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Providing psychosocial support to pediatric patients and their families at the end of life represents one of the most challenging yet vital aspects of healthcare practice. Despite the presence of grief and loss training in many pediatric healthcare professionals’ educational backgrounds, opportunities for practical training experience in delivering end-of-life care remain limited. This study explored the use of simulation-based training to enhance the self-reported knowledge, skills, and comfort levels of child life specialists in providing psychosocial care during end-of-life situations.
Methods
Forty-three child life specialists participated in the simulation-based training, which was combined with traditional didactic instruction, and the associated research study. Pre- and post-training surveys were used to assess impact of the training on child life specialists’ self-reported knowledge of end-of-life care and comfort in providing this care.
Results
A statistically significant increase was seen in all measured aspects of self-reported knowledge and comfort in providing end-of-life care following the training.
Significance of results
Simulation combined with traditional instruction methods provides an effective way to train healthcare professionals in providing high-stakes psychosocial care while protecting patients and families from the added strain of trainees and excess staff presence during sensitive times.
Archaeological sampling is a critical yet inconsistently applied aspect of field methodology. Poorly designed strategies produce biased or irreproducible results, especially when recovery is labor-intensive and research expectations are high. This article addresses that challenge through the lens of spatial microrefuse analysis, using simulation modeling to evaluate current practices and improve sampling design, training, and planning. A review of 27 published microrefuse studies reveals wide variation in sampling strategies, unit sizes, and volumes, with little evidence of statistical justification. To explore the consequences of this variation, I introduce the Archaeological Sampling Experiment Laboratory (tASEL), an open-source simulation tool developed in NetLogo and archived in the CoMSES model library. tASEL allows archaeologists to construct artifact distributions and test random, systematic, or hybrid sampling frames with immediate visual and statistical feedback. I used tASEL to conduct 22,000 virtual sampling experiments across two artifact distributions: a diffuse random scatter and a highly clustered pattern. Results show that sampling performance varies significantly by distribution, sample size, and frame design. Random strategies produced the highest accuracy and lowest bias. I conclude by demonstrating how tASEL can be used in classroom and field contexts to improve sampling literacy and support more robust archaeological practice.
Fractional Brownian motion, with its long-time correlated increments, has been applied in many fields in recent years. Since volatility was shown to be rough by Gatheral, Jaisson, and Rosenbaum, fractional Brownian motion has gained popularity as a financial model. In this work, we revisit the definitions and properties of the univariate and multivariate fractional Brownian motions, and consider four simulation methods. We demonstrate the issues associated with applying the standard Euler scheme for simulating stochastic processes driven by fractional Brownian motion with $H < \frac{1}{2}$ (which we call the rough models). We then introduce a novel approximate method for simulating such rough models based on the fast algorithm by Ma and Wu, which accounts for a factor of 10 speedup. Finally, we consider applications of these methods to option pricing.
This chapter covers the use of simulation as a method of disaster response preparation. It addresses case creation, high-fidelity techniques, and execution of a large, live action disaster simulation. It discusses how to build out a case from planned objectives, as well as pairing debriefing points for after the case is finished. It also gives advice on how to retain optimal control over the case to help ensure it runs smoothly. It gives advice on logistics and case flow, avoiding common pitfalls in planning such drills, and proper communication between instructors during the drill. It discusses how to implement a twist into the case to further constrain resources available to the learners and how to integrate such twists into the case without disruption.
This chapter is a quick introduction to the history of simulation, why simulation is a powerful tool in medical education, and basic tools needed to run a successful simulation.
Extropy-based divergence measures offer distinct advantages over entropy-based counterparts, owing to their mathematical simplicity and enhanced interpretability. Relative extropy by Lad et al. [5] is a symmetric divergence measure between two probability distributions, and Mohammadi et al. [8] introduced the asymmetric divergence between two distributions based on extropy. We further study these measures, their properties, and interrelationships in this article. To address the divergence between truncated lifetime distributions, we define dynamic relative extropy for residual and past lifetime scenarios. Exploring the interrelationships of dynamic cases of relative extropy, extropy divergence, and extropy inaccuracy, we derive some unique properties and characterizations for the exponential distribution. A nonparametric estimator for relative extropy is developed, and its performance is assessed through numerical simulation studies. The practical applicability of relative extropy is used to analyze the divergence in lifetime patterns of mice under a lifetime feeding experiment and the shopping patterns of customers based on age and income groups. Further, the application of relative extropy is also applied to find the dissimilarity between two images.
