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WAAGE, SISSEL. "Collaborative Salmon Recovery Planning:Examining Decision Making and Implementationin Northeastern Oregon." Society & Natural Resources 16, no. 4 (2003): 295–307. http://dx.doi.org/10.1080/08941920390178865.
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Dakins, Maxine E., Jeffery D. Long, and Michael Hart. "COLLABORATIVE ENVIRONMENTAL DECISION MAKING IN OREGON WATERSHED GROUPS: PERCEPTIONS OF EFFECTIVENESS." Journal of the American Water Resources Association 41, no. 1 (2005): 171–80. http://dx.doi.org/10.1111/j.1752-1688.2005.tb03726.x.
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Eddy, D. M. "Clinical decision making: from theory to practice. What's going on in Oregon?" JAMA: The Journal of the American Medical Association 266, no. 3 (1991): 417–20. http://dx.doi.org/10.1001/jama.266.3.417.
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Peterson, Larry L. "The Oregon resource interaction model: an application of systems energetics principles to decision-making in Oregon state government—1974." Ecological Modelling 178, no. 1-2 (2004): 169–70. http://dx.doi.org/10.1016/j.ecolmodel.2003.12.029.
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Tricker, Raymond, and Declan Connolly. "Drug Education and the College Athlete: Evaluation of a Decision-Making Model." Journal of Drug Education 26, no. 2 (1996): 159–81. http://dx.doi.org/10.2190/11q1-r721-qtwj-r6a5.
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In general there is a lack of information describing the components and structure of drug education and prevention programs (DEPP) for college student athletes. While concern about the prevalence of drug abuse among college student athletes has increased, a relative lack of clarity remains regarding what elements of drug education prevention programs have been successful or unsuccessful in this setting. In an effort to address this issue at Oregon State University a two-credit ten-week DEPP was implemented as a requirement for all collegiate athletes. This article describes the evaluation of this program. Altogether 635 student athletes from three National Collegiate Athletic Association (NCAA) Division One universities provided data in this two-year evaluation project. Participants were student athletes from Oregon State University (OSU), a Mid-Western University (MWU), and another Pacific North-Western University (PNWU). Pre- and post-test data were collected regarding knowledge about drugs, attitudes toward drug use, drug use, and decision-making factors. Students at OSU and MWU were enrolled in a structured DEPP, and the third group from PNWU was used as a control and did not receive regular instruction. The baseline data taken before the drug education course indicated that athletes at OSU, MWU, and PNWU were no different in their knowledge of drugs, attitudes toward drugs, or perception of the value of drug education in preventing drug abuse among student athletes. However, the data at the end of the ten-week course revealed many significant improvements among OSU and MWU students athletes, in knowledge, attitude related to performance enhancing drugs and recreational drugs, and perceptions of drug education. At the end of the course 88 percent of the participating OSU athletes agreed that drug education can be effective in preventing drug abuse among student athletes.
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Olsen, J. L., and C. D. Boyer. "420 Integrating Extension Field Faculty Into Academic Homes: The Oregon State University Experience." HortScience 34, no. 3 (1999): 516D—516. http://dx.doi.org/10.21273/hortsci.34.3.516d.
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In 1993, then OSU President John Byrne declared that: “All Extension Service faculty, county agents as well as specialists, will be assigned academic colleges, and will have an academic appointment in the appropriate college.” The selection of the academic home would involve a mutual agreement between the individual and the department and would take into consideration the faculty member's academic training, experience, and work assignment. The implementation of this decision was completed by July 1995. In the College of Agricultural Sciences, this assignment of faculty to academic homes was accommodated by adding county agents to the faculty of existing departments. The Dept. of Horticulture faculty numbers nearly doubled, with an increase from 34 to 58. The department head is now very involved in the annual review and salary administration of extension field faculty. Campus-based faculty are now involved in all of the hiring, promotion, and tenure decisions for extension field faculty and vice versa. Field faculty participate in departmental decision making. The change in the number and diversity of faculty in the department is a unique effort to unify programmatic focus for extension, research, and teaching at OSU. As a work in progress, many issues are being addressed including full faculty participation in the decision-making process, communication, evaluation of scholarship, and building departmental community. Successes, pitfalls, and challenges ahead will be discussed and illustrated.
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Castagnoli, Steven P. "Internet-based Decision Tools for Orchard Pest Management—Adoption in the Hood River Valley of Oregon." HortTechnology 16, no. 1 (2006): 133–38. http://dx.doi.org/10.21273/horttech.16.1.0133.
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The Internet has expanded access to real-time decision tools for pest management in agriculture. Starting in 2000, site-specific weather data and decision tools for key insect pests and diseases became available through the Internet to fruit growers and pest control advisors (PCAs) in the Hood River Valley of Oregon. Adoption of these decision tools was supported by educational programs conducted by extension. In this study, surveys were conducted to assess the importance of different sources of pest management information and the adoption of four Internet-based pest management decision tools by fruit growers and PCAs in the Hood River Valley. Growers relied on diverse sources for pest management information and ranked PCAs as the most important source for making pest management decisions. Grower use of the Internet-based pest management decision tools was relatively low despite computer ownership and Internet use that were higher than national trends. Growers preferred the website that provided the most complete access to up-to-date weather data and pertinent pest and disease models, despite somewhat less streamlined access. PCA use of the decision tools was proportionately higher, and included greater use of additional websites. Both growers and PCAs considered use of the Internet tools to have important benefits on pest management programs. In the Hood River Valley, fruit growers had access to technology-driven decision support tools, but continued to rely on more traditional information sources, particularly PCAs, for making pest management decisions. In view of trends in shrinking extension resources, these results suggest that the most efficient use of time and potential for greatest impact can be derived from focusing educational efforts on PCAs.
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DeWeber, J. Tyrell, and James T. Peterson. "Comparing Environmental Flow Implementation Options with Structured Decision Making: Case Study from the Willamette River, Oregon." JAWRA Journal of the American Water Resources Association 56, no. 4 (2020): 599–614. http://dx.doi.org/10.1111/1752-1688.12845.
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Kuonen, Jessica, Flaxen Conway, and Ted Strub. "Relating Ocean Condition Forecasts to the Process of End-User Decision Making: A Case Study of the Oregon Commercial Fishing Community." Marine Technology Society Journal 53, no. 1 (2019): 53–66. http://dx.doi.org/10.4031/mtsj.53.1.1.
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AbstractThis case study is in response to a recognized need to transform short-term regional ocean condition forecast information into useful data products for a range of end users, considering their perceptions of uncertainty and risk associated with these forecasts. It demonstrates the value of user engagement in achieving long-term goals for data providers. Commercial fishermen from Oregon are selected as key information users due to the physically risky and economically uncertain nature of their profession, their expertise at navigating the marine environment, and their important economic and cultural role at the Oregon coast. Semistructured interviews (n = 16) are used to clarify the processes that govern decision making, in terms of risk perception and comfort with uncertainty. The results characterize a community “mental model” in regard to ocean use and ocean forecasts. Findings reveal that commercial fishermen consume and interpret forecast data in a nonlinear fashion by combining multiple sources and data types and with a heavy reliance on real-time data. Our assessment is that improving accuracy at temporal and spatial scales that are relevant to decision making, improving the accessibility of forecasts, and increasing forecast lead time could potentially add more value to forecasts than quantifying and communicating the types of uncertainty metrics used within the scientific community.
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Kuonen, Jessica, Flaxen Conway, and Ted Strub. "Navigating Mental Models of Risk and Uncertainty within the Ocean Forecast System: An Oregon Case Study." Weather, Climate, and Society 11, no. 2 (2019): 431–47. http://dx.doi.org/10.1175/wcas-d-18-0057.1.
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Abstract This case study explores how to add value to regional ocean condition forecast information by bringing awareness to the processes that govern decision-making and outcomes within the system. A modified mental models research approach is applied to examine differences and similarities in perceptions of risk and comfort with uncertainty between two interdependent communities, the ocean “data provider” and “end user,” and how these perceptions impact accessibility and usefulness of data products. In this study, data providers are academic and agency scientists from institutions that provide ocean condition forecasts to public end users (n = 17). End users are members of the Oregon commercial-fishing community (n = 16). Comparisons reveal key differences and similarities related to the nature of each profession that impact perceptions of scale in time and space and reveal the ways that cumulative and intersecting risks and uncertainties act as key drivers in decision-making. Implications for expanding the current understanding of how ocean forecasts are produced and used include 1) highlighting the value of optimizing ocean forecast delivery tools based on end-user needs and information-seeking processes already in place, 2) identifying structural and cultural barriers within the data-provider network that prevent them from doing so, and 3) demonstrating the value of learning about both producers and users of scientific information and suggesting potential ways to structure cooperation and strengthen relationships between them by working toward a common desired outcome.
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Peters, Joyce M., Torry Piazza Templeman, and Glenn Brostrom. "The School and Community Partnership: Planning Transition for Students with Severe Handicaps." Exceptional Children 53, no. 6 (1987): 531–36. http://dx.doi.org/10.1177/001440298705300607.
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This article describes a process to provide solutions to the prevalent problem of interagency collaboration in planning for transition outcomes. The project is implementing and evaluating the process in seven Oregon sites that differed in respect to numbers of students served, rural versus urban, and availability of a range of adult service options. Results to date support the inclusion of procedures such as an outside stimulus to initiate the collaborative effort; locally generated plans; transitions teams empowered with policy-level decision making; and follow-up technical assistance at the administrative and direct service level.
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Mondragón, Jaime D., Latife Salame, Arnoldo Kraus, and Peter Paul De Deyn. "Clinical Considerations in Physician-Assisted Death for Probable Alzheimer’s Disease: Decision-Making Capacity, Anosognosia, and Suffering." Dementia and Geriatric Cognitive Disorders Extra 9, no. 2 (2019): 217–26. http://dx.doi.org/10.1159/000500183.
