Source Of Discrepancy Research Articles

Do we really collaborate effectively in the operating theatre? A cross- sectional study in two hospitals in Greece

The aim of this study was to translate the Disagreement and Aggression in the Operating Theatre Scale (DAOTS) into Greek and investigate the frequency of perceived conflicts, the sources of disagreement and the suggested methods of coping with them within and among professional groups in operating theatres in Greece. The results of this study support the reliability and validity of the DAOTS. The majority of the respondents had witnessed episodes of aggressive behaviour and/or disagreement during the last six months. Physicians more frequently revealed an aggressive behaviour towards a colleague, while nurses were found to be witnesses of a conflict between different professional teams. Daily/weekly disagreements among respondents about availability of equipment, theatre time, changes in the list order and availability of surgical staff were reported. Additionally, hospital type and years of professional experience are considered to affect the prevalence of exposure to a disagreement.

A good thing isn’t always a good thing: Dispositional attitudes predict non-normative judgments

A common belief in social sciences is that people like or dislike stimuli based on the properties possessed by those stimuli. Therefore, stimuli with many (few) positives should be universally liked (disliked). However, differences in opinion are common, and one source of disagreement may be personality. This research demonstrates that dispositional attitudes (an individual difference in the tendency to like/dislike stimuli), are associated with qualitative attitude differences (i.e., liking rather than disliking) for stimuli across important domains such as health, business, entertainment, and politics. Qualitative attitude differences frequently predict interpersonal conflict and diametrically opposed behavioral outcomes (e.g., voting for or against a candidate). Thus, these results have implications for understanding seemingly intractable differences found in nearly all social science fields.

PO-0318 Team–family Conflicts In Decisions To Forgo Life-sustaining Treatment (lst) In Picu

<h3>Background and aims</h3> Many sources of conflict exist in intensive care units between family’s members, team–family, or within the ICU team. These conflicts are frequents (48%) in adults ICU, and most are in relation to end-of-life decisions especially with decisions to forgo LST. In PICU, no study has previously reported the prevalence, characteristics and effects of these conflicts. <h3>Methods</h3> We conducted a retrospective observational study of children admitted to PICU of Lyon, France, for whom a meeting to forgo LST had been held between October 1st 2010 and February 28th 2014. We search in medical record if conflict or disagreement were noticed and we interviewed the referent physician about conflict. We distinguished simple disagreement (quickly resolved), continuing disagreement (parents refuse recommendations with communication still possible), and conflict (communication impossible). <h3>Results</h3> For 72 children (31 girls, 41 boys), 91 decision-making meetings were organised. We identified 27.7% (20/72) disagreements or conflicts: 4 simple disagreements, 12 continuing disagreements and 4 conflicts. Five children had acute disease and 15 children had chronic disease. Source of disagreements was continuing LST in 19 cases (families wanted to continue aggressive treatment). In 1 case, the family wanted to stop treatments despite medical opinion (refusal of tracheotomy). Consequences of theses disagreements were continuation of treatments despite LST decisions in 12 cases. For 3 cases a compromise solution was found. <h3>Conclusion</h3> Disagreements are frequent in decisions to forgo LST (27,7%) and most of the child undergo treatments that are medically futile.

Surgeons, intensivists, and discretion to refuse requested treatments.

Physicians are expected to engage patients as partners in identifying the possible benefits and harms associated with treatment options and selecting from among medically appropriate treatment options, rather than simply dictating what treatments patients will and will not receive. This collaborative model reflects the recognition that citizens in multicultural societies have diverse values and are likely to have different views about whether the possible benefits of a medical intervention outweigh the possible harms. However, there are circumstances in which the collaborative process breaks down due to irresolvable disagreement. Especially challenging are cases in which patients are expected to die if they do not receive a treatment and either the patients or their surrogates insist on the treatment despite the physician's belief that providing it is ill advised. The source of disagreement is often differing appraisals of the risks and potential benefits. In such cases, physicians generally judge that there is insufficient likelihood or magnitude of benefit to justify the burdens or expense of treatment, while patients or surrogates believe that the small chance of preventing the patient's death is sufficient to justify the costs and potential burdens to the patient. There is a perception that surgeons enjoy considerable discretion in deciding when the risks of a procedure outweigh the expected benefits. An important contrast can be drawn between surgeons and intensivists-physicians who specialize in the medical management of critically ill patients. We will argue that there are good reasons for subjecting the decisions of both surgeons and intensivists to some oversight. We begin by showing that, for many cases, major professional society guidelines for intensivists recommend oversight via a procedural mechanism rather than unilateral decision-making by individual clinicians. Next, we present reasons for adopting a procedural approach to dispute resolution, and we argue that these reasons apply to situations in which intensivists believe that patients or surrogates are requesting inappropriate life support as well as to many disagreements between surgeons and surrogates. Finally, we present and respond to several objections.

