Subject Matter Expert Opinion Research Articles

A Collaboration to Unify Emergency Nurse Practitioner Competencies

Competencies reflect evidence-based behaviors that graduates must demonstrate before graduation and entry to practice. When evidence is inadequate or absent, subject matter expert opinion serves as a reliable and valuable resource. The emergency nurse practitioner specialty represents a focused and discrete area of practice requiring competencies reflective of unique practice. This article discusses the collaborative journey of subject matter experts from the American Academy of Emergency Nurse Practitioners and the Emergency Nurses Association as they merged existing competency documents into 1 nationally recognized set of competencies for emergency nurse practitioners.

Nursing Perspectives on the Impacts of COVID-19: Social Media Content Analysis.

BackgroundNurses are at the forefront of the COVID-19 pandemic. During the pandemic, nurses have faced an elevated risk of exposure and have experienced the hazards related to a novel virus. While being heralded as lifesaving heroes on the front lines of the pandemic, nurses have experienced more physical, mental, and psychosocial problems as a consequence of the COVID-19 outbreak. Social media discussions by nursing professionals participating in publicly formed Facebook groups constitute a valuable resource that offers longitudinal insights.ObjectiveThis study aimed to explore how COVID-19 impacted nurses through capturing public sentiments expressed by nurses on a social media discussion platform and how these sentiments changed over time.MethodsWe collected over 110,993 Facebook discussion posts and comments in an open COVID-19 group for nurses from March 2020 until the end of November 2020. Scraping of deidentified offline HTML tags on social media posts and comments was performed. Using subject-matter expert opinions and social media analytics (ie, topic modeling, information retrieval, and sentiment analysis), we performed a human-in-a-loop analysis of nursing professionals’ key perspectives to identify trends of the COVID-19 impact among at-risk nursing communities. We further investigated the key insights of the trends of the nursing professionals’ perspectives by detecting temporal changes of comments related to emotional effects, feelings of frustration, impacts of isolation, shortage of safety equipment, and frequency of safety equipment uses. Anonymous quotes were highlighted to add context to the data.ResultsWe determined that COVID-19 impacted nurses’ physical, mental, and psychosocial health as expressed in the form of emotional distress, anger, anxiety, frustration, loneliness, and isolation. Major topics discussed by nurses were related to work during a pandemic, misinformation spread by the media, improper personal protective equipment (PPE), PPE side effects, the effects of testing positive for COVID-19, and lost days of work related to illness.ConclusionsPublic Facebook nursing groups are venues for nurses to express their experiences, opinions, and concerns and can offer researchers an important insight into understanding the COVID-19 impact on health care workers.

Common Myths About Coronavirus Disease-19 ( COVID-19) Among Adults

Objective. People adopted different attitudes and behaviors during the outbreak of COVID19pandemic. It results in development of various myths among the peoplewhichalso effect adoption ofprecautionary measures. The present study thus attempted to assess common myths related toCOVID-19 in Pakistan among general population of adults.Method. A list of 33 myths was generated based on literature, opinion of subject matter experts, andgeneral observation of myths prevailing in Pakistan. It was used to assess myths about COVID-19 forthe sample (N=220) of adults (Mage=27.9; SDage=10.2).Results. Results suggested that the most prevalent myths are:(a)older people are more vulnerable to getinfected of COVID-19 (82%) and (b) thermal scanners can detect if the person is infected of virus(75%). Participants also mention some associated indigenous myths e.g., COVID-19 doesn’t prevail,deaths are misreported as caused by Corona virus, and Corona recovered people can’t get infected againetc. Results of t-test suggested that men are stronger myths believers as compared to women.Differences with respect to education demonstrated that undergraduates and graduates are significantlyhigher believers of myth than postgraduates.Implications. Findings could help to develop a clear awareness of the false beliefs about COVID-19.Addressing the false beliefs would assist in ensuring the adoption of necessary precautionsas beliefsclosely associate with preventive measures adopted.