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Background: Requests for physician-assisted death (PAD) in patients with cognitive impairment are complex and require careful consideration. Of particular difficulty is determination of whether the request is voluntary and well considered. Results: Euthanasia and physician-assisted suicide (PAS) are both legal in The Netherlands, Luxemburg, Colombia, and Canada. Euthanasia is legal in Belgium, while PAS is legal in Switzerland and Oregon, Washington, Montana, Vermont, and California (USA). Upon a PAD request, evaluation of the capacity to consent medical treatment is relevant for the decision-making process, while evaluation of testamentary capacity is appropriate before an advance euthanasia directive is written. Anosognosia assessment throughout the Alzheimer’s disease continuum provides essential and relevant information regarding the voluntary and well-considered nature of the PAD request; meanwhile, early assessment of hypernosognosia or subjective cognitive decline assists in formulation of a clinical prognosis. Furthermore, the assessment of physical and psychological suffering should incorporate verbal and nonverbal cues as well as consideration of the psychosocial factors that might affect due care criteria. Conclusion: The clinical approach to a PAD request should consider the legal framework and the decision-making capacity, assess memory deficit awareness and the perception of suffering, and evaluate mental competency when considered pertinent.
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Bouranis, Nicole, Sherril Gelmon, Elizabeth Needham Waddell, Dawn Richardson, Hyeyoung Woo, and Allison Lindauer. "Improving Dementia Clinical Research Participation: Strategies From a Portland, Oregon, Pilot Study." Innovation in Aging 4, Supplement_1 (2020): 57–58. http://dx.doi.org/10.1093/geroni/igaa057.187.
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Abstract The NIA’s strategy to improve ADRD clinical research participation emphasizes local community collaboration. Literature that focuses on a person with dementia’s decision to participate in research does not speak to specific state or local factors nor the effects of local efforts. This study aimed to develop strategies to improve dementia research participation in the Portland, OR metropolitan area. A community advisory board comprised of clinicians, researchers, advocates, people with dementia, family caregivers, and older African Americans was established for this project. Thirty-three interviews were conducted with clinicians, researchers, advocates, people with ADRD, and family caregivers. The Robert Wood Johnson Foundation’s Culture of Health Action Framework was used to conceptualize motivation strategies and reflect elements that describe research participation among people with dementia. Strategies were identified to improve dementia clinical research participation: 1) Identify and promote local champions for ADRD clinical research participation; 2) Promote policies and processes that incentive cross-sector collaboration; 3) Recognize caregivers as full research participants; 4) Include people with ADRD and caregivers in the research design process; 5) Offer alternative options to reduce participation burden; 6) Evaluate and improve relationships between healthcare/research staff and patients/participants. These strategies can be used in conjunction with the Culture of Health Action Framework as a roadmap to form organization-community partnerships, facilitate motivation and empowerment, give decision-making power to people with ADRD and promote a local culture of research. Studies should be conducted in a larger context or as pilots in other communities to determine contextual relevance and generalizability for other areas.
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Haley, Kathleen, and Kimberly Fisher. "State Medical Boards Self-Examination:." Journal of Medical Regulation 101, no. 2 (2015): 35–38. http://dx.doi.org/10.30770/2572-1852-101.2.35.
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Consistency in the application of sanctions is a desirable objective of medical boards. This paper retrospectively reviews two types of misconduct that regularly come before medical boards: cases involving inappropriate prescribing of controlled substances to self, family and friends and sexual misconduct. To determine consistency in decision-making investigative case files, we reviewed who the complainant was and his or her relationship with the licensee, the conduct alleged and proven, the licensee's response, the licensee's investigative history, the interview demeanor, and other aggravating and mitigating factors. Each case was considered on its own merits. An analysis of this data suggests that the Oregon Medical Board is consistent in applying sanctions.
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Ramos-Santiago, Luis Enrique, Jeffrey R. Brown, and Hilary Nixon. "Transit Performance of Modern-Era Streetcars." Transportation Research Record: Journal of the Transportation Research Board 2534, no. 1 (2015): 57–67. http://dx.doi.org/10.3141/2534-08.
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This study examined the transit performance of streetcars in five U.S. cities: Little Rock, Arkansas; Memphis, Tennessee; Portland, Oregon; Seattle, Washington; and Tampa, Florida. The study documented strong and weak performing streetcars and identified the factors that might explain variation in streetcar performance. Portland emerged with the highest ridership and was the most productive and second-most cost-effective streetcar city. Portland's stronger transit performance was attributed to its local setting and to its planning and operating decisions, which emphasized the streetcar's role as a transportation investment and development tool. This approach contrasted with the other cities, where development and tourism objectives were the dominant factors in streetcar decision making.
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Slovic, Paul. "41st Annual North American Meeting of the Society for Medical Decision Making; October 21, 2019; Portland, Oregon Keynote Address The More Who Die, the Less We Care: Confronting the Deadly Arithmetic of Compassion." Medical Decision Making 40, no. 4 (2020): 407–15. http://dx.doi.org/10.1177/0272989x20919294.
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In this keynote address delivered at the 41st Annual North American Meeting of the Society for Medical Decision Making, I discuss the psychology behind valuing human lives. Research confirms what we experience in our daily lives. We are inconsistent and sometimes incoherent in our valuation of human life. We value individual lives greatly, but these lives lose their value when they become part of a larger crisis. As a result, we do too little to protect human lives in the face of catastrophic threats from violence, natural disasters, and other causes. In medicine, this may pose difficult choices when treating individual patients with expensive therapies that keep hope alive but are not cost-effective for the population, for example, with end of life. Lifesaving judgments and decisions are highly context-dependent, subject to many forms of response mode and framing effects and affective biases. This has implications for risk communication and the concept of shared decision making. Slower, more introspective decision making may reduce some of the biases associated with fast, intuitive decisions. But slow thinking can also introduce serious biases. Understanding the strengths and weaknesses of fast and slow thinking is a necessary first step toward valuing lives humanely and improving decisions.
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Slovic, Paul. "41st Annual North American Meeting of the Society for Medical Decision Making; October 21, 2019; Portland, Oregon Keynote Address The More Who Die, the Less We Care: Confronting the Deadly Arithmetic of Compassion." MDM Policy & Practice 5, no. 1 (2020): 238146832091431. http://dx.doi.org/10.1177/2381468320914310.
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In this keynote address delivered at the 41st Annual North American Meeting of the Society for Medical Decision Making, I discuss the psychology behind valuing human lives. Research confirms what we experience in our daily lives. We are inconsistent and sometimes incoherent in our valuation of human life. We value individual lives greatly, but these lives lose their value when they become part of a larger crisis. As a result, we do too little to protect human lives in the face of catastrophic threats from violence, natural disasters, and other causes. In medicine, this may pose difficult choices when treating individual patients with expensive therapies that keep hope alive but are not cost-effective for the population, for example, with end of life. Lifesaving judgments and decisions are highly context-dependent, subject to many forms of response mode and framing effects and affective biases. This has implications for risk communication and the concept of shared decision making. Slower, more introspective decision making may reduce some of the biases associated with fast, intuitive decisions. But slow thinking can also introduce serious biases. Understanding the strengths and weaknesses of fast and slow thinking is a necessary first step toward valuing lives humanely and improving decisions.
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Knobloch, Katherine R., Michael L. Barthel, and John Gastil. "Emanating Effects: The Impact of the Oregon Citizens’ Initiative Review on Voters’ Political Efficacy." Political Studies 68, no. 2 (2019): 426–45. http://dx.doi.org/10.1177/0032321719852254.
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Deliberative processes can alter participants’ attitudes and behavior, but deliberative minipublics connected to macro-level discourse may also influence the attitudes of non-participants. We theorize that changes in political efficacy occur when non-participants become aware of a minipublic and utilize its deliberative outputs in their decision making during an election. Statewide survey data on the 2010 and 2012 Oregon Citizens’ Initiative Reviews tested the link between awareness and use of the Citizens’ Initiative Review Statements and statewide changes in internal and external political efficacy. Results from a longitudinal 2010 panel survey show that awareness of the Citizens’ Initiative Reviews increases respondents’ external efficacy, whereas use of the Citizens’ Initiative Review Statements on ballot measures increases respondents’ internal efficacy. A cross-sectional 2012 survey found the same associations. Moreover, the 2010 survey showed that greater exposure to—and confidence in—deliberative outputs was associated with higher levels of both internal and external efficacy.
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Manoogian, Margaret. "Older Adult Learners’ Contributions to Enhancing Age-Friendly Practices Within the Classroom." Innovation in Aging 4, Supplement_1 (2020): 547. http://dx.doi.org/10.1093/geroni/igaa057.1787.
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Abstract Interest in college courses that focus on aging attract a variety of students. For older adults, the decision to take college courses may be fueled by a desire to engage in life-long learning, finish degrees that have been long desired, or retool and change careers. Older adults 65 years and older living in Oregon may audit courses for free in four-year public universities. Older auditors and degree-seeking students often work closely with faculty in providing support on course projects and sharing developmental insights that stimulate discussions about aging pathways. This presentation outlines the ways in which older adults contribute to educational conversations, mentor younger learners, and enhance classroom/university environments. How older adult learners have provided support in workshops, aided students in career decision-making, connected students to community resources, and provided contacts for intergenerational community activities will also be highlighted.
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Ahmad, Shahryar Khalique, and Faisal Hossain. "A web-based decision support system for smart dam operations using weather forecasts." Journal of Hydroinformatics 21, no. 5 (2019): 687–707. http://dx.doi.org/10.2166/hydro.2019.116.
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Abstract A web-based open-source decision support system (DSS) was developed to facilitate real-world engagement with dam-operating agencies in the decision-making process involving atmospheric modeling, hydrologic modeling, and web technology. The development process was decoupled into the container (frontend) and the modeling framework for the content (backend), to arrive at an intelligent system that improves the productivity and independent reuse of each component. The backend framework uses the weather forecasts from Numerical Weather Prediction models, downscales to a finer resolution, and simulates hydrologic and data-based artificial neural network models to optimize operations. The frontend architecture disseminates the forecasted meteorological variables, reservoir inflow, optimized operations, and retrospective weekly assessment of forecasts and hydropower benefits. The framework is automated and operationalized over the Detroit dam (Oregon) to generate the daily optimized release decisions. However, backend scripts and frontend elements are flexible and customizable enough that the DSS can be reproduced for other dams. The optimization of reservoir operations based on weather forecasts results in significant additional hydropower benefit without compromising other objectives when compared to the conventional operations. More importantly, the platform helps visualize for the dam operator how much more ‘smarter’ operations can be if weather forecasts and open-source technology are used.
