scholarly journals Another look at the eigenvalues of a population matrix model

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e8018
Author(s):  
Brenda Hanley ◽  
Patrick Connelly ◽  
Brian Dennis
Keyword(s):  
Matrix Model ◽  
Dominant Eigenvalue ◽  
Interactive Software ◽  
Vital Rates ◽  
Finite Rate ◽  
Management Intervention ◽  
Rate Of Growth ◽  
Management Interventions ◽  
Population Matrix Model ◽  
Population Matrix

Population matrix models are important tools in resource management, in part because they are used to calculate the finite rate of growth (“dominant eigenvalue”). But understanding how a population matrix model converts life history traits into the finite rate of growth can be tricky. We introduce interactive software (“IsoPOPd”) that uses the characteristic equation to display how vital rates (survival and fertility) contribute to the finite rate of growth. Higher-order interactions among vital rates complicate the linkage between a management intervention and a population’s growth rate. We illustrate the use of the software for investigating the consequences of three management interventions in a 3-stage model of white-tailed deer (Odocoileus virginianus). The software is applicable to any species with 2- or 3-stages, but the mathematical concepts underlying the software are applicable to a population matrix model of any size. The IsoPOPd software is available at: https://cwhl.vet.cornell.edu/tools/isopopd.

scholarly journals Developing an Indigenous goal-setting tool: Counting Coup

2020 ◽  
Vol 1 (1) ◽  
pp. 49-57
Author(s):  
Iitáa Dáakuash ◽  
Alma McCormick ◽  
Shannen Keene ◽  
John Hallett ◽  
Suzanne Held
Keyword(s):  
Chronic Illness ◽  
Goal Setting ◽  
Indigenous Communities ◽  
Self Management ◽  
Future Research ◽  
Goal Theory ◽  
Management Intervention ◽  
Management Interventions ◽  
Indigenous Paradigm ◽  
Relational Accountability

Chronic illness self-management best practices include goal-setting as an important tool for developing better self-management habits and are often included as elements of chronic disease self-management interventions. However, the goal theory that many of these tools employ relies on individualistic principles of self-efficacy that are not culturally consonant within many Indigenous communities. During the creation of the [blinded] program, a chronic illness management intervention, we developed a goal-setting tool specific to the [blinded] Nation. Emerging from an Indigenous paradigm and methodology, Counting Coup serves as a goal-setting tool that promotes the [blinded] culture, connects individuals with their ancestors, and focuses on achievement of goals within relationships. Future research and practice should be grounded in the historical and cultural contexts of their communities when designing and implementing goal-setting tools. Limitations to Counting Coup as a goal-setting tool include the need for program facilitators to have a relationship with participants due to Counting Coup’s foundation in relational accountability and that the environmental context may pose difficulties for participants in moving towards behavior change.

scholarly journals Individually tailored self-management app-based intervention (selfBACK) versus a self-management web-based intervention (e-Help) or usual care in people with low back and neck pain referred to secondary care: protocol for a multiarm randomised clinical trial

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e047921
Author(s):  
Anna Marcuzzi ◽  
Kerstin Bach ◽  
Anne Lovise Nordstoga ◽  
Gro Falkener Bertheussen ◽  
Ilya Ashikhmin ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Neck Pain ◽  
Usual Care ◽  
Secondary Care ◽  
Self Management ◽  
Low Back ◽  
Musculoskeletal Health ◽  
Web Based ◽  
Management Intervention ◽  
Management Interventions

IntroductionLow back pain (LBP) and neck pain (NP) are common and costly conditions. Self-management is a key element in the care of persistent LBP and NP. Artificial intelligence can be used to support and tailor self-management interventions, but their effectiveness needs to be ascertained. The aims of this trial are (1) to evaluate the effectiveness of an individually tailored app-based self-management intervention (selfBACK) adjunct to usual care in people with LBP and/or NP in secondary care compared with usual care only, and (2) to compare the effectiveness of selfBACK with a web-based self-management intervention without individual tailoring (e-Help).Methods and analysisThis is a randomised, assessor-blind clinical trial with three parallel arms: (1) selfBACK app adjunct to usual care; (2) e-Help website adjunct to usual care and (3) usual care only. Patients referred to St Olavs Hospital, Trondheim (Norway) with LBP and/or NP and accepted for assessment/treatment at the multidisciplinary outpatient clinic for back or neck rehabilitation are invited to the study. Eligible and consenting participants are randomised to one of the three arms with equal allocation ratio. We aim to include 279 participants (93 in each arm). Outcome variables are assessed at baseline (before randomisation) and at 6-week, 3-month and 6-month follow-up. The primary outcome is musculoskeletal health measured by the Musculoskeletal Health Questionnaire at 3 months. A mixed-methods process evaluation will document patients’ and clinicians’ experiences with the interventions. A health economic evaluation will estimate the cost-effectiveness of both interventions’ adjunct to usual care.Ethics and disseminationThe trial is approved by the Regional Committee for Medical and Health Research Ethics in Central Norway (Ref. 2019/64084). The results of the trial will be published in peer-review journals and presentations at national and international conferences relevant to this topic.Trial registration numberNCT04463043.