Electronic structure calculations of mercury mobilization from mineral phases and photocatalytic removal from water and the atmosphere

Mercury is a hazardous environmental pollutant mobilized from natural sources, and anthropogenically contaminated and disturbed areas. Current methods to assess mobility and environmental impact are mainly based on field measurements, soil monitoring, and kinetic modelling. In order to understand in detail the extent to which different mineral sources can give rise to mercury release it is necessary to investigate the complexity at the microscopic level and the possible degradation/dissolution processes. In this work, we investigated the potential for mobilization of mercury structurally trapped in three relevant minerals occurring in hot spring environments and mining areas, namely, cinnabar (α-HgS), corderoite (α-Hg3S2Cl2), and mercuric chloride (HgCl2). Quantum chemical methods based on density functional theory as well as more sophisticated approaches are used to assess the possibility of a) direct photoreduction and formation of elemental Hg at the surface of the minerals, providing a path for ready release in the environment; and b) reductive dissolution of the minerals in the presence of solutions containing halogens. Furthermore, we study the use of TiO2 as a potential photocatalyst for decontamination of polluted waters (mainly Hg2+-containing species) and air (atmospheric Hg0). Our results partially explain the observed pathways of Hg mobilization from relevant minerals and the microscopic mechanisms behind photocatalytic removal of Hg-based pollutants. Possible sources of disagreement with observations are discussed and further improvements to our approach are suggested.

Applying behavioural economics to health systems of low- and middle-income countries: what are policymakers' and practitioners' views?

Interest in behavioural economics has soared in recent years, particularly because of its application to several areas of public policy, now including international development, education, and health. Yet, little is known about how the policy and political implications of behavioural economics are perceived among stakeholders. Using an innovative vignette-based online survey, we assessed the opinions of 520 policymakers and practitioners around the world about health policy recommendations emanating from behavioural economics principles that are relevant to low- and middle-income country settings. We also determined the sources of disagreement among the respondents. The results suggest that there is strong support for health policies based on the concepts of framing choices to overcome present bias, providing periodic information to form habits, and messaging to promote social norms. There is less support for policies which use cash rewards as extrinsic motivators either to change individual behaviour related to the management of chronic conditions or to mitigate risky sexual behaviour. The sources of disagreement for these policy prescriptions derive mainly from normative concerns and perceived lack of effectiveness of such interventions. Addressing these disagreements may require developing a broader research agenda to explore the policy and political implications of these prescriptions.

Return-Predicting Factors for US Treasuries: On the Similarity of Tentss and Batss

Different authors find optically very different patterns (‘tents’ and ‘bats’) when excess returns from US Treasuries are regressed against forward rates. A separate source of disagreement is whether the recent tent-shaped factor found by Cochrane and Piazzesi is fundamentally different from the slope (in yields) explanatory factor for the time-dependent term premia that has been identified since the early 1990s. We show that ‘tent’ and ‘bat’ patterns produce predictions of excess returns which are economically indistinguishable, both locally and globally. We also argue that, if the slope (in yield space) is indeed the most important explanatory factor for excess returns, then a simple transformation of the loadings of the forwards rates on the slope factor naturally recovers an approximate tent shape in forward-rate space. However, a transformation from a slope factor in yields to loadings for forward rates does not easily produce a bat pattern. This may provide indirect corroboration to Cochrane and Piazzesi’s (2004) claim that the bat factor is a result of near colinearity for smoothed data, and that the ‘tent’ solution is intrinsically different from the ‘bat’ solution. We do not comment in this paper on the economic and statistic significance of this difference.

Exploring the Use of Categories in the Assessment of Airline Pilots’ Performance as a Potential Source of Examiners’ Disagreement

It is a current trend in aviation to use categories of technical (e.g., knowledge) and nontechnical skills (e.g., situation awareness) to assess airline pilots’ performance. Several studies have revealed large disagreement between assessors when airline professionals use these categories to assess the performance of their peers. The aim of the present study is to investigate whether the categories themselves are at the source of disagreement. We explore the reasoning of flight examiners who assess an engine fire scenario in pairs. The results provide insight into the overlap of topics that constitute certain categories. Implications are drawn in regards to the use of assessment categories and their influence on pilot performance assessment.

