The authors describe why and how different types of simulations can be used to understand and support the challenges of utility deregulation. They present an overview of liberalization and deregulation efforts in three utility markets - electricity, natural gas, and drinking water - and describe the main challenges and opportunities for regulators and business managers. A general classification of seven different types of simulation is presented, including market simulations, policy simulations, dynamic business simulations, capability simulations, day-in-a-life simulations, performance simulations, and gaming simulations. The authors reflect on the role of these simulations for utility deregulation and give examples.
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Abstract: Background: There has been a rapid increase in the population of senior citizens in many countries. The shortage of caregivers is becoming a pressing concern. Robots are being deployed in an attempt to fill this gap and reduce the workload of caregivers. This study explores how healthcare robots are perceived by trainee care professionals. Methods: A total of 2365 students at different vocational levels completed a questionnaire, rating ethical statements regarding beneficence, maleficence, justice, autonomy, utility, and use intentions with regard to three different types of robots (assistive, monitoring, and companion) along with six control variables: gender, age, school year, technical skills, interest in technology, and enjoying working with computers.
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OBJECTIVES: Amplitude-mode (A-mode) ultrasonography is a promising technique to monitor loss and recovery of skeletal muscle in patients with burns. However, its clinimetric properties are unknown. Therefore, we determined its feasibility, interrater, and intrarater reliability, and clinical utility.METHODS: Skeletal muscle thickness of upper arms and legs was assessed longitudinally in hospitalized adult patients with ≥ 5 % total body surface area (TBSA) burns, by pairs of two out of five raters. Feasibility was evaluated by % successful assessments, reliability by intra-class correlation coefficients (ICCs), and clinical utility by smallest detectable change (SDC).RESULTS: Thirty-four patients participated (77 % male; mean age 48 ± 17 y, median TBSA burned 12 % [IQR 7-19]). Images were acquired on 69 % of planned occasions, and 89 % of images could be analyzed. Overall interrater ICCs were ≥ 0.84 (for pairs: 0.63-0.99) and intrarater ICCs were ≥ 0.95 (for pairs: 0.45-0.99). The overall interrater SDC was ≤ 33 % of the measured mean (for pairs: 3-52 %), while intrarater SDC was ≤ 20 % (for pairs: 3-48 %). All five raters could measure legs with moderate to excellent reliability, whereas for arms some demonstrated poor reliability.CONCLUSION: A-mode ultrasonography assessment of skeletal muscle in patients with burns is feasible. However, reliability and clinical utility are rater-dependent; therefore we recommend assessments by the same rater.
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Background Total laryngectomy with or without adjuvant (chemo)radiation often induces speech, swallowing and neck and shoulder problems. Speech, swallowing and shoulder exercises may prevent or diminish these problems. The aim of the present paper is to describe the study, which is designed to investigate the effectiveness and cost-utility of a guided self-help exercise program built into the application “In Tune without Cords” among patients treated with total laryngectomy. Methods/design Patients, up to 5 years earlier treated with total laryngectomy with or without (chemo)radiation will be recruited for participation in this study. Patients willing to participate will be randomized to the intervention or control group (1:1). Patients in the intervention group will be provided access to a guided self-help exercise program and a self-care education program built into the application “In Tune without Cords”. Patients in the control group will only be provided access to the self-care education program. The primary outcome is the difference in swallowing quality (SWAL-QOL) between the intervention and control group. Secondary outcome measures address speech problems (SHI), shoulder disability (SDQ), quality of life (EORTC QLQ-C30, QLQ-H&N35 and EQ-5D), direct and indirect costs (adjusted iMCQ and iPCQ measures) and self-management (PAM). Patients will be asked to complete these outcome measures at baseline, immediately after the intervention or control period (i.e. at 3 months follow-up) and at 6 months follow-up. Discussion This randomized controlled trial will provide knowledge on the effectiveness of a guided self-help exercise program for patients treated with total laryngectomy. In addition, information on the value for money of such an exercise program will be provided. If this guided self-help program is (cost)effective for patients treated with total laryngectomy, the next step will be to implement this exercise program in current clinical practice.
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Rapid convergence of utility and mobility solutions enabled by data and the Internet of Things is future-proofing economies around the world, delivering liveability, sustainability and resilience, and importantly decreasing pressure on utility bills and infrastructure costs. Australians cannot miss out on the many benefits brought to families and businesses by the digitisation of infrastructure and services, not just reduced household bills but also the ability to generate income as prosumers, not consumers. Localised sustainable Next-Gen infrastructure and services are growing from within communities, creating a new class of consumer-the prosumer: where customers are more than consumers but also producers. Prosumers have the ability to generate free energy from the sun at home or office and sell the excess, recycle water and waste reaping the financial benefit, avoid the second largest household expense of a car by sharing mobility, and access shared data networks to plug in and play at little cost. Planning frameworks play a critical role in enabling a new utility prosumer future in Australia and reform of planning gateway processes is essential. This article highlights Sydney’s Central Park as a best practice urban infill development showcasing how the flows of water and energy are organised to provide enhanced sustainability, liveability and resilience for the local and neighbouring communities. Central Park proves the benefits of taking a precinct approach to utility and mobility services. It shows how these benefits can grow and be exported to neighbouring buildings and existing communities, in this case University of Technology driving inclusion and affordability. Central Park also demonstrates the opportunities to drive deeper socio/environmental benefits by enabling prosumer services through low-cost access to utility services and circular resource flows. Importantly, this article demonstrates that Central Park’s phenomenal sustainability benefits can be replicated at scale in land release communities, but planning reform is required.