A Simulation Framework for Evaluating the Effectiveness of Chronic Disease Management Interventions

2014 ◽  
Vol 6 (4) ◽  
pp. 40-59 ◽  
Author(s):  
Rafael Diaz ◽  
Joshua G. Behr
Keyword(s):  
Health Outcomes ◽  
Chronic Conditions ◽  
The United States ◽  
Dynamics Simulation ◽  
Contributory Factor ◽  
Simulation Framework ◽  
Management Intervention ◽  
Management Interventions ◽  
Intervention Cost ◽  
Financial Consequences

The treatment and management of chronic diseases currently comprise a major fraction of the United States' healthcare expenditures. These expenses are projected to increase as the US population ages. Utilization of the ambulatory healthcare system stemming from chronic conditions has been seen as contributory factor in the rising expenditures. Efforts to better manage chronic conditions ought to result in better health outcomes and, by extension, savings through lower utilization of ambulatory services. The longer-term financial consequences of such interventions, however, are more uncertain. This study offers a System Dynamics simulation framework that identifies and models the critical relationships associated with health outcomes and longer-term financial consequences. This framework is demonstrated through a comparison between groups with a similar generic chronic condition, but one group is subjected to a management intervention and the other group is not. The framework provides constructive insights into how the initial intervention cost estimates, the resulting savings, and the health status may change depending on uncertainties, feedback effects, and cost structures.

An effectiveness-implementation hybrid trial for informatics-based cancer symptom management.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 236-236
Author(s):  
Justin D. Smith ◽  
Sofia F. Garcia ◽  
Frank J. Penedo ◽  
Denise M. Scholtens ◽  
Betina Yanez ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Trial ◽  
Cancer Patients ◽  
Symptom Management ◽  
Trial Design ◽  
Self Management ◽  
Management Intervention ◽  
Management Interventions ◽  
Implementation Trial ◽  
Hybrid Trial

236 Background: Oncology outpatients can facesignificant cancer- and treatment-related symptoms that compromise health related quality of life and quality health care. Although the burden of symptoms on patients’ lives are well-known, most health care systems are not ideally set up to relieve them. Patients are not typically drawn into meaningful engagement with the health care team in ways that enable symptom self-management. As a result, opportunities for early identification and treatment are lost, causing avoidable human suffering and cost. The Northwestern University IMPACT (NU IMPACT) project aims to evaluate the effectiveness and implementation of an informatics-driven symptom monitoring and web-based self-management intervention. The project uses PROMIS measures, integrated into the EHR, to trigger response and intervention. This presentation describes the effectiveness-implementation hybrid trial design and measurement of implementation. Methods: NU IMPACT will test the effectiveness and implementation of a system-wide symptom management intervention, across six adult hematology/oncology and gynecologic oncology outpatient clinics at Northwestern Memorial HealthCare, using a cluster randomized pragmatic roll-out implementation trial with an embedded individual-level randomized clinical trial. This unique design allows for a fully-powered randomized trial to establish the efficacy of the intervention, as well as a randomized test of implementation. We are enrolling approximately 6,000 patients in pre-implementation and 6,000 in post-implementation, with half of the latter group randomly assigned to enhanced symptom management, and the other half to usual care. Results: Implementation process is guided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) model with evaluation following the RE-AIM framework. Particular focus is paid to adoption at the clinic and provider levels, the extent to which the intervention achieves meaningful reach to cancer patients, and the potential for sustainment. Additionally, we are testing and validating a newly developed method for tracking and reporting dynamic changes to implementation strategies. Conclusions: Achieving the aims of the NU IMPACT project is a critical step in the advancement of informatics-driven symptom management interventions for cancer patients. The innovative implementation trial design and measurement approach will aid in the rapid translation of findings to other healthcare systems. Clinical trial information: NCT03988543 .

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