Traffic Light Approach Research Articles

A traffic light approach for treatment and supportive care stratification in lung cancer.

Comprehensive supportive care interventions for patients with lung cancer are being investigated in a range of ways, including: early palliative care, prehabilitation and rehabilitation. We review recent literature on supportive care and propose a traffic light system to individualise comprehensive supportive care. Green for those very likely to receive anti-cancer treatment, red for those very unlikely to receive anti-cancer treatment and orange where the chance of accessing treatment is uncertain. Comprehensive supportive care can be individualised based on the group a particular patient is in. Lung cancer outcomes are improving with the availability of increasingly efficacious treatments; however, treatment rates for advanced disease remain low. In this review, we discuss how person-centred outcomes could be improved, how outcomes can be prognosticated and how the 'host' can be staged as well as the cancer. Recent data suggests that early comprehensive supportive care improves quality of life, reduces time spent in hospital and may affect survival. Comprehensive supportive care is likely to improve quality of life in patients with advanced lung cancer. Further work is needed to see if it can improve treatment rates and survival.

Performance in professional soccer players: normative data and benchmarks from official matches for metabolic power and high-intensity activities.

The opportunity to compare data among players using normative data and benchmarks may represent a helpful tool for coaches to assess the players' physical performance easily and quickly. This study aimed to create normative data and benchmarks that can be exploited to compare professional soccer players' physical capacity competing in the Premier Division Championship (series A). Match data from six professional soccer teams competing in the Premier Division championship (Serie A and Italy Cup matches) were collected during the entire season. Players (N.=112) were divided based on the role positioning as follows: forwards and wingers (FW), midfielders (MF), side-backs (SB), and center-backs (CB). All the teams analyzed competed with a 4-3-3 formation, and only players who played for the entire match (85-95 minutes) were considered. The video analysis system STATS SportVU was used to collect the data during official matches. Average metabolic power (AP) was considered to estimate the energy cost. The number of power events (PE), distance (m) covered at more than 25 W/kg (D25), and finally, the distance covered at v>25 km/h (VHS) were considered as high-intensity assessments. Standardized T-scores (scaled from 0 to 100) were calculated for each role and variable. T-score data was used to create performance bands combined with qualitative description (ranging from extremely poor to excellent), and a traffic light system approach was implemented to simplify the data's interpretation. The results could be used to compare different athletes' performance quickly and effectively, to detect symptoms of overtraining, and to give helpful insights to coaches on what the training should be focused on.

Sustainability of Agricultural Practices in Various Agro-Ecological Zones of Bhutan

Bhutan’s agriculture sector has consistently advocated sustainable agricultural practices, yet it grapples with a range of interconnected challenges. These challenges encompass limited arable land, labour shortages, human-wildlife conflicts, and inadequate irrigation facilities, outbreaks of pests and diseases, and impacts of climate change. Therefore, this study assessed the sustainability of agricultural practices at the farm level across three agro-ecological zones: dry subtropical, cool temperate, and alpine. A total of 392 households were selected through simple random sampling for face-to-face interviews. The data collection, analysis, and reporting adhered to the guidelines of Sustainable Development Goals Indicator 2.4.1. The study focused on three dimensions of sustainability, comprising eight themes and eight sub-indicators for agriculture sustainability. The sustainability status was visualized using traffic light approach: green for desirable, yellow for acceptable and red for unsustainable. Results showed social dimensions across the study areas were in a desirable status. The environmental dimension exhibited desirable status in alpine zone. However, around 60% of agricultural land in dry subtropical and 77% in cool temperate zones have acceptable fertilizer management, while about 38% and 23% respectively fall into unsustainable category. Similarly, only about 73% of agricultural areas in the cool temperate zone are in acceptable status in pesticide management, and 23% under unsustainable status. Furthermore, the economic dimension across agro-ecological zones displayed unsustainable status in farm output value with 30% of farms in cool temperate, 78% in dry subtropical, and 74% in alpine zones. Strategic interventions are imperative in addressing economic and environmental dimensions to promote resilient and sustainable agricultural practices in Bhutan and analogous regions. Findings underscore the importance of identifying that similar impacts could potentially extend to other dry subtropical regions worldwide.

