Browsing by Subject "uncertainty"

Now showing 1 - 8 of 8
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    Adapting to Uncertainty: Nursing Responsiveness to COVID-19
    (Wolters Kluwer, 2020-07) Wierenga, Kelly L.; Moore, Scott Emory; School of Nursing
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    If I Quit in the Clinic and Do Nothing but Teach, I'm Going to Be Looking for a New Job: An Exploration of Uncertainty Management in Medical Education
    (Taylor & Francis, 2020) Hoffmann-Longtin, Krista; Hernandez, Rachael; Communication Studies, School of Liberal Arts
    Academic medicine in the United States is a complex field, changing regularly in response to new healthcare knowledge, emerging technologies, and evolving funding models. Uncertainty management theory (UMT) provides scholars a lens to make sense of how individuals experience uncertainty. This study employs UMT to explore the experiences of clerkship and course directors (CDs), faculty in U.S. medical schools who serve in education administration roles. Fifteen semi-structured, in-depth interviews with eight CDs over 14 months indicate complicated relationships with uncertainty at work. Interpreted through UMT, these results reveal that some CDs manage uncertainty discursively, and at times, leverage uncertainty to maintain agency within their roles. These findings indicate that it may be important to recruit CDs who feel comfortable with and can manage uncertainty and provide them with appropriate socialization and ongoing support. Broadly, the results suggest that a more nuanced understanding of uncertainty management experiences can benefit both employees and institutions; as employees gain more role clarity, institutions receive information on how to better meet employees’ needs.
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    A Naïve Bayesian Classifier in Categorical Uncertain Data Streams
    (IEEE, 2014-10) Ge, Jiaqi; Xia, Yuni; Wang, Jian; Department of Computer & Information Science, School of Science
    This paper proposes a novel naïve Bayesian classifier in categorical uncertain data streams. Uncertainty in categorical data is usually represented by vector valued discrete pdf, which has to be carefully handled to guarantee the underlying performance in data mining applications. In this paper, we map the probabilistic attribute to deterministic points in the Euclidean space and design a distance based and a density based algorithms to measure the correlations between feature vectors and class labels. We also devise a new pre-binning approach to guarantee bounded computation and memory cost in uncertain data streams classification. Experimental results in real uncertain data streams prove that our density-based naive classifier is efficient, accurate, and robust to data uncertainty.
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    On Theory in Supply Chain Uncertainty and its Implications for Supply Chain Integration
    (Wiley, 2016-07) Flynn, Barbara B.; Koufteros, Xenophon; Lu, Guanyi; Kelley School of Business
    This article develops a theoretical conceptualization of supply chain uncertainty, based on the foundation provided by contingency theory, classical organization theory, and information processing theory. We develop a theoretical analogy between a supply chain and an organization, then highlight key differences, which leads us to hypothesize that there are three key types of supply chain uncertainty. Micro-level uncertainty is based on the variability of inputs to the technical core of a supply chain, corresponding to the traditional operationalization of uncertainty in the supply chain and operations management literature. Meso-level uncertainty is the lack of information needed by a supply chain member, corresponding to the information processing theory perspective. This is often due to the conflicting pressures of differentiation and interdependence in a supply chain, where members may withhold information that they feel could compromise their interests. Macro-level uncertainty, based on the equivocality construct, is related to unclear and ambiguous situations faced by supply chain members in rapidly changing external environments. We propose that all three types of uncertainty coexist in a supply chain and may interact with each other. Based on contingency theory's focus on alignment of process and structure with the environment, we test the relationship among supply chain integration (process), centralization, formalization and flatness (organization structure) and the dimensions of uncertainty (environment). Hypotheses are tested using hierarchical regression on data collected from 339 globally distributed manufacturing plants. It reveals that, as hypothesized, micro-level and meso-level uncertainty are positively related to SCI and that macro-level uncertainty is inversely related to it. The organization structure variables of centralization and formalization had a moderating effect, strengthening or reducing the main effects of uncertainty. The results are discussed in terms of their consistency with the theoretical foundation, implications for decision makers facing supply chain uncertainty and future research opportunities.
