Reasons For Variance Research Articles

Switch rates vary due to expected payoff but not due to individual risk tendency

When switching between different tasks, the initiation of task switches may depend on task characteristics (difficulty, salient cues, etc.) or reasons within the person performing the task (decisions, behavioral variability, etc.). The reasons for variance in switching strategies, especially in paradigms where participants are free to choose the order of tasks and the amount of switching between tasks, are not well researched. In this study, we follow up the recent discussion that variance in switching strategies might be partly explained by the characteristics of the person fulfilling the task. We examined whether risk tendency and impulsiveness differentiate individuals in their response (i.e., switch rates and time spent on tasks) to different task characteristics on a tracking-while-typing paradigm. In detail, we manipulated two aspects of loss prospect (i.e., “payoff” as the amount of points that could be lost when tracking was unattended for too long, and “cursor speed” determining the likelihood of such a loss occurring). To account for between-subject variance and within-subject variability in the data, we employed linear mixed effect analyses following the model selection procedure (Bates, Kliegl, et al., 2015). Besides, we tested whether risk tendency can be transformed into a decision parameter which could predict switching strategies when being computationally modelled. We transferred decision parameters from the Decision Field Theory to model “switching thresholds” for each individual. Results show that neither risk tendency nor impulsiveness explain between-subject variance in the paradigm, nonetheless linear mixed-effects models confirmed that within-subject variability plays a significant role for interpreting dual-task data. Our computational model yielded a good model fit, suggesting that the use of a decision threshold parameter for switching may serve as an alternative means to classify different strategies in task switching.

Predictors for the utilization of social service counseling by prostate cancer patients.

PurposeSocial service counseling (SSC) is an important instrument to support cancer patients, for example, regarding legal support, or rehabilitation. Several countries have established on-site SSC in routine care. Previous analyses have shown that SSC utilization varies across cancer centers. This analysis investigates patient and center-level predictors that explain variations in SSC utilization between centers.MethodsLogistic multilevel analysis was performed with data from 19,865 prostate cancer patients from 102 prostate cancer centers in Germany and Switzerland. Data was collected within an observational study between July 2016 and June 2020 using survey (online and paper) and tumor documentation.ResultsThe intraclass correlation coefficient for the null model implies that 51% of variance in SSC utilization is attributable to the center a patient is treated in. Patients aged 80 years and older, with higher education, private insurance, without comorbidities, localized intermediate risk, and undergoing androgen deprivation therapy before study inclusion were less likely to utilize SSC. Undergoing primary radiotherapy, active surveillance, or watchful waiting as compared to prostatectomy was associated with a lower likelihood of SSC utilization. Significant negative predictors at the center level were university hospital, center’s location in Switzerland, and a short period of certification.ConclusionThe results show that patient and center characteristics contribute to explaining the variance in SSC utilization in prostate cancer centers to a large extent. The findings may indicate different organizational processes in the countries included and barriers in the sectoral structure of the healthcare system. In-depth analyses of processes within cancer centers may provide further insights into the reasons for variance in SSC utilization.

Do They See What You See?: HR Practices, Employee Perceptions, and Outcomes

Strategic human resource management (HRM) scholars have recognized that employee perceptions and reactions to HR practices are consequential. However, the reasons for variance in employee perceptio...

Management of Fever, Hyperglycemia, and Dysphagia in an Acute Stroke Unit.

