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Abstract Background The rigorous elicitation of user needs is a crucial step for both medical device design and purchasing. However, user needs elicitation is often based on qualitative methods whose findings can be difficult to integrate into medical decision-making. This paper describes the application of AHP to elicit user needs for a new CT scanner for use in a public hospital. Methods AHP was used to design a hierarchy of 12 needs for a new CT scanner, grouped into 4 homogenous categories, and to prepare a paper questionnaire to investigate the relative priorities of these. The questionnaire was completed by 5 senior clinicians working in a variety of clinical specialisations and departments in the same Italian public hospital. Results Although safety and performance were considered the most important issues, user needs changed according to clinical scenario. For elective surgery, the five most important needs were: spatial resolution, processing software, radiation dose, patient monitoring, and contrast medium. For emergency, the top five most important needs were: patient monitoring, radiation dose, contrast medium control, speed run, spatial resolution. Conclusions AHP effectively supported user need elicitation, helping to develop an analytic and intelligible framework of decision-making. User needs varied according to working scenario (elective versus emergency medicine) more than clinical specialization. This method should be considered by practitioners involved in decisions about new medical technology, whether that be during device design or before deciding whether to allocate budgets for new medical devices according to clinical functions or according to hospital department.

Abstract Background With increased governmental interest in value assessment of technologies and where medical device manufacturers are finding it increasingly necessary to become more familiar with economic evaluation methods, the study sought to explore the levels of health economics knowledge within small and medium-sized enterprises (SMEs) and to scope strategies they employ to demonstrate the value of their products to purchasers. Methods A short questionnaire was completed by participants attending one of five workshops on product development in the medical device sector that took place in England between 2007 and 2011. From all responses obtained, a large proportion of participants were based in SMEs (N = 43), and these responses were used for the analysis. Statistical analysis using non-parametric tests was performed on questions with approximately interval scales. Qualitative data from participant responses were analysed to reveal emerging themes. Results The questionnaire results revealed that 60% of SME participants (mostly company directors or managers, including product or project managers) rated themselves as having low or no knowledge of health economics prior to the workshops but the rest professed at least medium knowledge. Clinical trials and cost analyses or cost-effectiveness studies were the most highly cited means by which SMEs aim to demonstrate value of products to purchasers. Purchasers were perceived to place most importance on factors of safety, expert opinion, cost-effectiveness and price. However many companies did not utilise formal decision-making tools to prioritise these factors. There was no significant dependence of the use of decision-making tools in general with respect to professed knowledge of health economics methods. SMEs did not state a preference for any particular aspect of potential value when deciding whether to develop a product. A majority of SMEs stated they would use a health economics tool. Research and development teams or marketing and sales departments would most likely use one. Conclusion This study points to the need for further research into the education requirements of SMEs in the area of Health Technology Assessment (HTA) and also for investigation into how SMEs engage with existing HTA processes as required by assessors such as NICE.

A respiration rate (RR) monitoring system was created by integrating a Fibre Bragg Grating (FBG) optical fibre sensor into a respirator mask. The system exploits the sensitivity of an FBG to temperature to identify an individual's RR by measuring airflow temperature variation near the nostrils and mouth. To monitor the FBG response, a portable, battery-powered, wireless miniature interrogator system was developed to replace a relatively bulky benchtop interrogator used in previous studies. A healthy volunteer study was conducted to evaluate the performance of the developed system (10 healthy volunteers). Volunteers were asked to perform normal breathing whilst simultaneously wearing the system and a reference spirometer for 120 s. Individual breaths are then identified using a peak detection algorithm. The result showed that the number of breaths detected by both devices matched exactly (100%) across all volunteer trials. [ABSTRACT FROM AUTHOR]

In the United States, women are more likely than men to enter and complete college, but they remain underrepresented among baccalaureates in science-related majors. We show that in a cohort of college entrants who graduated from high school in 2004, men were more than twice as likely as women to complete baccalaureate degrees in science, technology, engineering, and mathematics (STEM) fields, including premed fields, and more likely to persist in STEM/biomed after entering these majors by sophomore year. Conversely, women were more than twice as likely as men to earn baccalaureates in a health field, although persistence in health was low for both genders. We show that gender gaps in high school academic achievement, self-assessed math ability, and family-work orientation are only weakly associated with gender gaps in STEM completion and persistence. Gender differences in occupational plans, by contrast, are strongly associated with gender gaps in STEM outcomes, even in models that assume plans are endogenous to academic achievement, self-assessed math ability, and family-work orientation. These results can inform efforts to mitigate gender gaps in STEM attainment.

We propose to change the default P-value threshold for statistical significance for claims of new discoveries from 0.05 to 0.005.

