activity that increases the utilization of NOACs by 5% in all patients currently taking warfarin generates an additional 254 QALYs, compared with 973 QALYs in the subgroup with average to poor warfarin control. However, greater value could be achieved with higher uptake of anticoagulation more generally: switching 5% of patients who are potentially eligible for anticoagulation but are currently receiving no treatment or are using aspirin would generate an additional 4990 QALYs. This work can help health services make decisions on investment at different points of the care pathway or across disease areas in a manner consistent with the value assessment of new interventions.

Impact of physical activity and cardiovascular fitness on total homocysteine concentrations in European adolescents: The HELENA study.

PubMed

Benser, Jasmin; Valtueña, Jara; Ruiz, Jonatan R; Mielgo-Ayuso, Juan; Breidenassel, Christina; Vicente-Rodriguez, German; Ferrari, Marika; Widhalm, Kurt; Manios, Yannis; Sjöström, Michael; Molnar, Denes; Gómez-Martínez, Sonia; Kafatos, Antony; Palacios, Gonzalo; Moreno, Luis A; Castillo, Manuel J; Stehle, Peter; González-Gross, Marcela

2015-01-01

We examined the association of physical activity (PA), cardiovascular fitness (CVF) and fatness with total homocysteine (tHcy) concentrations in European adolescents. The present study comprised 713 European adolescents aged 14.8 ± 1.2 y (females 55.3%) from the multicenter HELENA cross-sectional study. PA was assessed through accelerometry, CVF by the 20-m shuttle run test, and body fat by skinfold thicknesses with the Slaughter equation. Plasma folate, cobalamin, and tHcy concentrations were measured. To examine the association of tHcy with PA, CVF, and fatness after controlling for a set of confounders including age, maturity, folate, cobalamin, creatinine, smoking, supplement use, and methylenetetrahydrofolate reductase 677 genotype (CC 47%, CT 43%, TT 10%), bivariate correlations followed by multiple regression models were performed. In the bivariate correlation analysis, tHcy concentrations were slightly negatively correlated (p<0.05) with CVF in females (measured both by stages: r=-0.118 and by VO2max: r=-0.102) and positively with body mass index (r=0.100). However, daily time spent with moderate and vigorous PA showed a weak positive association with tHcy in females (p<0.05). tHcy concentrations showed a tendency to decrease with increasing CVF and increase with increasing BMI in female European adolescents. However, tHcy concentrations were positively associated with moderate and vigorous PA in female European adolescents.

A conceptual framework for characterizing forest areas with high societal values: experiences from the Pacific Northwest of USA and Central Europe

Treesearch

Tina Simonèiè; Thomas A. Spies; Robert L. Deal; Andrej Bonèina

2015-01-01

In recent decades, much work has been invested to describe forest allocations with high societal values. Yet, few comparative analyses have been conducted on their importance and differences across the regions of the globe. This paper introduces a conceptual framework to characterize forest priority areas defined as areas with identified higher importance of societal...

Transitivity analysis: a framework for the study of social values in the context of points of view.

PubMed

Tsirogianni, Stavroula; Sammut, Gordon

2014-09-01

Since its inception, psychology has struggled with issues of conceptualization and operationalization of social-psychological phenomena. The study of social values and points of view has been prone to such difficulties, despite a predominant concern of qualitative distinctions in the variability of both of these phenomena across different individuals and social groups. And while interest in both traces a common origin in Rokeach's studies of narrow mindedness, the study of both phenomena has since proceeded apace. In this study, we posit a renewed reconciliation between the two that is best served through a social-psychological model of points of view in terms of the values that inspire them. We draw on critical linguistics to propose a theoretical and methodological framework that can aid a systematic study of value structures as they take different forms and meanings through particular types of points of view. In five stages of qualitative analysis, the model deconstructs utterances into distinct terms that reveal a predominant perspective-taking style that can be utilized towards the categorization of different points of view, in terms of values that imbue them and that serve to provide them with a coherent angle of constructing a particular narrative. © 2013 The British Psychological Society.

Prospective BMI category change associated with cardiovascular fitness change

USDA-ARS?s Scientific Manuscript database

The relationship of change in body mass index (BMI) percentile score group (from 6th to 8th grade) with change in cardiovascular fitness (CVF), baseline BMI z-score and CVF was tested. 3,998 (92%) children in the HEALTHY trial provided complete data at the beginning of 6th and end of 8th grades. Hei...

Phosphorus and other trace elements from secondary olivine in composite mantle xenoliths (CMX) from Cima Volcanic Field (CVF; California, USA): implications for crystal growth kinetics

NASA Astrophysics Data System (ADS)

Baziotis, Ioannis; Asimow, Paul; Ntaflos, Theodoros; Boyce, Jeremy; Koroneos, Antonios; Perugini, Diego; Liu, Yongsheng; Klemme, Stephan; Berndt, Jasper

2015-04-01

Phosphorus(P)-rich zones in olivine may reflect excess incorporation of P during rapid growth; zoning patterns may then record growth rate variations (Milman-Barris et al., 2008; Stolper et al., 2009). We report data on interior cuts of two CMX from alkali basalt flows (Mukasa & Wilshire, 1997) in the CVF with second-generation P-rich olivines. In Ci-1-196, a dark layer (~200 μm wide) between lherzolite and websterite is interpreted as a rapidly crystallized melt layer (ML), consisting of Ol+Gl+Pl+Spl+Cpx+Ap+Ilm. Glass (~15 vol%) is variable in composition (P2O5 ≤1.2 wt%, Li 8.22-20.0 ppm). Olivines in the layer have 0.03-0.62 wt% P2O5; P-rich Ol (P2O5 >0.1 wt%) are Fo85-89.3. The lowest P concentrations are consistent with equilibrium with liquid parental to Gl, but the higher concentrations are not. Li concentrations, zoned from 3.84 to 4.90 ppm (core-rim), indicate equilibrium incorporation during crystal growth from a small, evolving melt pool and preservation of this rapidly relaxing gradient. REEs are mostly consistent with equilibrium growth from liquids evolving towards the observed LREE-enriched glass. Most of the clinopyroxenes are diopsides with some augites. Apatite inclusions occur in the rim of P-rich Fo85 and in An54. In Ki-5-301, a dark-coloured area of irregular shape (~200 μm wide) is present along the contact between lherzolite and orthopyroxenite, consisting of Ol+Pl+Gl+Cpx+Spl+Ilm+Ap. It resembles a tabular dyke but is connected to melt-patches infiltrating the host rock. Widespread Glass in the layer has variable composition with two populations not related by fractional crystallization: 1) P2O5 1.02-1.09 wt% and 2) P2O51.62-2.35 wt% (a Gl inclusion in Ol has P2O5 3.57 wt% may have captured melt from the P-rich boundary layer at the interface with the rapidly growing olivine). REEs cluster in the same two groups. Li is as low as 3.66 ppm group 1 and 3-4× higher (9.64-13.3 ppm) in group 2. Olivine occurs as small idiomorphic crystals

Framework for the Future

ERIC Educational Resources Information Center

Schuller, Tom

2008-01-01

The main goal of the Inquiry into the Future for Lifelong Learning is to provide a "strategic framework" for the future. In this article, the author considers the key components that will make up the framework. These are: (1) a statement of vision and values; (2) a stock-take of the current position; (3) an "investment…

A clustering-based graph Laplacian framework for value function approximation in reinforcement learning.

PubMed

Xu, Xin; Huang, Zhenhua; Graves, Daniel; Pedrycz, Witold

2014-12-01

In order to deal with the sequential decision problems with large or continuous state spaces, feature representation and function approximation have been a major research topic in reinforcement learning (RL). In this paper, a clustering-based graph Laplacian framework is presented for feature representation and value function approximation (VFA) in RL. By making use of clustering-based techniques, that is, K-means clustering or fuzzy C-means clustering, a graph Laplacian is constructed by subsampling in Markov decision processes (MDPs) with continuous state spaces. The basis functions for VFA can be automatically generated from spectral analysis of the graph Laplacian. The clustering-based graph Laplacian is integrated with a class of approximation policy iteration algorithms called representation policy iteration (RPI) for RL in MDPs with continuous state spaces. Simulation and experimental results show that, compared with previous RPI methods, the proposed approach needs fewer sample points to compute an efficient set of basis functions and the learning control performance can be improved for a variety of parameter settings.

Understanding the medical and nonmedical value of diagnostic testing.

PubMed

Lee, David W; Neumann, Peter J; Rizzo, John A

2010-01-01

To develop a framework for defining the potential value of diagnostic testing, and discuss its implications for the health-care delivery system. We reviewed the conceptual and empirical literature related to the valuing of diagnostic tests, and used this information to create a framework for characterizing their value. We then made inferences about the impact of this framework on health insurance coverage, health technology assessment, physician-patient relationships, and public health policy. Three dimensions can effectively classify the potential value created by diagnostic tests: 1) medical value (impact on treatment decisions); 2) planning value (affect on patients' ability to make better life decisions); and 3) psychic value (how test information affects patients' sense of self). This comprehensive framework for valuing diagnostics suggests that existing health technology assessments may systematically under- or overvalue diagnostics, leading to potentially incorrect conclusions about cost-effectiveness. Further, failure to account for all value dimensions may lead to distorted payments under a value-based health-care system. The potential value created by medical diagnostics incorporates medical value as well as value associated with well-being and planning. Consideration of all three dimensions has important implications for technology assessment and value-based payment.

Leading Change, Adding Value.

PubMed

Evans, Nick

2016-09-12

Essential facts Leading Change, Adding Value is NHS England's new nursing and midwifery framework. It is designed to build on Compassion in Practice (CiP), which was published 3 years ago and set out the 6Cs: compassion, care, commitment, courage, competence and communication. CiP established the values at the heart of nursing and midwifery, while the new framework sets out how staff can help transform the health and care sectors to meet the aims of the NHS England's Five Year Forward View.

Leveraging the real value of laboratory medicine with the value proposition.

PubMed

Price, Christopher P; John, Andrew St; Christenson, Robert; Scharnhorst, Volker; Oellerich, Michael; Jones, Patricia; Morris, Howard A

2016-11-01

Improving quality and patient safety, containing costs and delivering value-for-money are the key drivers of change in the delivery of healthcare and have stimulated a shift from an activity-based service to a service based on patient-outcomes. The delivery of an outcomes-based healthcare agenda requires that the real value of laboratory medicine to all stakeholders be understood, effectively defined and communicated. The value proposition of any product or service is the link between the provider and the needs of the customer describing the utility of the product or service in terms of benefit to the customer. The framework of a value proposition for laboratory medicine provides the core business case that drives key activities in the evolution and maintenance of high quality healthcare from research through to adoption and quality improvement in an established service. The framework of a value proposition for laboratory medicine is described. The content is endorsed by IFCC and WASPaLM. Copyright © 2016 Elsevier B.V. All rights reserved.

Variability Studies of Two Prunus-Infecting Fabaviruses with the Aid of High-Throughput Sequencing

PubMed Central

Sarkisova, Tatiana; Lenz, Ondřej; Přibylová, Jaroslava; Špak, Josef; Lotos, Leonidas; Beta, Christina; Katsiani, Asimina; Candresse, Thierry

2018-01-01

During their lifetime, perennial woody plants are expected to face multiple infection events. Furthermore, multiple genotypes of individual virus species may co-infect the same host. This may eventually lead to a situation where plants harbor complex communities of viral species/strains. Using high-throughput sequencing, we describe co-infection of sweet and sour cherry trees with diverse genomic variants of two closely related viruses, namely prunus virus F (PrVF) and cherry virus F (CVF). Both viruses are most homologous to members of the Fabavirus genus (Secoviridae family). The comparison of CVF and PrVF RNA2 genomic sequences suggests that the two viruses may significantly differ in their expression strategy. Indeed, similar to comoviruses, the smaller genomic segment of PrVF, RNA2, may be translated in two collinear proteins while CVF likely expresses only the shorter of these two proteins. Linked with the observation that identity levels between the coat proteins of these two viruses are significantly below the family species demarcation cut-off, these findings support the idea that CVF and PrVF represent two separate Fabavirus species. PMID:29670059

Colonization of the cervicovaginal space with Gardnerella vaginalis leads to local inflammation and cervical remodeling in pregnant mice.

PubMed

Sierra, Luz-Jeannette; Brown, Amy G; Barilá, Guillermo O; Anton, Lauren; Barnum, Carrie E; Shetye, Snehal S; Soslowsky, Louis J; Elovitz, Michal A

2018-01-01

The role of the cervicovaginal (CV) microbiome in regulating cervical function during pregnancy is poorly understood. Gardnerella vaginalis (G. vaginalis) is the most common bacteria associated with the diagnosis of bacterial vaginosis (BV). While BV has been associated with preterm birth (PTB), clinical trials targeting BV do not decrease PTB rates. It remains unknown if G. vaginalis is capable of triggering molecular, biomechanical and cellular events that could lead to PTB. The objective of this study was to determine if cervicovaginal colonization with G. vaginalis, in pregnant mice, induced cervical remodeling and modified cervical function. CD-1 timed-pregnant mice received a 5X108 CFU/mL intravaginal inoculation of G. vaginalis or control on embryonic day 12 (E12) and E13. On E15, the mice were sacrificed and cervicovaginal fluid (CVF), amniotic fluid (AF), cervix, uterus, placentas and fetal membranes (FM) were collected. Genomic DNA was isolated from the CVF, placenta, uterus and FM and QPCR was performed to confirm colonization. IL-6 was measured in the CVF and AF and soluble e-cadherin (seCAD) was assessed in the CVF by ELISA. RNA was extracted from the cervices to evaluate IL-10, IL-8, IL-1β, TNF-α, Tff-1, SPINK-5, HAS-1 and LOX expression via QPCR. Mucicarmine and trichrome staining was used to assess cervical mucin and collagen. Biomechanical properties of the cervix were studied using quasi-static tensile load-to-failure biomechanical tests. G. vaginalis successfully colonized the CV space. This colonization induced immune responses (increased IL-6 levels in CVF and AF, increased mRNA expression of cervical cytokines), altered the epithelial barrier (increased seCAD in the CVF), induced cervical remodeling (increased mucin production, altered collagen) and altered cervical biomechanical properties (a decrease in biomechanical modulus and an increase in maximum strain). The ability of G. vaginalis to induce these molecular, immune, cellular and

Colonization of the cervicovaginal space with Gardnerella vaginalis leads to local inflammation and cervical remodeling in pregnant mice

PubMed Central

Brown, Amy G.; Barilá, Guillermo O.; Anton, Lauren; Barnum, Carrie E.; Shetye, Snehal S.; Soslowsky, Louis J.; Elovitz, Michal A.

2018-01-01

The role of the cervicovaginal (CV) microbiome in regulating cervical function during pregnancy is poorly understood. Gardnerella vaginalis (G. vaginalis) is the most common bacteria associated with the diagnosis of bacterial vaginosis (BV). While BV has been associated with preterm birth (PTB), clinical trials targeting BV do not decrease PTB rates. It remains unknown if G. vaginalis is capable of triggering molecular, biomechanical and cellular events that could lead to PTB. The objective of this study was to determine if cervicovaginal colonization with G. vaginalis, in pregnant mice, induced cervical remodeling and modified cervical function. CD-1 timed-pregnant mice received a 5X108 CFU/mL intravaginal inoculation of G. vaginalis or control on embryonic day 12 (E12) and E13. On E15, the mice were sacrificed and cervicovaginal fluid (CVF), amniotic fluid (AF), cervix, uterus, placentas and fetal membranes (FM) were collected. Genomic DNA was isolated from the CVF, placenta, uterus and FM and QPCR was performed to confirm colonization. IL-6 was measured in the CVF and AF and soluble e-cadherin (seCAD) was assessed in the CVF by ELISA. RNA was extracted from the cervices to evaluate IL-10, IL-8, IL-1β, TNF-α, Tff-1, SPINK-5, HAS-1 and LOX expression via QPCR. Mucicarmine and trichrome staining was used to assess cervical mucin and collagen. Biomechanical properties of the cervix were studied using quasi-static tensile load-to-failure biomechanical tests. G. vaginalis successfully colonized the CV space. This colonization induced immune responses (increased IL-6 levels in CVF and AF, increased mRNA expression of cervical cytokines), altered the epithelial barrier (increased seCAD in the CVF), induced cervical remodeling (increased mucin production, altered collagen) and altered cervical biomechanical properties (a decrease in biomechanical modulus and an increase in maximum strain). The ability of G. vaginalis to induce these molecular, immune, cellular and

SPL7013 Gel (VivaGel®) Retains Potent HIV-1 and HSV-2 Inhibitory Activity following Vaginal Administration in Humans

PubMed Central

Price, Clare F.; Tyssen, David; Sonza, Secondo; Davie, Ashley; Evans, Sonya; Lewis, Gareth R.; Xia, Shirley; Spelman, Tim; Hodsman, Peter; Moench, Thomas R.; Humberstone, Andrew; Paull, Jeremy R.A.; Tachedjian, Gilda

2011-01-01

SPL7013 Gel (VivaGel®) is a microbicide in development for prevention of HIV and HSV. This clinical study assessed retention and duration of antiviral activity following vaginal administration of 3% SPL7013 Gel in healthy women. Participants received 5 single doses of product with ≥5 days between doses. A cervicovaginal fluid (CVF) sample was collected using a SoftCup™ pre-dose, and immediately, or 1, 3, 12 or 24 h post-dose. HIV-1 and HSV-2 antiviral activities of CVF samples were determined in cell culture assays. Antiviral activity in the presence of seminal plasma was also tested. Mass and concentration of SPL7013 in CVF samples was determined. Safety was assessed by reporting of adverse events. Statistical analysis was performed using the Wilcoxon signed-rank test with Bonferroni adjustment; p≤0.003 was significant. Eleven participants completed the study. Inhibition of HIV-1 and HSV-2 by pre-dose CVF samples was negligible. CVF samples obtained immediately after dosing almost completely inhibited (median, interquartile range) HIV-1 [96% (95,97)] and HSV-2 [86% (85,94)], and activity was maintained in all women at 3 h (HIV-1 [96% (95,98), p = 0.9]; HSV-2 [94% (91,97), p = 0.005]). At 24 h, >90% of initial HIV-1 and HSV-2 inhibition was maintained in 6/11 women. SPL7013 was recovered in CVF samples obtained at baseline (46% of 105 mg dose). At 3 and 24 h, 22 mg and 4 mg SPL7013, respectively, were recovered. More than 70% inhibition of HIV-1 and HSV-2 was observed if there was >0.5 mg SPL7013 in CVF samples. High levels of antiviral activity were retained in the presence of seminal plasma. VivaGel was well tolerated with no signs or symptoms of vaginal, vulvar or cervical irritation reported. Potent antiviral activity was observed against HIV-1 and HSV-2 immediately following vaginal administration of VivaGel, with activity maintained for at least 3 h post-dose. The data provide evidence of antiviral activity in a clinical setting, and suggest

Flexible Residential Smart Grid Simulation Framework

NASA Astrophysics Data System (ADS)

Xiang, Wang

Different scheduling and coordination algorithms controlling household appliances' operations can potentially lead to energy consumption reduction and/or load balancing in conjunction with different electricity pricing methods used in smart grid programs. In order to easily implement different algorithms and evaluate their efficiency against other ideas, a flexible simulation framework is desirable in both research and business fields. However, such a platform is currently lacking or underdeveloped. In this thesis, we provide a simulation framework to focus on demand side residential energy consumption coordination in response to different pricing methods. This simulation framework, equipped with an appliance consumption library using realistic values, aims to closely represent the average usage of different types of appliances. The simulation results of traditional usage yield close matching values compared to surveyed real life consumption records. Several sample coordination algorithms, pricing schemes, and communication scenarios are also implemented to illustrate the use of the simulation framework.

Diagnostic frameworks and nursing diagnoses: a normative stance.

PubMed

Zanotti, Renzo; Chiffi, Daniele

2015-01-01

Diagnostic frameworks are essential to many scientific and technological activities and clinical practice. This study examines the main fundamental aspects of such frameworks. The three components required for all diagnoses are identified and examined, i.e. their normative dimension, temporal nature and structure, and teleological perspective. The normative dimension of a diagnosis is based on (1) epistemic values when associated with Hempel's inductive risk concerning the balance between false-positive and false-negative outcomes, leading to probabilistic judgements; and (2) non-epistemic values when related to ideas such as well-being, normality, illness, etc, as idealized norms or ideal points of reference. It should be noted that medical diagnoses match the three necessary components, while some essential diagnostic frameworks - the taxonomies of Gordon and NANDA - in nursing lack some components. The main lack is normative as the most popular frameworks in nursing diagnosis seem to be descriptions of observed reality rather than normative and value-based judgements in which both epistemic and non-epistemic values may coexist. © 2014 John Wiley & Sons Ltd.

A Framework for the Design of Service Systems

NASA Astrophysics Data System (ADS)

Tan, Yao-Hua; Hofman, Wout; Gordijn, Jaap; Hulstijn, Joris

We propose a framework for the design and implementation of service systems, especially to design controls for long-term sustainable value co-creation. The framework is based on the software support tool e3-control. To illustrate the framework we use a large-scale case study, the Beer Living Lab, for simplification of customs procedures in international trade. The BeerLL shows how value co-creation can be achieved by reduction of administrative burden in international beer export due to electronic customs. Participants in the BeerLL are Heineken, IBM and Dutch Tax & Customs.

The Future of Home Health Care: A Strategic Framework for Optimizing Value.

PubMed

Landers, Steven; Madigan, Elizabeth; Leff, Bruce; Rosati, Robert J; McCann, Barbara A; Hornbake, Rodney; MacMillan, Richard; Jones, Kate; Bowles, Kathryn; Dowding, Dawn; Lee, Teresa; Moorhead, Tracey; Rodriguez, Sally; Breese, Erica

2016-11-01

The Future of Home Health project sought to support transformation of home health and home-based care to meet the needs of patients in the evolving U.S. health care system. Interviews with key thought leaders and stakeholders resulted in key themes about the future of home health care. By synthesizing this qualitative research, a literature review, case studies, and the themes from a 2014 Institute of Medicine and National Research Council workshop on "The Future of Home Health Care," the authors articulate a vision for home-based care and recommend a bold framework for the Medicare-certified home health agency of the future. The authors also identify challenges and recommendations for achievement of this framework.

Entanglement and Weak Values: A Quantum Miracle Cookbook

NASA Astrophysics Data System (ADS)

Botero, Alonso

The concept of the weak value has proved to be a powerful and operationally grounded framework for the assignment of physical properties to a quantum system at any given time. More importantly, this framework has allowed us to identify a whole range of surprising quantum effects, or "miracles", which are readily testable but which lie buried "under the noise" when the results of measurements are not post-selected. In all cases, these miracles have to do with the fact that weak values can take values lying outside the conventional ranges of quantum expectation values. We explore the extent to which such miracles are possible within the weak value framework. As we show, given appropriate initial and final states, it is generally possible to produce any set of weak values that is consistent with the linearity of weak values, provided that the states are entangled states of the system with some external ancillary system. Through a simple constructive proof, we obtain a recipe for arbitrary quantum miracles, and give examples of some interesting applications. In particular, we show how the classical description of an infinitely-localized point in phase-space is contained in the weak-value framework augmented by quantum entanglement. [Editor's note: for a video of the talk given by Prof. Botero at the Aharonov-80 conference in 2012 at Chapman University, see http://quantum.chapman.edu/talk-27.

Role of Myocardial Collagen in Severe Aortic Stenosis With Preserved Ejection Fraction and Symptoms of Heart Failure.

PubMed

Echegaray, Kattalin; Andreu, Ion; Lazkano, Ane; Villanueva, Iñaki; Sáenz, Alberto; Elizalde, María Reyes; Echeverría, Tomás; López, Begoña; Garro, Asier; González, Arantxa; Zubillaga, Elena; Solla, Itziar; Sanz, Iñaki; González, Jesús; Elósegui-Artola, Alberto; Roca-Cusachs, Pere; Díez, Javier; Ravassa, Susana; Querejeta, Ramón

2017-10-01

We investigated the anatomical localization, biomechanical properties, and molecular phenotype of myocardial collagen tissue in 40 patients with severe aortic stenosis with preserved ejection fraction and symptoms of heart failure. Two transmural biopsies were taken from the left ventricular free wall. Mysial and nonmysial regions of the collagen network were analyzed. Myocardial collagen volume fraction (CVF) was measured by picrosirius red staining. Young's elastic modulus (YEM) was measured by atomic force microscopy in decellularized slices to assess stiffness. Collagen types I and III were measured as C I VF and C III VF, respectively, by confocal microscopy in areas with YEM evaluation. Compared with controls, patients exhibited increased mysial and nonmysial CVF and nonmysial:mysial CVF ratio (P < .05). In patients, nonmysial CVF (r = 0.330; P = .046) and the nonmysial:mysial CVF ratio (r = 0.419; P = .012) were directly correlated with the ratio of maximal early transmitral flow velocity in diastole to early mitral annulus velocity in diastole. Both the C I VF:C III VF ratio and YEM were increased (P ≤ .001) in nonmysial regions compared with mysial regions in patients, with a direct correlation (r = 0.895; P < .001) between them. These findings suggest that, in patients with severe aortic stenosis with preserved ejection fraction and symptoms of heart failure, diastolic dysfunction is associated with increased nonmysial deposition of collagen, predominantly type I, resulting in increased extracellular matrix stiffness. Therefore, the characteristics of collagen tissue may contribute to diastolic dysfunction in these patients. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Cobra venom factor immunoconjugates: effects of carbohydrate-directed versus amino group-directed conjugation.

PubMed

Zara, J; Pomato, N; McCabe, R P; Bredehorst, R; Vogel, C W

1995-01-01

Human IgM monoclonal antibody 16-88, derived from patients immunized with autologous colon carcinoma cells, was derivatized with two different cross-linkers, S-(2-thiopyridyl)-L-cysteine hydrazide (TPCH), which is carbohydrate-directed, and N-succinimidyl-3-(2- pyridyldithio)propionate (SPDP), which is amino group-directed. Two antibody functions, antigen binding and complement activation, were assayed upon derivatization with TPCH and SPDP. TPCH allowed for extensive modification (up to 17 TPCH molecules per antibody) without impairment of antigen binding activity, while this function was significantly compromised upon derivatization with SPDP. Antibody molecules derivatized with 16 SPDP residues showed almost complete loss of their antigen binding function. The complement activating ability of antibody 16-88 was significantly decreased after derivatization with TPCH or SPDP. In the case of SPDP derivatization, this decrease of the complement activating ability is predominantly a consequence of the impaired binding function. Upon conjugation of cobra venom factor (CVF), a nontoxic 137-kDa glycoprotein which is capable of activating the alternative pathway of complement, the antigen binding activity of SPDP-derivatized antibody was further compromised, whereas that of TPCH-derivatized antibody remained unaffected even after attachment of three or four CVF molecules per antibody. In both conjugates CVF retained good functional activity. CVF was slightly more active when attached to SPDP-derivatized antibody, suggesting a better accessibility of amino group-coupled CVF for its interaction with other complement proteins. These results indicate that carbohydrate-directed conjugation compromises the antibody function of complement activation, but allows for the generation of immunoconjugates with unimpaired antigen binding capability.(ABSTRACT TRUNCATED AT 250 WORDS)

Phase 1 Safety, Pharmacokinetics, and Pharmacodynamics of Dapivirine and Maraviroc Vaginal Rings: a Double-Blind Randomized Trial

PubMed Central

Chen, Beatrice A.; Panther, Lori; Marzinke, Mark A.; Hendrix, Craig W.; Hoesley, Craig J.; van der Straten, Ariane; Husnik, Marla J.; Soto-Torres, Lydia; Nel, Annalene; Johnson, Sherri; Richardson-Harman, Nicola; Rabe, Lorna K.; Dezzutti, Charlene S.

2015-01-01

Background Variable adherence limits effectiveness of daily oral and intravaginal tenofovir-containing pre-exposure prophylaxis. Monthly vaginal antiretroviral rings are one approach to improve adherence and drug delivery. Methods MTN-013/IPM 026, a multi-site, double-blind, randomized, placebo-controlled trial in 48 HIV-negative U.S. women, evaluated vaginal rings containing dapivirine (25 mg) and maraviroc (100 mg), dapivirine-only, maraviroc-only, and placebo used continuously for 28 days. Safety was assessed by adverse events. Drug concentrations were quantified in plasma, cervicovaginal fluid (CVF), and cervical tissue. Cervical biopsy explants were challenged with HIV ex vivo to evaluate pharmacodynamics. Results There was no difference in related genitourinary adverse events between treatment arms compared to placebo. Dapivirine and maraviroc concentrations rose higher initially before falling more rapidly with the combination ring compared to relatively stable concentrations with the single drug rings. Dapivirine concentrations in CVF were 1 and 5 log10 greater than cervical tissue and plasma for both rings. Maraviroc was consistently detected only in CVF. Dapivirine and maraviroc CVF and dapivirine tissue concentrations dropped rapidly after ring removal. Cervical tissue showed a significant inverse linear relationship between HIV replication and dapivirine levels. Conclusions In this first study of a combination microbicide vaginal ring, all four rings were safe and well tolerated. Tissue dapivirine concentrations were 1,000 times greater than plasma concentrations and single drug rings had more stable pharmacokinetics. Dapivirine, but not maraviroc, demonstrated concentration-dependent inhibition of HIV-1 infection in cervical tissue. Since maraviroc concentrations were consistently detectable only in CVF and not in plasma, improved drug release of maraviroc rings is needed. PMID:26034880

Phase 1 Safety, Pharmacokinetics, and Pharmacodynamics of Dapivirine and Maraviroc Vaginal Rings: A Double-Blind Randomized Trial.

PubMed

Chen, Beatrice A; Panther, Lori; Marzinke, Mark A; Hendrix, Craig W; Hoesley, Craig J; van der Straten, Ariane; Husnik, Marla J; Soto-Torres, Lydia; Nel, Annalene; Johnson, Sherri; Richardson-Harman, Nicola; Rabe, Lorna K; Dezzutti, Charlene S

2015-11-01

Variable adherence limits effectiveness of daily oral and intravaginal tenofovir-containing pre-exposure prophylaxis. Monthly vaginal antiretroviral rings are one approach to improve adherence and drug delivery. MTN-013/IPM 026, a multisite, double-blind, randomized, placebo-controlled trial in 48 HIV-negative US women, evaluated vaginal rings containing dapivirine (DPV) (25 mg) and maraviroc (MVC) (100 mg), DPV only, MVC only, and placebo used continuously for 28 days. Safety was assessed by adverse events. Drug concentrations were quantified in plasma, cervicovaginal fluid (CVF), and cervical tissue. Cervical biopsy explants were challenged with HIV ex vivo to evaluate pharmacodynamics. There was no difference in related genitourinary adverse events between treatment arms compared with placebo. DPV and MVC concentrations rose higher initially before falling more rapidly with the combination ring compared with relatively stable concentrations with the single-drug rings. DPV concentrations in CVF were 1 and 5 log10 greater than cervical tissue and plasma for both rings. MVC was consistently detected only in CVF. DPV and MVC CVF and DPV tissue concentrations dropped rapidly after ring removal. Cervical tissue showed a significant inverse linear relationship between HIV replication and DPV levels. In this first study of a combination microbicide vaginal ring, all 4 rings were safe and well tolerated. Tissue DPV concentrations were 1000 times greater than plasma concentrations and single drug rings had more stable pharmacokinetics. DPV, but not MVC, demonstrated concentration-dependent inhibition of HIV-1 infection in cervical tissue. Because MVC concentrations were consistently detectable only in CVF and not in plasma, improved drug release of MVC rings is needed.

Upping the "Anti-": The Value of an Anti-Racist Theoretical Framework in Music Education

ERIC Educational Resources Information Center

Hess, Juliet

2015-01-01

In a time that some have argued is "postracial" following the election and reelection of Barack Obama (see Wise 2010, for discussion), this paper argues that antiracism is a crucial theoretical framework for music education. I explore three areas of music education, in which such a framework can push toward change. The first area speaks…

Economic Values Implicit in the Social Construction of American Universities.

ERIC Educational Resources Information Center

Olson, Jeffery E.

Five economic hypotheses of what American universities value (profit, production, prestige, faculty consumption, or academic resources and activities) were tested to illustrate the implicit value framework, a conceptual framework for inferring the objective economic values of an organization from the manner in which society has defined its…

Using Action Research to Foster Positive Social Values

ERIC Educational Resources Information Center

Benton, Jean

2005-01-01

"Using Action Research to Foster Positive Social Values" provides teachers with a unique framework in which to consider classroom violence. It uses actual case studies and working models done through classroom research to produce more effective classrooms that foster positive social values. The author lays out a theoretical framework for: (1)…

Values and the Future: The Impact of Technological Change on American Values.

ERIC Educational Resources Information Center

Baier, Kurt, Ed; Rescher, Nicholas, Ed.

This collection of essays aims to draw attention to important areas of interaction between technology and values, to offer some ideas of where and how control of social problems may be attempted in ways which are compatible with the dominant values of the persons affected, and to map out a framework of categories within which one can describe and…

Achieving Value in Primary Care: The Primary Care Value Model.

PubMed

Rollow, William; Cucchiara, Peter

2016-03-01

The patient-centered medical home (PCMH) model provides a compelling vision for primary care transformation, but studies of its impact have used insufficiently patient-centered metrics with inconsistent results. We propose a framework for defining patient-centered value and a new model for value-based primary care transformation: the primary care value model (PCVM). We advocate for use of patient-centered value when measuring the impact of primary care transformation, recognition, and performance-based payment; for financial support and research and development to better define primary care value-creating activities and their implementation; and for use of the model to support primary care organizations in transformation. © 2016 Annals of Family Medicine, Inc.

Competence-Based Approach in Value Chain Processes

NASA Astrophysics Data System (ADS)

Azevedo, Rodrigo Cambiaghi; D'Amours, Sophie; Rönnqvist, Mikael

There is a gap between competence theory and value chain processes frameworks. While individually considered as core elements in contemporary management thinking, the integration of the two concepts is still lacking. We claim that this integration would allow for the development of more robust business models by structuring value chain activities around aspects such as capabilities and skills, as well as individual and organizational knowledge. In this context, the objective of this article is to reduce this gap and consequently open a field for further improvements of value chain processes frameworks.

NHS constitution values for values-based recruitment: a virtue ethics perspective.

PubMed

Groothuizen, Johanna Elise; Callwood, Alison; Gallagher, Ann

2018-05-17

Values-based recruitment is used in England to select healthcare staff, trainees and students on the basis that their values align with those stated in the Constitution of the UK National Health Service (NHS). However, it is unclear whether the extensive body of existing literature within the field of moral philosophy was taken into account when developing these values. Although most values have a long historical tradition, a tendency to assume that they have just been invented, and to approach them uncritically, exists within the healthcare sector. Reflection is necessary. We are of the opinion that selected virtue ethics writings, which are underpinned by historical literature as well as practical analysis of the healthcare professions, provide a helpful framework for evaluation of the NHS Constitution values, to determine whether gaps exist and improvements can be made. Based on this evaluation, we argue that the definitions of certain NHS Constitution values are ambiguous. In addition to this, we argue that 'integrity' and 'practical wisdom', two important concepts in the virtue ethics literature, are not sufficiently represented within the NHS Constitution values. We believe that the NHS Constitution values could be strengthened by providing clearer definitions, and by integrating 'integrity' and 'practical wisdom'. This will benefit values-based recruitment strategies. Should healthcare policy-makers in other countries wish to develop a similar values-based recruitment framework, we advise that they proceed reflectively, and take previously published virtue ethics literature into consideration. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Value-driven ERM: making ERM an engine for simultaneous value creation and value protection.

PubMed

Celona, John; Driver, Jeffrey; Hall, Edward

2011-01-01

Enterprise risk management (ERM) began as an effort to integrate the historically disparate silos of risk management in organizations. More recently, as recognition has grown of the need to cover the upside risks in value creation (financial and otherwise), organizations and practitioners have been searching for the means to do this. Existing tools such as heat maps and risk registers are not adequate for this task. Instead, a conceptually new value-driven framework is needed to realize the promise of enterprise-wide coverage of all risks, for both value protection and value creation. The methodology of decision analysis provides the means of capturing systemic, correlated, and value-creation risks on the same basis as value protection risks and has been integrated into the value-driven approach to ERM described in this article. Stanford Hospital and Clinics Risk Consulting and Strategic Decisions Group have been working to apply this value-driven ERM at Stanford University Medical Center. © 2011 American Society for Healthcare Risk Management of the American Hospital Association.

Graded Maximal Exercise Testing to Assess Mouse Cardio-Metabolic Phenotypes

PubMed Central

Petrosino, Jennifer M.; Heiss, Valerie J.; Maurya, Santosh K.; Kalyanasundaram, Anuradha; Periasamy, Muthu; LaFountain, Richard A.; Wilson, Jacob M.; Simonetti, Orlando P.; Ziouzenkova, Ouliana

2016-01-01

Functional assessments of cardiovascular fitness (CVF) are needed to establish animal models of dysfunction, test the effects of novel therapeutics, and establish the cardio-metabolic phenotype of mice. In humans, the graded maximal exercise test (GXT) is a standardized diagnostic for assessing CVF and mortality risk. These tests, which consist of concurrent staged increases in running speed and inclination, provide diagnostic cardio-metabolic parameters, such as, VO2max, anaerobic threshold, and metabolic crossover. Unlike the human-GXT, published mouse treadmill tests have set, not staged, increases in inclination as speed progress until exhaustion (PXT). Additionally, they often lack multiple cardio-metabolic parameters. Here, we developed a mouse-GXT with the intent of improving mouse-exercise testing sensitivity and developing translatable parameters to assess CVF in healthy and dysfunctional mice. The mouse-GXT, like the human-GXT, incorporated staged increases in inclination, speed, and intensity; and, was designed by considering imitations of the PXT and differences between human and mouse physiology. The mouse-GXT and PXTs were both tested in healthy mice (C57BL/6J, FVBN/J) to determine their ability to identify cardio-metabolic parameters (anaerobic threshold, VO2max, metabolic crossover) observed in human-GXTs. Next, theses assays were tested on established diet-induced (obese-C57BL/6J) and genetic (cardiac isoform Casq2-/-) models of cardiovascular dysfunction. Results showed that both tests reported VO2max and provided reproducible data about performance. Only the mouse-GXT reproducibly identified anaerobic threshold, metabolic crossover, and detected impaired CVF in dysfunctional models. Our findings demonstrated that the mouse-GXT is a sensitive, non-invasive, and cost-effective method for assessing CVF in mice. This new test can be used as a functional assessment to determine the cardio-metabolic phenotype of various animal models or the effects of

Environmental modulation of autoimmune arthritis involves the spontaneous microbial induction of T cell responses to regulatory determinants within heat shock protein 65.

PubMed

Moudgil, K D; Kim, E; Yun, O J; Chi, H H; Brahn, E; Sercarz, E E

2001-03-15

Both genetic and environmental factors are believed to be involved in the induction of autoimmune diseases. Adjuvant arthritis (AA) is inducible in susceptible rat strains by injection of Mycobacterium tuberculosis, and arthritic rats raise T cell responses to the 65-kDa mycobacterial heat-shock protein (Bhsp65). We observed that Fischer 344 (F344) rats raised in a barrier facility (BF-F344) are susceptible to AA, whereas F344 rats maintained in a conventional facility (CV-F344) show significantly reduced incidence and severity of AA, despite responding well to the arthritogenic determinant within Bhsp65. The acquisition of protection from AA can be circumvented if rats are maintained on neomycin/acidified water. Strikingly, naive unimmunized CV-F344 rats but not BF-F344 rats raised T cell responses to Bhsp65 C-terminal determinants (BCTD) (we have previously shown that BCTD are involved in regulation of acute AA in the Lewis rat); however, T cells of naive CV-F344 and BF-F344 gave a comparable level of proliferative response to a mitogen, but no response at all to an irrelevant Ag. Furthermore, adoptive transfer into naive BF-F344 rats of splenic cells of naive CV-F344 rats (restimulated with BCTD in vitro) before induction of AA resulted in a considerably reduced severity of AA. These results suggest that spontaneous (inadvertent) priming of BCTD-reactive T cells, owing to determinant mimicry between Bhsp65 and its homologues in microbial agents in the conventional environment, is involved in modulating the severity of AA in CV-F344 rats. These results have important implications in broadening understanding of the host-microbe interaction in human autoimmune diseases.

Graded Maximal Exercise Testing to Assess Mouse Cardio-Metabolic Phenotypes.

PubMed

Petrosino, Jennifer M; Heiss, Valerie J; Maurya, Santosh K; Kalyanasundaram, Anuradha; Periasamy, Muthu; LaFountain, Richard A; Wilson, Jacob M; Simonetti, Orlando P; Ziouzenkova, Ouliana

2016-01-01

Functional assessments of cardiovascular fitness (CVF) are needed to establish animal models of dysfunction, test the effects of novel therapeutics, and establish the cardio-metabolic phenotype of mice. In humans, the graded maximal exercise test (GXT) is a standardized diagnostic for assessing CVF and mortality risk. These tests, which consist of concurrent staged increases in running speed and inclination, provide diagnostic cardio-metabolic parameters, such as, VO2max, anaerobic threshold, and metabolic crossover. Unlike the human-GXT, published mouse treadmill tests have set, not staged, increases in inclination as speed progress until exhaustion (PXT). Additionally, they often lack multiple cardio-metabolic parameters. Here, we developed a mouse-GXT with the intent of improving mouse-exercise testing sensitivity and developing translatable parameters to assess CVF in healthy and dysfunctional mice. The mouse-GXT, like the human-GXT, incorporated staged increases in inclination, speed, and intensity; and, was designed by considering imitations of the PXT and differences between human and mouse physiology. The mouse-GXT and PXTs were both tested in healthy mice (C57BL/6J, FVBN/J) to determine their ability to identify cardio-metabolic parameters (anaerobic threshold, VO2max, metabolic crossover) observed in human-GXTs. Next, theses assays were tested on established diet-induced (obese-C57BL/6J) and genetic (cardiac isoform Casq2-/-) models of cardiovascular dysfunction. Results showed that both tests reported VO2max and provided reproducible data about performance. Only the mouse-GXT reproducibly identified anaerobic threshold, metabolic crossover, and detected impaired CVF in dysfunctional models. Our findings demonstrated that the mouse-GXT is a sensitive, non-invasive, and cost-effective method for assessing CVF in mice. This new test can be used as a functional assessment to determine the cardio-metabolic phenotype of various animal models or the effects of

Neurocognitive mechanisms underlying value-based decision-making: from core values to economic value

PubMed Central

Brosch, Tobias; Sander, David

2013-01-01

Value plays a central role in practically every aspect of human life that requires a decision: whether we choose between different consumer goods, whether we decide which person we marry or which political candidate gets our vote, we choose the option that has more value to us. Over the last decade, neuroeconomic research has mapped the neural substrates of economic value, revealing that activation in brain regions such as ventromedial prefrontal cortex (VMPFC), ventral striatum or posterior cingulate cortex reflects how much an individual values an option and which of several options he/she will choose. However, while great progress has been made exploring the mechanisms underlying concrete decisions, neuroeconomic research has been less concerned with the questions of why people value what they value, and why different people value different things. Social psychologists and sociologists have long been interested in core values, motivational constructs that are intrinsically linked to the self-schema and are used to guide actions and decisions across different situations and different time points. Core value may thus be an important determinant of individual differences in economic value computation and decision-making. Based on a review of recent neuroimaging studies investigating the neural representation of core values and their interactions with neural systems representing economic value, we outline a common framework that integrates the core value concept and neuroeconomic research on value-based decision-making. PMID:23898252

Breast-feeding Coparenting Framework: A New Framework to Improve Breast-feeding Duration and Exclusivity.

