An analysis of some conditions for representing N state Markov processes as general all or none models

Recently Markov learning models with two unidentifiable presolution success states, an error state, and an absorbing learned state, have been suggested to handle certain aspects of data better than the three state Markov models of the General All or None model type. In attempting to interpret psychologically, and evaluate statistically the adequacy of various classes of Markov models, a knowledge of the relationship between the classes of models would be helpful. This paper considers some aspects of the relationship between the class of General All or None models and the class of Stationary Absorbing Markov models with N error states, and M presolution success states.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45728/1/11336_2005_Article_BF02290602.pd

Federally Qualified Health Centers Use of Telehealth to Deliver Integrated Behavioral Health Care During COVID-19

Federally qualified health centers (FQHCs) that provide comprehensive health services, including integrated behavioral health (IBH), transitioned to deliver care via telehealth during the COVID-19 pandemic. This study explored how FQHCs adapted IBH services using telehealth. A mixed-method design was used, pairing a survey disseminated to FQHC administrators with a structured interview. Of the 46 administrators who participated in the survey, 14 (30.4%) reported delivering IBH using telecommunication prior to the pandemic. Since COVID-19, almost all of the FQHCs surveyed used telecommunication to deliver IBH (n = 44, 95.7%). Nine interviews with FQHC administrators resulted in the four themes: telehealth was essential; core components of IBH were impacted; payment parity and reimbursement were a concern; and telehealth addressed workforce issues. Findings confirm the necessity of telehealth for FQHCs during COVID-19. However due to the lack of co-location, warm-handoffs and other core components of IBH were limited

Reducing risk to security and privacy in the selection of trigger-action rules: Implicit vs. explicit priming for domestic smart devices

Smart home device usage is increasing, as is the diversity of users and range of devices. Additionally, it is becoming increasingly common to interconnect devices (e.g., via trigger-action rules) which, while bringing benefits, can bring unforeseen security and privacy risks. Developing strategies to protect users as well as understanding what biographical or attitudinal characteristics contribute to these risks is a critical step for ensuring empowered, but safe, interconnected smart device usage. Using narrative descriptions of domestic smart devices, two experiments explored how the prevailing security/privacy contexts—priming conditions—in which 20 trigger-action rules (developed via a Delphi Study) were presented influenced the adoption of rules favoring either security or privacy. Both experiments contrasted three priming conditions: no prime, security prime, privacy prime. Experiment 1 (n = 254) used explicit priming, giving direct instruction to maximize a security or privacy outcome while Experiment 2 (n = 325) used implicit priming, with an apparently unrelated security or privacy problem-solving puzzle. Across both experiments, priming promoted safer rule adoption, markedly so when explicit. Explicit priming produced an asymmetry however: privacy priming improved privacy scores with security scores unchanged and security primes improved security scores while worsening privacy scores. Across experiments, two dimensions of user attitudes shaped riskier rule choice: perceived benefits of technology and pre-existing trusting beliefs in online companies. Our novel findings reveal that implicit and explicit priming shape safe use of trigger-action rules in domestic settings and that age, perceived trust and perceived benefits should be considered when designing safety messaging

An Exploration of the Relations between External Representations and Working Memory

It is commonly hypothesized that external representations serve as memory aids and improve task performance by means of expanding the limited capacity of working memory. However, very few studies have directly examined this memory aid hypothesis. By systematically manipulating how information is available externally versus internally in a sequential number comparison task, three experiments were designed to investigate the relation between external representations and working memory. The experimental results show that when the task requires information from both external representations and working memory, it is the interaction of information from the two sources that determines task performance. In particular, when information from the two sources does not match well, external representations hinder instead of enhance task performance. The study highlights the important role the coordination among different representations plays in distributed cognition. The general relations between external representations and working memory are discussed

