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Context: Clinicians deciding whether to refer a patient or family to specialty palliative care report facing high levels of uncertainty. Most research on medical uncertainty has focused on prognostic uncertainty. As part of a pediatric palliative referral intervention for oncology teams we explored how uncertainty might influence palliative care referrals.Objectives: To describe distinct meanings of the term "uncertainty" that emerged during the qualitative evaluation of the development and implementation of an intervention to help oncologists overcome barriers to palliative care referrals.Methods: We conducted a phenomenological qualitative analysis of "uncertainty" as experienced and described by interdisciplinary pediatric oncology team members in discussions, group activities and semistructured interviews regarding the introduction of palliative care.Results: We found that clinicians caring for patients with advanced cancer confront seven broad categories of uncertainty: prognostic, informational, individual, communication, relational, collegial, and inter-institutional. Each of these kinds of uncertainty can contribute to delays in referring patients to palliative care.Conclusion: Various types of uncertainty arise in the care of pediatric patients with advanced cancer. To manage these forms of uncertainty, providers need to develop strategies and techniques to handle professionally challenging situations, communicate bad news, manage difficult interactions with families and colleagues, and collaborate with other organizations. [ABSTRACT FROM AUTHOR]

Outbreaks of Crown-of-Thorns Starfish (CoTS), Acanthaster planci , are a major cause of coral decline on the Great Barrier Reef, second only to cyclones. Although various models have been developed in the past to assist management decision making, most of these models were cohort-based deterministic descriptions with little inclusion of parameter and individual uncertainties, or they were structured around a generic ecological modelling framework, or they were not calibrated with observational data. A major challenge of statistical modelling occurs when estimation of the likelihood is computationally expensive or even intractable. However, approximate Bayesian computation (ABC) can be a convenient solution to this problem. In this study, we developed a semi-individual agent-based model for CoTS. Unlike previous models, this model amalgamated a species-specific individual-based process model with statistical methods of parameter estimation, namely replenishment ABC (RABC) and ABC-rejection. This Bayesian modelling framework facilitates quantification of the uncertainty in parameter estimation while the individual-based aspect of the model enables it to take into account individual variation in life histories. In this relatively complex setting and in the absence of an informative prior, ABC-rejection was unable to efficiently estimate the posterior distribution of model parameters within a reasonable time frame. In contrast, RABC demonstrated promising results in estimating model parameters. The results of posterior predictive checks showed that most observations were within the 95% predicted intervals. Therefore, the semi-individual agent-based model developed in this study showed promising ability to accurately predict the general population trends at the three locations studied. The results of modelling identified a strong link between observed sharp declines in CoTS populations and depletion of their food (i.e. coral cover). As outbreaks of CoTS have caused substantial decline in the coral cover of the Great Barrier Reef, this model should eventually be combined with operation models to predict the outcome of different interventions, and the design of optimal control strategies. [ABSTRACT FROM AUTHOR]

Abstract: Based on a survey of US Chief Financial Officers (CFOs), we present expectations of the equity risk premium measured over a 10-year horizon relative to a 10-year US Treasury bond. This multi-year survey has been conducted each quarter from June 2000 to June 2005. Each quarter the survey also provides measures of cross-sectional disagreement about the risk premium, skewness, and a measure of individual uncertainty. The individual uncertainty is deduced from the 80% confidence interval that each respondent provides for his or her risk premium assessment. We also present evidence on the determinants of the long-run risk premium. Our analysis suggests there is a positive correlation between the ex ante risk premium and real interest rates as reflected in Treasury Inflation Indexed Notes. [Copyright &y& Elsevier]

The aim of this paper is to develop some measure-theoretic methods for the study of large economic systems with individual-specific randomness and multiple optimal actions. In particular, for a suitably formulated continuum of correspondences, an exact version of the law of large numbers in distribution is characterized in terms of almost independence, which leads to several other versions of the law of large numbers in terms of integration of correspondences. Widespread correlation due to multiple optimal actions is also shown to be removable via a redistribution. These results allow the complete removal of individual risks or uncertainty in economic models where non-unique best choices are inevitable. Applications are illustrated through establishing stochastic consistency in general equilibrium models with idiosyncratic shocks in endowments and preferences. In particular, the existence of "global" solutions preserving microscopic independence structure is shown in terms of competitive equilibria for the cases of divisible and indivisible goods as well as in terms of core for a case with indivisible goods where a competitive equilibrium may not exist. An important feature of the idealized equilibrium models considered here is that standard results on measure-theoretic economies are now directly applicable to the case of random economies. Some asymptotic interpretation of the results are also discussed. It is also pointed out that the usual unit interval [0, 1] can be used as an index set in our setting, provided that it is endowed together with some sample space a suitable larger measure structure. [ABSTRACT FROM AUTHOR]