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    Patient perspectives on variant reclassification after cancer susceptibility testing
    (Wiley, 2020-04-24) Halverson, Colin M. E.; Connors, Laurie M.; Wessinger, Bronson C.; Clayton, Ellen W.; Wiesner, Georgia L.; Medicine, School of Medicine
    Background Little is known about the impact of reclassification on patients’ perception of medical uncertainty or trust in genetics‐based clinical care. Methods Semistructured telephone interviews were conducted with 20 patients who had received a reclassified genetic test result related to hereditary cancer. All participants had undergone genetic counseling and testing for cancer susceptibility at Vanderbilt‐Ingram Cancer Center Hereditary Cancer Clinic within the last six years. Results Most of the participants did not express distress related to the variant reclassification and only a minority expressed a decrease in trust in medical genetics. However, recall of the new interpretation was limited, even though all participants were recontacted by letter, phone, or clinic visit. Conclusion Reclassification of genetic tests is an important issue in modern healthcare because changes in interpretation have the potential to alter previously recommended management. Participants in this study did not express strong feelings of mistrust or doubt about their genetic evaluation. However, there was a low level of comprehension and information retention related to the updated report. Future research can build on this study to improve communication with patients about their reclassified results.
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    To be a great innovator, learn to embrace and thrive in uncertainty
    (2020) Saxton, Todd; Kelley School of Business
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    Uncertainty as a Key Influence in the Decision To Admit Patients with Transient Ischemic Attack
    (Springer, 2018-09) Homoya, Barbara J.; Damush, Teresa M.; Sico, Jason J.; Miech, Edward J.; Arling, Gregory W.; Myers, Laura J.; Ferguson, Jared B.; Phipps, Michael S.; Cheng, Eric M.; Bravata, Dawn M.; Medicine, School of Medicine
    Background Patients with transient ischemic attacks (TIA) are at high risk of subsequent vascular events. Hospitalization improves quality of care, yet admission rates for TIA patients vary considerably. Objectives We sought to identify factors associated with the decision to admit patents with TIA. Design We conducted a secondary analysis of a prior study’s data including semi-structured interviews, administrative data, and chart review. Participants We interviewed multidisciplinary clinical staff involved with TIA care. Administrative data included information for TIA patients in emergency departments or inpatient settings at VA medical centers (VAMCs) for fiscal years (FY) 2011 and 2014. Chart reviews were conducted on a subset of patients from 12 VAMCs in FY 2011. Approach For the qualitative data, we focused on interviewees’ responses to the prompt: “Tell me what influences you in the decision to or not to admit TIA patients.” We used administrative data to identify admission rates and chart review data to identify ABCD2 scores (a tool to classify stroke risk after TIA). Key Results Providers’ decisions to admit TIA patients were related to uncertainty in several domains: lack of a facility TIA-specific policy, inconsistent use of ABCD2 score, and concerns about facilities’ ability to complete a timely workup. There was a disconnect between staff perceptions about TIA admission and facility admission rates. According to chart review data, staff at facilities with higher admission rates in FY 2011 reported consistent reliance on ABCD2 scores and related guidelines in admission decision-making. Conclusions Many factors contributed to decisions regarding admitting a patient with TIA; however, clinicians’ uncertainty appeared to be a key driver. Further quality improvement interventions for TIA care should focus on facility adoption of TIA protocols to address uncertainty in TIA admission decision-making and to standardize timely evaluation of TIA patients and delivery of secondary prevention strategies.
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    Uncertainty of Social Network Members in the Case of Communication-Debilitating Illness or Injury
    (2008-01) Donovan-Kicken, Erin; Bute, Jennifer J.
    Uncertainty is a consequential aspect of chronic illness for patients as well as their family and friends, yet little research has focused on how non-ill individuals experience uncertainty about the condition of someone in their social network. Thirty-one individuals with loved ones who had a communication-debilitating illness or injury (CDI) participated in one-on-one interviews about their experiences. We analyzed transcripts for participants' sources of uncertainty and for ways that they managed the uncertainty. Participants' experiences with uncertainty included questions about the condition itself and involved the impaired communication resulting from the CDI. Participants described managing uncertainty through information seeking, changing the ways they communicated with the person with the CDI, and creating schemata to help reduce uncertainty. We discuss the findings in terms of predominant conceptualizations of uncertainty in illness and address the prevalence of communication as both a significant source of uncertainty and an important means of managing uncertainty.