Team Cognition for Coordinated Decision-Making during Hurricane Harvey: A Case Study from Interviews with Responding Commanders

PresentationTo protect and assist threatened populations and infrastructures in response to natural and man- made disasters, emergency responders from diverse backgrounds collectively work as ad hoc teams. However, responders’ coordinated decision-making in real-time has not been adequately addressed in terms of team cognition. Here team cognition is a binding mechanism that produces coordinated behaviors among responders (adapted from Fiore & Salas, 2004). We are particularly interested in cognition of an incident management team (IMT), an ad hoc strategic decision-making team of command-level responders co-located at the incident command post of major incidents such as Hurricane Harvey. To develop and provide an incident action plan to subordinate branch directors in the field, an IMT continuously manages information based on incoming cues from outside, following a cyclical planning process. Interestingly, an IMT is a team of functional sub-teams, and each sub-team is also a team of functional units. The purpose of this on-going case study is to investigate the role of team cognition for coordinated real-time decision-making in emergency response, through a case study of a recent disaster, Hurricane Harvey. During the interviews with subject matter experts (SMEs, i.e., responding commanders worked during Hurricane Harvey), we asked how responding commanders as a cognitive system-of-systems (or a team-of-teams) continuously made coordinated decisions, especially in terms of communication and information management. In a prior work, a P∙D∙A (Perceive∙Diagnose∙Adapt) model, a theoretical interactionist model of team cognition in emergency response, was proposed as a proof-of-concept that depicts nonlinear, interdependent, and dynamic interactions observed within and among three functional sub-teams of a planning team of an IMT at a simulated incident command post (Moon, Son, Sasangohar, Peres, & Neville, 2018). Through interviews with SMEs, this case study is expected to validate the P∙D∙A model

Predictors of Hospital Readmissions for People with Chronic Conditions

Background: Hospital readmissions remain prominent in health care. Functional, cognitive, and environmental factors predict hospital readmissions but may not be thoroughly measured or addressed prior to discharge. Method: In this cross-sectional study, people hospitalized with chronic conditions completed measures of self-care function, functional cognition, occupational competence, and environmental impact. They also participated in a phone call or medical records review to identify hospital readmissions within 30 days of discharge. In a group session, occupational therapists who work in acute care completed acceptability, appropriateness, and feasibility measures for the standardized assessments administered to hospital participants. Results: Occupational competence and functional cognition were significant predictors of hospital readmissions. Therapists rated the Activity Measure of Post-Acute Care (AM-PAC) as the most acceptable, appropriate, and feasible measure for acute care. Conclusions: Occupational competence and functional cognition are predictors of hospital readmissions in people with chronic conditions. Occupational therapists in acute care should consider supplementing current evaluation practices with standardized measures of functional cognition and occupational competence to identify client needs objectively and initiate post-acute referrals that help clients discharge home successfully. Standardized measures, such as the AM-PAC may be feasible in acute care. Further research on the efficacy of standardized measures in this setting is needed

Predictors of Occupational Competence in People Hospitalized with Chronic Conditions

Background: Chronic diseases limit participation in meaningful daily activities, roles, and routines, which can negatively impact occupational competence, a sense of self, and life satisfaction, especially when hospitalization is required to manage disease symptoms. Standardized measures of occupational competence and related functional, cognitive, and environmental factors may enhance occupational therapists’ ability to identify potential barriers to and make targeted recommendations for self- and health management in the community. Method: This cross-sectional study investigated occupational competence in patients hospitalized with chronic conditions. The participants completed measures of occupational competence, values, self-care function, environmental impact, and functional cognition while hospitalized. Results: The participants (n = 51) reported moderate to high levels of occupational competence. The overall regression model was significant. Values, self-care function, and environmental impact were significant predictors of occupational competence. Conclusion: Values, self-care function, and environmental impact predict occupational competence in people hospitalized with chronic conditions. Occupational therapists should incorporate standardized measures of occupational competence, values, self-care function, and environmental impact into current evaluation practices to support recommendations for follow-up care and community supports. Future research should include a larger sample that is more representative of an occupational therapy caseload and incorporate alternative measures of functional cognition to better measure this construct

