Science.gov

Sample records for aid decision makers

  1. Automation: Decision Aid or Decision Maker?

    NASA Technical Reports Server (NTRS)

    Skitka, Linda J.

    1998-01-01

    This study clarified that automation bias is something unique to automated decision making contexts, and is not the result of a general tendency toward complacency. By comparing performance on exactly the same events on the same tasks with and without an automated decision aid, we were able to determine that at least the omission error part of automation bias is due to the unique context created by having an automated decision aid, and is not a phenomena that would occur even if people were not in an automated context. However, this study also revealed that having an automated decision aid did lead to modestly improved performance across all non-error events. Participants in the non- automated condition responded with 83.68% accuracy, whereas participants in the automated condition responded with 88.67% accuracy, across all events. Automated decision aids clearly led to better overall performance when they were accurate. People performed almost exactly at the level of reliability as the automation (which across events was 88% reliable). However, also clear, is that the presence of less than 100% accurate automated decision aids creates a context in which new kinds of errors in decision making can occur. Participants in the non-automated condition responded with 97% accuracy on the six "error" events, whereas participants in the automated condition had only a 65% accuracy rate when confronted with those same six events. In short, the presence of an AMA can lead to vigilance decrements that can lead to errors in decision making.

  2. Ecological rationality: a framework for understanding and aiding the aging decision maker.

    PubMed

    Mata, Rui; Pachur, Thorsten; von Helversen, Bettina; Hertwig, Ralph; Rieskamp, Jörg; Schooler, Lael

    2012-01-01

    The notion of ecological rationality sees human rationality as the result of the adaptive fit between the human mind and the environment. Ecological rationality focuses the study of decision making on two key questions: First, what are the environmental regularities to which people's decision strategies are matched, and how frequently do these regularities occur in natural environments? Second, how well can people adapt their use of specific strategies to particular environmental regularities? Research on aging suggests a number of changes in cognitive function, for instance, deficits in learning and memory that may impact decision-making skills. However, it has been shown that simple strategies can work well in many natural environments, which suggests that age-related deficits in strategy use may not necessarily translate into reduced decision quality. Consequently, we argue that predictions about the impact of aging on decision performance depend not only on how aging affects decision-relevant capacities but also on the decision environment in which decisions are made. In sum, we propose that the concept of the ecological rationality is crucial to understanding and aiding the aging decision maker.

  3. International exchange of emergency phase information and assessments: an aid to national/international decision makers.

    PubMed

    Sullivan, Thomas J; Chino, Masamichi; Ehrhardt, Joachim; Shershakov, Vyacheslav

    2004-01-01

    This paper discusses a collaborative project (1) to demonstrate the feasibility and benefit of a system seeking early review, in a 'quasi peer review' mode, of nuclear accident plume and dose assessment predictions by four major international nuclear accident emergency response systems before release of calculations to respective national authorities followed by (2) sharing these results with responsible national/international authorities, (3) development of an affordable/accessible system to distribute results to countries without prediction capabilities and (4) utilisation for exercises and collaboration studies. The project exploits Internet browser technology and low-cost PC hardware, incorporates an Internet node, with access control, for depositing a minimal set of XML-based graphics files for presentation in an identical map format. Side-by-side viewing and televideo conferencing will permit rapid evaluation, data elaboration and recalculation (if necessary) and should produce strong consensus among decision makers. Successful completion affords easy utilisation by national/international organisations and non-nuclear states at risk of trans-boundary incursion.

  4. International Exchange of Emergency Phase Information and Assessment: An Aid to Inter/National Decision Makers

    SciTech Connect

    Sullivan, T J; Chino, M; Ehrhardt, J; Shershakov, V

    2003-09-01

    This paper discusses a collaborative project whose purpose is (1) to demonstrate the technical feasibility and mutual benefit of a system seeking early review or preview, in a ''quasi peer review'' mode, of nuclear accident plume and dose assessment predictions by four major international nuclear accident emergency response systems before release of their calculations to their respective national authorities followed by (2) sharing these results with responsible international authorities. The extreme sensitivity of the general public to any nuclear accident information has been a strong motivation to seek peer review prior to public release. Another intended objective of this work is (3) the development of an affordable/accessible system for distribution of prediction results to countries having no prediction capabilities and (4) utilization of the link for exercises and collaboration studies. The project exploits the Internet as a ubiquitous communications medium, browser technology as a simple, user friendly interface, and low-cost PC level hardware. The participants are developing a web based dedicated node with ID and password access control, where the four systems can deposit a minimal set of XML-based data and graphics files, which are then displayed in a common identical map format. Side-by-side viewing and televideo conferencing will permit rapid evaluation, correction or elaboration of data, recalculation (if necessary) and should produce a strong level of consensus to assist international decision makers. Successful completion of this work could lead to easy utilization by national and international organizations, such as the IAEA and WHO, as well as by non-nuclear states at risk of a trans-boundary incursion on their territory.

