Differential Attention to Attributes in Utility-theoretic Choice Models

We show in a theoretical model that benefits of allocating additional attention to evaluating the marginal attribute with in choice set depend upon the expected utility loss from making a suboptimal choice as a result of ignoring that incremental attribute. Guided by this analysis, we then develop a very general and practical empirical method for measuring the individual's propensity to attend to attributes. As a proof of concept, we offer an empirical example of our method using a conjoint analysis of demand for programs to reduce health risks. Our results suggest that respondents differentially allocate attention across attributes, as a function of the mix of attribute levels in a choice set. This behavior can cause researchers who fail to model attention allocation to incorrectly estimate the marginal utilities derived from selected attributes. This illustrative example is a first attempt to implement an attention-corrected choice model with a sample of field data from a conjoint choice experiment.conjoint choice, bounded rationality, attention to attributes, choice set design

Medical Knowledge as a Recalcitrant Epistemological System: An Application of Standpoint Epistemology in the Analysis of Marginalization within U.S Healthcare

Research on healthcare disparities outside the field of epistemology tend to miss the true origins of oppressions imposed on marginalized individuals by the U.S healthcare system. This happens because of the false belief that these oppressions are reducible to social or political oppressions. By employing the perspective of a standpoint epistemologist, we can better identify the origins of these oppressions and subsequently consider more appropriate solutions. The standpoint epistemologist’s perspective (1) provides an intuitive case for the role individuals’ schemas play in the evaluation of what healthcare professionals know; (2) situates medical knowledge within epistemology, leading us to the determination of the system’s recalcitrance; (3) and lastly, provides us with new and appropriate diagnostic tools for addressing these distinctively epistemic oppressions. The standpoint epistemologist’s perspective is our only saving grace, because when we fail to consider medical knowledge as an epistemological system, we fail to understand the origins of these healthcare oppressions altogether

Consolidating Security and Development in Colombia: Lessons for Peru and Panama

Colombia\u27s increasingly effective efforts to mitigate the power of the FARC and other illegitimately armed groups in the country can offer important lessons for the Peruvian government as it strives to prevent a resurgence of Sendero Luminoso and other illegal non-state actors. Both countries share certain particular challenges: deep economic, social, and in the case of Peru ethnic divisions, the presence of and/or the effects of violent insurgencies, a large-scale narcotics production and trafficking, and a history of weak state presence in large tracts of isolated and scarcely-populated areas. Important differences exist, however in the nature of the insurgencies in the two countries, the government response to them and the nature of government and society that affects the applicability of Colombia\u27s experience to Peru. The security threat to Panama from drug trafficking and Colombian insurgents --often a linked phenomenon-- are in many ways different from the drug/insurgent factor in Colombia itself and in Peru, although there are similar variables. Unlike the Colombian and Peruvian cases, the security threat in Panama is not directed against the state, there are no domestic elements seeking to overthrow the government -- as the case of the FARC and Sendero Luminoso, security problems have not spilled over from rural to urban areas in Panama, and there is no ideological component at play in driving the threat. Nor is drug cultivation a major factor in Panama as it is in Colombia and Peru. The key variable that is shared among all three cases is the threat of extra-state actors controlling remote rural areas or small towns where state presence is minimal. The central lesson learned from Colombia is the need to define and then address the key problem of a sovereignity gap, lack of legitimate state presence in many part of the country. Colombia\u27s success in broadening the presence of the national government between 2002 and the presence is owed to many factors, including an effective national strategy, improvements in the armed forces and police, political will on the part of government for a sustained effort, citizen buy-in to the national strategy, including the resolve of the elite to pay more in taxes to bring change about, and the adoption of a sequenced approach to consolidated development in conflicted areas. Control of territory and effective state presence improved citizen security, strengthened confidence in democracy and the legitimate state, promoted economic development, and helped mitigate the effect of illegal drugs. Peru can benefit from the Colombian experience especially in terms of the importance of legitimate state authority, improved institutions, gaining the support of local citizens, and furthering development to wean communities away from drugs. State coordinated integration efforts in Peru as practiced in Colombia have the potential for success if properly calibrated to Peruvian reality, coordinated within government, and provided with sufficient resources. Peru\u27s traditionally weak political institutions and lack of public confidence in the state in many areas of the country must be overcome if this effort is to be successful

An evaluation of personality-environmental factors related to job satisfaction of secondary school natural science teachers