Two-Stage Passive Vibration Isolator

The design and testing of a structural system were implemented to hold the optics of the planned Space Interferometry Mission (SIM) at positions and orientations characterized by vibrational translation and rotation errors of no more than a few nanometers or a few milliarcseconds, respectively. Much of the effort was devoted to a test bed for verifying the predicted behavior of a vibration- isolation structural subsystem working together with an active control system for positioning and orienting the SIM optics. There was considerable emphasis on the vibration-isolation subsystem, which was passive and comprised two stages. The main sources of vibration were six reaction wheels in an assembly denoted the "backpack." The first vibration-isolation stage consisted of hexapod isolator mounts - one for each reaction wheel - characterized by a natural vibration frequency of 10 Hz. The second stage was a set of three beams, disposed between the backpack and the structure that held the SIM optics, that were flexured such that they transmitted only bending loads, with a natural vibrational frequency and damping of about 5 Hz and 4 percent, respectively. Preliminary test results were presented and characterized as demonstrating the effectiveness of the two-stage vibration-isolation design

Freeze casting of porous monolithic composites for hydrogen storage

Hydrogen storage by adsorption offers operational benefits over energy intensive compression techniques. Incorporating physisorption materials in compression stores could improve hydrogen capacities, reducing the volume or pressure needed for storage vessels. However, such materials are often presented as fine powders and development efforts to date have predominantly focused on improving hydrogen uptake alone. Without due attention to industry-relevant attributes, such as handling, processability, and mechanical properties it is unlikely that these materials will find commercial application. In the paper, the desirable mechanical properties of hydrogen-adsorbent PIM-1 are exploited to yield a series of composite monoliths doped with a high surface area activated carbon, intended to act as pressure vessel inserts. Freeze casting techniques were successfully adapted for use with chloroform, facilitating the production of coherent and controlled three-dimensional geometries. This included the use of an innovative elastomeric mould made by additive manufacture to allow facile adoption, with the ability to vary multiple forming factors in the future. The composite monolith formed exhibited a stiffness of 0.26 GPa, a compressive strength of 6.7 MPa, and an increased BET surface area of 847 m2 g−1 compared to PIM-1 powders, signifying the first steps towards producing hydrogen adsorbents in truly useful monolithic forms

Scandium separation from tungsten crucibles : preliminary investigation into the separation of scandium metal from tungsten metal crucibles using an acid soak process.

The first step in an attempt to isolate Sco from a Wo crucible was explored by soaking the samples in a series of organic (HOAc) and inorganic (HCl, H2SO4, H3PO4, HNO3) acids. All samples, except the HOAc, yielded a powder. The weight loss suggests that HNO3 is the most efficient solvent; however, the powders were tentatively identified by PXRD and found to contain both W and Sc by-products. The higher weight loss may also indicate dissolution of the Wo crucible, which was further evidenced upon visual inspection of the crucible. The H3PO4 acid soak yielded the cleanest removal of Sc from the crucible. More work to understand the separation of the Sco from the Wo crucible is necessary but the acid routes appear to hold promise under not as of yet established criteria

Health and mortality consequences of abdominal obesity : evidence from the AusDiab study

Objective: To provide an estimate of the morbidity and mortality resulting from abdominal overweight and obesity in the Australian population.Design and setting: Prospective, national, population-based study (the Australian Diabetes, Obesity and Lifestyle [AusDiab] study).Participants: 6072 men and women aged ≥ 25 years at study entry between May 1999 and December 2000, and aged ≤ 75 years, not pregnant and for whom there were waist circumference data at the follow-up survey between June 2004 and December 2005.Main outcome measures: Incident health outcomes (type 2 diabetes, hypertension, dyslipidaemia, the metabolic syndrome and cardiovascular diseases) at 5 years and mortality at 8 years. Comparison of outcome measures between those classified as abdominally overweight or obese and those with a normal waist circumference at baseline, and across quintiles of waist circumference, and (for mortality only) waist-to-hip ratio.Results: Abdominal obesity was associated with odds ratios of between 2 and 5 for incident type 2 diabetes, dyslipidaemia, hypertension and the metabolic syndrome. The risk of myocardial infarction among obese participants was similarly increased in men (hazard ratio [HR], 2.75; 95% CI, 1.08–7.03), but not women (HR, 1.43; 95% CI, 0.37–5.50). Abdominal obesity-related population attributable fractions for these outcomes ranged from 13% to 47%, and were highest for type 2 diabetes. No significant associations were observed between all-cause mortality and increasing quintiles of abdominal obesity.Conclusions: Our findings confirm that abdominal obesity confers a considerably heightened risk for type 2 diabetes, the metabolic syndrome (as well as its components) and cardiovascular disease, and they provide important information that enables a more precise estimate of the burden of disease attributable to obesity in Australia

Evaluating Active U: an Internet-mediated physical activity program.