Predicting the effect of decompression sickness on survival following submarine tower escape

Purpose The purpose of the present study was the development of a methodology for translating predicted rates of decompression sickness (DCS), following tower escape from a sunken submarine, into predicted probability of survival, a more useful statistic for making operational decisions. Design/methodology/approach Predictions were made, using existing models, for the probabilities of a range of DCS symptoms following submarine tower escape. Subject matter expert estimates of the effect of these symptoms on a submariner’s ability to survive in benign weather conditions on the sea surface until rescued were combined with the likelihoods of the different symptoms occurring using standard probability theory. Plots were generated showing the dependence of predicted probability of survival following escape on the escape depth and the pressure within the stricken submarine. Findings Current advice on whether to attempt tower escape is based on avoiding rates of DCS above approximately 5%–10%. Consideration of predicted survival rates, based on subject matter expert opinion, suggests that the current advice might be considered as conservative in the distressed submarine scenario, as DCS rates of 10% are not anticipated to markedly affect survival rates. Originality/value According to the authors’ knowledge, this study represents the first attempt to quantify the effect of different DCS symptoms on the probability of survival in submarine tower escape.

Consumer adoption of interactive teller machines: evidence from the Arabian Gulf

With the rise of technology, banks have been seeking strategies to retain consumer loyalty. This increases customer's share of the wallet. Offering unified experience across banking channel touchpoints increases customer loyalty. Recently, banks have been executing branch transformation initiatives, utilising new technologies such as interactive teller machines (ITMs). This study investigated the factors that influence banking consumers to adopt the ITMs in the Arabian Gulf region. It combined variables from research related to consumer adoption of digital e-banking services, effects of retail banking services staff, and design of branches. A model based on previous studies and subject matter expert opinions was proposed. Quantitative research was conducted targeting consumers in the Arabian Gulf. Responses were analysed using Pearson's correlation, hierarchical regression analysis, and other statistical analysis tools. The findings of the research suggest that convenience, security, and social influence were the factors that significantly impacted consumer intention to adopt the ITM.

MENTAL STATE TALK: ASSESSMENT THROUGH WORDLESS PICTURE STORY BOOK READING

Mental state talk involves words that describe the mental world of individuals. These could be words that are about thoughts, feelings, desires, intentions, and emotions. There has been dearth of research in Pakistan assessing the parents and teachers’ use of mental state talk in conversation with young children, commonly because of lack of assessment tool that are employed to measure the mental state talk in Pakistan. The present study aimed at validation and development of indigenous tool for the assessment of mental state talk of parents/teachers to use with children. Wordless picture story book reading was selected as one the various methods devised for mental state talk assessment; which facilitates interactions between parents/teachers and their children. For validation, Indigenous picture story books were reviewed for its content and modified through opinion of subject matter experts. Content and face validity of the story book were examined and found to be good. The finding concluded that finalized wordless picture story book has rich mental state content and has great potential to stimulate rich discourse on mental state talk. It will bridge the research gap and will promote as a good measurement instrument for research on mental state talk in Pakistan.

Problems with research methods in medical device big data analytics

This paper reviews the literature as well as subject matter expert opinions and examines how research methods are being applied in medical device big data analytics. The focus of the study is to identify benefits and illustrate problems when applying certain research methods with healthcare big data. The intended audience is high-level healthcare decision makers, data science researchers, and healthcare big data practitioners. The key results address unintended access to healthcare data, statistical sampling violations with the use of healthcare big data, and the challenges associated with statistical false positives in big data. Solutions for these problems are proposed along with recommendations for further research.