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Mostafizi, Alireza, Haizhong Wang, and Shangjia Dong. "Understanding the Multimodal Evacuation Behavior for a Near-Field Tsunami." Transportation Research Record: Journal of the Transportation Research Board 2673, no. 11 (2019): 480–92. http://dx.doi.org/10.1177/0361198119837511.
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This paper presents an agent-based tsunami evacuation modeling (ABTEM) framework in Netlogo to analyze the impact of various multimodal evacuation behaviors on life safety for a near-field tsunami. The objective of this work is to investigate how: milling time, choice of modes (i.e., walking and automobile), and critical variables involved in an evacuation scenario (e.g., walking, driving speed), affect life safety. Using the city of Seaside, Oregon, which is one of the most vulnerable cities on the Oregon coast, as a study site, different evacuation scenarios are included in the model to assess the impact of parameters involved on the mortality rate in a tsunami evacuation event. The results show that: choice of evacuation mode strongly and non-linearly influences the expected number of casualties; use of vehicles leads to the creation of congestion and bottlenecks, and thus, higher mortality rate; the mortality rate is strongly correlated with milling time; and the mortality rate is sensitive to the variations in average walking speed of the population. The results will help emergency managers, community leaders, and city and state agencies in their decision-making process for creating effective and efficient evacuation plans to increase life safety and community resilience.
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Metlen, Kerry L., Terry Fairbanks, Max Bennett, et al. "Integrating forest restoration, adaptation, and proactive fire management: Rogue River Basin case study." Canadian Journal of Forest Research 51, no. 9 (2021): 1292–306. http://dx.doi.org/10.1139/cjfr-2020-0480.
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Uncharacteristic disturbances exacerbated by climate change are challenging forests and social systems of North America. To improve efficiency and effectiveness of forest management to address these challenges, we demonstrated structured decision-making in the collaborative development of a novel 20-year dry forest management strategy for southwestern Oregon, USA. We framed priorities and evaluated options with a wildfire risk assessment, then modeled stand-scale prescriptions to estimate management outputs (e.g., area treated, fuels reduced, and timber volume). We mapped landscape-scale objectives and used optimization software to prioritize treatment placement constrained by realistic access considerations and robust habitat protections. The resulting prioritization integrated proactive forest adaptation and fire management (ecological forest thinning, prescribed fire) with protection of imperiled species. To evaluate tradeoffs, we tested three 20-year scenarios, finding that the All-Lands scenario best mitigated wildfire risk; it reduced risk overall by 70%, to homes by 50%, and to core northern spotted owl habitat by 47%. This scenario treated 25% of the 1.9 million ha landscape, including 31% of federal land and 40% of the community at risk. Clear articulation of collaborative objectives and evaluation of scenarios have expanded partnerships and co-investment in actions supporting a shared vision of resilient southwestern Oregon forests applicable to other landscapes.
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Hogland, John, Christopher J. Dunn, and James D. Johnston. "21st Century Planning Techniques for Creating Fire-Resilient Forests in the American West." Forests 12, no. 8 (2021): 1084. http://dx.doi.org/10.3390/f12081084.
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Data-driven decision making is the key to providing effective and efficient wildfire protection and sustainable use of natural resources. Due to the complexity of natural systems, management decision(s) require clear justification based on substantial amounts of information that are both accurate and precise at various spatial scales. To build information and incorporate it into decision making, new analytical frameworks are required that incorporate innovative computational, spatial, statistical, and machine-learning concepts with field data and expert knowledge in a manner that is easily digestible by natural resource managers and practitioners. We prototyped such an approach using function modeling and batch processing to describe wildfire risk and the condition and costs associated with implementing multiple prescriptions for risk mitigation in the Blue Mountains of Oregon, USA. Three key aspects of our approach included: (1) spatially quantifying existing fuel conditions using field plots and Sentinel 2 remotely sensed imagery; (2) spatially defining the desired future conditions with regards to fuel objectives; and (3) developing a cost/revenue assessment (CRA). Each of these components resulted in spatially explicit surfaces describing fuels, treatments, wildfire risk, costs of implementation, projected revenues associated with the removal of tree volume and biomass, and associated estimates of model error. From those spatially explicit surfaces, practitioners gain unique insights into tradeoffs among various described prescriptions and can further weigh those tradeoffs against financial and logistical constraints. These types of datasets, procedures, and comparisons provide managers with the information needed to identify, optimize, and justify prescriptions across the landscape.
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Guegan, Dawn P., Peter T. Martin, and Wayne D. Cottrell. "Prioritizing Traffic-Calming Projects Using the Analytic Hierarchy Process." Transportation Research Record: Journal of the Transportation Research Board 1708, no. 1 (2000): 61–67. http://dx.doi.org/10.3141/1708-07.
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The analytic hierarchy process (AHP), a multiple-criteria decision-making tool, is used to prioritize traffic-calming projects. AHP is proposed as an alternative to existing point scoring systems. Prioritization methods used in traffic-calming programs in Portland, Oregon, and Canberra, Australia, are applied; the results are compared to those of AHP. The three methods apparently produce similar rankings when applied to local streets that have speeding problems. AHP produces rankings different from those of the other two methods, however, when complex issues and qualitative factors must be taken into account. AHP may be more suitable in cases in which some factors cannot be quantified. In the examples studied, these factors included traffic diversion, the importance of the street, the impacts of existing traffic-control devices and measures adjacent to elementary schools, terrain, and neighborhood residents’ opinions. None of these factors could readily be assigned a value in a point scoring system. Some of the concerns in applying AHP are the tediousness of making pairwise comparisons between alternatives, the consistency of the comparisons, and the defensibility of the scores. The decision maker should examine the scores to ensure that they are sensible and should be adequately aware of the issues so as to defend the scores. If there are n alternatives, then n( n - 1)/2 pairwise comparisons are needed. Clearly, for expedient application of AHP, the alternatives must be limited to a reasonable number.
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Landsbergis, Paul, Jeanette Zoeckler, Zerin Kashem, Bianca Rivera, Darryl Alexander, and Amy Bahruth. "Organizational Policies and Programs to Reduce Job Stress and Risk of Workplace Violence Among K-12 Education Staff." NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy 27, no. 4 (2017): 559–80. http://dx.doi.org/10.1177/1048291117739420.
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We examine strategies, programs, and policies that educators have developed to reduce work stressors and thus health risks. First, we review twenty-seven empirical studies and review papers on organizational programs and policies in K-12 education published from 1990 to 2015 and find some evidence that mentoring, induction, and Peer Assistance and Review programs can increase support, skill development, decision-making authority, and perhaps job security, for teachers—and thus have the potential to reduce job stressors. Second, we describe efforts to reduce workplace violence in Oregon, especially in special education, including legislation, collective bargaining, research, and public awareness. We conclude that to reduce workplace violence, adequate resources are needed for staffing, training, equipment, injury/assault reporting, and investigation. Third, we discuss collective bargaining initiatives that led to mentoring and Peer Assistance and Review and state legislation on prevention of bullying and harassment of school staff. Finally, we present a research agenda on these issues.
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Nemeth, D., and K. Chustz. "B-17 Examining Driving Abilities in Autistic Young Adults." Archives of Clinical Neuropsychology 34, no. 6 (2019): 962. http://dx.doi.org/10.1093/arclin/acz034.100.
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Abstract Objectives A single white 27 year-old male with autism was referred for an evaluation of his neurocognitive skills for driver’s training competency. Typically, the following criteria are required for special needs individuals to be issued a driver’s license: 1) Must pass neuropsychologist evaluation, 2) Must be cleared by occupational therapist, and 3) must be approved by primary care physician; Schultheis presented a symposium on this topic at the International Neuropsychology Society meeting in Portland, Oregon in 2007. As driving is one of the primary methods of achieving independence in our society, most teens and young adults, regardless of diagnosis, strive to obtain a license. Methods This case presentation will profile the results of this individual’s neurocognitive driving skills. This neuropsychological evaluation included the Cognitive Behavioral Driver’s Inventory (CBDI). Results Significant results included: Average to low average intellectual skills, high average to average memory and attentional skills, weakness in math, multi-tasking perceptual motor difficulties, visual spatial/constructional difficulties, normal affective functioning, and positive personality profile. This individual had a “clearly failing” CBDI score of 91, with weaknesses in the following areas: Visual scrutiny and attention to detail, Visual motor coordination and fine motor speed, attention and concentration, rapid decision-making, distractibility, and mental flexibility, and consistency of performance. Although previously diagnosed with ADD, results of objective testing (TOVA) did not support this diagnosis. Conclusions Outpatient occupational therapy program to include visual spatial and rapid decision-making skills was recommended. Upon completion of this program, a re-administration of the CBDI is recommended.
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Olsen, Christine S., and Bruce A. Shindler. "Trust, acceptance, and citizen - agency interactions after large fires: influences on planning processes." International Journal of Wildland Fire 19, no. 1 (2010): 137. http://dx.doi.org/10.1071/wf08168.
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Wildfires have increased in number and size in recent years, making post-fire forest management an increasingly important topic. Citizen–agency interactions, citizen trust, and citizen acceptance of management strategies are central to successful planning and decision-making in these settings. In this study, citizen opinions from the attentive public are evaluated in two locations near recent fires in Oregon: the 2003 Bear and Booth Complex Fires and the 2002 Biscuit Fire. Results suggest an agency’s commitment to long-term interactions with citizens influences citizen trust in the agencies and acceptance of post-fire management strategies. There is broad acceptance for several post-fire management strategies (i.e. erosion control, replanting, reseeding). However, acceptance is highly dependent on trustworthy relations. Further, results suggest it is not enough to simply offer opportunities for public engagement; citizens need to feel that these activities were meaningful opportunities to participate. Although results differed between locations, overall the majority of respondents did not agree with how the local Forest Service and Bureau of Land Management handled forest planning after recent fires. Findings from this research indicate that positive citizen–agency relations need to be long-term and developed well before a fire occurs if post-fire actions are to be supported by communities.