PubMed

Abbass-Dick, Jennifer; Dennis, Cindy-Lee

Targeting mothers and fathers in breast-feeding promotion programs is recommended as research has found that father's support positively impacts breast-feeding duration and exclusivity. Breast-feeding coparenting refers to the manner in which parents work together to achieve their breast-feeding goals. The Breast-feeding Coparenting Framework was developed on the basis of diverse coparenting models and research related to father's involvement with breast-feeding. This framework consists of 5 components: joint breast-feeding goal setting, shared breast-feeding responsibility, proactive breast-feeding support, father's/partner's parental-child interactions, and productive communication and problem solving. This framework may be of value to policy makers and program providers working to improve breast-feeding outcomes.

Identifying common values among seven health professions: An interprofessional analysis.

PubMed

Grace, Sandra; Innes, Ev; Joffe, Beverly; East, Leah; Coutts, Rosanne; Nancarrow, Susan

2017-05-01

This article reviews the competency frameworks of seven Australian health professions to explore relationships among health professions of similar status as reflected in their competency frameworks and to identify common themes and values across the professions. Frameworks were compared using a constructivist grounded theory approach to identify key themes, against which individual competencies for each profession were mapped and compared. The themes were examined for underlying values and a higher order theoretical framework was developed. In contrast to classical theories of professionalism that foreground differentiation of professions, our study suggests that the professions embrace a common structure and understanding, based on shared underpinning values. We propose a model of two core values that encompass all identified themes: the rights of the client and the capacity of a particular profession to serve the healthcare needs of clients. Interprofessional practice represents the intersection of the rights of the client to receive the best available healthcare and the recognition of the individual contribution of each profession. Recognising that all health professions adhere to a common value base, and exploring professional similarities and differences from that value base, challenges a paradigm that distinguishes professions solely on scope of practice.

Interplay wellbeing framework: a collaborative methodology 'bringing together stories and numbers' to quantify Aboriginal cultural values in remote Australia.

PubMed

Cairney, Sheree; Abbott, Tammy; Quinn, Stephen; Yamaguchi, Jessica; Wilson, Byron; Wakerman, John

2017-05-03

Wellbeing has been difficult to understand, measure and strengthen for Aboriginal people in remote Australia. Part of the challenge has been genuinely involving community members and incorporating their values and priorities into assessment and policy. Taking a 'shared space' collaborative approach between remote Aboriginal communities, governments and scientists, we merged Aboriginal knowledge with western science - by bringing together stories and numbers. This research aims to statistically validate the holistic Interplay Wellbeing Framework and Survey that bring together Aboriginal-identified priorities of culture, empowerment and community with government priorities including education, employment and health. Quantitative survey data were collected from a cohort of 842 Aboriginal people aged 15-34 years, recruited from four different Aboriginal communities in remote Australia. Aboriginal community researchers designed and administered the survey. Structural equation modeling showed good fit statistics (χ/df = 2.69, CFI = 0.95 and RMSEA = 0.045) confirming the holistic nature of the Interplay Wellbeing Framework. The strongest direct impacts on wellbeing were 'social and emotional wellbeing' (r = 0.23; p < 0.001), 'English literacy and numeracy' (r = 0.15; p < 0.001), 'Aboriginal literacy' (r = 0.14; p < 0.001), 'substances' (lack thereof; r = 0.13; p = 0.003), 'work' (r = 0.12; p = 0.02) and 'community' (r = 0.08; p = 0.05). Correlation analyses suggested cultural factors have indirect impacts on wellbeing, such as through Aboriginal literacy. All cultural variables correlated highly with each other, and with empowerment and community. Empowerment also correlated highly with all education and work variables. 'Substances' (lack thereof) was linked with positive outcomes across culture, education and work. Specific interrelationships will be explored in detail separately. The Interplay Wellbeing

The Valued Living Questionnaire: Defining and Measuring Valued Action within a Behavioral Framework

ERIC Educational Resources Information Center

Wilson, Kelly G.; Sandoz, Emily K.; Kitchens, Jennifer; Roberts, Miguel

2010-01-01

A number of cognitive-behavior therapies now strongly emphasize particular behavioral processes as mediators of clinical change specific to that therapy. This shift in emphasis calls for the development of measures sensitive to changes in the therapies' processes. Among these is acceptance and commitment therapy (ACT), which posits valued living…

A framework for rating environmental value of urban parks.

PubMed

Jabben, Jan; Weber, Miriam; Verheijen, Edwin

2015-03-01

In this study, indicators are proposed to characterize the intrinsic environmental properties and external value of urban parks. The intrinsic properties involve both acoustic factors and non-acoustic factors, such as visual aspects and size. To assess external value, the restoration level is defined, which measures the nearby presence of a quiet, 'green' area at residential areas outside parks. The restoration levels of green areas are based on intrinsic properties and the distances of each dwelling to urban park areas. The overall environmental value of a park, the group restoration level, is defined as a logarithmic summation of the restoration levels over its surrounding residential areas. Restoration levels were determined for sixteen public parks in the city of Rotterdam and compared with survey data from questionnaires. Results show that the investigated parks display a large variation in the group restoration level levels, mainly due to differences in size and average noise levels. To validate the proposed method, survey data from questionnaires are investigated as to correlation with restoration levels. Copyright © 2014 Elsevier B.V. All rights reserved.

The Value of Darkness: A Moral Framework for Urban Nighttime Lighting.

PubMed

Stone, Taylor

2018-04-01

The adverse effects of artificial nighttime lighting, known as light pollution, are emerging as an important environmental issue. To address these effects, current scientific research focuses mainly on identifying what is bad or undesirable about certain types and uses of lighting at night. This paper adopts a value-sensitive approach, focusing instead on what is good about darkness at night. In doing so, it offers a first comprehensive analysis of the environmental value of darkness at night from within applied ethics. A design for values orientation is utilized to conceptualize, define, and categorize the ways in which value is derived from darkness. Nine values are identified and categorized via their type of good, temporal outlook, and spatial characteristics. Furthermore, these nine values are translated into prima facie moral obligations that should be incorporated into future design choices, policy-making, and innovations to nighttime lighting. Thus, the value of darkness is analyzed with the practical goal of informing future decision-making about urban nighttime lighting.

Value of Flexibility - Phase 1

DTIC Science & Technology

2010-09-25

weaknesses of each approach. During this period, we also explored the development of an analytical framework based on sound mathematical constructs... mathematical constructs. A review of the current state-of-the-art showed that there is little unifying theory or guidance on best approaches to...research activities is in developing a coherent value based definition of flexibility that is based on an analytical framework that is mathematically

Examining the Value of a Scaffolded Critique Framework to Promote Argumentative and Explanatory Writings Within an Argument-Based Inquiry Approach

NASA Astrophysics Data System (ADS)

Jang, Jeong-yoon; Hand, Brian

2017-12-01

This study investigated the value of using a scaffolded critique framework to promote two different types of writing—argumentative writing and explanatory writing—with different purposes within an argument-based inquiry approach known as the Science Writing Heuristic (SWH) approach. A quasi-experimental design with sixth and seventh grade students taught by two teachers was used. A total of 170 students participated in the study, with 87 in the control group (four classes) and 83 in the treatment group (four classes). All students used the SWH templates as an argumentative writing to guide their written work and completed these templates during the SWH investigations of each unit. After completing the SWH investigations, both groups of students were asked to complete the summary writing task as an explanatory writing at the end of each unit. All students' writing samples were scored using analytical frameworks developed for the study. The results indicated that the treatment group performed significantly better on the explanatory writing task than the control group. In addition, the results of the partial correlation suggested that there is a very strong significantly positive relationship between the argumentative writing and the explanatory writing.

Inadequate environment, resources and values lead to missed nursing care: A focused ethnographic study on the surgical ward using the Fundamentals of Care framework.

PubMed

Jangland, Eva; Teodorsson, Therese; Molander, Karin; Muntlin Athlin, Åsa

2018-06-01

To explore the delivery of care from the perspective of patients with acute abdominal pain focusing on the contextual factors at system level using the Fundamentals of Care framework. The Fundamentals of Care framework describes several contextual and systemic factors that can impact the delivery of care. To deliver high-quality, person-centred care, it is important to understand how these factors affect patients' experiences and care needs. A focused ethnographic approach. A total of 20 observations were performed on two surgical wards at a Swedish university hospital. Data were collected using participant observation and informal interviews and analysed using deductive content analysis. The findings, presented in four categories, reflect the value patients place on the caring relationship and a friendly atmosphere on the ward. Patients had concerns about the environment, particularly the high-tempo culture on the ward and its impact on their integrity, rest and sleep, access to information and planning, and need for support in addressing their existential thoughts. The observers also noted that missed nursing care had serious consequences for patient safety. Patients with acute abdominal pain were cared for in the high-tempo culture of a surgical ward with limited resources, unclear leadership and challenges to patients' safety. The findings highlight the crucial importance of prioritising and valuing the patients' fundamental care needs for recovery. Nursing leaders and nurses need to take the lead to reconceptualise the value of fundamental care in the acute care setting. To improve clinical practice, the value of fundamentals of care must be addressed regardless of patient's clinical condition. Providing a caring relationship is paramount to ensure a positive impact on patient's well-being and recovery. © 2017 John Wiley & Sons Ltd.

Advancing Value Assessment in the United States: A Multistakeholder Perspective.

PubMed

Sorenson, Corinna; Lavezzari, Gabriela; Daniel, Gregory; Burkholder, Randy; Boutin, Marc; Pezalla, Edmund; Sanders, Gillian; McClellan, Mark

2017-02-01

Rising costs without perceived proportional improvements in quality and outcomes have motivated fundamental shifts in health care delivery and payment to achieve better value. Aligned with these efforts, several value assessment frameworks have been introduced recently to help providers, patients, and payers better understand the potential value of drugs and other interventions and make informed decisions about their use. Given their early stage of development, it is imperative to evaluate these efforts on an ongoing basis to identify how best to support and improve them moving forward. This article provides a multistakeholder perspective on the key limitations and opportunities posed by the current value assessment frameworks and areas of and actions for improvement. In particular, we outline 10 fundamental guiding principles and associated strategies that should be considered in subsequent iterations of the existing frameworks or by emerging initiatives in the future. Although value assessment frameworks may not be able to meet all the needs and preferences of stakeholders, we contend that there are common elements and potential next steps that can be supported to advance value assessment in the United States. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Reconciling nature conservation and traditional farming practices: a spatially explicit framework to assess the extent of High Nature Value farmlands in the European countryside

PubMed Central

Lomba, Angela; Alves, Paulo; Jongman, Rob H G; McCracken, David I

2015-01-01

Agriculture constitutes a dominant land cover worldwide, and rural landscapes under extensive farming practices acknowledged due to high biodiversity levels. The High Nature Value farmland (HNVf) concept has been highlighted in the EU environmental and rural policies due to their inherent potential to help characterize and direct financial support to European landscapes where high nature and/or conservation value is dependent on the continuation of specific low-intensity farming systems. Assessing the extent of HNV farmland by necessity relies on the availability of both ecological and farming systems' data, and difficulties associated with making such assessments have been widely described across Europe. A spatially explicit framework of data collection, building out from local administrative units, has recently been suggested as a means of addressing such difficulties. This manuscript tests the relevance of the proposed approach, describes the spatially explicit framework in a case study area in northern Portugal, and discusses the potential of the approach to help better inform the implementation of conservation and rural development policies. Synthesis and applications: The potential of a novel approach (combining land use/cover, farming and environmental data) to provide more accurate and efficient mapping and monitoring of HNV farmlands is tested at the local level in northern Portugal. The approach is considered to constitute a step forward toward a more precise targeting of landscapes for agri-environment schemes, as it allowed a more accurate discrimination of areas within the case study landscape that have a higher value for nature conservation. PMID:25798221

Component Cost Reduction by Value Engineering: A Case Study

NASA Astrophysics Data System (ADS)

Kalluri, Vinayak; Kodali, Rambabu

2017-04-01

The concept value engineering (VE) acts to increase the value of a product through the improvement in existent functions without increasing their costs. In other words, VE is a function oriented, systematic team approach study to provide value in a product, system or service. The authors systematically explore VE through the six step framework proposed by SAVE and a case study is presented to address the concern of reduction in cost without compromising the function of a hydraulic steering cylinder through the aforementioned VE framework.

Measurements and Slope Analyses of Quaternary Cinder Cones, Camargo Volcanic Field, Chihuahua, Mexico

NASA Astrophysics Data System (ADS)

Gallegos, M. I.; Espejel-Garcia, V. V.

2012-12-01

The Camargo volcanic field (CVF) covers ~3000 km2 and is located in the southeast part of the state of Chihuahua, within the Basin and Range province. The CVF represents the largest mafic alkali volcanic field in northern Mexico. Over a 300 cinder cones have been recognized in the Camargo volcanic field. Volcanic activity ranges from 4.7 to 0.09 Ma revealed by 40Ar/39Ar dating methods. Previous studies say that there is a close relationship between the cinder cone slope angle, due to mechanical weathering, and age. This technique is considered a reliable age indicator, especially in arid climates, such as occur in the CVF. Data were acquired with digital topographic maps (DRG) and digital elevation models (DEM) overlapped in the Global Mapper software. For each cone, the average radius (r) was calculated from six measurements, the height (h) is the difference between peak elevation and the altitude of the contour used to close the radius, and the slope angle was calculated using the equation Θ = tan-1(h/r). The slope angles of 30 cinder cones were calculated showing angles ranging from 4 to 15 degrees. A diffusion model, displayed by an exponential relationship between slope angle and age, places the ages of these 30 cones from 215 to 82 ka, within the range marked by radiometric methods. Future work include the analysis of more cinder cones to cover the whole CVF, and contribute to the validation of this technique.

Understanding the Learning of Values Using a Domains-of-Socialization Framework

ERIC Educational Resources Information Center

Vinik, Julia; Johnston, Megan; Grusec, Joan E.; Farrell, Renee

2013-01-01

The narratives that emerging adults wrote about a time when they learned an important moral, value or lesson were explored in order to determine the characteristics of events that lead to internalized values as well as to compare the way different kinds of moral values are socialized. Lessons resulting from misbehavior were reported most…

Using humanising values to support care.

PubMed

Scammell, Janet; Tait, Desi

National responses to the Francis report recommendations call for a stronger emphasis on the service-user perspective. This article uses a client scenario to reflect on how dehumanised aspects of care can become humanised by basing our practice on a humanising values framework, and argues that the framework can, despite the system, provide a guide to support us "to do the right thing".

Adaptive notification framework for smart nursing home.

PubMed

Betge-Brezetz, S; Dupont, M P; Ghorbel, M; Kamga, G B; Piekarec, S

2009-01-01

This paper presents an adaptive notification framework which allows to optimally deliver and handle multimedia requests and alerts in a nursing home. This framework is operated with various applications (e.g., health alert, medicine reminder, and activity proposition) and has been evaluated with different real end-users (elderly resident and medical staff) in a pilot site. Results of these evaluations are presented and highlight the added value of the framework technology to enhance the quality of life of elderly people as well as the efficiency of the medical staff.

Overstating values: medical facts, diverse values, bioethics and values-based medicine.

PubMed

Parker, Malcolm

2013-02-01

Fulford has argued that (1) the medical concepts illness, disease and dysfunction are inescapably evaluative terms, (2) illness is conceptually prior to disease, and (3) a model conforming to (2) has greater explanatory power and practical utility than the conventional value-free medical model. This 'reverse' model employs Hare's distinction between description and evaluation, and the sliding relationship between descriptive and evaluative meaning. Fulford's derivative 'Values Based Medicine' (VBM) readjusts the imbalance between the predominance of facts over values in medicine. VBM allegedly responds to the increased choices made available by, inter alia, the progress of medical science itself. VBM attributes appropriate status to evaluative meaning, where strong consensus about descriptive meaning is lacking. According to Fulford, quasi-legal bioethics, while it can be retained as a kind of deliberative framework, is outcome-based and pursues 'the right answer', while VBM approximates a democratic, process-oriented method for dealing with diverse values, in partnership with necessary contributions from evidence-based medicine (EBM). I support the non-cognitivist underpinnings of VBM, and its emphasis on the importance of values in medicine. But VBM overstates the complexity and diversity of values, misrepresents EBM and VBM as responses to scientific and evaluative complexity, and mistakenly depicts 'quasi-legal bioethics' as a space of settled descriptive meaning. Bioethical reasoning can expose strategies that attempt to reduce authentic values to scientific facts, illustrating that VBM provides no advantage over bioethics in delineating the connections between facts and values in medicine. © 2011 Blackwell Publishing Ltd.

Strategies in Values Education: Horse or Cart?

ERIC Educational Resources Information Center

Brady, Laurie

2008-01-01

This article describes briefly the growing emphasis in Australia on values education as evidenced by the Australian Government's National Framework for Values Education in Australian Schools (2005), and the responses of the respective States and Territories. Arguing that the major approaches to the teaching of values (the trait approach often…

A Health Economics Approach to US Value Assessment Frameworks-Summary and Recommendations of the ISPOR Special Task Force Report [7].

PubMed

Garrison, Louis P; Neumann, Peter J; Willke, Richard J; Basu, Anirban; Danzon, Patricia M; Doshi, Jalpa A; Drummond, Michael F; Lakdawalla, Darius N; Pauly, Mark V; Phelps, Charles E; Ramsey, Scott D; Towse, Adrian; Weinstein, Milton C

2018-02-01

This summary section first lists key points from each of the six sections of the report, followed by six key recommendations. The Special Task Force chose to take a health economics approach to the question of whether a health plan should cover and reimburse a specific technology, beginning with the view that the conventional cost-per-quality-adjusted life-year metric has both strengths as a starting point and recognized limitations. This report calls for the development of a more comprehensive economic evaluation that could include novel elements of value (e.g., insurance value and equity) as part of either an "augmented" cost-effectiveness analysis or a multicriteria decision analysis. Given an aggregation of elements to a measure of value, consistent use of a cost-effectiveness threshold can help ensure the maximization of health gain and well-being for a given budget. These decisions can benefit from the use of deliberative processes. The six recommendations are to: 1) be explicit about decision context and perspective in value assessment frameworks; 2) base health plan coverage and reimbursement decisions on an evaluation of the incremental costs and benefits of health care technologies as is provided by cost-effectiveness analysis; 3) develop value thresholds to serve as one important input to help guide coverage and reimbursement decisions; 4) manage budget constraints and affordability on the basis of cost-effectiveness principles; 5) test and consider using structured deliberative processes for health plan coverage and reimbursement decisions; and 6) explore and test novel elements of benefit to improve value measures that reflect the perspectives of both plan members and patients. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Ethical Frameworks, Moral Practices and Outdoor Education.

ERIC Educational Resources Information Center

Fox, Karen M.; Lautt, Mick

Insights from quantum physics and chaos theory help create new metaphors about ethical frameworks and moral practices in outdoor education. The seemingly straightforward concept of values is analogous to the initial simple nonlinear equation of a fractal. The value claims of outdoor education--trust, cooperation, environmental awareness,…

A Mixed-Methods Research Framework for Healthcare Process Improvement.

PubMed

Bastian, Nathaniel D; Munoz, David; Ventura, Marta

2016-01-01

The healthcare system in the United States is spiraling out of control due to ever-increasing costs without significant improvements in quality, access to care, satisfaction, and efficiency. Efficient workflow is paramount to improving healthcare value while maintaining the utmost standards of patient care and provider satisfaction in high stress environments. This article provides healthcare managers and quality engineers with a practical healthcare process improvement framework to assess, measure and improve clinical workflow processes. The proposed mixed-methods research framework integrates qualitative and quantitative tools to foster the improvement of processes and workflow in a systematic way. The framework consists of three distinct phases: 1) stakeholder analysis, 2a) survey design, 2b) time-motion study, and 3) process improvement. The proposed framework is applied to the pediatric intensive care unit of the Penn State Hershey Children's Hospital. The implementation of this methodology led to identification and categorization of different workflow tasks and activities into both value-added and non-value added in an effort to provide more valuable and higher quality patient care. Based upon the lessons learned from the case study, the three-phase methodology provides a better, broader, leaner, and holistic assessment of clinical workflow. The proposed framework can be implemented in various healthcare settings to support continuous improvement efforts in which complexity is a daily element that impacts workflow. We proffer a general methodology for process improvement in a healthcare setting, providing decision makers and stakeholders with a useful framework to help their organizations improve efficiency. Published by Elsevier Inc.

Pharmacokinetic assessment of dapivirine vaginal microbicide gel in healthy, HIV-negative women.

PubMed

Nel, Annalene M; Coplan, Paul; Smythe, Shanique C; McCord, Karen; Mitchnick, Mark; Kaptur, Paulina E; Romano, Joseph

2010-11-01

To assess the pharmacokinetics of dapivirine in plasma and dapivirine concentrations in cervicovaginal fluids (CVF) and cervicovaginal tissues following vaginal administration of dapivirine microbicide gel in healthy, HIV-negative women for 10 days. A randomized, double-blind, phase I study was conducted at a single research center in South Africa. A total of 18 women used dapivirine gel (0.001%, 0.005%, or 0.02%) once daily on Days 1 and 10 and twice daily on Days 2-9. Pharmacokinetics of dapivirine were assessed in plasma on Days 1 and 10. Dapivirine concentrations were measured in CVF on Days 1 and 10 and in cervicovaginal tissues on Day 10. Safety was evaluated through laboratory tests (hematology, clinical chemistry, and urinalysis), physical examinations, and assessment of adverse events. Plasma concentrations of dapivirine increased over time with gel dose and were greater on Day 10 (C(max) 31 to 471 pg/ml) than Day 1 (C(max) 23 to 80 pg/ml). T(max) was 10-12 h on Day 1, and 9 h on Day 10. Concentrations in CVF generally increased with dose but were highly variable among participants. Mean peak values ranged from 4.6-8.3 × 10(6) pg/ml on Day 1 and from 2.3-20.7 × 10(6) pg/ml on Day 10 across dose groups. Dapivirine was detectable in all tissue biopsies on Day 10 at concentrations of 1.0-356 × 10(3) pg/mg. Dapivirine was widely distributed throughout the lower genital tract with low systemic absorption when administered in a vaginal gel formulation for 10 consecutive days. The gel was safe and well tolerated.

Toward Effective Advocacy for Humanistic Values.

ERIC Educational Resources Information Center

Aspy, David N.; Aspy, Cheryl B.

1998-01-01

There is a vigorous, national values debate in America today because of the general sense that the nation's moral standards are in decline. Historically, humanistically oriented counselors such as Abraham Maslow and Carl Rogers have contributed to the values discussions. This article provides a conceptual framework for humanistic counselors of…

The dimensional salience solution to the expectancy-value muddle: an extension.

PubMed

Newton, Joshua D; Newton, Fiona J; Ewing, Michael T

2014-01-01

The theory of reasoned action (TRA) specifies a set of expectancy-value, belief-based frameworks that underpin attitude (behavioural beliefs × outcome evaluations) and subjective norm (normative beliefs × motivation to comply). Unfortunately, the most common method for analysing these frameworks generates statistically uninterpretable findings, resulting in what has been termed the 'expectancy-value muddle'. Recently, however, a dimensional salience approach was found to resolve this muddle for the belief-based framework underpinning attitude. An online survey of 262 participants was therefore conducted to determine whether the dimensional salience approach could also be applied to the belief-based framework underpinning subjective norm. Results revealed that motivations to comply were greater for salient, as opposed to non-salient, social referents. The belief-based framework underpinning subjective norm was therefore represented by evaluating normative belief ratings for salient social referents. This modified framework was found to predict subjective norm, although predictions were greater when participants were forced to select five salient social referents rather than being free to select any number of social referents. These findings validate the use of the dimensional salience approach for examining the belief-based frameworks underpinning subjective norm. As such, this approach provides a complete solution to addressing the expectancy-value muddle in the TRA.

Graduate Employability: A Conceptual Framework for Understanding Employers' Perceptions

ERIC Educational Resources Information Center

Cai, Yuzhuo

2013-01-01

This study provides a conceptual framework for understanding what employers think about the value of graduates with similar educational credentials in the workplace (their employability), using insights from the new institutionalism. In this framework, the development of employers' beliefs about graduates' employability is broken into a number of…

A practical guide for implementing and maintaining value-added clinical systems learning roles for medical students using a diffusion of innovations framework.

PubMed

Gonzalo, Jed D; Graaf, Deanna; Ahluwalia, Amarpreet; Wolpaw, Dan R; Thompson, Britta M

2018-03-21

After emphasizing biomedical and clinical sciences for over a century, US medical schools are expanding experiential roles that allow students to learn about health care delivery while also adding value to patient care. After developing a program where all 1st-year medical students are integrated into interprofessional care teams to contribute to patient care, authors use a diffusion of innovations framework to explore and identify barriers, facilitators, and best practices for implementing value-added clinical systems learning roles. In 2016, authors conducted 32 clinical-site observations, 29 1:1 interviews with mentors, and four student focus-group interviews. Data were transcribed verbatim, and a thematic analysis was used to identify themes. Authors discussed drafts of the categorization scheme, and agreed upon results and quotations. Of 36 sites implementing the program, 17 (47%) remained, 8 (22%) significantly modified, and 11 (31%) withdrew from the program. Identified strategies for implementing value-added roles included: student education, patient characteristics, patient selection methods, activities performed, and resources. Six themes influencing program implementation and maintenance included: (1) educational benefit, (2) value added to patient care from student work, (3) mentor time and site capacity, (4) student engagement, (5) working relationship between school, site, and students, and, (6) students' continuity at the site. Health systems science is an emerging focus for medical schools, and educators are challenged to design practice-based roles that enhance education and add value to patient care. Health professions' schools implementing value-added roles will need to invest resources and strategize about best-practice strategies to guide efforts.

A Spatiotemporal Prediction Framework for Air Pollution Based on Deep RNN

NASA Astrophysics Data System (ADS)

Fan, J.; Li, Q.; Hou, J.; Feng, X.; Karimian, H.; Lin, S.

2017-10-01

Time series data in practical applications always contain missing values due to sensor malfunction, network failure, outliers etc. In order to handle missing values in time series, as well as the lack of considering temporal properties in machine learning models, we propose a spatiotemporal prediction framework based on missing value processing algorithms and deep recurrent neural network (DRNN). By using missing tag and missing interval to represent time series patterns, we implement three different missing value fixing algorithms, which are further incorporated into deep neural network that consists of LSTM (Long Short-term Memory) layers and fully connected layers. Real-world air quality and meteorological datasets (Jingjinji area, China) are used for model training and testing. Deep feed forward neural networks (DFNN) and gradient boosting decision trees (GBDT) are trained as baseline models against the proposed DRNN. Performances of three missing value fixing algorithms, as well as different machine learning models are evaluated and analysed. Experiments show that the proposed DRNN framework outperforms both DFNN and GBDT, therefore validating the capacity of the proposed framework. Our results also provides useful insights for better understanding of different strategies that handle missing values.

Optimising the collection of female genital tract fluid for cytokine analysis in pregnant women.

PubMed

Short, C S; Quinlan, R; Bennett, P; Shattock, R J; Taylor, G P

2018-07-01

To better understand the immunology of pregnancy, study of female genital tract fluid (FGF) is desirable. However the optimum method of collection of FGF in pregnant women for immunological methods, specifically cytokine measurement, is unknown. A prospective study of HIV-uninfected pregnant women comparing two methods of FGF collection: polyvinyl acetal sponge collection of cervical fluid (CF) and menstrual cup collection of cervicovaginal fluid (CVF). Samples were collected at 3 time points across the second and third trimesters: 14-21, 22-25 and 26-31 weeks. Multiplex chemi-luminescent assays were used to measure: IFN-γ, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-13 and TNF-α. Optimal methodology for cytokine normalisation (sample weight, volume and total protein) was explored. All cytokines were measurable in both fluid types. IL-1β, IL-8 and IL-6 were detected at the highest concentrations (ranking order CF > CVF > plasma). CVF collection was simpler, provided the largest volume of sample (median 0.5 g) with the potential for undiluted usage, and allowed for self-insertion. CF cytokine concentrations were intrinsically associated with sample weight and protein concentration however CVF cytokines were independent of these. Both methods of collection are robust for measurement of FGF cytokines during pregnancy. We recommend CVF collection using a menstrual cup as a viable option in pregnant women for high dimensional biological techniques. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Prevent and "British Values"

ERIC Educational Resources Information Center

Kenny, Alex; Ghale, Baljeet

2015-01-01

At the recent National Union of Teachers' conference the role of the Prevent strategy and the introduction of "British Values" in the Office for Standards in Education, Children's Services and Skills framework emerged as key issues for delegates. Two of the speeches made at the conference are presented here.

Closing the delivery gaps in pediatric HIV care in Togo, West Africa: using the care delivery value chain framework to direct quality improvement.

PubMed

Fiori, Kevin; Schechter, Jennifer; Dey, Monica; Braganza, Sandra; Rhatigan, Joseph; Houndenou, Spero; Gbeleou, Christophe; Palerbo, Emmanuel; Tchangani, Elfamozo; Lopez, Andrew; Bensen, Emily; Hirschhorn, Lisa R

2016-03-01

Providing quality care for all children living with HIV/AIDS remains a global challenge and requires the development of new healthcare delivery strategies. The care delivery value chain (CDVC) is a framework that maps activities required to provide effective and responsive care for a patient with a particular disease across the continuum of care. By mapping activities along a value chain, the CDVC enables managers to better allocate resources, improve communication, and coordinate activities. We report on the successful application of the CDVC as a strategy to optimize care delivery and inform quality improvement (QI) efforts with the overall aim of improving care for Pediatric HIV patients in Togo, West Africa. Over the course of 12 months, 13 distinct QI activities in Pediatric HIV/AIDS care delivery were monitored, and 11 of those activities met or exceeded established targets. Examples included: increase in infants receiving routine polymerase chain reaction testing at 2 months (39-95%), increase in HIV exposed children receiving confirmatory HIV testing at 18 months (67-100%), and increase in patients receiving initial CD4 testing within 3 months of HIV diagnosis (67-100%). The CDVC was an effective approach for evaluating existing systems and prioritizing gaps in delivery for QI over the full cycle of Pediatric HIV/AIDS care in three specific ways: (1) facilitating the first comprehensive mapping of Pediatric HIV/AIDS services, (2) identifying gaps in available services, and (3) catalyzing the creation of a responsive QI plan. The CDVC provided a framework to drive meaningful, strategic action to improve Pediatric HIV care in Togo.

Respiratory manifestations in late-onset Pompe disease: a case series conducted in Brazil.

PubMed

Sixel, Bruna de Souza; Silva, Luanda Dias da; Cavalcanti, Nicolette Celani; Penque, Glória Maria Cardoso de Andrade; Lisboa, Sandra; Horovitz, Dafne Dain Gandelman; Llerena, Juan Clinton

2017-01-01

To describe respiratory function in a series of patients with late-onset Pompe disease after the definitive diagnosis and before enzyme replacement therapy. This was a cross-sectional study involving patients with a definitive molecular diagnosis of late-onset Pompe disease. The data analyzed included age at symptom onset; age at definitive diagnosis; type of initial symptoms; time from symptom onset to diagnosis; FVC in the sitting and supine positions; six-minute walk distance; and locomotor ability. Analyses were carried out using frequencies, medians, minimum values, and maximum values. Six patients were included in the study. The median age at symptom onset was 15 years (range, 13-50 years), and the median age at diagnosis was 39.5 years (range, 10-64 years). The median time from symptom onset to diagnosis was 8 years (range, 0-45 years). In all cases, the initial manifestation of the disease had been motor weakness. The median FVC in percentage of the predicted value (FVC%) in the sitting and supine positions was 71.0% (range, 22.9-104.6%) and 58.0% (range, 10.9-106.9%), respectively. The median ΔFVC% was 24.5% (range, -4.59 to 52.40%).The median six-minute walk distance was 391.7 m (range, 97-702 m) . In this case series, the time from symptom onset to diagnosis was long. Although respiratory signs or symptoms were not the initial manifestations of the disease, 66.7% of the patients showed reduced FVC% in the sitting and supine positions at diagnosis. Descrever a função respiratória em uma série de pacientes com doença de Pompe de início tardio após o diagnóstico definitivo e antes do início do tratamento através de terapia de reposição enzimática. Estudo transversal em pacientes com diagnóstico molecular de doença de Pompe de início tardio. As informações analisadas incluíram idade ao início dos sintomas e ao diagnóstico, tipo de sintoma inicial, tempo entre início dos sintomas e diagnóstico, CVF em posição sentada e supina, dist

The Army’s Institutional Values: Current Doctrine and the Army’s Values Training Strategy

DTIC Science & Technology

2001-06-01

laws to the military over the course of 20 years, at first to combat racism and sexism , had opened the door to endless litigation . . . Writers of...consistent with organizational values construction theory ? 7. Are the Army’s values training initiatives consistent with Army training doctrine? The ...doctrine attempts to provide the systematic framework for good leader- theory . Assumptions This study begins with several assumptions. These

A Categorization Model for Educational Values of the History of Mathematics. An Empirical Study

NASA Astrophysics Data System (ADS)

Wang, Xiao-qin; Qi, Chun-yan; Wang, Ke

2017-11-01

There is not a clear consensus on the categorization framework of the educational values of the history of mathematics. By analyzing 20 Chinese teaching cases on integrating the history of mathematics into mathematics teaching based on the relevant literature, this study examined a new categorization framework of the educational values of the history of mathematics by combining the objectives of high school mathematics curriculum in China. This framework includes six dimensions: the harmony of knowledge, the beauty of ideas or methods, the pleasure of inquiries, the improvement of capabilities, the charm of cultures, and the availability of moral education. The results show that this framework better explained the all-educational values of the history of mathematics that all teaching cases showed. Therefore, the framework can guide teachers to better integrate the history of mathematics into teaching.

The social value of mortality risk reduction: VSL versus the social welfare function approach.

PubMed

Adler, Matthew D; Hammitt, James K; Treich, Nicolas

2014-05-01

We examine how different welfarist frameworks evaluate the social value of mortality risk reduction. These frameworks include classical, distributively unweighted cost-benefit analysis--i.e., the "value per statistical life" (VSL) approach-and various social welfare functions (SWFs). The SWFs are either utilitarian or prioritarian, applied to policy choice under risk in either an "ex post" or "ex ante" manner. We examine the conditions on individual utility and on the SWF under which these frameworks display sensitivity to wealth and to baseline risk. Moreover, we discuss whether these frameworks satisfy related properties that have received some attention in the literature, namely equal value of risk reduction, preference for risk equity, and catastrophe aversion. We show that the particular manner in which VSL ranks risk-reduction measures is not necessarily shared by other welfarist frameworks. Copyright © 2014 Elsevier B.V. All rights reserved.

Bridging the gap from values to actions: a family systems framework for family-centered AAC services.

PubMed

Mandak, Kelsey; O'Neill, Tara; Light, Janice; Fosco, Gregory M

2017-03-01

Despite the growing recognition of the importance of family involvement in augmentative and alternative communication (AAC) intervention, little guidance exists on how professionals can establish successful collaborative relationships with families. In this paper, we discuss family systems theory and ecological systems theory as a framework to guide family-centered AAC practice, review family-focused research in AAC, consider how AAC may impact the family system, and provide examples of the clinical implications of using the proposed family systems framework to improve family-centered AAC practice.

Effect of framework soldering on the deformation of implant abutments after framework seating: a study with strain gauges.

PubMed

Mendes, Stella de N C; Edwards Rezende, Carlos E; Moretti Neto, Rafael T; Capello Sousa, Edson A; Henrique Rubo, José

2013-04-01

Passive fit has been considered an important requirement for the longevity of implant-supported prostheses. Among the different steps of prostheses construction, casting is a feature that can influence the precision of fit and consequently the uniformity of possible deformation among abutments upon the framework connection. This study aimed at evaluating the deformation of abutments after the connection of frameworks either cast in one piece or after soldering. A master model was used to simulate a human mandible with 5 implants. Ten frameworks were fabricated on cast models and divided into 2 groups. Strain gauges were attached to the mesial and distal sides of the abutments to capture their deformation after the framework's screw retentions were tightened to the abutments. The mean values of deformation were submitted to a 3-way analysis of variance that revealed significant differences between procedures and the abutment side. The results showed that none of the frameworks presented a complete passive fit. The soldering procedure led to a better although uneven distribution of compression strains on the abutments.

Values and Norms of Proof for Mathematicians and Students

ERIC Educational Resources Information Center

Dawkins, Paul Christian; Weber, Keith

2017-01-01

In this theoretical paper, we present a framework for conceptualizing proof in terms of mathematical values, as well as the norms that uphold those values. In particular, proofs adhere to the values of establishing a priori truth, employing decontextualized reasoning, increasing mathematical understanding, and maintaining consistent standards for…

A Conceptual Framework for Exploring the Role of Studies Abroad in Nurturing Global Citizenship

ERIC Educational Resources Information Center

Tarrant, Michael Andrew

2010-01-01

A conceptual framework, adapted from the Value-Belief-Norm theory, is proposed for understanding the role of studying abroad in nurturing global citizenship. The framework is oriented in concepts of justice, the environment, and civic obligations as key issues in the predictive validity of values, beliefs, and norms. The VBN approach is then…

Models of consumer value cocreation in health care.

PubMed

Nambisan, Priya; Nambisan, Satish

2009-01-01

In recent years, consumer participation in health care has gained critical importance as health care organizations (HCOs) seek varied avenues to enhance the quality and the value of their offerings. Many large HCOs have established online health communities where health care consumers (patients) can interact with one another to share knowledge and offer emotional support in disease management and care. Importantly, the focus of consumer participation in health care has moved beyond such personal health care management as the potential for consumers to participate in innovation and value creation in varied areas of the health care industry becomes increasingly evident. Realizing such potential, however, will require HCOs to develop a better understanding of the varied types of consumer value cocreation that are enabled by new information and communication technologies such as online health communities and Web 2.0 (social media) technologies. This article seeks to contribute toward such an understanding by offering a concise and coherent theoretical framework to analyze consumer value cocreation in health care. We identify four alternate models of consumer value cocreation-the partnership model, the open-source model, the support-group model, and the diffusion model-and discuss their implications for HCOs. We develop our theoretical framework by drawing on theories and concepts in knowledge creation, innovation management, and online communities. A set of propositions are developed by combining theoretical insights from these areas with real-world examples of consumer value cocreation in health care. The theoretical framework offered here informs on the potential impact of the different models of consumer value cocreation on important organizational variables such as innovation cost and time, service quality, and consumer perceptions of HCO. An understanding of the four models of consumer value cocreation can help HCOs adopt appropriate strategies and practices to

Simulation of permeability evolution of leakage pathway in carbonate-rich caprocks in carbon sequestration

NASA Astrophysics Data System (ADS)

Guo, B.; Fitts, J. P.; Dobossy, M. E.; Peters, C. A.

2013-12-01

Geologic carbon sequestration in deep saline aquifers is a promising strategy for mitigating climate change. A major concern is the possibility of brine and CO2 migration through the caprock such as through fractures and faults. In this work, we examine the extent to which mineral dissolution will substantially alter the porosity and permeability of caprock leakage pathways as CO2-acidified brine flows through them. Three models were developed. Firstly, a reactive transport model, Permeability Evolution of Leakage pathway (PEL), was developed to simulate permeability evolution of a leakage pathway during the injection period, and assumes calcite is the only reactive mineral. The system domain is a 100 m long by 0.2 m diameter cylindrical flow path with fixed boundaries containing a rock matrix with an initial porosity of 30% and initial permeability of 1×10-13 m2. One example result is for an initial calcite volume fraction (CVF) of 0.20, in which all the calcite is dissolved after 50 years and the permeability reaches 3.2×10-13 m2. For smaller values of CVF, the permeability reaches its final value earlier but the increase in permeability is minimal. For a large value of CVF such as 0.50, the permeability could eventually reach 1×10-12 m2, but the large amount of dissolved calcium buffers the solution and slows the reaction. After 50 years the permeability change is negligible. Thus, there is a non-monotonic relationship between the amount of calcite in the rock and the resulting permeability change because of the competing dynamics of calcite dissolution and alkalinity build-up. In the second model, PEL was coupled to an existing basin-scale multiphase flow model, Princeton's Estimating Leakage Semi-Analytical (ELSA) model. The new model, ELSA-PEL, estimates the brine and CO2 leakage rates during the injection period under conditions of permeability evolution. The scenario considered in this work is for 50 years of CO2 injection into the Mt. Simon formation in

Visceral perfusion abnormalities following complement activation. Clues to the mediators of organ ischemia in trauma and sepsis. First place winner: Conrad Jobst Award.

PubMed

Schirmer, W J; Schirmer, J M; Naff, G B; Fry, D E

1988-12-01

Complement, activated during infection and injury, has been implicated as a mediator of microvascular injury and obstruction. This study examines how two potent activators of complement, zymosan, and cobra venom factor (CVF), affect systemic and visceral perfusion. Rats were injected with either saline (1 ml/kg), zymosan (5 mg/kg) or CVF (5 units/kg) at t = 0 and 30 minutes. Thermodilution cardiac output, mean arterial pressure, heart rate, systemic vascular resistance, and hematocrit were determined at t = 2 hours. Effective hepatic and renal blood flows, by clearance of galactose and p-aminohippurate respectively, were determined over the next hour. The per cent change in total hemolytic complement from t = 0 to t = 3 hours was determined by immune hemolysis of sheep erythrocytes. There was no difference in systemic hemodynamic parameters between the three groups. Hepatic blood flow was depressed in both the zymosan (3.83 +/- 0.23 ml/min/100 g) and CVF (3.72 +/- 0.20 ml/min/100 g) groups compared with controls (4.62 +/- 0.19 ml/min/100 g, P less than 0.05). Renal blood flow in the zymosan-treated group (6.40 +/- 0.24 ml/min/100 g) increased over control (4.80 +/- 0.40 ml/min/100 g, P less than 0.05) but was unchanged in the CVF group (5.06 +/- 0.23 ml/min/100 g). The amount of complement activated correlated with the change in hepatic (r = -0.419, P less than 0.05) but not renal (r = -0.008, P = 0.917) flow. Complement activation may occupy a proximal position in the pathogenesis of hepatic ischemia associated with trauma and sepsis.