Benchmarking kinetic calculations of resistive wall mode stability

Validating the calculations of kinetic resistive wall mode (RWM) stability is important for confidently predicting RWM stable operating regions in ITER and other high performance tokamaks for disruption avoidance. Benchmarking the calculations of the Magnetohydrodynamic Resistive Spectrum—Kinetic (MARS-K) [Y. Liu et al., Phys. Plasmas 15, 112503 (2008)], Modification to Ideal Stability by Kinetic effects (MISK) [B. Hu et al., Phys. Plasmas 12, 057301 (2005)], and Perturbed Equilibrium Nonambipolar Transport (PENT) [N. Logan et al., Phys. Plasmas 20, 122507 (2013)] codes for two Solov'ev analytical equilibria and a projected ITER equilibrium has demonstrated good agreement between the codes. The important particle frequencies, the frequency resonance energy integral in which they are used, the marginally stable eigenfunctions, perturbed Lagrangians, and fluid growth rates are all generally consistent between the codes. The most important kinetic effect at low rotation is the resonance between the mode rotation and the trapped thermal particle's precession drift, and MARS-K, MISK, and PENT show good agreement in this term. The different ways the rational surface contribution was treated historically in the codes is identified as a source of disagreement in the bounce and transit resonance terms at higher plasma rotation. Calculations from all of the codes support the present understanding that RWM stability can be increased by kinetic effects at low rotation through precession drift resonance and at high rotation by bounce and transit resonances, while intermediate rotation can remain susceptible to instability. The applicability of benchmarked kinetic stability calculations to experimental results is demonstrated by the prediction of MISK calculations of near marginal growth rates for experimental marginal stability points from the National Spherical Torus Experiment (NSTX) [M. Ono et al., Nucl. Fusion 40, 557 (2000)].

Evaluating approaches for estimating peat depth

Estimates of peat depth are required to inform understanding of peatland development, functioning, and ecosystem services such as carbon storage. However, there is a considerable lack of peat depth data at local, national, and global scales. Recent studies have attempted to address this knowledge deficit by using manual probing and ground-penetrating radar (GPR) to estimate depth. Despite increasing application, little consideration has been given to the accuracy of either of these techniques. This study examines the accuracy of probing and GPR for measuring peat depth. Corresponding GPR and probing surveys were carried out at a catchment scale in a blanket peatland. GPR depth estimations, calibrated using common midpoint (CMP) surveys, were found to be on average 35% greater than probe measurements. The source of disagreement was found to be predominantly caused by depth probes becoming obstructed by artifacts within the peat body, although occasionally probing rods also penetrated sediments underlying the peat. Using the Complex Refractive Index Model, it was found that applying a single velocity of 0.036 m ns−1 across a single site may also result in −8 to +17% error in estimation of peat depth due to spatial variability in water content and porosity. It is suggested that GPR calibrated at each site using CMP surveys may provide a more accurate method for measuring peat depth.

Rethinking religion and political legitimacy across the Islam–West divide

The relationship between religion and politics is a bone of political contention and a source of deep confusion across the Islam–West divide. When most western liberals cast their gaze on Muslim societies today, what they see is deeply disconcerting. From their perspective there is simply too much religion in public life in the Arab-Islamic world, which raises serious questions for them about the prospects for democracy in this part of the world. This article critically explores the relationship between religion and political legitimacy with a geographical and cultural focus on the Muslim Middle East. The broad historical question that shapes this inquiry is: Why is religion a source of political legitimacy in Muslim societies today while in the West, broadly speaking, religion is a source of disagreement and illegitimacy?

Letter from the Editor-in-Chief: Irreproducible Results.

Dear Colleagues, As you probably know, significant concern has developed over the irreproducibility of published results, and the NIH has expressed serious concern over this problem [1, 4]. There is no real worry that this is due to scientific misconduct. Rather, it is believed to be due to poor training of investigators in experimental design, lack of reporting of methodologies in published papers, lack of critical evaluation and reviewing, and lack of publications on negative data or on critiquing others’ methods. Other forces such as various kinds of bias presumably contribute to this as well. There are a number of papers on this topic and I cite a few that may be helpful [1, 2, 3, 4, 5]. Preclinical studies are more of a concern than clinical studies, where standardized reporting procedures exist and where there is more rigorous design and oversight [1]. The use of animal models in preclinical work seems to be an area where problems seem to crop up more often. The use of different strains of animals, for example, can be a source of disagreement. Preclinical work may be an area where rapid progress can be made. Obviously, something must be done, and it is being done. The NIH is developing a number of initiatives, some of which will become mandatory in NIH sponsored training programs. There will be specific training opportunities with an emphasis on good experimental design. A checklist will be developed for reviewers and evaluators that address experimental procedures such as sample size calculations, randomization, blinding and so forth. Access to raw data and increased transparency will be addressed. Other groups in the scientific community will have to participate as well. These groups will include journals, private granting agencies, various review panels, and others. Journal of Drug and Alcohol Research (JDAR) has not had a problem with irreproducible results, but it is not a problem that can be ignored. I write this letter because this is a significant issue that is not going away. Correcting this problem can only be a good thing. This journal will support efforts to improve reproducibility, and will judiciously follow recommendations made by responsible groups. It seems reasonable to suggest that readers and submitters follow this topic and the recommendations from the NIH and elsewhere. Everyone—authors, editorial staff, readers, and reviewers—want JDAR to be a solid and trustworthy journal.

