812,573 research outputs found

    Value and effectiveness of National Immunization Technical Advisory Groups in low- and middle-income countries : A qualitative study of global and national perspectives

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    © The Author(s) 2019. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.The Global Vaccine Action Plan proposes that every country establish or have access to a National Immunization Technical Advisory Group (NITAG) by 2020. The NITAG role is to produce evidence-informed recommendations that incorporate local context, to guide national immunization policies and practice. This study aimed to explore the value and effectiveness of NITAGs in low- and middle-income countries (LMICs), identifying areas in which NITAGs may require further support to improve their functionality and potential barriers to global investment. A multi-methods study design was used, comprising 134 semi-structured interviews and 82 literature review sources that included 38 countries. Interviews were conducted with 53 global/regional and 81 country-level participants able to provide insight into NITAG effectiveness, including NITAG members, national immunization programme staff, and global agency representatives (e.g. the World Health Organisation, the Bill and Melinda Gates Foundation, Gavi the Vaccine Alliance). The review, including published and unpublished sources on NITAGs in LMICs, was conducted to supplement and corroborate interview findings. Data were analysed thematically. NITAGs were described as valuable in promoting evidence-informed vaccination decision-making, with NITAG involvement enhancing national immunization programme strength and sustainability. Challenges to NITAG effectiveness included: (1) unreliable funding; (2) insufficient diversity of member expertise; (3) inadequate conflicts of interest management procedures; (4) insufficient capacity to access and use evidence; (5) lack of transparency; and (6) limited integration with national decision-making processes that reduced the recognition and incorporation of NITAG recommendations. LMIC NITAGs have developed significantly in the past decade. Well-functioning NITAGs were trusted national resources that enhanced country ownership of immunization provision. However, many LMIC NITAGs require additional technical and funding support to strengthen quality and effectiveness, while maintaining impartiality and ensuring sufficient integration with national decision-making processes. Barriers to sustainable global support need to be addressed for LMIC NITAGs to both continue and develop further.Peer reviewedFinal Published versio

    Development of Training Scenarios in the Flight Training Device for Flight Courses at Embry-Riddle Aeronautical University

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    Embry-Riddle Aeronautical University’s (ERAU) Daytona Beach Campus operates as a certificated flight school under 14 Code of Federal Regulations (CFR) Part 141. Additionally, ERAU employs the use of Frasca Level 6 Flight Training Devices (FTD) for each of their flight courses. Scenario based training cross-country lessons are included in each of the private pilot, instrument rating, commercial pilot, and multi-engine additional rating courses. Each FTD is equipped with software that allows a programmable lesson plan to be created and replayed for each student. They allow for voice recognition from the student, real radio calls and background chatter, automatic dependent surveillance – broadcast (ADS-B), and visual traffic displays. While the student is flying, they will be presented with a situation that will force them to make a decision. The software will allow the scenario to branch off and allow the student to experience the result of that decision further and will allow multiple branches and decisions to be made, if needed, for the duration of the simulation. This form of decision-based scenario training using this software was created with the goal of training the flight students to the application or correlation level of learning. This paper describes the process that a team of flight instructors and support staff completed to use this software and their experience to create more realistic scenarios and a more immersive flight training experience

