Development of a generic activities model of command and control

This paper reports on five different models of command and control. Four different models are reviewed: a process model, a contextual control model, a decision ladder model and a functional model. Further to this, command and control activities are analysed in three distinct domains: armed forces, emergency services and civilian services. From this analysis, taxonomies of command and control activities are developed that give rise to an activities model of command and control. This model will be used to guide further research into technological support of command and control activities

Practices and Obstacles to Provider-Initiated HIV Testing and Counseling (PITC) Among Healthcare Providers in Côte d’Ivoire

Practices of Provider-Initiated HIV Testing and Counseling (PITC) remains suboptimal in Côte d'Ivoire. The aim of this survey was to identify the practices and obstacles to PITC among healthcare professionals in Côte d'Ivoire. A nationally representative cross-sectional survey was conducted in 2018 by telephone among three separate samples of midwives, nurses and physicians practicing in Côte d'Ivoire. The number of HIV tests proposed during consultation in the month preceding the survey was collected for each professional. Factors associated with the number of proposed tests were identified through ordinal logistic regression models. A total of 298 midwives, 308 nurses and 289 physicians were interviewed. Midwives proposed the test more frequently, followed by nurses and physicians. Among midwives, a higher number of proposed tests was associated with the perception that HIV testing does not require specific consent compared to other diseases (aOR 4.00 [95% CI 1.37-14.29]). Among nurses, having received HIV training and the presence of community HIV counselors were associated with a higher number of proposed tests (aOR 2.01 [1.31-3.09] and aOR 1.75 [1.14-2.70], respectively). For physicians, the presence of a voluntary testing center was associated with a higher number of proposed tests (aOR 1.69 [1.01-2.86]). PITC practices and barriers differed across professions. Beyond improving environmental opportunities such as dedicated staff or services, strengthening the motivations and capabilities of healthcare professionals to propose testing could improve PITC coverage

Designing an automated clinical decision support system to match clinical practice guidelines for opioid therapy for chronic pain

Abstract Background Opioid prescribing for chronic pain is common and controversial, but recommended clinical practices are followed inconsistently in many clinical settings. Strategies for increasing adherence to clinical practice guideline recommendations are needed to increase effectiveness and reduce negative consequences of opioid prescribing in chronic pain patients. Methods Here we describe the process and outcomes of a project to operationalize the 2003 VA/DOD Clinical Practice Guideline for Opioid Therapy for Chronic Non-Cancer Pain into a computerized decision support system (DSS) to encourage good opioid prescribing practices during primary care visits. We based the DSS on the existing ATHENA-DSS. We used an iterative process of design, testing, and revision of the DSS by a diverse team including guideline authors, medical informatics experts, clinical content experts, and end-users to convert the written clinical practice guideline into a computable algorithm to generate patient-specific recommendations for care based upon existing information in the electronic medical record (EMR), and a set of clinical tools. Results The iterative revision process identified numerous and varied problems with the initially designed system despite diverse expert participation in the design process. The process of operationalizing the guideline identified areas in which the guideline was vague, left decisions to clinical judgment, or required clarification of detail to insure safe clinical implementation. The revisions led to workable solutions to problems, defined the limits of the DSS and its utility in clinical practice, improved integration into clinical workflow, and improved the clarity and accuracy of system recommendations and tools. Conclusions Use of this iterative process led to development of a multifunctional DSS that met the approval of the clinical practice guideline authors, content experts, and clinicians involved in testing. The process and experiences described provide a model for development of other DSSs that translate written guidelines into actionable, real-time clinical recommendations.http://deepblue.lib.umich.edu/bitstream/2027.42/78267/1/1748-5908-5-26.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/2/1748-5908-5-26.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/3/1748-5908-5-26-S3.TIFFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/4/1748-5908-5-26-S2.TIFFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/5/1748-5908-5-26-S1.TIFFPeer Reviewe

A Small Angle Scattering Sensor System for the Characterization of Combustion Generated Particulate

