A Method for Modeling Low-Probability, High- Consequence Risk Events: Vessel Traffic on the Lower Mississippi River

[Excerpt] A variety of commodities, from chlorine to corn and petroleum to passengers, are transported on the lower Mississippi River regularly. Corn, wheat and coal are the most commonly carried commodities. From a human health and safety perspective, these are relatively benign products in that a vessel accident and spill of these are not directly hazardous to people, whatever other ecological disturbances may ensue. However, over eighty million tons of petroleum products are transported on the river annually. Over a million tons of liquid natural gas traverse the river through the center of New Orleans. Additionally, over 400,000 tons of ammonium nitrate2 pass through the center of Baton Rouge annually. The potential for a technological disaster is certainly present […] The vast majority of the literature relevant to the question of vessel accident risk concerns the question of on-board causes of vessel accidents. It is assumed that the predictors of which vessel will have an accident are on-board the vessel (i.e., vessel and crew characteristics). The most commonly cited on-board hazards include: the size of the vessel; the age of the vessel; the length of the vessel; whether the vessel is single or double hulled; the maintenance of the vessel; the classification society under which the vessel is registered; the type of ownership; the history of ownership; where the vessel is flagged (i.e., flag of convenience or traditional maritime nation); license qualifications of mates and engineers; the vessel’s casualty history; the vessel’s history of violations; whether the vessel has system (e.g., steering) redundancy; and personnel history (including manning levels and the comparison of the present levels of manning with that of the vessel in the past and with similar type vessels)

An Empirical Examination of Two Models of Cultural Causation

The traditional macroscopic model of cultural causation advanced by Weber and modified by Parsons assumes that values provide orientation for human action. Thus, values are conceptualized as the intervening link between culture and behavior and in general, are viewed as predictive of human action. Swidler (1986) contends that values are a poor predictor of behavior. As an a/tentative model, Swidler asserts that cultures provide actors with a limited array of behavioral options. Because this array is finite and indicative of a particular cultural setting, inuacultural behavioral similatities are observable. We empirically test the link between culture and behavior in a situation which Swidler defines as "unsettled lives." Our findings offer little support for the traditionally assumed link between values and behavior. The theoretical implications of our findings are discussed and an expansion of Swidler's model is offered

The Implementation of Measuring What Matters in Research and Practice: Series Commentary

The joint American Academy of Hospice and Palliative Medicine (AAHPM) and Hospice and Palliative Nurses Association (HPNA) “Measuring What Matters” (MWM) initiative selected and recommended ten quality indicators for hospice and palliative care practice (1) (Table 1). These quality indicators were chosen after a systematic process, relying on the existing evidence base. The intent was identification of a core set of clinically relevant, cross-cutting performance measures for use by palliative care and hospice programs to drive quality improvement efforts

Visit satisfaction and the use of tailored health behavior communications in primary care

BACKGROUND: Though studies suggest that computer-tailored health communications can help patients improve health behaviors, their effect on patient satisfaction, when used in health care settings, has yet to be examined. METHODS: A computer application was developed to provide tailored, printed feedback for patients and physicians about two of the most common adverse health behaviors seen in primary care, smoking and physical inactivity. Ten primary care providers and 150 of their patients were recruited to use the program in the office before their visit. After the visit, patients completed a self-report survey that addressed demographics, computer use history, satisfaction with the visit and the extent to which the physician addressed the reports during the visit. RESULTS: Most patients were female (67.6%), approximately half (46.0%) were seen for a routine exam, most (63.3%) had at least one chronic illness and fewer than a third (31.3%) had ever used the Internet or email. Most (81.1%) patients reported that the program was easy to use, but fewer than half of the doctors looked at the report in front of the patient (49.2%) or discussed the report with the patient (44.3%). Multivariate modeling showed that visit satisfaction was significantly greater among those whose doctor examined the report. This effect of the doctor examining the report on satisfaction was even greater for those who reported a chronic illness. CONCLUSIONS: Physicians who incorporate computer tailored messaging programs into the primary care setting, but who do not address the feedback reports that they create may contribute to patients being less satisfied with their care

