12,666 research outputs found

    Employing dynamic fuzzy membership functions to assess environmental performance in the supplier selection process

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    The proposed system illustrates that logic fuzzy can be used to aid management in assessing a supplier's environmental performance in the supplier selection process. A user-centred hierarchical system employing scalable fuzzy membership functions implement human priorities in the supplier selection process, with particular focus on a supplier's environmental performance. Traditionally, when evaluating supplier performance, companies have considered criteria such as price, quality, flexibility, etc. These criteria are of varying importance to individual companies pertaining to their own specific objectives. However, with environmental pressures increasing, many companies have begun to give more attention to environmental issues and, in particular, to their suppliers’ environmental performance. The framework presented here was developed to introduce efficiently environmental criteria into the existing supplier selection process and to reflect on its relevant importance to individual companies. The system presented attempts to simulate the human preference given to particular supplier selection criteria with particular focus on environmental issues when considering supplier selection. The system considers environmental data from multiple aspects of a suppliers business, and based on the relevant impact this will have on a Buying Organization, a decision is reached on the suitability of the supplier. This enables a particular supplier's strengths and weaknesses to be considered as well as considering their significance and relevance to the Buying OrganizationPeer reviewe

    Educating Grandparents of Grandchildren with Type I Diabetes Using Simulation: A Dissertation

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    The purpose of this study was to explore the feasibility of using human patient simulation (HPS) to teach Type 1 diabetes (T1DM) management to grandparents of grandchildren with T1DM. Thirty grandparents (11 male, 19 female) of young grandchildren (aged 12 and under) with T1DM were recruited from an urban medical center. Experimental group (n = 14) grandparents received hands-on visual T1DM management education using an HPS intervention, and control group (n = 16) grandparents received similar education using a non-HPS intervention. Post-intervention, researchers interviewed twelve grandparents (50% HPS, 50% non-HPS) who scored highest and lowest on the Hypoglycemia Fear Survey. Using a mixed-method design, researchers integrated study instrument data and post-intervention interview data to describe grandparent’s experience learning T1DM management. Post-intervention, grandparent scores for knowledge, confidence, and fear showed no significant difference by group assignment, however, all grandparent scores showed improvement from Time 1 to Time 2. Grandparents described how taking part in T1DM education heightened their awareness of T1DM risks. GP T1DM knowledge gains aided GPs to make sense of T1DM risks. Newfound T1DM knowledge enhanced GP T1DM management confidence. Improved T1DM knowledge and confidence helped to defuse T1DM management fear. Although study instruments did not measure significant difference between grandparents who received the HPS intervention and those who did not, the consistency of larger HPS-taught grandparent score improvement is suggestive of a benefit for HPS

    Depression, Anxiety, and Stress Severity Impact Social Media Use and TikTok Addiction

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    Learning to remember: The early ontogeny of episodic memory

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    AbstractOver the past 60 years the neural correlates of human episodic memory have been the focus of intense neuroscientific scrutiny. By contrast, neuroscience has paid substantially less attention to understanding the emergence of this neurocognitive system. In this review we consider how the study of memory development has evolved. In doing so, we concentrate primarily on the first postnatal year because it is within this time window that the most dramatic shifts in scientific opinion have occurred. Moreover, this time frame includes the critical age (∌9 months) at which human infants purportedly first begin to demonstrate rudimentary hippocampal-dependent memory. We review the evidence for and against this assertion, note the lack of direct neurocognitive data speaking to this issue, and question how demonstrations of exuberant relational learning and memory in infants as young as 3-months old can be accommodated within extant models. Finally, we discuss whether current impasses in the infant memory literature could be leveraged by making greater use of neuroimaging techniques, such as magnetic resonance imaging (MRI), which have been deployed so successfully in adults

    Creating national weights for a patient-level longitudinal database

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    Onur BaƟer (MEF Author)##nofulltext##To create a nationally-representative estimate from longitudinal data by controlling for sociodemographic factors and health status. The Agency for Healthcare Research and Quality’s (AHRQ) Medicare Expenditures Panel Survey (MEPS) was used as the basis for adjustment methodology. MEPS is a data source representing health insurance coverage cost and utilization, and comprises several large-scale surveys of families, individuals, employers, and health care providers. Using these data, we created subset populations. We then used multivariate logistic regression to construct demographics and case-mix-based weights, which were applied to create a population sample that is similar to the national population. The weight was derived using the inverse probability of the weighting approach, as well as a raking mechanism. We compared the results with the projected number of persons in the US population in the same categories to examine the validity of the weights. The following variables were used in the logistic regression: Age group, gender, race, location, income level and health status (Charlson Comorbidity Index scores and chronic condition diagnosis). Relative to MEPS data, patients included in the private insurance data were more likely to be male, older, to have a chronic condition, and to be white (p=0.0000). Adjusted weighted values for patients in the commercial group ranged from 15.47 to 36.36 (median: 16.91). Commercial insurance and MEPS data populations were similar in terms of their socioeconomic and clinical categories. As an outcomes measure, the predicted annual number of patients with prescription claims from private insurance data was 6 963 034. The annual number of statin users were predicted as 6 709 438 using weighted MEPS data. National projections of large-scale patient longitudinal databases require adjustment utilizing demographic factors and case-mix differences related to health status

    Development of a Short Trauma Screening Tool (STST) to Measure Child Trauma Symptoms: Establishing Content Validity

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    Purpose: The purpose of the study was to identify major symptom domain variables common to child trauma and create a prototype short trauma symptom screening tool (STST) intended for use in pediatric medical settings. Methods: This manuscript describes the first two phases of an on-going prospective mixed-method instrument development study. Phase 1 exploratory factor analysis was conducted with an archived LONGSCAN CBCL dataset to: (1) identify behavioral symptoms endorsed by children with known trauma exposure; and (2) generate a preliminary STST item pool. During Phase 2, researchers convened an expert panel (N = 10) and conducted Content Validity Index (CVI) procedures with the 20-item preliminary STST item pool, to further inform item retention, elimination and modification for an updated prototype STST. Findings: Expert quantitative scores yielded a CVI of 0.90 for the overall preliminary STST. The first two phases of this study assisted researchers with identifying 12 items that represent nine child trauma symptom domain variables, which include: (1) aggression/anger; (2) anxiety/fear; (3) sexual concerns; (4) elimination concerns; (5) somatic concerns; (6) depression; (7) dissociation; (8) physical acting out; and (9) dysregulation. Conclusions: The first two phases of STST development resulted in development of a brief, empirically-derived prototype screening tool that features 12 items operationalizing nine domains of child trauma symptoms. Developers can now advance to the next phase of STST development; feasibility assessment and psychometric testing
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