The choice of the social discount rate and the opportunity cost of public funds

The decades-old literature on the correct method for choosing and estimating a social discount rate (SDR) has resulted in two, largely opposing viewpoints. This note seeks to clarify the key sources of disagreement between these two camps. One view advocates that the choice should be based chiefly on the social opportunity cost of the return to foregone private capital investment (SOC), and suggests a SDR of around 7%. The other viewpoint, expressed by the authors, argues that the choice should be based on the social rate of time preference (STP), the rate at which society is willing to trade present for future consumption, suggesting a SDR of around 3.5%. Because of the fundamentally normative basis of the SDR choice, neither approach generates testable hypotheses that would allow falsification. For government project evaluation, the choice ultimately depends on the opportunity cost of public funds, which in turn depends on how fiscal policy actually operates. The STP approach contends that governments set targets for deficits and public debt, so that a marginal government project will be tax-financed, largely crowding out current consumption. The SOC belief is that governments set revenue targets, so that any government project will be deficit-financed on the margin, which will largely crowd out private investment. The authors also argue that a SDR based on the STP approach is appropriate for: benefit-cost analysis of government regulations, self-financing government projects, and government cost-effectiveness studies.

Research agendas in climate studies: the case of West Antarctic Ice Sheet research

Concern over anthropogenic climatic change has been the major driver behind the rapid expansion in climate studies in recent decades. However, research agendas revolving around other intellectual or practical problems motivate much of the work that contributes to scientific understanding of present changes in climate. Understanding these agendas and their historical development can help in planning research programs and in communicating results, and it can often elucidate the sources of disagreements between scientists pursuing differing agendas. This paper focuses on research agendas relating to the possible glaciological instability of the West Antarctic Ice Sheet (WAIS). For much of the history of this research, which dates back to International Geophysical Year traverses, WAIS instability was thought of as innate rather than climatically triggered, even as a growing program of intensive field research was heavily motivated by tentative links drawn between WAIS instability and concerns over anthropogenic climatic change. Meanwhile, climate models for many years did not countenance instability mechanisms. It is only over the past fifteen years that field glaciological research has been integrated with other forms of empirical research, and that empirical studies ofWAIS have been more closely integrated with the broader body of climate studies.

Independent priming of location and color in identification of briefly presented letters

Attention shifts are facilitated if the items to be attended remain the same across trials. Some researchers argue that this priming effect is perceptual, whereas others propose that priming is postperceptual, involving facilitated response selection. The experimental findings have not been consistent regarding the roles of variables such as task difficulty, response repetition, expectancies, and decision-making. Position priming, when repetition of a target position facilitates responses on a subsequent trial, is another source of disagreement among researchers. Experimental results have likewise been inconsistent as to whether position priming is dependent on the repetition of target features or has an independent effect on attention shifts. We attempted to isolate the perceptual components of priming by presenting brief (10-180ms) search arrays to eight healthy observers. The task was to identify a color-singleton letter among distractors. All stimulus presentation contingencies were randomized, and responses were unspeeded, to avoid effects of observer expectation and postperceptual effects. Repeating target color and/or position strongly improved performance. The effects of color and position repetition were independent of one another and were stable across participants. The results argue for a strong perceptual component in priming, which biases selection toward recent target features and positions, showing that perceptual mechanisms are sufficient to produce priming in visual search and that such effects can be elicited with limited sensory evidence. The results are the first to demonstrate independent priming of color and position in the identification of briefly presented, postmasked stimuli.