  5. A decision aid regarding long-term tube feeding targeting substitute decision makers for cognitively impaired older persons in Japan: A small-scale before-and-after study

    PubMed Central

    2014-01-01

    Background In Japan, there is no decision-making guide regarding long-term tube feeding that specifically targets individuals making decisions on behalf of cognitively impaired older persons (substitute decision makers). The objective of this study was to describe the development and evaluation of such a decision aid. Methods In this before-and-after study, participants comprised substitute decision makers for 13 cognitively impaired inpatients aged 65 years and older who were being considered for placement of a percutaneous endoscopic gastrostomy tube in acute care hospitals and mixed-care hospitals in Japan. Questionnaires were used to compare substitute decision makers’ knowledge, decisional conflict, and predisposition regarding feeding tube placement before and after exposure to a decision aid. The acceptability of the decision aid was also assessed. Paired t-tests were used to compare participants’ knowledge and decisional conflict scores before and after using the decision aid. Results Substitute decision makers showed significantly increased knowledge (P < .001) and decreased decisional conflict (P < .01) regarding long-term tube feeding after using the decision aid. All substitute decision makers found the decision aid helpful and acceptable. Conclusions The decision aid facilitated the decision-making process of substitute decision makers by decreasing decisional conflict and increasing knowledge. PMID:24495735

  6. To notify or not to notify: decision aid for policy makers on whether to make an infectious disease mandatorily notifiable.

    PubMed

    Bijkerk, Paul; Fanoy, Ewout B; Kardamanidis, Katina; van der Plas, Simone M; Te Wierik, Margreet J; Kretzschmar, Mirjam E; Haringhuizen, George B; van Vliet, Hans J; van der Sande, Marianne A

    2015-01-01

    Mandatory notification can be a useful tool to support infectious disease prevention and control. Guidelines are needed to help policymakers decide whether mandatory notification of an infectious disease is appropriate. We developed a decision aid, based on a range of criteria previously used in the Netherlands or in other regions to help decide whether to make a disease notifiable. Criteria were categorised as being effective, feasible and necessary with regard to the relevance of mandatory notification. Expert panels piloted the decision aid. Here we illustrate its use for three diseases (Vibrio vulnificus infection, chronic Q fever and dengue fever) for which mandatory notification was requested. For dengue fever, the expert panel advised mandatory notification; for V. vulnificus infection and chronic Q fever, the expert panel concluded that mandatory notification was not (yet) justified. Use of the decision aid led to a structured, transparent decision making process and a thorough assessment of the advantages and disadvantages of mandatory notification of these diseases. It also helped identify knowledge gaps that required further research before a decision could be made. We therefore recommend use of this aid for public health policy making.

  7. Single-photon decision maker

    PubMed Central

    Naruse, Makoto; Berthel, Martin; Drezet, Aurélien; Huant, Serge; Aono, Masashi; Hori, Hirokazu; Kim, Song-Ju

    2015-01-01

    Decision making is critical in our daily lives and for society in general and is finding evermore practical applications in information and communication technologies. Herein, we demonstrate experimentally that single photons can be used to make decisions in uncertain, dynamically changing environments. Using a nitrogen-vacancy in a nanodiamond as a single-photon source, we demonstrate the decision-making capability by solving the multi-armed bandit problem. This capability is directly and immediately associated with single-photon detection in the proposed architecture, leading to adequate and adaptive autonomous decision making. This study makes it possible to create systems that benefit from the quantum nature of light to perform practical and vital intelligent functions. PMID:26278007

  8. Single-photon decision maker

    NASA Astrophysics Data System (ADS)