    Cognitive Task Analysis for the LCS Operator

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    In support of Plan Understanding for Mixed-initiative control of Autonomous systems (PUMA)The following Tables and Figures detail the cognitive task analysis (CTA) performed to determine the information requirements needed to support a single operator located aboard the futuristic Littoral Combat Ship (LCS). This operator is responsible for controlling four underwater unmanned vehicles in conjunction with a UAV operating on a shared network. • Table 1 is a scenario task overview that breaks the overall mission into 3 phases (planning, execution, and recovery) and then details the subtasks for each of the 3 mission phases. • Figure 1 is an event flow diagram that demonstrates what events must occur in a temporal order for each of the 3 phases. There are three basic event types in Figure 1: 1) a loop (L) that represents a process that occurs in a looping fashion until some predetermined event occurs, 2) a decision (D) that represents some decision that is required from the LCS operator, and 3) a process (P) which requires some human-computer interaction to support the required tasks. In each event block, an alphanumeric code is included which labels that particular event type (L#, D#, P#). This label is important because later information requirements will be mapped to one of these events. • Table 2, which details the situation awareness (SA) requirements for the LCS Operator for each of the 3 mission phases and associated subtasks. Each of these SA requirements is mapped directly to one or more events in Figure 1. Because the decisions in Figure 1 represent critical events that require detailed understanding of what information and knowledge is needed to support the operator’s decision-making process, decision ladders were constructed for the diamonds and loops in Figure 1 that correspond to an involved decision process to resolve the question being posed at that stage in the event flow (Figures 2-4). Decision ladders are modeling tools that capture the states of knowledge and information-processing activities necessary to reach a decision. Decision ladders can help identify the information that either the automation and/or the human will need to perform or monitor a task. Decision Ladders, illustrate the need not only for the same information identified by the cognitive task analysis, but the need for several other pieces of information such as the need for visual or aural alerts in contingency situations. In Figures 2-4, three versions are included that detail (a) the basic decision ladder, (b) the decision ladder with corresponding display requirements, and (c) the decision ladder with possible levels of automation. • Figure 2 represents the automated target recognition (ATR) decision ladder (D3 from Event Flow): (a) decision ladder, (b) decision ladder with corresponding display requirements, and (c) decision ladder with possible levels of automation. • Figure 3 shows the decision ladder information and knowledge requirements for the sentry handoff (L3 from Event Flow). • Figure 4, the UUV Recovery Decision Ladder (D7 from Event Flow), illustrates what information is nominally needed. Since this phase was not a major focus, the decision ladder is not as detailed as it could be. This should be a point of focus in Phase II. Lastly Figure 5 demonstrates the coordination loop that must occur in the case where a handoff failure occurs (for a number of reasons to include equipment failure, communication delays, etc.) Again, because the multi-player coordination issues are not a primary focus in Phase I but are a significant consideration for any follow-on phases.Prepared for Charles River Analytic

    Visualizations for an Explainable Planning Agent

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    In this paper, we report on the visualization capabilities of an Explainable AI Planning (XAIP) agent that can support human in the loop decision making. Imposing transparency and explainability requirements on such agents is especially important in order to establish trust and common ground with the end-to-end automated planning system. Visualizing the agent's internal decision-making processes is a crucial step towards achieving this. This may include externalizing the "brain" of the agent -- starting from its sensory inputs, to progressively higher order decisions made by it in order to drive its planning components. We also show how the planner can bootstrap on the latest techniques in explainable planning to cast plan visualization as a plan explanation problem, and thus provide concise model-based visualization of its plans. We demonstrate these functionalities in the context of the automated planning components of a smart assistant in an instrumented meeting space.Comment: PREVIOUSLY Mr. Jones -- Towards a Proactive Smart Room Orchestrator (appeared in AAAI 2017 Fall Symposium on Human-Agent Groups

    Improving Holistic Sustainability through Complexity Leadership

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    This Organizational Improvement Plan (OIP) outlines a planned change to improve decision-making spaces and processes-related sustainability. The OIP details a problem of practice examining how to incorporate holistic sustainability into university governance by identifying critical values to improve processes and outcomes. This examination aligns with the university’s 2030 plans and goals. A critical pragmatism worldview underpins this OIP and applies individual and organizational reflection to support a change transition. Higher education sustainability operation systems require multiple disciplinary perspectives to engage in this evolution. The initial change is co-creating a university definition for holistic sustainability that substantiates additional framework building and policy development. The OIP presents a frames-based organizational analysis to assess university resource requirements and change readiness. Adaptive and complexity leadership theories are employed to navigate systems change and to enact the change implementation compass. Blending the change processes with the leadership theories to bolster diverse perspectives is the keystone to the improvement. Applying the change path model to the proposed three-phase solution engages various university stakeholder networks deliberately. A participatory evaluation approach integrated into the implementation compass enables assessment of the improvement process and the communication plan through cycles of quality improvement. Engaging stakeholder networks in the adaptive space to promote top-down and bottom-up ideation and information flow is essential for holistic sustainability governance to emerge at the university. The future university state is the recognition of a holistic sustainability lens on all decision-making practices and spaces throughout university operations, outreach, research, and curriculum

    Supporting information : application for recognition

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    Building Medical Homes in State Medicaid and CHIP Programs

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    Presents strategies, best practices, and lessons learned from ten states' efforts to advance the medical home model of comprehensive and coordinated care in Medicaid and Children's Health Insurance Programs in order to improve quality and contain costs
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