Understanding the causes and drivers of extinction is critical for mitigating future anthropogenic extinctions. This study explored the extinction process of the Crested Ibis Nipponia nippon in Japan, focusing on the last wild population on Sado Island. An integrated population model–population viability analysis (IPM-PVA) framework was applied to estimate demographic parameters and population dynamics using four historical data sources, i.e. population counts, records of dead or rescued individuals, reproductive data, and captures for captive breeding. The IPM estimated an average of 0.703 fledglings per breeding pair per season, with adult and juvenile survival rates of 0.870 and 0.730, respectively. Human disturbances were found to substantially reduce fecundity. PVA results indicated an extinction probability of 56.6% under observed historical conditions, which could have been reduced to 11.2% if human access to nesting forests had been restricted. The study identified low fecundity caused by human disturbance at nest-sites as a likely contributor to the species’ extinction. Despite the need for cautious interpretation due to data limitations, this study highlights the practical utility of the IPM-PVA framework in providing detailed insights into the extinction process.
Overseas large-scale combat operations (LSCOs) could require domestic hospitals to treat large numbers of combat casualties. Our goal was to evaluate the financial impact on hospitals of treating combat casualties during an LSCO.
Methods
Using a discrete event simulation model, we explored how 5 civilian hospitals in Omaha, Nebraska, would fare after accepting combat casualties during a National Disaster Medical System (NDMS) activation. We compared changes in financial measures (government payments, hospital revenues) and occupancy measures (civilian patient displacement) under different scenarios for combat casualty reimbursement rates as fractions (75%-125%) of Medicare rates.
Results
Combat casualties replaced 100% of civilian patients at 3 of 5 hospitals, displacing a total of 10,905 civilian patients [95% CI: 10551-11248]. Combat casualty reimbursement at 125% of Medicare rates resulted in government payments of $462 million and net income gains for civilian hospitals of approximately 23 times pre-activation baselines. Combat casualty reimbursement below 125% of Medicare rates led to net income losses.
Conclusions
Large influxes of combat casualties could result in rapid, profound displacement of civilian patients and revenue loss at NDMS-participating facilities, potentially affecting hospitals’ ability and willingness to treat them. Policymakers need to identify appropriate reimbursement rates for combat casualties.
Word frequency databases like SPALEX and SUBTLEX-ESP treat Spanish as a uniform language, but prior studies and an initial survey (Experiment 1) revealed significant lexical differences between Spanish in Spain and Latin American countries, especially Chile. To establish subjective frequencies of Spanish word usage, an extended survey (Experiment 2) was conducted with Chilean participants, categorizing words by usage area: General, Spain, Chile, and Latin America. Consistent with the initial survey, Chilean participants assigned subjective higher ratings to General and Chilean words. In a lexical decision experiment (Experiment 3), participants responded faster and more accurately to words from these categories. Using survey data, simulations with Multilink+ (Experiment 4) revealed that subjective word ratings better predicted Chilean reaction times than frequencies from existing databases. These findings emphasize the need to address Spanish dialectal differences in research, with word ratings offering a more accurate measure of region-specific lexical nuances than current databases.
Exercises are an essential component of preparedness and should be used to enhance capability and contribute to continuous improvement. An exercise can be as simple as a planning group discussing an emergency plan or as complex as a major multi-agency event involving several organizations and participants. This study aims to identify and conceptualize quality indicators (QIs) influencing prehospital disaster exercises across structure, conduct, and outcome.
Methods
This research was conducted through a systematic review and searching of the databases of PubMed, Scopus, Web of Science, and Google Scholar. Thematic content analysis was used for data analysis. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for systematic search, and the Critical Appraisal Skills Program (CASP) was used for quality assessment of the final extracted articles.
Results
From an initial set of 3,083 articles, 10 high-quality studies were included for analysis. The quality indicators influencing prehospital disaster exercises were analyzed into 3 themes, 8 categories, and 21 subcategories. The primary themes and related main categories included: Exercise structure QIs (knowledge promotion and cognitive skills, supply of exercise hardware and software requirements and resources desirable management), Exercise conduct QIs (practical proficiency in essential skills and decision-making capacity), and Exercise outcome QIs (evaluation and reporting of exercise, promotion of managerial capabilities and competencies, and development of psychological capabilities).