    Naruse, Makoto; Berthel, Martin; Drezet, Aurélien; Huant, Serge; Aono, Masashi; Hori, Hirokazu; Kim, Song-Ju

    2015-08-01

    Decision making is critical in our daily lives and for society in general and is finding evermore practical applications in information and communication technologies. Herein, we demonstrate experimentally that single photons can be used to make decisions in uncertain, dynamically changing environments. Using a nitrogen-vacancy in a nanodiamond as a single-photon source, we demonstrate the decision-making capability by solving the multi-armed bandit problem. This capability is directly and immediately associated with single-photon detection in the proposed architecture, leading to adequate and adaptive autonomous decision making. This study makes it possible to create systems that benefit from the quantum nature of light to perform practical and vital intelligent functions.

  9. Cost Accounting for Decision Makers.

    ERIC Educational Resources Information Center

    Kaneklides, Ann L.

    1985-01-01

    Underscores the importance of informed decision making through accurate anticipation of cost incurrence in light of changing economic and environmental conditions. Explains the concepts of cost accounting, full allocation of costs, the selection of an allocation base, the allocation of indirect costs, depreciation, and implications for community…

  10. A scientist's guide to engaging decision makers

    NASA Astrophysics Data System (ADS)

    Vano, J. A.

    2015-12-01

    Being trained as a scientist provides many valuable tools needed to address society's most pressing environmental issues. It does not, however, provide training on one of the most critical for translating science into action: the ability to engage decision makers. Engagement means different things to different people and what is appropriate for one project might not be for another. However, recent reports have emphasized that for research to be most useful to decision making, engagement should happen at the beginning and throughout the research process. There are an increasing number of boundary organizations (e.g., NOAA's Regional Integrated Sciences and Assessment program, U.S. Department of the Interior's Climate Science Centers) where engagement is encouraged and rewarded, and scientists are learning, often through trial and error, how to effectively include decision makers (a.k.a. stakeholders, practitioners, resource managers) in their research process. This presentation highlights best practices and practices to avoid when scientists engage decision makers, a list compiled through the personal experiences of both scientists and decision makers and a literature review, and how this collective knowledge could be shared, such as through a recent session and role-playing exercise given at the Northwest Climate Science Center's Climate Boot Camp. These ideas are presented in an effort to facilitate conversations about how the science community (e.g., AGU researchers) can become better prepared for effective collaborations with decision makers that will ultimately result in more actionable science.

  11. Climate modeling with decision makers in mind

    DOE PAGES

    Jones, Andrew; Calvin, Katherine; Lamarque, Jean -Francois

    2016-04-27

    The need for regional- and local-scale climate information is increasing rapidly as decision makers seek to anticipate and manage a variety of context-specific climate risks over the next several decades. Furthermore, global climate models are not developed with these user needs in mind, and they typically operate at resolutions that are too coarse to provide information that could be used to support regional and local decisions.

  12. The Morality of University Decision-Makers

    ERIC Educational Resources Information Center

    Hatier, Cécile

    2014-01-01

    Ethical failures in UK higher education have recently made the news but are not a recent development. University decision-makers can, in order to adopt an ethical way of reasoning, resort to several ethical traditions. This article focuses, through the use of concrete examples, on three which have had a significant impact in recent higher…

  13. Worksite Nutrition: A Decision-Maker's Guide.

    ERIC Educational Resources Information Center

    American Dietetic Association, Chicago, IL.

    This guide is designed specifically to assist decision makers in business and industry, including chief executive officers, benefits managers, human resource directors, wellness coordinators, and owners of small businesses, in understanding how diet and nutrition affect employees and the company. It addresses the concerns of both small and large…

  14. Peircean Decision Aid

    SciTech Connect

    SENGLAUB, MICHAEL; & WHITFIELD, GREG

    2008-08-14

    The Peircean decision aid (PDA) is a decision support architecture and embedded functionality that supports a decision maker in very complex environments dealing with massive amounts of disparate data, information and knowledge. The solution generated is a hybrid system solution employing a number of technologies that are based on Peircean reasoning, modal logic, and formal concept analysis. The system convolves data/information with knowledge to create a virtual belief state that is passed to a decision maker for consideration. The system can capture categorized knowledge or it can inductively learn or acquire new knowledge from suites of observations. Captured knowledge is used to abductively generate hypotheses that are potential explanations to observations or collected data. The zero order modal logic architecture is designed to augment knowledge update and belief revision and can be extended to include disjunctive screening of collected data. While intended to be a library for integration into a decision support architecture it possesses a basic stand-alone GUI for use as an analysis support tool.

