Implementation of Evidence-based Practice Within a Physician-led Quality Improvement Collaborative: A Multimethod Analysis of Facilitators and Barriers to Implementation.

In this dissertation, I have reported on a multimethod study of the barriers and facilitators to implementation of imaging appropriateness criteria, an evidence-based practice to improve the use of imaging for prostate cancer patients, within the Michigan Urological Surgery Improvement Collaborative (MUSIC). I conducted seven months of field research throughout MUSIC to study the history and organization of the collaborative. I conducted field site visits and interviews with key members of the urology practices. I performed a comparative case study assessment of this qualitative data to explain the barriers and facilitators of the implementation efforts within the urology practices. I also developed and deployed an instrument to assess and explain the specific factors affecting the behavioral intentions of the urologists in the collaborative. Through this extensive assessment, I have shown how the collaborative can organize in a purposefully way to positively shape the behaviors of the members. These strategies included: 1) Professional interplay to build trust and professional relationships; 2) positive reinforcement to strengthen beliefs about legitimacy; and 3) inclusiveness to shape attitudes about the grassroots efforts. I suggested these strategies helped influence the collaborative members’ to adopt and use the innovation. Therefore, the collaborative assumed the role as the “collective opinion leader.” I have shown that beliefs related to professional identity, along with patient or resource constraints, can be barriers to implementation. Additionally, knowing the criteria and its evidence, as well as having strong beliefs about the consequences, are the strongest predictors of an urologist’s intention to follow the imaging appropriateness criteria. Furthermore, strong social influences from the practice and positive attitudes towards the collaborative will facilitate implementation efforts and possibly reduce barriers from the environment.PhDHealth Services Organization and PolicyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/116751/1/dwsexton_1.pd

Why the Economics Profession Must Actively Participate in the Privacy Protection Debate

When Google or the U.S. Census Bureau publish detailed statistics on browsing habits or neighborhood characteristics, some privacy is lost for everybody while supplying public information. To date, economists have not focused on the privacy loss inherent in data publication. In their stead, these issues have been advanced almost exclusively by computer scientists who are primarily interested in technical problems associated with protecting privacy. Economists should join the discussion, first, to determine where to balance privacy protection against data quality; a social choice problem. Furthermore, economists must ensure new privacy models preserve the validity of public data for economic research

Anne Sexton: 09-10-1973

Sexton talks about her designation as a confessional poet and the shifts in the themes of her poems through the years. She says that she writes what she wants and has to write, but that she often uses other people\u27s stories, making them her own with an I voice. She also feels free to fictionalize experience, and isn\u27t worried about being misinterpreted. Sexton talks about a progression in her poems from madness and sin to love and God, but feels that sin is a theme she has carried throughout.https://digitalcommons.brockport.edu/writers_videos/1036/thumbnail.jp

Privately Answering Queries on Skewed Data via Per Record Differential Privacy

We consider the problem of the private release of statistics (like aggregate payrolls) where it is critical to preserve the contribution made by a small number of outlying large entities. We propose a privacy formalism, per-record zero concentrated differential privacy (PzCDP), where the privacy loss associated with each record is a public function of that record's value. Unlike other formalisms which provide different privacy losses to different records, PzCDP's privacy loss depends explicitly on the confidential data. We define our formalism, derive its properties, and propose mechanisms which satisfy PzCDP that are uniquely suited to publishing skewed or heavy-tailed statistics, where a small number of records contribute substantially to query answers. This targeted relaxation helps overcome the difficulties of applying standard DP to these data products.Comment: 14 pages, 5 figure

Union

The colored engraving depicts Abraham Lincoln (reworked over John Calhoun) and other statesmen: Winfield Scott, Lewis Cass, Henry Clay, Daniel Webster, Millard Fillmore, Howell Cobb of Georgia, James McDowell, Thomas Hart Benton of Missouri, John M. Clayton of Delaware, Thomas Corwin, James Buchanan, Stephen A. Douglas, John J. Crittenden, Sam Houston of Texas, Henry Foote of Mississippi, Willie P. Mangum of North Carolina, W. R. King of Alabama, Daniel S. Dickinson of New York, John McLean of Ohio, John Bell of Tennessee, and John C. Fremont of Californiahttps://scholarsjunction.msstate.edu/fvw-prints/1019/thumbnail.jp

Severe Spotted Fever Group Rickettsiosis, Australia

We report 3 cases of spotted fever group rickettsial infection (presumed Queensland tick typhus) in residents of northern Queensland, Australia, who had unusually severe clinical manifestations. Complications included renal failure, purpura fulminans, and severe pneumonia. Clinical illness caused by Rickettsia australis may not be as benign as previously described

Assessment of biological responses of EpiAirway 3-D cell constructs versus A549 cells for determining toxicity of ambient air pollution

EpiAirway™ 3-D constructs are human-derived cell cultures of differentiated airway epithelial cells that may represent a more biologically relevant model of the human lung. However, limited information is available of its utility for exposures to air pollutants at the air-liquid interface (ALI)

Turn off the Tap: Behavioural messages increase water efficiency during toothbrushing

Reducing consumer demand is part of a multidimensional strategy to increase water resilience. Theory-based ‘nudges’ or behaviour-change strategies may be effective at reducing demand at little cost. This paper reports a unique partnership between GlaxoSmithKline, water utility Anglian Water, and researchers at the University of East Anglia. Two experimental studies drawing on the strengths of these organizations investigated a behaviour change intervention designed to reduce water usage when toothbrushing. Study 1 tested the efficacy of three theory-based behavioural messages (social norms, ingroup norms, and collective efficacy) designed to encourage participants (N = 164) to turn off the tap whilst brushing teeth. In an actual toothbrushing scenario, all three messages proved to be effective compared to a no-treatment control condition. In study 2, homes in Newmarket, Suffolk (N = 382) were given toothbrushing packs containing a collective efficacy message that highlighted turning off the tap while toothbrushing. Smart-meter recorded water usage was obtained for three weeks before and three weeks after receiving the toothbrushing packs. Household water usage significantly decreased after receiving the packs. A control group of N = 382 households did not show a significant decrease in water usage during this timeframe. These studies suggest that behavioural messages from public or private companies can be effective in reducing real-world water usage while toothbrushing. This model of collaboration between industry, water utilities, and academics can serve as a model of best practice for public and private companies interested in reducing household water usage

Bayesian and Frequentist Semantics for Common Variations of Differential Privacy: Applications to the 2020 Census

The purpose of this paper is to guide interpretation of the semantic privacy guarantees for some of the major variations of differential privacy, which include pure, approximate, R\'enyi, zero-concentrated, and $f$ differential privacy. We interpret privacy-loss accounting parameters, frequentist semantics, and Bayesian semantics (including new results). The driving application is the interpretation of the confidentiality protections for the 2020 Census Public Law 94-171 Redistricting Data Summary File released August 12, 2021, which, for the first time, were produced with formal privacy guarantees