The Social Psychology of Organizations.

Hawaii International Conference on System Sciences

Over the past two decades, as the prevalence of chronic pain and health care costs have exploded, an opioid epidemic with adverse consequences has escalated. Efforts to increase opioid use and a campaign touting the alleged undertreatment of pain continue to be significant factors in the escalation. Many arguments in favor of opioids are based solely on traditions, expert opinion, practical experience and uncontrolled anecdotal observations. Over the past 20 years, the liberalization of laws governing the prescribing of opioids for the treatment of chronic non-cancer pain by the state medical boards has led to dramatic increases in opioid use. This has evolved into the present stage, with the introduction of new pain management standards by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) in 2000, an increased awareness of the right to pain relief, the support of various organizations supporting the use of opioids in large doses, and finally, aggressive marketing by the pharmaceutical industry. These positions are based on unsound science and blatant misinformation, and accompanied by the dangerous assumptions that opioids are highly effective and safe, and devoid of adverse events when prescribed by physicians. Results of the 2010 National Survey on Drug Use and Health (NSDUH) showed that an estimated 22.6 million, or 8.9% of Americans, aged 12 or older, were current or past month illicit drug users, The survey showed that just behind the 7 million people who had used marijuana, 5.1 million had used pain relievers. It has also been shown that only one in 6 or 17.3% of users of non-therapeutic opioids indicated that they received the drugs through a prescription from one doctor. The escalating use of therapeutic opioids shows hydrocodone topping all prescriptions with 136.7 million prescriptions in 2011, with all narcotic analgesics exceeding 238 million prescriptions. It has also been illustrated that opioid analgesics are now responsible for more deaths than the number of deaths from both suicide and motor vehicle crashes, or deaths from cocaine and heroin combined. A significant relationship exists between sales of opioid pain relievers and deaths. The majority of deaths (60%) occur in patients when they are given prescriptions based on prescribing guidelines by medical boards, with 20% of deaths in low dose opioid therapy of 100 mg of morphine equivalent dose or less per day and 40% in those receiving morphine of over 100 mg per day. In comparison, 40% of deaths occur in individuals abusing the drugs obtained through multiple prescriptions, doctor shopping, and drug diversion. The purpose of this comprehensive review is to describe various aspects of crisis of opioid use in the United States. The obstacles that must be surmounted are primarily inappropriate prescribing patterns, which are largely based on a lack of knowledge, perceived safety, and inaccurate belief of undertreatment of pain.

Opioid Epidemic in the United States

This book gathers chapters from some of the top international empirical software engineering researchers focusing on the practical knowledge necessary for conducting, reporting and using empirical methods in software engineering. Topics and features include guidance on how to design, conduct and report empirical studies. The volume also provides information across a range of techniques, methods and qualitative and quantitative issues to help build a toolkit applicable to the diverse software development contexts

/pdf/guide-to-advanced-empirical-software-engineering-2f0my2wuh8.pdf

Guide to Advanced Empirical Software Engineering

The original edition of this book summarized more than a decade of work on communications flow in science and engineering organizations, showing how human and organizational systems could be restructured to bring about improved productivity and better person-to-person contact. While many studies have been done since then, few of them invalidate the general conclusions and recommendations Allen offers. In a new preface he points out new developments, noting areas that need some modification, elaboration, or extension, and directing readers to the appropriate journal articles where the findings, are reported. The first three chapters provide an overview of the communication system in technology, present the author's research methods, and describe differences in the career paths and goals of engineers and scientists that cause special problems for organizations. The book then discusses how technological information is acquired by the R & D organization, shows how critical technical communication within the laboratory is for R & D performance, and originates the idea of the \"gatekeeper,\" the person who links his or her organization to the world at large. Concluding chapters take up the influence of formal and informal organization and of architecture and office layouts on communication. Many of these ideas have been successfully incorporated by architects and managers in the design of new R & D facilities and complexes. Suggested Citation Handle: RePEc:mtp:titles:0262510278 Download reference as HTML Thomas J. Allen, 1984. \"Managing the Flow of Technology: Technology Transfer and the Dissemination of Technological Information Within the R&D Organization,\" MIT Press Books, The MIT Press, edition 1, volume 1, number 0262510278, November. More services and features MyIDEAS Follow serials, authors, keywords & more New papers by email Subscribe to new additions to RePEc Author registration Public profiles for Economics researchers MPRA Upload your paper to be listed on RePEc and IDEAS EconAcademics Blog aggregator for economics research Plagiarism Cases of plagiarism in Economics Rankings Various rankings of research in Economics & related fields RePEc Genealogy Who was a student of whom, using RePEc RePEc Biblio Curated articles & papers on various economics topics Job market papers RePEc working paper series dedicated to the job market Fantasy league Pretend you are at the helm of an economics department Services from the StL Fed Data, research, apps & more from the St. Louis Fed IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.