A Framework for Teaching Security Design Analysis Using Case Studies and the Hybrid Flipped Classroom

With ever-greater reliance of the developed world on information and communication technologies, constructing secure software has become a top priority. To produce secure software, security activities need to be integrated throughout the software development lifecycle. One such activity is security design analysis (SDA), which identifies security requirements as early as the software design phase. While considered an important step in software development, the general opinion of information security subject matter experts and researchers is that SDA is challenging to learn and teach. Experimental evidence provided in literature confirms this claim. To help solve this, we have developed a framework for teaching SDA by utilizing case study analysis and the hybrid flipped classroom approach. We evaluate our framework by performing a comparative analysis between a group of students who attended labs generated using our framework and a group that participated in traditional labs. Our results show that labs created using our framework achieve better learning outcomes for SDA, as opposed to the traditional labs. Secondary contributions of our article include teaching materials, such as lab descriptions and a case study of a hospital information system to be used for SDA. We outline instructions for using our framework in different contexts, including university courses and corporate training programs. By using our proposed teaching framework, with our or any other case study, we believe that both students and employees can learn the craft of SDA more effectively.

Preschool Social Behavior Scale-Peer Form: Turkish validity and reliability study

Objective: The aim of this study is to test the validity and reliability of Preschool Social Behavior Scale-Peer Form, which was developed to measure preschool children’s social behaviors based on peers’ assessment for Turk-ish. Methods: The Preschool Social Behavior Scale-Peer Form is a 12-item survey that was developed to evaluate in-class social behaviors of preschool children from the perspective of their peers. The form consists of three dimensions, i.e. overt/physical aggression, relational aggression, and prosocial behavior. The data for testing the validity and reliability of the survey were collected from 239 preschool children aged between 36 and 72 months, who have attended preschool living in five districts of Ankara, Turkey. With regard to validity study, subject-matter expert opinions were to ensure the content validity, and Confirmatory Factor Analysis was conducted/used to test construct validity. Internal consistency (Cronbach’s alpha) was used for the reliability study. Findings: The results of confirmatory factor analysis showed that fit indices of the scale mainly indicate a perfect model-data fit (RMSEA=0.047, GFI=0.95, AGFI=0.92, RMR=0.042, S-RMR=0.044, NFI=0.93, NNFI=0.96, IFI=0.97, RFI=0.91, and CFI=0.97), and that the adapted version comprises the three dimensions and 12 items, that already exist in the original version (i.e. overt/physical aggression, relational aggression, and prosocial behavior). The internal consistency values of dimensions of overt/physical aggression, relational aggression, and prosocial behavior are respectively 0.73, 0.65, and 0.73. Result: These findings state that the Turkish version of the scale is a valid and reliable instrument.

Modeling uncertainty of expert elicitation for use in risk-based optimization

Capital budgeting optimization models, used in a broad number of fields, require certain and uncertain parameters. Often times, elicited subject matter expert (SME) opinion is used as a parameter estimate, which does not always yield perfect information or correspond to a single value. Because of the uncertainty of the elicitation, the unknown true value of a parameter can be modeled as a random variable from a to-be-determined distribution. We estimate a univariate distribution using four different approaches, the Beta and Gaussian distributions, a standard Gaussian Kernel estimate, and an exponential epi-spline. We also capture dependencies within the parameters through three multivariate approaches: the multivariate Gaussian distribution, the multivariate Kernel and the multivariate exponential epi-spline. This is the first three-dimensional application of the latter. Sampling from the densities, we generate scenarios and implement a superquantile risk-based, capital budgeting optimization model. Numerical experiments contrast the differences between estimators, as well as their effects on an optimal solution. Our findings demonstrate that naively averaging the SME observations for use in optimization, rather than incorporating uncertainty, results in an overly optimistic portfolio. The flexibility of the exponential epi-spline estimator to fuse soft information with observed data produces reasonable density functions for univariate and multivariate random variables. Including a decision-maker’s risk-averseness through risk-based optimization delivers conservative results while incorporating the uncertainty of unknown parameters. We demonstrate a 20% improvement for this specific case when using our approach as opposed to the naive method.