One of the critical issues for the US space program is fire safety of the space station and future launch vehicles. A detailed understanding of the scattering signatures of particulate is essential for the development of a false alarm free fire detection system. This paper describes advanced optical instrumentation developed and applied for fire detection. The system is being designed to determine four important physical properties of disperse fractal aggregates and particulates including size distribution, number density, refractive indices, and fractal dimension. Combustion generated particulate are the primary detection target; however, in order to discriminate from other particulate, non-combustion generated particles should also be characterized. The angular scattering signature is measured and analyzed using two photon optical laser scattering. The Rayleigh-Debye-Gans (R-D-G) scattering theory for disperse fractal aggregates is utilized. The system consists of a pulsed laser module, detection module and data acquisition system and software to analyze the signals. The theory and applications are described

A Candidate Subspecies Discrimination System Involving a Vomeronasal Receptor Gene with Different Alleles Fixed in M. m. domesticus and M. m. musculus

Assortative mating, a potentially efficient prezygotic reproductive barrier, may prevent loss of genetic potential by avoiding the production of unfit hybrids (i.e., because of hybrid infertility or hybrid breakdown) that occur at regions of secondary contact between incipient species. In the case of the mouse hybrid zone, where two subspecies of Mus musculus (M. m. domesticus and M. m. musculus) meet and exchange genes to a limited extent, assortative mating requires a means of subspecies recognition. We based the work reported here on the hypothesis that, if there is a pheromone sufficiently diverged between M. m. domesticus and M. m. musculus to mediate subspecies recognition, then that process must also require a specific receptor(s), also sufficiently diverged between the subspecies, to receive the signal and elicit an assortative mating response. We studied the mouse V1R genes, which encode a large family of receptors in the vomeronasal organ (VNO), by screening Perlegen SNP data and identified one, Vmn1r67, with 24 fixed SNP differences most of which (15/24) are nonsynonymous nucleotide substitutions between M. m. domesticus and M. m. musculus. We observed substantial linkage disequilibrium (LD) between Vmn1r67 and Abpa27, a mouse salivary androgen-binding protein gene that encodes a proteinaceous pheromone (ABP) capable of mediating assortative mating, perhaps in conjunction with its bound small lipophilic ligand. The LD we observed is likely a case of association rather than residual physical linkage from a very recent selective sweep, because an intervening gene, Vmn1r71, shows significant intra(sub)specific polymorphism but no inter(sub)specific divergence in its nucleotide sequence. We discuss alternative explanations of these observations, for example that Abpa27 and Vmn1r67 are coevolving as signal and receptor to reinforce subspecies hybridization barriers or that the unusually divergent Vmn1r67 allele was not a product of fast positive selection, but was derived from an introgressed allele, possibly from Mus spretus

Epidemic infectious gastrointestinal illness aboard U.S. Navy ships deployed to the Middle East during peacetime operations – 2000–2001

BACKGROUND: Infectious gastrointestinal illness (IGI) outbreaks have been reported in U.S. Navy ships and could potentially have an adverse mission impact. Studies to date have been anecdotal. METHODS: We conducted a retrospective analysis of weekly reported disease and non-battle injury health data collected in 2000 – 2001 from 44 U.S. Navy ships while sailing in the 5(th )Fleet (Persian Gulf and nearby seas). RESULTS: During this period, 11 possible IGI outbreaks were identified. Overall, we found 3.3 outbreaks per 100 ship-weeks, a mean outbreak duration of 4.4 weeks, and a mean cumulative ship population attack rate of 3.6%. Morbidity, represented by days lost due to personnel being placed on sick-in-quarters status, was higher during outbreak weeks compared to non-outbreak weeks (p = 0.002). No clear seasonal distribution was identified. CONCLUSION: Explosive outbreaks due to viruses and bacteria with the potential of incapacitating large proportions of the crew raise serious concerns of mission impact and military readiness

Global Retinoblastoma Presentation and Analysis by National Income Level

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- A nd middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