Significance: Our goal is to understand the root cause of reported oxygen saturation (SpO2) overestimation in heavily pigmented skin types to devise solutions toward enabling equity in pulse oximeter designs. Aim: We aim to gain theoretical insights into the effect of skin tone on SpO2-R curves using a three-dimensional, four-layer tissue model representing a finger. Approach: A finger tissue model, comprising the epidermis, dermis, two arteries, and a bone, was developed using a Monte Carlo-based approach in the MCmatlab software. Two skin tones--light and dark--were simulated by adjusting the absorption and scattering properties within the epidermal layer. Following this, SpO2-R curves were generated in various tissue configurations, including transmission and reflection modes using red and infrared wavelengths. In addition, the influence of source-detector (SD) separation distances on both light and dark skin tissue models was studied. Results: In transmission mode, SpO2-R curves did not deviate with changes in skin tones because both pulsatile and non-pulsatile terms experienced equal attenuation at red and infrared wavelengths. However, in reflection mode, measurable variations in SpO2-R curves were evident. This was due to differential attenuation of the red components, which resulted in a lower perfusion index at the red wavelength in darker skin. As the SD separation increased, the effect of skin tone on SpO2-R curves in reflection mode became less pronounced, with the largest SD separation exhibiting effects similar to those observed in transmission mode. Conclusions: Monte Carlo simulations have demonstrated that different light pathlengths within the tissue contribute to the overestimation of SpO2 in people with darker skin in reflection mode pulse oximetry. Increasing the SD separation may mitigate the effect of skin tone on SpO2 readings. These trends were not observed in transmission mode; however, further planned research using more complex models of the tissue is essential. [ABSTRACT FROM AUTHOR]

n processing systems face a continual challenge of extracting only the most important information from the environment, resulting in awareness of some but not all of the available Information. The? current study investigates the psychophysical determinants of awareness. It examines the hypothesis that relative energy level of a stimulus is the critical factor in determining what comes to consciousness. In Experiments 1 and 3 two conceptually incompatible stimuli (one lexical, one pictorial) are presented successively in the same position of a tachistoscope for only 1 msec each, with a zero interstimulus interval. Observers report seeing one or the other, or nothing at all, at a more-or-less chance level when the stimulus durations are equal. As soon as one stimulus is given as little as onequarter to one-half a millisecond more duration than the other, the longer stimulus is reported on 68% to 84% of the test trials. In Experiment 2 an advantage for word perception at these low energy levels was investigated and measured. The results of these experiments indicate that extremely small differences in duration (about .25 or .50 msec) were sufficient to bring one concept to the consciousness of the observer at the expense of the other. Small stimulus intensity differences were investigated in Experiment 4, yielding similar results. The results can be accounted for by contemporary parallel-distributed-processing, connectionist network models of perception and cognition which use a winner-take-all decision rule.

To evaluate a stutter-step model of academic performance in high school, this article adopts a unique measure of the beliefs of 12,591 high school sophomores from the Education Longitudinal Study, 2002-2006. Verbatim responses to questions on occupational plans are coded to capture specific job titles, the listing of multiple jobs, and the listing of multiple jobs with divergent characteristics. The educational requirements of detailed jobs, as specified in the Department of Labor's Occupational Information Network database, are then matched to all jobs that students list within their plans. Students with uncertain beliefs about their occupational futures are then shown to have lower levels of commitment to and performance in school. These results support the conjecture that uncertainty about the future has consequences for the short-run behavior that determines important educational outcomes, beyond the effects that are commonly attributed to existing models of performance.

Candidates for public office in the United States frequently justify their positions on education policy priorities by stating the need to strengthen the nation's economic competitiveness against new global challengers. In this article, the authors investigate the consequences of this form of policy motivation for attitudes toward and support of public schooling in the United States. Using a national survey experiment where a two-question prime on international competitiveness is randomized across respondents, the authors test for differential responses to attitude items that have been included regularly since the 1970s in the Phi Delta Kappa/Gallup Poll and the General Social Survey. The results suggest that framing educational policy with the goal of enhancing international competitiveness lowers subjective assessments of the quality of local schooling without increasing interest in additional spending to improve the nation's education system. (Contains 12 notes, 4 tables and 1 figure.)

This article reexamines the conjecture of James S. Coleman that intergenerational social closure promotes student achievement in high schools, analyzing the best national data on academic achievement and social networks: the 2002 and 2004 waves of the Education Longitudinal Study. The results show that within the Catholic school sector, schools that are characterized by dense parental networks have substantially higher average student achievement. This association can be reduced but not eliminated by conditioning on available measures of student network structure and standard measures of family background. In contrast, in the public school sector, a similarly strong bivariate association between dense parental networks and student achievement can be attributed almost entirely to these basic conditioning variables. These results represent, at best, a mixed verdict for Coleman's predictions. Intergenerational closure in its currently observed form does not increase achievement in public schools, suggesting that parental monitoring of discipline does not outweigh some of the costs of parental closure. However, intergenerational closure may increase achievement in Catholic schools to a modest degree because Catholic schools are affiliated with religious communities that have appropriable norms. (Contains 2 figures, 4 tables and 11 notes.)

The black-white gap in achievement, as measured by performance on standardized tests, has received considerable attention from researchers in the past five years. Claude Steele's stereotype threat and disidentification mechanism is perhaps the most heralded of the new explanations for residual racial differences that persist after adjustments for social background are performed. Analyzing data from the National Education Longitudinal Study, we found qualified support for portions of the disidentification explanation. Black students' academic self-evaluations are more weakly associated with their measured academic performances, a difference that could stem from stereotype threat or a belief that the evaluations are racially biased. But this discounting of performance evaluations does not seem to provoke a more complete disidentification with the schooling process or with academic achievement in general. The findings suggest that there is no clear path from being stereotyped to disidentifying, and in conclusion we discuss alternative explanations for why it may be so.