The purpose of this study was to examine the relationship among certain personality traits, vocational interests, and demographic factors with job satisfaction among secondary school natural science teachers. Implications for future research and educational practice were explored.;Volunteers teaching secondary school natural science classes in seven Virginia public school districts primarily in the Hampton Rhodes area were subjects for this study. Subjects completed the Myers-Briggs Type Indicator, the Vocational Preference Inventory, The Job Descriptive Index, and a biographical informational questionnaire.;It was hypothesized that (1) there would be a positive correlation between the predominant basic preference, INTJ, and job satisfaction, (2) there would be a positive correlation between congruence of the Holland code IRS and job satisfaction, (3) there would be a positive correlation between differentiation and job satisfaction, and (4) there would be a positive correlation between age, sex, years as natural science teacher, years in present position, total years in education, highest degree earned and job satisfaction.;Hypotheses 1, 2, and 3 were rejected. In hypothesis 4, years in present position and years as natural science teacher were negatively correlated with job satisfaction. Recommendations for further research and future educational practice were made

A comparison of a multistate inpatient EHR database to the HCUP Nationwide Inpatient Sample

Background The growing availability of electronic health records (EHRs) in the US could provide researchers with a more detailed and clinically relevant alternative to using claims-based data. Methods In this study we compared a very large EHR database (Health Facts©) to a well-established population estimate (Nationwide Inpatient Sample). Weighted comparisons were made using t-value and relative difference over diagnoses and procedures for the year 2010. Results The two databases have a similar distribution pattern across all data elements, with 24 of 50 data elements being statistically similar between the two data sources. In general, differences that were found are consistent across diagnosis and procedures categories and were specific to the psychiatric–behavioral and obstetrics–gynecology services areas. Conclusions Large EHR databases have the potential to be a useful addition to health services researchers, although they require different analytic techniques compared to administrative databases; more research is needed to understand the differences

A comparison of a multistate inpatient EHR database to the HCUP Nationwide Inpatient Sample

Background The growing availability of electronic health records (EHRs) in the US could provide researchers with a more detailed and clinically relevant alternative to using claims-based data. Methods In this study we compared a very large EHR database (Health Facts©) to a well-established population estimate (Nationwide Inpatient Sample). Weighted comparisons were made using t-value and relative difference over diagnoses and procedures for the year 2010. Results The two databases have a similar distribution pattern across all data elements, with 24 of 50 data elements being statistically similar between the two data sources. In general, differences that were found are consistent across diagnosis and procedures categories and were specific to the psychiatric–behavioral and obstetrics–gynecology services areas. Conclusions Large EHR databases have the potential to be a useful addition to health services researchers, although they require different analytic techniques compared to administrative databases; more research is needed to understand the differences

An interactive and user-centered computer system to predict physician’s disease judgments in discharge summaries

AbstractPurpose: This article describes a formative natural language processing (NLP) system that is grounded in user-centered design, simplification, and transparency of function. Methods: The NLP system was tasked to classify diseases within patient discharge summaries and is evaluated against clinician judgment during the 2008 i2b2 Shared Task competition. Text classification is performed by interactive, fully supervised learning using rule-based processes and support vector machines (SVMs). Results: The macro-averaged F-score for textual (t) and intuitive (i) classification were 0.614(t) and 0.629(i), while micro-averaged F-scores were recorded at 0.966(t) and 0.954(i) for the competition. These results were comparable to the top 10 performing systems. Discussion: The results of this study indicate that an interactive training method, de novo knowledge base with no external data sources, and simplified text mining processes can achieve a comparably high performance in classifying health-related texts. Further research is needed to determine if the user-centered advantages of a NLP system translate into real world benefits

An Empirical Model of Demand for Future Health States when Valuing Risk-Mitigating Programs

51 p.We develop a structural option price model in which individuals choose among competing risk-mitigating programs to alter their probability of experiencing future years in various degraded health states. The novel aspects of this model include separate estimates of the marginal utilities of avoiding years of morbidity and lost life-years. With these marginal utilities, we may evaluate a broad spectrum of probabilistic health outcomes over any period of an individual’s future life. The model also reduces potential biases associated with singleperiod, single-risk models typically used to produce estimates of the Value of a Statistical Life (VSL) by allowing individuals to substitute risk mitigation across competing sources of risk and across future years of their lives. We evaluate this model using data from a national survey that contains a choice experiment on demand for the mitigation of illness-specific risks.US Environmental Protection Agency (R829485) and Health Canada (Contract H5431-010041/001/SS

Evidence-Based Acquisition: A Real Life Account of Managing the Program Within The Orbis Cascade Alliance

In 2015 the Orbis Cascade Alliance investigated a consortium wide evidence-based acquisition (EBA) model to incorporate into its established eBook program, and began a pilot of Wiley’s Usage Based Collection Management Model. EBA is an acquisition model that grants library patrons access to a title list over an agreed-upon time period for a pre-negotiated amount of money, and titles from that list are then selected for purchase based on the evidence of usage from the initial access period. This article shares the consortium’s experiences evaluating usage, managing titles and records, controlling duplication, predicting costs, and the inclusion of MARC records to enhance discoverability