Pharmacodynamic correlations using fresh and cryopreserved tissue following use of vaginal rings containing dapivirine and/or maraviroc in a randomized, placebo controlled trial.

PubMed

Dezzutti, Charlene S; Richardson-Harman, Nicola; Rohan, Lisa C; Marzinke, Mark A; Hoesley, Craig J; Panther, Lori; Johnson, Sherri; Nuttall, Jeremy P; Nel, Annalene; Chen, Beatrice A

2016-07-01

The ex vivo challenge assay is a bio-indicator of drug efficacy and was utilized in this randomized, placebo controlled trial as one of the exploratory endpoints. Fresh and cryopreserved tissues were evaluated for human immunodeficiency virus (HIV) infection and pharmacokinetic (PK)/pharmacodynamic (PD) relationships. HIV-negative women used vaginal rings containing 25 mg dapivirine (DPV)/100 mg maraviroc (MVC) (n = 12), DPV only (n = 12), MVC only (n = 12), or placebo (n = 12) for 28 days. Blood plasma, cervicovaginal fluid (CVF), and cervical biopsies were collected for drug quantification and the ex vivo challenge assay; half (fresh) were exposed immediately to HIV while the other half were cryopreserved, thawed, then exposed to HIV. HIV replication was monitored by p24 enzyme-linked immunosorbent assay from culture supernatant. Data were log-transformed and analyzed by linear least squared regression, nonlinear Emax dose-response model and Satterthwaite t test. HIV replication was greater in fresh compared to cryopreserved tissue (P = 0.04). DPV was detected in all compartments, while MVC was consistently detected only in CVF. Significant negative correlations between p24 and DPV levels were observed in fresh cervical tissue (P = 0.01) and CVF (P = 0.03), but not plasma. CVF MVC levels showed a significant negative correlation with p24 levels (P = 0.03); drug levels in plasma and tissue were not correlated with HIV suppression. p24 levels from cryopreserved tissue did not correlate to either drug from any compartment. Fresh tissue replicated HIV to greater levels and defined PK/PD relationships while cryopreserved tissue did not. The ex vivo challenge assay using fresh tissue could prioritize drugs being considered for HIV prevention.

Exploring the development of a cultural care framework for European caring science

PubMed Central

Rosser, Elizabeth; Bach, Shirley; Uhrenfeldt, Lisbeth; Lundberg, Pranee; Law, Kate

2011-01-01

The aim of this paper is to discuss the development of a cultural care framework that seeks to inform and embrace the philosophical ideals of caring science. Following a review of the literature that identified a lack of evidence of an explicit relationship between caring science and cultural care, a number of well-established transcultural care frameworks were reviewed. Our purpose was to select one that would resonate with underpinning philosophical values of caring science and that drew on criteria generated by the European Academy of Caring Science members. A modified framework based on the work of Giger and Davidhizar was developed as it embraced many of the values such as humanism that are core to caring science practice. The proposed caring science framework integrates determinants of cultural lifeworld-led care and seeks to provide clear directions for humanizing the care of individuals. The framework is offered to open up debate and act as a platform for further academic enquiry. PMID:22171224

Value-informed space systems design and acquisition

NASA Astrophysics Data System (ADS)

Brathwaite, Joy

Investments in space systems are substantial, indivisible, and irreversible, characteristics that make them high-risk, especially when coupled with an uncertain demand environment. Traditional approaches to system design and acquisition, derived from a performance- or cost-centric mindset, incorporate little information about the spacecraft in relation to its environment and its value to its stakeholders. These traditional approaches, while appropriate in stable environments, are ill-suited for the current, distinctly uncertain, and rapidly changing technical and economic conditions; as such, they have to be revisited and adapted to the present context. This thesis proposes that in uncertain environments, decision-making with respect to space system design and acquisition should be value-based, or at a minimum value-informed. This research advances the value-centric paradigm by providing the theoretical basis, foundational frameworks, and supporting analytical tools for value assessment of priced and unpriced space systems. For priced systems, stochastic models of the market environment and financial models of stakeholder preferences are developed and integrated with a spacecraft-sizing tool to assess the system's net present value. The analytical framework is applied to a case study of a communications satellite, with market, financial, and technical data obtained from the satellite operator, Intelsat. The case study investigates the implications of the value-centric versus the cost-centric design and acquisition choices. Results identify the ways in which value-optimal spacecraft design choices are contingent on both technical and market conditions, and that larger spacecraft for example, which reap economies of scale benefits, as reflected by their decreasing cost-per-transponder, are not always the best (most valuable) choices. Market conditions and technical constraints for which convergence occurs between design choices under a cost-centric and a value

Culture and Literacy: Frameworks for Understanding.

ERIC Educational Resources Information Center

Westby, Carol E.

1995-01-01

This article presents a framework for understanding cultural variations in beliefs, values, and communication styles and considers the role of culture in relation to children's response to formal education and literacy. Major dimensions of cultural variability discussed include individualism/collectivism and high-context/low-context. (Author/DB)

School Violence Assessment: A Conceptual Framework, Instruments, and Methods

ERIC Educational Resources Information Center

Benbenishty, Rami; Astor, Ron Avi; Estrada, Joey Nunez

2008-01-01

This article outlines a philosophical and theoretical framework for conducting school violence assessments at the local level. The authors advocate that assessments employ a strong conceptual foundation based on social work values. These values include the active measurement of ecological factors inside and outside the school that reflect the…

An Argumentation Framework based on Paraconsistent Logic

NASA Astrophysics Data System (ADS)

Umeda, Yuichi; Takahashi, Takehisa; Sawamura, Hajime

Argumentation is the most representative of intelligent activities of humans. Therefore, it is natural to think that it could have many implications for artificial intelligence and computer science as well. Specifically, argumentation may be considered a most primitive capability for interaction among computational agents. In this paper we present an argumentation framework based on the four-valued paraconsistent logic. Tolerance and acceptance of inconsistency that this logic has as its logical feature allow for arguments on inconsistent knowledge bases with which we are often confronted. We introduce various concepts for argumentation, such as arguments, attack relations, argument justification, preferential criteria of arguments based on social norms, and so on, in a way proper to the four-valued paraconsistent logic. Then, we provide the fixpoint semantics and dialectical proof theory for our argumentation framework. We also give the proofs of the soundness and completeness.

The Employment of Ethical Decision-Making Frameworks in Educational Change

ERIC Educational Resources Information Center

Horn, Raymond A., Jr.

2004-01-01

In this article, the author provides a prefacing narrative that examines the work of Simpson et al. (2004, this issue), situating the reader as the importance of a framework for curriculum design. Importantly, the author illuminates a set a democratic values that animate the framework, and which work to instruct a democratic ethic of curriculum…

A framework for selecting indicators of bioenergy sustainability

DOE PAGES

Dale, Virginia H.; Efroymson, Rebecca Ann; Kline, Keith L.; ...

2015-05-11

A framework for selecting and evaluating indicators of bioenergy sustainability is presented. This framework is designed to facilitate decision-making about which indicators are useful for assessing sustainability of bioenergy systems and supporting their deployment. Efforts to develop sustainability indicators in the United States and Europe are reviewed. The first steps of the framework for indicator selection are defining the sustainability goals and other goals for a bioenergy project or program, gaining an understanding of the context, and identifying the values of stakeholders. From the goals, context, and stakeholders, the objectives for analysis and criteria for indicator selection can be developed.more » The user of the framework identifies and ranks indicators, applies them in an assessment, and then evaluates their effectiveness, while identifying gaps that prevent goals from being met, assessing lessons learned, and moving toward best practices. The framework approach emphasizes that the selection of appropriate criteria and indicators is driven by the specific purpose of an analysis. Realistic goals and measures of bioenergy sustainability can be developed systematically with the help of the framework presented here.« less

An intertemporal decision framework for electrochemical energy storage management

NASA Astrophysics Data System (ADS)

He, Guannan; Chen, Qixin; Moutis, Panayiotis; Kar, Soummya; Whitacre, Jay F.

2018-05-01

Dispatchable energy storage is necessary to enable renewable-based power systems that have zero or very low carbon emissions. The inherent degradation behaviour of electrochemical energy storage (EES) is a major concern for both EES operational decisions and EES economic assessments. Here, we propose a decision framework that addresses the intertemporal trade-offs in terms of EES degradation by deriving, implementing and optimizing two metrics: the marginal benefit of usage and the average benefit of usage. These metrics are independent of the capital cost of the EES system, and, as such, separate the value of EES use from the initial cost, which provides a different perspective on storage valuation and operation. Our framework is proved to produce the optimal solution for EES life-cycle profit maximization. We show that the proposed framework offers effective ways to assess the economic values of EES, to make investment decisions for various applications and to inform related subsidy policies.

Carrying capacity as "informed judgment": The values of science and the science of values

Treesearch

Robert E. Manning

2001-01-01

Contemporary carrying capacity frameworks, such as Limits of Acceptable Change and Visitor Experience and Resource Protection, rely on formulation of standards of quality, which are defined as minimum acceptable resource and social conditions in parks and wilderness. Formulation of standards of quality involves elements of both science and values, and both of these...

Mapping the Delivery of Societal Benefit through the International Arctic Observations Assessment Framework

NASA Astrophysics Data System (ADS)

Lev, S. M.; Gallo, J.

2017-12-01

The international Arctic scientific community has identified the need for a sustained and integrated portfolio of pan-Arctic Earth-observing systems. In 2017, an international effort was undertaken to develop the first ever Value Tree framework for identifying common research and operational objectives that rely on Earth observation data derived from Earth-observing systems, sensors, surveys, networks, models, and databases to deliver societal benefits in the Arctic. A Value Tree Analysis is a common tool used to support decision making processes and is useful for defining concepts, identifying objectives, and creating a hierarchical framework of objectives. A multi-level societal benefit area value tree establishes the connection from societal benefits to the set of observation inputs that contribute to delivering those benefits. A Value Tree that relies on expert domain knowledge from Arctic and non-Arctic nations, international researchers, Indigenous knowledge holders, and other experts to develop a framework to serve as a logical and interdependent decision support tool will be presented. Value tree examples that map the contribution of Earth observations in the Arctic to achieving societal benefits will be presented in the context of the 2017 International Arctic Observations Assessment Framework. These case studies will highlight specific observing products and capability groups where investment is needed to contribute to the development of a sustained portfolio of Arctic observing systems.

Eli Lilly and Company's bioethics framework for human biomedical research.

PubMed

Van Campen, Luann E; Therasse, Donald G; Klopfenstein, Mitchell; Levine, Robert J

2015-11-01

Current ethics and good clinical practice guidelines address various aspects of pharmaceutical research and development, but do not comprehensively address the bioethical responsibilities of sponsors. To fill this void, in 2010 Eli Lilly and Company developed and implemented a Bioethics Framework for Human Biomedical Research to guide ethical decisions. (See our companion article that describes how the framework was developed and implemented and provides a critique of its usefulness and limitations.) This paper presents the actual framework that serves as a company resource for employee education and bioethics deliberations. The framework consists of four basic ethical principles and 13 essential elements for ethical human biomedical research and resides within the context of our company's mission, vision and values. For each component of the framework, we provide a high-level overview followed by a detailed description with cross-references to relevant well regarded guidance documents. The principles and guidance described should be familiar to those acquainted with research ethics. Therefore the novelty of the framework lies not in the foundational concepts presented as much as the attempt to specify and compile a sponsor's bioethical responsibilities to multiple stakeholders into one resource. When such a framework is employed, it can serve as a bioethical foundation to inform decisions and actions throughout clinical planning, trial design, study implementation and closeout, as well as to inform company positions on bioethical issues. The framework is, therefore, a useful tool for translating ethical aspirations into action - to help ensure pharmaceutical human biomedical research is conducted in a manner that aligns with consensus ethics principles, as well as a sponsor's core values.

The Values System in the Franchising Entrepreneurship

NASA Astrophysics Data System (ADS)

Konstantopoulos, Nikolaos; Tomaras, Petros; Zondiros, Dimitrios

2007-12-01

This paper examines the values system delimiting the entrepreneurial activity. The total of these entrepreneurial activities is defined within the franchising framework. The reason for choosing to examine these activities is that franchising is considered to be a rather special kind of entrepreneurship. By this way, it can be examined whether specific entrepreneurial values are required in order to turn to franchising, or it concerns a strategic entrepreneurial choice which is independent from the value standards.

Managing Across Cultures: A Learning Framework.

ERIC Educational Resources Information Center

Wilson, Meena S.; And Others

An approach to managing personnel across cultures is outlined. A framework is provided to help the supervisor become aware of beliefs and values that underlie the workplace preferences of managers in the United States and of other cultures. It integrates research in anthropology, cross-cultural psychology, and international business management. An…

Developing an evaluation framework for clinical redesign programs: lessons learnt.

PubMed

Samaranayake, Premaratne; Dadich, Ann; Fitzgerald, Anneke; Zeitz, Kathryn

2016-09-19

Purpose The purpose of this paper is to present lessons learnt through the development of an evaluation framework for a clinical redesign programme - the aim of which was to improve the patient journey through improved discharge practices within an Australian public hospital. Design/methodology/approach The development of the evaluation framework involved three stages - namely, the analysis of secondary data relating to the discharge planning pathway; the analysis of primary data including field-notes and interview transcripts on hospital processes; and the triangulation of these data sets to devise the framework. The evaluation framework ensured that resource use, process management, patient satisfaction, and staff well-being and productivity were each connected with measures, targets, and the aim of clinical redesign programme. Findings The application of business process management and a balanced scorecard enabled a different way of framing the evaluation, ensuring measurable outcomes were connected to inputs and outputs. Lessons learnt include: first, the importance of mixed-methods research to devise the framework and evaluate the redesigned processes; second, the need for appropriate tools and resources to adequately capture change across the different domains of the redesign programme; and third, the value of developing and applying an evaluative framework progressively. Research limitations/implications The evaluation framework is limited by its retrospective application to a clinical process redesign programme. Originality/value This research supports benchmarking with national and international practices in relation to best practice healthcare redesign processes. Additionally, it provides a theoretical contribution on evaluating health services improvement and redesign initiatives.

ESR concept paper on value-based radiology.

PubMed

2017-10-01

The European Society of Radiology (ESR) established a Working Group on Value-Based Imaging (VBI WG) in August 2016 in response to developments in European healthcare systems in general, and the trend within radiology to move from volume- to value-based practice in particular. The value-based healthcare (VBH) concept defines "value" as health outcomes achieved for patients relative to the costs of achieving them. Within this framework, value measurements start at the beginning of therapy; the whole diagnostic process is disregarded, and is considered only if it is the cause of errors or complications. Making the case for a new, multidisciplinary organisation of healthcare delivery centred on the patient, this paper establishes the diagnosis of disease as a first outcome in the interrelated activities of the healthcare chain. Metrics are proposed for measuring the quality of radiologists' diagnoses and the various ways in which radiologists provide value to patients, other medical specialists and healthcare systems at large. The ESR strongly believes value-based radiology (VBR) is a necessary complement to existing VBH concepts. The Society is determined to establish a holistic VBR programme to help European radiologists deal with changes in the evolution from volume- to value-based evaluation of radiological activities. Main Messages • Value-based healthcare defines value as patient's outcome over costs. • The VBH framework disregards the diagnosis as an outcome. • VBH considers diagnosis only if wrong or a cause of complications. • A correct diagnosis is the first outcome that matters to patients. • Metrics to measure radiologists' impacts on patient outcomes are key. • The value provided by radiology is multifaceted, going beyond exam volumes.

A Categorization Model for Educational Values of the History of Mathematics: An Empirical Study

ERIC Educational Resources Information Center

Wang, Xiao-qin; Qi, Chun-yan; Wang, Ke

2017-01-01

There is not a clear consensus on the categorization framework of the educational values of the history of mathematics. By analyzing 20 Chinese teaching cases on integrating the history of mathematics into mathematics teaching based on the relevant literature, this study examined a new categorization framework of the educational values of the…

A Value-Added Framework for Analyzing Electronic and Print Publishing.

ERIC Educational Resources Information Center

Perritt, Henry H., Jr.

1991-01-01

Discusses changes in the publishing industry resulting from digital electronic networks and optical storage technologies, and explains attributes of information products as types of value for both print and electronic contexts. Electronic products necessary for a shift from paper to electronic formats are identified, and legal issues are…

The Value of Physical Examination: A New Conceptual Framework.

PubMed

Zaman, Junaid; Verghese, Abraham; Elder, Andrew

2016-12-01

The physical examination defines medical practice, yet its role is being questioned increasingly, with statistical comparisons of diagnostic accuracy often the sole metric used against newer technologies. We set out to highlight seven ways in which the physical examination has value beyond diagnostic accuracy to reaffirm its place in the core skills of a physician and guide future research, teaching, and curriculum design. We show that this more comprehensive approach to the physical examination of its "utility" beyond that of reaching a diagnosis can be beneficial to both doctor and patient.

Project Assessment Framework through Design (PAFTD) - A Project Assessment Framework in Support of Strategic Decision Making

NASA Technical Reports Server (NTRS)

Depenbrock, Brett T.; Balint, Tibor S.; Sheehy, Jeffrey A.

2014-01-01

Research and development organizations that push the innovation edge of technology frequently encounter challenges when attempting to identify an investment strategy and to accurately forecast the cost and schedule performance of selected projects. Fast moving and complex environments require managers to quickly analyze and diagnose the value of returns on investment versus allocated resources. Our Project Assessment Framework through Design (PAFTD) tool facilitates decision making for NASA senior leadership to enable more strategic and consistent technology development investment analysis, beginning at implementation and continuing through the project life cycle. The framework takes an integrated approach by leveraging design principles of useability, feasibility, and viability and aligns them with methods employed by NASA's Independent Program Assessment Office for project performance assessment. The need exists to periodically revisit the justification and prioritization of technology development investments as changes occur over project life cycles. The framework informs management rapidly and comprehensively about diagnosed internal and external root causes of project performance.

The Royal Australian and New Zealand College of Radiologists (RANZCR) relative value unit workload model, its limitations and the evolution to a safety, quality and performance framework.

PubMed

Pitman, A; Jones, D N; Stuart, D; Lloydhope, K; Mallitt, K; O'Rourke, P

2009-10-01

The study reports on the evolution of the Australian radiologist relative value unit (RVU) model of measuring radiologist reporting workloads in teaching hospital departments, and aims to outline a way forward for the development of a broad national safety, quality and performance framework that enables value mapping, measurement and benchmarking. The Radiology International Benchmarking Project of Queensland Health provided a suitable high-level national forum where the existing Pitman-Jones RVU model was applied to contemporaneous data, and its shortcomings and potential avenues for future development were analysed. Application of the Pitman-Jones model to Queensland data and also a Victorian benchmark showed that the original recommendation of 40,000 crude RVU per full-time equivalent consultant radiologist (97-98 baseline level) has risen only moderately, to now lie around 45,000 crude RVU/full-time equivalent. Notwithstanding this, the model has a number of weaknesses and is becoming outdated, as it cannot capture newer time-consuming examinations particularly in CT. A significant re-evaluation of the value of medical imaging is required, and is now occurring. We must rethink how we measure, benchmark, display and continually improve medical imaging safety, quality and performance, throughout the imaging care cycle and beyond. It will be necessary to ensure alignment with patient needs, as well as clinical and organisational objectives. Clear recommendations for the development of an updated national reporting workload RVU system are available, and an opportunity now exists for developing a much broader national model. A more sophisticated and balanced multidimensional safety, quality and performance framework that enables measurement and benchmarking of all important elements of health-care service is needed.

Climate Services for Development Planning and Implementation: A Framework for Assessing and Valuing Climate Services

NASA Astrophysics Data System (ADS)

Anderson, G.

2012-04-01

Climate Services for Development Planning and Implementation: A Framework for Assessing and Valuing Climate Services Anderson, Glen D. While weather forecasting products have been available globally for decades, the full suite of climate services - including historical and real time observational meteorological data, daily, weekly, and seasonal forecasts, and longer-term climate projections - has only been under development in the last 15 to 20 years. Climate services have been developed and implemented quite quickly in developed countries for public and private sector users. However, diffusion of these tools in developing countries has been slower for several reasons related to 1) lack of awareness of the opportunities and benefits of climate services; 2) spotty record of managing local weather and climate data; and 3) limited resources to build and sustain capacity in providing climate services. The Climate Services Partnership (CSP) was formed during the International Conference on Climate Services (ICCS) in October 2011. The CSP seeks to improve the provision and development of climate services worldwide. During the ICCS, three working groups were formed to carry out the work program of the CSP leading up to the second ICCS in Berlin in September 2012. The Economic Valuation of Climate Services Working Group, chaired by John Zillman and myself, is collaborating on several activities to demonstrate the benefits of climate services and help providers prioritize opportunities for expanding the use of climate services. The proposed paper will provide an overview of the Working Group's activities leading up to the next ICCS and describe specific work that is underway and expected to be completed prior to the EGU meetings. The focal point of the Working Group's activities is the development of matrix to help identify and value the best opportunities for using climate services. Different categories of climate services will be listed in rows and potential users of

Respiratory muscle strength and pulmonary function in children with rhinitis and asthma after a six-minute walk test.

PubMed

Soares, Ana Alice de Almeida; Barros, Camila Moraes; Santos, Cássia Giulliane Costa; Dos Santos, Maria Renata Aragão; Silva, José Rodrigo Santos; Silva Junior, Walderi Monteiro da; Simões, Silvia de Magalhães

2018-03-01

Rhinitis and asthma decrease quality of life. Few studies have assessed the performance of children with asthma or rhinitis under submaximal exercise. We evaluated maximal respiratory pressures, spirometric parameters, and ability to sustain submaximal exercise in these children before and after the 6-minute walk test (6MWT), compared to healthy children. This cross-sectional, analytical study included 89 children aged 6-12 years in outpatient follow-up: 27 healthy (H), 31 with rhinitis (R), and 31 with mild asthma under control (A). Pulmonary function parameters and maximal respiratory pressures were measured before and 5, 10, and 30 minutes after the 6MWT. Wilcoxon test was used to compare numerical numerical variables between two groups and analysis of variance or Kruskal-Wallis test for comparison among three groups. Total distance traveled in the 6MWT was similar among the three groups. Compared to pre-test values, VEF1 (Forced Expiratory Volume in 1 second), VEF0.75 (Forced Expiratory Volume in 0.75 second), and FEF25-75 (Forced Expiratory Flow 25-75% of the Forced Vital Capacity - CVF - curve) decreased significantly after the 6MWT in group A, and VEF0.75, FEF25-75, and VEF1/CVF decreased significantly in group R. Groups A and R had lower Maximum Inspiratory Pressure values than group H before and after the 6MWT at all time points assessed. The findings suggest that children with rhinitis and mild asthma present with alterations in respiratory muscle strength and pulmonary function not associated with clinical complaints, reinforcing the concept of the united airways.

Learning Difficulties and Ethnicity: Updating a Framework for Action

ERIC Educational Resources Information Center

Poxton, Richard

2012-01-01

This update of the Framework for Action highlights the continuing relevance of its message as well as those raised by Valuing People Now. People with learning difficulties and their families from Black and minority ethnic (BME) communities have been highlighted as a priority group by Valuing People since 2001 and remain a priority for better…

Electrical parameters of Au/n-GaN and Pt/n-GaN Schottky diodes

NASA Astrophysics Data System (ADS)

Kadaoui, Mustapha Amine; Bouiadjra, Wadi Bachir; Saidane, Abdelkader; Belahsene, Sofiane; Ramdane, Abderrahim

2015-06-01

Electrical properties of Si-doped GaN epitaxial layers, grown on a c-plane sapphire substrate by MOCVD to form Schottky diodes with Gold (Au) and platinum (Pt) and using Ti/Al/Au as Ohmic contact, are investigated. Characterization was performed through I-V and C-V-f measurements at room temperature. Schottky barrier height (Φb), ideality factor (n), and series resistance (Rs) were extracted from forward I-V characteriztics using Cheung and Lien methods. Φb, doping concentration (Nd) and Rs frequency dependence were extracted from C-V-f characteriztics. Pt/n-GaN shows a non-linear behavior with a barrier height of 0.63 eV, an ideality factor of 2.3, and series resistance of 63 Ω. Au/n-GaN behaves like two diodes in parallel with two barrier heights of (0.83 and 0.9 eV), two ideality factors of (5.8 and 3.18) and two series resistance of (10.6 and 68 Ω). Interface state properties in both samples have been investigated taking into account the bias dependence of the effective barrier height. The amount of stimulated traps along the energy-gap at the interface increases with voltage bias, which increases NSS exponentially from 4.24 ṡ 1013 to 3.67 ṡ 1014 eV-1 cm-2 in the range (Ec - 0.17) to (Ec - 0.61) eV for Pt/n-GaN, and from 2.3 ṡ 1013 to 1.14 ṡ 1014 eV-1 cm-2, in the range (Ec - 0.31) to (Ec - 0.82) eV for Au/n-GaN. The values of interface states density and series resistance for both samples are found to decrease with increasing frequency. Peak intensity was a measure of active interface states. C-V-f results confirm the model of the Schottky diode with a native interfacial insulator layer along the space charge region.

[Effect of edaravone on oxidative stress and myocardial fibrosis induced by isoproterenol in rats].

PubMed

Wang, Shixiang; Lu, Zhifeng; Xu, Wei; Chen, Youquan; Chen, Ximing

2015-11-01

To investigate the effect of edaravone on oxidative stress and myocardial fibrosis induced by isoproterenol in rats. Fifty male SD rats were randomly divided into 5 groups, including a control group, a myocardial fibrosis model (established by injections of isopropyl adrenaline for 10 days) group, and 3 edaravone groups with edaravone treatment at low, medium, or high doses for 14 days. After the treatments, the rats were examined for the degree of myocardial fibrosis, left ventricular mass index (LVMI), collagen volume fraction (CVF), and myocardial contents of collagen I (Col I), collage III (Col III), hydroxyproline (Hyp), superoxide dismutase (SOD), malondialdehyde (MDA), and nitric oxide (NO); The expression of transforming growth factor-β1 (TGF-β1) in the myocardial tissues was examined by immunofluorescence assay and Western blotting. Compared with the control rats, the rat models of myocardial fibrosis showed significantly increased CVF and LVMI (P=0.000), which were lowered by edaravone treatments in a dose-dependent manner (P<0.05). The myocardial contents of Col I, Col III and Hyp also increased in the model group (P=0.000) and were lowered dose-dependently by edaravone; the contents of MDA was higher (P=0.000) and SOD and NO were lower in the model group (P=0.000), and edaravone treatments obviously increased SOD and NO contents (P<0.05). The model rats showed significantly increased myocardial expression of TGF-β1 (P=0.000), which was markedly lowered by edaravone treatments (P=0.000). The myocardial content of MDA was positively correlated while SOD and NO were negatively with LVMI, CVF, Col I, Col III and Hyp; TGF-β1 was positively correlated with LVMI, CVF, Col I, Col III, Hyp and MDA but negatively with SOD and NO. Edaravone can relieve oxidative stress and inhibit TGF-β1 activation to ameliorate myocardial fibrosis in rats.

Pharmacodynamic correlations using fresh and cryopreserved tissue following use of vaginal rings containing dapivirine and/or maraviroc in a randomized, placebo controlled trial

PubMed Central

Dezzutti, Charlene S.; Richardson-Harman, Nicola; Rohan, Lisa C.; Marzinke, Mark A.; Hoesley, Craig J.; Panther, Lori; Johnson, Sherri; Nuttall, Jeremy P.; Nel, Annalene; Chen, Beatrice A.

2016-01-01

Abstract Background: The ex vivo challenge assay is a bio-indicator of drug efficacy and was utilized in this randomized, placebo controlled trial as one of the exploratory endpoints. Fresh and cryopreserved tissues were evaluated for human immunodeficiency virus (HIV) infection and pharmacokinetic (PK)/pharmacodynamic (PD) relationships. Methods: HIV-negative women used vaginal rings containing 25 mg dapivirine (DPV)/100 mg maraviroc (MVC) (n = 12), DPV only (n = 12), MVC only (n = 12), or placebo (n = 12) for 28 days. Blood plasma, cervicovaginal fluid (CVF), and cervical biopsies were collected for drug quantification and the ex vivo challenge assay; half (fresh) were exposed immediately to HIV while the other half were cryopreserved, thawed, then exposed to HIV. HIV replication was monitored by p24 enzyme-linked immunosorbent assay from culture supernatant. Data were log-transformed and analyzed by linear least squared regression, nonlinear Emax dose–response model and Satterthwaite t test. Results: HIV replication was greater in fresh compared to cryopreserved tissue (P = 0.04). DPV was detected in all compartments, while MVC was consistently detected only in CVF. Significant negative correlations between p24 and DPV levels were observed in fresh cervical tissue (P = 0.01) and CVF (P = 0.03), but not plasma. CVF MVC levels showed a significant negative correlation with p24 levels (P = 0.03); drug levels in plasma and tissue were not correlated with HIV suppression. p24 levels from cryopreserved tissue did not correlate to either drug from any compartment. Conclusion: Fresh tissue replicated HIV to greater levels and defined PK/PD relationships while cryopreserved tissue did not. The ex vivo challenge assay using fresh tissue could prioritize drugs being considered for HIV prevention. PMID:27428211

Organizational culture in an academic health center: an exploratory study using a competing values framework.

PubMed

Ovseiko, Pavel V; Buchan, Alastair M

2012-06-01

Implementing cultural change and aligning organizational cultures could enhance innovation, quality, safety, and job satisfaction. The authors conducted this mixed-methods study to assess academic physician-scientists' perceptions of the current and preferred future organizational culture at a university medical school and its partner health system. In October 2010, the authors surveyed academic physicians and scientists jointly employed by the University of Oxford and its local, major partner health system. The survey included the U.S. Veterans Affairs Administration's 14-item Competing Values Framework instrument and two extra items prompting respondents to identify their substantive employer and to provide any additional open-ended comments. Of 436 academic physicians and scientists, 170 (39%) responded. Of these, 69 (41%) provided open-ended comments. Dominant hierarchical culture, moderate rational and team cultures, and underdeveloped entrepreneurial culture characterized the health system culture profile. The university profile was more balanced, with strong rational and entrepreneurial cultures, and moderate-to-strong hierarchical and team cultures. The preferred future culture (within five years) would emphasize team and entrepreneurial cultures and-to a lesser degree-rational culture, and would deemphasize hierarchical culture. Whereas the university and the health system currently have distinct organizational cultures, academic physicians and scientists would prefer the same type of culture across the two organizations so that both could more successfully pursue the shared mission of academic medicine. Further research should explore strengthening the validity and reliability of the organizational culture instrument for academic medicine and building an evidence base of effective culture change strategies and interventions.

Expected net present value of sample information: from burden to investment.

PubMed

Hall, Peter S; Edlin, Richard; Kharroubi, Samer; Gregory, Walter; McCabe, Christopher

2012-01-01

The Expected Value of Information Framework has been proposed as a method for identifying when health care technologies should be immediately reimbursed and when any reimbursement should be withheld while awaiting more evidence. This framework assesses the value of obtaining additional evidence to inform a current reimbursement decision. This represents the burden of not having the additional evidence at the time of the decision. However, when deciding whether to reimburse now or await more evidence, decision makers need to know the value of investing in more research to inform a future decision. Assessing this value requires consideration of research costs, research time, and what happens to patients while the research is undertaken and after completion. The investigators describe a development of the calculation of the expected value of sample information that assesses the value of investing in further research, including an only-in-research strategy and an only-with-research strategy.

Decision making from economic and signal detection perspectives: development of an integrated framework

PubMed Central

Lynn, Spencer K.; Wormwood, Jolie B.; Barrett, Lisa F.; Quigley, Karen S.

2015-01-01

Behavior is comprised of decisions made from moment to moment (i.e., to respond one way or another). Often, the decision maker cannot be certain of the value to be accrued from the decision (i.e., the outcome value). Decisions made under outcome value uncertainty form the basis of the economic framework of decision making. Behavior is also based on perception—perception of the external physical world and of the internal bodily milieu, which both provide cues that guide decision making. These perceptual signals are also often uncertain: another person's scowling facial expression may indicate threat or intense concentration, alternatives that require different responses from the perceiver. Decisions made under perceptual uncertainty form the basis of the signals framework of decision making. Traditional behavioral economic approaches to decision making focus on the uncertainty that comes from variability in possible outcome values, and typically ignore the influence of perceptual uncertainty. Conversely, traditional signal detection approaches to decision making focus on the uncertainty that arises from variability in perceptual signals and typically ignore the influence of outcome value uncertainty. Here, we compare and contrast the economic and signals frameworks that guide research in decision making, with the aim of promoting their integration. We show that an integrated framework can expand our ability to understand a wider variety of decision-making behaviors, in particular the complexly determined real-world decisions we all make every day. PMID:26217275

Peddling Poverty for Profit: Elements of Oppression in Ruby Payne's Framework

ERIC Educational Resources Information Center

Gorski, Paul C.

2008-01-01

Ruby Payne, CEO of aha! Process, Inc., and author of "A Framework for Understanding Poverty" (2005), has become one of the most influential figures in the U.S. public education milieu. Payne's framework, built largely upon understanding the "culture" of poverty, instructs educators on the values and mindsets poor students carry into the classroom…

A dynamic modelling framework towards the solution of reduction in smoking prevalence

NASA Astrophysics Data System (ADS)

Halim, Tisya Farida Abdul; Sapiri, Hasimah; Abidin, Norhaslinda Zainal

2016-10-01

This paper presents a hypothetical framework towards the solution for reduction in smoking prevalence in Malaysia. The framework is design to assist in decision making process related to reduction in smoking prevalence using SD and OCT. In general, this framework is developed using SD approach where OCT is embedded in the policy evaluation process. Smoking prevalence is one of the determinant which plays an important role in measuring a successful implementation of anti-smoking strategies. Therefore, it is critical to determine the optimal value of smoking prevalence in order to trim down the hazardous effects of smoking to society. Conversely, smoking problem becomes increasingly complex since many issues that ranged from behavioral to economical need to be considered simultaneously. Thus, a hypothetical framework of the control model embedded in the SD methodology is expected to obtain the minimum value of smoking prevalence which the output in turn will provide a guideline for tobacco researchers as well as decision makers for policy design and evaluation.

From Community Gyms to Classrooms: A Framework for Values-Transfer in Schools

ERIC Educational Resources Information Center

Martinek, Tom; Lee, Okseon

2012-01-01

Although it is assumed that the values learned in physical activity-based youth programs can be applied in other areas of life, the transfer of values has not been widely explored. The purpose of this article is to address the transfer issue as it relates to physical activity programs and school cultures. The article begins with an overview of the…

The Conceptual Framework of Thematic Mapping in Case Conceptualization.

PubMed

Ridley, Charles R; Jeffrey, Christina E

2017-04-01

This article, the 3rd in a series of 5, introduces the conceptual framework for thematic mapping, a novel approach to case conceptualization. The framework is transtheoretical in that it is not constrained by the tenets or concepts of any one therapeutic orientation and transdiagnostic in that it conceptualizes clients outside the constraints of diagnostic criteria. Thematic mapping comprises 4 components: a definition, foundational principles, defining features, and core concepts. These components of the framework, deemed building blocks, are explained in this article. Like the foundation of any structure, the heuristic value of the method requires that the building blocks have integrity, coherence, and sound anchoring. We assert that the conceptual framework provides a solid foundation, making thematic mapping a potential asset in mental health treatment. © 2017 Wiley Periodicals, Inc.

Value-based genomics.

PubMed

Gong, Jun; Pan, Kathy; Fakih, Marwan; Pal, Sumanta; Salgia, Ravi

2018-03-20

Advancements in next-generation sequencing have greatly enhanced the development of biomarker-driven cancer therapies. The affordability and availability of next-generation sequencers have allowed for the commercialization of next-generation sequencing platforms that have found widespread use for clinical-decision making and research purposes. Despite the greater availability of tumor molecular profiling by next-generation sequencing at our doorsteps, the achievement of value-based care, or improving patient outcomes while reducing overall costs or risks, in the era of precision oncology remains a looming challenge. In this review, we highlight available data through a pre-established and conceptualized framework for evaluating value-based medicine to assess the cost (efficiency), clinical benefit (effectiveness), and toxicity (safety) of genomic profiling in cancer care. We also provide perspectives on future directions of next-generation sequencing from targeted panels to whole-exome or whole-genome sequencing and describe potential strategies needed to attain value-based genomics.

Value-based genomics

PubMed Central

Gong, Jun; Pan, Kathy; Fakih, Marwan; Pal, Sumanta; Salgia, Ravi

2018-01-01

Advancements in next-generation sequencing have greatly enhanced the development of biomarker-driven cancer therapies. The affordability and availability of next-generation sequencers have allowed for the commercialization of next-generation sequencing platforms that have found widespread use for clinical-decision making and research purposes. Despite the greater availability of tumor molecular profiling by next-generation sequencing at our doorsteps, the achievement of value-based care, or improving patient outcomes while reducing overall costs or risks, in the era of precision oncology remains a looming challenge. In this review, we highlight available data through a pre-established and conceptualized framework for evaluating value-based medicine to assess the cost (efficiency), clinical benefit (effectiveness), and toxicity (safety) of genomic profiling in cancer care. We also provide perspectives on future directions of next-generation sequencing from targeted panels to whole-exome or whole-genome sequencing and describe potential strategies needed to attain value-based genomics. PMID:29644010

Cardiovascular fitness moderates the relations between estimates of obesity and physical self-perceptions in rural elementary school students.

PubMed

Mitchell, Nathanael G; Moore, Justin B; Bibeau, Wendy S; Rudasill, Kathleen M

2012-02-01

Levels of physical activity decline throughout childhood. Children's physical self-perceptions have been found to relate to their physical activity. Understanding the relationships among physical self-perceptions, obesity, and physical activity could have important implications for interventions in children. The current study investigated the moderating effect of cardiovascular fitness (CVF, heart rate recovery from a 3-minute step test) on the relationship between obesity (BMI, waist circumference) and physical self-perceptions (athletic competence, physical appearance) in 104 fourth- and fifth-grade children from a small rural community. Hierarchical regression analyses indicated that CVF moderated the relations between BMI and waist circumference on athletic competence. For children with lower fitness, higher waist circumference was associated with lower athletic competence, while for children with higher fitness levels, higher BMI was associated with higher athletic competence. Results also indicated that both BMI and waist circumference were negatively related to physical appearance. CVF moderated these relations such that only children with lower fitness, greater BMI and waist circumference was associated with poorer physical appearance scores. Implications include the need for support of fitness programs to promote psychological well-being and to investigate the relationship between obesity and physical self-perceptions within the context of fitness.

A Framework for Measuring the Economic Benefits of Ground Water (1995)

EPA Pesticide Factsheets

The primary goal of this 1995 report is to develop a framework for assessing the economic value of ground water that is applicable to all offices within U.S. EPA that consider the value of ground water resources when conducting Regulatory Impact Analyses

Valuing Trial Designs from a Pharmaceutical Perspective Using Value-Based Pricing.

PubMed

Breeze, Penny; Brennan, Alan

2015-11-01

Our aim was to adapt the traditional framework for expected net benefit of sampling (ENBS) to be more compatible with drug development trials from the pharmaceutical perspective. We modify the traditional framework for conducting ENBS and assume that the price of the drug is conditional on the trial outcomes. We use a value-based pricing (VBP) criterion to determine price conditional on trial data using Bayesian updating of cost-effectiveness (CE) model parameters. We assume that there is a threshold price below which the company would not market the new intervention. We present a case study in which a phase III trial sample size and trial duration are varied. For each trial design, we sampled 10,000 trial outcomes and estimated VBP using a CE model. The expected commercial net benefit is calculated as the expected profits minus the trial costs. A clinical trial with shorter follow-up, and larger sample size, generated the greatest expected commercial net benefit. Increasing the duration of follow-up had a modest impact on profit forecasts. Expected net benefit of sampling can be adapted to value clinical trials in the pharmaceutical industry to optimise the expected commercial net benefit. However, the analyses can be very time consuming for complex CE models. © 2014 The Authors. Health Economics published by John Wiley & Sons Ltd.

Evidence, Ethics, and Values: A Framework for Health Promotion

PubMed Central

Rychetnik, Lucie; Dietetics, PGradDip; Lloyd, Beverley; Kerridge, Ian H.; Baur, Louise; Bauman, Adrian; Hooker, Claire; Zask, Avigdor

2011-01-01

We propose a new approach to guide health promotion practice. Health promotion should draw on 2 related systems of reasoning: an evidential system and an ethical system. Further, there are concepts, values, and procedures inherent in both health promotion evidence and ethics, and these should be made explicit. We illustrate our approach with the exemplar of intervention in weight, and use a specific mass-media campaign to show the real-world dangers of intervening with insufficient attention to ethics and evidence. Both researchers and health promotion practitioners should work to build the capacities required for evidential and ethical deliberation in the health promotion profession. PMID:21233436

Valuing ecosystem services in terms of ecological risks and returns.

PubMed

Abson, David J; Termansen, Mette

2011-04-01

The economic valuation of ecosystem services is a key policy tool in stemming losses of biological diversity. It is proposed that the loss of ecosystem function and the biological resources within ecosystems is due in part to the failure of markets to recognize the benefits humans derive from ecosystems. Placing monetary values on ecosystem services is often suggested as a necessary step in correcting such market failures. We consider the effects of valuing different types of ecosystem services within an economic framework. We argue that provisioning and regulating ecosystem services are generally produced and consumed in ways that make them amenable to economic valuation. The values associated with cultural ecosystem services lie outside the domain of economic valuation, but their worth may be expressed through noneconomic, deliberative forms of valuation. We argue that supporting ecosystem services are not of direct value and that the losses of such services can be expressed in terms of the effects of their loss on the risk to the provision of the directly valued ecosystem services they support. We propose a heuristic framework that considers the relations between ecological risks and returns in the provision of ecosystem services. The proposed ecosystem-service valuation framework, which allows the expression of the value of all types of ecosystem services, calls for a shift from static, purely monetary valuation toward the consideration of trade-offs between the current flow of benefits from ecosystems and the ability of those ecosystems to provide future flows. ©2010 Society for Conservation Biology.

A Generalized Framework for Non-Stationary Extreme Value Analysis

NASA Astrophysics Data System (ADS)

Ragno, E.; Cheng, L.; Sadegh, M.; AghaKouchak, A.