Learning classification models from multiple experts

Building classification models from clinical data using machine learning methods often relies on labeling of patient examples by human experts. Standard machine learning framework assumes the labels are assigned by a homogeneous process. However, in reality the labels may come from multiple experts and it may be difficult to obtain a set of class labels everybody agrees on; it is not uncommon that different experts have different subjective opinions on how a specific patient example should be classified. In this work we propose and study a new multi-expert learning framework that assumes the class labels are provided by multiple experts and that these experts may differ in their class label assessments. The framework explicitly models different sources of disagreements and lets us naturally combine labels from different human experts to obtain: (1) a consensus classification model representing the model the group of experts converge to, as well as, and (2) individual expert models. We test the proposed framework by building a model for the problem of detection of the Heparin Induced Thrombocytopenia (HIT) where examples are labeled by three experts. We show that our framework is superior to multiple baselines (including standard machine learning framework in which expert differences are ignored) and that our framework leads to both improved consensus and individual expert models.

Sources of Disagreement in Inflation Forecasts: An International Empirical Investigation

Central to the conduct of monetary policy are inflation forecasts. Inflation forecast are not unique. Central banks and professional organizations generate inflation forecasts while households are surveyed about their inflation outlook. This paper estimates inflation forecast disagreement for nine economies over the 1999-2009 period, five of which target inflation. I find that central bank transparency tends to increase forecast disagreement. To the extent this reflects the attention paid to inflation performance the implication is that transparency is beneficial. Moreover, this finding does not appear to be a feature that applies only to central banks that must adhere to an inflation target.

Precipitation Sensitivity to Surface Heat Fluxes over North America in Reanalysis and Model Data

AbstractA new methodology for assessing the impact of surface heat fluxes on precipitation is applied to data from the North American Regional Reanalysis (NARR) and to output from the Geophysical Fluid Dynamics Laboratory’s Atmospheric Model 2.1 (AM2.1). The method assesses the sensitivity of afternoon convective rainfall frequency and intensity to the late-morning partitioning of latent and sensible heating, quantified in terms of evaporative fraction (EF). Over North America, both NARR and AM2.1 indicate sensitivity of convective rainfall triggering to EF but no appreciable influence of EF on convective rainfall amounts. Functional relationships between the triggering feedback strength (TFS) metric and mean EF demonstrate the occurrence of stronger coupling for mean EF in the range of 0.6 to 0.8. To leading order, AM2.1 exhibits spatial distributions and seasonality of the EF impact on triggering resembling those seen in NARR: rainfall probability increases with higher EF over the eastern United States and Mexico and peaks in Northern Hemisphere summer. Over those regions, the impact of EF variability on afternoon rainfall triggering in summer can explain up to 50% of seasonal rainfall variability. However, the AM2.1 metrics also exhibit some features not present in NARR, for example, strong coupling extending northwestward from the central Great Plains into Canada. Sources of disagreement may include model hydroclimatic biases that affect the mean patterns and variability of surface flux partitioning, with EF variability typically much lower in NARR. Finally, the authors also discuss the consistency of their results with other assessments of land–precipitation coupling obtained from different methodologies.

Merit, fit, and basic desert

Basic desert is central to the dispute between compatibilists and incompatibilists over the four-case manipulation argument. I argue that there are two distinct ways of understanding the desert salient to moral responsibility; moral desert can be understood as a claim about fitting responses to an agent or as a claim about the merit of the agent. Failing to recognize this distinction has contributed to a stalemate between both sides. I suggest that recognizing these distinct approaches to moral desert will help clarify a central source of disagreement between compatibilists and incompatibilists and assist both sides in resolving the current stalemate.

Expert assessments of the cost of light water small modular reactors

Analysts and decision makers frequently want estimates of the cost of technologies that have yet to be developed or deployed. Small modular reactors (SMRs), which could become part of a portfolio of carbon-free energy sources, are one such technology. Existing estimates of likely SMR costs rely on problematic top-down approaches or bottom-up assessments that are proprietary. When done properly, expert elicitations can complement these approaches. We developed detailed technical descriptions of two SMR designs and then conduced elicitation interviews in which we obtained probabilistic judgments from 16 experts who are involved in, or have access to, engineering-economic assessments of SMR projects. Here, we report estimates of the overnight cost and construction duration for five reactor-deployment scenarios that involve a large reactor and two light water SMRs. Consistent with the uncertainty introduced by past cost overruns and construction delays, median estimates of the cost of new large plants vary by more than a factor of 2.5. Expert judgments about likely SMR costs display an even wider range. Median estimates for a 45 megawatts-electric (MWe) SMR range from $4,000 to $16,300/kWe and from $3,200 to $7,100/kWe for a 225-MWe SMR. Sources of disagreement are highlighted, exposing the thought processes of experts involved with SMR design. There was consensus that SMRs could be built and brought online about 2 y faster than large reactors. Experts identify more affordable unit cost, factory fabrication, and shorter construction schedules as factors that may make light water SMRs economically viable.