Feature Specific Assessment of Time History Signals by Objective Evaluation and Subject Matter Expert Opinion

Objective evaluation (OE) methods provide quantitative insight into how well time history data from computational models match data from physical systems. Two feature specific techniques commonly used for this purpose are cora and the ISO/TS 18571 standards. These ostensibly objective techniques have differences in their algorithms that lead to discrepancies when interpreting their results. The objectives of this study were (1) to apply both techniques to a dataset from a computational model, and compare the scores and (2) conduct a survey of subject matter experts (SMEs) to determine which OE method compares more consistently with SME interpretation. The GHBMC male human model was used in simulations of biomechanics experiments, producing 58 time history curves. Because both techniques produce scores based on specific features of the signal comparison (phase, size, and shape), 174 pairwise comparisons were made. Statistical analysis revealed significant differences between the two OE methods for each component rating metric. SMEs (n = 40) surveyed scored how well the computational traces matched the experiments for the three rating metrics. SME interpretation was found to statistically agree with the ISO shape and phase metrics, but was significantly different from the ISO size rating. SME interpretation agreed with the cora size rating. The findings suggest that when possible, engineers should use a mixed approach to reporting objective ratings, using the ISO shape and phase methods, and size methods of cora. We recommend to weight metrics greatest to least for shape, phase, and size. Given the general levels of agreement observed and the sample size, the results require a nuanced interpretation.

A model‐based systems engineering approach to critical infrastructure vulnerability assessment and decision analysis

AbstractSecuring critical infrastructure against attack presents significant challenges. As new infrastructure is built and existing infrastructure is maintained, a method to assess the vulnerabilities and support decision makers in determining the best use of security resources is needed. In response to this need, this research develops a methodology for performing vulnerability assessment and decision analysis of critical infrastructure using model‐based systems engineering, an approach that has not been applied to this problem. The approach presented allows architects to link regulatory requirements, system architecture, subject matter expert opinion and attack vectors to a Department of Defense Architecture Framework (DoDAF)‐based model that allows decision makers to evaluate system vulnerability and determine alternatives to securing their systems based on their budget constraints. The decision analysis is done using an integer linear program that is integrated with DoDAF to provide solutions for how to allocate scarce security resources. Securing an electrical substation is used as an illustrative case study to demonstrate the methodology. The case study shows that the method presented here can be used to answer key questions, for example, what security resources should a decision maker invest in based on their budget constraints? Results show that the modeling and analysis approach provides a means to effectively evaluate the infrastructure vulnerability and presents a set of security alternatives for decision makers to choose from, based on their vulnerabilities and budget profile.

Paediatric traumatic cardiac arrest: a Delphi study to establish consensus on definition and management

AimsPaediatric traumatic cardiac arrest (TCA) is associated with low survival and poor outcomes. The mechanisms that underlie TCA are different from medical cardiac arrest; the approach to treatment of TCA...

Conversion between 2 military combat-related injury coding systems.

Deployable medical systems(DEPMEDS) patient conditions (PCs) and Military Combat Injury Scale (MCIS) are 2 important military medical coding systems. However, both of them have defects when applied in military medical planning. Although each PC code contains information about treatment, intensity of care, treatment time, length of stay, and probability of disposition that is relevant to simulation, its description is too comprehensive and ambiguous to code historical military medical records. Therefore, conversion between PC and other medical coding systems applied in standard medical data is required when validity is required following simulation. The information linked to each PC code is based on subject matter expert opinion instead of standard medical data from the theater that need to be continuously updated depending on the results of medical data analysis. MCIS, a combat-related injury coding system, shows significant promise in coding real medical data, but it does not seek detailed information important for prediction and simulation unlike PCs. Therefore, MCIS cannot be used in planning tools directly. Thus, the effort to map MCIS to PCs is significant for medical logistic planning. We aim to identify whether conversion between PCs and MCIS is possible and to evaluate inter-coder reliability.Three senior coders assigned all possible MCIS codes to 187 combat-related PC codes. The data records were structured based on an earlier study. Inter-rater reliability was measured by using Cohen's k statistic and percent agreement.Low inter-rater reliability indicated the difficulty in conversion between PCs and MCIS.The injury descriptors of PCs should be expanded by referring to new standard medical data. The existing MCIS codes need to be modified to include more information on treatment brief, treatment time, length of stay, and other key information, and historical data statistics need to be developed.