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Steel, E. Ashley, Blake E. Feist, David W. Jensen, et al. "Landscape models to understand steelhead (Oncorhynchus mykiss) distribution and help prioritize barrier removals in the Willamette basin, Oregon, USA." Canadian Journal of Fisheries and Aquatic Sciences 61, no. 6 (2004): 999–1011. http://dx.doi.org/10.1139/f04-042.
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We use linear mixed models to predict winter steelhead (Oncorhynchus mykiss) redd density from geology, land use, and climate variables in the Willamette River basin, Oregon. Landscape variables included in the set of best models were alluvium, hillslope < 6%, landslide-derived geology, young (<40 years) forest, shrub vegetation, agricultural land use, and mafic volcanic geology. Our approach enables us to model the temporal correlation between annual redd counts at the same site while extracting patterns of relative redd density across sites that are consistent even among years with varying strengths of steelhead returns. We use our model to predict redd density (redds per kilometre) upstream of 111 probable migration barriers as well as the 95% confidence interval around the redd density prediction and the total number of potential redds behind each barrier. Using a metric that incorporates uncertainty, we identified high-priority barriers that might have been overlooked using only stream length or mean predicted fish benefit and we clearly differentiated between otherwise similar barriers. We show that landscape features can be used to describe and predict the distribution of winter steelhead redds and that these models can be used immediately to improve decision-making for anadromous salmonids.
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Jashami, Hisham, David S. Hurwitz, Christopher Monsere, and Sirisha Kothuri. "Evaluation of Driver Comprehension and Visual Attention of the Flashing Yellow Arrow Display for Permissive Right Turns." Transportation Research Record: Journal of the Transportation Research Board 2673, no. 8 (2019): 397–407. http://dx.doi.org/10.1177/0361198119843093.
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This research explored driver comprehension and behaviors in Oregon with respect to right-turn signal displays focusing on the Flashing Yellow Arrow (FYA) in a driving simulator. A counterbalanced, factorial design was chosen to explore three independent variables: signal indication type and active display, length of the right-turn bay, and presence of pedestrians. Driver decision-making and visual attention were considered. Data were obtained from 46 participants (21 women, 25 men) turning right 736 times in 16 experimental scenarios. A Mixed-effects Ordered Probit Model and a Linear mixed model were used to examine the influence of driver demographics on observed performance. Results suggest that the FYA indication improves driver comprehension and behavioral responses to the permissive right-turn condition. When presented with the FYA indication in the presence of pedestrians, nearly all drivers exhibited caution while turning and yielding to pedestrians and stopping when necessary. For the same turning maneuver, drivers presented with a circular green (CG) indication were less likely to exhibit correct behavior. At least for Oregon drivers, another clear finding was a general lack of understanding of the steady red arrow (SRA) display for right turns. Most drivers assume the SRA indication requires a different response than the circular red (CR) and remain stopped during the entire red interval, thus resulting in efficiency losses. These findings suggest that transportation agencies could potentially improve driver yielding behavior and pedestrian safety at signalized intersections with high volumes of permissive right turns from exclusive right-turn lanes by using the FYA display in lieu of a steady CG display.
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Semiromi, F. Babaei, A. H. Hassani, A. Torabian, A. R. Karbassi, and F. Hosseinzadeh Lotfi. "Evolution of a new surface water quality index for Karoon catchment in Iran." Water Science and Technology 64, no. 12 (2011): 2483–91. http://dx.doi.org/10.2166/wst.2011.780.
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Water quality standards are developed worldwide by national and international agencies for pollution control decision-making. Use-based water quality classification criteria and Water Quality Indices (WQIs) also play an important role in the assessment of the suitability of water resources for various applications. The present study proposes a better overall index for water quality in Iran and its application in Karoon River by exploring the behavior and limitations of conventional methods for quality evaluation. For this purpose, six variables were employed. Water quality determinants of the new index include Dissolved Oxygen, Total Dissolved Solids, Turbidity, Nitrate, Fecal coliform and pH. Besides, the mathematical equations applied to transform the actual concentration values into quality indices have been formulated. This study compares a new index called the Iranian Water Quality Index with other pre-existing indices such as NSFWQI, Oregon, CPCB WQI, MDOE WQI, Kaurish and Younos WQI, and Ahmed Said WQI. Results revealed that the overall quality of the surface water falls under the ‘good’ class. A case study of Karoon River is made to illustrate the application of this new index system.
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Herzberg, Simone, Matt Hansen, Amanda Schoonover, et al. "Association between measured teamwork and medical errors: an observational study of prehospital care in the USA." BMJ Open 9, no. 10 (2019): e025314. http://dx.doi.org/10.1136/bmjopen-2018-025314.
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ObjectivesThe goal of this study was to examine the relationship between measured teamwork and adverse safety events in the prehospital emergency care of children using high-fidelity simulation. We posit that non-technical skills such as leadership, teamwork, situation awareness and decision-making are associated with the clinical success of teams.DesignObservational study.SettingEmergency medical services (EMS) responders were recruited from public fire and private transport agencies in Oregon State to participate in four simulations of paediatric emergencies using high-fidelity patient simulators, scene design, and professional actors playing parents and bystanders.ParticipantsForty-four fire/transport teams consisting of 259 EMS professionals consented to participate and completed simulations.Primary and secondary outcome measuresTeams were assessed using the Clinical Teamwork Scale (CTS), a validated instrument that measures overall teamwork and 15 specific elements in five overarching domains: communication, decision-making, role responsibility (leadership and followership), situational awareness/resource management and patient-friendliness. We used generalised estimating equations to estimate the odds of error with increasing overall CTS teamwork score while adjusting for clinical scenario and potential clustering by team.ResultsAcross 176 simulations, the mean overall score on the CTS was 6.04 (SD 2.10; range 1=poor to 10=perfect) and was normally distributed. The distribution of scores was similar across the four clinical scenarios. At least one error was observed in 82% of the simulations. In simulations with at least one observed error, the mean CTS score was 5.76 (SD 2.04) compared with 7.16 (SD 1.95) in scenarios with no observed error. Logistic regression analysis accounting for clustering at the team level revealed that the odds of an error decreased 28% with each unit increase in CTS (OR 0.72, 95% CI 0.59 to 0.88).ConclusionsThis study found that overall teamwork among care delivery teams was strongly associated with the risk of serious adverse events in simulated scenarios of caring for critically ill and injured children.
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Tucker, K. "End-of-life care: Empowering cancer patients with information and choices." Journal of Clinical Oncology 27, no. 15_suppl (2009): e20739-e20739. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.e20739.
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e20739 Background: Terminally ill patients want information and choices, including aid in dying, as they confront death due to cancer and other terminal illnesses. Physicians treating such patients want to feel safe in having candid conversations with patients about their wishes and to provide aid in dying when appropriate. Methods: Review the law governing end of life decision making, including aid in dying. Review the data from Oregon, which has more than 10 years experience with a regulated practice. Review what has been learned in OR, and how that is transferring to other states making aid in dying an end of life option. Results: Oregon's experience shows that when aid in dying is a legal option for mentally competent terminally ill patients overall end of life care improves. Conversations between physicians and patients are more open and candid; Referrals to hospice increase and occur earlier; clinician enrollment in CE for pain and symptom management increase; rx of strong pain medication increase; more patients die at home; patients are comforted to have aid in dying as an option; there is no negative impact on the practice of medicine. Conclusions: Terminally ill patients should be able to recieve comprehensive counseling about all end of life options. There is a growing trend of support for expanding end of life options to include aid in dying for mentally competent terminally ill patients who find themselves trapped in an unbearable dying process. No significant financial relationships to disclose.
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Heiderman, Ryan R., and Mark J. Kimsey. "A species-specific, site-sensitive maximum stand density index model for Pacific Northwest conifer forests." Canadian Journal of Forest Research 51, no. 8 (2021): 1166–77. http://dx.doi.org/10.1139/cjfr-2020-0426.
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Maximum stand density index (SDIMAX) models were developed for important Pacific Northwest conifers of western Oregon and Washington, USA, based on site and species influences and interactions. Inventory and monitoring data from numerous federal, state, and private forest management groups were obtained throughout the region to ensure a wide coverage of site characteristics. These observations include information on tree size, number, and species composition. The effects and influence on the self-thinning frontier of plot-specific factors such as climate, topography, soils, and geology, as well as species composition, were evaluated based on geographic location using a multistep approach to analysis involving linear quantile mixed models, random forest, and stochastic frontier functions. The self-thinning slope of forest stands dominated by Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco) was found to be –1.517 and that of stands dominated by western hemlock (Tsuga heterophylla (Raf.) Sarg.) was found to be –1.461, leading to regionwide modelled SDIMAX values at the 95th percentile of 1728 and 1952 trees per hectare, respectively. The regional model of site-specific SDIMAX will support forest managers in decision-making regarding density management and species selection to more efficiently utilize site resources toward healthy, productive forests.
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Tate Woodson, Tanisha, Rose Gunn, Khaya D. Clark, et al. "Designing health information technology tools for behavioural health clinicians integrated within US-based primary care teams." BMJ Health & Care Informatics 25, no. 3 (2018): 148–68. http://dx.doi.org/10.14236/jhi.v25i3.998.
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BackgroundElectronic health records (EHRs) are a key tool for primary care practice. However, the EHR functionality is not keeping pace with the evolving informational and decision-support needs of behavioural health clinicians (BHCs) working on integrated teams.ObjectiveDescribe the workflows and tasks of integrated BHCs working with adult patients identify their health information technology (health IT) needs and develop EHR tools to address them.MethodA mixed-methods, comparative case study of six community health centres (CHCs) in Oregon, each with at least one BHC integrated into their primary care team. We observed clinical work and conducted interviews to understand workflows and clinical tasks, aiming to identify how effectively current EHRs supported integrated care delivery, including transitions, documentation, information sharing and decision-making. We analysed these data and employed a user-centred design process to develop EHR tools addressing the identified needs.ResultsBHCs used the primary care EHR for documentation and communication with other team members, but the EHR lacked the functionality to fully support integrated care. Needs include the ability to: (1) automate and track paper-based screening; (2) document behavioural health history; (3) access patient social and medical history relevant to behavioural health issues and (4) rapidly document and track progress on goals. To meet these needs, we engaged users and developed a set of EHR tools called the Behavioural Health e-Suite (BH e-Suite).ConclusionUS-based integrated primary care teams, and particularly BHCs working with adult populations, have unique information needs, workflows and tasks. These needs can be met and supported by the EHR with a moderate level of modification.