Usual Primary Care Provider Characteristics of a Patient-Centered Medical Home and Mental Health Service Use

BACKGROUND: The benefits of the patient-centered medical home (PCMH) over and above that of a usual source of medical care have yet to be determined, particularly for adults with mental health disorders. OBJECTIVE: To examine qualities of a usual provider that align with PCMH goals of access, comprehensiveness, and patient-centered care, and to determine whether PCMH qualities in a usual provider are associated with the use of mental health services (MHS). DESIGN: Using national data from the Medical Expenditure Panel Survey, we conducted a lagged cross-sectional study of MHS use subsequent to participant reports of psychological distress and usual provider and practice characteristics. PARTICIPANTS: A total of 2,358 adults, aged 18–64 years, met the criteria for serious psychological distress and reported on their usual provider and practice characteristics. MAIN MEASURES: We defined “usual provider” as a primary care provider/practice, and “PCMH provider” as a usual provider that delivered accessible, comprehensive, patient-centered care as determined by patient self-reporting. The dependent variable, MHS, included self-reported mental health visits to a primary care provider or mental health specialist, counseling, and psychiatric medication treatment over a period of 1 year. RESULTS: Participants with a usual provider were significantly more likely than those with no usual provider to have experienced a primary care mental health visit (marginal effect [ME] = 8.5, 95 % CI = 3.2–13.8) and to have received psychiatric medication (ME = 15.5, 95 % CI = 9.4–21.5). Participants with a PCMH were additionally more likely than those with no usual provider to visit a mental health specialist (ME = 7.6, 95 % CI = 0.7–14.4) and receive mental health counseling (ME = 8.5, 95 % CI = 1.5–15.6). Among those who reported having had any type of mental health visit, participants with a PCMH were more likely to have received mental health counseling than those with only a usual provider (ME = 10.0, 95 % CI = 1.0–19.0). CONCLUSIONS: Access to a usual provider is associated with increased receipt of needed MHS. Patients who have a usual provider with PCMH qualities are more likely to receive mental health counseling

An enterprise engineering approach for the alignment of business and information technology strategy