Adherence to treatment protocols to manage fever, hyperglycemia, and dysphagia is associated with reduced levels of mortality and morbidity in acute stroke patients. However, the extent of research translation in this area is unclear. The aim of this study was to determine whether there is an evidence-practice gap in the management of fever, hyperglycemia, and dysphagia in an acute stroke unit. Medical records were audited to determine whether clinical practice was consistent with best practice, as defined by treatment protocols used within the Quality in Acute Stroke Care study. Data were collected regarding the assessment and management of fever, hyperglycemia, and dysphagia. Reasons for variance from "best practice" care were noted. The case note audit took place in an acute stroke unit in a large teaching hospital in Australia. Participants were 53 stroke survivors discharged from the study site over a 6-month period in 2013. Care processes did not consistently reflect best practice. Temperature was monitored 4-6 hourly in 62% of the patients. Fifty-three percent of the patients had a fingerprick blood glucose level on admission to the stroke unit and only 4% of the patients were monitored 6th hourly. Data showed that 83% of the patients received a swallow assessment within 24hours by a speech pathologist. Thirty percent of the patients were given food and fluids before speech assessment. Only eight patients (26%) directly admitted to the stroke unit received best practice assessment of temperature, blood glucose, and dysphagia. Current practice does not reflect best practice. Barriers to research translation are currently unclear but must be overcome to improve care quality for stroke survivors. Multifaceted interventions to ensure uptake of care protocols are required. Consistent provision of evidence-based practice needs to be available to ensure patients are provided with the best nursing care following stroke.

Expenditure Analysis of HIV Testing and Counseling Services Using the Cascade Framework in Vietnam.

ObjectivesCurrently, HIV testing and counseling (HTC) services in Vietnam are primarily funded by international sources. However, international funders are now planning to withdraw their support and the Government of Vietnam (GVN) is seeking to identify domestic funding and generate client fees to continue services. A clear understanding of the cost to sustain current HTC services is becoming increasingly important to facilitate planning that can lead to making HTC and other HIV services more affordable and sustainable in Vietnam. The objectives of this analysis were to provide a snapshot of current program costs to achieve key program outcomes including 1) testing and identifying PLHIV unaware of their HIV status and 2) successfully enrolling HIV (+) clients in care.MethodsWe reviewed expenditure data reported by 34 HTC sites in nine Vietnamese provinces over a one-year period from October 2012 to September 2013. Data on program outcomes were extracted from the HTC database of 42,390 client records. Analysis was carried out from the service providers’ perspective.ResultsThe mean expenditure for a single client provided HTC services (testing, receiving results and referral for care/treatment) was US $7.6. The unit expenditure per PLHIV identified through these services varied widely from US $22.8 to $741.5 (median: $131.8). Excluding repeat tests, the range for expenditure to newly diagnose a PLHIV was even wider (from US $30.8 to $1483.0). The mean expenditure for one successfully referred HIV client to care services was US $466.6. Personnel costs contributed most to the total cost.ConclusionsOur analysis found a wide range of expenditures by site for achieving the same outcomes. Re-designing systems to provide services at the lowest feasible cost is essential to making HIV services more affordable and treatment for prevention programs feasible in Vietnam. The analysis also found that understanding the determinants and reasons for variance in service costs by site is an important enhancement to the cascade of HIV services framework now adapted for and extensively used in Vietnam for planning and evaluation.

Lean Manufacturing: Selected Financial Performance Of Recognized Lean Manufacturers

Since the Japanese development of lean manufacturing practices after World War II, American companies have slowly begun to embrace the concepts and results offered by the lean manufacturing concept. Companies in America did not fully embrace the value of the processes until the mid to late 1990s and some firms are finding that financial results that should have been positively impacted immediately are not showing the results promised by Japanese practitioners. Two companies, Delphi and Johnson Controls, were selected for comparative analysis because of the numerous facilities that each have had selected for the Shingo Prize for Excellence in Manufacturing. Both companies have been engrained in the traditional mass-producing methods of American production from mother companies, customers, and suppliers. Both companies have adopted and implemented lean manufacturing into their organizations in the late 1990s. Using targets set forth by the lean manufacturing leaders of Japan, a comparison will be made of both of these companies as well as comparisons of these two companies to other firms in their industry. The S&P 500 financial ratios will also be used along with those of two of the most recognized leaders in lean manufacturing, Wal-Mart and Toyota, in order to determine the effectiveness of implementation of lean practices by two of the newest leaders in manufacturing excellence. The financial ratios will be evaluated and compared along with reasons for variances that are found in the comparisons.