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Olsen, Christine S., Angela L. Mallon, and Bruce A. Shindler. "Public Acceptance of Disturbance-Based Forest Management: Factors Influencing Support." ISRN Forestry 2012 (June 14, 2012): 1–10. http://dx.doi.org/10.5402/2012/594067.
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Growing emphasis on ecosystem and landscape-level forest management across North America has spurred an examination of alternative management strategies which focus on emulating dynamic natural disturbance processes, particularly those associated with forest fire regimes. This topic is the cornerstone of research in the Blue River Landscape Study (BRLS) on the Willamette National Forest in the McKenzie River watershed of western Oregon. As scientists and managers work to unravel the ecological and economic implications of disturbance-based forest management, they must also consider public acceptance for such an approach. In this study, citizen opinions from the local attentive public in McKenzie River watershed communities are examined. Results suggest the attentive public has moderate to low levels of knowledge about landscape-level disturbance processes and terms. Further, public confidence in agencies and the information they provide appears to be low, though respondents indicated a somewhat higher level of trust for local agency personnel than agencies as institutions. Overall, respondents display cautious support of disturbance-based management (DBM), but many are still undecided. Findings also demonstrate support may be improved through transparent and inclusive decision-making processes that demonstrate the use of sound science in project planning, frank disclosure of risks and uncertainties, and clear management objectives.
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Mason, Jeffrey D. "‘Affront or Alarm’: Performance, the Law and the ‘Female Breast’ from Janet Jackson to Crazy Girls." New Theatre Quarterly 21, no. 2 (2005): 178–94. http://dx.doi.org/10.1017/s0266464x05000084.
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A momentary glimpse of Janet Jackson's breast on American television precipitated an earnest debate on the overstepping of marks (and recording-breaking TiVo replays) – while in many states, most notably Nevada, explicitly sexual performance is a respected contributor to the local economy. In this paper, Jeffrey D. Mason finds a way through the maze of state legislation and Supreme Court decision-making on the subject, exploring the interpretations of a constitutional right to self-exposure in conflict with the perceived need for protection against it; and he assesses the performance of Crazy Girls, a typical Las Vegas revue of the more ‘acceptable’ kind. He argues that the law, ‘constituting a text analogous to a playscript in its delineation of roles, actions, interactions, and even costume choices, attempts to impose taste with a special precision by addressing display, intent, and effect; and serves as both an expression of disapprobation and an instrument to censor performance’. Jeffrey D. Mason is Professor of Theatre Arts and Head of the Department of Theatre Arts in the University of Oregon. A shorter version of this article was delivered as a plenary session paper at the annual conference of the American Society for Theatre Research at the Riviera Hotel in Las Vegas, on 20 November 2004.
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Shatzel, Joseph, Derrick Tao, Sven R. Olson, et al. "Evaluating the Effects of an Evidence-Based Hemostasis and Thrombosis Treatment Algorithm Tool on Medical Practitioner and Trainee Clinical Decision Making." Blood 128, no. 22 (2016): 4736. http://dx.doi.org/10.1182/blood.v128.22.4736.4736.
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Abstract INTRODUCTION There are many interventions in the disciplines of hemostasis and thrombosis that have been shown to be effective by high quality evidence, leading to the development of evidence-based guidelines by several professional groups. The extent to which providers and medical trainees make use of these guidelines in real-time clinical decision making is not known. Current hemostasis and thrombosis guidelines also lack an easy to navigate algorithmic design such as what is used by the National Comprehensive Cancer Network (NCCN) which may limit their utilization. Using several evidence based guidelines and consensus expert opinion we created an algorithmic tool designed to easily answer clinical questions in thrombosis and hemostasis, and conducted a prospective study assessing provider understanding of current evidence based recommendations and the effects of the algorithmic tool on clinical decision making. METHODS We implemented a prospective survey study of health care providers and medical students from the Oregon Health & Science University during July of 2016. Practitioners who care for patients with thrombotic or hemostatic issues were eligible; including internists, hematologist and oncologists, family medicine practitioners, nurse practitioners & physician assistants, hematology and oncology fellows, internal medicine and family medicine residents, and medical students. The survey included demographic questions, 11 clinical vignettes with multiple-choice questions asking participants for the most evidence-based treatment decision and to rate their confidence in the answer, and post-assessment feedback. Participants were encouraged to use the resources they would typically use in a clinical setting to make these decisions. Included subjects were randomly assigned access to our evidence-based algorithmic tool, (available online at http://tinyurl.com/Hemostasis-ThrombosisGuideline) available as downloadable PDF. The 11 clinical questions were scored, and an unpaired t-test was performed to determine if any significant difference existed in scores between participants with and without the evidence-based algorithmic tool. RESULTS During the study period, 101 individuals participated: 48 medical students, 23 medicine residents, 17 attending physicians, 9 fellows, and 4 NP/PAs. Across all participants, those with access to the algorithms on average answered 3.84 (34%) more questions correctly (95% CI 3.08 - 4.60, P < 0.0001) (Table 1). Participants randomized to receive the algorithm were significantly more confident in their treatment decisions than participants without the algorithm (P < 0.0001). Significantly higher scores were found among individual groups including medical students, (mean difference 4.73, 95% CI 3.64 - 5.82, P < 0.0001), attending physicians (mean difference 2.58, 95% CI 0.63 - 4.53, P = 0.0131), and residents & fellows (mean difference 3.81, 95% CI 2.66 - 4.96, P < 0.0001). There was insufficient data to find a difference in score among NP/PAs who did and did not receive the algorithm. Participant reported confidence in their answers was significantly higher in those who were randomized to receive the algorithm (mean difference of0.95 on a 5-point confidence scale, 95% CI0.50 to 1.39, P < 0.0001). CONCLUSION Our study found that at baseline, there were limitations in provider and trainee understanding of the current evidence based management of clinical issues relevant to hemostasis and thrombosis, and that the use of an easy to navigate algorithmic tool significantly altered treatment decisions in commonly encountered clinical vignettes. Our findings suggest that utilization and decision-making may benefit from a more streamlined, algorithmic display of guidelines. Future prospective studies are needed to determine if such a tool improves management and outcomes in practice. Disclosures No relevant conflicts of interest to declare.
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Daly, Christopher, Jonathan W. Smith, Joseph I. Smith, and Robert B. McKane. "High-Resolution Spatial Modeling of Daily Weather Elements for a Catchment in the Oregon Cascade Mountains, United States." Journal of Applied Meteorology and Climatology 46, no. 10 (2007): 1565–86. http://dx.doi.org/10.1175/jam2548.1.
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Abstract High-quality, daily meteorological data at high spatial resolution are essential for a variety of hydrologic and ecological modeling applications that support environmental risk assessments and decision making. This paper describes the development, application, and assessment of methods to construct daily high-resolution (∼50-m cell size) meteorological grids for the 2003 calendar year in the Upper South Santiam Watershed (USSW), a 500-km2 mountainous catchment draining the western slope of the Oregon Cascade Mountains. Elevations within the USSW ranged from 194 to 1650 m. Meteorological elements modeled were minimum and maximum temperature; total precipitation, rainfall, and snowfall; and solar radiation and radiation-adjusted maximum temperature. The Parameter–Elevation Regressions on Independent Slopes Model (PRISM) was used to interpolate minimum and maximum temperature and precipitation. The separation of precipitation into rainfall and snowfall components used a temperature-based regression function. Solar radiation was simulated with the Image-Processing Workbench. Radiation-based adjustments to maximum temperature employed equations developed from data in the nearby H. J. Andrews Experimental Forest. The restrictive terrain of the USSW promoted cold-air drainage and temperature inversions by reducing large-scale airflow. Inversions were prominent nearly all year for minimum temperature and were noticeable even for maximum temperature during the autumn and winter. Precipitation generally increased with elevation over the USSW. In 2003, precipitation was nearly always in the form of rain at the lowest elevations but was about 50% snow at the highest elevations. Solar radiation followed a complex pattern related to terrain slope, aspect, and position relative to other terrain features. Clear, sunny days with a large proportion of direct radiation exhibited the greatest contrast in radiation totals, whereas cloudy days with primarily diffuse radiation showed little contrast. Radiation-adjusted maximum temperatures showed similar patterns. The lack of a high-quality observed dataset was a major issue in the interpolation of precipitation and solar radiation. However, observed data available for the USSW were superior to those available for most mountainous regions in the western United States. In this sense, the methods and results presented here can inform others performing similar studies in other mountainous regions.
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Slovic, Paul. "41st Annual North American Meeting of the Society for Medical Decision Making; October 21, 2019; Portland, Oregon. Keynote Address: The More Who Die, the Less We Care: Confronting the Deadly Arithmetic of Compassion." Obstetrical & Gynecological Survey 75, no. 9 (2020): 550–53. http://dx.doi.org/10.1097/01.ogx.0000696616.66851.7b.
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Bekemeier, Betty, Seungeun Park, Uba Backonja, India Ornelas, and Anne M. Turner. "Data, capacity-building, and training needs to address rural health inequities in the Northwest United States: a qualitative study." Journal of the American Medical Informatics Association 26, no. 8-9 (2019): 825–34. http://dx.doi.org/10.1093/jamia/ocz037.