Backtesting Systemic Risk Forecasts Using Multi-Objective Elicitability

Systemic risk measures such as CoVaR, CoES, and MES are widely-used in finance, macroeconomics and by regulatory bodies. Despite their importance, we show that they fail to be elicitable and identifiable. This renders forecast comparison and validation, commonly summarized as “backtesting,” impossible. The novel notion of multi-objective elicitability solves this problem by relying on bivariate scores equipped with the lexicographic order. Based on this concept, we propose Diebold–Mariano type tests with suitable bivariate scores to compare systemic risk forecasts. We illustrate the test decisions by an easy-to-apply traffic-light approach. Finally, we apply our traffic-light approach to DAX 30 and S&P 500 returns, and infer some recommendations for regulators.

Perceived Utility of Intracranial Pressure Monitoring in Traumatic Brain Injury: A Seattle International Brain Injury Consensus Conference Consensus-Based Analysis and Recommendations.

Intracranial pressure (ICP) monitoring is widely practiced, but the indications are incompletely developed, and guidelines are poorly followed. To study the monitoring practices of an established expert panel (the clinical working group from the Seattle International Brain Injury Consensus Conference effort) to examine the match between monitoring guidelines and their clinical decision-making and offer guidance for clinicians considering monitor insertion. We polled the 42 Seattle International Brain Injury Consensus Conference panel members' ICP monitoring decisions for virtual patients, using matrices of presenting signs (Glasgow Coma Scale [GCS] total or GCS motor, pupillary examination, and computed tomography diagnosis). Monitor insertion decisions were yes, no, or unsure (traffic light approach). We analyzed their responses for weighting of the presenting signs in decision-making using univariate regression. Heatmaps constructed from the choices of 41 panel members revealed wider ICP monitor use than predicted by guidelines. Clinical examination (GCS) was by far the most important characteristic and differed from guidelines in being nonlinear. The modified Marshall computed tomography classification was second and pupils third. We constructed a heatmap and listed the main clinical determinants representing 80% ICP monitor insertion consensus for our recommendations. Candidacy for ICP monitoring exceeds published indicators for monitor insertion, suggesting the clinical perception that the value of ICP data is greater than simply detecting and monitoring severe intracranial hypertension. Monitor insertion heatmaps are offered as potential guidance for ICP monitor insertion and to stimulate research into what actually drives monitor insertion in unconstrained, real-world conditions.

Development of an environmental hazard-based rating assessment for defence-related chemical compounds in ecological soil systems.

Environmental hazard-based methods are commonly used to categorise the severity of chemical contamination to ecological soil systems, although a traffic-light approach (green, amber, red) has never been used to assess these consequences. A traffic light approach is an easy to interpretate data as it has a clear visual display which can provide an early warning approach for stakeholders to identify areas that require further investigation. This approach should be underpinned by extensive research data and systematic methods of development. However, the extent of reliable data available for specific chemicals can be limited and therefore decision making may rely on expert judgement. Therefore, in this study, an environmental hazard-based rating methodology was developed by combining the guidelines from the European Chemical Agency (ECHA) and the USEPA for Predicted Non-effect Concentration (PNEC) and Ecological Soil Screening Levels (Eco-SSL) for defence-related chemicals (2,4,6-trinitrotoluene (TNT), 1,3,5-trinitro-1,3,5-triazinane (RDX), cypermethrin, perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS)). The developed hazard-based rating assessment was design to categorise the chemicals into low, medium and high environmental hazards priority to inform and ease the decision-making process for contaminated areas to ensure that sustainable operations are carried out.