Information systems and information technology (IS/IT, hereafter just IT) strategies usually depend on a business strategy. The alignment of both strategies improves their strategic plans. From an external perspective, business and IT alignment is the extent to which the IT strategy enables and drives the business strategy. This article reviews strategic alignment between business and IT, and proposes the use of enterprise engineering (EE) to achieve this alignment. The EE approach facilitates the definition of a formal dialog in the alignment design. In relation to this, new building blocks and life-cycle phases have been defined for their use in an enterprise architecture context. This proposal has been adopted in a critical process of a ceramic tile company for the purpose of aligning a strategic business plan and IT strategy, which are essential to support this process. © 2011 Taylor & Francis.Cuenca, L.; Boza, A.; Ortiz, A. (2011). An enterprise engineering approach for the alignment of business and information technology strategy. International Journal of Computer Integrated Manufacturing. 24(11):974-992. https://doi.org/10.1080/0951192X.2011.579172S9749922411(1993). CIMOSA: Open System Architecture for CIM. doi:10.1007/978-3-642-58064-2Ang, J., Shaw, N., & Pavri, F. (1995). Identifying strategic management information systems planning parameters using case studies. International Journal of Information Management, 15(6), 463-474. doi:10.1016/0268-4012(95)00049-dAvison, D., Jones, J., Powell, P., & Wilson, D. (2004). Using and validating the strategic alignment model. The Journal of Strategic Information Systems, 13(3), 223-246. doi:10.1016/j.jsis.2004.08.002Avgerou, & McGrath. (2007). Power, Rationality, and the Art of Living through Socio-Technical Change. MIS Quarterly, 31(2), 295. doi:10.2307/25148792Bergeron, F., Raymond, L., & Rivard, S. (2004). Ideal patterns of strategic alignment and business performance. Information & Management, 41(8), 1003-1020. doi:10.1016/j.im.2003.10.004Bernus, P., Nemes, L., & Schmidt, G. (Eds.). (2003). Handbook on Enterprise Architecture. doi:10.1007/978-3-540-24744-9Bleistein, S. J., Cox, K., Verner, J., & Phalp, K. T. (2006). B-SCP: A requirements analysis framework for validating strategic alignment of organizational IT based on strategy, context, and process. Information and Software Technology, 48(9), 846-868. doi:10.1016/j.infsof.2005.12.001Buchanan, S., & Gibb, F. (1998). The information audit: An integrated strategic approach. International Journal of Information Management, 18(1), 29-47. doi:10.1016/s0268-4012(97)00038-8Buchanan, S., & Gibb, F. (2007). The information audit: Role and scope. International Journal of Information Management, 27(3), 159-172. doi:10.1016/j.ijinfomgt.2007.01.002Chen, D., & Vernadat, F. (2004). Standards on enterprise integration and engineering—state of the art. International Journal of Computer Integrated Manufacturing, 17(3), 235-253. doi:10.1080/09511920310001607087Chen, D., Doumeingts, G., & Vernadat, F. (2008). Architectures for enterprise integration and interoperability: Past, present and future. Computers in Industry, 59(7), 647-659. doi:10.1016/j.compind.2007.12.016Chen, H.-M., Kazman, R., & Garg, A. (2005). BITAM: An engineering-principled method for managing misalignments between business and IT architectures. Science of Computer Programming, 57(1), 5-26. doi:10.1016/j.scico.2004.10.002Cuenca, L., Ortiz, A., & Vernadat, F. (2006). From UML or DFD models to CIMOSA partial models and enterprise components. International Journal of Computer Integrated Manufacturing, 19(3), 248-263. doi:10.1080/03081070500065841Davis, G. B. (2000). Information Systems Conceptual Foundations: Looking Backward and Forward. IFIP Advances in Information and Communication Technology, 61-82. doi:10.1007/978-0-387-35505-4_5Gindy, N., Morcos, M., Cerit, B., & Hodgson, A. (2008). Strategic technology alignment roadmapping STAR® aligning R&D investments with business needs. International Journal of Computer Integrated Manufacturing, 21(8), 957-970. doi:10.1080/09511920801927148Goethals, F. G., Lemahieu, W., Snoeck, M., & Vandenbulcke, J. A. (2007). The data building blocks of the enterprise architect. Future Generation Computer Systems, 23(2), 269-274. doi:10.1016/j.future.2006.05.004Greefhorst, D., Koning, H., & Vliet, H. van. (2006). The many faces of architectural descriptions. Information Systems Frontiers, 8(2), 103-113. doi:10.1007/s10796-006-7975-xGregor, S., Hart, D., & Martin, N. (2007). Enterprise architectures: enablers of business strategy and IS/IT