Conclusion
The findings of this research present a knowledge framework that can help exercise planners in prehospital settings in designing scientifically sound and standardized exercises aimed at enhancing disaster response processes. Furthermore, the implementation and evaluation of both discussion-based and operation-based disaster exercises informed by these identified quality indicators can foster the development of knowledge and promote behavioral change among prehospital staff, and facilitate a standardized response to emergencies and disasters.
Random-effects meta-analysis is a widely applied methodology to synthesize research findings of studies related to a specific scientific question. Besides estimating the mean effect, an important aim of the meta-analysis is to summarize the heterogeneity, that is, the variation in the underlying effects caused by the differences in study circumstances. The prediction interval is frequently used for this purpose: a 95% prediction interval contains the true effect of a similar new study in 95% of the cases when it is constructed, or in other words, it covers 95% of the true effects distribution on average in repeated sampling. In this article, after providing a clear mathematical background, we present an extensive simulation investigating the performance of all frequentist prediction interval methods published to date. The work focuses on the distribution of the coverage probabilities and how these distributions change depending on the amount of heterogeneity and the number of involved studies. Although the single requirement that a prediction interval has to fulfill is to keep a nominal coverage probability on average, we demonstrate why the distribution of coverages should not be disregarded. We show that for meta-analyses with small number of studies, this distribution has an unideal, asymmetric shape. We argue that assessing only the mean coverage can easily lead to misunderstanding and misinterpretation. The length of the intervals and the robustness of the methods concerning the non-normality of the true effects are also investigated.
Increasingly, simulation-based teaching and learning is finding a place within politics and international relations (IR) programmes. The majority of literature on this style of teaching and learning has positioned it as both an aid to content delivery and as a response to the many challenges facing contemporary higher education. Little guidance is given, however, to the practical considerations of using simulations as a component of assessment or as informing assessed tasks. This article draws upon the experience of the authors in adapting the well-established Model United Nations (MUN) simulation programme for delivery as an assessed module at a British university. This has involved balancing institutional teaching, assessment and validation requirements with the successful simulation of diplomatic practice. The article introduces the MUN simulation and explores the extant pedagogic literature encouraging the use of simulation-based learning in IR curricula, before moving on to provide an overview of the rationale for the various decisions the authors have made in adapting the simulation for delivery as an assessed curriculum component. The article asserts the value of introducing assessed simulations within IR coursework and provides guidance on how student performance in pedagogic simulations might best be assessed.
Collaboration and its promotion by funders continue to accelerate. Although research has identified significant transaction costs associated with collaboration, little empirical work has examined the broader, societal-level economic outcomes of a resource-sharing environment. Does an environment that encourages collaboration shift our focus toward certain types of social objectives and away from others? This paper uses agent-based Monte Carlo simulation to demonstrate that collaboration is particularly useful when resources are rare but a social objective is commonly held. However, collaboration can lead to bad outcomes when the objective is not commonly shared; in such cases, markets outperform collaborative arrangements. These findings suggest that encouraging a resource-sharing environment can lead to inefficiencies even worse than market failure. We also demonstrate that failure to account for transaction costs when prescribing collaboration can result in quantifiably lower outcome levels than expected.
In recent years, a growing body of literature has widely investigated the impact of role-playing simulations in teaching politics and international relations. While scholars agree that participating in simulations is helpful for the students in developing their skills, the evidence about benefits is more mixed. Moreover, the question whether all students—regardless of their demographic or academic background—benefit similarly from simulations remains largely unanswered. This article, based on a cross-national survey submitted to students from Italy and the Netherlands who have participated in the Model United Nations (MUN), provides an innovative contribution to the current literature by looking at views and opinions of students coming from different educational contexts. Our empirical results suggest that students perceive that MUN increases their skills regardless of their academic and socio-demographic background. The quantitative analysis, based on OLS regression models, reveals that the individual students’ background does not influence their perceived benefit, nor their enjoyment of the experience. MUNs appear to be educational as well as fun for all students, regardless of their age, gender, field of study, seniority, and academic homeland.