2017-12-01

Empirical trends in climate variables including precipitation, temperature, snow-water equivalent at regional to continental scales are evidence of changes in climate over time. The evolving climate conditions and human activity-related factors such as urbanization and population growth can exert further changes in weather and climate extremes. As a result, the scientific community faces an increasing demand for updated appraisal of the time-varying climate extremes. The purpose of this study is to offer a robust and flexible statistical tool for non-stationary extreme value analysis which can better characterize the severity and likelihood of extreme climatic variables. This is critical to ensure a more resilient environment in a changing climate. Following the positive feedback on the first version of Non-Stationary Extreme Value Analysis (NEVA) Toolbox by Cheng at al. 2014, we present an improved version, i.e. NEVA2.0. The upgraded version herein builds upon a newly-developed hybrid evolution Markov Chain Monte Carlo (MCMC) approach for numerical parameters estimation and uncertainty assessment. This addition leads to a more robust uncertainty estimates of return levels, return periods, and risks of climatic extremes under both stationary and non-stationary assumptions. Moreover, NEVA2.0 is flexible in incorporating any user-specified covariate other than the default time-covariate (e.g., CO2 emissions, large scale climatic oscillation patterns). The new feature will allow users to examine non-stationarity of extremes induced by physical conditions that underlie the extreme events (e.g. antecedent soil moisture deficit, large-scale climatic teleconnections, urbanization). In addition, the new version offers an option to generate stationary and/or non-stationary rainfall Intensity - Duration - Frequency (IDF) curves that are widely used for risk assessment and infrastructure design. Finally, a Graphical User Interface (GUI) of the package is provided, making NEVA

Asian Care Certificate (ACC): a care quality assurance framework.

PubMed

Talaie, Tony

2018-04-16

Purpose Quality assuring elderly care through a viable and feasible standard framework is a major challenge for Asian governments. Although several attempts have been made to tackle foreign care worker (FCW) shortage, assuring the quality of the care they provide has been overlooked. The original framework allowed a better control over service quality to assure the elderly about their care according to the agreed standards. The paper aims to discuss these issues. Design/methodology/approach Through several Japanese Governmental meetings, a new Asian Care Certificate (ACC) program is discussed based on the Japanese Care Certificate (JCC). The governments' representatives adopted the JCC to form the ACC, which enables the ACC board to evaluate care workers and to intervene whenever the desired quality level is not achieved. Findings The author describes a new program. The findings of this paper will be confirmed when the ACC is implemented. Practical implications Using the ACC framework, the challenge in providing a high-quality care service using FCWs across Asia would be partly resolved. FCWs' quality of life might also gradually improve especially regarding to their human rights. Originality/value The ACC provides a new framework. Its value is recognized if one considers that many Asian populations are rapidly aging and many governments compromise quality by employing overseas workers to solve care worker shortages.

Health technology assessment, value-based decision making, and innovation.

PubMed

Henshall, Chris; Schuller, Tara

2013-10-01

Identifying treatments that offer value and value for money is becoming increasingly important, with interest in how health technology assessment (HTA) and decision makers can take appropriate account of what is of value to patients and to society, and in the relationship between innovation and assessments of value. This study summarizes points from an Health Technology Assessment International (HTAi) Policy Forum discussion, drawing on presentations, discussions among attendees, and background papers. Various perspectives on value were considered; most place patient health at the core of value. Wider elements of value comprise other benefits for: patients; caregivers; the health and social care systems; and society. Most decision-making systems seek to take account of similar elements of value, although they are assessed and combined in different ways. Judgment in decisions remains important and cannot be replaced by mathematical approaches. There was discussion of the value of innovation and of the effects of value assessments on innovation. Discussion also included moving toward "progressive health system decision making," an ongoing process whereby evidence-based decisions on use would be made at various stages in the technology lifecycle. Five actions are identified: (i) development of a general framework for the definition and assessment of value; development by HTA/coverage bodies and regulators of (ii) disease-specific guidance and (iii) further joint scientific advice for industry on demonstrating value; (iv) development of a framework for progressive licensing, usage, and reimbursement; and (v) promoting work to better adapt HTA, coverage, and procurement approaches to medical devices.

Extrinsic local regression on manifold-valued data

PubMed Central

Lin, Lizhen; St Thomas, Brian; Zhu, Hongtu; Dunson, David B.

2017-01-01

We propose an extrinsic regression framework for modeling data with manifold valued responses and Euclidean predictors. Regression with manifold responses has wide applications in shape analysis, neuroscience, medical imaging and many other areas. Our approach embeds the manifold where the responses lie onto a higher dimensional Euclidean space, obtains a local regression estimate in that space, and then projects this estimate back onto the image of the manifold. Outside the regression setting both intrinsic and extrinsic approaches have been proposed for modeling i.i.d manifold-valued data. However, to our knowledge our work is the first to take an extrinsic approach to the regression problem. The proposed extrinsic regression framework is general, computationally efficient and theoretically appealing. Asymptotic distributions and convergence rates of the extrinsic regression estimates are derived and a large class of examples are considered indicating the wide applicability of our approach. PMID:29225385

Integrated framework for developing search and discrimination metrics

NASA Astrophysics Data System (ADS)

Copeland, Anthony C.; Trivedi, Mohan M.

1997-06-01

This paper presents an experimental framework for evaluating target signature metrics as models of human visual search and discrimination. This framework is based on a prototype eye tracking testbed, the Integrated Testbed for Eye Movement Studies (ITEMS). ITEMS determines an observer's visual fixation point while he studies a displayed image scene, by processing video of the observer's eye. The utility of this framework is illustrated with an experiment using gray-scale images of outdoor scenes that contain randomly placed targets. Each target is a square region of a specific size containing pixel values from another image of an outdoor scene. The real-world analogy of this experiment is that of a military observer looking upon the sensed image of a static scene to find camouflaged enemy targets that are reported to be in the area. ITEMS provides the data necessary to compute various statistics for each target to describe how easily the observers located it, including the likelihood the target was fixated or identified and the time required to do so. The computed values of several target signature metrics are compared to these statistics, and a second-order metric based on a model of image texture was found to be the most highly correlated.

Towards a Framework for Student Self-Assessment.

ERIC Educational Resources Information Center

Adams, Carl; King, Karen

1995-01-01

Discusses the case for self-assessment and examines its value as a teaching and learning aid, its usefulness to business, and as a means of coping with high student numbers. Describes learning tasks that may develop this skill and argues that these need to be put into a coordinated framework. (Author/AEF)

Assessing the Value of Post-processed State-of-the-art Long-term Weather Forecast Ensembles within An Integrated Agronomic Modelling Framework

NASA Astrophysics Data System (ADS)

LI, Y.; Castelletti, A.; Giuliani, M.

2014-12-01

Over recent years, long-term climate forecast from global circulation models (GCMs) has been demonstrated to show increasing skills over the climatology, thanks to the advances in the modelling of coupled ocean-atmosphere dynamics. Improved information from long-term forecast is supposed to be a valuable support to farmers in optimizing farming operations (e.g. crop choice, cropping time) and for more effectively coping with the adverse impacts of climate variability. Yet, evaluating how valuable this information can be is not straightforward and farmers' response must be taken into consideration. Indeed, while long-range forecast are traditionally evaluated in terms of accuracy by comparison of hindcast and observed values, in the context of agricultural systems, potentially useful forecast information should alter the stakeholders' expectation, modify their decisions and ultimately have an impact on their annual benefit. Therefore, it is more desirable to assess the value of those long-term forecasts via decision-making models so as to extract direct indication of probable decision outcomes from farmers, i.e. from an end-to-end perspective. In this work, we evaluate the operational value of thirteen state-of-the-art long-range forecast ensembles against climatology forecast and subjective prediction (i.e. past year climate and historical average) within an integrated agronomic modeling framework embedding an implicit model of farmers' behavior. Collected ensemble datasets are bias-corrected and downscaled using a stochastic weather generator, in order to address the mismatch of the spatio-temporal scale between forecast data from GCMs and distributed crop simulation model. The agronomic model is first simulated using the forecast information (ex-ante), followed by a second run with actual climate (ex-post). Multi-year simulations are performed to account for climate variability and the value of the different climate forecast is evaluated against the perfect

A pilot study to assess feasibility of value based pricing in Cyprus through pharmacoeconomic modelling and assessment of its operational framework: sorafenib for second line renal cell cancer.

PubMed

Petrou, Panagiotis; Talias, Michael A

2014-01-01

The continuing increase of pharmaceutical expenditure calls for new approaches to pricing and reimbursement of pharmaceuticals. Value based pricing of pharmaceuticals is emerging as a useful tool and possess theoretical attributes to help health system cope with rising pharmaceutical expenditure. To assess the feasibility of introducing a value-based pricing scheme of pharmaceuticals in Cyprus and explore the integrative framework. A probabilistic Markov chain Monte Carlo model was created to simulate progression of advanced renal cell cancer for comparison of sorafenib to standard best supportive care. Literature review was performed and efficacy data were transferred from a published landmark trial, while official pricelists and clinical guidelines from Cyprus Ministry of Health were utilised for cost calculation. Based on proposed willingness to pay threshold the maximum price of sorafenib for the indication of second line renal cell cancer was assessed. Sorafenib value based price was found to be significantly lower compared to its current reference price. Feasibility of Value Based Pricing is documented and pharmacoeconomic modelling can lead to robust results. Integration of value and affordability in the price are its main advantages which have to be weighed against lack of documentation for several theoretical parameters that influence outcome. Smaller countries such as Cyprus may experience adversities in establishing and sustaining essential structures for this scheme.

The value of health information technology: filling the knowledge gap.

PubMed

Rudin, Robert S; Jones, Spencer S; Shekelle, Paul; Hillestad, Richard J; Keeler, Emmett B

2014-11-01

Despite rapid growth in the rate of adoption of health information technology (HIT), and in the volume of evaluation studies, the existing knowledge base for the value of HIT is not advancing at a similar rate. Most evaluation articles are limited in that they use incomplete measures of value and fail to report the important contextual and implementation characteristics that would allow for an adequate understanding of how the study results were achieved. To address these deficiencies, we present a conceptual framework for measuring HIT value and we propose a checklist of characteristics that should be considered in HIT evaluation studies. The framework consists of 3 key principles: 1) value includes both costs and benefits; 2) value accrues over time; and 3) value depends on which stakeholder's perspective is used. Through examples, we show how these principles can be used to guide and improve HIT evaluation studies. The checklist includes a list of contextual and implementation characteristics that are important for interpretation of results. These improvements will make future studies more useful for policy makers and more relevant to the current needs of the healthcare system.

A Framework for Determining the Return on Investment of Simulation-Based Training in Health Care

PubMed Central

Bukhari, Hatim; Andreatta, Pamela; Goldiez, Brian; Rabelo, Luis

2017-01-01

This article describes a framework that has been developed to monetize the real value of simulation-based training in health care. A significant consideration has been given to the incorporation of the intangible and qualitative benefits, not only the tangible and quantitative benefits of simulation-based training in health care. The framework builds from three works: the value measurement methodology (VMM) used by several departments of the US Government, a methodology documented in several books by Dr Jack Phillips to monetize various training approaches, and a traditional return on investment methodology put forth by Frost and Sullivan, and Immersion Medical. All 3 source materials were adapted to create an integrated methodology that can be readily implemented. This article presents details on each of these methods and how they can be integrated and presents a framework that integrates the previous methods. In addition to that, it describes the concept and the application of the developed framework. As a test of the applicability of the framework, a real case study has been used to demonstrate the application of the framework. This case study provides real data related to the correlation between the pediatric patient cardiopulmonary arrest (CPA) survival rates and a simulation-based mock codes at the University of Michigan tertiary care academic medical center. It is important to point out that the proposed framework offers the capability to consider a wide range of benefits and values, but on the other hand, there are several limitations that has been discussed and need to be taken in consideration. PMID:28133988

A Framework for Determining the Return on Investment of Simulation-Based Training in Health Care.

PubMed

Bukhari, Hatim; Andreatta, Pamela; Goldiez, Brian; Rabelo, Luis

2017-01-01

This article describes a framework that has been developed to monetize the real value of simulation-based training in health care. A significant consideration has been given to the incorporation of the intangible and qualitative benefits, not only the tangible and quantitative benefits of simulation-based training in health care. The framework builds from three works: the value measurement methodology (VMM) used by several departments of the US Government, a methodology documented in several books by Dr Jack Phillips to monetize various training approaches, and a traditional return on investment methodology put forth by Frost and Sullivan, and Immersion Medical. All 3 source materials were adapted to create an integrated methodology that can be readily implemented. This article presents details on each of these methods and how they can be integrated and presents a framework that integrates the previous methods. In addition to that, it describes the concept and the application of the developed framework. As a test of the applicability of the framework, a real case study has been used to demonstrate the application of the framework. This case study provides real data related to the correlation between the pediatric patient cardiopulmonary arrest (CPA) survival rates and a simulation-based mock codes at the University of Michigan tertiary care academic medical center. It is important to point out that the proposed framework offers the capability to consider a wide range of benefits and values, but on the other hand, there are several limitations that has been discussed and need to be taken in consideration.

What is low-value and/or low-grade hardwood?

Treesearch

William Luppold; Matthew Bumgardner

2003-01-01

The utilization of low-value and low-grade hardwood material is a recurrent concern in forest products research. This paper clarifies and expands on this topic and provides a framework to help researchers isolate specific researchable problems in this area and to discuss potential products that might be produced from this resource. Although low-value and low-grade...

A cost-effective add-on-value card-assisted firewall over Taiwan's NHI VPN framework.

PubMed

Huang, Jyh-Win; Hou, Ting-Wei

2007-06-01

Besides the overall budget for building the infrastructure of a healthcare-service-based virtual private network (VPN) in Taiwan, two issues were considered critical for its acceptance by the country's 17,000 plus medical institutions. One was who was to pay for the network (ADSL or modem) connection fee; the other was who was to pay for the firewall/anti-virus software. This paper addresses the second issue by proposing an efficient freeware firewall, named card-assisted firewall (CAF), for NHI VPN edge-hosts, which is also an add-on-value application of the National Healthcare IC card that every insurant and medical professional has. The innovative concept is that any NHI VPN site (edge-host) can establish diversified secure-authenticated connections with other sites only by an authentication mechanism, which requires a NHI Java card state machine and the Access Control List of the host. It is different from two-factor authentication cards in four ways: (1) a PIN code is not a must; (2) it requires authentication with the remote IC card Data Centre; (3) the NHI cards are already available, no modification is needed, and there is no further cost for the deployment of the cards; (4) although the cards are in the reader, the communication cannot start unless the cards are in the corresponding states; i.e. the states allow communication. An implementation, on a Microsoft Windows XP platform, demonstrated the system's feasibility over an emulation of the NHI VPN framework. It maintained a high line speed, the driver took up 39 KB of disk space, installation was simple, not requiring any extra hardware or software, and the average packet processing time of the CAF driver measured was 0.3084 ms. The average overhead in comparing the Access Control List predefined routing in card, in an FTP testing experiment, was 5.7 micros (receiving) and 8 micros (sending).

How to Assess the Value of Medicines?

PubMed Central

Simoens, Steven

2010-01-01

This study aims to discuss approaches to assessing the value of medicines. Economic evaluation assesses value by means of the incremental cost-effectiveness ratio (ICER). Health is maximized by selecting medicines with increasing ICERs until the budget is exhausted. The budget size determines the value of the threshold ICER and vice versa. Alternatively, the threshold value can be inferred from pricing/reimbursement decisions, although such values vary between countries. Threshold values derived from the value-of-life literature depend on the technique used. The World Health Organization has proposed a threshold value tied to the national GDP. As decision makers may wish to consider multiple criteria, variable threshold values and weighted ICERs have been suggested. Other approaches (i.e., replacement approach, program budgeting and marginal analysis) have focused on improving resource allocation, rather than maximizing health subject to a budget constraint. Alternatively, the generalized optimization framework and multi-criteria decision analysis make it possible to consider other criteria in addition to value. PMID:21607066

How to assess the value of medicines?

PubMed

Simoens, Steven

2010-01-01

This study aims to discuss approaches to assessing the value of medicines. Economic evaluation assesses value by means of the incremental cost-effectiveness ratio (ICER). Health is maximized by selecting medicines with increasing ICERs until the budget is exhausted. The budget size determines the value of the threshold ICER and vice versa. Alternatively, the threshold value can be inferred from pricing/reimbursement decisions, although such values vary between countries. Threshold values derived from the value-of-life literature depend on the technique used. The World Health Organization has proposed a threshold value tied to the national GDP. As decision makers may wish to consider multiple criteria, variable threshold values and weighted ICERs have been suggested. Other approaches (i.e., replacement approach, program budgeting and marginal analysis) have focused on improving resource allocation, rather than maximizing health subject to a budget constraint. Alternatively, the generalized optimization framework and multi-criteria decision analysis make it possible to consider other criteria in addition to value.

Influence of the veneer-framework interface on the mechanical behavior of ceramic veneers: a nonlinear finite element analysis.

PubMed

Lazari, Priscilla Cardoso; Sotto-Maior, Bruno Salles; Rocha, Eduardo Passos; de Villa Camargos, Germana; Del Bel Cury, Altair Antoninha

2014-10-01

The chipping of ceramic veneers is a common problem for zirconia-based restorations and is due to the weak interface between both structures. The purpose of this study was to evaluate the mechanical behavior of ceramic veneers on zirconia and metal frameworks under 2 different bond-integrity conditions. The groups were created to simulate framework-veneer bond integrity with the crowns partially debonded (frictional coefficient, 0.3) or completely bonded as follows: crown with a silver-palladium framework cemented onto a natural tooth, ceramic crown with a zirconia framework cemented onto a natural tooth, crown with a silver-palladium framework cemented onto a Morse taper implant, and ceramic crown with a zirconia framework cemented onto a Morse taper implant. The test loads were 49 N applied to the palatal surface at 45 degrees to the long axis of the crown and 25.5 N applied perpendicular to the incisal edge of the crown. The maximum principal stress, shear stress, and deformation values were calculated for the ceramic veneer; and the von Mises stress was determined for the framework. Veneers with partial debonding to the framework (frictional coefficient, 0.3) had greater stress concentrations in all structures compared with the completely bonded veneers. The metal ceramic crowns experienced lower stress values than ceramic crowns in models that simulate a perfect bond between the ceramic and the framework. Frameworks cemented to a tooth exhibited greater stress values than frameworks cemented to implants, regardless of the material used. Incomplete bonding between the ceramic veneer and the prosthetic framework affects the mechanical performance of the ceramic veneer, which makes it susceptible to failure, independent of the framework material or complete crown support. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

MVIAeval: a web tool for comprehensively evaluating the performance of a new missing value imputation algorithm.

PubMed

Wu, Wei-Sheng; Jhou, Meng-Jhun

2017-01-13

Missing value imputation is important for microarray data analyses because microarray data with missing values would significantly degrade the performance of the downstream analyses. Although many microarray missing value imputation algorithms have been developed, an objective and comprehensive performance comparison framework is still lacking. To solve this problem, we previously proposed a framework which can perform a comprehensive performance comparison of different existing algorithms. Also the performance of a new algorithm can be evaluated by our performance comparison framework. However, constructing our framework is not an easy task for the interested researchers. To save researchers' time and efforts, here we present an easy-to-use web tool named MVIAeval (Missing Value Imputation Algorithm evaluator) which implements our performance comparison framework. MVIAeval provides a user-friendly interface allowing users to upload the R code of their new algorithm and select (i) the test datasets among 20 benchmark microarray (time series and non-time series) datasets, (ii) the compared algorithms among 12 existing algorithms, (iii) the performance indices from three existing ones, (iv) the comprehensive performance scores from two possible choices, and (v) the number of simulation runs. The comprehensive performance comparison results are then generated and shown as both figures and tables. MVIAeval is a useful tool for researchers to easily conduct a comprehensive and objective performance evaluation of their newly developed missing value imputation algorithm for microarray data or any data which can be represented as a matrix form (e.g. NGS data or proteomics data). Thus, MVIAeval will greatly expedite the progress in the research of missing value imputation algorithms.

Preservice Elementary School Teachers' Conceptual Understanding of Place Value within a Constructivist Framework

ERIC Educational Resources Information Center

Murawska, Jaclyn Marie

2013-01-01

This research study examined the development of 43 preservice elementary school teachers' conceptual understanding of place value after participating in a research-based constructivist unit of instruction in place value. The preservice teachers were enrolled in one of three terms of an elementary mathematics methods course in a private midwestern…

Using a Theoretical Framework of Institutional Culture to Analyse an Institutional Strategy Document

ERIC Educational Resources Information Center

Jacobs, Anthea Hydi Maxine

2016-01-01

This paper builds on a conceptual analysis of institutional culture in higher education. A theoretical framework was proposed to analyse institutional documents of two higher education institutions in the Western Cape, for the period 2002 to 2012 (Jacobs 2012). The elements of this theoretical framework are "shared values and beliefs",…

Fit Analysis of Different Framework Fabrication Techniques for Implant-Supported Partial Prostheses.

PubMed

Spazzin, Aloísio Oro; Bacchi, Atais; Trevisani, Alexandre; Farina, Ana Paula; Dos Santos, Mateus Bertolini

2016-01-01

This study evaluated the vertical misfit of implant-supported frameworks made using different techniques to obtain passive fit. Thirty three-unit fixed partial dentures were fabricated in cobalt-chromium alloy (n = 10) using three fabrication methods: one-piece casting, framework cemented on prepared abutments, and laser welding. The vertical misfit between the frameworks and the abutments was evaluated with an optical microscope using the single-screw test. Data were analyzed using one-way analysis of variance and Tukey test (α = .05). The one-piece casted frameworks presented significantly higher vertical misfit values than those found for framework cemented on prepared abutments and laser welding techniques (P < .001 and P < .003, respectively). Laser welding and framework cemented on prepared abutments are effective techniques to improve the adaptation of three-unit implant-supported prostheses. These techniques presented similar fit.

Value Preferences of Social Workers.

PubMed

Tartakovsky, Eugene; Walsh, Sophie D

2018-04-01

The current study examines value preferences of social workers in Israel. Using a theoretical framework of person-environment fit paradigm and theory of values, the study compared social workers (N = 641, mean age = 37.7 years, 91 percent female) with a representative sample of Israeli Jews (N = 1,600, mean age = 44.2, 52 percent female). Questionnaires included personal value preferences and sociodemographic variables (gender, age, education, religiosity, and immigrant status). Multivariate analysis of covariance showed that value preferences of social workers differed significantly from those of the general population. Analyses of covariance showed that social workers reported a higher preference for self-transcendence and a lower preference for conservation and self-enhancement values. Results have significance for the selection, training, and supervision of social workers. They suggest that it is important to assess to what extent selection processes for social workers are primarily recruiting social workers with shared values, thus creating an overly homogenous population of social workers. An understanding of personal value motivations can help social workers in their own process of self-development and growth, and to understand how the profession can fulfill their basic motivations.

The effects of two torque values on the screw preload of implant-supported prostheses with passive fit or misfit.

PubMed

Al-Otaibi, Hanan Nejer; Akeel, Riyadh Fadul

2014-01-01

To determine the effect of increased torque of the abutment screw and retorquing after 10 minutes on implant-supported fixed prostheses. Two strain gauges (SGs) were attached to four implants stabilized on an acrylic resin mandible. Four implant-supported frameworks were constructed to represent passive fit (PF) and different amounts of misfit (MF1, MF2, and MF3). Vertical misfit was measured using a traveling microscope. Each framework was torqued to 35 Ncm (the manufacturer's recommendation) and 40 Ncm, and the preload was recorded immediately and again after retorquing 10 minutes later (torque stage). The smallest gap was observed under the PF framework. Three-way analysis of variance revealed significant effects of the framework, torque value, and torque stage on preload. The PF showed the highest mean preload under both torque values. An independent-sample t test between the torque values revealed a statistically significant difference only for MF1 and MF2. A dependent-sample t test of the torque stage revealed a statistically significant difference at a torque value of 35 Ncm under the PF and MF3 frameworks. Increasing the torque value beyond the manufacturer's recommended amount and retorquing of the screws at 10 minutes after the initial torque did not necessarily lead to a significant increase in preload in full-arch implant-supported fixed prostheses, particularly under non-passively fitting frameworks.

Magmatic infiltration and melting in the lower crust and upper mantle beneath the Cima volcanic field, California

USGS Publications Warehouse

Wilshire, H.G.; McGuire, A.V.

1996-01-01

Xenoliths of lower crustal and upper mantle rocks from the Cima volcanic field (CVF) commonly contain glass pockets, veins, and planar trains of glass and/or fluid inclusions in primary minerals. Glass pockets occupy spaces formerly occupied by primary minerals of the host rocks, but there is a general lack of correspondence between the composition of the glass and that of the replaced primary minerals. The melting is considered to have been induced by infiltration of basaltic magma and differentiates of basaltic magma from complex conduits formed by hydraulic fracturing of the mantle and crustal rocks, and to have occurred during the episode of CVF magmatism between ???7.5 Ma and present. Variable compositions of quenched melts resulted from mixing of introduced melts and products of melting of primary minerals, reaction with primary minerals, partial crystallization, and fractionation resulting from melt and volatile expulsion upon entrainment of the xenoliths. High silica melts (> ??? 60% SiO2) may result by mixing introduced melts with siliceous melts produced by reaction of orthopyroxene. Other quenched melt compositions range from those comparable to the host basalts to those with intermediate Si compositions and elevated Al, alkalis, Ti, P, and S; groundmass compositions of CVF basalts are consistent with infiltration of fractionates of those basalts, but near-solidus melting may also contribute to formation of glass with intermediate silica contents with infiltration only of volatile constituents.

Value added medicines: what value repurposed medicines might bring to society?

PubMed

Toumi, Mondher; Rémuzat, Cécile

2017-01-01

; (2) to improve healthcare system efficiency; and (3) to contribute to sustainability of healthcare systems through economic advantages. Current HTA framework, generic stigma, and pricing rules, such as internal reference pricing or tendering processes in place in some countries, were reported as the current key hurdles preventing the full recognition of value added medicines' benefits, discouraging manufacturers from bringing such products to the market. Discussion & conclusions : There is currently a gap between increasing regulatory authority interest in capturing value added medicines' benefits and the resistance of HTA bodies/payers, who tend to ignore this important segment of the pharmaceutical field. This situation calls for policy changes to foster appropriate incentives to enhance value recognition of value added medicines and deliver the expected benefit to society. Policy changes from HTA perspective should include: absence of any legislative barriers preventing companies from pursuing HTA; HTA requirements proportionate to potential reward; HTA decision-making framework taking into account the specific characteristics of value added medicines; eligibility for early HTA dialogues; Policy changes from pricing perspective should encompass: tenders/procurement policies allowing differentiation from generic medicines; eligibility for early entry agreement; non-systematic implementation of external and internal reference pricing policies; recognition of indication-specific pricing. At the same time, the pharmaceutical industry should engage all the stakeholders (patients, healthcare providers, HTA bodies/payers) in early dialogues to identify their expectations and to ensure the developed value added medicines address their needs.

Value added medicines: what value repurposed medicines might bring to society?

PubMed Central

Toumi, Mondher; Rémuzat, Cécile

2017-01-01

access; (2) to improve healthcare system efficiency; and (3) to contribute to sustainability of healthcare systems through economic advantages. Current HTA framework, generic stigma, and pricing rules, such as internal reference pricing or tendering processes in place in some countries, were reported as the current key hurdles preventing the full recognition of value added medicines’ benefits, discouraging manufacturers from bringing such products to the market. Discussion & conclusions: There is currently a gap between increasing regulatory authority interest in capturing value added medicines’ benefits and the resistance of HTA bodies/payers, who tend to ignore this important segment of the pharmaceutical field. This situation calls for policy changes to foster appropriate incentives to enhance value recognition of value added medicines and deliver the expected benefit to society. Policy changes from HTA perspective should include: absence of any legislative barriers preventing companies from pursuing HTA; HTA requirements proportionate to potential reward; HTA decision-making framework taking into account the specific characteristics of value added medicines; eligibility for early HTA dialogues; Policy changes from pricing perspective should encompass: tenders/procurement policies allowing differentiation from generic medicines; eligibility for early entry agreement; non-systematic implementation of external and internal reference pricing policies; recognition of indication-specific pricing. At the same time, the pharmaceutical industry should engage all the stakeholders (patients, healthcare providers, HTA bodies/payers) in early dialogues to identify their expectations and to ensure the developed value added medicines address their needs. PMID:28265347

Kepler Science Operations Center Pipeline Framework

NASA Technical Reports Server (NTRS)

Klaus, Todd C.; McCauliff, Sean; Cote, Miles T.; Girouard, Forrest R.; Wohler, Bill; Allen, Christopher; Middour, Christopher; Caldwell, Douglas A.; Jenkins, Jon M.

2010-01-01

The Kepler mission is designed to continuously monitor up to 170,000 stars at a 30 minute cadence for 3.5 years searching for Earth-size planets. The data are processed at the Science Operations Center (SOC) at NASA Ames Research Center. Because of the large volume of data and the memory and CPU-intensive nature of the analysis, significant computing hardware is required. We have developed generic pipeline framework software that is used to distribute and synchronize the processing across a cluster of CPUs and to manage the resulting products. The framework is written in Java and is therefore platform-independent, and scales from a single, standalone workstation (for development and research on small data sets) to a full cluster of homogeneous or heterogeneous hardware with minimal configuration changes. A plug-in architecture provides customized control of the unit of work without the need to modify the framework itself. Distributed transaction services provide for atomic storage of pipeline products for a unit of work across a relational database and the custom Kepler DB. Generic parameter management and data accountability services are provided to record the parameter values, software versions, and other meta-data used for each pipeline execution. A graphical console allows for the configuration, execution, and monitoring of pipelines. An alert and metrics subsystem is used to monitor the health and performance of the pipeline. The framework was developed for the Kepler project based on Kepler requirements, but the framework itself is generic and could be used for a variety of applications where these features are needed.

The image of psychology programs: the value of the instrumental-symbolic framework.

PubMed

Van Hoye, Greet; Lievens, Filip; De Soete, Britt; Libbrecht, Nele; Schollaert, Eveline; Baligant, Dimphna

2014-01-01

As competition for funding and students intensifies, it becomes increasingly important for psychology programs to have an image that is attractive and makes them stand out from other programs. The current study uses the instrumental-symbolic framework from the marketing domain to determine the image of different master's programs in psychology and examines how these image dimensions relate to student attraction and competitor differentiation. The samples consist of both potential students (N = 114) and current students (N = 68) of three psychology programs at a Belgian university: industrial and organizational psychology, clinical psychology, and experimental psychology. The results demonstrate that both instrumental attributes (e.g., interpersonal activities) and symbolic trait inferences (e.g., sincerity) are key components of the image of psychology programs and predict attractiveness as well as differentiation. In addition, symbolic image dimensions seem more important for current students of psychology programs than for potential students.

Probabilistic economic frameworks for disaster risk management

NASA Astrophysics Data System (ADS)

Dulac, Guillaume; Forni, Marc

2013-04-01

range from simple elicitation of data from a subject matter expert to calibrate a probability distribution to more advanced stochastic modelling. This approach can be referred to more as a proficiency in the language of uncertainty rather than modelling per se in the sense that it allows for greater flexibility to adapt a given context. In a real decision making context, one seldom has neither time nor budget resources to investigate all of these variables thoroughly, hence the importance of being able to prioritize the level of effort among them. Under the proposed framework, this can be done in an optimised fashion. The point here consists in applying probabilistic sensitivity analysis together with the fundamentals of the economic value of information; the framework as built is well suited to such considerations, and variables can be ranked according to their contribution to risk understanding. Efforts to deal with second order uncertainties on variables prove to be valuable when dealing with the economic value of sample information.

An evaluation of a new instrument to measure organisational safety culture values and practices.

PubMed

Díaz-Cabrera, D; Hernández-Fernaud, E; Isla-Díaz, R

2007-11-01

The main aim of this research is to evaluate a safety culture measuring instrument centred upon relevant organisational values and practices related to the safety management system. Seven dimensions that reflect underlying safety meanings are proposed. A second objective is to explore the four cultural orientations in the field of safety arising from the competing values framework. The study sample consisted of 299 participants from five companies in different sectors. The results show six dimensions of organisational values and practices and different company profiles in the organisations studied. The four cultural orientations proposed by the competing values framework are not confirmed. Nevertheless, a coexistence of diverse cultural orientations or paradoxes in the companies is observed.

Measuring Incompatible Observables by Exploiting Sequential Weak Values.

PubMed

Piacentini, F; Avella, A; Levi, M P; Gramegna, M; Brida, G; Degiovanni, I P; Cohen, E; Lussana, R; Villa, F; Tosi, A; Zappa, F; Genovese, M

2016-10-21

One of the most intriguing aspects of quantum mechanics is the impossibility of measuring at the same time observables corresponding to noncommuting operators, because of quantum uncertainty. This impossibility can be partially relaxed when considering joint or sequential weak value evaluation. Indeed, weak value measurements have been a real breakthrough in the quantum measurement framework that is of the utmost interest from both a fundamental and an applicative point of view. In this Letter, we show how we realized for the first time a sequential weak value evaluation of two incompatible observables using a genuine single-photon experiment. These (sometimes anomalous) sequential weak values revealed the single-operator weak values, as well as the local correlation between them.

Measuring Incompatible Observables by Exploiting Sequential Weak Values

NASA Astrophysics Data System (ADS)

Piacentini, F.; Avella, A.; Levi, M. P.; Gramegna, M.; Brida, G.; Degiovanni, I. P.; Cohen, E.; Lussana, R.; Villa, F.; Tosi, A.; Zappa, F.; Genovese, M.

2016-10-01

One of the most intriguing aspects of quantum mechanics is the impossibility of measuring at the same time observables corresponding to noncommuting operators, because of quantum uncertainty. This impossibility can be partially relaxed when considering joint or sequential weak value evaluation. Indeed, weak value measurements have been a real breakthrough in the quantum measurement framework that is of the utmost interest from both a fundamental and an applicative point of view. In this Letter, we show how we realized for the first time a sequential weak value evaluation of two incompatible observables using a genuine single-photon experiment. These (sometimes anomalous) sequential weak values revealed the single-operator weak values, as well as the local correlation between them.

The Organizational Values of "Gimnazija" in Slovenia

ERIC Educational Resources Information Center

Pang, Nicholas Sun-Keung

2006-01-01

This article assesses the organizational values of "gimnazija" in Slovenia and examines the factors that contribute to the building of quality management. The theoretical framework is built on Schein's model of levels of culture, Sathe's interpretation of organizational culture and Getzels and Guba's model of organizational behaviour.…

Force-Field Prediction of Materials Properties in Metal-Organic Frameworks

PubMed Central

2016-01-01

In this work, MOF bulk properties are evaluated and compared using several force fields on several well-studied MOFs, including IRMOF-1 (MOF-5), IRMOF-10, HKUST-1, and UiO-66. It is found that, surprisingly, UFF and DREIDING provide good values for the bulk modulus and linear thermal expansion coefficients for these materials, excluding those that they are not parametrized for. Force fields developed specifically for MOFs including UFF4MOF, BTW-FF, and the DWES force field are also found to provide accurate values for these materials’ properties. While we find that each force field offers a moderately good picture of these properties, noticeable deviations can be observed when looking at properties sensitive to framework vibrational modes. This observation is more pronounced upon the introduction of framework charges. PMID:28008758

Designing robots for care: care centered value-sensitive design.

PubMed

van Wynsberghe, Aimee

2013-06-01

The prospective robots in healthcare intended to be included within the conclave of the nurse-patient relationship--what I refer to as care robots--require rigorous ethical reflection to ensure their design and introduction do not impede the promotion of values and the dignity of patients at such a vulnerable and sensitive time in their lives. The ethical evaluation of care robots requires insight into the values at stake in the healthcare tradition. What's more, given the stage of their development and lack of standards provided by the International Organization for Standardization to guide their development, ethics ought to be included into the design process of such robots. The manner in which this may be accomplished, as presented here, uses the blueprint of the Value-sensitive design approach as a means for creating a framework tailored to care contexts. Using care values as the foundational values to be integrated into a technology and using the elements in care, from the care ethics perspective, as the normative criteria, the resulting approach may be referred to as care centered value-sensitive design. The framework proposed here allows for the ethical evaluation of care robots both retrospectively and prospectively. By evaluating care robots in this way, we may ultimately ask what kind of care we, as a society, want to provide in the future.

Urban Middle School Students' Perceptions of the Value and Difficulty of Inquiry

ERIC Educational Resources Information Center

Sandoval, William A.; Harven, Aletha M.

2011-01-01

Following their participation in a guided-inquiry unit, 129 seventh-graders from five diverse urban middle schools were asked about their perceptions of specific inquiry tasks, from an expectancy-value framework. Students were asked to rate the interest value, utility value, and task difficulty of (a) data collection design; (b) explanation; (c)…

Values-Based Education in Schools in the 2000s: The Australian Experience

ERIC Educational Resources Information Center

Leichsenring, Andrew

2010-01-01

This thesis explores the teaching of values in Australian schools through a framework established by the Australian Federal government during the 2000s. This paper focuses on: the approaches employed by the Australian Federal government in the implementation of Values Education; and the application of cases of values-based education utilized by…

A novel fusion framework of visible light and infrared images based on singular value decomposition and adaptive DUAL-PCNN in NSST domain

NASA Astrophysics Data System (ADS)

Cheng, Boyang; Jin, Longxu; Li, Guoning

2018-06-01

Visible light and infrared images fusion has been a significant subject in imaging science. As a new contribution to this field, a novel fusion framework of visible light and infrared images based on adaptive dual-channel unit-linking pulse coupled neural networks with singular value decomposition (ADS-PCNN) in non-subsampled shearlet transform (NSST) domain is present in this paper. First, the source images are decomposed into multi-direction and multi-scale sub-images by NSST. Furthermore, an improved novel sum modified-Laplacian (INSML) of low-pass sub-image and an improved average gradient (IAVG) of high-pass sub-images are input to stimulate the ADS-PCNN, respectively. To address the large spectral difference between infrared and visible light and the occurrence of black artifacts in fused images, a local structure information operator (LSI), which comes from local area singular value decomposition in each source image, is regarded as the adaptive linking strength that enhances fusion accuracy. Compared with PCNN models in other studies, the proposed method simplifies certain peripheral parameters, and the time matrix is utilized to decide the iteration number adaptively. A series of images from diverse scenes are used for fusion experiments and the fusion results are evaluated subjectively and objectively. The results of the subjective and objective evaluation show that our algorithm exhibits superior fusion performance and is more effective than the existing typical fusion techniques.

A Framework for Assessing Health Risk of Environmental ...

EPA Pesticide Factsheets

EPA released the final report entitled, A Framework for Assessing Health Risk of Environmental Exposures to Children, which examines the impact of potential exposures during developmental lifestages and subsequent lifestages, while emphasizing the iterative nature of the analysis phase with a multidisciplinary team. Major findings and conclusions: This report outlines the framework in which mode of action(s) (MOA) can be considered across life stages. The framework is based upon existing approaches adopted in the Framework on Cumulative Risk Assessment and identifies existing guidance, guidelines and policy papers that relate to children's health risk assessment. It emphasizes the importance of an iterative approach between hazard, dose response, and exposure analyses. In addition, it includes discussion of principles for weight of evidence consideration across life stages for the hazard characterization database.Key science/assessment issues:This framework addresses the questions of why and how an improved children's health risk assessment will strengthen the overall risk assessment process across the Agency. This approach improves the scientific explanation of children's risk and will add value by: 1) providing for a more complete evaluation of the potential for vulnerability at different life stages, including a focus on the underlying biological events and critical developmental periods for incorporating MOA considerations; 2) evaluating of the potential fo

[Value-based cancer care. From traditional evidence-based decision making to balanced decision making within frameworks of shared values].

PubMed

Palazzo, Salvatore; Filice, Aldo; Mastroianni, Candida; Biamonte, Rosalbino; Conforti, Serafino; Liguori, Virginia; Turano, Salvatore; De Simone, Rosanna; Rovito, Antonio; Manfredi, Caterina; Minardi, Stefano; Vilardo, Emmanuelle; Loizzo, Monica; Oriolo, Carmela

2016-04-01

Clinical decision making in oncology is based so far on the evidence of efficacy from high-quality clinical research. Data collection and analysis from experimental studies provide valuable insight into response rates and progression-free or overall survival. Data processing generates valuable information for medical professionals involved in cancer patient care, enabling them to make objective and unbiased choices. The increased attention of many scientific associations toward a more rational resource consumption in clinical decision making is mirrored in the Choosing Wisely campaign against the overuse or misuse of exams and procedures of little or no benefit for the patient. This cultural movement has been actively promoting care solutions based on the concept of "value". As a result, the value-based decision-making process for cancer care should not be dissociated from economic sustainability and from ethics of the affordability, also given the growing average cost of the most recent cancer drugs. In support of this orientation, the National Comprehensive Cancer Network (NCCN) has developed innovative and "complex" guidelines based on values, defined as "evidence blocks", with the aim of assisting the medical community in making overall sustainable choices.

Public values for integration in natural disaster management and planning: A case study from Victoria, Australia.

PubMed

Rawluk, Andrea; Ford, Rebecca M; Neolaka, Fendi L; Williams, Kathryn J

2017-01-01

Values can be useful for identifying what is important to individuals and communities, yet there is currently not a coherent way to conceptualize, identify, and organize the breadth of values that can be affected by a natural disaster. This research proposes a conceptual framework for how to conceptualize, identify, and organize values, and proposes a concrete, tangible value called the valued entity. The framework is applied in two studies of bushfire in Victoria, Australia: 112 submissions from individuals to the 2009 Victorian Bushfires Royal Commission and interviews with 30 members of the public in bushfire risk landscapes. Our findings suggest that: what people value ranges from abstract to concrete; prevalent abstract values include benevolence and universalism; prevalent mid-level valued attributes include natural attributes of landscapes and human life and welfare; prevalent valued entities are people and properties close to the person. Comparison between the two studies suggests people with more recent experience with bushfire refer less to the importance of natural places and natural attributes. The conceptual framework can act as a boundary object to facilitate researchers and policy-makers understanding the breadth of values affected by natural disaster events and management actions and how governance can better consider values at different scales. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Characteristics of cloud occurrence using ceilometer measurements and its relationship to precipitation over Seoul

NASA Astrophysics Data System (ADS)

Lee, Sanghee; Hwang, Seung-On; Kim, Jhoon; Ahn, Myoung-Hwan

2018-03-01

Clouds are an important component of the atmosphere that affects both climate and weather, however, their contributions can be very difficult to determine. Ceilometer measurements can provide high resolution information on atmospheric conditions such as cloud base height (CBH) and vertical frequency of cloud occurrence (CVF). This study presents the first comprehensive analysis of CBH and CVF derived using Vaisala CL51 ceilometers at two urban stations in Seoul, Korea, during a three-year period from January 2014 to December 2016. The average frequency of cloud occurrence detected by the ceilometers is 54.3%. It is found that the CL51 is better able to capture CBH as compared to another ceilometer CL31 at a nearby meteorological station because it could detect high clouds more accurately. Frequency distributions for CBH up to 13,000 m providing detailed vertical features with 500-m interval show 55% of CBHs below 2 km for aggregated CBHs. A bimodal frequency distribution was observed for three-layers CBHs. A monthly variation of CVF reveals that frequency concentration of lower clouds is found in summer and winter, and higher clouds more often detected in spring and autumn. Monthly distribution features of cloud occurrence and precipitation are depending on seasons and it might be easy to define their relationship due to higher degree of variability of precipitation than cloud occurrence. However, a fluctuation of cloud occurrence frequency in summer is similar to precipitation in trend, whereas clouds in winter are relatively frequent but precipitation is not accompanied. In addition, recent decrease of summer precipitation could be mostly explained by a decrease of cloud occurrence. Anomalous precipitation recorded sometimes is considerably related to corresponding cloud occurrence. The diurnal and daily variations of CBH and CVF from ceilometer observations and the analysis of microwave radiometer measurements for two typical cloudiness cases are also reviewed

Quantum interval-valued probability: Contextuality and the Born rule

NASA Astrophysics Data System (ADS)

Tai, Yu-Tsung; Hanson, Andrew J.; Ortiz, Gerardo; Sabry, Amr

2018-05-01

We present a mathematical framework based on quantum interval-valued probability measures to study the effect of experimental imperfections and finite precision measurements on defining aspects of quantum mechanics such as contextuality and the Born rule. While foundational results such as the Kochen-Specker and Gleason theorems are valid in the context of infinite precision, they fail to hold in general in a world with limited resources. Here we employ an interval-valued framework to establish bounds on the validity of those theorems in realistic experimental environments. In this way, not only can we quantify the idea of finite-precision measurement within our theory, but we can also suggest a possible resolution of the Meyer-Mermin debate on the impact of finite-precision measurement on the Kochen-Specker theorem.