alignment in government. Information Technology & People, 20(2), 96-120. doi:10.1108/09593840710758031Hartono, E., Lederer, A. L., Sethi, V., & Zhuang, Y. (2003). Key predictors of the implementation of strategic information systems plans. ACM SIGMIS Database, 34(3), 41-53. doi:10.1145/937742.937747Henderson, J. C., & Venkatraman, H. (1993). Strategic alignment: Leveraging information technology for transforming organizations. IBM Systems Journal, 32(1), 472-484. doi:10.1147/sj.382.0472Hirschheim, R., & Sabherwal, R. (2001). Detours in the Path toward Strategic Information Systems Alignment. California Management Review, 44(1), 87-108. doi:10.2307/41166112Hoogervorst, J. A. P. (2009). Enterprise Governance and Enterprise Engineering. doi:10.1007/978-3-540-92671-9Johnson, A. M., & Lederer, A. L. (2010). CEO/CIO mutual understanding, strategic alignment, and the contribution of IS to the organization. Information & Management, 47(3), 138-149. doi:10.1016/j.im.2010.01.002JONKERS, H., LANKHORST, M., VAN BUUREN, R., HOPPENBROUWERS, S., BONSANGUE, M., & VAN DER TORRE, L. (2004). CONCEPTS FOR MODELING ENTERPRISE ARCHITECTURES. International Journal of Cooperative Information Systems, 13(03), 257-287. doi:10.1142/s0218843004000985King, W. R. (1978). Strategic Planning for Management Information Systems. MIS Quarterly, 2(1), 27. doi:10.2307/249104Leonard, J. (2007). Sharing a Vision: comparing business and IS managers’ perceptions of strategic alignment issues. Australasian Journal of Information Systems, 15(1). doi:10.3127/ajis.v15i1.299Luftman, J. N., Lewis, P. R., & Oldach, S. H. (1993). Transforming the enterprise: The alignment of business and information technology strategies. IBM Systems Journal, 32(1), 198-221. doi:10.1147/sj.321.0198Luftman, J., Ben-Zvi, T., Dwivedi, R., & Rigoni, E. H. (2010). IT Governance. International Journal of IT/Business Alignment and Governance, 1(2), 13-25. doi:10.4018/jitbag.2010040102Melville, Kraemer, & Gurbaxani. (2004). Review: Information Technology and Organizational Performance: An Integrative Model of IT Business Value. MIS Quarterly, 28(2), 283. doi:10.2307/25148636Newkirk, H. E., & Lederer, A. L. (2006). Incremental and Comprehensive Strategic Information Systems Planning in an Uncertain Environment. IEEE Transactions on Engineering Management, 53(3), 380-394. doi:10.1109/tem.2006.877446Noran, O. (2003). An analysis of the Zachman framework for enterprise architecture from the GERAM perspective. Annual Reviews in Control, 27(2), 163-183. doi:10.1016/j.arcontrol.2003.09.002Noran, O. (2005). A systematic evaluation of the C4ISR AF using ISO15704 Annex A (GERAM). Computers in Industry, 56(5), 407-427. doi:10.1016/j.compind.2004.12.005Ortiz, A., Lario, F., & Ros, L. (1999). Enterprise Integration—Business Processes Integrated Management: a proposal for a methodology to develop Enterprise Integration Programs. Computers in Industry, 40(2-3), 155-171. doi:10.1016/s0166-3615(99)00021-4Panetto, H., Baïna, S., & Morel, G. (2007). Mapping the IEC 62264 models onto the Zachman framework for analysing products information traceability: a case study. Journal of Intelligent Manufacturing, 18(6), 679-698. doi:10.1007/s10845-007-0040-xPapp, R. (Ed.). (2001). Strategic Information Technology. doi:10.4018/978-1-87828-987-2Peñaranda, N., Mejía, R., Romero, D., & Molina, A. (2010). Implementation of product lifecycle management tools using enterprise integration engineering and action-research. International Journal of Computer Integrated Manufacturing, 23(10), 853-875. doi:10.1080/0951192x.2010.495136Reich, B. H., & Benbasat, I. (2000). Factors That Influence the Social Dimension of Alignment between Business and Information Technology Objectives. MIS Quarterly, 24(1), 81. doi:10.2307/3250980Sledgianowski, D., & Luftman, J. (2005). IT-Business Strategic Alignment Maturity. Journal of Cases on Information Technology, 7(2), 102-120. doi:10.4018/jcit.2005040107Sowa, J. F., & Zachman, J. A. (1992). Extending and formalizing the framework for information systems architecture. IBM Systems Journal, 31(3), 590-616. doi:10.1147/sj.313.0590Van Grembergen, W., & De Haes, S. (2010). A Research Journey into Enterprise Governance of IT, Business/IT Alignment and Value Creation. International Journal of IT/Business Alignment and Governance, 1(1), 1-13. doi:10.4018/jitbag.2010120401Xueying Wang, Xiongwei Zhou, & Longbin Jiang. (2008). A method of business and IT alignment based on Enterprise Architecture. 2008 IEEE International Conference on Service Operations and Logistics, and Informatics. doi:10.1109/soli.2008.468649