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Abstract Objective Rural public health system leaders struggle to access and use data for understanding local health inequities and to effectively allocate scarce resources to populations in need. This study sought to determine these rural public health system leaders’ data access, capacity, and training needs. Materials and Methods We conducted qualitative interviews across Alaska, Idaho, Oregon, and Washington with individuals expected to use population data for analysis or decision-making in rural communities. We used content analysis to identify themes. Results We identified 2 broad themes: (1) challenges in accessing or using data to monitor and address health disparities and (2) needs for training in data use to address health inequities. Participants faced challenges accessing or using data to address rural disparities due to (a) limited availability or access to data, (b) data quality issues, (c) limited staff with expertise and resources for analyzing data, and (d) the diversity within rural jurisdictions. Participants also expressed opportunities for filling capacity gaps through training—particularly for displaying and communicating data. Discussion Rural public health system leaders expressed data challenges, many of which can be aided by informatics solutions. These include interoperable, accessible, and usable tools that help capture, access, analyze, and display data to support health equity efforts in rural communities. Conclusion Informatics has the potential to address some of the daunting data-related challenges faced by rural public health system leaders working to enhance health equity. Future research should focus on developing informatics solutions to support data access and use in rural communities.
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Spies, Thomas A., and Jon R. Martin. "Monitoring late-successional forest biodiversity in the Pacific Northwest, U.S.A." Forestry Chronicle 82, no. 3 (2006): 364–67. http://dx.doi.org/10.5558/tfc82364-3.
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The era of ecosystem management for federal forest lands in the Pacific Northwest began in 1994 with the adoption of the Northwest Forest Plan. This plan was designed to maintain and restore species and ecosystems associated with late successional and old-growth forests on over 10 million ha of federal lands in Washington, Oregon and California. The plan called for implementation monitoring, effectiveness monitoring, and validation monitoring for a variety of ecological and socio-economic components. Monitoring has become a central part of management of the federal forests in the region and managers and scientists have gained considerable experience in implementing this large and complex program. The components of the monitoring plan include late-successional/old growth vegetation, northern spotted owls, marbled murrelets, aquatic habitat and social conditions. The monitoring plan is strongly based on vegetation layer created with TM satellite imagery and on a regional grid of forest inventory plots. The lessons learned from the implementation of this monitoring plan include: 1) agencies need to devote considerable resources to insure that effective monitoring will occur at broad scales; 2) aggregation of local monitoring efforts is not a substitute for a designed regional monitoring plan; 3) vegetation structure and composition, measured with satellite imagery and inventory plots, is a cost-effective, broad-scale indicator of biological diversity; 4) some species, such as threatened and endangered species, are not necessarily covered with habitat approaches and may require population monitoring; 5) our scientific understanding of monitoring components will vary widely as will the approaches to data collection and analysis; 6) monitoring requires research support to develop and test metrics and biodiversity models; 7) links of monitoring to decision-making (adaptive management) are still being forged. Key words: aquatic ecosystems, endangered species, old-growth forests, Pacific Northwest, USA, regional ecosystem management
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Zimmerman, Erika, Arnar Palsson, and Greg Gibson. "Quantitative Trait Loci Affecting Components of Wing Shape inDrosophila melanogaster." Genetics 155, no. 2 (2000): 671–83. http://dx.doi.org/10.1093/genetics/155.2.671.
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AbstractTwo composite multiple regression-interval mapping analyses were performed to identify candidate quantitative trait loci (QTL) affecting components of wing shape in Drosophila melanogaster defined by eight relative warp-based measures. A recombinant inbred line design was used to map QTL for the shape of two intervein regions in the anterior compartment of the wing, using a high resolution map of retrotransposon insertion sites between Oregon-R and Russian 2b. A total of 35 QTL representing up to 23 different loci were identified, many of which are located near components of the epidermal growth factor-Ras signal transduction pathway that regulates vein vs. intervein decision making and vein placement. Over one-half of the loci were detected in both sexes, and just under one-half were detected at two different growth temperatures. Different loci were found to affect aspects of shape in each intervein region, confirming that the shape of the whole wing should be regarded as a compound trait composed of several developmental units. In addition, a reciprocal backcross design was used to map QTL affecting shape in the posterior compartment of the wings of 831 flies, using a molecular map of 16 allele-specific oligohybridization single nucleotide polymorphism (SNP) markers between two divergent inbred lines. A total of 13 QTL were detected and shown to have generally additive effects on separable components of shape, in both sexes. By contrast, 8 QTL that affected wing size in these backcrosses were nearly dominant in their effects. The results confirm at the genetic level that wing shape is regulated independent of wing size and set up the hypothesis that wing shape is regulated in part through the regulation of the length and positioning of wing veins, involving quantitative regulation of the activity of secreted growth factors.
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Raslan, Ahmed M., Reynaldo DeJesus, Caglar Berk, Andrew Zacest, Jim C. Anderson, and Kim J. Burchiel. "Sensitivity of high-resolution three-dimensional magnetic resonance angiography and three-dimensional spoiled-gradient recalled imaging in the prediction of neurovascular compression in patients with hemifacial spasm." Journal of Neurosurgery 111, no. 4 (2009): 733–36. http://dx.doi.org/10.3171/2009.3.jns08393.
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Object Hemifacial spasm is a clinical syndrome caused by vascular compression of the facial nerve in the cerebellopontine angle, which can be relieved by surgical intervention. Advances in medical imaging technology allow for direct visualization of the offending blood vessels in hemifacial spasm and similar conditions (such as trigeminal neuralgia). The utility of high resolution 3D MR angiography and 3D spoiled-gradient recalled (SPGR) imaging sequences for surgical decision-making in hemifacial spasm, as measured by sensitivity, specificity, and positive and negative predictive values, has not been previously determined. Methods A retrospective review was undertaken of 23 patients with hemifacial spasm who underwent operations between January 2001 and December 2006 at Oregon Health & Science University. All patients underwent preoperative high-resolution 3D MR angiography and 3D SPGR imaging. The sensitivity of the SPGR imaging/MR angiography interpretation of neurovascular compression (NVC) by both a neurosurgeon and 2 neuroradiologists was determined in relation to the presence of actual NVC during surgery. Results All patients were found to have NVC at surgery. After review by a neurosurgeon and 2 neuroradiologists, imaging data from 19 of the 23 patients were evaluated. The neurosurgeon's interpretation had a sensitivity of 79% and a positive predictive value (PPV) of 100%. The first neuroradiologist's interpretation had a sensitivity of 21% with a PPV of 100%. Further interpretation by a blinded second neuroradiologist with expertise in MR imaging of hemifacial spasm and trigeminal neuralgia was conducted, and sensitivity was 59% and PPV was 100%. Specificity was not determined because there were no true negative cases. The negative predictive value was 0% for both the neurosurgeon's and neuroradiologists' evaluations. Conclusions Although high-resolution 3D MR angiography and 3D SPGR imaging was helpful in providing information about the anatomical relationship of cranial nerve VII and surrounding blood vessels, the authors determined that in the case of hemifacial spasm these types of imaging did not influence preoperative surgical decisionmaking.
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Zell, Adrienne, Lindsey Smith, David Yanez, Jeanne-Marie Guise, and David Ellison. "2237 From bedside to benchmarks: A physician-scientist workforce dashboard for biomedical research institutions." Journal of Clinical and Translational Science 2, S1 (2018): 57. http://dx.doi.org/10.1017/cts.2018.214.
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OBJECTIVES/SPECIFIC AIMS: A growing concern about the declining physician-scientist workforce prompted the 2014 National Institutes of Health (NIH) Physician Scientist Workforce to recommended that “tools for assessing the strength of the biomedical workforce” be developed. To aid strategic planning, the Oregon Clinical and Translational Research Institute convened key stakeholders at its home university, Oregon Health and Science University (OHSU), to survey the local landscape of physician scientists. Surprisingly, few consensus methods were available to measure and benchmark OHSU with respect to national comparators. To address this deficit, we sought to develop clear and objective metrics describing physician-scientist success at our institution. By focusing on local funding, we were able to generate more complete and robust data than others have reported. These data also permit us to compare ourselves to the national workforce, using well-curated and accessible national databases. The goal of the analyses is to contribute to strategic decision-making by portraying the local physician-scientist workforce, comparing it to the national landscape, and making recommendations about mechanisms to address potential opportunities. This has led us to develop a simple quantitative dashboard, which now permits OHSU to craft strategic targets and address successes and opportunities. These approaches are likely to be valuable elsewhere. METHODS/STUDY POPULATION: OHSU is a medium-sized academic health center in Portland, Oregon with over 1200 principal investigators and over $230M in NIH funding. The primary focus of our investigation was physician-scientists who receive extramural funding. To align with other analyses, we distinguish physician-scientists with an M.D. only, or with an M.D. and a master’s degree, from physician-scientists who hold an M.D./Ph.D. For this distinction, we use the indicator “M.D.-only” to indicate the former. The study design consisted of (a) selection of available and relevant national level data on the physician-scientist workforce, (b) curating of local level data to align it with the national indicators, (c) comparing the 2 sets of data to look for differences in trends over time, and (d) supplementing the analyses with additional local data not available at the national level. Key comparisons were tested for statistical significance and plotted on a dashboard, which was then reviewed by an OHSU internal working group focused on physician-scientists. Data elements included degrees, age, gender, and grants awarded. National data come directly from the NIH Data Book, updated for fiscal year 2016. The NIH makes all funded project data available in the publicly downloadable ExPORTER Data Catalog. These project data were used to supplement the summarized data available from the NIH Data Book, allowing us to extract OHSU investigators and to complete the K to R comparative analysis. For analyses of OHSU investigators holding funding other than RPGs, we relied on institutional data from the OHSU grants and contracts office. Demographic data on OHSU investigators were obtained from departmental and human resource records. The time period for these analyses was 1998–2016. RESULTS/ANTICIPATED RESULTS: At OHSU, as nationally, there has been an increase in RPG-holding Ph.D.s but not in RPG-holding physician-scientists. At OHSU, nearly three-fourth of physician-scientist RPGs hold an M.D.-only degree, compared with nationally, where nearly half of physician-scientists are M.D./Ph.D.s. The percent of younger, early-career, RPG-holding physician-scientists has declined precipitously at OHSU and nationally. At OHSU, the percentage of RPGs held by women physician-scientists is below the national figure. Funding sources for physician-scientists at OHSU were more diverse than for Ph.D. scientists, and physician-scientists comprise the majority of Principal Investigators on clinical trials. These non-RPG sources of funding remain a critical source of support, although local analyses of time spent on research indicate that physician-scientists with NIH funding spend a greater percentage of their time on research than those without. OHSU PI’s have had success in transitioning from K08 and K23 grants to R-level grants, with similar percentages receiving RPGs within 5 years. A dashboard comparing these trends was developed. DISCUSSION/SIGNIFICANCE OF IMPACT: There were 3 key impacts from our analyses. First, we developed and disseminated a dashboard with both local data and national comparators. Second, in consultation with institutional leadership, we selected target values to define success for each metric. Third, we recommended actions that will help OHSU meet the selected targets. A major accomplishment of this structured approach has been the identification of opportunities for change that were not recognized previously. For example, leadership was not aware of the substantial and growing deficit in female physician-scientists at OHSU, compared with the impressive increases nationally. Thus, to reduce gender disparity at OHSU, we have recommended purposeful recruitment; one approach is to target female graduates of Medical Scientist Training Programs for faculty positions, as this group has better success at achieving R-level funding than do M.D.-only applicants. Another outcome is to help set ambitious but reasonable targets for improving the local landscape. Thus, we aim to reduce the average age of RGP-holding physician-scientists at OHSU by one year during the next 5 years. Although reversing current trends will not be easy, our analyses suggest that the average age of RPG level physician-scientists at OHSU would decrease were OHSU were to match the national-level proportions of women and M.D./Ph.D. physician-scientists. In addition to targeting gender disparities, we have recently implemented a program that supplements funding for recruiting young physician scientists, and then supporting their pursuit of RPG funding. Locally, a bright spot is the K to RPG transition rate for K23 awardees, which compare favorably with national data, an outcome that we plan to maintain. In analyzing this area of success, one reason is our strong mentorship program, called OCTRI Scholars, which is provided through our CTSA-sponsored institute. This has fostered an atmosphere of success among young physician-scientists and is one of the reasons that we endorse recommendation #9 from the PSWR, suggesting that Clinical and Translational Science Award (CTSA) Institutes play pivotal roles in monitoring and enhancing the success of the physician-scientist workforce. Thus, several perceived deficiencies might be addressed with adjustment of 1 or 2 specific institutional policies. While the specific opportunities and strengths may be different at other institutions, our proposed dashboard, which couples publicly curated, freely accessible databases, with readily available institutional resources, should help institutions to set and achieve their own goals.