A pilot study to assess feasibility of value based pricing in Cyprus through pharmacoeconomic modelling and assessment of its operational framework: sorafenib for second line renal cell cancer

PubMed Central

2014-01-01

Background The continuing increase of pharmaceutical expenditure calls for new approaches to pricing and reimbursement of pharmaceuticals. Value based pricing of pharmaceuticals is emerging as a useful tool and possess theoretical attributes to help health system cope with rising pharmaceutical expenditure. Aim To assess the feasibility of introducing a value-based pricing scheme of pharmaceuticals in Cyprus and explore the integrative framework. Methods A probabilistic Markov chain Monte Carlo model was created to simulate progression of advanced renal cell cancer for comparison of sorafenib to standard best supportive care. Literature review was performed and efficacy data were transferred from a published landmark trial, while official pricelists and clinical guidelines from Cyprus Ministry of Health were utilised for cost calculation. Based on proposed willingness to pay threshold the maximum price of sorafenib for the indication of second line renal cell cancer was assessed. Results Sorafenib value based price was found to be significantly lower compared to its current reference price. Conclusion Feasibility of Value Based Pricing is documented and pharmacoeconomic modelling can lead to robust results. Integration of value and affordability in the price are its main advantages which have to be weighed against lack of documentation for several theoretical parameters that influence outcome. Smaller countries such as Cyprus may experience adversities in establishing and sustaining essential structures for this scheme. PMID:24910539

Adding Value to the Health Care System: Identifying Value-Added Systems Roles for Medical Students.

PubMed

Gonzalo, Jed D; Graaf, Deanna; Johannes, Bobbie; Blatt, Barbara; Wolpaw, Daniel R

To catalyze learning in Health Systems Science and add value to health systems, education programs are seeking to incorporate students into systems roles, which are not well described. The authors sought to identify authentic roles for students within a range of clinical sites and explore site leaders' perceptions of the value of students performing these roles. From 2013 to 2015, site visits and interviews with leadership from an array of clinical sites (n = 30) were conducted. Thematic analysis was used to identify tasks and benefits of integrating students into interprofessional care teams. Types of systems roles included direct patient benefit activities, including monitoring patient progress with care plans and facilitating access to resources, and clinic benefit activities, including facilitating coordination and improving clinical processes. Perceived benefits included improved value of the clinical mission and enhanced student education. These results elucidate a framework for student roles that enhance learning and add value to health systems.

A revised energy-balance framework for the Earth

NASA Astrophysics Data System (ADS)

Dessler, A. E.

2017-12-01

Some of the most important conclusions of climate science are based on energy balance calculations, in which solar energy absorbed by the Earth system is set equal to infrared energy radiated to space. Traditionally, energy radiated to space is assumed to be proportional to surface temperature. We show here problems with this framework, including potential biases in estimates of climate sensitivity based on the 20th-century historical record. This could potentially explain why estimates of equilibrium climate sensitivity (ECS) using observations over the 20th century yield values lower than other estimates. We then present a modified version of the energy balance framework in which energy radiated to space is assumed to be proportional to tropical atmospheric temperature. We use this new framework to estimate ECS and obtain an estimate of 3°C, with a likely range (66% confidence interval) of 2.2-4.1°C.

How Should We Value a Planet?

NASA Astrophysics Data System (ADS)

Haqq-Misra, J.

2014-04-01

The idea that a planet or its biota may be intrinsically valuable, apart from its usefulness to humans, is contentious among ethicists, while difficulties abound in attempting to decide what is objectively better or worse for a planet or life. As a way of dissecting the issue of value and life, I present a two-axis comparative tool for ethical frameworks that considers the intrinsic or instrumental value placed upon organisms, environments, planetary systems, and space. I discuss ethical considerations relevant to contemporary space exploration, near-future human exploration of Solar System bodies, and long-term possibilities of interplanetary colonization. This allows for more transparent discussions of value with regard to future space exploration or the discovery of extraterrestrial life.

Alternative complement pathway activation increases mortality in a model of burn injury in mice.

PubMed Central

Gelfand, J A; Donelan, M; Hawiger, A; Burke, J F

1982-01-01

We have studied the role of the complement system in burn injury in an experimental model in mice. A 25% body surface area, full-thickness scald wound was produced in anesthetized animals. Massive activation of the alternative complement pathway, but not the classical pathway, was seen. This activation was associated with the generation of neutrophil aggregating activity in the plasma, neutrophil aggregates in the lungs, increased pulmonary vascular permeability, and increased lung edema formation. Decomplementation with cobra venom factor (CVF) or genetic C5 deficiency diminished these pathologic changes, and CVF pretreatment substantially reduced burn mortality in the first 24 h. Preliminary data show that human burn patients have a similar pattern of complement activation involving predominantly the alternative pathway, indicating the possible relevance of the murine model to human disease. Images PMID:7174787

Value Driven Information Processing and Fusion

DTIC Science & Technology

2016-03-01

consensus approach allows a decentralized approach to achieve the optimal error exponent of the centralized counterpart, a conclusion that is signifi...SECURITY CLASSIFICATION OF: The objective of the project is to develop a general framework for value driven decentralized information processing...including: optimal data reduction in a network setting for decentralized inference with quantization constraint; interactive fusion that allows queries and

Marginal discrepancy of CAD-CAM complete-arch fixed implant-supported frameworks.

PubMed

Yilmaz, Burak; Kale, Ediz; Johnston, William M

2018-02-21

Computer-aided design and computer-aided manufacturing (CAD-CAM) high-density polymers (HDPs) have recently been marketed for the fabrication of long-term interim implant-supported fixed prostheses. However, information regarding the precision of fit of CAD-CAM HDP implant-supported complete-arch screw-retained prostheses is scarce. The purpose of this in vitro study was to evaluate the marginal discrepancy of CAD-CAM HDP complete-arch implant-supported screw-retained fixed prosthesis frameworks and compare them with conventional titanium (Ti) and zirconia (Zir) frameworks. A screw-retained complete-arch acrylic resin prototype with multiunit abutments was fabricated on a typodont model with 2 straight implants in the anterior region and 2 implants with a 30-degree distal tilt in the posterior region. A 3-dimensional (3D) laboratory laser scanner was used to digitize the typodont model with scan bodies and the resin prototype to generate a virtual 3D CAD framework. A CAM milling unit was used to fabricate 5 frameworks from HDP, Ti, and Zir blocks. The 1-screw test was performed by tightening the prosthetic screw in the maxillary left first molar abutment (terminal location) when the frameworks were on the typodont model, and the marginal discrepancy of frameworks was evaluated using an industrial computed tomographic scanner and a 3D volumetric software. The 3D marginal discrepancy at the abutment-framework interface of the maxillary left canine (L1), right canine (L2), and right first molar (L3) sites was measured. The mean values for 3D marginal discrepancy were calculated for each location in a group with 95% confidence limits. The results were analyzed by repeated-measures 2-way ANOVA using the restricted maximum likelihood estimation and the Satterthwaite degrees of freedom methods, which do not require normality and homoscedasticity in the data. The between-subjects factor was material, the within-subjects factor was location, and the interaction was

The Analysing Children's Creative Thinking Framework: Development of an Observation-Led Approach to Identifying and Analysing Young Children's Creative Thinking

ERIC Educational Resources Information Center

Robson, Sue

2014-01-01

Increased international recognition of the value of supporting creative thinking suggests the value of development of approaches to its identification in children. Development of an observation-led framework, the Analysing Children's Creative Thinking (ACCT) framework, is described, and a case made for the validity of inferring creative thinking…

Harmonization of nutrient intake values.

PubMed

King, Janet C; Garza, Cutberto

2007-03-01

The conceptual framework for the various NIVs is depicted in figure 1 along with the methodological approaches and applications. The NIVs consist of two values derived from a statistical evaluation of data on nutrient requirements, the average nutrient requirement (ANR), or nutrient toxicities, the upper nutrient level (UNL). The individual nutrient levelx (INLx) is derived from the distribution of average nutrient requirements. The percentile chosen is often 98%, which is equivalent to 2 SD above the mean requirement. Concepts underlying the NIVs include criteria for establishing a nutrient requirement, e.g., ferritin stores, nitrogen balance, or serum vitamin C. Once the requirement for the absorbed nutrient is determined, it may be necessary to adjust the value for food sources, i.e., bioavailability, or host factors, such as the effect of infection on nutrient utilization. Other concepts that committees may want to consider when establishing NIVs include the effects of genetic variation on nutrient requirements and the role of the nutrient in preventing long-term disease. Two fundamental uses of NIVs are for assessing the adequacy of nutrient intakes and for planning diets for individuals and populations. Establishing the NIV using the statistical framework proposed in this report improves the efficacy of the values for identifying risks of nutrient deficiency or excess among individuals and populations. NIVs also are applied to a number of aspects of food and nutrition policy. Some examples include regulatory issues and trade, labeling, planning programs for alleviating public health nutrition problems, food fortification, and dietary guidance.

A national framework for disaster health education in Australia.

PubMed

FitzGerald, Gerard J; Aitken, Peter; Arbon, Paul; Archer, Frank; Cooper, David; Leggat, Peter; Myers, Colin; Robertson, Andrew; Tarrant, Michael; Davis, Elinor R

2010-01-01

Recent events have heightened awareness of disaster health issues and the need to prepare the health workforce to plan for and respond to major incidents. This has been reinforced at an international level by the World Association for Disaster and Emergency Medicine, which has proposed an international educational framework. The aim of this paper is to outline the development of a national educational framework for disaster health in Australia. The framework was developed on the basis of the literature and the previous experience of members of a National Collaborative for Disaster Health Education and Research. The Collaborative was brought together in a series of workshops and teleconferences, utilizing a modified Delphi technique to finalize the content at each level of the framework and to assign a value to the inclusion of that content at the various levels. The framework identifies seven educational levels along with educational outcomes for each level. The framework also identifies the recommended contents at each level and assigns a rating of depth for each component. The framework is not intended as a detailed curriculum, but rather as a guide for educationalists to develop specific programs at each level. This educational framework will provide an infrastructure around which future educational programs in Disaster Health in Australia may be designed and delivered. It will permit improved articulation for students between the various levels and greater consistency between programs so that operational responders may have a consistent language and operational approach to the management of major events.

Diversity, Values and Social Change: Renegotiating a Consensus on Sex Education.

ERIC Educational Resources Information Center

Thomson, Rachel

1997-01-01

Proposes a framework for school sex education within a plural society based on three themes: social changes contributing to uncertainty about sexual values in British society, sex education policy changes' impact on claims to moral legitimacy in this area, and initiatives renegotiating a moral consensus on school sex education values. (DSK)

Force-field prediction of materials properties in metal-organic frameworks

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

Boyd, Peter G.; Moosavi, Seyed Mohamad; Witman, Matthew

In this work, MOF bulk properties are evaluated and compared using several force fields on several well-studied MOFs, including IRMOF-1 (MOF-5), IRMOF-10, HKUST-1, and UiO-66. It is found that, surprisingly, UFF and DREIDING provide good values for the bulk modulus and linear thermal expansion coefficients for these materials, excluding those that they are not parametrized for. Force fields developed specifically for MOFs including UFF4MOF, BTW-FF, and the DWES force field are also found to provide accurate values for these materials’ properties. While we find that each force field offers a moderately good picture of these properties, noticeable deviations can bemore » observed when looking at properties sensitive to framework vibrational modes. As a result, this observation is more pronounced upon the introduction of framework charges.« less

Force-field prediction of materials properties in metal-organic frameworks

DOE PAGES

Boyd, Peter G.; Moosavi, Seyed Mohamad; Witman, Matthew; ...

2016-12-23

In this work, MOF bulk properties are evaluated and compared using several force fields on several well-studied MOFs, including IRMOF-1 (MOF-5), IRMOF-10, HKUST-1, and UiO-66. It is found that, surprisingly, UFF and DREIDING provide good values for the bulk modulus and linear thermal expansion coefficients for these materials, excluding those that they are not parametrized for. Force fields developed specifically for MOFs including UFF4MOF, BTW-FF, and the DWES force field are also found to provide accurate values for these materials’ properties. While we find that each force field offers a moderately good picture of these properties, noticeable deviations can bemore » observed when looking at properties sensitive to framework vibrational modes. As a result, this observation is more pronounced upon the introduction of framework charges.« less

Comparability of outcome frameworks in medical education: Implications for framework development.

PubMed

Hautz, Stefanie C; Hautz, Wolf E; Feufel, Markus A; Spies, Claudia D

2015-01-01

Given the increasing mobility of medical students and practitioners, there is a growing need for harmonization of medical education and qualifications. Although several initiatives have sought to compare national outcome frameworks, this task has proven a challenge. Drawing on an analysis of existing outcome frameworks, we identify factors that hinder comparability and suggest ways of facilitating comparability during framework development and revisions. We searched MedLine, EmBase and the Internet for outcome frameworks in medical education published by national or governmental organizations. We analyzed these frameworks for differences and similarities that influence comparability. Of 1816 search results, 13 outcome frameworks met our inclusion criteria. These frameworks differ in five core features: history and origins, formal structure, medical education system, target audience and key terms. Many frameworks reference other frameworks without acknowledging these differences. Importantly, the level of detail of the outcomes specified differs both within and between frameworks. The differences identified explain some of the challenges involved in comparing outcome frameworks and medical qualifications. We propose a two-level model distinguishing between "core" competencies and culture-specific "secondary" competencies. This approach could strike a balance between local specifics and cross-national comparability of outcome frameworks and medical education.

Conceptual framework alignment between primary literature and education in animal behaviour

NASA Astrophysics Data System (ADS)

Bierema, Andrea Marie-Kryger

In 1963, Tinbergen revolutionized the study of animal behaviour in his paper On aims and methods of ethology (Zeitschrift Tierpsycholgie, 20, 410-433) by revamping the conceptual framework of the discipline. His framework suggests an integration of four questions: causation, ontogeny, survival value, and evolution. The National Research Council Committee (U.S.) on Undergraduate Biology Education to Prepare Research Scientists for the 21st Century published BIO2010: Transforming Undergraduate Education for Future Research Biologists (Washington, DC: The National Academies Press, 2003), which suggests alignment between current research and undergraduate education. Unfortunately, alignment has been rarely studied in college biology, especially for fundamental concepts. The purpose of this study, therefore, is to determine if the conceptual framework used by animal behaviour scientists, as presented in current primary literature, aligns with what students are exposed to in undergraduate biology education. After determining the most commonly listed textbooks from randomlyselected animal behaviour syllabi, four of the most popular textbooks, as well as the course descriptions provided in the collected syllabi, underwent content analysis in order to determine the extent that each of Tinbergen's four questions is being applied in education. Mainstream animal behaviour journal articles from 2013 were also assessed via content analysis in order to evaluate the current research framework. It was discovered that over 80% of the textbook text covered only two of Tinbergen's questions (survival value and causation). The other two questions, evolution and ontogeny, were rarely described in the text. A similar trend was found in journal articles. Therefore, alignment is occurring between primary literature and education, but neither aligns with the established conceptual framework of the discipline. According to course descriptions, many instructors intend to use an integrated

Conceptual Framework for Using Computers to Enhance Employee Engagement in Large Offices

ERIC Educational Resources Information Center

Gill, Rob

2010-01-01

Using computers to engage with staff members on their organization's Employer of Choice (EOC) program as part of a human resource development (HRD) framework can add real value to that organization's reputation. EOC is an evolving principle for Australian business. It reflects the value and importance organizations place on their key stakeholders,…

Modeling Value Chain Analysis of Distance Education using UML

NASA Astrophysics Data System (ADS)

Acharya, Anal; Mukherjee, Soumen

2010-10-01

Distance education continues to grow as a methodology for the delivery of course content in higher education in India as well as abroad. To manage this growing demand and to provide certain flexibility, there must be certain strategic planning about the use of ICT tools. Value chain analysis is a framework for breaking down the sequence of business functions into a set of activities through which utility could be added to service. Thus it can help to determine the competitive advantage that is enjoyed by an institute. To implement these business functions certain visual representation is required. UML allows for this representation by using a set of structural and behavioral diagrams. In this paper, the first section defines a framework for value chain analysis and highlights its advantages. The second section gives a brief overview of related work in this field. The third section gives a brief discussion on distance education. The fourth section very briefly introduces UML. The fifth section models value chain of distance education using UML. Finally we discuss the limitations and the problems posed in this domain.

EarthCube's Assessment Framework: Ensuring Return on Investment

NASA Astrophysics Data System (ADS)

Lehnert, K.

2016-12-01

EarthCube is a community-governed, NSF-funded initiative to transform geoscience research by developing cyberinfrastructure that improves access, sharing, visualization, and analysis of all forms of geosciences data and related resources. EarthCube's goal is to enable geoscientists to tackle the challenges of understanding and predicting a complex and evolving solid Earth, hydrosphere, atmosphere, and space environment systems. EarthCube's infrastructure needs capabilities around data, software, and systems. It is essential for EarthCube to determine the value of new capabilities for the community and the progress of the overall effort to demonstrate its value to the science community and Return on Investment for the NSF. EarthCube is therefore developing an assessment framework for research proposals, projects funded by EarthCube, and the overall EarthCube program. As a first step, a software assessment framework has been developed that addresses the EarthCube Strategic Vision by promoting best practices in software development, complete and useful documentation, interoperability, standards adherence, open science, and education and training opportunities for research developers.

A framework for sensitivity analysis of decision trees.

PubMed

Kamiński, Bogumił; Jakubczyk, Michał; Szufel, Przemysław

2018-01-01

In the paper, we consider sequential decision problems with uncertainty, represented as decision trees. Sensitivity analysis is always a crucial element of decision making and in decision trees it often focuses on probabilities. In the stochastic model considered, the user often has only limited information about the true values of probabilities. We develop a framework for performing sensitivity analysis of optimal strategies accounting for this distributional uncertainty. We design this robust optimization approach in an intuitive and not overly technical way, to make it simple to apply in daily managerial practice. The proposed framework allows for (1) analysis of the stability of the expected-value-maximizing strategy and (2) identification of strategies which are robust with respect to pessimistic/optimistic/mode-favoring perturbations of probabilities. We verify the properties of our approach in two cases: (a) probabilities in a tree are the primitives of the model and can be modified independently; (b) probabilities in a tree reflect some underlying, structural probabilities, and are interrelated. We provide a free software tool implementing the methods described.

The social values at risk from sea-level rise

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

Graham, Sonia, E-mail: sonia.graham@unimelb.edu.au; Barnett, Jon, E-mail: jbarn@unimelb.edu.au; Fincher, Ruth, E-mail: r.fincher@unimelb.edu.au

Analysis of the risks of sea-level rise favours conventionally measured metrics such as the area of land that may be subsumed, the numbers of properties at risk, and the capital values of assets at risk. Despite this, it is clear that there exist many less material but no less important values at risk from sea-level rise. This paper re-theorises these multifarious social values at risk from sea-level rise, by explaining their diverse nature, and grounding them in the everyday practices of people living in coastal places. It is informed by a review and analysis of research on social values frommore » within the fields of social impact assessment, human geography, psychology, decision analysis, and climate change adaptation. From this we propose that it is the ‘lived values’ of coastal places that are most at risk from sea-level rise. We then offer a framework that groups these lived values into five types: those that are physiological in nature, and those that relate to issues of security, belonging, esteem, and self-actualisation. This framework of lived values at risk from sea-level rise can guide empirical research investigating the social impacts of sea-level rise, as well as the impacts of actions to adapt to sea-level rise. It also offers a basis for identifying the distribution of related social outcomes across populations exposed to sea-level rise or sea-level rise policies.« less

Which Social Values Are Considered in Iranian Health System?

PubMed

Rashidian, Arash; Arab, Mohammad; Vaez Mahdavi, Mohammadreza; Ashtarian, Koimars; Mostafavi, Hakimeh

2018-05-01

Health systems have a set of limited resources for meeting the needs of communities. Health priority setting based on criteria and values is inevitable in such situation. This paper aims to identify the social values that are considered in Iranian health system. This qualitative study was conducted in 3 steps including collecting national documents and literature review, interviewing key informants, and a 2 round Delphi. Interviews and documents were analyzed through thematic framework analysis. Statistical guidance was applied for determining consensus cut-off in Delphi technique. Five social values including freedom of choice, equity, solidarity, severity of disease(s), and burden of disease(s) were considered more important than other values in the health priority setting decisions. Moreover, 2 non-value based factors including conflict of interest and lobbying had a high effect on decision making. Most health policy makers decide based on Egalitarian school, but restriction of resources in the country decreases the outcome. Moreover, personal judgments and preferences sometimes affect their decisions. It seems that developing a value-based framework and making it as a national guidance could have affirmative effect on health administers decisions. © 2018 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

A framework for multi-stakeholder decision-making and conflict resolution

EPA Science Inventory

We propose a decision-making framework to compute compromise solutions that balance conflicting priorities of multiple stakeholders on multiple objectives. In our setting, we shape the stakeholder dis-satisfaction distribution by solving a conditional-value-at-risk (CVaR) minimiz...

A Security Audit Framework to Manage Information System Security

NASA Astrophysics Data System (ADS)

Pereira, Teresa; Santos, Henrique

The widespread adoption of information and communication technology have promoted an increase dependency of organizations in the performance of their Information Systems. As a result, adequate security procedures to properly manage information security must be established by the organizations, in order to protect their valued or critical resources from accidental or intentional attacks, and ensure their normal activity. A conceptual security framework to manage and audit Information System Security is proposed and discussed. The proposed framework intends to assist organizations firstly to understand what they precisely need to protect assets and what are their weaknesses (vulnerabilities), enabling to perform an adequate security management. Secondly, enabling a security audit framework to support the organization to assess the efficiency of the controls and policy adopted to prevent or mitigate attacks, threats and vulnerabilities, promoted by the advances of new technologies and new Internet-enabled services, that the organizations are subject of. The presented framework is based on a conceptual model approach, which contains the semantic description of the concepts defined in information security domain, based on the ISO/IEC_JCT1 standards.

Pandemic influenza preparedness: an ethical framework to guide decision-making

PubMed Central

Thompson, Alison K; Faith, Karen; Gibson, Jennifer L; Upshur, Ross EG

2006-01-01

Background Planning for the next pandemic influenza outbreak is underway in hospitals across the world. The global SARS experience has taught us that ethical frameworks to guide decision-making may help to reduce collateral damage and increase trust and solidarity within and between health care organisations. Good pandemic planning requires reflection on values because science alone cannot tell us how to prepare for a public health crisis. Discussion In this paper, we present an ethical framework for pandemic influenza planning. The ethical framework was developed with expertise from clinical, organisational and public health ethics and validated through a stakeholder engagement process. The ethical framework includes both substantive and procedural elements for ethical pandemic influenza planning. The incorporation of ethics into pandemic planning can be helped by senior hospital administrators sponsoring its use, by having stakeholders vet the framework, and by designing or identifying decision review processes. We discuss the merits and limits of an applied ethical framework for hospital decision-making, as well as the robustness of the framework. Summary The need for reflection on the ethical issues raised by the spectre of a pandemic influenza outbreak is great. Our efforts to address the normative aspects of pandemic planning in hospitals have generated interest from other hospitals and from the governmental sector. The framework will require re-evaluation and refinement and we hope that this paper will generate feedback on how to make it even more robust. PMID:17144926

Pandemic influenza preparedness: an ethical framework to guide decision-making.

PubMed

Thompson, Alison K; Faith, Karen; Gibson, Jennifer L; Upshur, Ross E G

2006-12-04

Planning for the next pandemic influenza outbreak is underway in hospitals across the world. The global SARS experience has taught us that ethical frameworks to guide decision-making may help to reduce collateral damage and increase trust and solidarity within and between health care organisations. Good pandemic planning requires reflection on values because science alone cannot tell us how to prepare for a public health crisis. In this paper, we present an ethical framework for pandemic influenza planning. The ethical framework was developed with expertise from clinical, organisational and public health ethics and validated through a stakeholder engagement process. The ethical framework includes both substantive and procedural elements for ethical pandemic influenza planning. The incorporation of ethics into pandemic planning can be helped by senior hospital administrators sponsoring its use, by having stakeholders vet the framework, and by designing or identifying decision review processes. We discuss the merits and limits of an applied ethical framework for hospital decision-making, as well as the robustness of the framework. The need for reflection on the ethical issues raised by the spectre of a pandemic influenza outbreak is great. Our efforts to address the normative aspects of pandemic planning in hospitals have generated interest from other hospitals and from the governmental sector. The framework will require re-evaluation and refinement and we hope that this paper will generate feedback on how to make it even more robust.

Establishing a General Framework Civic Competency for European Youth

ERIC Educational Resources Information Center

Chow, Joseph

2012-01-01

This paper proposes a project that aims to construct a general framework of civic competency that will help understand civic competence as a blended measure of civic knowledge, skills, attitudes, values, beliefs, behavioural intentions and behaviours. By distinguishing between civic potential, civic behaviour and civic outcomes, with empirical…

Development and validation of a child health workforce competence framework.

PubMed

Smith, Lynda; Hawkins, Jean; McCrum, Anita

2011-05-01

Providing high quality, effective services is fundamental to the delivery of key health outcomes for children and young people. This requires a competent workforce. This paper reports on the development of a validated competence framework tool for the children and young people's health workforce. The framework brings together policy, strategic agendas and existing workforce competences. The framework will contribute to the improvement of children's physical and mental wellbeing by identifying competences required to provide proactive services that respond to children and young people with acute, continuing and complex needs. It details five core competences for the workforce, the functions that underpin them and levels of competence required to deliver a particular service. The framework will be of value to commissioners to inform contracting, to providers to ensure services are delivered by a workforce with relevant competences to meet identified needs, and to the workforce to assess existing capabilities and identify gaps in competence.

Estimating the value of life and injury for pedestrians using a stated preference framework.

PubMed

Niroomand, Naghmeh; Jenkins, Glenn P

2017-09-01

The incidence of pedestrian death over the period 2010 to 2014 per 1000,000 in North Cyprus is about 2.5 times that of the EU, with 10.5 times more pedestrian road injuries than deaths. With the prospect of North Cyprus entering the EU, many investments need to be undertaken to improve road safety in order to reach EU benchmarks. We conducted a stated choice experiment to identify the preferences and tradeoffs of pedestrians in North Cyprus for improved walking times, pedestrian costs, and safety. The choice of route was examined using mixed logit models to obtain the marginal utilities associated with each attribute of the routes that consumers chose. These were used to estimate the individuals' willingness to pay (WTP) to save walking time and to avoid pedestrian fatalities and injuries. We then used the results to obtain community-wide estimates of the value of a statistical life (VSL) saved, the value of an injury (VI) prevented, and the value per hour of walking time saved. The estimate of the VSL was €699,434 and the estimate of VI was €20,077. These values are consistent, after adjusting for differences in incomes, with the median results of similar studies done for EU countries. The estimated value of time to pedestrians is €7.20 per person hour. The ratio of deaths to injuries is much higher for pedestrians than for road accidents, and this is completely consistent with the higher estimated WTP to avoid a pedestrian accident than to avoid a car accident. The value of time of €7.20 is quite high relative to the wages earned. Findings provide a set of information on the VRR for fatalities and injuries and the value of pedestrian time that is critical for conducing ex ante appraisals of investments to improve pedestrian safety. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

Using virtual reality to estimate aesthetic values of coral reefs

PubMed Central

Clifford, Sam; Caley, M. Julian; Pearse, Alan R.; Brown, Ross; James, Allan; Christensen, Bryce; Bednarz, Tomasz; Anthony, Ken; González-Rivero, Manuel; Mengersen, Kerrie; Peterson, Erin E.

2018-01-01

Aesthetic value, or beauty, is important to the relationship between humans and natural environments and is, therefore, a fundamental socio-economic attribute of conservation alongside other ecosystem services. However, beauty is difficult to quantify and is not estimated well using traditional approaches to monitoring coral-reef aesthetics. To improve the estimation of ecosystem aesthetic values, we developed and implemented a novel framework used to quantify features of coral-reef aesthetics based on people's perceptions of beauty. Three observer groups with different experience to reef environments (Marine Scientist, Experienced Diver and Citizen) were virtually immersed in Australian's Great Barrier Reef (GBR) using 360° images. Perceptions of beauty and observations were used to assess the importance of eight potential attributes of reef-aesthetic value. Among these, heterogeneity, defined by structural complexity and colour diversity, was positively associated with coral-reef-aesthetic values. There were no group-level differences in the way the observer groups perceived reef aesthetics suggesting that past experiences with coral reefs do not necessarily influence the perception of beauty by the observer. The framework developed here provides a generic tool to help identify indicators of aesthetic value applicable to a wide variety of natural systems. The ability to estimate aesthetic values robustly adds an important dimension to the holistic conservation of the GBR, coral reefs worldwide and other natural ecosystems. PMID:29765676

Using virtual reality to estimate aesthetic values of coral reefs.

PubMed

Vercelloni, Julie; Clifford, Sam; Caley, M Julian; Pearse, Alan R; Brown, Ross; James, Allan; Christensen, Bryce; Bednarz, Tomasz; Anthony, Ken; González-Rivero, Manuel; Mengersen, Kerrie; Peterson, Erin E

2018-04-01

Aesthetic value, or beauty, is important to the relationship between humans and natural environments and is, therefore, a fundamental socio-economic attribute of conservation alongside other ecosystem services. However, beauty is difficult to quantify and is not estimated well using traditional approaches to monitoring coral-reef aesthetics. To improve the estimation of ecosystem aesthetic values, we developed and implemented a novel framework used to quantify features of coral-reef aesthetics based on people's perceptions of beauty. Three observer groups with different experience to reef environments (Marine Scientist, Experienced Diver and Citizen) were virtually immersed in Australian's Great Barrier Reef (GBR) using 360° images. Perceptions of beauty and observations were used to assess the importance of eight potential attributes of reef-aesthetic value. Among these, heterogeneity, defined by structural complexity and colour diversity, was positively associated with coral-reef-aesthetic values. There were no group-level differences in the way the observer groups perceived reef aesthetics suggesting that past experiences with coral reefs do not necessarily influence the perception of beauty by the observer. The framework developed here provides a generic tool to help identify indicators of aesthetic value applicable to a wide variety of natural systems. The ability to estimate aesthetic values robustly adds an important dimension to the holistic conservation of the GBR, coral reefs worldwide and other natural ecosystems.

Driving out waste: a framework to enhance value in clinical care.

PubMed

Burton, David A

2013-06-01

Many healthcare providers today are seeking to improve the value of the care they deliver by implementing standardized clinical practice guidelines aimed at reducing variations in care, avoiding complications, and lowering costs. To succeed, such an initiative requires the full support and participation of the clinicians who will use the guidelines. Providers also should have a fully developed infrastructure consisting of a clinical content system, an analytics system, and a deployment system.

Discussion on water resources value accounting and its application

NASA Astrophysics Data System (ADS)

Guo, Biying; Huang, Xiaorong; Ma, Kai; Gao, Linyun; Wang, Yanqiu

2018-06-01

The exploration of the compilation of natural resources balance sheet has been proposed since 2013. Several elements of water resources balance sheet have been discussed positively in China, including basic concept, framework and accounting methods, which focused on calculating the amount of water resources with statistical methods but lacked the analysis of the interrelationship between physical volume and magnitude of value. Based on the study of physical accounting of water resources balance sheet, the connotation of water resources value is analyzed in combination with research on the value of water resources in the world. What's more, the theoretical framework, form of measurement and research methods of water resources value accounting are further explored. Taking Chengdu, China as an example, the index system of water resources balance sheet in Chengdu which includes both physical and valuable volume is established to account the depletion of water resources, environmental damage and ecological water occupation caused by economic and social water use. Moreover, the water resources balance sheet in this region which reflects the negative impact of the economy on the environment is established. It provides a reference for advancing water resources management, improving government and social investment, realizing scientific and rational allocation of water resources.

Value Types in Higher Education--Students' Perspective

ERIC Educational Resources Information Center

Dziewanowska, Katarzyna

2017-01-01

The purpose of the paper is to propose the service-dominant logic in marketing as a framework for analysing the value co-creation process in the higher education sector and present the results of a quantitative study (a survey) conducted among business students from four Polish public universities. The results of the study led to identification of…

The added clinical and economic value of diagnostic testing for epilepsy surgery.

PubMed

Hinde, Sebastian; Soares, Marta; Burch, Jane; Marson, Anthony; Woolacott, Nerys; Palmer, Stephen

2014-05-01

The costs, benefits and risks associated with diagnostic imaging investigations for epilepsy surgery necessitate the identification of an optimal pathway in the pre-surgical workup. In order to assess the added value of additional investigations a full cost-effectiveness evaluation should be conducted, taking into account all of the life-time costs and benefits associated with undertaking additional investigations. This paper considers and applies the appropriate framework against which a full evaluation should be assessed. We conducted a systematic review to evaluate the progression of the literature through this framework, finding that only isolated elements of added value have been appropriately evaluated. The results from applying the full added value framework are also presented, identifying an optimal strategy for pre-surgical evaluation for temporal lobe epilepsy surgery. Our results suggest that additional FDG-PET and invasive EEG investigations after an initially discordant MRI and video-EEG appears cost-effective, and that the value of subsequent invasive-EEGs is closely linked to the maintenance of longer-term benefits after surgery. It is integral to the evaluation of imaging technologies in the work-up for epilepsy surgery that the impact of the use of these technologies on clinical decision-making, and on further treatment decisions, is considered fully when informing cost-effectiveness. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

BEACON: A Summary Framework to Overcome Potential Reimbursement Hurdles.

PubMed

Dunlop, William C N; Mullins, C Daniel; Pirk, Olaf; Goeree, Ron; Postma, Maarten J; Enstone, Ashley; Heron, Louise

2016-10-01

To provide a framework for addressing payers' criteria during the development of pharmaceuticals. A conceptual framework was presented to an international health economic expert panel for discussion. A structured literature search (from 2010 to May 2015), using the following databases in Ovid: Medline(®) and Medline(®) In-Process (PubMed), Embase (Ovid), EconLit (EBSCOhost) and the National Health Service Economic Evaluation Database (NHS EED), and a 'grey literature' search, were conducted to identify existing criteria from the payer perspective. The criteria assessed by existing frameworks and guidelines were collated; the most commonly reported criteria were considered for inclusion in the framework. A mnemonic was conceived as a memory aide to summarise these criteria. Overall, 41 publications were identified as potentially relevant to the objective. Following further screening, 26 were excluded upon full-text review on the basis of no framework presented (n = 13), redundancy (n = 11) or abstract only (n = 2). Frameworks that captured criteria developed for or utilised by the pharmaceutical industry (n = 5) and reimbursement guidance (n = 10) were reviewed. The most commonly identified criteria-unmet need/patient burden, safety, efficacy, quality-of-life outcomes, environment, evidence quality, budget impact and comparator-were incorporated into the summary framework. For ease of communication, the following mnemonic was developed: BEACON (Burden/target population, Environment, Affordability/value, Comparator, Outcomes, Number of studies/quality of evidence). The BEACON framework aims to capture the 'essence' of payer requirements by addressing the most commonly described criteria requested by payers regarding the introduction of a new pharmaceutical.

A novel multi-target regression framework for time-series prediction of drug efficacy.

PubMed

Li, Haiqing; Zhang, Wei; Chen, Ying; Guo, Yumeng; Li, Guo-Zheng; Zhu, Xiaoxin

2017-01-18

Excavating from small samples is a challenging pharmacokinetic problem, where statistical methods can be applied. Pharmacokinetic data is special due to the small samples of high dimensionality, which makes it difficult to adopt conventional methods to predict the efficacy of traditional Chinese medicine (TCM) prescription. The main purpose of our study is to obtain some knowledge of the correlation in TCM prescription. Here, a novel method named Multi-target Regression Framework to deal with the problem of efficacy prediction is proposed. We employ the correlation between the values of different time sequences and add predictive targets of previous time as features to predict the value of current time. Several experiments are conducted to test the validity of our method and the results of leave-one-out cross-validation clearly manifest the competitiveness of our framework. Compared with linear regression, artificial neural networks, and partial least squares, support vector regression combined with our framework demonstrates the best performance, and appears to be more suitable for this task.

Stability of Teacher Value-Added Rankings across Measurement Model and Scaling Conditions

ERIC Educational Resources Information Center

Hawley, Leslie R.; Bovaird, James A.; Wu, ChaoRong

2017-01-01

Value-added assessment methods have been criticized by researchers and policy makers for a number of reasons. One issue includes the sensitivity of model results across different outcome measures. This study examined the utility of incorporating multivariate latent variable approaches within a traditional value-added framework. We evaluated the…

Low Lactobacilli abundance and polymicrobial diversity in the lower reproductive tract of female rhesus monkeys do not compromise their reproductive success.

PubMed

Amaral, Wellington Z; Lubach, Gabriele R; Kapoor, Amita; Proctor, Alexandra; Phillips, Gregory J; Lyte, Mark; Coe, Christopher L

2017-10-01

The lower reproductive tract of nonhuman primates is colonized with a diverse microbiota, resembling bacterial vaginosis (BV), a gynecological condition associated with negative reproductive outcomes in women. Our 4 aims were to: (i) assess the prevalence of low Lactobacilli and a BV-like profile in female rhesus monkeys; (ii) quantify cytokines in their cervicovaginal fluid (CVF); (iii) examine the composition and structure of their mucosal microbiota with culture-independent sequencing methods; and (iv) evaluate the potential influence on reproductive success. CVF specimens were obtained from 27 female rhesus monkeys for Gram's staining, and to determine acidity (pH), and quantify proinflammatory cytokines. Based on Nugent's classification, 40% had a score of 7 or higher, which would be indicative of BV in women. Nugent scores were significantly correlated with the pH of the CVF. Interleukin-1ß was present at high concentrations, but not further elevated by high Nugent scores. Vaginal swabs were obtained from eight additional females to determine microbial diversity by rRNA gene amplicon sequencing. At the phylum level, the Firmicutes/Bacteroidetes ratio was low. The relative abundance of Lactobacilli was also low (between 3% and 17%), and 11 other genera were present at >1%. However, neither the microbial diversity in the community structure, nor high Nugent scores, was associated with reduced fecundity. Female monkeys provide an opportunity to understand how reproductive success can be sustained in the presence of a diverse polymicrobial community in the reproductive tract. © 2017 Wiley Periodicals, Inc.

Value of information in natural resource management: technical developments and application to pink-footed geese

USGS Publications Warehouse

Williams, Byron K.; Johnson, Fred A.

2015-01-01

The “value of information” (VOI) is a generic term for the increase in value resulting from better information to guide management, or alternatively, the value foregone under uncertainty about the impacts of management (Yokota and Thompson, Medical Decision Making 2004;24: 287). The value of information can be characterized in terms of several metrics, including the expected value of perfect information and the expected value of partial information. We extend the technical framework for the value of information by further developing the relationship between value metrics for partial and perfect information and describing patterns of their performance. We use two different expressions for the expected value of partial information to highlight its relationship to the expected value of perfect information. We also develop the expected value of partial information for hierarchical uncertainties. We highlight patterns in the value of information for the Svalbard population of the pink-footed goose (Anser brachyrhynchus), a population that is subject to uncertainty in both reproduction and survival functions. The framework for valuing information is seen as having widespread potential in resource decision making, and serves as a motivation for resource monitoring, assessment, and collaboration.

Social Return on Investment: Valuing health outcomes or promoting economic values?

PubMed

Leck, Chris; Upton, Dominic; Evans, Nick

2016-07-01

Interventions and activities that influence health are often concerned with intangible outcomes that are difficult to value despite their potential significance. Social Return on Investment is an evaluation framework that explores all aspects of change and expresses these in comparable terms. It combines qualitative narratives and quantitative measurements with a financial approach to enable outcomes that can otherwise be overlooked or undervalued to be incorporated appropriately. This article presents Social Return on Investment as an effective tool for supporting the development of a holistic appreciation of how interventions impact on the health and well-being of individuals, communities and societies. © The Author(s) 2014.

Marginal fit and photoelastic stress analysis of CAD-CAM and overcast 3-unit implant-supported frameworks.

PubMed

Presotto, Anna Gabriella Camacho; Bhering, Cláudia Lopes Brilhante; Mesquita, Marcelo Ferraz; Barão, Valentim Adelino Ricardo

2017-03-01

Several studies have shown the superiority of computer-assisted design and computer-assisted manufacturing (CAD-CAM) technology compared with conventional casting. However, an advanced technology exists for casting procedures (the overcasting technique), which may serve as an acceptable and affordable alternative to CAD-CAM technology for fabricating 3-unit implant-supported fixed dental prostheses (FDPs). The purpose of this in vitro study was to evaluate, using quantitative photoelastic analysis, the effect of the prosthetic framework fabrication method (CAD-CAM and overcasting) on the marginal fit and stress transmitted to implants. The correlation between marginal fit and stress was also investigated. Three-unit implant-supported FDP frameworks were made using the CAD-CAM (n=10) and overcasting (n=10) methods. The frameworks were waxed to simulate a mandibular first premolar (PM region) to first molar (M region) FDP using overcast mini-abutment cylinders. The wax patterns were overcast (overcast experimental group) or scanned to obtain the frameworks (CAD-CAM control group). All frameworks were fabricated from cobalt-chromium (CoCr) alloy. The marginal fit was analyzed according to the single-screw test protocol, obtaining an average value for each region (M and PM) and each framework. The frameworks were tightened for the photoelastic model with standardized 10-Ncm torque. Stress was measured by quantitative photoelastic analysis. The results were submitted to the Student t test, 2-way ANOVA, and Pearson correlation test (α=.05). The framework fabrication method (FM) and evaluation site (ES; M and PM regions) did not affect the marginal fit values (P=.559 for FM and P=.065 for ES) and stress (P=.685 for FM and P=.468 for ES) in the implant-supported system. Positive correlations between marginal fit and stress were observed (CAD-CAM: r=0.922; P<.001; overcast: r=0.908; P<.001). CAD-CAM and overcasting methods present similar marginal fit and stress values

An environmental decision framework applied to marine engine control technologies.