The Potential for Sex Bias in Physical Employment Test Design

Physical employment tests often simulate job-related tasks. The implementation of such tests can be constrained by cost, ease, and simplicity, which may unintentionally create a sex bias. PURPOSE: To investigate potential sex bias in prototype UK Royal Navy (RN) physical employment tests. METHODS: One hundred and fifty RN personnel volunteered (men n=75, women n=75). Physical characteristics, mean ± SD were (men vs. women): age 32 ± 8 vs. 29 ± 6 years; stature 1.77 ± 0.06 vs. 1.65 ± 0.05 m; body mass 81.0 ± 10.7 vs. 67.5 ± 9.8 kg. Five tests were developed with cylindrical, sand-filled Powerbags that simulated manual handling tasks performed onboard RN warships. Tests included two variants of an Aft Casualty Carry (35.0 kg and 41.5 kg, 10 m), Fore Casualty Carry (27.0 kg, 10 m), Foam Drum Carry (2 × 21.6 kg, 60 m), and Damage Control Timber Carry (28.4 kg, 50 m). Loads and distances were derived from equipment, infrastructure, Subject Matter Expert opinion, and anthropometric norms. Tests were performed as quickly as possible. A sub-sample of women (n=19) also performed a modified Aft Casualty Carry test using a Barbell (circumference 0.08 m) instead of a Powerbag (circumference 0.91 m). Cut-scores were developed for all tests. RESULTS: All men (100%) passed all tests. Compared to men the pass rates of women were above 80% in three tests (Fore Casualty Carry (88%), Foam Drum Carry (92%), Damage Control Timber Carry (89%)), but lower than 80% in both Aft Casualty Carry tests (29% 35.0 kg test; 8% 41.5 kg test). The lifting phase accounted for the majority of Aft Casualty Carry failures (49% 35.0 kg test; 77% 41.5 kg test). Within the sub-sample (n=19), 100% of women successfully lifted the Barbell Aft Casualty Carry loads, but markedly less lifted the same loads in the Powerbag version of the test (58 % and 32 % in the 35.0 kg and 41.5 kg tests, respectively). CONCLUSIONS: The larger circumferential girth of the Powerbag in the Aft Casualty Carry test was not representative of the anthropometric dimensions of a casualty, and appeared to create a sex bias against women. This highlights the potential risk of sex bias if physical employment test implementation considerations are prioritised above the faithful replication of simulated job-based tasks.

Mapeamento da Fragilidade Ambiental na Bacia do Rio Aldeia Velha, RJ

RESUMO Este trabalho apresenta um modelo para determinar a fragilidade ambiental em bacias hidrográficas. O estudo foi realizado na Bacia do Rio Aldeia Velha, RJ, localizada na zona de contato e transição entre a baixada litorânea e o relevo montanhoso da Serra do Mar. Fatores que influenciam a ocorrência de processos erosivos foram integrados por algoritmos em um SIG para construção de classes de fragilidade. A análise multicriterial considerou o modelo numérico de terreno, dados oficiais sobre variáveis ambientais, imagem orbital de alta resolução e a opinião de especialistas. Através de informações secundárias sobre pedologia, intensidade das chuvas e declividade do terreno gerou-se o Mapa de Fragilidade Potencial (MFP). Através da combinação desse mapa com informações sobre uso e cobertura da terra obteve-se o Mapa da Fragilidade Emergente (MFE). Os resultados mostram que mais de 70% da área da bacia possui fragilidade ambiental considerada alta ou muito alta, tanto potencial como emergente. Os Processos Erosivos Aparentes (PEA) relacionaram-se positivamente com as áreas de alta fragilidade nos produtos cartográficos finais, destacando regiões mais propensas à intensificação de movimentos de massa e prioritárias para prevenção contra perda de solo. Os modelos geraram informações importantes para o planejamento territorial, possibilitando um zoneamento acessível e de fácil atualização para as prefeituras municipais e organizações da sociedade civil, inclusive para o monitoramento das áreas de alta fragilidade ambiental.