Interventions to reduce sugar‐sweetened beverage consumption using a nudge approach in Victorian community sports settings

ObjectiveTo assess the effectiveness of interventions using a nudge approach to reduce sugar‐sweetened beverage purchases in community sports settings. MethodsA total of 155 community sporting organisations participating in VicHealth funded programs were invited to nominate a nudge based on a traffic light approach to drinks classification. These included limit red drinks, red drinks off display, water the cheapest option, and meal deals. Sales data was collected for a predetermined period prior to and following the introduction of the nudge. Nudges were classified initially on whether they were implemented to VicHealth standards. Appropriately implemented nudges were classified as successful if they achieved a relative decrease in sales from drinks classified as red. ResultsIn all, 148 organisations trialled 195 nudges; 15 (7.7%) were successful and 20 (10.3%) were appropriately implemented but unsuccessful. Limit red drinks was the most frequently attempted nudge (30.8%). Red drinks off display had the greatest rate of success (20.0%). ConclusionsRed drinks off display was the simplest and most successful nudge. Implications for public healthGuidelines limiting the display of sugar‐sweetened beverages may be an effective means of altering consumer behaviour.

The integration of mixed methods data to develop the quality of life \u2013 aged care consumers (QOL-ACC) instrument

BackgroundThis paper describes the collection and integration of mixed methods data to facilitate the final selection of items for the Quality of Life – Aged Care Consumers (QOL-ACC) instrument. The aim of the wider project is to develop a preference-based quality of life instrument that can be used for quality assessment and economic evaluation. Older people have been involved at every stage of the development of the QOL-ACC to ensure that the final instrument captures their perspectives and preferences.MethodsMixed methods data was collected on draft items for the QOL-ACC instrument across six key quality of life dimensions (mobility, pain management, emotional well-being, independence, social connections, and activities). Qualitative face validity data was collected from older people (aged 66 to 100 years) living in the community and in residential aged care via semi-structured interviews (n = 59). Quantitative data was collected from older people (aged 65 to 91 years) receiving aged care services in the community via an online survey (n = 313). A traffic light pictorial approach was adopted as a practical and systematic way to categorise and present data in a meaningful way that was easy for non-academic workshop members to understand and to be able to discuss the relative merits of each draft item.ResultsThe traffic light approach supported the involvement of consumer and aged care provider representatives in the selection of the final items. Six items were selected for the QOL-ACC instrument with one item representing each of the six dimensions.ConclusionsThis methodological approach has ensured that the final instrument is psychometrically robust as well as meaningful, relevant and acceptable to aged care consumers and providers.

The Traffic Light Approach: Indicators and Algorithms to Identify Covid-19 Epidemic Risk Across Italian Regions.

With the beginning of the autumn-winter season, Italy experienced an increase of SARS-CoV-2 cases, requiring the Government to adopt new restrictive measures. The national surveillance system in place defines 21 key process and performance indicators addressing for each Region/Autonomous Province: (i) the monitoring capacity, (ii) the degree of diagnostic capability, investigation and contact tracing, and (iii) the characteristics of the transmission dynamics as well as the resilience of health services. Overall, the traffic light approach shows a collective effort by the Italian Government to define strategies to both contain the spread of COVID-19 and to minimize the economic and social impact of the epidemic. Nonetheless, on what principles color-labeled risk levels are assigned on a regional level, it remains rather unclear or difficult to track.

Responses to positive and negative feedback on organizational aspects of school quality: teachers’ and leaders’ views on a Swiss traffic light approach to school inspection

ABSTRACT In social contexts, feedback by observers, participants, or recipients provides information on performance and products, thereby creating an opportunity to learn and improve. In education governance, many countries rely on school inspection by professional observers to convey feedback on organizational and pedagogical processes and outcomes. This article examines the reactions of teachers and leaders to a Swiss inspection approach that uses a traffic light system to evaluate process features of school quality. Using SPSS and Mplus, the multilevel analysis distinguishes between individual and collective effects. On the individual level, school leaders respond to the traffic light inspections in general slightly more positively than teachers. On the collective level, feedback that flags organizational disturbances or failures of local schools does not evoke a sweeping rejection. Overall, the results indicate a rather high acceptance of the traffic light approach.