  15. Peircean Decision Aid

    2008-08-14

    The Peircean decision aid (PDA) is a decision support architecture and embedded functionality that supports a decision maker in very complex environments dealing with massive amounts of disparate data, information and knowledge. The solution generated is a hybrid system solution employing a number of technologies that are based on Peircean reasoning, modal logic, and formal concept analysis. The system convolves data/information with knowledge to create a virtual belief state that is passed to a decisionmore » maker for consideration. The system can capture categorized knowledge or it can inductively learn or acquire new knowledge from suites of observations. Captured knowledge is used to abductively generate hypotheses that are potential explanations to observations or collected data. The zero order modal logic architecture is designed to augment knowledge update and belief revision and can be extended to include disjunctive screening of collected data. While intended to be a library for integration into a decision support architecture it possesses a basic stand-alone GUI for use as an analysis support tool.« less

  16. FAmily CEntered (FACE) advance care planning: Study design and methods for a patient-centered communication and decision-making intervention for patients with HIV/AIDS and their surrogate decision-makers

    PubMed Central

    Kimmel, Allison L.; Wang, Jichuan; Scott, Rachel; Briggs, Linda; Lyon, Maureen E.

    2016-01-01

    Although the Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) has become a chronic illness, disease-specific advance care planning has not yet been evaluated for the palliative care needs of adults with HIV/AIDS. This prospective, longitudinal, randomized, two-arm controlled clinical trial aims to test the efficacy of FAmily CEntered Advance Care Planning among adults living with AIDS and/or HIV with co-morbidities on congruence in treatment preferences, healthcare utilization, and quality of life. The FAmily CEntered intervention arm is two face-to-face sessions with a trained, certified facilitator: Session 1) Disease-Specific Advance Care Planning Respecting Choices Interview; Session 2) Completion of advance directive. The Healthy Living control arm is: Session 1) Developmental/Relationship History; Session 2) Nutrition. Follow-up data will be collected at 3, 6, 12, and 18-month post-intervention. A total of 288 patient/surrogate dyads will be enrolled from five hospital-based, out-patient clinics in Washington, District of Columbia. Participants will be HIV positive and ≥21 years of age; surrogates will be ≥18 years of age. Exclusion criteria are homicidality, suicidality, psychosis, and impaired cognitive functioning. We hypothesize that this intervention will enhance patient-centered communication with a surrogate decision-maker about end of life treatment preferences over time, enhance patient quality of life and decrease health care utilization. We further hypothesize that this intervention will decrease health disparities for Blacks in completion of advance directives. If proposed aims are achieved, the benefits of palliative care, particularly increased treatment preferences about end-of-life care and enhanced quality of life, will be extended to people living with AIDS. PMID:26044463

  17. FAmily CEntered (FACE) advance care planning: Study design and methods for a patient-centered communication and decision-making intervention for patients with HIV/AIDS and their surrogate decision-makers.

    PubMed

    Kimmel, Allison L; Wang, Jichuan; Scott, Rachel K; Briggs, Linda; Lyon, Maureen E

    2015-07-01

    Although the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has become a chronic illness, disease-specific advance care planning has not yet been evaluated for the palliative care needs of adults with HIV/AIDS. This prospective, longitudinal, randomized, two-arm controlled clinical trial aims to test the efficacy of FAmily CEntered advance care planning among adults living with AIDS and/or HIV with co-morbidities on congruence in treatment preferences, healthcare utilization, and quality of life. The FAmily CEntered intervention arm is two face-to-face sessions with a trained, certified facilitator: Session 1) Disease-Specific Advance Care Planning Respecting Choices Interview; Session 2) Completion of advance directive. The Healthy Living Control arm is: Session 1) Developmental/Relationship History; Session 2) Nutrition. Follow-up data will be collected at 3, 6, 12, and 18 months post-intervention. A total of 288 patient/surrogate dyads will be enrolled from five hospital-based, out-patient clinics in Washington, District of Columbia. Participants will be HIV positive and ≥ 21 years of age; surrogates will be ≥ 18 years of age. Exclusion criteria are homicidality, suicidality, psychosis, and impaired cognitive functioning. We hypothesize that this intervention will enhance patient-centered communication with a surrogate decision-maker about end of life treatment preferences over time, enhance patient quality of life and decrease health care utilization. We further hypothesize that this intervention will decrease health disparities for Blacks in completion of advance directives. If proposed aims are achieved, the benefits of palliative care, particularly increased treatment preferences about end-of-life care and enhanced quality of life, will be extended to people living with AIDS.