Racial disparities in the SOFA score among patients hospitalized with COVID-19

BACKGROUND: Sequential Organ Failure Assessment (SOFA) score predicts probability of in-hospital mortality. Many crisis standards of care suggest the use of SOFA scores to allocate medical resources during the COVID-19 pandemic. RESEARCH QUESTION: Are SOFA scores elevated among Non-Hispanic Black and Hispanic patients hospitalized with COVID-19, compared to Non-Hispanic White patients? STUDY DESIGN AND METHODS: Retrospective cohort study conducted in Yale New Haven Health System, including 5 hospitals with total of 2681 beds. Study population drawn from consecutive patients aged ≥18 admitted with COVID-19 from March 29th to August 1st, 2020. Patients excluded from the analysis if not their first admission with COVID-19, if they did not have SOFA score recorded within 24 hours of admission, if race and ethnicity data were not Non-Hispanic Black, Non-Hispanic White, or Hispanic, or if they had other missing data. The primary outcome was SOFA score, with peak score within 24 hours of admission dichotomized as \u3c6 or ≥6. RESULTS: Of 2982 patients admitted with COVID-19, 2320 met inclusion criteria and were analyzed, of whom 1058 (45.6%) were Non-Hispanic White, 645 (27.8%) were Hispanic, and 617 (26.6%) were Non-Hispanic Black. Median age was 65.0 and 1226 (52.8%) were female. In univariate logistic screen and in full multivariate model, Non-Hispanic Black patients but not Hispanic patients had greater odds of an elevated SOFA score ≥6 when compared to Non-Hispanic White patients (OR 1.49, 95%CI 1.11-1.99). INTERPRETATION: Given current unequal patterns in social determinants of health, US crisis standards of care utilizing the SOFA score to allocate medical resources would be more likely to deny these resources to Non-Hispanic Black patients

An academic health center cost analysis of screening mammography

BACKGROUND The current study sought to determine the institutional financial impact of a screening mammography (SM) program in the context of an integrated cancer center. METHODS Using administrative databases, 10,048 women were identified as receiving screening mammograms in fiscal year 1999 and the first one-half of fiscal year 2000. The utilization of breast care resources was followed for an average of 1208 days. The University of Michigan cost accounting system was then used to determine overall margin (revenues − total costs) and contribution margin (revenues − actual costs) of the SM program, as well as other breast care services. RESULTS The percentage of variable costs to total costs for the SM program was 24%. The overall facility losses in the breast care line were $1.7 million with a positive contribution margin of$2.0 million. The annual yield of nonscreening/diagnostic mammographic procedures was 0.9%. All types of radiologic activity failed to cover their total costs, but did provide a positive contribution margin. Overall margins for surgery procedures were approximately even, and adjuvant medical and radiotherapy services were net positive. Modeling helped to identify overhead limits necessary to achieve margin targets associated with increased activity. CONCLUSIONS The current study showed that SM programs are unlikely to succeed financially without careful selection of those screened to increase the yield of diagnostic and therapeutic procedures. Based on favorable contribution margins, SM programs were viable when viewed as incremental business. Cancer 2004. © 2004 by the American Cancer Society.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34389/1/20476_ftp.pd

Dificultades para codificar, relacionar y categorizar problemas verbales algebraicos: dos estudios con estudiantes de secundaria y profesores en formación

En resolución de problemas verbales por transferencia, la activación de problemas ya conocidos que sirvan de guía, depende de las analogías percibidas entre éstos y el problema a resolver. Se desarrollan dos estudios relacionados para analizar en qué características se basan los estudiantes para codificar problemas y detectar sus analogías, en tareas de categorización (sorting). Se utilizaron técnicas cuantitativas y cualitativas combinadas. Primero se analizó cómo los estudiantes de secundaria son influidos por diferentes variables características de problemas de ciencias. Una gran proporción de sujetos no fue capaz de percibir las analogías y diferencias adecuadas entre problemas. El segundo estudio trató de avanzar una explicación de estos resultados. El nivel académico y la familiaridad con las temáticas fueron factores significativos, pero los futuros profesores participantes mostraron demasiadas dificultades, alertando sobre la conveniencia de revisar algunos supuestos instruccionales habituales

Researching Teachers’ Agentic Orientations to Educational Change in Finnish Schools

Peer reviewe