Self-reported inhaler use in patients with chronic obstructive pulmonary disease

COPD is a common disease which is increasing in prevalence. The proportion of patients who vary their inhaler use from what is prescribed and the reasons for variance are largely unknown. The objective of this study was to determine the extent of and reported reasons for patient-reported variance in the use of inhalers prescribed for COPD. A 17-item survey was mailed to 600 ambulatory patients with spirometry-defined COPD. The survey included questions about inhaler use and reasons for using inhalers differently than prescribed. Survey responses were compared between patients reporting no variance vs. variance from prescribed instructions. Logistic regression was used to determine predictors for variance. The response rate was 45.8% (48.7% male; mean age: 73+/-8 years). Forty percent of respondents were not using inhalers as prescribed. The most common reasons were: feeling the inhalers did not help breathing (20%), forgetting to use inhalers (19%) and cost (15%). Higher education level, home oxygen use and prescriptions for ipratropium were predictors for inhaler variance. The impact of inhaler variance on morbidity of COPD should be evaluated.

Medication Administration Variances Before and After Implementation of Computerized Physician Order Entry in a Neonatal Intensive Care Unit

The goal was to determine whether implementation of a computerized physician order entry system was associated with a decrease in medication administration variances in a NICU. A prospective observational study was conducted. Research nurses recorded details of medication administrations for patients in a NICU during standardized observation periods. Details of each administration were compared with the medication order; a variance was defined as a discrepancy between the order and the medication administration. Rates of variances before and after implementation of computerized physician order entry in the NICU were compared. Specific types of and reasons for variances were also compared. Data on 526 medication administrations, including 254 during the pre-computerized physician order entry period and 272 after implementation of computerized physician order entry, were collected. Medication variances were detected for 19.8% of administrations during the pre-computerized physician order entry period, compared with 11.6% with computerized physician order entry (rate ratio: 0.53). Overall, administration mistakes, prescribing problems, and pharmacy problems accounted for 74% of medication variances; there were no statistically significant differences in rates for any of these specific reasons before versus after introduction of computerized physician order entry. Administration of a medication at the wrong time accounted for 53.1% of all variances. Variance rates related to giving a drug at the wrong time were significantly lower in the computerized physician order entry period than in the pre-computerized physician order entry period (rates: 6.7% and 9.9%, respectively; rate ratio: 0.53). Implementation of computerized physician order entry in a NICU was associated with a significant decrease in the rate of medication administration variances. However, even with the use of computerized physician order entry, variances were noted for >11% of all medication administrations, which suggests that additional methods may be needed to improve neonatal patient safety.

Achieving long-term compliance with colonoscopic surveillance guidelines for patients at increased risk of colorectal cancer in Australia

We have previously demonstrated that we could improve colonoscopic surveillance practice for patients at increased risk of colorectal cancer by the adoption of guidelines, facilitated by a nurse co-ordinator. This study was to determine whether we could sustain this improvement over a longer period (4 years). All colonoscopic surveillance decisions made by the co-ordinated colorectal screening programme of our hospital between 2000 and April 2004 were reviewed. Reasons for variance were recorded, and surveillance decisions made in the last 4 months of the study time were compared with decisions made 4 years previously, both before and after the introduction of the co-ordinated programme. Between 2000 and 2004, 1794 surveillance decisions were made with variance occurring in 100. In the last 4 months of the period of study, 98% of decisions matched guidelines, suggesting that the improvement made following the adoption of the guidelines (45-96% p < 0.05) could be maintained. Reasons for variance from guidelines included a belief that the particular clinical scenario was not covered in the guidelines, disagreement with the guidelines or patient anxiety. Adherence to evidence based medicine guidelines for colonoscopy surveillance can be maintained over time at a high level. A number of clinical scenarios are not covered adequately by the existing guidelines and continue to generate disagreement amongst clinicians.

