Fast and frugal models of clinical judgement in novice and expert physicians

Our objective was to study whether “compensatory” models provide better descriptions of clinical judgment than fast and frugal models, according to expertise and experience. Fifty practitioners appraised 60 vignettes describing a child with an exacerbation of asthma and rated their propensities to admit the child. Linear logistic (LL) models of their judgments were compared with a matching heuristic (MH) model that searched available cues in order of importance for a critical value indicating an admission decision. There was a small difference between the 2 models in the proportion of patients allocated correctly (admit or not-admit decisions), 91.2% and 87.8%, respectively. The proportion allocated correctly by the LL model was lower for consultants than juniors, whereas the MH model performed equally well for both. In this vignette study, neither model provided any better description of judgments made by consultants or by pediatricians compared to other grades and specialties.

An innovative approach to integrated medicines management

To determine whether an increased input by clinical pharmacists at each stage of the patient's hospital journey, from admission through discharge, resulted in an enhanced level of patient care as measured by a number of clinical and economic outcomes.

Impact of operator experience on information feedback and reusability

Keeping a record of operator experience remains a challenge to operation management and a major source of inefficiency in information management. The objective is to develop a framework that enables an explicit presentation of experience based on information use. A purposive sampling method is used to select four small and medium-sized enterprises as case studies. The unit of analysis is the production process in the machine shop. Data collection is by structured interview, observation and documentation. A comparative case analysis is applied. The findings suggest experience is an accumulation of tacit information feedback, which can be made explicit in information use interoperatability matrix. The matrix is conditioned upon information use typology, which is strategic in waste reduction. The limitations include difficulty of participant anonymity where the organisation nominates a participant. Areas for further research include application of the concepts to knowledge management and shop floor resource management.

Secure D2D Communication in Large-Scale Cognitive Cellular Networks: A Wireless Power Transfer Model

In this paper, we investigate secure device-to-device (D2D) communication in energy harvesting large-scale cognitive cellular networks. The energy constrained D2D transmitter harvests energy from multiantenna equipped power beacons (PBs), and communicates with the corresponding receiver using the spectrum of the primary base stations (BSs). We introduce a power transfer model and an information signal model to enable wireless energy harvesting and secure information transmission. In the power transfer model, three wireless power transfer (WPT) policies are proposed: 1) co-operative power beacons (CPB) power transfer, 2) best power beacon (BPB) power transfer, and 3) nearest power beacon (NPB) power transfer. To characterize the power transfer reliability of the proposed three policies, we derive new expressions for the exact power outage probability. Moreover, the analysis of the power outage probability is extended to the case when PBs are equipped with large antenna arrays. In the information signal model, we present a new comparative framework with two receiver selection schemes: 1) best receiver selection (BRS), where the receiver with the strongest channel is selected; and 2) nearest receiver selection (NRS), where the nearest receiver is selected. To assess the secrecy performance, we derive new analytical expressions for the secrecy outage probability and the secrecy throughput considering the two receiver selection schemes using the proposed WPT policies. We presented Monte carlo simulation results to corroborate our analysis and show: 1) secrecy performance improves with increasing densities of PBs and D2D receivers due to larger multiuser diversity gain; 2) CPB achieves better secrecy performance than BPB and NPB but consumes more power; and 3) BRS achieves better secrecy performance than NRS but demands more instantaneous feedback and overhead. A pivotal conclusion- is reached that with increasing number of antennas at PBs, NPB offers a comparable secrecy performance to that of BPB but with a lower complexity.

Is there really "nothing you can do"? Pathways to enhanced flood-risk preparedness

Whilst policy makers have tended to adopt an ‘information-deficit model’ to bolster levels of flood-risk preparedness primarily though communication strategies promoting awareness, the assumed causal relation between awareness and preparedness is empirically weak. As such, there is a growing interest amongst scholars and policy makers alike to better understand why at-risk individuals are underprepared. In this vein, empirical studies, typically employing quantitative methods, have tended to focus on exploring the extent to which flood-risk preparedness levels vary depending not only on socio-demographic variables, but also (and increasingly so) the perceptual factors that influence flood risk preparedness. This study builds upon and extends this body of research by offering a more solution-focused approach that seeks to identify how pathways to flood-risk preparedness can be opened up. Specifically, through application of a qualitative methodology, we seek to explore how the factors that negatively influence flood-risk preparedness can be addressed to foster a shift towards greater levels of mitigation behaviour. In doing so, we focus our analysis on an urban community in Ireland that is identified as ‘at risk’ of flash flooding and is currently undergoing significant flood relief works. In this regard, the case study offers an interesting laboratory to explore how attitudes towards flood-risk preparedness at the individual level are being influenced within the context of a flood relief scheme that is only partially constructed. In order to redress the dearth of theoretically informed qualitative studies in this field, we draw on Protection Motivation Theory (PMT) to help guide our analysis and make sense of our results. Our findings demonstrate that flood-risk preparedness can be undermined by low levels of efficacy amongst individuals in terms of the preparedness measures available to them and their own personal capacity to implement them. We also elucidate that the ‘levee effect’ can occur before engineered flood defences are fully constructed as the flood relief works within our case study are beginning to affect people’s perception of flood risk in the case study area. We conclude by arguing that 1) individuals’ coping appraisals need to be enhanced through communication strategies and other interventions which highlight that future floods may not replicate past events; and 2) the concept of residual risk needs to be communicated at all stages of a flood relief scheme, not just upon completion.