  18. Physician-facilitated designation of proxy decision maker.

    PubMed

    Arora, Amit; Cummings, Laura; Crome, Peter

    2016-01-01

    With vast improvements in healthcare in recent decades, people are living longer but often with higher rates of morbidity and chronic illnesses. This has resulted in a higher proportion of the population who may benefit from early end-of-life 'conversation and planning', but also gives healthcare professionals more time during which these discussions are relevant, as people live longer with their chronic diseases. A survey conducted by Lifshitz et al (Isr J Health Policy Res 5:6, 2016) sought to assess physician awareness and willingness to discuss designating a proxy decision-maker with patients, in order to aid end-of-life care in the event that the patient is rendered unable to make or communicate these decisions later in life. Their article suggests that proxy decision-maker designation is only one aspect of end-of-life care; a challenging area littered with ethical and moral dilemmas. Without early, open and frank discussions with patients regarding their wishes at the end of life, proxy decision-makers may be in no better position than physicians or a court appointed proxy to make decisions in the patients' best interests/benefits. This commentary also touches upon the use of health and care passports being developed or in early phases in the United Kingdom, and whether these may be utilised in the field of palliative care in Israel.

  19. Physician-facilitated designation of proxy decision maker.

    PubMed

    Arora, Amit; Cummings, Laura; Crome, Peter

    2016-01-01

    With vast improvements in healthcare in recent decades, people are living longer but often with higher rates of morbidity and chronic illnesses. This has resulted in a higher proportion of the population who may benefit from early end-of-life 'conversation and planning', but also gives healthcare professionals more time during which these discussions are relevant, as people live longer with their chronic diseases. A survey conducted by Lifshitz et al (Isr J Health Policy Res 5:6, 2016) sought to assess physician awareness and willingness to discuss designating a proxy decision-maker with patients, in order to aid end-of-life care in the event that the patient is rendered unable to make or communicate these decisions later in life. Their article suggests that proxy decision-maker designation is only one aspect of end-of-life care; a challenging area littered with ethical and moral dilemmas. Without early, open and frank discussions with patients regarding their wishes at the end of life, proxy decision-makers may be in no better position than physicians or a court appointed proxy to make decisions in the patients' best interests/benefits. This commentary also touches upon the use of health and care passports being developed or in early phases in the United Kingdom, and whether these may be utilised in the field of palliative care in Israel. PMID:27358723

  20. Women as decision and policy makers. Asia.

    PubMed

    1995-09-01

    The focus of this news brief is on the Community-based Sustainable Family Planning/Maternal and Child Health (FP/MCH) Project promoted in Bangladesh, Laos, Nepal, and the Philippines. The project emphasizes women's involvement as policy makers and evaluators. The aim is to involve women at all project levels as part of an effort to correct gender imbalances. Programs are being directed toward sustainability. Women are placed in positions at each level of the tiered system of steering committees, which range from local village committees to central committees. Men may still retain the top positions, but women are given decision making power at the highest levels of policy and program development and implementation. The Asia region is challenged by quality of care issues related to reproductive health services. Program expansion is proceeding into rural areas with outreach services and fee charging. Projects are community-based, which means mobilization of community people. The community approach is suitable to an Asian culture that does not adhere to strict rules of privacy. Women's groups are eager to discuss sensitive issues such as contraception and to offer personal experiences and solutions to problems. Mass meetings and individual counseling sessions are available. IEC materials are available to the Asian FP/MCH program from JOICFP. Some of these materials promote the concept of the Asian community spirit as a building block of development. The Asian approach is an alternative to Western models and may be valid for other regions.

  1. Connecting Geoscience and Decision Makers Through a Common Interface

    NASA Astrophysics Data System (ADS)

    Gonzales, L. M.; Wood, C.; Boland, M. A.