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The user’s experience with a recommender system is significantly shaped by the dynamics of user-algorithm interactions. These interactions are often evaluated using interaction qualities, such as controllability, trust, and autonomy, to gauge their impact. As part of our effort to systematically categorize these evaluations, we explored the suitability of the interaction qualities framework as proposed by Lenz, Dieffenbach and Hassenzahl. During this examination, we uncovered four challenges within the framework itself, and an additional external challenge. In studies examining the interaction between user control options and interaction qualities, interdependencies between concepts, inconsistent terminology, and the entity perspective (is it a user’s trust or a system’s trustworthiness) often hinder a systematic inventory of the findings. Additionally, our discussion underscored the crucial role of the decision context in evaluating the relation of algorithmic affordances and interaction qualities. We propose dimensions of decision contexts (such as ‘reversibility of the decision’, or ‘time pressure’). They could aid in establishing a systematic three-way relationship between context attributes, attributes of user control mechanisms, and experiential goals, and as such they warrant further research. In sum, while the interaction qualities framework serves as a foundational structure for organizing research on evaluating the impact of algorithmic affordances, challenges related to interdependencies and context-specific influences remain. These challenges necessitate further investigation and subsequent refinement and expansion of the framework.
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Reinstatement of memory-related neural activity measured with high temporal precision potentially provides a useful index for real-time monitoring of the timing of activation of memory content during cognitive processing. The utility of such an index extends to any situation where one is interested in the (relative) timing of activation of different sources of information in memory, a paradigm case of which is tracking lexical activation during language processing. Essential for this approach is that memory reinstatement effects are robust, so that their absence (in the average) definitively indicates that no lexical activation is present. We used electroencephalography to test the robustness of a reported subsequent memory finding involving reinstatement of frequency-specific entrained oscillatory brain activity during subsequent recognition. Participants learned lists of words presented on a background flickering at either 6 or 15 Hz to entrain a steady-state brain response. Target words subsequently presented on a non-flickering background that were correctly identified as previously seen exhibited reinstatement effects at both entrainment frequencies. Reliability of these statistical inferences was however critically dependent on the approach used for multiple comparisons correction. We conclude that effects are not robust enough to be used as a reliable index of lexical activation during language processing.
MULTIFILE
Purpose - Focusing on management training, this study aimed to establish whether identical elements in a training program (i.e. aspects resembling participants' work situation) can improve training transfer and whether they do so beyond the contribution of two well-established predictors -- motivation to learn and expected utility. In an effort to establish mechanisms connecting identical elements with training transfer, we proposed and tested motivation to transfer as a mediator. Design/methodology/approach - Data were collected online from 595 general managers who participated in a management training program. Structural equations modeling was used to test the model. Findings - Identical elements, expected utility and motivation to learn each had a unique contribution to the prediction of training transfer. Whereas motivation to learn partly mediated these relationships, identical elements and expected utility also showed direct associations with training transfer. Research limitations/implications - Identical elements represent a relevant predictor of training transfer. In future research, a longitudinal analysis from different perspectives would be useful to better understand the process of training transfer. Practical implications - Participants may profit more from management training programs when the training better resembles participants' work situation. Organisations and trainers should therefore apply the concept of identical elements in their trainings, in order to increase its value and impact. Originality/value - This study contributes to the training literature by showing the relevance of identical elements for transfer, over and above established predictors.
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We applaud many of the sentiments put forward by Cohen et al in their critique of language and logic in pain medicine. 8 Pleas to avoid conflation between nociception and pain are not new - “The mislabelling of nociceptors as pain fibres was not an elegant simplification but a most unfortunate trivialisation of pain”29 ; “.. we don't actually have ‘pain receptors’, or ‘pain nerves’ or ‘pain pathways’ or ‘pain centres.’”4 We are among those who see such conflation as contrasting with contemporary understandings of ‘how pain works’ and undermining evidence-based treatment approaches.
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The Kennedy Axis V is a routine outcome measurement instrument which can assist the assessment of the short-term risk for violence and other adverse patient outcomes. The purpose of this study was to evaluate the interrater reliability and clinical utility of the instrument when used by mental health nurses in daily care of patients with mental illness. This cross-sectional study was conducted in inpatient and outpatient adult psychiatric care units and in one adolescent inpatient unit at a university hospital in the Netherlands. Interrater reliability was measured based on the independent scores of two different nurses for the same patients. The clinical utility of the instrument was evaluated by means of a clinical utility questionnaire. To gain a deeper understanding of rating difficulties at the adolescent unit, additional data were collected in two focus group interviews. The overall results revealed a substantial level of agreement between nurses (intraclass correlation coefficient and Pearson 0.79). Some rating challenges were identified, including difficulties with scoring the instrument and using tailor-made interventions related to the scores. These challenges can be resolved using refined training and implementation strategies. When the Kennedy Axis V is accompanied by a solid implementation strategy in adult mental health care, the instrument can be used for short-term risk assessment and thereby contribute in efforts to reduce violence, suicide, self-harm, severe selfneglect, and enhanced objectivity in clinical decision-making.
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