Measuring Youth Health Engagement: Development of the Youth Engagement With Health Services Survey

PurposeThe purpose of this study was to create and validate a survey instrument designed to measure Youth Engagement with Health Services (YEHS!). MethodsA 61-item YEHS! survey was created through a multistaged process, which included literature review, subject matter expert opinion, review of existing validated measures, and cognitive interviewing with 41 adolescents in Colorado and New Mexico. The YEHS! was then pilot tested with a diverse group of high school students (n = 354) accessing health services at one of eight school-based health centers in Colorado and New Mexico. We conducted psychometric analyses and examined correlations between the youth health engagement scales and measures of quality of care. ResultsWe created scales to measure two domains of youth health engagement: health access literacy and health self-efficacy. The youth health engagement scales demonstrated strong reliability (Cronbach's α .76 and .82) and construct validity (mean factor loading .71 and .76). Youth health engagement scores predicted higher experiences of care scores (p < .001) and receipt of more anticipatory guidance (p < .01). ConclusionsThis study supports the YEHS! as a valid and reliable measure of youth health engagement among adolescents using school-based health centers. We demonstrate an association between youth health engagement and two quality of care measures. Additional testing is needed to ensure the reliability and validity of the instrument in diverse adolescent populations.

Statistical Modeling of Combat Mortality Events by Using Subject Matter Expert Opinions and Operation Iraqi Freedom Empirical Results from the Navy-Marine Corps Combat Trauma Registry

In 12 Navy—Marine Corps medical logistics studies and analyses conducted by the Naval Health Research Center (NHRC) and Teledyne Brown Engineering (TBE) over the past 5 years, estimates of battlefield mortality have been a major metric of interest to medical planners. An ongoing concern is how mortality is related to delays in treatment for medical logistics reasons. In this paper, we describe how NHRC and TBE have been developing a statistically based model for mortality since 2003, first starting with panel results from a group of military medical doctors and continuing here with an analysis of empirical injury data from Operation Iraqi Freedom (OIF). The panel results and statistical analysis of life-threatening injury data in OIF from early 2004 to mid-2006 indicate that the Weibull distribution describes the timing of high risk of mortality events in a reasonable manner within surgical medical treatment facilities. The quest for a best-fitting probability distribution with parameters dependent on the casualty flow chain of treatment and evacuation in the theater is ongoing. In reality, combining analytical and subject matter expert (SME) results to model mortality is necessary given the breadth of theater medical delivery systems and general paucity of adequate empirical data in many of the segments of patient flow.

The Need for a Lower Extremity Risk Assessment Model

Current ergonomic risk assessment tools do not assess possible occupational (extrinsic) and personal (intrinsic) risk factors for the lower extremity regions of employees. This document proposes that it is possible to develop a lower extremity risk assessment (LERA) model for quantifying such risks. A literature review was conducted for work-related musculoskeletal disorders of the lower extremity that affect the nervous, muscular, vascular, and skeletal systems. This initial model of LERA was developed using epidemiological literature and subject matter expert opinion specifically for the knee joint and is considered a preliminary step towards quantifying the etiology of cumulative occupational knee disorders.

The Need for a Lower Extremity Risk Assessment Model

Current ergonomic risk assessment tools do not assess possible occupational (extrinsic) and personal (intrinsic) risk factors for the lower extremity regions of employees. This document proposes that it is possible to develop a lower extremity risk assessment (LERA) model for quantifying such risks. A literature review was conducted for work-related musculoskeletal disorders of the lower extremity that affect the nervous, muscular, vascular, and skeletal systems. This initial model of LERA was developed using epidemiological literature and subject matter expert opinion specifically for the knee joint and is considered a preliminary step towards quantifying the etiology of cumulative occupational knee disorders.