PubMed

Corbett, James J; Chapman, David

2006-06-01

This paper develops a decision framework for considering emission control technologies on marine engines, informed by standard decision theory, with an open structure that may be adapted by operators with specific vessel and technology attributes different from those provided here. Attributes relate objectives important to choosing control technologies with specific alternatives that may meet several of the objectives differently. The transparent framework enables multiple stakeholders to understand how different subjective judgments and varying attribute properties may result in different technology choices. Standard scoring techniques ensure that attributes are not biased by subjective scoring and that weights are the primary quantitative input where subjective preferences are exercised. An expected value decision structure is adopted that considers probabilities (likelihood) that a given alternative can meet its claims; alternative decision criteria are discussed. Capital and annual costs are combined using a net present value approach. An iterative approach is advocated that allows for screening and disqualifying alternatives that do not meet minimum conditions for acceptance, such as engine warranty or U.S. Coast Guard requirements. This decision framework assists vessel operators in considering explicitly important attributes and in representing choices clearly to other stakeholders concerned about reducing air pollution from vessels. This general decision structure may also be applied similarly to other environmental controls in marine applications.

The Social Value of Knowledge and the Responsiveness Requirement for International Research.

PubMed

Wenner, Danielle M

2017-02-01

Ethicists have long recognized that two necessary features of ethical research are scientific validity and social value. Yet despite a significant literature surrounding the validity component of this dictate, until recently there has been little attention paid to unpacking what the social value component might require. This article introduces a framework for assessing the social value of research, and in particular, for determining whether a given research program is likely to have significant social value of the kind necessary to fulfill the social value requirement. The article goes on to illustrate how this framework can provide a clearer account of the responsiveness requirement, an ethical dictum that is oft-repeated but whose content and value as a guideline in international research remains contested. Although I introduce this conception of social value in the context of the responsiveness requirement, the account offered can, and is intended to, stand alone as a tool for the assessment of the social value of research. As such it can be usefully applied to discussions about the value of comparative effectiveness trials, the assessment of the continued proliferation of me-too drugs and the research done to develop them, the demand for public access to study-generated data, and persistent deficits in the publication of negative results. © 2017 John Wiley & Sons Ltd.

Polynomials for crystal frameworks and the rigid unit mode spectrum

PubMed Central

Power, S. C.

2014-01-01

To each discrete translationally periodic bar-joint framework in , we associate a matrix-valued function defined on the d-torus. The rigid unit mode (RUM) spectrum of is defined in terms of the multi-phases of phase-periodic infinitesimal flexes and is shown to correspond to the singular points of the function and also to the set of wavevectors of harmonic excitations which have vanishing energy in the long wavelength limit. To a crystal framework in Maxwell counting equilibrium, which corresponds to being square, the determinant of gives rise to a unique multi-variable polynomial . For ideal zeolites, the algebraic variety of zeros of on the d-torus coincides with the RUM spectrum. The matrix function is related to other aspects of idealized framework rigidity and flexibility, and in particular leads to an explicit formula for the number of supercell-periodic floppy modes. In the case of certain zeolite frameworks in dimensions two and three, direct proofs are given to show the maximal floppy mode property (order N). In particular, this is the case for the cubic symmetry sodalite framework and some other idealized zeolites. PMID:24379422

A conceptualisation framework for building consensus on environmental sensitivity.

PubMed

González Del Campo, Ainhoa

2017-09-15

Examination of the intrinsic attributes of a system that render it more or less sensitive to potential stressors provides further insight into the baseline environment. In impact assessment, sensitivity of environmental receptors can be conceptualised on the basis of their: a) quality status according to statutory indicators and associated thresholds or targets; b) statutory protection; or c) inherent risk. Where none of these considerations are pertinent, subjective value judgments can be applied to determine sensitivity. This pragmatic conceptual framework formed the basis of a stakeholder consultation process for harmonising degrees of sensitivity of a number of environmental criteria. Harmonisation was sought to facilitate their comparative and combined analysis. Overall, full or wide agreement was reached on relative sensitivity values for the large majority of the reviewed criteria. Consensus was easier to reach on some themes (e.g. biodiversity, water and cultural heritage) than others (e.g. population and soils). As anticipated, existing statutory measures shaped the outcomes but, ultimately, knowledge-based values prevailed. The agreed relative sensitivities warrant extensive consultation but the conceptual framework provides a basis for increasing stakeholder consensus and objectivity of baseline assessments. This, in turn, can contribute to improving the evidence-base for characterising the significance of potential impacts. Copyright © 2017 Elsevier Ltd. All rights reserved.

A framework for the social valuation of ecosystem services.

PubMed

Felipe-Lucia, María R; Comín, Francisco A; Escalera-Reyes, Javier

2015-05-01

Methods to assess ecosystem services using ecological or economic approaches are considerably better defined than methods for the social approach. To identify why the social approach remains unclear, we reviewed current trends in the literature. We found two main reasons: (i) the cultural ecosystem services are usually used to represent the whole social approach, and (ii) the economic valuation based on social preferences is typically included in the social approach. Next, we proposed a framework for the social valuation of ecosystem services that provides alternatives to economics methods, enables comparison across studies, and supports decision-making in land planning and management. The framework includes the agreements emerged from the review, such as considering spatial-temporal flows, including stakeholders from all social ranges, and using two complementary methods to value ecosystem services. Finally, we provided practical recommendations learned from the application of the proposed framework in a case study.

Value-based integrated (renal) care: setting a development agenda for research and implementation strategies.

PubMed

Valentijn, Pim P; Biermann, Claus; Bruijnzeels, Marc A

2016-08-02

Integrated care services are considered a vital strategy for improving the Triple Aim values for people with chronic kidney disease. However, a solid scholarly explanation of how to develop, implement and evaluate such value-based integrated renal care services is limited. The aim of this study was to develop a framework to identify the strategies and outcomes for the implementation of value-based integrated renal care. First, the theoretical foundations of the Rainbow Model of Integrated Care and the Triple Aim were united into one overarching framework through an iterative process of key-informant consultations. Second, a rapid review approach was conducted to identify the published research on integrated renal care, and the Cochrane Library, Medline, Scopus, and Business Source Premier databases were searched for pertinent articles published between 2000 and 2015. Based on the framework, a coding schema was developed to synthesis the included articles. The overarching framework distinguishes the integrated care domains: 1) type of integration, 2) enablers of integration and the interrelated outcome domains, 3) experience of care, 4) population health and 5) costs. The literature synthesis indicated that integrated renal care implementation strategies have particularly focused on micro clinical processes and physical outcomes, while little emphasis has been placed on meso organisational as well as macro system integration processes. In addition, evidence regarding patients' perceived outcomes and economic outcomes has been weak. These results underscore that the future challenge for researchers is to explore which integrated care implementation strategies achieve better health and improved experience of care at a lower cost within a specific context. For this purpose, this study's framework and evidence synthesis have set a developmental agenda for both integrated renal care practice and research. Accordingly, we plan further work to develop an implementation

Professional nursing values: A concept analysis.

PubMed

Schmidt, Bonnie J; McArthur, Erin C

2018-01-01

The aim of this concept analysis is to clarify the meaning of professional nursing values. In a time of increasing ethical dilemmas, it is essential that nurses internalize professional values to develop and maintain a professional identity. However, nursing organizations and researchers provide different conceptions of professional nursing values, leading to a lack of clarity as to the meaning and attributes of this construct. Walker and Avant's (2011) method was used to guide an analysis of this concept. Resources published from 1973 to 2016 were identified via electronic databases and hand-searching of reference lists. A review of the literature was completed and the data were analyzed to identify uses of the concept; the defining attributes of the concept; borderline, related, contrary, and illegitimate examples; antecedents and consequences; and empirical referents. Professional nursing values were defined as important professional nursing principles of human dignity, integrity, altruism, and justice that serve as a framework for standards, professional practice, and evaluation. Further research is needed in the development and testing of professional nursing values theory, and the reassessment of values instruments. Core professional values that are articulated may help unify the profession and demonstrate the value of nursing to the public. © 2017 Wiley Periodicals, Inc.

Offering a Framework for Value Co-Creation in Virtual Academic Learning Environments

ERIC Educational Resources Information Center

Ranjbarfard, Mina; Heidari Sureshjani, Mahboobeh

2018-01-01

Purpose: This research aims to convert the traditional teacher-student models, in which teachers determine the learning resources, into a flexible structure and an active learning environment so that students can participate in the educational processes and value co-creation in virtual academic learning environments (VALEs).…

Psychopharmacological enhancement: a conceptual framework

PubMed Central

2012-01-01

The availability of a range of new psychotropic agents raises the possibility that these will be used for enhancement purposes (smart pills, happy pills, and pep pills). The enhancement debate soon raises questions in philosophy of medicine and psychiatry (eg, what is a disorder?), and this debate in turn raises fundament questions in philosophy of language, science, and ethics. In this paper, a naturalistic conceptual framework is proposed for addressing these issues. This framework begins by contrasting classical and critical concepts of categories, and then puts forward an integrative position that is based on cognitive-affective research. This position can in turn be used to consider the debate between pharmacological Calvinism (which may adopt a moral metaphor of disorder) and psychotropic utopianism (which may emphasize a medical metaphor of disorder). I argue that psychiatric treatment of serious psychiatric disorders is justified, and that psychotropics are an acceptable kind of intervention. The use of psychotropics for sub-threshold phenomena requires a judicious weighing of the relevant facts (which are often sparse) and values. PMID:22244084

Adoption of high technology medical imaging and hospital quality and efficiency: Towards a conceptual framework.

PubMed

Sandoval, Guillermo A; Brown, Adalsteinn D; Wodchis, Walter P; Anderson, Geoffrey M

2018-05-17

Measuring the value of medical imaging is challenging, in part, due to the lack of conceptual frameworks underlying potential mechanisms where value may be assessed. To address this gap, this article proposes a framework that builds on the large body of literature on quality of hospital care and the classic structure-process-outcome paradigm. The framework was also informed by the literature on adoption of technological innovations and introduces 2 distinct though related aspects of imaging technology not previously addressed specifically in the literature on quality of hospital care: adoption (a structural hospital characteristic) and use (an attribute of the process of care). The framework hypothesizes a 2-part causality where adoption is proposed to be a central, linking factor between hospital structural characteristics, market factors, and hospital outcomes (ie, quality and efficiency). The first part indicates that hospital structural characteristics and market factors influence or facilitate the adoption of high technology medical imaging within an institution. The presence of this technology, in turn, is hypothesized to improve the ability of the hospital to deliver high quality and efficient care. The second part describes this ability throughout 3 main mechanisms pointing to the importance of imaging use on patients, to the presence of staff and qualified care providers, and to some elements of organizational capacity capturing an enhanced clinical environment. The framework has the potential to assist empirical investigations of the value of adoption and use of medical imaging, and to advance understanding of the mechanisms that produce quality and efficiency in hospitals. Copyright © 2018 John Wiley & Sons, Ltd.

Values underpinning poverty programs for children.

PubMed

Heclo, H H

1997-01-01

Values create a framework through which the American public gives meaning to particular concepts and events. To better understand the values underlying public support for poverty programs for children, this article examines public attitudes toward children, poverty, and government. Although Americans continue to view helping children as a top policy priority, there is ambivalence with regard to poor children because of their inevitable connection to poor adults and the public's expectation that adults be self-sufficient. Rather than choosing between extreme ideological views of the causes of poverty and the ideal role of government in curbing poverty, the American public takes an integrative perspective that both values individual initiative and supports opportunities for all Americans. Favored are government programs fitted to the practical needs of everyday life. Such programs should support personal efforts but not assume responsibility for individual or particular group outcomes.

Structured decision making as a conceptual framework to identify thresholds for conservation and management

USGS Publications Warehouse

Martin, J.; Runge, M.C.; Nichols, J.D.; Lubow, B.C.; Kendall, W.L.

2009-01-01

Thresholds and their relevance to conservation have become a major topic of discussion in the ecological literature. Unfortunately, in many cases the lack of a clear conceptual framework for thinking about thresholds may have led to confusion in attempts to apply the concept of thresholds to conservation decisions. Here, we advocate a framework for thinking about thresholds in terms of a structured decision making process. The purpose of this framework is to promote a logical and transparent process for making informed decisions for conservation. Specification of such a framework leads naturally to consideration of definitions and roles of different kinds of thresholds in the process. We distinguish among three categories of thresholds. Ecological thresholds are values of system state variables at which small changes bring about substantial changes in system dynamics. Utility thresholds are components of management objectives (determined by human values) and are values of state or performance variables at which small changes yield substantial changes in the value of the management outcome. Decision thresholds are values of system state variables at which small changes prompt changes in management actions in order to reach specified management objectives. The approach that we present focuses directly on the objectives of management, with an aim to providing decisions that are optimal with respect to those objectives. This approach clearly distinguishes the components of the decision process that are inherently subjective (management objectives, potential management actions) from those that are more objective (system models, estimates of system state). Optimization based on these components then leads to decision matrices specifying optimal actions to be taken at various values of system state variables. Values of state variables separating different actions in such matrices are viewed as decision thresholds. Utility thresholds are included in the objectives

Prediction of Alzheimer's Disease Dementia: Data from the GuidAge Prevention Trial.

PubMed

Di Stefano, Francesca; Epelbaum, Stephane; Coley, Nicola; Cantet, Christelle; Ousset, Pierre-Jean; Hampel, Harald; Bakardjian, Hovagim; Lista, Simone; Vellas, Bruno; Dubois, Bruno; Andrieu, Sandrine

2015-01-01

In therapeutic trials, it is crucial to identify Alzheimer's disease (AD) at its prodromal stage. We assessed the accuracy of the free and cued selective reminding test (FCSRT) compared to other cognitive tests to predict AD dementia in subjects with subjective cognitive decline or mild cognitive impairment. Subjects from the placebo group of the GuidAge trial over 70 years old and without clinical signs of dementia at baseline who completed the 5-year follow-up free of dementia (n = 840) or developed AD dementia (n = 73) were included in our study. Among all the tests, the sum of the 3 free recall of the FCSRT (FCSRT-FR) and the sum of free and cued recall (FCSRT-TR) yielded the best results to predict AD dementia occurrence (all p values <0.05 for comparison of FCSRT-FR ROC and MMSE, CDRsb, and CVF ROCs). FCSRT-FR had an area under the ROC curve of 0.799 (95% CI 0.738-0.85) and the optimal cut-off was 20 (se 68.06% , sp 81.43% , PPV 23.90% , NPV 96,75%). Concerning FCSRT-TR, the AUC was 0.776 and the optimal cut-off was 42 (se 62.5% , sp 82.26% , PPV 23.20% and NPV 96.24%). This study sets the framework for implementing the FCSRT in clinical and therapeutic trials for efficient subject selection.

Engineering Values Into Genetic Engineering: A Proposed Analytic Framework for Scientific Social Responsibility.

PubMed

Sankar, Pamela L; Cho, Mildred K

2015-01-01

Recent experiments have been used to "edit" genomes of various plant, animal and other species, including humans, with unprecedented precision. Furthermore, editing the Cas9 endonuclease gene with a gene encoding the desired guide RNA into an organism, adjacent to an altered gene, could create a "gene drive" that could spread a trait through an entire population of organisms. These experiments represent advances along a spectrum of technological abilities that genetic engineers have been working on since the advent of recombinant DNA techniques. The scientific and bioethics communities have built substantial literatures about the ethical and policy implications of genetic engineering, especially in the age of bioterrorism. However, recent CRISPr/Cas experiments have triggered a rehashing of previous policy discussions, suggesting that the scientific community requires guidance on how to think about social responsibility. We propose a framework to enable analysis of social responsibility, using two examples of genetic engineering experiments.

A Framework for Multi-Stakeholder Decision-Making and ...

EPA Pesticide Factsheets

This contribution describes the implementation of the conditional-value-at-risk (CVaR) metric to create a general multi-stakeholder decision-making framework. It is observed that stakeholder dissatisfactions (distance to their individual ideal solutions) can be interpreted as random variables. We thus shape the dissatisfaction distribution and find an optimal compromise solution by solving a CVaR minimization problem parameterized in the probability level. This enables us to generalize multi-stakeholder settings previously proposed in the literature that minimizes average and worst-case dissatisfactions. We use the concept of the CVaR norm to give a geometric interpretation to this problem and use the properties of this norm to prove that the CVaR minimization problem yields Pareto optimal solutions for any choice of the probability level. We discuss a broad range of potential applications of the framework. We demonstrate the framework in a bio-waste processing facility location case study, where we seek compromise solutions (facility locations) that balance stakeholder priorities on transportation, safety, water quality, and capital costs. This conference presentation abstract explains a new decision-making framework that computes compromise solution alternatives (reach consensus) by mitigating dissatisfactions among stakeholders as needed for SHC Decision Science and Support Tools project.

Value management: optimizing quality, service, and cost.

PubMed

Makadon, Harvey J; Bharucha, Farzan; Gavin, Michael; Oliveira, Jason; Wietecha, Mark

2010-01-01

Hospitals have wrestled with balancing quality, service, and cost for years--and the visibility and urgency around measuring and communicating real metrics has grown exponentially in the last decade. However, even today, most hospital leaders cannot articulate or demonstrate the "value" they provide to patients and payers. Instead of developing a strategic direction that is based around a core value proposition, they focus their strategic efforts on tactical decisions like physician recruitment, facility expansion, and physician alignment. In the healthcare paradigm of the next decade, alignment of various tactical initiatives will require a more coherent understanding of the hospital's core value positioning. The authors draw on their experience in a variety of healthcare settings to suggest that for most hospitals, quality (i.e., clinical outcomes and patient safety) will become the most visible indicator of value, and introduce a framework to help healthcare providers influence their value positioning based on this variable.

Phenyl/Perfluorophenyl Stacking Interactions Enhance Structural Order in Two-Dimensional Covalent Organic Frameworks

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

Johnson, Justin C; Braunecker, Wade A; Hurst, Katherine E

A two-dimensional imine-based covalent organic framework (COF) was designed and synthesized such that phenyl and perfluorophenyl structural units can seamlessly alternate between layers of the framework. X-ray diffraction of the COF powders reveals a striking increase in crystallinity for the COF with self-complementary phenyl/perfluorophenyl interactions (FASt-COF). Whereas measured values of the Brunauer-Emmet-Teller (BET) surface areas for the nonfluorinated Base-COF and the COF employing hydrogen bonding were ~37% and 59%, respectively, of their theoretical Connolly surface areas, the BET value for FASt-COF achieves >90% of its theoretical value (~1700 m2/g). Transmission electron microscopy images also revealed unique micron-sized rodlike features inmore » FASt-COF that were not present in the other materials. The results highlight a promising approach for improving surface areas and long-range order in two-dimensional COFs.« less

A framework for monitoring social process and outcomes in environmental programs.

PubMed

Chapman, Sarah

2014-12-01

When environmental programs frame their activities as being in the service of human wellbeing, social variables need to be integrated into monitoring and evaluation (M&E) frameworks. This article draws upon ecosystem services theory to develop a framework to guide the M&E of collaborative environmental programs with anticipated social benefits. The framework has six components: program need, program activities, pathway process variables, moderating process variables, outcomes, and program value. Needs are defined in terms of ecosystem services, as well as other human needs that must be addressed to achieve outcomes. The pathway variable relates to the development of natural resource governance capacity in the target community. Moderating processes can be externalities such as the inherent capacity of the natural system to service ecosystem needs, local demand for natural resources, policy or socio-economic drivers. Internal program-specific processes relate to program service delivery, targeting and participant responsiveness. Ecological outcomes are expressed in terms of changes in landscape structure and function, which in turn influence ecosystem service provision. Social benefits derived from the program are expressed in terms of the value of the eco-social service to user-specified goals. The article provides suggestions from the literature for identifying indicators and measures for components and component variables, and concludes with an example of how the framework was used to inform the M&E of an adaptive co-management program in western Kenya. Copyright © 2014 Elsevier Ltd. All rights reserved.

Fuzzy decision-making framework for treatment selection based on the combined QUALIFLEX-TODIM method

NASA Astrophysics Data System (ADS)

Ji, Pu; Zhang, Hong-yu; Wang, Jian-qiang

2017-10-01

Treatment selection is a multi-criteria decision-making problem of significant concern in the medical field. In this study, a fuzzy decision-making framework is established for treatment selection. The framework mitigates information loss by introducing single-valued trapezoidal neutrosophic numbers to denote evaluation information. Treatment selection has multiple criteria that remarkably exceed the alternatives. In consideration of this characteristic, the framework utilises the idea of the qualitative flexible multiple criteria method. Furthermore, it considers the risk-averse behaviour of a decision maker by employing a concordance index based on TODIM (an acronym in Portuguese of interactive and multi-criteria decision-making) method. A sensitivity analysis is performed to illustrate the robustness of the framework. Finally, a comparative analysis is conducted to compare the framework with several extant methods. Results indicate the advantages of the framework and its better performance compared with the extant methods.

Gender Ideologies in Europe: A Multidimensional Framework.

PubMed

Grunow, Daniela; Begall, Katia; Buchler, Sandra

2018-02-01

The authors argue, in line with recent research, that operationalizing gender ideology as a unidimensional construct ranging from traditional to egalitarian is problematic and propose an alternative framework that takes the multidimensionality of gender ideologies into account. Using latent class analysis, they operationalize their gender ideology framework based on data from the 2008 European Values Study, of which eight European countries reflecting the spectrum of current work-family policies were selected. The authors examine the form in which gender ideologies cluster in the various countries. Five ideology profiles were identified: egalitarian, egalitarian essentialism, intensive parenting, moderate traditional, and traditional. The five ideology profiles were found in all countries, but with pronounced variation in size. Ideologies mixing gender essentialist and egalitarian views appear to have replaced traditional ideologies, even in countries offering some institutional support for gendered separate spheres.

Gender Ideologies in Europe: A Multidimensional Framework

PubMed Central

Begall, Katia; Buchler, Sandra

2018-01-01

The authors argue, in line with recent research, that operationalizing gender ideology as a unidimensional construct ranging from traditional to egalitarian is problematic and propose an alternative framework that takes the multidimensionality of gender ideologies into account. Using latent class analysis, they operationalize their gender ideology framework based on data from the 2008 European Values Study, of which eight European countries reflecting the spectrum of current work–family policies were selected. The authors examine the form in which gender ideologies cluster in the various countries. Five ideology profiles were identified: egalitarian, egalitarian essentialism, intensive parenting, moderate traditional, and traditional. The five ideology profiles were found in all countries, but with pronounced variation in size. Ideologies mixing gender essentialist and egalitarian views appear to have replaced traditional ideologies, even in countries offering some institutional support for gendered separate spheres. PMID:29491532

Accounting for reasonableness: Exploring the personal internal framework affecting decisions about cancer drug funding.

PubMed

Sinclair, Shane; Hagen, Neil A; Chambers, Carole; Manns, Braden; Simon, Anita; Browman, George P

2008-05-01

Drug decision-makers are involved in developing and implementing policy, procedure and processes to support health resource allocation regarding drug treatment formularies. A variety of approaches to decision-making, including formal decision-making frameworks, have been developed to support transparent and fair priority setting. Recently, a decision tool, 'The 6-STEPPPs Tool', was developed to assist in making decisions about new cancer drugs within the public health care system. We conducted a qualitative study, utilizing focus groups and participant observation, in order to investigate the internal frameworks that supported and challenged individual participants as they applied this decision tool within a multi-stakeholder decision process. We discovered that health care resource allocation engaged not only the minds of decision-makers but profoundly called on the often conflicting values of the heart. Objective decision-making frameworks for new drug therapies need to consider the subjective internal frameworks of decision-makers that affect decisions. Understanding the very human, internal turmoil experienced by individuals involved in health care resource allocation, sheds additional insight into how to account for reasonableness and how to better support difficult decisions through transparent, values-based resource allocation policy, procedures and processes.

The Politics of Maintaining Professional Values in the 21st Century

ERIC Educational Resources Information Center

Charles, John M.

2016-01-01

Looking ahead, it seems clear that organizing together the values we espouse as a profession could help us to live and work in a global kinesiology community in the best possible way. It is politic, in that it seems sensible and judicious to act on this principle, to organize and maintain a coherent framework of professional values. In which case,…

A Framework for Multi-Stakeholder Decision-Making and Conflict Resolution (abstract)

EPA Science Inventory

This contribution describes the implementation of the conditional-value-at-risk (CVaR) metric to create a general multi-stakeholder decision-making framework. It is observed that stakeholder dissatisfactions (distance to their individual ideal solutions) can be interpreted as ran...

Philosophical approaches to the nursing informatics data-information-knowledge-wisdom framework.

PubMed

Matney, Susan; Brewster, Philip J; Sward, Katherine A; Cloyes, Kristin G; Staggers, Nancy

2011-01-01

Although informatics is an important area of nursing inquiry and practice, few scholars have articulated the philosophical foundations of the field or how these translate into practice including the often-cited data, information, knowledge, and wisdom (DIKW) framework. Data, information, and knowledge, often approached through postpositivism, can be exhibited in computer systems. Wisdom aligns with constructivist epistemological perspectives such as Gadamerian hermeneutics. Computer systems can support wisdom development. Wisdom is an important element of the DIKW framework and adds value to the role of nursing informaticists and nursing science.

Estimating the Value of Life, Injury, and Travel Time Saved Using a Stated Preference Framework.

PubMed

Niroomand, Naghmeh; Jenkins, Glenn P

2016-06-01

The incidence of fatality over the period 2010-2014 from automobile accidents in North Cyprus is 2.75 times greater than the average for the EU. With the prospect of North Cyprus entering the EU, many investments will need to be undertaken to improve road safety in order to reach EU benchmarks. The objective of this study is to provide local estimates of the value of a statistical life and injury along with the value of time savings. These are among the parameter values needed for the evaluation of the change in the expected incidence of automotive accidents and time savings brought about by such projects. In this study we conducted a stated choice experiment to identify the preferences and tradeoffs of automobile drivers in North Cyprus for improved travel times, travel costs, and safety. The choice of route was examined using mixed logit models to obtain the marginal utilities associated with each attribute of the routes that consumers choose. These estimates were used to assess the individuals' willingness to pay (WTP) to avoid fatalities and injuries and to save travel time. We then used the results to obtain community-wide estimates of the value of a statistical life (VSL) saved, the value of injury (VI) prevented, and the value per hour of travel time saved. The estimates for the VSL range from €315,293 to €1,117,856 and the estimates of VI from € 5,603 to € 28,186. These values are consistent, after adjusting for differences in incomes, with the median results of similar studies done for EU countries. Copyright © 2016 Elsevier Ltd. All rights reserved.

On nonepistemic values in conservation biology.

PubMed

Baumgaertner, Bert; Holthuijzen, Wieteke

2017-02-01

Conservation biology is a uniquely interdisciplinary science with strong roots in ecology, but it also embraces a value-laden and mission-oriented framework. This combination of science and values causes conservation biology to be at the center of critique regarding the discipline's scientific credibility-especially the division between the realms of theory and practice. We identify this dichotomy between seemingly objective (fact-based) and subjective (value-laden) practices as the measure-value dichotomy, whereby measure refers to methods and analyses used in conservation biology (i.e., measuring biodiversity) and value refers to nonepistemic values. We reviewed and evaluated several landmark articles central to the foundation of conservation biology and concepts of biodiversity with respect to their attempts to separate measures and values. We argue that the measure-value dichotomy is false and that conservation biology can make progress in ways unavailable to other disciplines because its practitioners are tasked with engaging in both the realm of theory and the realm of practice. The entanglement of measures and values is by no means a weakness of conservation biology. Because central concepts such as biodiversity contain both factual and evaluative aspects, conservation biologists can make theoretical progress by examining, reviewing, and forming the values that are an integral part of those concepts. We suggest that values should be included and analyzed with respect to the methods, results, and conclusions of scientific work in conservation biology. © 2016 Society for Conservation Biology.

FP-receptor gene silencing ameliorates myocardial fibrosis and protects from diabetic cardiomyopathy.

PubMed

Ding, Wen-yuan; Liu, Lin; Wang, Zhi-hao; Tang, Meng-xiong; Ti, Yun; Han, Lu; Zhang, Lei; Zhang, Yun; Zhong, Ming; Zhang, Wei

2014-06-01

Prostaglandin F2(α)-F-prostanoid (PGF2(α)-FP) receptor is closely related to insulin resistance, which plays a causal role in the pathogenesis of diabetic cardiomyopathy (DCM). We sought to reveal whether PGF2(α)-FP receptor plays an important part in modulating DCM and the mechanisms involved. We established the type 2 diabetes rat model by high-fat diet and low-dose streptozotocin (STZ) and then evaluated its characteristics by metabolite tests, Western blot analysis for FP-receptor expression, histopathologic analyses of cardiomyocyte density and fibrosis area. Next, we used gene silencing to investigate the role of FP receptor in the pathophysiologic features of DCM. Our study showed elevated cholesterol, triglyceride, glucose, and insulin levels, severe insulin resistance, and FP-receptor overexpression in diabetic rats. The collagen volume fraction (CVF) and perivascular collagen area/luminal area (PVCA/LA) were higher in the diabetic group than the control group (CVF% 10.99 ± 0.99 vs 1.59 ± 0.18, P < 0.05; PVCA/LA% 17.07 ± 2.61 vs 2.86 ± 0.69, P < 0.05). We found that the silencing of FP receptor decreased cholesterol, triglyceride, glucose, and insulin levels and ameliorated insulin resistance. The CVF and PVCF/LA were significantly downregulated in FP-receptor short hairpin RNA (shRNA) treatment group (FP-receptor shRNA group vs vehicle group: CVF% 5.59 ± 0.92 vs 10.97 ± 1.33, P < 0.05, PVCA/LA% 4.74 ± 1.57 vs 14.79 ± 2.22, P < 0.05; FP-receptor shRNA + PGF2(α) group vs vehicle group : CVF% 5.19 ± 0.79 vs 10.97 ± 1.33, P < 0.05, PVCA/LA% 5.96 ± 1.15 vs 14.79 ± 2.22, P < 0.05, respectively). Furthermore, with FP-receptor gene silencing, the activated protein kinase C (PKC) and Rho kinase were significantly decreased, and the blunted phosphorylation of Akt was restored. FP-receptor gene silencing may exert a protective effect on DCM by improving myocardial fibrosis

Collateral missing value imputation: a new robust missing value estimation algorithm for microarray data.

PubMed

Sehgal, Muhammad Shoaib B; Gondal, Iqbal; Dooley, Laurence S

2005-05-15

Microarray data are used in a range of application areas in biology, although often it contains considerable numbers of missing values. These missing values can significantly affect subsequent statistical analysis and machine learning algorithms so there is a strong motivation to estimate these values as accurately as possible before using these algorithms. While many imputation algorithms have been proposed, more robust techniques need to be developed so that further analysis of biological data can be accurately undertaken. In this paper, an innovative missing value imputation algorithm called collateral missing value estimation (CMVE) is presented which uses multiple covariance-based imputation matrices for the final prediction of missing values. The matrices are computed and optimized using least square regression and linear programming methods. The new CMVE algorithm has been compared with existing estimation techniques including Bayesian principal component analysis imputation (BPCA), least square impute (LSImpute) and K-nearest neighbour (KNN). All these methods were rigorously tested to estimate missing values in three separate non-time series (ovarian cancer based) and one time series (yeast sporulation) dataset. Each method was quantitatively analyzed using the normalized root mean square (NRMS) error measure, covering a wide range of randomly introduced missing value probabilities from 0.01 to 0.2. Experiments were also undertaken on the yeast dataset, which comprised 1.7% actual missing values, to test the hypothesis that CMVE performed better not only for randomly occurring but also for a real distribution of missing values. The results confirmed that CMVE consistently demonstrated superior and robust estimation capability of missing values compared with other methods for both series types of data, for the same order of computational complexity. A concise theoretical framework has also been formulated to validate the improved performance of the CMVE

A Planning and Evaluation Six-Pack for Sustainable Organizations: The Six-P Framework

ERIC Educational Resources Information Center

Marker, Anthony; Johnsen, Elizabeth; Caswell, Christina

2009-01-01

As performance improvement (PI) practitioners, we seek not only to solve organizational problems but also to add value. For some time, we have focused on financial value. However, we are beginning to be held accountable also for the impact of our interventions on society and the environment. The Six-P framework--proposed here--can help PI…

Engineering Values into Genetic Engineering: A Proposed Analytic Framework for Scientific Social Responsibility

PubMed Central

Cho, Mildred K.

2016-01-01

Recent experiments have been used to “edit” genomes of various plant, animal and other species, including humans, with unprecedented precision. Furthermore, editing Cas9 endonuclease gene with a gene encoding the desired guide RNA into an organism, adjacent to an altered gene, could create a “gene drive” that could spread a trait through an entire population of organisms. These experiments represent advances along a spectrum of technological abilities that genetic engineers have been working on since the advent of recombinant DNA techniques. The scientific and bioethics communities have built substantial literatures about the ethical and policy implications of genetic engineering, especially in the age of bioterrorism. However, recent CRISPr/Cas experiments have triggered a rehashing of previous policy discussions, suggesting that the scientific community requires guidance on how to think about social responsibility. We propose a framework to enable analysis of social responsibility, using two examples of genetic engineering experiments. PMID:26632356

Measuring patient-perceived hospital service quality: a conceptual framework.

PubMed

Pai, Yogesh P; Chary, Satyanarayana T

2016-04-18

Purpose - Although measuring healthcare service quality is not a new phenomenon, the instruments used to measure are timeworn. With the shift in focus to patient centric processes in hospitals and recognizing healthcare to be different compared to other services, service quality measurement needs to be tuned specifically to healthcare. The purpose of this paper is to design a conceptual framework for measuring patient perceived hospital service quality (HSQ), based on existing service quality literature. Design/methodology/approach - Using HSQ theories, expanding existing healthcare service models and literature, a conceptual framework is proposed to measure HSQ. The paper outlines patient perceived service quality dimensions. Findings - An instrument for measuring HSQ dimensions is developed and compared with other service quality measuring instruments. The latest dimensions are in line with previous studies, but a relationship dimension is added. Practical implications - The framework empowers managers to assess healthcare quality in corporate, public and teaching hospitals. Originality/value - The paper helps academics and practitioners to assess HSQ from a patient perspective.

Process change evaluation framework for allogeneic cell therapies: impact on drug development and commercialization.

PubMed

Hassan, Sally; Huang, Hsini; Warren, Kim; Mahdavi, Behzad; Smith, David; Jong, Simcha; Farid, Suzanne S

2016-04-01

Some allogeneic cell therapies requiring a high dose of cells for large indication groups demand a change in cell expansion technology, from planar units to microcarriers in single-use bioreactors for the market phase. The aim was to model the optimal timing for making this change. A development lifecycle cash flow framework was created to examine the implications of process changes to microcarrier cultures at different stages of a cell therapy's lifecycle. The analysis performed under assumptions used in the framework predicted that making this switch earlier in development is optimal from a total expected out-of-pocket cost perspective. From a risk-adjusted net present value view, switching at Phase I is economically competitive but a post-approval switch can offer the highest risk-adjusted net present value as the cost of switching is offset by initial market penetration with planar technologies. The framework can facilitate early decision-making during process development.

A decision tree approach to screen drinking water contaminants for multiroute exposure potential in developing guideline values.

PubMed

Krishnan, Kannan; Carrier, Richard

2017-07-03

The consideration of inhalation and dermal routes of exposures in developing guideline values for drinking water contaminants is important. However, there is no guidance for determining the eligibility of a drinking water contaminant for its multiroute exposure potential. The objective of the present study was to develop a 4-step framework to screen chemicals for their dermal and inhalation exposure potential in the process of developing guideline values. The proposed framework emphasizes the importance of considering basic physicochemical properties prior to detailed assessment of dermal and inhalation routes of exposure to drinking water contaminants in setting guideline values.

Defining the Value of Neurosurgery in the New Healthcare Era.

PubMed

Benzil, Deborah L; Zusman, Edie E

2017-04-01

Healthcare delivery is evolving rapidly with an increasing emphasis on the concept of "value." At the same time, neurosurgeons are disproportionately working in employed positions where external definition of value becomes directly linked with compensation, work environment, and career satisfaction. Few neurosurgeons have an understanding of the various ways in which value is and can be defined and there are limited resources to assist in this realm. This paper covers the essential value concepts of National Standards, Pitfalls of National Standards, Call Coverage Compensation, Valuation Through Demand, Value Beyond Productivity, and Neurosurgical Value in the Accountable Care Organization Era. This framework should help neurosurgeons better understand critical trends impacting practice across the country. Copyright © 2017 by the Congress of Neurological Surgeons.

From a declaration of values to the creation of value in global health: a report from Harvard University's Global Health Delivery Project.

PubMed

Kim, J Y; Rhatigan, J; Jain, S H; Weintraub, R; Porter, M E

2010-01-01

To make best use of the new dollars available for the treatment of disease in resource-poor settings, global health practice requires a strategic approach that emphasises value for patients. Practitioners and global health academics should seek to identify and elaborate the set of factors that drives value for patients through the detailed study of actual care delivery organisations in multiple settings. Several frameworks can facilitate this study, including the care delivery value chain. We report on our efforts to catalyse the study of health care delivery in resource-limited settings in the hope that this inquiry will lead to insights that can improve the health of the neediest worldwide.

Value in cardiovascular care.

PubMed

Bradley, Steven M; Strauss, Craig E; Ho, P Michael

2017-08-01

Healthcare value, defined as health outcomes achieved relative to the costs of care, has been proposed as a unifying approach to measure improvements in the quality and affordability of healthcare. Although value is of increasing interest to payers, many providers remain unfamiliar with how value differs from other approaches to the comparison of cost and outcomes (ie, cost-effectiveness analysis). While cost-effectiveness studies can be used by policy makers and payers to inform decisions about coverage and reimbursement for new therapies, the assessment of healthcare can guide improvements in the delivery of healthcare to achieve better outcomes at lower cost. Comparison on value allows for the identification of healthcare delivery organisations or care delivery settings where patient outcomes have been optimised at a lower cost. Gaps remain in the measurement of healthcare value, particularly as it relates to patient-reported health status (symptoms, functional status and health-related quality of life). The use of technology platforms that capture health status measures with minimal disruption to clinical workflow (ie, web portals, automated telephonic systems and tablets to facilitate capture outside of in-person clinical interaction) is facilitating use of health status measures to improve clinical care and optimise patient outcomes. Furthermore, the use of a value framework has catalysed quality improvement efforts and research to seek better patient outcomes at lower cost. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The broiler meat system in Nairobi, Kenya: Using a value chain framework to understand animal and product flows, governance and sanitary risks.

PubMed

Carron, Maud; Alarcon, Pablo; Karani, Maurice; Muinde, Patrick; Akoko, James; Onono, Joshua; Fèvre, Eric M; Häsler, Barbara; Rushton, Jonathan

2017-11-01

Livestock food systems play key subsistence and income generation roles in low to middle income countries and are important networks for zoonotic disease transmission. The aim of this study was to use a value chain framework to characterize the broiler chicken meat system of Nairobi, its governance and sanitary risks. A total of 4 focus groups and 8 key informant interviews were used to collect cross-sectional data from: small-scale broiler farmers in selected Nairobi peri-urban and informal settlement areas; medium to large integrated broiler production companies; traders and meat inspectors in live chicken and chicken meat markets in Nairobi. Qualitative data were collected on types of people operating in the system, their interactions, sanitary measures in place, sourcing and selling of broiler chickens and products. Framework analysis was used to identify governance themes and risky sanitary practices present in the system. One large company was identified to supply 60% of Nairobi's day-old chicks to farmers, mainly through agrovet shops. Broiler meat products from integrated companies were sold in high-end retailers whereas their low value products were channelled through independent traders to consumers in informal settlements. Peri-urban small-scale farmers reported to slaughter the broilers on the farm and to sell carcasses to retailers (hotels and butcheries mainly) through brokers (80%), while farmers in the informal settlement reported to sell their broilers live to retailers (butcheries, hotels and hawkers mainly) directly. Broiler heads and legs were sold in informal settlements via roadside vendors. Sanitary risks identified were related to lack of biosecurity, cold chain and access to water, poor hygiene practices, lack of inspection at farm slaughter and limited health inspection in markets.
 Large companies dominated the governance of the broiler system through the control of day-old chick production. Overall government control was described as

An Ethical (Descriptive) Framework for Judgment of Actions and Decisions in the Construction Industry and Engineering-Part I.

PubMed

Alkhatib, Omar J; Abdou, Alaa

2018-04-01

The construction industry is usually characterized as a fragmented system of multiple-organizational entities in which members from different technical backgrounds and moral values join together to develop a particular business or project. The greatest challenge in the construction process for the achievement of a successful practice is the development of an outstanding reputation, which is built on identifying and applying an ethical framework. This framework should reflect a common ethical ground for myriad people involved in this process to survive and compete ethically in today's turbulent construction market. This study establishes a framework for ethical judgment of behavior and actions conducted in the construction process. The framework was primarily developed based on the essential attributes of business management identified in the literature review and subsequently incorporates additional attributes identified to prevent breaches in the construction industry and common ethical values related to professional engineering. The proposed judgment framework is based primarily on the ethical dimension of professional responsibility. The Ethical Judgment Framework consists of descriptive approaches involving technical, professional, administrative, and miscellaneous terms. The framework provides the basis for judging actions as either ethical or unethical. Furthermore, the framework can be implemented as a form of preventive ethics, which would help avoid ethical dilemmas and moral allegations. The framework can be considered a decision-making model to guide actions and improve the ethical reasoning process that would help individuals think through possible implications and consequences of ethical dilemmas in the construction industry.