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Borate, Uma, Amy S. Ruppert, Fei Yang, et al. "Newly Diagnosed AML Patient Samples Demonstrate High Degree of Concordance in Identification of Pathogenic Mutations By Next Generation Sequencing (NGS) Performed at Enrolling Institutions Compared to Central Laboratory Results in the Beat AML Master Trial." Blood 134, Supplement_1 (2019): 2145. http://dx.doi.org/10.1182/blood-2019-131253.
Full textAbstract:
Background: NGS of myeloid mutations is an integral part of AML clinical decision-making. There is currently no information regarding concordance between NGS panels in AML using samples from the same patient across various platforms in different diagnostic laboratories. To study this important question, we analyzed NGS of myeloid mutations in diagnostic samples from The Beat AML Master Trial (BAMT) for newly diagnosed older AML patients, and compared variant calls made between institutional laboratories enrolling the study subject with those made by Foundation Medicine (FM), the central laboratory used for treatment assignment in this precision medicine trial. Methods: We identified newly diagnosed AML patient samples (peripheral blood (PB) and/or bone marrow (BM)) from 2 lead institutions in the BAMT(Ohio State, OSU and Oregon Health and Sciences University, OHSU) that were analyzed by both the institutional and by FM from Nov 15, 2016 to Apr 15, 2019. Samples sent to both laboratories >3 days apart were excluded. Samples were analyzed at the institutional laboratories using their respective NGS mutational panels and by FM using the FoundationOne®Heme(FMH) NGS panel which utilizes capture based sequencing. The OSU NGS assay utilizes sequencing on Illumina MiSeq. The OHSU NGS assay employs semiconductor-based sequencing (Ion Torrent PGM platform). The variant allele frequency (VAF) sensitivity for detection for all 3 laboratories range from 1-2%. We evaluated the ability to identify mutations in 8 genes : FLT3, IDH1/ 2, NPM1, TET2, DNMT3A, WT1 and TP53 used in treatment assignment in theBAMT. A detection cutoff of 2% was used to define the presence or absence of a mutation. Overall, agreement was defined as the number of times the local and central laboratories made the same call divided by the total number of patients. Sensitivity was defined as the number of present calls made locally divided by the number of present calls made centrally, and specificity as the number of absent calls made locally divided by the number of absent calls made centrally. The overall kappa statistic, controlling for institution, provided another measure of agreement between local and central calls, where a value of 1 indicates perfect agreement. Results: 194 patient samples were identified using methods above and analyzed locally at the screening institution (125 at OSU, 69 at OHSU) and centrally at FM. Type of tissue analyzed for variants between local site and FM were 59 PB, 129 BM, and 6 with BM/PB mismatch. Overall agreement in presence/absence calls between local and central results for each of the 8 genes was over 95% (Table 1). There was perfect agreement for NPM1. The sensitivity was above 94% for all genes except TP53 (88.6%) and WT1 (63.6%). Failure to detect a mutation locally was primarily due to reporting of all TP53 variants, including variants of unknown significance (VUS) (5) by FM as agreed upon in the study protocol, detection at low levels below local site sensitivity cutoff (1), detection of variants in a portion of gene not covered at the local site(1)and possible artifact (1). For the WT1 gene, discordance in 5 samples included VUS (3) reported by FM ,a variant detected in a portion of the gene not covered at the local site(1).and difference in leukemic tissue analyzed with mutation not detected by the central laboratory on a PB sample, and present at the institutional lab on a BM sample; affecting the overall agreement and specificity but not sensitivity. Specificity was at least 98% for each of the 8 genes. Finally, most discrepancies in reported mutations in FLT3 (n=2), IDH1 (n=1), IDH2 (n=2), DNMT3A (n=4) and TET2 (n=5) were due to reporting of VUS in one laboratory and not by another. Conclusion: Detection of pathogenic myeloid mutations using orthogonal assays showed a high degree of concordance for genes used in therapeutic assignment on the BAMT.The small number of discordant results, in TP53 and WT1, were attributed to the reporting of VUS. This study illustrates the importance of quality control and standardization as NGS continues to be widely utilized in AML for clinical decision making, with a variety of platforms across multiple laboratories. Our next steps involve evaluating the differences in VAFs reported between local and central laboratories when a given mutation is identified, as well as the potential reasons for observed differences and clinical implications of known pathogenic mutations vs putative VUS. Disclosures Borate: Daiichi Sankyo: Consultancy; AbbVie: Consultancy; Novartis: Consultancy; Takeda: Consultancy; Pfizer: Consultancy. Vergilio:Foundation Medicine: Employment; Roche Holding AG: Equity Ownership. Stein:Novartis: Membership on an entity's Board of Directors or advisory committees; Celgene Corporation: Membership on an entity's Board of Directors or advisory committees; Daiichi Sankyo, Inc.: Membership on an entity's Board of Directors or advisory committees; Agios: Consultancy, Membership on an entity's Board of Directors or advisory committees; Astellas Pharma US, Inc: Membership on an entity's Board of Directors or advisory committees; Bioline: Membership on an entity's Board of Directors or advisory committees; Genentech: Membership on an entity's Board of Directors or advisory committees; PTC Therapeutics: Membership on an entity's Board of Directors or advisory committees; Syros: Membership on an entity's Board of Directors or advisory committees. Patel:France Foundation: Honoraria; Dava Oncology: Honoraria; Celgene: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Baer:Astellas: Research Funding; Abbvie: Research Funding; AI Therapeutics: Research Funding; Forma: Research Funding; Incyte: Research Funding; Kite: Research Funding; Takeda: Research Funding. Stock:Daiichi: Membership on an entity's Board of Directors or advisory committees; Astellas: Membership on an entity's Board of Directors or advisory committees; Agios: Membership on an entity's Board of Directors or advisory committees; Research to Practice: Honoraria; UpToDate: Honoraria; Kite, a Gilead Company: Membership on an entity's Board of Directors or advisory committees; Pfizer: Membership on an entity's Board of Directors or advisory committees. Schiller:Amgen: Other, Research Funding; Astellas: Research Funding; Biomed Valley Discoveries: Research Funding; Bristol Myer Squibb: Research Funding; Celgene: Research Funding, Speakers Bureau; Constellation Pharmaceutical: Research Funding; Daiichi Sankyo: Research Funding; Eli Lilly and Company: Research Funding; FujiFilm: Research Funding; Genzyme: Research Funding; Gilead: Research Funding; Incyte: Research Funding; J&J: Research Funding; Jazz Pharmaceuticals: Honoraria, Research Funding; Karyopharm: Research Funding; Novartis: Research Funding; Onconova: Research Funding; Pfizer Pharmaceuticals: Equity Ownership, Research Funding; Sangamo Therapeutics: Research Funding; Agios: Research Funding, Speakers Bureau. Blum:AmerisourceBergen: Consultancy; Boehringer Ingelheim: Research Funding; Celgene: Research Funding; Astellas,: Research Funding; Xencor: Research Funding; Forma: Research Funding. Kovacsovics:Pfizer: Research Funding; Jazz: Consultancy; Novartis: Research Funding; Abbvie: Research Funding; Amgen: Consultancy, Research Funding. Foran:Agios: Honoraria, Research Funding. Druker:Pfizer: Research Funding; OHSU (licensing fees): Patents & Royalties: #2573, Constructs and cell lines harboring various mutations in TNK2 and PTPN11, licensing fees ; Cepheid: Consultancy, Honoraria; Aileron Therapeutics: #2573, Constructs and cell lines harboring various mutations in TNK2 and PTPN11, licensing fees , Membership on an entity's Board of Directors or advisory committees; ALLCRON: Membership on an entity's Board of Directors or advisory committees; Amgen: Equity Ownership, Membership on an entity's Board of Directors or advisory committees; Aptose Biosciences: Consultancy, Equity Ownership, Membership on an entity's Board of Directors or advisory committees; Beta Cat: Membership on an entity's Board of Directors or advisory committees, Other: Stock options; GRAIL: Equity Ownership, Other: former member of Scientific Advisory Board; Patient True Talk: Consultancy; The RUNX1 Research Program: Membership on an entity's Board of Directors or advisory committees; Vivid Biosciences: Membership on an entity's Board of Directors or advisory committees, Other: Stock options; Beat AML LLC: Other: Service on joint steering committee; CureOne: Membership on an entity's Board of Directors or advisory committees; Celgene: Consultancy; Gilead Sciences: Other: former member of Scientific Advisory Board; ICON: Other: Scientific Founder of Molecular MD, which was acquired by ICON in Feb. 2019; Monojul: Other: former consultant; Novartis: Other: PI or co-investigator on clinical trial(s) funded via contract with OHSU., Patents & Royalties: Patent 6958335, Treatment of Gastrointestinal Stromal Tumors, exclusively licensed to Novartis, Research Funding; Bristol-Myers Squibb: Other: PI or co-investigator on clinical trial(s) funded via contract with OHSU., Research Funding; Pfizer: Other: PI or co-investigator on clinical trial(s) funded via contract with OHSU., Research Funding; Merck & Co: Patents & Royalties: Dana-Farber Cancer Institute license #2063, Monoclonal antiphosphotyrosine antibody 4G10, exclusive commercial license to Merck & Co; Dana-Farber Cancer Institute (antibody royalty): Patents & Royalties: #2524, antibody royalty; Burroughs Wellcome Fund: Membership on an entity's Board of Directors or advisory committees; Blueprint Medicines: Consultancy, Equity Ownership, Membership on an entity's Board of Directors or advisory committees; Bristol-Myers Squibb: Patents & Royalties, Research Funding. Byrd:Gilead: Other: Travel Expenses, Research Funding, Speakers Bureau; Genentech: Research Funding; Acerta: Research Funding; TG Therapeutics: Other: Travel Expenses, Research Funding, Speakers Bureau; Novartis: Other: Travel Expenses, Speakers Bureau; Pharmacyclics LLC, an AbbVie Company: Other: Travel Expenses, Research Funding, Speakers Bureau; Janssen: Consultancy, Other: Travel Expenses, Research Funding, Speakers Bureau; BeiGene: Research Funding; Ohio State University: Patents & Royalties: OSU-2S. Levine:C4 Therapeutics: Membership on an entity's Board of Directors or advisory committees; Isoplexis: Membership on an entity's Board of Directors or advisory committees; Celgene: Consultancy, Research Funding; Roche: Consultancy, Research Funding; Loxo: Membership on an entity's Board of Directors or advisory committees; Qiagen: Membership on an entity's Board of Directors or advisory committees; Amgen: Honoraria; Prelude Therapeutics: Research Funding; Novartis: Consultancy; Gilead: Consultancy; Lilly: Honoraria; Imago Biosciences: Membership on an entity's Board of Directors or advisory committees. Mims:Jazz Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; Astellas Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; PTC Therapeutics: Membership on an entity's Board of Directors or advisory committees; Agios Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; Abbvie: Membership on an entity's Board of Directors or advisory committees.