Characteristics of Handwriting of Subjects with Multiple Sclerosis

Multiple sclerosis is a widespread neurological disorder with a variety of symptoms, some of which are noticeable in handwriting. The handwritings of two groups of 23 subjects each (people with multiple sclerosis and a comparison group), matched for age and gender, were compared, using the Roman-Staempfli Psychogram, a graphological charting system with seven additional categories. Of 50 indicators examined, statistical analysis showed means of 37 to be significantly different. The one-way analyses of variance showed that 26 of the 32 indicators originally expected to be significantly different between the groups were. 14 of the 17 predictions of higher MS scores were significantly confirmed as were 11 of the 15 predictions of lower MS scores. These results suggest that neurological damage is reflected in handwriting and can be measured graphologically for physical or psychological characteristics. Possible reasons for variance from the hypotheses were discussed.

CHARACTERISTICS OF HANDWRITING OF SUBJECTS WITH MULTIPLE SCLEROSIS

Multiple sclerosis is a widespread neurological disorder with a variety of symptoms, some of which are noticeable in handwriting. The handwritings of two groups of 23 subjects each (people with multiple sclerosis and a comparison group), matched for age and gender, were compared, using the Roman-Staempfli Psychogram, a graphological charting system with seven additional categories. Of 50 indicators examined, statistical analysis showed means of 37 to be significantly different. The one-way analyses of variance showed that 26 of the 32 indicators originally expected to be significantly different between the groups were. 14 of the 17 predictions of higher MS scores were significantly confirmed as were 11 of the 15 predictions of lower MS scores. These results suggest that neurological damage is reflected in handwriting and can be measured graphologically for physical or psychological characteristics. Possible reasons for variance from the hypotheses were discussed.

Evaluation of the Handwriting of Successful Women through the Roman-Staempfli Psychogram

Data on women who create satisfying lives for themselves are needed to identify the personality characteristics of strong, successful women. The handwritings of two groups (70 successful and 42 not-so-successful) of women were compared, using the Roman-Staempfli Psychogram, a graphological charting system, and nine additional categories. The women were divorced, married, or single; their ages ranged from 19 to 80 yr.; their backgrounds were socioeconomically varied. The one-way analyses of variance showed that 24 of the 38 indicators originally expected to be significantly different between the groups proved to be so. Also supporting specific hypotheses were 10 of the 14 indicators originally expected to not be significantly different. These results suggest the qualities considered important for achievement can be inferred from the handwritings of successful women and can be measured graphologically. Possible reasons for variance from the hypotheses were discussed.

EVALUATION OF THE HANDWRITING OF SUCCESSFUL WOMEN THROUGH THE ROMAN-STAEMPFLI PSYCHOGRAM

Data on women who create satisfying lives for themselves are needed to identify the personality characteristics of strong, successful women. The handwritings of two groups (70 successful and 42 not-so-successful) of women were compared, using the Roman-Staempfli Psychogram, a graphological charting system, and nine additional categories. The women were divorced, married, or single; their ages ranged from 19 to 80 yr.; their backgrounds were socioeconomically varied. The one-way analyses of variance showed that 24 of the 38 indicators originally expected to be significantly different between the groups proved to be so. Also supporting specific hypotheses were 10 of the 14 indicators originally expected to not be significantly different. These results suggest the qualities considered important for achievement can be inferred from the handwritings of successful women and can be measured graphologically. Possible reasons for variance from the hypotheses were discussed.

Low back pain: the controversy of radiologic evaluation.

A prospective study was performed to evaluate the efficacy of including oblique radiographs as part of a lumbar vertebral column examination. Five hundred patients in the second through ninth decades of life were evaluated. Of those, 12% had an abnormality detected on the 45 degree oblique view that was not apparent on the frontal or lateral radiographs. Those abnormalities included degenerative changes of apophyseal joints (6%), spondylolysis (4%), osteoid osteoma, anomalous apophyseal joint, and abnormal pars interarticularis (2%). These results are compared with those of other investigators and the reasons for variance are discussed.