From representing views to representativeness of views: illustrating a new (Q2S) approach in the context of health care priority setting in nine European countries

Governments across Europe are required to make decisions about how best to allocate scarce health care resources. There are legitimate arguments for eliciting societal vales in relation to health care resource allocation given the roles of the general public as payers and potential patients. However, relatively little is known about the views of the general public on general principles which could guide these decisions. In this paper we present five societal viewpoints on principles for health care resources allocation and develop a new approach, Q2S, designed to investigate the extent to which these views are held across a range of European countries. An online survey was developed, based on a previously completed study Q methodology, and delivered between November 2009 and February 2010 across nine countries to 33,515 respondents. The largest proportion of our respondents (44%), were found to most associate themselves with an egalitarian perspective. Differences in views were more strongly associated with countries than with socio-demographic characteristics. These results provide information which could be useful for decision makers in understanding the pluralistic context in which they are making health care resource allocation decisions and how different groups in society may respond to such decisions

Electronic witness system in IVF—patients perspective

Objective The objective of this study is to evaluate patient concerns about in vitro fertilization (IVF) errors and electronic witness systems (EWS) satisfaction. Design The design of this study is a prospective single-center cohort study. Setting The setting of this study was located in the private IVF center. Patient(s) Four hundred eight infertile patients attending an IVF cycle at a GENERA center in Italy were equipped with an EWS. Intervention(s) Although generally recognized as a very rare event in IVF, biological sample mix-up has been reported in the literature. For this reason, some IVF laboratories have introduced EWS with the aim to further reduce the risk of error during biological samples handling. Participating patients received a questionnaire developed through a Likert scale ranging from 1 to 6. Main outcomes measure(s) Patient concerns about sample mix-up without and with an EWS were assessed. Result(s) 90.4 % of patients expressed significant concerns relating to sample mix-up. The EWS reduced these concerns in 92.1 % of patients, 97.1 % of which were particularly satisfied with the electronic traceability of their gametes and embryos in the IVF laboratory. 97.1 % of patients felt highly comfortable with an IVF center equipped with an EWS. Female patients had a significantly higher appreciation of the EWS when compared to their male partners (p = 0.029). A significant mix-up event occurred in an Italian hospital during the study and patient's satisfaction increased significantly towards the use of the EWS after the event (p = 0.032). Conclusion(s) EWS, by sensibly reducing the risk for sample mix-up in IVF cycles, has been proved to be a trusted strategy from patient's perspective

Multi-objective optimal designs in comparative clinical trials with covariates: The reinforced doubly adaptive biased coin design

The present paper deals with the problem of allocating patients to two competing treatments in the presence of covariates or prognostic factors in order to achieve a good trade-off among ethical concerns, inferential precision and randomness in the treatment allocations. In particular we suggest a multipurpose design methodology that combines efficiency and ethical gain when the linear homoscedastic model with both treatment/covariate interactions and interactions among covariates is adopted. The ensuing compound optimal allocations of the treatments depend on the covariates and their distribution on the population of interest, as well as on the unknown parameters of the model. Therefore, we introduce the reinforced doubly adaptive biased coin design, namely a general class of covariate-adjusted response-adaptive procedures that includes both continuous and discontinuous randomization functions, aimed to target any desired allocation proportion. The properties of this proposal are described both theoretically and through simulations.Comment: Published in at http://dx.doi.org/10.1214/12-AOS1007 the Annals of Statistics (http://www.imstat.org/aos/) by the Institute of Mathematical Statistics (http://www.imstat.org

Reducing Exclusionary Attitudes through Interpersonal Conversation: Evidence from Three Field Experiments

Exclusionary attitudes-prejudice toward outgroups and opposition to policies that promote their well-being-are presenting challenges to democratic societies worldwide. Drawing on insights from psychology, we argue that non-judgmentally exchanging narratives in interpersonal conversations can facilitate durable reductions in exclusionary attitudes. We support this argument with evidence from three pre-registered field experiments targeting exclusionary attitudes toward unauthorized immigrants and transgender people. In these experiments, 230 canvassers conversed with 6,869 voters across 7 US locations. In Experiment 1, face-To-face conversations deploying arguments alone had no effects on voters' exclusionary immigration policy or prejudicial attitudes, but otherwise identical conversations also including the non-judgmental exchange of narratives durably reduced exclusionary attitudes for at least four months (d = 0.08). Experiments 2 and 3, targeting transphobia, replicate these findings and support the scalability of this strategy (ds = 0.08, 0.04). Non-judgmentally exchanging narratives can help overcome the resistance to persuasion often encountered in discussions of these contentious topics

Rayman: Interoperability use of Meteorological Observation

The observation of atmospheric phenomena enables generating of knowledge about the weather and meteors occurrence in a region. When this information is georeferenced it becomes useful for a great number of professional and public activities in the field of e.g. building, infrastructures, aeronautics, biota, tourism, agriculture and energy. At the present time access to that information is limited. Few meteorological agencies apply geo-Standards, hindering the development of GIS tools for monitoring, threshold alerts and decision support helping. This work describes how public agencies publish meteorological data and the solution developed at the Spanish Electrical Network (REE) to store the information provided by the Spanish Meteorological Agency (AEMET). The implemented solution enables the access to the weather observations collected by the meteorological agency and the rays captured by the detection network in a interoperable way and the exploitation, by as well a desktop GIS capable of connecting with Oracle-Spatial database as through the interfaces of the OGC standardized services (WMS, WFS and SOS)

Process as a world transaction

Transaction is process closure: for a transaction is the limiting process of process itself. In the process world view the universe is the ultimate (intensional) transaction of all its extensional limiting processes that we call reality. ANPA’s PROGRAM UNIVERSE is a computational model which can be explored empirically in commercial database transactions where there has been a wealth of activity over the real world for the last 40 years. Process category theory demonstrates formally the fundamental distinctions between the classical model of a transaction as in PROGRAM UNIVERSE and physical reality. The paper concludes with a short technical summary for those who do not wish to read all the detail