    2015-12-01

    Geoscientists and decision makers often use different words to describe the same thing. The American Geosciences Institute has developed a consistent definition for the geosciences (Wilson, 2014); however this definition often varies from how decision maker groups at the national, state, local, and regional levels often categorize geoscience topics. Where geoscientists may to refer to "geoscience," decision makers may use terms like "energy," "environment," and "natural resources." How may the geoscience community provide geoscience information to decision makers in a context they understand while at the same time providing a simple, yet consistent representation of all that the geosciences include? The American Geoscience Institute's (AGI's) Critical Issues program's main goal is to connect decision makers at all levels with decision-relevant, impartial, expert information from across the geosciences. The program uses a multi-faceted approach to reach different decision maker groups, including policy makers and government employees at the federal, state and local level. We discuss the challenges the Critical Issues program has overcome in representing the geosciences to decision makers in a cohesive fashion such that decision makers can access the information they need, while at the same time becoming aware of the breadth of information the geosciences has to offer, and the value of including geoscience in the decision-making process. References: Wilson, C.E. (2014) Status of the Geoscience Workforce 2014. American Geological Institute. Alexandria, VA.

  2. Role Perceptions of Black Decision Makers: A Case Study.

    ERIC Educational Resources Information Center

    Uzzell, Odell

    1981-01-01

    A study in Wake County, North Carolina, designed to determine how racist structural barriers influence role perceptions of Black decision makers, identified the following discriminators of role perceptions: 1) officials' perceptions of themselves as decision makers or decision influencers; 2) age; 3) racial composition of organization; 4)…

  3. Effective Engagement of Decision Makers in Program Evaluation.

    ERIC Educational Resources Information Center

    Hegarty, Timothy W.; Sporn, Douglas L.

    1988-01-01

    Techniques developed in a federal agency to forge links between evaluators and decision makers using evaluation information are described. Focus is on engaging the decision maker in the identification of candidate programs, selection among candidates, program evaluation, reporting of evaluation results, and assessment of evaluation impact. (SLD)

  4. Overcoming Fear: Helping Decision Makers Understand Risk in Outdoor Education

    ERIC Educational Resources Information Center

    Haras, Kathy

    2010-01-01

    The long history of outdoor education does little to alleviate the fears of many parents, teachers, principals and superintendents who believe that outdoor education is too risky. These decision makers often lack both the knowledge to make informed decisions and the time and resources to investigate their assumptions. Pair these circumstances with…

  5. Educational Goods and Values: A Framework for Decision Makers

    ERIC Educational Resources Information Center

    Brighouse, Harry; Ladd, Helen F.; Loeb, Susanna; Swift, Adam

    2016-01-01

    This article articulates a framework suitable for use when making decisions about education policy. Decision makers should establish what the feasible options are and evaluate them in terms of their contribution to the development, and distribution, of educational goods in children, balanced against the negative effect of policies on important…

  6. Training conservation practitioners to be better decision makers

    USGS Publications Warehouse

    Johnson, Fred A.; Eaton, Mitchell J.; Williams, James H.; Jensen, Gitte H.; Madsen, Jesper

    2015-01-01

    Traditional conservation curricula and training typically emphasizes only one part of systematic decision making (i.e., the science), at the expense of preparing conservation practitioners with critical skills in values-setting, working with decision makers and stakeholders, and effective problem framing. In this article we describe how the application of decision science is relevant to conservation problems and suggest how current and future conservation practitioners can be trained to be better decision makers. Though decision-analytic approaches vary considerably, they all involve: (1) properly formulating the decision problem; (2) specifying feasible alternative actions; and (3) selecting criteria for evaluating potential outcomes. Two approaches are available for providing training in decision science, with each serving different needs. Formal education is useful for providing simple, well-defined problems that allow demonstrations of the structure, axioms and general characteristics of a decision-analytic approach. In contrast, practical training can offer complex, realistic decision problems requiring more careful structuring and analysis than those used for formal training purposes. Ultimately, the kinds and degree of training necessary depend on the role conservation practitioners play in a decision-making process. Those attempting to facilitate decision-making processes will need advanced training in both technical aspects of decision science and in facilitation techniques, as well as opportunities to apprentice under decision analysts/consultants. Our primary goal should be an attempt to ingrain a discipline for applying clarity of thought to all decisions.