Background: Engaging in regular physical activity can be challenging, particularly during the winter months. To promote physical activity at the University of Michigan during the winter months, an eight-week Internet-mediated program (Active U) was developed providing participants with an online physical activity log, goal setting, motivational emails, and optional team participation and competition. Methods: This study is a program evaluation of Active U. Approximately 47,000 faculty, staff, and graduate students were invited to participate in the online Active U intervention in the winter of 2007. Participants were assigned a physical activity goal and were asked to record each physical activity episode into the activity log for eight weeks. Statistics for program reach, effectiveness, adoption, and implementation were calculated using the Re-Aim framework. Multilevel regression analyses were used to assess the decline in rates of data entry and goal attainment during the program, to assess the likelihood of joining a team by demographic characteristics, to test the association between various predictors and the number of weeks an individual met his or her goal, and to analyze server load. Results: Overall, 7,483 individuals registered with the Active U website (≈16% of eligible), and 79% participated in the program by logging valid data at least once. Staff members, older participants, and those with a BMI < 25 were more likely to meet their weekly physical activity goals, and average rate of meeting goals was higher among participants who joined a competitive team compared to those who participated individually (IRR = 1.28, P < .001). Conclusion: Internet-mediated physical activity interventions that focus on physical activity logging and goal setting while incorporating team competition may help a significant percentage of the target population maintain their physical activity during the winter months

Refinement of Saliva MicroRNA Biomarkers for Sports-Related Concussion

Purpose Recognizing sport-related concussion (SRC) is challenging and relies heavily on subjective symptom reports. An objective, biological marker could improve recognition and understanding of SRC. There is emerging evidence that salivary micro-ribonucleic acids (miRNAs) may serve as biomarkers of concussion; however, it remains unclear whether concussion-related miRNAs are impacted by exercise. We sought to determine whether 40 miRNAs previously implicated in concussion pathophysiology were affected by participation in a variety of contact and non-contact sports. Our goal was to refine a miRNA-based tool capable of identifying athletes with SRC without the confounding effects of exercise. Methods This case-control study harmonized data from concussed and non-concussed athletes recruited across 10 sites. Levels of salivary miRNAs within 455 samples from 314 individuals were measured with RNA sequencing. Within-subjects testing was used to identify and exclude miRNAs that changed with either: (a) a single episode of exercise (166 samples from 83 individuals) or (b) season-long participation in contact sports (212 samples from 106 individuals). The miRNAs that were not impacted by exercise were interrogated for SRC diagnostic utility using logistic regression (172 samples from 75 concussed and 97 non-concussed individuals). Results Two miRNAs (miR-532-5p, miR-182-5p) decreased (adjusted p \u3c 0.05) after a single episode of exercise, and 1 miRNA (miR-4510) increased only after contact sports participation. Twenty-three miRNAs changed at the end of a contact sports season. Two of these miRNAs (miR-26b-3p, miR-29c-3p) were associated (R \u3e 0.5; adjusted p \u3c 0.05) with the number of head impacts sustained in a single football practice. Among the 15 miRNAs not confounded by exercise or season-long contact sports participation, 11 demonstrated a significant difference (adjusted p \u3c 0.05) between concussed and non-concussed participants, and 6 displayed moderate ability (AUC \u3e 0.70) to identify concussion. A single ratio (miR-27a-5p/miR-30a-3p) displayed the highest accuracy (AUC = 0.810, sensitivity = 82.4%, specificity = 73.3%) for differentiating concussed and non-concussed participants. Accuracy did not differ between participants with SRC and non-SRC (z = 0.5, p = 0.60). Conclusion Salivary miRNA levels may accurately identify SRC when not confounded by exercise. Refinement of this approach in a large cohort of athletes could eventually lead to a non-invasive, sideline adjunct for SRC assessment