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"41st Annual Meeting of the Society for Medical Decision Making, Portland, Oregon, October 20–23, 2019." Medical Decision Making 40, no. 1 (2020): E1—E379. http://dx.doi.org/10.1177/0272989x19890544.
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Upton, Erin, and Max Nielsen-Pincus. "Climate Change and Water Governance: Decision Making for Individual Vineyard Owners in Global Wine Regions." Frontiers in Climate 3 (June 7, 2021). http://dx.doi.org/10.3389/fclim.2021.654953.
Full textAbstract:
This study investigates the institutional, social, and ecological dynamics that influence regional water governance and individual vineyard owners' decision making in global wine regions. Global wine grape production has grown steadily over the past 20 years, and climate change has emerged as a driver of transformation in wine regions resulting in a range of impacts. Changes to the climate are anticipated to accelerate in the future and present a number of challenges for wine regions; including risks to human systems, e.g., agriculture, labor, and economics, as well as ecological systems, e.g., surface and groundwater. Water is a critical resource for environmental and economic sustainability in wine regions, and vulnerability to freshwater resources in wine producing regions is expected to increase as wine regions experience climate extremes like heat and drought. We use the Institutional-Social-Ecological Dynamics (ISED) framework to help understand individual vineyard owner decision making about water management within the context of institutional, social, and ecological systems. We ask how the relationships between these systems impact outcomes for individual grape farmers adapting to climate challenges. Our empirical research uses document review and interviews with vineyard owners, planners, and natural resource managers in wine regions in Oregon, USA and Tasmania, Australia as a means to explore climate vulnerabilities and adaptation approaches. Subsequently we focus on an example vignette in each region to better understand individual decision making at the farm scale within the unique institutional, social, and ecological contexts identified in each region. Our cases highlight the finding that entrenched institutional regimes, in the context of ecological variability contribute to a social unevenness in access to water. Landowner conflict over water resources is likely to increase in the context of a hotter, drier climate in regions with wine industry growth. Individual vineyard owners have a range of attitudes and approaches to climate change planning and management; and adaptation around water is dependent on both economic resources and social values. Lessons from the individual farm scale help to inform broader implications of how institutional, social, and ecological drivers influence opportunities or barriers to the implementation of climate change adaptation practices in wine regions.
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Glass, Nancy E., Amber Clough, Jill T. Messing, et al. "Longitudinal Impact of the myPlan App on Health and Safety Among College Women Experiencing Partner Violence." Journal of Interpersonal Violence, February 12, 2021, 088626052199188. http://dx.doi.org/10.1177/0886260521991880.
Full textAbstract:
The objective of this study was to examine differences in change over time in health and safety outcomes among female college students randomized to myPlan, a tailored safety planning app, or usual web-based safety planning resources. Three hundred forty-six women (175 intervention, 171 control) from 41 colleges/universities in Oregon and Maryland completed surveys at baseline, 6- and 12-months from July 2015 to October 2017. Generalized estimating equations were used to test group differences across time. Both groups improved on four measure of intimate partner violence (IPV; Composite Abuse Scale [CAS], TBI-related IPV, digital abuse, reproductive coercion [RC]) and depression. Reduction in RC and improvement in suicide risk were significantly greater in the myPlan group relative to controls ( p = .019 and p = .46, respectively). Increases in the percent of safety behaviors tried that were helpful significantly reduced CAS scores, indicating a reduction in IPV over time in the myPlan group compared to controls ( p = .006). Findings support the feasibility and importance of technology-based IPV safety planning for college women. myPlan achieved a number of its objectives related to safety planning and decision-making, the use of helpful safety behaviors, mental health, and reductions in some forms of IPV.
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Mushinski, David, Sammy Zahran, and Aanston Frazier. "Physician behaviour, malpractice risk and defensive medicine: an investigation of cesarean deliveries." Health Economics, Policy and Law, February 1, 2021, 1–19. http://dx.doi.org/10.1017/s1744133120000432.
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Abstract Analyzing whether physicians use cesarean sections (c-sections) as defensive medicine (DM) has proven difficult. Using natural experiments arising out of Oregon court decisions overturning a state legislative cap on non-economic damages in tort cases, we analyze the impact of patient conditions on estimates of DM. Consistent with theory, we find heterogeneous impacts of tort laws across patient conditions. When medical exigencies dictate a c-section, tort laws have no impact on physician decisions. When physicians have latitude in their decision making, we find evidence of DM. When we estimate a model combining all women and not accounting for patient conditions (such as models estimated in previous studies) we obtain a result which is the opposite of DM, which we call offensive medicine (OM). The OM result appears to arise out of a bias in the difference-in-differences estimator associated with changes in the marginal distributions of patient conditions in control and treatment groups. The changes in the marginal distributions appear to arise from the impact of tort law on the market for midwives (substitutes for physicians for low-risk women). Our analysis suggests that not accounting for theoretically expected heterogeneity in physician reactions to changes in tort laws may produce biased estimates of DM.
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Garcia Godoy, Laura, Erin J. Madriago, and christina ronai. "Abstract 14242: Homogeneous Fetal Access to Cardiac Care in a Heterogeneous State." Circulation 142, Suppl_3 (2020). http://dx.doi.org/10.1161/circ.142.suppl_3.14242.
Full textAbstract:
Introduction: Timely prenatal diagnosis of congenital heart disease (CHD) allows for families to participate in complex decisions and plan for the care of their child. This study sought to investigate if the timing of the first fetal echocardiogram (FE) and the characteristics of fetal counseling were impacted by parental socioeconomic factors. Hypothesis: We hypothesized that the scheduling of initial FE would be delayed due to distance from hospital, rurality of maternal home and median income. Methods: We performed a retrospective chart review of all fetal patients referred to our institution from 1/1/17 to 12/31/18 with a diagnosis of CHD. We looked at the gestational age at the first FE, age of mother, zip code of residence, rurality index, distance from our hospital and maternal ethnicity. Counseling was evaluated based on documentation in the FE report regarding use of interpreter, time billed for counseling, individuals accompanying mother, and treatment option chosen. Results: 138 maternal-fetal dyads met inclusion criteria, 29 dyads had a diagnosis of single ventricle heart disease. The median gestational age (GA) at first FE was 24 weeks 4 days. The median income was $57,019 ($42,624-$83,695), and the median distance to the hospital was 51 miles (3.2-379.9miles). There was no difference in income, distance from hospital or rurality index and timing of first FE. There was no significant difference between maternal ethnicity and age of mother, GA at initial FE, number of follow-up FEs or family accompanying mother to the visit. There was no difference in maternal ethnicity and use of interpreter with time counseled. Patients who lived in rural areas did have increased counseling time (p<.05). Importantly, there was no difference between socioeconomic factors and ultimate parental choices (termination, palliative delivery or surgery). Conclusions: Oregon comprises a heterogeneous population from a large geographical catchment. While prenatal counseling and family decision making is multifaceted we demonstrated that dyads were referred from across the state and received care in a uniformly timely manner, and once at our center received consistent counseling despite differences in parental socioeconomic factors.