  7. 38 CFR 39.4 - Decision makers, notifications, and additional information.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Decision makers, notifications, and additional information. 39.4 Section 39.4 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AID TO STATES FOR ESTABLISHMENT, EXPANSION, AND IMPROVEMENT,...

  8. 38 CFR 39.4 - Decision makers, notifications, and additional information.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Decision makers, notifications, and additional information. 39.4 Section 39.4 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AID FOR THE ESTABLISHMENT, EXPANSION, AND IMPROVEMENT, OR...

  9. 38 CFR 39.4 - Decision makers, notifications, and additional information.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Decision makers, notifications, and additional information. 39.4 Section 39.4 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AID FOR THE ESTABLISHMENT, EXPANSION, AND IMPROVEMENT, OR...

  10. 38 CFR 39.4 - Decision makers, notifications, and additional information.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Decision makers, notifications, and additional information. 39.4 Section 39.4 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AID FOR THE ESTABLISHMENT, EXPANSION, AND IMPROVEMENT, OR...

  11. Decision Makers, a Simulation Game about Community Change.

    ERIC Educational Resources Information Center

    Jitkoff, Julia Armstrong; Doty, Edward

    Decision Makers is designed to simulate the problems faced by groups trying to produce peaceful social change in their communities. This version illustrates the problems faced when a community group attempts to introduce a course on the issues of war and peace in the local high school. All participants assume roles as residents of a typical…

  12. Focusing Biodiversity Research on the Needs of Decision Makers

    PubMed

    SMYTHE; BERNABO; CARTER; JUTRO

    1996-11-01

    / The project on Biodiversity Uncertainties and Research Needs (BURN) ensures the advancement of usable knowledge on biodiversity by obtaining input from decision makers on their priority information needs about biodiversity and then using this input to engage leading scientists in designing policy-relevant research. Decision makers articulated concerns related to four issues: significance of biodiversity; status and trends of biodiversity; management for biodiversity; and the linkage of social, cultural, economic, legal, and biological objectives. Leading natural and social scientists then identified the research required to address the decision makers' needs and determined the probability of success. The diverse group of experts reached consensus on several fundamental issues, helping to clarify the role of biodiversity in land and resource management. The BURN participants identified several features that should be incorporated into policy-relevant research plans and management strategies for biodiversity. Research and assessment efforts should be: multidisciplinary and integrative, participatory with stakeholder involvement, hierarchical (multiple scales), and problem- and region-specific. The activities should be focused regionally within a global perspective. Meta-analysis of existing data is needed on all fronts to assess the state of the science. More specifically, the scientists recommended six priority research areas that should be pursued to address the information needs articulated by decision makers: (1) characterization of biodiversity, (2) environmental valuation, (3) management for sustainability-for humans and the environment (adaptive management), (4) information management strategies, (5) governance and stewardship issues, and (6) communication and outreach. Broad recommendations were developed for each research area to provide direction for research planning and resource management strategies. The results will directly benefit those groups that

  13. Rationality versus reality: the challenges of evidence-based decision making for health policy makers

    PubMed Central

    2010-01-01

    Background Current healthcare systems have extended the evidence-based medicine (EBM) approach to health policy and delivery decisions, such as access-to-care, healthcare funding and health program continuance, through attempts to integrate valid and reliable evidence into the decision making process. These policy decisions have major impacts on society and have high personal and financial costs associated with those decisions. Decision models such as these function under a shared assumption of rational choice and utility maximization in the decision-making process. Discussion We contend that health policy decision makers are generally unable to attain the basic goals of evidence-based decision making (EBDM) and evidence-based policy making (EBPM) because humans make decisions with their naturally limited, faulty, and biased decision-making processes. A cognitive information processing framework is presented to support this argument, and subtle cognitive processing mechanisms are introduced to support the focal thesis: health policy makers' decisions are influenced by the subjective manner in which they individually process decision-relevant information rather than on the objective merits of the evidence alone. As such, subsequent health policy decisions do not necessarily achieve the goals of evidence-based policy making, such as maximizing health outcomes for society based on valid and reliable research evidence. Summary In this era of increasing adoption of evidence-based healthcare models, the rational choice, utility maximizing assumptions in EBDM and EBPM, must be critically evaluated to ensure effective and high-quality health policy decisions. The cognitive information processing framework presented here will aid health policy decision makers by identifying how their decisions might be subtly influenced by non-rational factors. In this paper, we identify some of the biases and potential intervention points and provide some initial suggestions about how the