Recent literature suggests that undergraduate students in political science dread studying methods, especially quantitative methods. Nonetheless, we believe that teaching students the value of quantitative analysis is critical. Going beyond traditional teaching approaches, we use a simulation to conceptualize the logic and process of quantitative analysis. In our simulation, student participants are told they are in a prison with another prisoner, where both have the objective to make the other prisoner crossover, using any strategy. The simulation allows students to generate and test basic hypothesis about students’ characteristics and their strategies, as well as operationalizing variables and quantifying results.
The benefits of simulation exercises easily outweigh potential weaknesses, and most of these weaknesses can be addressed by careful preparation. This article seeks to encourage instructors in higher education to embrace simulations as a means of encouraging active learning and greater retention as well as improving student and teacher satisfaction. However, there is not to date much helpful guidance, for first-time appliers, as to how to set up simulations. This contribution seeks to contribute to closing that gap by reflecting on the experience of two EU Council simulations that the author has organised. The aim is to openly review things that worked well and things that did not so as to allow colleagues interested in engaging in simulations in the future to see the reasons behind certain choices and perhaps avoid weaknesses of simulations set up by ‘freshers’. In this context, articles are all too often presented as success stories, hiding errors or adaptations in the process, whereas in fact much can be learned from publically exposing and reflecting upon shortcomings and weaknesses of research and teaching design and processes. To finish up, some tips for ‘freshers’ have been compiled.
Dissociative identity disorder (DID) manifests with distinct trauma-avoidant and trauma-related identity states. Overtly conscious trauma-related knowledge processing is identity state-dependent. Previous research on covertly subconscious knowledge processing in DID lacks subject-specific trauma-related stimuli.
Aims
Our controlled functional magnetic resonance imaging (fMRI) study explored neural and behavioural differences of overt and covert knowledge processing of individualised self-relevant words in DID.
Method
Behavioural data were gathered while 56 participants underwent task-based fMRI: 14 with DID, 14 DID simulators and a paired control group of 14 healthy controls and 14 participants with post-traumatic stress disorder. Individuals with DID and simulators participated in a trauma-avoidant and a trauma-related identity state. Reaction times and brain activation following overtly and covertly presented individualised words were statistically analysed.
Results
Behavioural analyses showed a main effect of consciousness (P < 0.001). Post hoc between-group pairwise comparisons revealed slower reaction times for individuals with DID compared with simulating (P < 0.05) and paired controls (P < 0.05). Neural data analyses showed increased brain activation in frontal and parietal regions within the diagnosed DID group, especially during overt processing. Between-group comparisons mostly showed less pronounced activation in frontal, occipital and temporal areas.
Conclusions
The present study showed increased cognitive control during overt self-relevant knowledge processing in the trauma-avoidant identity state of DID, in line with previous research. The slower reaction times and increased frontoparietal activation shown in individuals with diagnosed DID, as compared with both control groups, support the notion of cognitive avoidance of trauma-related information in DID and further reinforce the authenticity of DID experiences.
This chapter introduces the reader to the big picture of what analytics science is. What is analytics science? What types does it have, and what is its scope? How can analytics science be used to improve various tasks that society needs to carry out? Is analytics science all about using data? Or can it work without data? What is the role of data versus models? How can one develop and rely on a model to answer essential questions when the model can be wrong due to its assumptions? What is ambiguity in analytics science? Is that different from risk? And how do analytics scientists address ambiguity? What is the role of simulation in analytics science? These are some of the questions that the chapter addresses. Finally, the chapter discusses the notion of "centaurs" and how a successful use of analytics science often requires combining human intuition with the power of strong analytical models.
This chapter explores the intersection of historical linguistics and psycholinguistics by investigating the role of core psycholinguistic factors and phenomena in language change: frequency, salience, chunking, priming, analogy, ambiguity and acquisition. Recent research from cognitive sciences, particularly within a complex systems framework, reveals that language change is influenced by patterns of use and is interconnected with language acquisition and cognition. Bridging the gap between community and individual research, the chapter highlights studies that explore this relationship. It also examines the potential of psycholinguistic methodologies for diachronic research. Additionally, the chapter suggests avenues for further research where psycholinguistic perspectives have had less impact on the study of historical language change. Furthermore, it discusses how psycholinguistic factors have been incorporated into various theoretical approaches to English language change, such as generative and usage-based modelling.