Studying Emotions in Tele-Palliative Care, a Small Formative Study

Can emotional connection be formed in virtual consults?https://knowledgeconnection.mainehealth.org/lambrew-retreat-2021/1047/thumbnail.jp

Is the association between optimistic cardiovascular risk perceptions and lower rates of cardiovascular disease mortality explained by biomarkers of systemic inflammation or endothelial function? A case-cohort study

<p>Abstract</p> <p>Background</p> <p>More optimistic perceptions of cardiovascular disease risk are associated with substantively lower rates of cardiovascular death among men. It remains unknown whether this association represents causality (i.e. perception leads to actions/conditions that influence cardiovascular disease occurrence) or residual confounding by unmeasured factors that associate with risk perceptions and with physiological processes that promote cardiovascular disease (i.e. inflammation or endothelial dysfunction).</p> <p>Purpose</p> <p>To evaluate whether previously unmeasured biological markers of inflammation or endothelial dysregulation confound the observed association between cardiovascular disease risk perceptions and cardiovascular disease outcomes;</p> <p>Methods</p> <p>We conducted a nested case-cohort study among community-dwelling men from Southeastern New England (USA) who were interviewed between 1989 and 1990 as part of the Pawtucket Heart Health Program. We measured C-reactive protein (CRP) and Vascular Endothelial Growth Factor (VEGF) levels from stored sera for a random sample of the parent cohort (control sample, n = 127) and all cases of cardiovascular death observed through 2005 (case sample, n = 44). We evaluated potential confounding using stratified analyses and logistic regression modeling.</p> <p>Results</p> <p>Optimistic ratings of risk associated with lower odds of dying from cardiovascular causes among men (OR = 0.39, 95% CI = 0.17, 0.91). Neither CRP nor VEGF confounded these findings.</p> <p>Conclusions</p> <p>The strong cardio-protective association between optimistic ratings of cardiovascular disease risk and lower rates of cardiovascular mortality among men is not confounded by baseline biomarkers of systemic inflammation or endothelial dysfunction.</p

Emotional Distress and Compassionate Responses in Palliative Care Decision-Making Consultations

Background: Seriously ill hospitalized patients and their loved ones are frequently faced with complex treatment decisions laden with expressions of emotional distress during palliative care (PC) consultations. Little is known about these emotional expressions or the compassionate responses providers make and how common these are in PC decision-making conversations

Use of Science in Gulf of Mexico Decision Making Involving Climate Change

This material is based upon research supported by the U.S. Environmental Protection Agency's National Center for Environmental Assessment/Global Change Research Program under Cooperative Agreement No. R-83023601-0. It is a joint project of Texas A&M University's Institute for Science, Technology and Public Policy in The Bush School of Government and Public Service, the Center for Hazards Assessment, Response and Technology at the University of New Orleans, the Center for Socioeconomic Research at the University of Louisiana at Lafayette, and the Environmental Sciences Institute at Florida A&M University. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the U.S. Environmental Protection Agency.project final reportsurveyU.S. Environmental Protection Agency (Cooperative Agreement No. R-83023601-0

Attitudes toward offshore oil development: A summary of current evidence

Attitudes toward offshore petroleum have varied widely across both time and place. This paper summarizes the accumulated evidence from around the globe and then examines two regions that represent the polar extremes - both drawn from the same country and the same era - southern Louisiana and northern California, over the past two decades. The comparison illustrates that attitudes toward offshore oil development are best understood through a closer examination of the ways in which the offshore industry has interacted with a given region, over time, in terms of three sets of factors - the historical, biophysical, and social factors that shape the people and culture of a given place and time. (c) 2006 Elsevier Ltd. All rights reserved