Practical implementation of the management of local flexible generation and consumption units using a quota-based grid traffic light approach

Practical implementation of the management of local flexible generation and consumption units using a quota-based grid traffic light approach

Optimal Access Management for Cooperative Intersection Control

This paper presents an intersection access management methodology that optimizes the crossing sequence of an automated intersection, where the low-level vehicle control is performed by a cooperative intersection control (CIC) strategy. While the CIC regulates the safe and efficient relative motion of vehicles in the intersection, a high-level hybrid queuing model is proposed to describe the dynamics of the vehicle queues associated to each intersection lane. This model, including constraints, is used to design an optimal access management approach based on the model predictive control that minimizes the time that the vehicles spend within the intersection, thereby optimizing the traffic throughput of the intersection. The performance of this methodology is studied by means of two representative examples. The impact of the design parameters of the optimal access management approach is shown for a T-intersection case study. Moreover, using a real-life five lane intersection case study, the proposed approach is compared to a vehicle-actuated traffic light approach, and a first come first served approach. The comparison shows the benefits of the automated optimal serving of vehicles from different lanes.

Backtesting expected shortfall: a simple recipe?

We propose a new backtesting framework for Expected Shortfall that could be used by the regulator. Instead of looking at the estimated capital reserve and the realised cash-flow separately, one could bind them into the secured position, for which risk measurement is much easier. Using this simple concept combined with monotonicity of Expected Shortfall with respect to its target confidence level we introduce a natural and efficient backtesting framework. Our test statistics is given by the biggest number of worst realisations for the secured position that add up to a negative total. Surprisingly, this simple quantity could be used to construct an efficient backtesting framework for unconditional coverage of Expected Shortfall in a natural extension of the regulatory traffic-light approach for Value-at-Risk. While being easy to calculate, the test statistic is based on the underlying duality between coherent risk measures and scale-invariant performance measures.

A Simple Traffic Light Approach to Backtesting Expected Shortfall

We propose a Traffic Light approach to backtesting Expected Shortfall which is completely consistent with, and analogous to, the Traffic Light approach to backtesting VaR (Value at Risk) initially proposed by the Basel Committee on Banking Supervision in their 1996 consultative document Basle Committee on Banking Supervision (1996). The approach relies on the generalized coverage test for Expected Shortfall developed in Costanzino and Curran (2015).

Risk Indicators for Financial Market Infrastructure: From High Frequency Transaction Data to a Traffic Light Signal

This paper identifies quantitative risks in financial market infrastructures (FMIs), which are inspired by the Principles for Financial Market Infrastructures. We convert transaction level data into indicators that provide information on operational risk, changes in the network structure and interdependencies. As a proof of concept we use TARGET2 level data. The indicators are based on legislation, guidelines and their own history. Indicators that are based on their own history are corrected for cyclical patterns. We also define a method for setting the signaling threshold of relevant changes. For the signaling, we opt for a traffic light approach: a green, yellow or red light for a small, moderate or substantial change in the indicator, respectively. The indicators developed in this paper can be used by overseers and operators of FMIs and by financial stability experts.

Backtesting Expected Shortfall: Is It Really that Hard?

We propose a new backtesting framework for Expected Shortfall that could be used by the regulator. Instead of looking at the estimated capital reserve and the realised cash-flow separately, one could bind them into the secured position, for which risk measurement is much easier. Using this simple concept combined with monotonicity of Expected Shortfall with respect to its target confidence level we introduce a natural and efficient backtesting framework. Our test statistics is given by the biggest number of worst realisations for the secured position that add up to a negative total. Surprisingly, this simple quantity could be used to construct an efficient backtesting framework for unconditional coverage of Expected Shortfall in a natural extension of the regulatory traffic-light approach for Value-at-Risk. While being easy to calculate, the test statistic is based on the underlying duality between coherent risk measures and scale-invariant performance measures.