/pdf/managing-the-flow-of-technology-technology-transfer-and-the-27luzgsrys.pdf

Managing the Flow of Technology: Technology Transfer and the Dissemination of Technological Information Within the R&D Organization (Book Review)

A dramatic rise in the nonmedical of pharmaceutical opioids has presented the United States with a substantial public health problem. Nonmedical use of prescription pain relievers has become increasingly prevalent in the US over the last two decades, and diversion of medicines obtained by prescription is assumed to be a major source of supply for nonmedical opioid use. Policymakers striving to protect population health by ameliorating the adverse outcomes of nonmedical use of opioid analgesics could benefit from a systems-level model which reflects the complexity of the system and incorporates the full range of available data. To address this need, the current project describes the conceptualization and development of a System Dynamics model that is used to complement and leverage results from existing research. Additional testing is needed to authenticate preliminary intervention simulation results, which suggest that a reduction in the initiation of nonmedical use may have a more profound impact on the total number of opioid overdose deaths than more tamper-resistant formulations, decreases in opioid prescribing, or decreases in rates of abuse among medical users. Results indicate that System Dynamics can help to identify points of high leverage for policy interventions as well as bring attention to the unanticipated negative consequences of these interventions.

/pdf/a-system-dynamics-model-of-pharmaceutical-opioids-medical-39yaem7h0o.pdf

A system dynamics model of pharmaceutical opioids : medical use, diversion, and nonmedical use

We describe the calibration of a computer model of intracranial pressure (ICP) dynamics to correspond with annotated clinical data taken from a patient being treated for elevated ICP due to a traumatic brain injury. The research protocol employed during treatment includes adjusting the elevation of the head of the bed, adjusting the ventilator settings to induce mild hyperventilation and hypoventilation, and adjusting the height of the cerebrospinal fluid drainage system. The model behavior corresponds to the experimental data quite well in the case of the changing the head of the bed, but less well in the case of changing the ventilator settings.

/pdf/calibrating-an-intracranial-pressure-dynamics-model-with-3eg73tsgjh.pdf

Calibrating an intracranial pressure dynamics model with clinical data - a progress report

*† In using evolutionary structural optimization (ESO) for topology optimization, it seems that some important questions regarding the initial and optimal thickness have not been addressed. How is the initial thickness decided? Is it optimal? If not, how does one find the optimum? Will that choice affect the optimality of topology? In this paper, an initial investigation on directly using a sizing optimizer to also optimize topology is reported. The problem formulation is based on distributed plate thickness, not distributed density. For simple problems, each finite element is assigned a unique property number ― the design variable with bounds. Partial ground structure approach is needed for complex 3D problems. Ideally, the optimizer assigns the values only within the bounds, or near zero with stress constraints relaxed if any. Until such ideal methodology is developed, an iterative approach may be used to gradually delete the thinner elements to achieve improved or even optimal structures. After that, the design problem is reformulated with much fewer design variables for final sizing optimization. The approach was applied to several numerical examples to minimize the weight subject to stress or displacement constraints, with results very close to those from other methods. The approach was also used to evaluate different options for a real design project, showing its applicability and efficiency.

http://www.researchgate.net/profile/Wayne_Wakeland/publication/228910782_Using_a_Sizing-Optimizer_to_Optimize_Topology_and_Partial_Ground_Structure_Approach/links/02bfe510168ec13ba4000000.pdf

Using a Sizing-Optimizer to Optimize Topology and Partial Ground Structure Approach

We present a practical guide, including a step-by-step flowchart, for establishing uncertainty intervals for key model outcomes in the face of uncertain parameters. The process starts with Powell optimization (e.g., using VensimTM) to find a set of uncertain parameters (the “optimum” parameter set or OPS) that minimize the model fitness error relative to available reference behavior data. The optimization process also helps in refinement of assumed parameter uncertainty ranges. Next, Markov Chain Monte Carlo (MCMC) or conventional Monte Carlo (MC) randomization is used to create a sample of parameter sets that fit the reference behavior data nearly as well as the OPS. Under the MC method, the entire parameter space is explored broadly (with a very large number of runs), and the results are sorted for selection of qualifying parameter sets (QPS) based on goodness-of-fit criteria. The statistical properties of the QPS parameter distributions are analyzed to ensure their centrality relative to the uncertainty ranges. Also, the full set of QPS outputs are graphed (as sensitivity graphs or box-and-whisker plots) for comparison with the reference behavior data. Finally, alternative policies and scenarios are run against the OPS and all QPS, and confidence intervals are found for key model outcomes. We demonstrate the method with a substantial model that is in the process of being published, and we discuss how such analyses can be used by policy/decision makers. Addressing parameter uncertainty in SD Models 7/5/2020, page 2

/pdf/addressing-parameter-uncertainty-in-sd-models-with-fit-to-ztj8w8ozec.pdf

Addressing parameter uncertainty in SD models with fit-to-history and Monte-Carlo sensitivity methods

/pdf/using-discrete-system-simulation-to-model-the-lane-county-35su1vzvig.pdf

Wayne W. Wakeland

Papers

A system dynamics model of pharmaceutical opioids : medical use, diversion, and nonmedical use

Calibrating an intracranial pressure dynamics model with clinical data - a progress report

Using a Sizing-Optimizer to Optimize Topology and Partial Ground Structure Approach

Addressing parameter uncertainty in SD models with fit-to-history and Monte-Carlo sensitivity methods

Using Discrete System Simulation to Model the Lane County Criminal Justice System