The social impacts of dams: A new framework for scholarly analysis

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

Kirchherr, Julian, E-mail: julian.kirchherr@sant.ox.ac.uk; Charles, Katrina J., E-mail: katrina.charles@ouce.ox.ac.uk

No commonly used framework exists in the scholarly study of the social impacts of dams. This hinders comparisons of analyses and thus the accumulation of knowledge. The aim of this paper is to unify scholarly understanding of dams' social impacts via the analysis and aggregation of the various frameworks currently used in the scholarly literature. For this purpose, we have systematically analyzed and aggregated 27 frameworks employed by academics analyzing dams' social impacts (found in a set of 217 articles). A key finding of the analysis is that currently used frameworks are often not specific to dams and thus omitmore » key impacts associated with them. The result of our analysis and aggregation is a new framework for scholarly analysis (which we call ‘matrix framework’) specifically on dams' social impacts, with space, time and value as its key dimensions as well as infrastructure, community and livelihood as its key components. Building on the scholarly understanding of this topic enables us to conceptualize the inherently complex and multidimensional issues of dams' social impacts in a holistic manner. If commonly employed in academia (and possibly in practice), this framework would enable more transparent assessment and comparison of projects.« less

A novel multi-target regression framework for time-series prediction of drug efficacy

PubMed Central

Li, Haiqing; Zhang, Wei; Chen, Ying; Guo, Yumeng; Li, Guo-Zheng; Zhu, Xiaoxin

2017-01-01

Excavating from small samples is a challenging pharmacokinetic problem, where statistical methods can be applied. Pharmacokinetic data is special due to the small samples of high dimensionality, which makes it difficult to adopt conventional methods to predict the efficacy of traditional Chinese medicine (TCM) prescription. The main purpose of our study is to obtain some knowledge of the correlation in TCM prescription. Here, a novel method named Multi-target Regression Framework to deal with the problem of efficacy prediction is proposed. We employ the correlation between the values of different time sequences and add predictive targets of previous time as features to predict the value of current time. Several experiments are conducted to test the validity of our method and the results of leave-one-out cross-validation clearly manifest the competitiveness of our framework. Compared with linear regression, artificial neural networks, and partial least squares, support vector regression combined with our framework demonstrates the best performance, and appears to be more suitable for this task. PMID:28098186

An Integrated Finite Element-based Simulation Framework: From Hole Piercing to Hole Expansion

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

Hu, Xiaohua; Sun, Xin; Golovashchenko, Segey F.

An integrated finite element-based modeling framework is developed to predict the hole expansion ratio (HER) of AA6111-T4 sheet by considering the piercing-induced damages around the hole edge. Using damage models and parameters calibrated from previously reported tensile stretchability studies, the predicted HER correlates well with experimentally measured HER values for different hole piercing clearances. The hole piercing model shows burrs are not generated on the sheared surface for clearances less than 20%, which corresponds well with the experimental data on pierced holes cross-sections. Finite-element-calculated HER also is not especially sensitive to piercing clearances less than this value. However, as clearancesmore » increase to 30% and further to 40%, the HER values are predicted to be considerably smaller, also consistent with experimental measurements. Upon validation, the integrated modeling framework is used to examine the effects of different hole piercing and hole expansion conditions on the critical HERs for AA6111-T4.« less

An empirically based conceptual framework for fostering meaningful patient engagement in research.

PubMed

Hamilton, Clayon B; Hoens, Alison M; Backman, Catherine L; McKinnon, Annette M; McQuitty, Shanon; English, Kelly; Li, Linda C

2018-02-01

Patient engagement in research (PEIR) is promoted to improve the relevance and quality of health research, but has little conceptualization derived from empirical data. To address this issue, we sought to develop an empirically based conceptual framework for meaningful PEIR founded on a patient perspective. We conducted a qualitative secondary analysis of in-depth interviews with 18 patient research partners from a research centre-affiliated patient advisory board. Data analysis involved three phases: identifying the themes, developing a framework and confirming the framework. We coded and organized the data, and abstracted, illustrated, described and explored the emergent themes using thematic analysis. Directed content analysis was conducted to derive concepts from 18 publications related to PEIR to supplement, confirm or refute, and extend the emergent conceptual framework. The framework was reviewed by four patient research partners on our research team. Participants' experiences of working with researchers were generally positive. Eight themes emerged: procedural requirements, convenience, contributions, support, team interaction, research environment, feel valued and benefits. These themes were interconnected and formed a conceptual framework to explain the phenomenon of meaningful PEIR from a patient perspective. This framework, the PEIR Framework, was endorsed by the patient research partners on our team. The PEIR Framework provides guidance on aspects of PEIR to address for meaningful PEIR. It could be particularly useful when patient-researcher partnerships are led by researchers with little experience of engaging patients in research. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Value-based recruitment in midwifery: do the values align with what women say is important to them?

PubMed

Callwood, Alison; Cooke, Debbie; Allan, Helen

2016-10-01

The aim of this study was to discuss theoretical conceptualization and definition of values and value-based recruitment in the context of women's views about what they would like from their midwife. Value-based recruitment received headline status in the UK government's response to pervasive deficiencies in compassionate care identified in the health service. Core values which aim to inform service user's experience are defined in the National Health Service Constitution but clarity about whether these encompass all that women say is important to them is needed. Discussion paper. A literature search included published papers written in English relating to values, VBR and women's views of a 'good' midwife with no date limiters. Definitions of values and value-based recruitment are examined. Congruence is explored between what women say is important to them and key government and professional regulatory documentation. The importance of a 'sustainable emotional' dimension in the midwife-mother relationship is suggested. Inconsistencies are identified between women's views, government, professional documentation and what women say they want. An omission of any reference to emotions or emotionality in value-based recruitment policy, professional recruitment and selection guidance documentation is identified. A review of key professional documentation, in relation to selection for 'values', is proposed. We argue for clarity and revision so that values embedded in value-based recruitment are consistent with health service users' views. An enhancement of the 'values' in the value-based recruitment framework is recommended to include the emotionality that women state is a fundamental part of their relationship with their midwife. © 2016 John Wiley & Sons Ltd.

Defining and Assessing Quality Improvement Outcomes: A Framework for Public Health

PubMed Central

Nawaz, Saira; Thomas, Craig; Young, Andrea

2015-01-01

We describe an evidence-based framework to define and assess the impact of quality improvement (QI) in public health. Developed to address programmatic and research-identified needs for articulating the value of public health QI in aggregate, this framework proposes a standardized set of measures to monitor and improve the efficiency and effectiveness of public health programs and operations. We reviewed the scientific literature and analyzed QI initiatives implemented through the Centers for Disease Control and Prevention’s National Public Health Improvement Initiative to inform the selection of 5 efficiency and 8 effectiveness measures. This framework provides a model for identifying the types of improvement outcomes targeted by public health QI efforts and a means to understand QI’s impact on the practice of public health. PMID:25689185

Reorienting an Information Literacy Program toward Social Justice: Mapping the Core Values of Librarianship to the ACRL Framework

ERIC Educational Resources Information Center

Gregory, Lua; Higgins, Shana

2017-01-01

Since the publication of the Association of College and Research Libraries' (ACRL) "Framework for Information Literacy for Higher Education," librarians have grappled with the purposes, impact, and meaning of this teaching document for their daily instructional practice, for curriculum development, and for institutional and programmatic…

Ecosystem service tradeoff analysis reveals the value of marine spatial planning for multiple ocean uses

PubMed Central

White, Crow; Halpern, Benjamin S.; Kappel, Carrie V.

2012-01-01

Marine spatial planning (MSP) is an emerging responsibility of resource managers around the United States and elsewhere. A key proposed advantage of MSP is that it makes tradeoffs in resource use and sector (stakeholder group) values explicit, but doing so requires tools to assess tradeoffs. We extended tradeoff analyses from economics to simultaneously assess multiple ecosystem services and the values they provide to sectors using a robust, quantitative, and transparent framework. We used the framework to assess potential conflicts among offshore wind energy, commercial fishing, and whale-watching sectors in Massachusetts and identify and quantify the value from choosing optimal wind farm designs that minimize conflicts among these sectors. Most notably, we show that using MSP over conventional planning could prevent >$1 million dollars in losses to the incumbent fishery and whale-watching sectors and could generate >$10 billion in extra value to the energy sector. The value of MSP increased with the greater the number of sectors considered and the larger the area under management. Importantly, the framework can be applied even when sectors are not measured in dollars (e.g., conservation). Making tradeoffs explicit improves transparency in decision-making, helps avoid unnecessary conflicts attributable to perceived but weak tradeoffs, and focuses debate on finding the most efficient solutions to mitigate real tradeoffs and maximize sector values. Our analysis demonstrates the utility, feasibility, and value of MSP and provides timely support for the management transitions needed for society to address the challenges of an increasingly crowded ocean environment. PMID:22392996

An evaluation framework for participatory modelling

NASA Astrophysics Data System (ADS)

Krueger, T.; Inman, A.; Chilvers, J.

2012-04-01

Strong arguments for participatory modelling in hydrology can be made on substantive, instrumental and normative grounds. These arguments have led to increasingly diverse groups of stakeholders (here anyone affecting or affected by an issue) getting involved in hydrological research and the management of water resources. In fact, participation has become a requirement of many research grants, programs, plans and policies. However, evidence of beneficial outcomes of participation as suggested by the arguments is difficult to generate and therefore rare. This is because outcomes are diverse, distributed, often tacit, and take time to emerge. In this paper we develop an evaluation framework for participatory modelling focussed on learning outcomes. Learning encompasses many of the potential benefits of participation, such as better models through diversity of knowledge and scrutiny, stakeholder empowerment, greater trust in models and ownership of subsequent decisions, individual moral development, reflexivity, relationships, social capital, institutional change, resilience and sustainability. Based on the theories of experiential, transformative and social learning, complemented by practitioner experience our framework examines if, when and how learning has occurred. Special emphasis is placed on the role of models as learning catalysts. We map the distribution of learning between stakeholders, scientists (as a subgroup of stakeholders) and models. And we analyse what type of learning has occurred: instrumental learning (broadly cognitive enhancement) and/or communicative learning (change in interpreting meanings, intentions and values associated with actions and activities; group dynamics). We demonstrate how our framework can be translated into a questionnaire-based survey conducted with stakeholders and scientists at key stages of the participatory process, and show preliminary insights from applying the framework within a rural pollution management situation in

Use of Annotations for Component and Framework Interoperability

NASA Astrophysics Data System (ADS)

David, O.; Lloyd, W.; Carlson, J.; Leavesley, G. H.; Geter, F.

2009-12-01

western United States at the USDA NRCS National Water and Climate Center. PRMS is a component based modular precipitation-runoff model developed to evaluate the impacts of various combinations of precipitation, climate, and land use on streamflow and general basin hydrology. The new OMS 3.0 PRMS model source code is more concise and flexible as a result of using the new framework’s annotation based approach. The fully annotated components are now providing information directly for (i) model assembly and building, (ii) dataflow analysis for implicit multithreading, (iii) automated and comprehensive model documentation of component dependencies, physical data properties, (iv) automated model and component testing, and (v) automated audit-traceability to account for all model resources leading to a particular simulation result. Experience to date has demonstrated the multi-purpose value of using annotations. Annotations are also a feasible and practical method to enable interoperability among models and modeling frameworks. As a prototype example, model code annotations were used to generate binding and mediation code to allow the use of OMS 3.0 model components within the OpenMI context.

Uncovering values-based practice: VBP's implicit commitments to subjectivism and relativism.

PubMed

Cassidy, Ben

2013-06-01

Despite assertions to the contrary, KWM Fulford's values-based practice is implicitly committed to subjectivism when it comes to reasoning about values. This renders the approach unworkable. The act of merely uncovering underlying values is not enough to effect change and, therefore, resolve problems if we have no way, even in principle, of determining which values are right and which are wrong. Fulford's only departure from subjectivism about value is his commitment to 'framework values', which seems grounded in a version of ethical relativism. I argue that we need to reject both subjectivism and relativism if progress within ethical discussions about practice is to be meaningful and a real possibility. © 2013 John Wiley & Sons Ltd.

A proposed framework to operationalize ESS for the mitigation of soil threats

NASA Astrophysics Data System (ADS)

Schwilch, Gudrun; Bernet, Lea; Fleskens, Luuk; Mills, Jane; Stolte, Jannes; van Delden, Hedwig; Verzandvoort, Simone

2015-04-01

Despite various research activities in the last decades across the world, many challenges remain to integrate the concept of ecosystem services (ESS) in decision-making, and a coherent approach to assess and value ESS is still lacking. There are a lot of different - often context-specific - ESS frameworks with their own definitions and understanding of terms. Based on a thorough review, the EU FP7 project RECARE (www.recare-project.eu) suggests an adapted framework for ecosystem services related to soils that can be used for practical application in preventing and remediating degradation of soils in Europe. This lays the foundation for the development and selection of appropriate methods to measure, evaluate, communicate and negotiate the services we obtain from soils with stakeholders in order to improve land management. Similar to many ESS frameworks, the RECARE framework distinguishes between an ecosystem and human well-being part. As the RECARE project is focused on soil threats, this is the starting point on the ecosystem part of the framework. Soil threats affect natural capital, such as soil, water, vegetation, air and animals, and are in turn influenced by those. Within the natural capital, the RECARE framework focuses especially on soil and its properties, classified in inherent and manageable properties. The natural capital then enables and underpins soil processes, while at the same time being affected by those. Soil processes, finally, are the ecosystem's capacity to provide services, thus they support the provision of soil functions and ESS. ESS may be utilized to produce benefits for individuals and human society. Those benefits are explicitly or implicitly valued by individuals and human society. The values placed on those benefits influence policy and decision-making and thus lead to a societal response. Individual (e.g. farmers') and societal decision making and policy determine land management and other (human) driving forces, which in turn affect

Geologic framework for the national assessment of carbon dioxide storage resources—Southern Rocky Mountain Basins: Chapter M in Geologic framework for the national assessment of carbon dioxide storage resources

USGS Publications Warehouse

Merrill, Matthew D.; Drake, Ronald M.; Buursink, Marc L.; Craddock, William H.; East, Joseph A.; Slucher, Ernie R.; Warwick, Peter D.; Brennan, Sean T.; Blondes, Madalyn S.; Freeman, Philip A.; Cahan, Steven M.; DeVera, Christina A.; Lohr, Celeste D.; Warwick, Peter D.; Corum, Margo D.

2016-06-02

The U.S. Geological Survey has completed an assessment of the potential geologic carbon dioxide storage resources in the onshore areas of the United States. To provide geological context and input data sources for the resources numbers, framework documents are being prepared for all areas that were investigated as part of the national assessment. This report, chapter M, is the geologic framework document for the Uinta and Piceance, San Juan, Paradox, Raton, Eastern Great, and Black Mesa Basins, and subbasins therein of Arizona, Colorado, Idaho, Nevada, New Mexico, and Utah. In addition to a summary of the geology and petroleum resources of studied basins, the individual storage assessment units (SAUs) within the basins are described and explanations for their selection are presented. Although appendixes in the national assessment publications include the input values used to calculate the available storage resource, this framework document provides only the context and source of the input values selected by the assessment geologists. Spatial-data files of the boundaries for the SAUs, and the well-penetration density of known well bores that penetrate the SAU seal, are available for download with the release of this report.

Predicting who will major in a science discipline: Expectancy-value theory as part of an ecological model for studying academic communities

NASA Astrophysics Data System (ADS)

Sullins, Ellen S.; Hernandez, Delia; Fuller, Carol; Shiro Tashiro, Jay

Research on factors that shape recruitment and retention in undergraduate science majors currently is highly fragmented and in need of an integrative research framework. Such a framework should incorporate analyses of the various levels of organization that characterize academic communities (i.e., the broad institutional level, the departmental level, and the student level), and should also provide ways to study the interactions occurring within and between these structural levels. We propose that academic communities are analogous to ecosystems, and that the research paradigms of modern community ecology can provide the necessary framework, as well as new and innovative approaches to a very complex area. This article also presents the results of a pilot study that demonstrates the promise of this approach at the student level. We administered a questionnaire based on expectancy-value theory to undergraduates enrolled in introductory biology courses. Itself an integrative approach, expectancy-value theory views achievement-related behavior as a joint function of the person's expectancy of success in the behavior and the subjective value placed on such success. Our results indicated: (a) significant gender differences in the underlying factor structures of expectations and values related to the discipline of biology, (b) expectancy-value factors significantly distinguished biology majors from nonmajors, and (c) expectancy-value factors significantly predicted students' intent to enroll in future biology courses. We explore the expectancy-value framework as an operationally integrative framework in our ecological model for studying academic communities, especially in the context of assessing the underrepresentation of women and minorities in the sciences. Future research directions as well as practical implications are also discussed.

A Conceptual Framework for the Social Analysis of Reproductive Health

PubMed Central

Hawkins, Kirstan

2007-01-01

The dominant conceptual framework for understanding reproductive behaviour is highly individualistic. In this article, it is demonstrated that such a conceptualization is flawed, as behaviour is shaped by social relations and institutions. Using ethnographic evidence, the value of a social analysis of the local contexts of reproductive health is highlighted. A framework is set out for conducting such a social analysis, which is capable of generating data necessary to allow health programmes to assess the appropriate means of improving the responsiveness of service-delivery structures to the needs of the most vulnerable. Six key issues are identified in the framework for the analysis of social vulnerability to poor reproductive health outcomes. The key issues are: poverty and livelihood strategies, gender, health-seeking behaviour, reproductive behaviour, and access to services. The article concludes by briefly identifying the key interventions and strategies indicated by such an analysis. PMID:17615901

Advancing patient safety: a framework for accountability and practical action.

PubMed

Wilson, N J; Hatlie, M J

2001-01-01

This article traces the development of the patient safety movement in healthcare from 1997 to the present. It reviews the findings and recommendations in the Institute of Medicine report on medical errors, which issued a call to action. Moving beyond the call to action requires aligning incentives, in both public and private sectors, consistent with complexity theory and the tenets of a systems approach to the reliable delivery of service in dynamic environments in which failure produces severe consequences. Because safety is a fundamental value of healthcare and has money-saving potential, it can be a powerful pathway forcultural change. Thisarticle explains a simple framework that requires alignment among stakeholder groups and communities. It recommends a practical problem-solving approach and explores the roles and responsibilities of each segment within the framework. Finally, it describes a VHA Inc. leadership initiative, based on the framework, to promote change within healthcare systems.

USEEIO Framework Demo

EPA Science Inventory

The code base for creating versions of the USEEIO model and USEEIO-like models is called the USEEIO Modeling Framework. The framework is built in a combination of R and Python languages.This demonstration provides a brief overview and introduction into the framework.

Improving Value for Patients with Eczema.

PubMed

Block, Julie

2018-04-01

Chronic diseases now represent a cost majority in the United States health care system. Contributing factors to rising costs include expensive novel and emerging therapies, under-treatment of disease, under-management of comorbidities, and patient dissatisfaction with care results. Critical to identifying replicable improvement methods is a reliable model to measure value. If we understand value within healthcare consumerism to be equal to a patient's health outcome improvement over costs associated with care (Value=Outcomes/Costs), we can use this equation to measure the improvement of value. Research and literature show that patient activation-the skills and confidence that equip patients to become actively engaged in their health care-impact health outcomes, costs, and patient experience. Reaching patient activation through engagement methods including shared decision-making (SDM) lead to improved value of care received. The National Eczema Association (NEA) Shared Decision-Making Resource Center can be a transformative strategy to measure and evaluate value of health care interventions for eczema patients to advance a value-driven health care system in the United States. Through this Resource Center, NEA will measure patient value through their own perceptions using validated PRO instruments and other patient-generated health data. Assessment of this data will reveal findings that can assist researchers in evaluating the impact this care framework on patient-perceived value across other chronic diseases. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Neural correlates of continuous causal word generation.

PubMed

Wende, Kim C; Straube, Benjamin; Stratmann, Mirjam; Sommer, Jens; Kircher, Tilo; Nagels, Arne

2012-09-01

Causality provides a natural structure for organizing our experience and language. Causal reasoning during speech production is a distinct aspect of verbal communication, whose related brain processes are yet unknown. The aim of the current study was to investigate the neural mechanisms underlying the continuous generation of cause-and-effect coherences during overt word production. During fMRI data acquisition participants performed three verbal fluency tasks on identical cue words: A novel causal verbal fluency task (CVF), requiring the production of multiple reasons to a given cue word (e.g. reasons for heat are fire, sun etc.), a semantic (free association, FA, e.g. associations with heat are sweat, shower etc.) and a phonological control task (phonological verbal fluency, PVF, e.g. rhymes with heat are meat, wheat etc.). We found that, in contrast to PVF, both CVF and FA activated a left lateralized network encompassing inferior frontal, inferior parietal and angular regions, with further bilateral activation in middle and inferior as well as superior temporal gyri and the cerebellum. For CVF contrasted against FA, we found greater bold responses only in the left middle frontal cortex. Large overlaps in the neural activations during free association and causal verbal fluency indicate that the access to causal relationships between verbal concepts is at least partly based on the semantic neural network. The selective activation in the left middle frontal cortex for causal verbal fluency suggests that distinct neural processes related to cause-and-effect-relations are associated with the recruitment of middle frontal brain areas. Copyright © 2012 Elsevier Inc. All rights reserved.

A phase 1 randomized placebo-controlled safety and pharmacokinetic trial of a tenofovir disoproxil fumarate vaginal ring.

PubMed

Keller, Marla J; Mesquita, Pedro M; Marzinke, Mark A; Teller, Ryan; Espinoza, Lilia; Atrio, Jessica M; Lo, Yungtai; Frank, Bruce; Srinivasan, Sujatha; Fredricks, David N; Rabe, Lorna; Anderson, Peter L; Hendrix, Craig W; Kiser, Patrick F; Herold, Betsy C

2016-03-13

Tenofovir disoproxil fumarate (TDF), a prodrug of tenofovir (TFV), may be ideal for topical HIV preexposure prophylaxis because it has higher tissue and cell permeability than TFV; is not adversely impacted by seminal proteins; and its active metabolite, TFV-diphosphate (TFV-DP), has a long intracellular half-life. We engineered a TDF eluting polyurethane reservoir intravaginal ring (IVR) to provide near constant mucosal antiretroviral concentrations. A first-in-human randomized placebo-controlled trial was conducted to assess the safety and pharmacokinetics of the TDF IVR in healthy, sexually abstinent women (15 TDF and 15 placebo). Drug concentrations were measured in cervicovaginal fluid (CVF) obtained by swab, cervical tissue, plasma, and dried blood spots (DBS) over 14 days of continuous ring use. There were 43 total, 23 reproductive tract, and eight product-related grade 1 adverse events. Steady-state CVF TFV concentrations were achieved proximal (vagina, ectocervix) and distal (introitus) to the TDF IVR 1 day after ring insertion. Median tissue TFV-DP concentrations 14 days after TDF IVR placement were 120 fmol/mg (interquartile range 90, 550). CVF collected from the cervix 1 week and 2 weeks after TDF IVR insertion provided significant protection against ex-vivo HIV challenge. Eleven of 14 (78%) participants had detectable TFV-DP DBS concentrations 14 days after TDF IVR placement, suggesting that DBS may provide a surrogate marker of adherence in future clinical trials. A TDF IVR is safe, well tolerated, and results in mucosal TFV concentrations that exceed those associated with HIV protection. The findings support further clinical evaluation of this TDF IVR.

Thermoregulation of Capsule Production by Streptococcus pyogenes

PubMed Central

Kang, Song Ok; Wright, Jordan O.; Tesorero, Rafael A.; Lee, Hyunwoo; Beall, Bernard; Cho, Kyu Hong

2012-01-01

The capsule of Streptococcus pyogenes serves as an adhesin as well as an anti-phagocytic factor by binding to CD44 on keratinocytes of the pharyngeal mucosa and the skin, the main entry sites of the pathogen. We discovered that S. pyogenes HSC5 and MGAS315 strains are further thermoregulated for capsule production at a post-transcriptional level in addition to the transcriptional regulation by the CovRS two-component regulatory system. When the transcription of the hasABC capsular biosynthetic locus was de-repressed through mutation of the covRS system, the two strains, which have been used for pathogenesis studies in the laboratory, exhibited markedly increased capsule production at sub-body temperature. Employing transposon mutagenesis, we found that CvfA, a previously identified membrane-associated endoribonuclease, is required for the thermoregulation of capsule synthesis. The mutation of the cvfA gene conferred increased capsule production regardless of temperature. However, the amount of the capsule transcript was not changed by the mutation, indicating that a post-transcriptional regulator mediates between CvfA and thermoregulated capsule production. When we tested naturally occurring invasive mucoid strains, a high percentage (11/53, 21%) of the strains exhibited thermoregulated capsule production. As expected, the mucoid phenotype of these strains at sub-body temperature was due to mutations within the chromosomal covRS genes. Capsule thermoregulation that exhibits high capsule production at lower temperatures that occur on the skin or mucosal surface potentially confers better capability of adhesion and invasion when S. pyogenes penetrates the epithelial surface. PMID:22615992

Value co-creation in healthcare through positive deviance.

PubMed

Zanetti, Cole Anthony; Taylor, Natalie

2016-12-01

To explore how converging fields of co-creation and positive deviance may increase value in healthcare. Informed by research in positive deviance, patient engagement, value co-creation, and quality improvement, we propose a positive deviance approach to co-creation of health. Co-creation has shown to improve health outcomes with regard to multiple health conditions. Positive deviance has also shown to improve outcomes in multiple healthcare and patient community environments. A positive deviance co-creation framework may aid in achieving improved outcomes for patients, care teams and their respective healthcare organizations. Copyright © 2016 Elsevier Inc. All rights reserved.

The relative value of growth.

PubMed

Mass, Nathaniel J

2005-04-01

Most executives would say that adding a point of growth and gaining a point of operating-profit margin contribute about equally to shareholder value. Margin improvements hit the bottom line immediately, while growth compounds value over time. But the reality is that the two are rarely equivalent. Growth often is far more valuable than managers think. For some companies, convincing the market that they can grow by just one additional percentage point can be worth six, seven, or even ten points of margin improvement. This article presents a new strategic metric, called the relative value of growth (RVG), which gives managers a clear picture of how growth projects and margin improvement initiatives affect shareholder value. Using basic balance sheet and income sheet data, managers can determine their companies' RVGs, as well as those of their competitors. Calculating RVGs gives managers insights into which corporate strategies are working to deliver value and whether their companies are pulling the most powerful value-creation levers. The author examines a number of well-known companies and explains what their RVG numbers say about their strategies. He reviews the unspoken assumption that growth and profits are incompatible over the long term and shows that a fair number of companies are effective at delivering both. Finally, he explains how managers can use the RVG framework to help them define strategies that balance growth and profitability at both the corporate and business unit levels.

A Framework for Dynamic Constraint Reasoning Using Procedural Constraints

NASA Technical Reports Server (NTRS)

Jonsson, Ari K.; Frank, Jeremy D.

1999-01-01

Many complex real-world decision and control problems contain an underlying constraint reasoning problem. This is particularly evident in a recently developed approach to planning, where almost all planning decisions are represented by constrained variables. This translates a significant part of the planning problem into a constraint network whose consistency determines the validity of the plan candidate. Since higher-level choices about control actions can add or remove variables and constraints, the underlying constraint network is invariably highly dynamic. Arbitrary domain-dependent constraints may be added to the constraint network and the constraint reasoning mechanism must be able to handle such constraints effectively. Additionally, real problems often require handling constraints over continuous variables. These requirements present a number of significant challenges for a constraint reasoning mechanism. In this paper, we introduce a general framework for handling dynamic constraint networks with real-valued variables, by using procedures to represent and effectively reason about general constraints. The framework is based on a sound theoretical foundation, and can be proven to be sound and complete under well-defined conditions. Furthermore, the framework provides hybrid reasoning capabilities, as alternative solution methods like mathematical programming can be incorporated into the framework, in the form of procedures.

Reaching common ground: a patient-family-based conceptual framework of quality EOL care.

PubMed

Howell, Doris; Brazil, Kevin

2005-01-01

Improvement in the quality of end-of-life (EOL) care is a priority health care issue since serious deficiencies in quality of care have been reported across care settings. Increasing pressure is now focused on Canadian health care organizations to be accountable for the quality of palliative and EOL care delivered. Numerous domains of quality EOL care upon which to create accountability frameworks are now published, with some derived from the patient/family perspective. There is a need to reach common ground on the domains of quality EOL care valued by patients and families in order to develop consistent performance measures and set priorities for health care improvement. This paper describes a meta-synthesis study to develop a common conceptual framework of quality EOL care integrating attributes of quality valued by patients and their families.

Pedagogical competence and value clarification among health educators.

PubMed

Wistoft, Karen

2009-09-01

Individual and social values are increasingly important in health education. This article examines how health educators in Greenland and Denmark engage in value clarification as part of their educational practices. It presents the results of a study of health professionals in a variety of settings, focusing in particular on how development work and experimentation can strengthen their pedagogical competences. The study focuses on belief, reasoning, interpretation and reflection, rather than routines, skills, or ethical rules, and takes a participatory approach that oscillates between dialogical and qualitative empirical methodologies. It observes pedagogical practice in selected settings in Greenland and the municipality of Copenhagen. Within the framework provided by four discourses that appear to organize communication about health, it shows how values became important to the progress of two research-based development projects. On this basis, the article argues that health education can be effectively grounded in the values, perceptions, and experiences of a given population, while being guided by the health educators' biomedical knowledge and educational values.

Quality Teaching in Science: an Emergent Conceptual Framework

NASA Astrophysics Data System (ADS)

Jordens, J. Zoe; Zepke, Nick

2017-09-01

Achieving quality in higher education is a complex task involving the interrelationship of many factors. The influence of the teacher is well established and has led to some general principles of good teaching. However, less is known about the extent that specific disciplines influence quality teaching. The purposes of the paper are to investigate how quality teaching is perceived in the sciences and from these perceptions to develop for discussion a framework for teaching practice in the sciences. A New Zealand study explored the views of national teaching excellence award winners in science on quality teaching in undergraduate science. To capture all possible views from this expert panel, a dissensus-recognising Delphi method was used together with sensitising concepts based on complexity and wickedity. The emergent conceptual framework for quality teaching in undergraduate science highlighted areas of consensus and areas where there were a variety of views. About the purposes of science and its knowledge base, there was relative consensus, but there was more variable support for values underpinning science teaching. This highlighted the complex nature of quality teaching in science. The findings suggest that, in addition to general and discipline-specific influences, individual teacher values contribute to an understanding of quality in undergraduate science teaching.

Applying a Comprehensive Contextual Climate Change Vulnerability Framework to New Zealand's Tourism Industry.

PubMed

Hopkins, Debbie

2015-03-01

Conceptualisations of 'vulnerability' vary amongst scholarly communities, contributing to a wide variety of applications. Research investigating vulnerability to climate change has often excluded non-climatic changes which may contribute to degrees of vulnerability perceived or experienced. This paper introduces a comprehensive contextual vulnerability framework which incorporates physical, social, economic and political factors which could amplify or reduce vulnerability. The framework is applied to New Zealand's tourism industry to explore its value in interpreting a complex, human-natural environment system with multiple competing vulnerabilities. The comprehensive contextual framework can inform government policy and industry decision making, integrating understandings of climate change within the broader context of internal and external social, physical, economic, and institutional stressors.

Teachers' Experience of the Implementation of Values in Education in Schools: "Mind the Gap"

ERIC Educational Resources Information Center

Ferreira, C.; Schulze, S.

2014-01-01

In many societies violence, crime and intolerance have become an everyday reality. In this context teachers are responsible for facilitating values in education. The study aimed to investigate teachers' experiences of the implementation of values in education in classroom praxis. Constructivism was used as conceptual framework. Data were collected…

UAF: a generic OPC unified architecture framework

NASA Astrophysics Data System (ADS)

Pessemier, Wim; Deconinck, Geert; Raskin, Gert; Saey, Philippe; Van Winckel, Hans

2012-09-01

As an emerging Service Oriented Architecture (SOA) specically designed for industrial automation and process control, the OPC Unied Architecture specication should be regarded as an attractive candidate for controlling scientic instrumentation. Even though an industry-backed standard such as OPC UA can oer substantial added value to these projects, its inherent complexity poses an important obstacle for adopting the technology. Building OPC UA applications requires considerable eort, even when taking advantage of a COTS Software Development Kit (SDK). The OPC Unied Architecture Framework (UAF) attempts to reduce this burden by introducing an abstraction layer between the SDK and the application code in order to achieve a better separation of the technical and the functional concerns. True to its industrial origin, the primary requirement of the framework is to maintain interoperability by staying close to the standard specications, and by expecting the minimum compliance from other OPC UA servers and clients. UAF can therefore be regarded as a software framework to quickly and comfortably develop and deploy OPC UA-based applications, while remaining compatible to third party OPC UA-compliant toolkits, servers (such as PLCs) and clients (such as SCADA software). In the rst phase, as covered by this paper, only the client-side of UAF has been tackled in order to transparently handle discovery, session management, subscriptions, monitored items etc. We describe the design principles and internal architecture of our open-source software project, the rst results of the framework running at the Mercator Telescope, and we give a preview of the planned server-side implementation.

Chromium metal organic frameworks and synthesis of metal organic frameworks

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

Zhou, Hong-Cai; Liu, Tian-Fu; Lian, Xizhen

The present invention relates to monocrystalline metal organic frameworks comprising chromium ions and carboxylate ligands and the use of the same, for example their use for storing a gas. The invention also relates to methods for preparing metal organic frameworks comprising chromium, titanium or iron ions and carboxylate ligands. The methods of the invention allow such metal organic frameworks to be prepared in monocrystalline or polycrystalline forms.

CFOs and strategists: forging a common framework.

PubMed

Rappaport, A

1992-01-01

Companies have become increasingly polarized into two divergent camps: those who consider shareholder value the key to managing the company and those who put their faith in gaining competitive advantage. Indeed, that age-old debate between investing for the long term and showing outstanding short-term results is back - only this time the camps are flying banners with the new buzzwords of corporate America: competitive advantage and shareholder value. In this article, Alfred Rappaport attempts to settle the debate once and for all, arguing forcefully that establishing competitive advantage and creating shareholder value both stem from a common economic framework. In fact, long-term productivity is the hinge from which both sustainable competitive advantage and consistent results for the shareholder hang. But many managers refuse to accept this theory and cling to the mistaken belief that the market does not actually value the long-term productivity of their company but judges it only by its short-term performance. They then jump to a second mistaken conclusion: assuming they must depart from the shareholder-value model to improve their competitive position. Rappaport attacks these mistaken beliefs, showing that the stock market does value the long-term productivity of a company and that it is not necessary to depart from the shareholder-value model to improve a company's competitive position. Maximum returns for current shareholders will materialize only when managers maximize long-term shareholder value and deliver interim results that attest credibly to sustainable competitive advantage.

A Moral (Normative) Framework for the Judgment of Actions and Decisions in the Construction Industry and Engineering: Part II.

PubMed

Alkhatib, Omar J

2017-12-01

The construction industry is typically characterized as a fragmented, multi-organizational setting in which members from different technical backgrounds and moral values join together to develop a particular business or project. The most challenging obstacle in the construction process is to achieve a successful practice and to identify and apply an ethical framework to manage the behavior of involved specialists and contractors and to ensure the quality of all completed construction activities. The framework should reflect a common moral ground for myriad people involved in this process to survive and compete ethically in today's turbulent construction market. This study establishes a framework for moral judgment of behavior and actions conducted in the construction process. The moral framework provides the basis of judging actions as "moral" or "immoral" based on three levels of moral accountability: personal, professional, and social. The social aspect of the proposed framework is developed primarily from the essential attributes of normative business decision-making models identified in the literature review and subsequently incorporates additional attributes related to professional and personal moral values. The normative decision-making models reviewed are based primarily on social attributes as related to moral theories (e.g., utilitarianism, duty, rights, virtue, etc.). The professional and moral attributes are established by identifying a set of common moral values recognized by professionals in the construction industry and required to prevent common construction breaches. The moral framework presented here is the complementary part of the ethical framework developed in Part I of this article and is based primarily on the personal behavior or the moral aspect of professional responsibility. The framework can be implemented as a form of preventive personal ethics, which would help avoid ethical dilemmas and moral implications in the first place

A Game Theoretic Framework for Analyzing Re-Identification Risk

PubMed Central

Wan, Zhiyu; Vorobeychik, Yevgeniy; Xia, Weiyi; Clayton, Ellen Wright; Kantarcioglu, Murat; Ganta, Ranjit; Heatherly, Raymond; Malin, Bradley A.

2015-01-01

Given the potential wealth of insights in personal data the big databases can provide, many organizations aim to share data while protecting privacy by sharing de-identified data, but are concerned because various demonstrations show such data can be re-identified. Yet these investigations focus on how attacks can be perpetrated, not the likelihood they will be realized. This paper introduces a game theoretic framework that enables a publisher to balance re-identification risk with the value of sharing data, leveraging a natural assumption that a recipient only attempts re-identification if its potential gains outweigh the costs. We apply the framework to a real case study, where the value of the data to the publisher is the actual grant funding dollar amounts from a national sponsor and the re-identification gain of the recipient is the fine paid to a regulator for violation of federal privacy rules. There are three notable findings: 1) it is possible to achieve zero risk, in that the recipient never gains from re-identification, while sharing almost as much data as the optimal solution that allows for a small amount of risk; 2) the zero-risk solution enables sharing much more data than a commonly invoked de-identification policy of the U.S. Health Insurance Portability and Accountability Act (HIPAA); and 3) a sensitivity analysis demonstrates these findings are robust to order-of-magnitude changes in player losses and gains. In combination, these findings provide support that such a framework can enable pragmatic policy decisions about de-identified data sharing. PMID:25807380

Narrative insight in psychosis: The relationship with spiritual and religious explanatory frameworks.

PubMed

Marriott, Michael R; Thompson, Andrew R; Cockshutt, Graham; Rowse, Georgina

2018-03-25

When considering psychosis, the concept of narrative insight has been offered as an alternative to clinical insight in determining individuals' responses to their difficulties, as it allows for a more holistic and person-centred framework to be embraced within professional practice. This study aims to explore the validity of the narrative insight construct within a group of people who have experienced psychosis. Inductive qualitative methods were used to explore how eight participants utilized spiritual or religious explanatory frameworks for their experiences of psychosis and to consider these in relation to the construct of narrative insight. Semi-structured interviews were undertaken with individuals who identified themselves as interested in spiritual or religious ideas and whose self-reported experiences which were identified as akin to psychosis by experienced academic clinicians. Transcriptions from these interviews were subject to interpretative phenomenological analysis within a broader research question; a selection of themes and data from the resultant phenomenological structure are explored here for their relevance to narrative insight. Participants discussed spiritual and biological explanations for their experiences and were able to hold alternative potential explanations alongside each other. They were reflective regarding the origins of their explanations and would describe a process of testing and proof in relation to them. These findings suggest that the narrative insight construct has the potential to be a valid approach to understanding experiences of psychosis, and challenge the dominance of the clinical insight construct within clinical practice. Clinicians should value the explanatory framework for experiences which are provided by individuals experiencing psychosis, and encourage them to develop a framework which is coherent to their own world view rather than predominantly pursuing a biomedical explanation. Assessments of psychosis should

GeoFramework: A Modeling Framework for Solid Earth Geophysics

NASA Astrophysics Data System (ADS)

Gurnis, M.; Aivazis, M.; Tromp, J.; Tan, E.; Thoutireddy, P.; Liu, Q.; Choi, E.; Dicaprio, C.; Chen, M.; Simons, M.; Quenette, S.; Appelbe, B.; Aagaard, B.; Williams, C.; Lavier, L.; Moresi, L.; Law, H.

2003-12-01

As data sets in geophysics become larger and of greater relevance to other earth science disciplines, and as earth science becomes more interdisciplinary in general, modeling tools are being driven in new directions. There is now a greater need to link modeling codes to one another, link modeling codes to multiple datasets, and to make modeling software available to non modeling specialists. Coupled with rapid progress in computer hardware (including the computational speed afforded by massively parallel computers), progress in numerical algorithms, and the introduction of software frameworks, these lofty goals of merging software in geophysics are now possible. The GeoFramework project, a collaboration between computer scientists and geoscientists, is a response to these needs and opportunities. GeoFramework is based on and extends Pyre, a Python-based modeling framework, recently developed to link solid (Lagrangian) and fluid (Eulerian) models, as well as mesh generators, visualization packages, and databases, with one another for engineering applications. The utility and generality of Pyre as a general purpose framework in science is now being recognized. Besides its use in engineering and geophysics, it is also being used in particle physics and astronomy. Geology and geophysics impose their own unique requirements on software frameworks which are not generally available in existing frameworks and so there is a need for research in this area. One of the special requirements is the way Lagrangian and Eulerian codes will need to be linked in time and space within a plate tectonics context. GeoFramework has grown beyond its initial goal of linking a limited number of exiting codes together. The following codes are now being reengineered within the context of Pyre: Tecton, 3-D FE Visco-elastic code for lithospheric relaxation; CitComS, a code for spherical mantle convection; SpecFEM3D, a SEM code for global and regional seismic waves; eqsim, a FE code for dynamic

Uncertainty of Monetary Valued Ecosystem Services – Value Transfer Functions for Global Mapping

PubMed Central

Schmidt, Stefan; Manceur, Ameur M.; Seppelt, Ralf

2016-01-01

Growing demand of resources increases pressure on ecosystem services (ES) and biodiversity. Monetary valuation of ES is frequently seen as a decision-support tool by providing explicit values for unconsidered, non-market goods and services. Here we present global value transfer functions by using a meta-analytic framework for the synthesis of 194 case studies capturing 839 monetary values of ES. For 12 ES the variance of monetary values could be explained with a subset of 93 study- and site-specific variables by utilizing boosted regression trees. This provides the first global quantification of uncertainties and transferability of monetary valuations. Models explain from 18% (water provision) to 44% (food provision) of variance and provide statistically reliable extrapolations for 70% (water provision) to 91% (food provision) of the terrestrial earth surface. Although the application of different valuation methods is a source of uncertainty, we found evidence that assuming homogeneity of ecosystems is a major error in value transfer function models. Food provision is positively correlated with better life domains and variables indicating positive conditions for human well-being. Water provision and recreation service show that weak ownerships affect valuation of other common goods negatively (e.g. non-privately owned forests). Furthermore, we found support for the shifting baseline hypothesis in valuing climate regulation. Ecological conditions and societal vulnerability determine valuation of extreme event prevention. Valuation of habitat services is negatively correlated with indicators characterizing less favorable areas. Our analysis represents a stepping stone to establish a standardized integration of and reporting on uncertainties for reliable and valid benefit transfer as an important component for decision support. PMID:26938447

A computational framework for prime implicants identification in noncoherent dynamic systems.

PubMed

Di Maio, Francesco; Baronchelli, Samuele; Zio, Enrico

2015-01-01

Dynamic reliability methods aim at complementing the capability of traditional static approaches (e.g., event trees [ETs] and fault trees [FTs]) by accounting for the system dynamic behavior and its interactions with the system state transition process. For this, the system dynamics is here described by a time-dependent model that includes the dependencies with the stochastic transition events. In this article, we present a novel computational framework for dynamic reliability analysis whose objectives are i) accounting for discrete stochastic transition events and ii) identifying the prime implicants (PIs) of the dynamic system. The framework entails adopting a multiple-valued logic (MVL) to consider stochastic transitions at discretized times. Then, PIs are originally identified by a differential evolution (DE) algorithm that looks for the optimal MVL solution of a covering problem formulated for MVL accident scenarios. For testing the feasibility of the framework, a dynamic noncoherent system composed of five components that can fail at discretized times has been analyzed, showing the applicability of the framework to practical cases. © 2014 Society for Risk Analysis.

An Analytical Framework for Evaluating E-Commerce Business Models and Strategies.

ERIC Educational Resources Information Center

Lee, Chung-Shing

2001-01-01

Considers electronic commerce as a paradigm shift, or a disruptive innovation, and presents an analytical framework based on the theories of transaction costs and switching costs. Topics include business transformation process; scale effect; scope effect; new sources of revenue; and e-commerce value creation model and strategy. (LRW)

Combining aesthetic with ecological values for landscape sustainability.