An integrated assessment of pollution and biological effects in flounder, mussels and sediment in the southern Baltic Sea coastal area

Organic and metal contaminants and biological effects were investigated in flounder, mussels, and sediments in the southern Baltic Sea coastal area in order to assess environmental quality status in that area. Four sites were selected, including two within the Gulf of Gdańsk (GoG). In biota and sediment at each site, DDTs dominated over PCBs and PBDEs were the least abundant among organic contaminants. Their concentrations decreased progressively outward from GoG. Among metal contaminants, the levels of Hg, Pb, and Cd were elevated in GoG. Biomarkers in flounder, EROD activity and DNA SB, showed moderate positive correlations with organic and metal contaminants. In flounder, the integrated biomarker index (IBR/n) presented a spatial trend coherent with chemical pollution index (CPI), but there was no clear spatial correspondence between IBR/n and CPI in mussels nor between sediment toxicity index (STI) and sediment CPI. The integrated assessment of contaminant and biological effect data against available assessment criteria indicated that in biota, the contaminant assessment thresholds were most often exceeded by CB-118, heptachlor, PBDE, and Hg (in the GoG sediments by p,p'-DDT, Hg and Cd), while of the biological determinants, the threshold was breeched by AChE activity in mussels in GoG. Applying the ICES/OSPAR traffic-light approach showed that of the 50 parameters assessed at each site, there were 18% of determinants in the red color category in the two GoG sites and 8% of determinants in the two sites outside GoG, which indicated that none of the four investigated sites attained good environmental status (GES).

Statistical Methods for Measuring Market Risk Model Performance - Comparison in View of the Fundamental Review of the Trading Book

During the last two decades, the general superiority of Expected Shortfall (ES) over Value-at-Risk (VaR) has been highlighted frequently. Nevertheless, VaR remained the fundamental regime for regulatory internal model approaches to market risk under Basel I, Basel II(.5) and Basel III for more than 15 years. Just recently, the Basel Committee on Banking Supervision finally announced to move to ES taking into account the experiences made during the financial crisis and the significant weaknesses of VaR. Their resistance can be attributed to the specific characteristic of ES as it cannot be easily backtested compared with VaR. While a lot of different backtesting methodologies have already been identified for VaR, less work has been done for ES. In 2011, it was even shown that ES does not fulfill the requirements of an elicitable risk measure, which was interpreted as the fundamental proof that ES could not be backtested. This thesis presents and evaluates three alternative backtesting approaches which could even be used for backtesting ES. The thesis finds clear evidence against the criticism of ES by showing that backtesting is generally possible and that concrete tests can be applied to evaluate market risk model performance. The results will also offer added-value to regulators as first thoughts will be provided on the question of how this test could be converted into a traffic light approach similar to what is currently in place for regulatory VaR backtesting.

A Simple Traffic Light Approach to Backtesting Expected Shortfall

We propose a Traffic Light approach to backtesting Expected Shortfall which is completely consistent and analogous to the Traffic Light approach to backtesting VaR initially proposed by the Basel Committee on Banking Supervision in their 1996 consultative document. The approach relies on the generalized coverage test for Expected Shortfall developed in.

Evaluation of an eco-driving support system

In this study an eco-driving support system was evaluated within a driving simulator study. The presented system was able to communicate with traffic lights and to detect traffic signs. On the basis of this information the system gave recommendations to the participants concerning fuel efficient gear shifting and acceleration/deceleration behavior. Thirty participants experienced three different driving situations (traffic light approach, curves, and stop signs) with and without the eco-driving support system in an urban and a rural scenario. As a result with the systems mean fuel savings between 15.9 and 18.4 percent could be realized because the participants shifted up earlier and used more coasting strategies than in the condition without the system. Thus the number of stops decreased. At the same time travel time increased significantly only in the rural scenario (+5.4%) and there were no negative effects on safety. Further, the eco-driving support system was highly accepted by the participants. The high potential of the system for fuel saving should be researched further with a focus on interactions between vehicle drivers.