PubMed

Yang, Dewei; Luo, Tao; Lin, Tao; Qiu, Quanyi; Luo, Yunjian

2014-01-01

Humans receive multiple benefits from various landscapes that foster ecological services and aesthetic attractiveness. In this study, a hybrid framework was proposed to evaluate ecological and aesthetic values of five landscape types in Houguanhu Region of central China. Data from the public aesthetic survey and professional ecological assessment were converted into a two-dimensional coordinate system and distribution maps of landscape values. Results showed that natural landscapes (i.e. water body and forest) contributed positively more to both aesthetic and ecological values than semi-natural and human-dominated landscapes (i.e. farmland and non-ecological land). The distribution maps of landscape values indicated that the aesthetic, ecological and integrated landscape values were significantly associated with landscape attributes and human activity intensity. To combine aesthetic preferences with ecological services, the methods (i.e. field survey, landscape value coefficients, normalized method, a two-dimensional coordinate system, and landscape value distribution maps) were employed in landscape assessment. Our results could facilitate to identify the underlying structure-function-value chain, and also improve the understanding of multiple functions in landscape planning. The situation context could also be emphasized to bring ecological and aesthetic goals into better alignment.

Combining Aesthetic with Ecological Values for Landscape Sustainability

PubMed Central

Yang, Dewei; Luo, Tao; Lin, Tao; Qiu, Quanyi; Luo, Yunjian

2014-01-01

Humans receive multiple benefits from various landscapes that foster ecological services and aesthetic attractiveness. In this study, a hybrid framework was proposed to evaluate ecological and aesthetic values of five landscape types in Houguanhu Region of central China. Data from the public aesthetic survey and professional ecological assessment were converted into a two-dimensional coordinate system and distribution maps of landscape values. Results showed that natural landscapes (i.e. water body and forest) contributed positively more to both aesthetic and ecological values than semi-natural and human-dominated landscapes (i.e. farmland and non-ecological land). The distribution maps of landscape values indicated that the aesthetic, ecological and integrated landscape values were significantly associated with landscape attributes and human activity intensity. To combine aesthetic preferences with ecological services, the methods (i.e. field survey, landscape value coefficients, normalized method, a two-dimensional coordinate system, and landscape value distribution maps) were employed in landscape assessment. Our results could facilitate to identify the underlying structure-function-value chain, and also improve the understanding of multiple functions in landscape planning. The situation context could also be emphasized to bring ecological and aesthetic goals into better alignment. PMID:25050886

Values exchange: using online technology to raise awareness of values and ethics in radiography education.

PubMed

Mc Inerney, John; Lees, Amanda

2018-03-01

Ethics and values are increasingly significant aspects of patient-centred healthcare. While it is widely agreed that ethics and values are essential for healthcare delivery, there is also an acknowledgement that these are areas that are challenging to teach. The purpose of this study is to report a small-scale evaluative research project of a web-based technology with the educational potential to facilitate learning in relation to ethics, values, self-reflection and peer-based learning. Five diagnostic radiography students took part in a semi-structured focus group with the aim of exploring their experiences of using Values Exchange, an online ethical decision-making framework, to examine practice-based ethical issues. Transcripts were interrogated for key themes. From the thematic analysis three major themes emerged, understanding and appreciating others, addressing the theory-practice gap and delivering a safe and effective learning environment. Perceived limitations of the platform included students' fear of misinterpreted responses and possibility of poor group dynamics. There are varied approaches to how ethics and values are taught and assessed within health-related environments. Values Exchange is one such teaching tool and has been investigated and described positively by radiography students in this study. Online teaching tools can have a positive effect in helping students identify their own values but require skilled implementation to reap positive rewards. © 2018 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

New Zealand Defense Policy Framework, A Strategic Reappraisal

DTIC Science & Technology

2004-03-19

viii THE NEW ZEALAND DEFENSE POLICY FRAMEWORK – A STRATEGIC APPRAISAL What we demand is that the world be made fit and safe to live in. Woodrow Wilson...pressure on some governments and often results in armed conflict. The former Yugoslavia and Soviet Union stand out as prominent examples of the... demand access to the products, services and lifestyles that are evident in other nations. This is problematic for governments who set values and

What is epistemic value in free energy models of learning and acting? A bounded rationality perspective.

PubMed

Ortega, Pedro A; Braun, Daniel A

2015-01-01

Free energy models of learning and acting do not only care about utility or extrinsic value, but also about intrinsic value, that is, the information value stemming from probability distributions that represent beliefs or strategies. While these intrinsic values can be interpreted as epistemic values or exploration bonuses under certain conditions, the framework of bounded rationality offers a complementary interpretation in terms of information-processing costs that we discuss here.

Research ethics committees and community values: Devlin, Dworkin, Hart and beyond.

PubMed

Salako, Solomon E

2010-03-01

Two fundamental requirements ought to be met in any selection to research ethics committees: (i) professional scientific competence, and (ii) the understanding of moral values which prevail in any community. The question is: Should the verdicts of research ethics committees be based on community values? This article critically examines theories of community as were propounded by Devlin, Dworkin and Hart in answer to this question. It is argued that community values are complementary rather than conflicting, and that Dworkin's theory of community provides an analytical framework for research ethics on the new genetic technologies. Finally, it is submitted that the verdicts of research ethics committees should be based on community values.

Organizational culture based on the example of an Estonian hospital.

PubMed

Saame, Iisi; Reino, Anne; Vadi, Maaja

2011-01-01

The concept of organisational culture (also referred to later as OC) is one of the approaches in modern organisational analysis exploring the values, attitudes and beliefs behind human behaviour in the workplace. OC as a social phenomenon is considered to be important for the sustainability of every organisation. In the service sector, OC may affect the nature and quality of the services provided. The aim of this paper is twofold: on the one hand, to highlight the patterns of OC in a hospital; and, on the other hand, to outline relationships between OC and patient satisfaction. The study was conducted in Tartu University Hospital, one of the most influential health care organisations in Estonia. This paper has original value by presenting an insight into organisational culture in the Estonian health care sector, and the findings of the study will expand knowledge of OC in the health care sector in general. The OC instrument applied in a quantitative cross-sectional study was earlier developed according to the Competing Values Framework (CVF). Data from 456 medical and non-medical professionals were analysed using non-parametric tests of descriptive statistics. A factor analysis was performed to assess the instrument's compatibility for analysing the OC pattern in the health care sector. The dominant culture type in all the groups investigated was the Internal Processes type, mainly followed by the Rational Goal type, while different cultural patterns were observed in professional groups. The factor analysis yielded a three-subscale solution. Clinics with high patient satisfaction did not score more than clinics with low patient satisfaction in terms of the Human Relations type. In future studies a random sample design and a multidisciplinary approach to OC research should be followed in order to further explore OC patterns in hospitals and their consequences for different aspects of hospital performance.

An entropic framework for modeling economies

NASA Astrophysics Data System (ADS)

Caticha, Ariel; Golan, Amos

2014-08-01

We develop an information-theoretic framework for economic modeling. This framework is based on principles of entropic inference that are designed for reasoning on the basis of incomplete information. We take the point of view of an external observer who has access to limited information about broad macroscopic economic features. We view this framework as complementary to more traditional methods. The economy is modeled as a collection of agents about whom we make no assumptions of rationality (in the sense of maximizing utility or profit). States of statistical equilibrium are introduced as those macrostates that maximize entropy subject to the relevant information codified into constraints. The basic assumption is that this information refers to supply and demand and is expressed in the form of the expected values of certain quantities (such as inputs, resources, goods, production functions, utility functions and budgets). The notion of economic entropy is introduced. It provides a measure of the uniformity of the distribution of goods and resources. It captures both the welfare state of the economy as well as the characteristics of the market (say, monopolistic, concentrated or competitive). Prices, which turn out to be the Lagrange multipliers, are endogenously generated by the economy. Further studies include the equilibrium between two economies and the conditions for stability. As an example, the case of the nonlinear economy that arises from linear production and utility functions is treated in some detail.

Children Learning to Use Technologies through Play: A Digital Play Framework

ERIC Educational Resources Information Center

Bird, Jo; Edwards, Susan

2015-01-01

Digital technologies are increasingly acknowledged as an important aspect of early childhood education. A significant problem for early childhood education has been how to understand the pedagogical use of technologies in a sector that values play-based learning. This paper presents a new framework to understand how children learn to use…

Using the Expectancy-Value Theory of Motivation to Predict Behavioral and Emotional Risk among High School Students

ERIC Educational Resources Information Center

Dever, Bridget V.

2016-01-01

Within the expectancy-value framework, much work has been done linking expectancies and task values to academic outcomes such as performance, persistence, and choice. Research on the associations between student motivation (including efficacy and task values) and behavioral and emotional problems, however, is nascent. The present study examined a…

BlueSky Cloud Framework: An E-Learning Framework Embracing Cloud Computing

NASA Astrophysics Data System (ADS)

Dong, Bo; Zheng, Qinghua; Qiao, Mu; Shu, Jian; Yang, Jie

Currently, E-Learning has grown into a widely accepted way of learning. With the huge growth of users, services, education contents and resources, E-Learning systems are facing challenges of optimizing resource allocations, dealing with dynamic concurrency demands, handling rapid storage growth requirements and cost controlling. In this paper, an E-Learning framework based on cloud computing is presented, namely BlueSky cloud framework. Particularly, the architecture and core components of BlueSky cloud framework are introduced. In BlueSky cloud framework, physical machines are virtualized, and allocated on demand for E-Learning systems. Moreover, BlueSky cloud framework combines with traditional middleware functions (such as load balancing and data caching) to serve for E-Learning systems as a general architecture. It delivers reliable, scalable and cost-efficient services to E-Learning systems, and E-Learning organizations can establish systems through these services in a simple way. BlueSky cloud framework solves the challenges faced by E-Learning, and improves the performance, availability and scalability of E-Learning systems.

The innovation value chain.

PubMed

Hansen, Morten T; Birkinshaw, Julian

2007-06-01

The challenges of coming up with fresh ideas and realizing profits from them are different for every company. One firm may excel at finding good ideas but may have weak systems for bringing them to market. Another organization may have a terrific process for funding and rolling out new products and services but a shortage of concepts to develop. In this article, Hansen and Birkinshaw caution executives against using the latest and greatest innovation approaches and tools without understanding the unique deficiencies in their companies' innovation systems. They offer a framework for evaluating innovation performance: the innovation value chain. It comprises the three main phases of innovation (idea generation, conversion, and diffusion) as well as the critical activities performed during those phases (looking for ideas inside your unit; looking for them in other units; looking for them externally; selecting ideas; funding them; and promoting and spreading ideas companywide). Using this framework, managers get an end-to-end view of their innovation efforts. They can pinpoint their weakest links and tailor innovation best practices appropriately to strengthen those links. Companies typically succumb to one of three broad "weakest-link" scenarios. They are idea poor, conversion poor, or diffusion poor. The article looks at the ways smart companies - including Intuit, P&G, Sara Lee, Shell, and Siemens- modify the best innovation practices and apply them to address those organizations' individual needs and flaws. The authors warn that adopting the chain-based view of innovation requires new measures of what can be delivered by each link in the chain. The approach also entails new roles for employees "external scouts" and "internal evangelists," for example. Indeed, in their search for new hires, companies should seek out those candidates who can help address particular weaknesses in the innovation value chain.

Using an ecological ethics framework to make decisions about the relocation of wildlife.

PubMed

McCoy, Earl D; Berry, Kristin

2008-12-01

Relocation is an increasingly prominent conservation tool for a variety of wildlife, but the technique also is controversial, even among conservation practitioners. An organized framework for addressing the moral dilemmas often accompanying conservation actions such as relocation has been lacking. Ecological ethics may provide such a framework and appears to be an important step forward in aiding ecological researchers and biodiversity managers to make difficult moral choices. A specific application of this framework can make the reasoning process more transparent and give more emphasis to the strong sentiments about non-human organisms held by many potential users. Providing an example of the application of the framework may also increase the appeal of the reasoning process to ecological researchers and biodiversity managers. Relocation as a conservation action can be accompanied by a variety of moral dilemmas that reflect the interconnection of values, ethical positions, and conservation decisions. A model that is designed to address moral dilemmas arising from relocation of humans provides/demonstrates/illustrates a possible way to apply the ecological ethics framework and to involve practicing conservationists in the overall decision-making process.

Quality of service routing in the differentiated services framework

NASA Astrophysics Data System (ADS)

Oliveira, Marilia C.; Melo, Bruno; Quadros, Goncalo; Monteiro, Edmundo

2001-02-01

In this paper we present a quality of service routing strategy for network where traffic differentiation follows the class-based paradigm, as in the Differentiated Services framework. This routing strategy is based on a metric of quality of service. This metric represents the impact that delay and losses verified at each router in the network have in application performance. Based on this metric, it is selected a path for each class according to the class sensitivity to delay and losses. The distribution of the metric is triggered by a relative criterion with two thresholds, and the values advertised are the moving average of the last values measured.

Structural Validity of the Polish Adaptation of the Picture-Based Value Survey for Children (PBVS-C)

ERIC Educational Resources Information Center

Cieciuch, Jan; Harasimczuk, Justyna; Doring, Anna K.

2013-01-01

Recent years have witnessed an increasing number of studies, also in the field of educational psychology, on values within the framework proposed by Schwartz, involving younger and younger respondents. A fresh impetus to studies on children's values was given by the Picture-Based Value Survey for Children (PBVS-C), which was developed by Doring…

HCI∧2 framework: a software framework for multimodal human-computer interaction systems.

PubMed

Shen, Jie; Pantic, Maja

2013-12-01

This paper presents a novel software framework for the development and research in the area of multimodal human-computer interface (MHCI) systems. The proposed software framework, which is called the HCI∧2 Framework, is built upon publish/subscribe (P/S) architecture. It implements a shared-memory-based data transport protocol for message delivery and a TCP-based system management protocol. The latter ensures that the integrity of system structure is maintained at runtime. With the inclusion of bridging modules, the HCI∧2 Framework is interoperable with other software frameworks including Psyclone and ActiveMQ. In addition to the core communication middleware, we also present the integrated development environment (IDE) of the HCI∧2 Framework. It provides a complete graphical environment to support every step in a typical MHCI system development process, including module development, debugging, packaging, and management, as well as the whole system management and testing. The quantitative evaluation indicates that our framework outperforms other similar tools in terms of average message latency and maximum data throughput under a typical single PC scenario. To demonstrate HCI∧2 Framework's capabilities in integrating heterogeneous modules, we present several example modules working with a variety of hardware and software. We also present an example of a full system developed using the proposed HCI∧2 Framework, which is called the CamGame system and represents a computer game based on hand-held marker(s) and low-cost camera(s).

Stress distribution in Co-Cr implant frameworks after laser or TIG welding.

PubMed

de Castro, Gabriela Cassaro; de Araújo, Cleudmar Amaral; Mesquita, Marcelo Ferraz; Consani, Rafael Leonardo Xediek; Nóbilo, Mauro Antônio de Arruda

2013-01-01

Lack of passivity has been associated with biomechanical problems in implant-supported prosthesis. The aim of this study was to evaluate the passivity of three techniques to fabricate an implant framework from a Co-Cr alloy by photoelasticity. The model was obtained from a steel die simulating an edentulous mandible with 4 external hexagon analog implants with a standard platform. On this model, five frameworks were fabricated for each group: a monoblock framework (control), laser and TIG welding frameworks. The photoelastic model was made from a flexible epoxy resin. On the photoelastic analysis, the frameworks were bolted onto the model for the verification of maximum shear stress at 34 selected points around the implants and 5 points in the middle of the model. The stresses were compared all over the photoelastic model, between the right, left, and center regions and between the cervical and apical regions. The values were subjected to two-way ANOVA, and Tukey's test (α=0.05). There was no significant difference among the groups and studied areas (p>0.05). It was concluded that the stresses generated around the implants were similar for all techniques.

Strain gauge analysis of the effect of porcelain firing simulation on the prosthetic misfit of implant-supported frameworks.

PubMed

De Vasconcellos, Diego Klee; Özcan, Mutlu; Maziero Volpato, Cláudia Ângela; Bottino, Marco Antonio; Yener, Esra Salihoğlu

2012-06-01

This study investigated the effect of porcelain firing on the misfit of implant-supported frameworks and analyzed the influence of preheat treatment on the dimensional alterations. Four external-hex cylindrical implants were placed in polyurethane block. Ten frameworks of screw-retained implant-supported prostheses were cast in Pd-Ag using 2 procedures: (1) control group (CG, n = 5): cast in segments and laser welded; and test group (TG, n = 5): cast in segments, preheated, and laser welded. All samples were subjected to firing to simulate porcelain veneering firing. Strain gauges were bonded around the implants, and microstrain values (με = 10⁻⁶ε) were recorded after welding (M1), oxidation cycle (M2), and glaze firing (M3). Data were statistically analyzed (2-way analysis of variance, Bonferroni, α = 0.05). The microstrain value in the CG at M3 (475.2 με) was significantly different from the values observed at M1 (355.6 με) and M2 (413.9 με). The values at M2 and M3 in the CG were not statistically different. Microstrain values recorded at different moments (M1: 361.6 με/M2: 335.3 με/M3: 307.2 με) did not show significant difference. The framework misfit deteriorates during firing cycles of porcelain veneering. Metal distortion after porcelain veneering could be controlled by preheat treatment.

The value of aortic valve replacement in elderly patients: an economic analysis.

PubMed

Wu, YingXing; Grunkemeier, Gary L; Starr, Albert

2007-03-01

Economists have designed frameworks to measure the economic value of improvements in health and longevity. Heart valve replacement surgery has significantly prolonged life expectancy and quality of life. For the example of aortic valve replacement, what is its economic value according to this framework? From 1961 through 2003, a total of 4617 adult patients underwent aortic valve replacement by one team of cardiac surgeons. These patients were provided with a prospective lifetime follow-up service. As of 2005, observed follow-up was 31,671 patient-years, with a maximum of 41 years. A statistical model was used to generate the future life-years of patients currently alive. The value of life-years proposed by economists was applied to determine the economic value of the additional life given to these patients by aortic valve replacement. The total life-years after aortic valve replacement were 53,323, with a gross value of 14.6 billion dollars. The total expected life-years without surgery were 10,157, with an estimated value of 3.0 billion dollars. Thus the net life-years gained by AVR were 43,166, worth 11.6 billion dollars. Subtracting the 451 million dollars total lifetime cost of surgery, the net value of the life-years gained by AVR was 11.2 billion dollars. The mean net value decreases according to age at surgery but is still worth 600,000 dollars for octogenarians and 200,000 dollars for nonagenarians. According to the economic concept of the value of a statistical life, the return on the investment for aortic valve replacement is enormous for patients of all ages, even very elderly patients.

Challenging Operations: An Ethical Framework to Assist Humanitarian Aid Workers in their Decision-making Processes.

PubMed

Clarinval, Caroline; Biller-Andorno, Nikola

2014-06-23

This paper aims to raise awareness regarding ethical issues in the context of humanitarian action, and to offer a framework for systematically and effectively addressing such issues. Several cases highlight ethical issues that humanitarian aid workers are confronted with at different levels over the course of their deployments. The first case discusses a situation at a macro-level concerning decisions being made at the headquarters of a humanitarian organization. The second case looks at meso-level issues that need to be solved at a country or regional level. The third case proposes an ethical dilemma at the micro-level of the individual patient-provider relationship. These real-life cases have been selected to illustrate the ethical dimension of conflicts within the context of humanitarian action that might remain unrecognized in everyday practice. In addition, we propose an ethical framework to assist humanitarian aid workers in their decision-making process. The framework draws on the principles and values that guide humanitarian action and public health ethics more generally. Beyond identifying substantive core values, the framework also includes a ten-step process modelled on tools used in the clinical setting that promotes a transparent and clear decision-making process and improves the monitoring and evaluation of aid interventions. Finally, we recommend organizational measures to implement the framework effectively. This paper uses a combination of public health/clinical ethics concepts and practices and applies them to the decision-making challenges encountered in relief operations in the humanitarian aid context.

Evidence-Based and Value-Based Decision Making About Healthcare Design: An Economic Evaluation of the Safety and Quality Outcomes.

PubMed

Zadeh, Rana; Sadatsafavi, Hessam; Xue, Ryan

2015-01-01

This study describes a vision and framework that can facilitate the implementation of evidence-based design (EBD), scientific knowledge base into the process of the design, construction, and operation of healthcare facilities and clarify the related safety and quality outcomes for the stakeholders. The proposed framework pairs EBD with value-driven decision making and aims to improve communication among stakeholders by providing a common analytical language. Recent EBD research indicates that the design and operation of healthcare facilities contribute to an organization's operational success by improving safety, quality, and efficiency. However, because little information is available about the financial returns of evidence-based investments, such investments are readily eliminated during the capital-investment decision-making process. To model the proposed framework, we used engineering economy tools to evaluate the return on investments in six successful cases, identified by a literature review, in which facility design and operation interventions resulted in reductions in hospital-acquired infections, patient falls, staff injuries, and patient anxiety. In the evidence-based cases, calculated net present values, internal rates of return, and payback periods indicated that the long-term benefits of interventions substantially outweighed the intervention costs. This article explained a framework to develop a research-based and value-based communication language on specific interventions along the planning, design and construction, operation, and evaluation stages. Evidence-based and value-based design frameworks can be applied to communicate the life-cycle costs and savings of EBD interventions to stakeholders, thereby contributing to more informed decision makings and the optimization of healthcare infrastructures. © The Author(s) 2015.

Proverbs as Theoretical Frameworks for Lifelong Learning in Indigenous African Education

ERIC Educational Resources Information Center

Avoseh, Mejai B. M.

2013-01-01

Every aspect of a community's life and values in indigenous Africa provide the theoretical framework for education. The holistic worldview of the traditional system places a strong emphasis on the centrality of the human element and orature in the symmetrical relationship between life and learning. This article focuses on proverbs and the words…

The effects of wildfire and environmental amenities on property values in northwest Montana, USA

Treesearch

Kyle M. Stetler; Tyron J. Venn; David E. Calkin

2010-01-01

This study employed the hedonic price framework to examine the effects of 256 wildfires and environmental amenities on home values in northwest Montana between June 1996 and January 2007. The study revealed environmental amenities, including proximity to lakes, national forests, Glacier National Park and golf courses, have large positive effects on property values in...

Translational Scholarship and a Palliative Approach: Enlisting the Knowledge-As-Action Framework.

PubMed

Reimer-Kirkham, Sheryl; Doane, Gweneth Hartrick; Antifeau, Elisabeth; Pesut, Barbara; Porterfield, Pat; Roberts, Della; Stajduhar, Kelli; Wikjord, Nicole

2015-01-01

Based on a retheorized epistemology for knowledge translation (KT) that problematizes the "know-do gap" and conceptualizes the knower, knowledge, and action as inseparable, this paper describes the application of the Knowledge-As-Action Framework. When applied as a heuristic device to support an inquiry process, the framework with the metaphor of a kite facilitates a responsiveness to the complexities that characterize KT. Examples from a KT demonstration project on the integration of a palliative approach at 3 clinical sites illustrate the interrelatedness of 6 dimensions-the local context, processes, people, knowledge, fluctuating realities, and values.

A New Framework for Quantifying Lidar Uncertainty

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

Newman, Jennifer, F.; Clifton, Andrew; Bonin, Timothy A.

2017-03-24

As wind turbine sizes increase and wind energy expands to more complex and remote sites, remote sensing devices such as lidars are expected to play a key role in wind resource assessment and power performance testing. The switch to remote sensing devices represents a paradigm shift in the way the wind industry typically obtains and interprets measurement data for wind energy. For example, the measurement techniques and sources of uncertainty for a remote sensing device are vastly different from those associated with a cup anemometer on a meteorological tower. Current IEC standards discuss uncertainty due to mounting, calibration, and classificationmore » of the remote sensing device, among other parameters. Values of the uncertainty are typically given as a function of the mean wind speed measured by a reference device. However, real-world experience has shown that lidar performance is highly dependent on atmospheric conditions, such as wind shear, turbulence, and aerosol content. At present, these conditions are not directly incorporated into the estimated uncertainty of a lidar device. In this presentation, we propose the development of a new lidar uncertainty framework that adapts to current flow conditions and more accurately represents the actual uncertainty inherent in lidar measurements under different conditions. In this new framework, sources of uncertainty are identified for estimation of the line-of-sight wind speed and reconstruction of the three-dimensional wind field. These sources are then related to physical processes caused by the atmosphere and lidar operating conditions. The framework is applied to lidar data from an operational wind farm to assess the ability of the framework to predict errors in lidar-measured wind speed.« less

Farm-specific economic value of automatic lameness detection systems in dairy cattle: From concepts to operational simulations.

PubMed

Van De Gucht, Tim; Saeys, Wouter; Van Meensel, Jef; Van Nuffel, Annelies; Vangeyte, Jurgen; Lauwers, Ludwig

2018-01-01

Although prototypes of automatic lameness detection systems for dairy cattle exist, information about their economic value is lacking. In this paper, a conceptual and operational framework for simulating the farm-specific economic value of automatic lameness detection systems was developed and tested on 4 system types: walkover pressure plates, walkover pressure mats, camera systems, and accelerometers. The conceptual framework maps essential factors that determine economic value (e.g., lameness prevalence, incidence and duration, lameness costs, detection performance, and their relationships). The operational simulation model links treatment costs and avoided losses with detection results and farm-specific information, such as herd size and lameness status. Results show that detection performance, herd size, discount rate, and system lifespan have a large influence on economic value. In addition, lameness prevalence influences the economic value, stressing the importance of an adequate prior estimation of the on-farm prevalence. The simulations provide first estimates for the upper limits for purchase prices of automatic detection systems. The framework allowed for identification of knowledge gaps obstructing more accurate economic value estimation. These include insights in cost reductions due to early detection and treatment, and links between specific lameness causes and their related losses. Because this model provides insight in the trade-offs between automatic detection systems' performance and investment price, it is a valuable tool to guide future research and developments. Copyright © 2018 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Evaluation Framework for Telemedicine Using the Logical Framework Approach and a Fishbone Diagram

PubMed Central

2015-01-01

Objectives Technological advances using telemedicine and telehealth are growing in healthcare fields, but the evaluation framework for them is inconsistent and limited. This paper suggests a comprehensive evaluation framework for telemedicine system implementation and will support related stakeholders' decision-making by promoting general understanding, and resolving arguments and controversies. Methods This study focused on developing a comprehensive evaluation framework by summarizing themes across the range of evaluation techniques and organized foundational evaluation frameworks generally applicable through studies and cases of diverse telemedicine. Evaluation factors related to aspects of information technology; the evaluation of satisfaction of service providers and consumers, cost, quality, and information security are organized using the fishbone diagram. Results It was not easy to develop a monitoring and evaluation framework for telemedicine since evaluation frameworks for telemedicine are very complex with many potential inputs, activities, outputs, outcomes, and stakeholders. A conceptual framework was developed that incorporates the key dimensions that need to be considered in the evaluation of telehealth implementation for a formal structured approach to the evaluation of a service. The suggested framework consists of six major dimensions and the subsequent branches for each dimension. Conclusions To implement telemedicine and telehealth services, stakeholders should make decisions based on sufficient evidence in quality and safety measured by the comprehensive evaluation framework. Further work would be valuable in applying more comprehensive evaluations to verify and improve the comprehensive framework across a variety of contexts with more factors and participant group dimensions. PMID:26618028

Evaluation Framework for Telemedicine Using the Logical Framework Approach and a Fishbone Diagram.

PubMed

Chang, Hyejung

2015-10-01

Technological advances using telemedicine and telehealth are growing in healthcare fields, but the evaluation framework for them is inconsistent and limited. This paper suggests a comprehensive evaluation framework for telemedicine system implementation and will support related stakeholders' decision-making by promoting general understanding, and resolving arguments and controversies. This study focused on developing a comprehensive evaluation framework by summarizing themes across the range of evaluation techniques and organized foundational evaluation frameworks generally applicable through studies and cases of diverse telemedicine. Evaluation factors related to aspects of information technology; the evaluation of satisfaction of service providers and consumers, cost, quality, and information security are organized using the fishbone diagram. It was not easy to develop a monitoring and evaluation framework for telemedicine since evaluation frameworks for telemedicine are very complex with many potential inputs, activities, outputs, outcomes, and stakeholders. A conceptual framework was developed that incorporates the key dimensions that need to be considered in the evaluation of telehealth implementation for a formal structured approach to the evaluation of a service. The suggested framework consists of six major dimensions and the subsequent branches for each dimension. To implement telemedicine and telehealth services, stakeholders should make decisions based on sufficient evidence in quality and safety measured by the comprehensive evaluation framework. Further work would be valuable in applying more comprehensive evaluations to verify and improve the comprehensive framework across a variety of contexts with more factors and participant group dimensions.

Integral Nursing: An Emerging Framework for Engaging the Evolution of the Profession.

ERIC Educational Resources Information Center

Fiandt, Kathryn; Forman, John; Megel, Mary Erickson; Pakieser, Ruth A.; Burge, Stephanie

2003-01-01

Proposes the Integral Nursing framework, which combines Wilber's All-Quadrant/All-Level model, a heuristic device to organize human experience, and the Spiral Dynamics model of human development organized around value memes or cultural units of information. Includes commentary by Beth L. Rodgers. (Contains 17 references.) (JOW)

An Evidence Framework for Off-Patent Pharmaceutical Review (EFOR) for Health Technology Assessment in Emerging Markets.

PubMed

Brixner, Diana; Kaló, Zoltán; Maniadakis, Nikos; Kim, Kyoo; Wijaya, Kalman

2018-03-29

This article introduces an Evidence Framework for Off-Patent Pharmaceutical Review (EFOR), which establishes value-based criteria in a template that manufacturers use to provide evidence showing how their products meet those criteria. Health authorities in emerging markets can then use the evidence presented in the EFOR to evaluate off-patent pharmaceuticals (OPPs) in a consistent, transparent, and evidence-based manner to support policy decisions, including pricing, reimbursement, formulary listing, and drug procurement. A literature search found no multi-criteria evidence framework for evaluating OPPs in emerging markets. An International Outcomes Research Board (IORB) of academia and industry experts conducted extensive research, meetings, and workshops to define high-priority criteria to incorporate into an evidence-based health technology assessment (HTA) tool using the multi-criteria decision analysis (MCDA) technique. The resulting framework was further tailored for country-specific needs in workshops in three emerging countries (Kazakhstan, Vietnam, and Indonesia). The IORB defined nine criteria four categories (Product, Manufacturing, Service, and Value Assessment), which OPP manufacturers can use to provide evidence for reimbursement and health policy decision making. Then the IORB developed the EFOR as a base case document, which can be adapted and used as a template by health authorities in emerging countries. Emerging countries have a significant need for an HTA tool that balances affordability with accurate evidence showing the value differentiation of OPPs. The value attributes in this setting often are different from those in developed markets, which emphasize new products and have high regulation and manufacturing standards. The EFOR is an easy-to-use, adaptable framework that emerging countries can use to increase the consistency, transparency, and effectiveness of drug decision making. The open source EFOR is available as Supplemental Materials

On the value of endangered and other species

NASA Astrophysics Data System (ADS)

Sagoff, Mark

1996-11-01

This paper describes two frameworks—utilitarian and Kantian—society uses to make decisions concerning environmental management and, in particular, species protection. The utilitarian framework emphasizes the consequences of choices for prior preferences. A perfectly competitive market, on this model, correctly values environmental resources. The Kantian approach identifies rules appropriate to recognized situations given the identity of the decision maker. It relies on democratic political processes and institutions to provide the means by which citizens determine the identity of their community—its moral character and aspirations—and match appropriate rules to recognized situations. This paper argues that markets do not fail in any general way in measuring the economic value of plants and animals. Market prices, in general, correctly represent the marginal or exchange value of species. If society legislates against extinction, this must be understood as an exercise in Kantian decision making in view of the moral value of species, not as an attempt to “correct” a market failure or to promote social welfare or utility.

Tobacco Regulation and Cost-Benefit Analysis: How Should We Value Foregone Consumer Surplus?

PubMed

Levy, Helen G; Norton, Edward C; Smith, Jeffrey A

2018-01-01

Recent tobacco regulations proposed by the Food and Drug Administration have raised a thorny question: how should the cost-benefit analysis accompanying such policies value foregone consumer surplus associated with regulation-induced reductions in smoking? In a model with rational and fully informed consumers, this question is straightforward. There is disagreement, however, about whether consumers are rational and fully informed, and the literature offers little practical guidance about what approach the FDA should use if they are not. In this paper, we outline the history of the FDA's recent attempts to regulate cigarettes and other tobacco products and how they have valued foregone consumer surplus in cost-benefit analyses. We advocate replacing the approach used in most of this literature, which first calculates health gains associated with regulation and then "offsets" them by some factor reflecting consumer surplus losses, with a more general behavioral public finance framework for welfare analysis. This framework applies standard tools of welfare analysis to consumer demand that may be "biased" (that is, not necessarily rational and fully informed) without requiring specific assumptions about the reason for the bias. This framework would require estimates of both biased and unbiased consumer demand; we sketch an agenda to help develop these in the context of smoking. The use of this framework would substantially reduce the confusion currently surrounding welfare analysis of tobacco regulation.

Tobacco Regulation and Cost-Benefit Analysis: How Should We Value Foregone Consumer Surplus?

PubMed Central

Levy, Helen G.; Norton, Edward C.; Smith, Jeffrey A.

2016-01-01

Recent tobacco regulations proposed by the Food and Drug Administration have raised a thorny question: how should the cost-benefit analysis accompanying such policies value foregone consumer surplus associated with regulation-induced reductions in smoking? In a model with rational and fully informed consumers, this question is straightforward. There is disagreement, however, about whether consumers are rational and fully informed, and the literature offers little practical guidance about what approach the FDA should use if they are not. In this paper, we outline the history of the FDA’s recent attempts to regulate cigarettes and other tobacco products and how they have valued foregone consumer surplus in cost-benefit analyses. We advocate replacing the approach used in most of this literature, which first calculates health gains associated with regulation and then “offsets” them by some factor reflecting consumer surplus losses, with a more general behavioral public finance framework for welfare analysis. This framework applies standard tools of welfare analysis to consumer demand that may be “biased” (that is, not necessarily rational and fully informed) without requiring specific assumptions about the reason for the bias. This framework would require estimates of both biased and unbiased consumer demand; we sketch an agenda to help develop these in the context of smoking. The use of this framework would substantially reduce the confusion currently surrounding welfare analysis of tobacco regulation. PMID:29404381

Drivers Of Health As A Shared Value: Mindset, Expectations, Sense Of Community, And Civic Engagement.

PubMed

Chandra, Anita; Miller, Carolyn E; Acosta, Joie D; Weilant, Sarah; Trujillo, Matthew; Plough, Alonzo

2016-11-01

Making health a shared value is central to building a culture of health, a new action framework intended to spur faster progress toward equitable health outcomes in the United States. Unlike in other US social movements, such as the environmental and civil rights movements, the necessary understanding of shared values has not yet been achieved for health. Discussions about values regarding health have primarily focused on health care instead of health or well-being. These discussions have not progressed to a clear focus on prioritizing values on health instead of simply health care. The evidence base for understanding health as a shared value is only now emerging. Making health a shared value is the first of four Action Areas in the Robert Wood Johnson Foundation's Culture of Health Action Framework. We assert that the achievement of this shared understanding of health as a cultural value will be enhanced through action in specific drivers: mindset and expectations, sense of community, and civic engagement. Building on a literature review and stakeholder engagement, this article examines the evidence base for these drivers and identifies where policy and research actions are needed to advance positive change on population health and well-being outcomes. Project HOPE—The People-to-People Health Foundation, Inc.

Analysis of System-Wide Investment in the National Airspace System: A Portfolio Analytical Framework and an Example

NASA Technical Reports Server (NTRS)

Bhadra, Dipasis; Morser, Frederick R.

2006-01-01

In this paper, the authors review the FAA s current program investments and lay out a preliminary analytical framework to undertake projects that may address some of the noted deficiencies. By drawing upon the well developed theories from corporate finance, an analytical framework is offered that can be used for choosing FAA s investments taking into account risk, expected returns and inherent dependencies across NAS programs. The framework can be expanded into taking multiple assets and realistic values for parameters in drawing an efficient risk-return frontier for the entire FAA investment programs.

Dynamic value assessments in oncology supported by the PACE Continuous Innovation Indicators.

PubMed

Paddock, Silvia; Goodman, Clifford; Shortenhaus, Scott; Grainger, David; Zummo, Jacqueline; Thomas, Samuel

2017-10-01

Several recently developed frameworks aim to assess the value of cancer treatments, but the most appropriate metrics remain uncertain. We use data from the Patient Access to Cancer care Excellence Continuous Innovation Indicators to examine the relationship between hazard ratios (HRs) from clinical trials and dynamic therapeutic value accumulating over time. Our analysis shows that HRs from initial clinical trials poorly predict the eventual therapeutic value of cancer treatments. Relying strongly on HRs from registration trials to predict the long-term success of treatments leaves a lot of the variance unexplained. The Continuous Innovation Indicators offer a complementing, dynamic method to track the therapeutic value of cancer treatments and continuously update value assessments as additional evidence accumulates.

Mechanistic deductions from kinetic isotope effects and pH studies of pyridoxal phosphate dependent carbon-carbon lyases: Erwinia herbicola and Citrobacter freundii tyrosine phenol-lyase

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

Kiick, D.M.; Phillips, R.S.

1988-09-20

The pH dependence of the kinetic parameters and primary deuterium isotope effects have been determined for tyrosine phenol-lyase from both Erwinia herbicola and Citrobacter freundii. The primary deuterium isotope effects indicate that proton abstraction from the 2-position of the substrate is partially rate-limiting for both enzymes. The C. freundii enzyme primary deuterium isotope effects (DV = 3.5 and D(V/Ktyr) = 2.5) are pH independent, indicating that tyrosine is not sticky (i.e., does not dissociate slower than it reacts to give products). Since Vmax for both tyrosine and the alternate substrate S-methyl-L-cysteine is also pH independent, substrate binds only to themore » correctly protonated form of the enzyme. For the E. herbicola enzyme, both Vmax and V/K for tyrosine or S-methyl-L-cysteine are pH dependent, as well as both DV and D(V/Ktyr). Thus, while both the protonated and unprotonated enzyme can bind substrate, and may be interconverted directly, only the unprotonated Michaelis complex is catalytically competent. At pH 9.5, DV = 2.5 and D(V/Ktyr) = 1.5. However, at pH 6.4 the isotope effect on both parameters is equal to 4.1. From these data, the forward commitment factor (cf = 5.2) and catalytic ratio (cvf = 1.1) for tyrosine and S-methyl-L-cysteine (cf = 2.2, cvf = 24) are calculated. Also, the Michaelis complex partition ratio (cf/cvf) for substrate and products is calculated to be 4.7 for tyrosine and 0.1 for S-methyl-L-cysteine.« less

An after-school exercise program improves fitness, and body composition in elementary school children.

PubMed

Carrel, Aaron L; Logue, Julie; Deininger, Heidi; Clark, R Randall; Curtis, Vanessa; Montague, Paul; Baldwin, Sharon

2011-07-01

Reduced cardiovascular fitness (CVF) is a risk factor for obesity and cardiovascular disease. It has previously shown that a school-based fitness curriculum can improve CVF, and other health indicators in middle school aged children. Whether an afterschool program improves CVF and other health markers in elementary-school children is unresolved. The objective of this study was therefore to determine whether an on-site afterschool-based fitness program improves body composition, cardiovascular fitness level, in elementary school children. 80 elementary school children were evaluated in a "fitness-oriented" afterschool program managed by the local YMCA. Children underwent evaluation of cardiovascular fitness by maximal VO 2 treadmill testing and body composition by dual x-ray absorptiometry (DXA), at baseline (prior to the school-year) and again at end of the school year. Findings revealed that, at baseline, children had a mean age of 8.8 years, BMI of 18.7± 3, with a maximal VO 2 of 40.03 ± 7.6 ml/kg/min, and percent body fat of 28.7 ± 7%. After a 9-month intervention, children maximal VO 2 increased to 44.8 ± 7.5 ml/kg/min (p=0.04) and percent body fat decreased to 25.8 ± 6.2% (p=0.033). The study concluded that on-site afterschool programming focusing on fitness improved body composition and cardiovascular fitness, in elementary school children. Combined with prior studies, these data demonstrate that afterschool-based fitness curricula can benefit both obese and non-obese children. It was therefore recommended that, partnerships with schools to promote fitness even outside of school time should be a part of a school approach to improving children's health.

Graph-cut based discrete-valued image reconstruction.

PubMed

Tuysuzoglu, Ahmet; Karl, W Clem; Stojanovic, Ivana; Castañòn, David; Ünlü, M Selim

2015-05-01

Efficient graph-cut methods have been used with great success for labeling and denoising problems occurring in computer vision. Unfortunately, the presence of linear image mappings has prevented the use of these techniques in most discrete-amplitude image reconstruction problems. In this paper, we develop a graph-cut based framework for the direct solution of discrete amplitude linear image reconstruction problems cast as regularized energy function minimizations. We first analyze the structure of discrete linear inverse problem cost functions to show that the obstacle to the application of graph-cut methods to their solution is the variable mixing caused by the presence of the linear sensing operator. We then propose to use a surrogate energy functional that overcomes the challenges imposed by the sensing operator yet can be utilized efficiently in existing graph-cut frameworks. We use this surrogate energy functional to devise a monotonic iterative algorithm for the solution of discrete valued inverse problems. We first provide experiments using local convolutional operators and show the robustness of the proposed technique to noise and stability to changes in regularization parameter. Then we focus on nonlocal, tomographic examples where we consider limited-angle data problems. We compare our technique with state-of-the-art discrete and continuous image reconstruction techniques. Experiments show that the proposed method outperforms state-of-the-art techniques in challenging scenarios involving discrete valued unknowns.

Development of an Analysis and Design Optimization Framework for Marine Propellers

NASA Astrophysics Data System (ADS)

Tamhane, Ashish C.

In this thesis, a framework for the analysis and design optimization of ship propellers is developed. This framework can be utilized as an efficient synthesis tool in order to determine the main geometric characteristics of the propeller but also to provide the designer with the capability to optimize the shape of the blade sections based on their specific criteria. A hybrid lifting-line method with lifting-surface corrections to account for the three-dimensional flow effects has been developed. The prediction of the correction factors is achieved using Artificial Neural Networks and Support Vector Regression. This approach results in increased approximation accuracy compared to existing methods and allows for extrapolation of the correction factor values. The effect of viscosity is implemented in the framework via the coupling of the lifting line method with the open-source RANSE solver OpenFOAM for the calculation of lift, drag and pressure distribution on the blade sections using a transition kappa-o SST turbulence model. Case studies of benchmark high-speed propulsors are utilized in order to validate the proposed framework for propeller operation in open-water conditions but also in a ship's wake.