  14. Feedback Delays: How Can Decision Makers Learn Not to Buy a New Car Every Time the Garage Is Empty?

    PubMed

    Gibson

    2000-09-01

    Decision makers in dynamic environments (e.g., stock trading, inventory control, and firefighting) learn poorly in experiments where feedback about the outcomes of their actions is delayed. In searching for ways to mitigate these effects, this paper presents two computational models of learning with feedback delays and contrasts them against human decision-makers' performance. The no-memory model hypothesizes that decision makers always perceive feedback as immediate. The with-memory model hypothesizes that, over time, decision makers are able to develop internal representations of the task that help them to perform with delayed feedback. As borne out by human subjects, both models predict that a display of past history improves learning with delay and that increasing delay increasingly degrades performance. Even though the length of training in this task exceeds that used in many laboratory-based dynamic tasks, neither the two models nor the subjects are able to effectively learn without decision aids when faced with feedback delays. When given an amount of training that more closely approximates that provided in functioning dynamic environments, the with-memory model predicts that human decision makers may learn without decision aids over the long term if feedback delays are simple. These results raise several issues for continued theoretical investigation as well as potential suggestions for training and supporting decision makers in dynamic environments with feedback delays. Copyright 2000 Academic Press.

  15. Focusing biodiversity research on the needs of decision makers

    SciTech Connect

    Smythe, K.D.; Bernabo, J.C.; Carter, T.B.; Jutro, P.R.

    1996-11-01

    The project on Biodiversity Uncertainties and Research Needs (BURN) ensures the advancement of usable knowledge on biodiversity by obtaining input from decision makers on their priority information needs about biodiversity and then using this input to engage leading scientists in designing policy-relevant research. Decision makers had concerns about four issues: significance of biodiversity; status and trends of biodiversity; management for biodiversity; the linkage of social, cultural, economic, legal, and biological objectives. Leading scientists identified research required to address these needs and determined the probability of success. The diverse group of experts reached consensus on several fundamental issues, helping to clarify the role of biodiversity in land and resource management. Several features that should be incorporated into policy-relevant research plans and management strategies for biodiversity were identified: multidisciplinary and integrative, participatory with stakeholder involvement, hierarchical, and problem- and region-specific. Activities should be focused regionally within a global perspective. More specifically, the scientists recommended six priority research areas that should be pursued to address the information needs articulated by decision makers: (1) characterization of biodiversity, (2) environmental valuation, (3) management for sustainability-for humans and the environment (adaptive management), (4) information management strategies, (5) governance and stewardship issues, and (6) communication and outreach. Broad recommendations wee developed for each research area to provide direction for research planning and resource management strategies. The results will directly benefit those groups that require biodiversity research to address their needs-whether to develop policy, manage natural resources, or make other decisions affecting biodiversity. 11 refs., 1 fig., 5 tabs.

  16. Eco-informatics for decision makers advancing a research agenda

    USGS Publications Warehouse

    Cushing, J.B.; Wilson, T.; Brandt, L.; Gregg, V.; Spengler, S.; Borning, A.; Delcambre, L.; Bowker, G.; Frame, M.; Fulop, J.; Hert, C.; Hovy, E.; Jones, J.; Landis, E.; Schnase, J.L.; Schweik, C.; Sonntag, W.; ,

    2005-01-01

    Resource managers often face significant information technology (IT) problems when integrating ecological or environmental information to make decisions. At a workshop sponsored by the NSF and USGS in December 2004, university researchers, natural resource managers, and information managers met to articulate IT problems facing ecology and environmental decision makers. Decision making IT problems were identified in five areas: 1) policy, 2) data presentation, 3) data gaps, 4) tools, and 5) indicators. To alleviate those problems, workshop participants recommended specific informatics research in modeling and simulation, data quality, information integration and ontologies, and social and human aspects. This paper reports the workshop findings, and briefly compares these with research that traditionally falls under the emerging eco-informatics rubric. ?? Springer-Verlag Berlin Heidelberg 2005.

  17. Gender differences in follower behavior. An experimental study of reactions to ambitious decision makers.

    PubMed

    Larimer, Christopher W; Hannagan, Rebecca J

    2010-09-01

    This study investigates whether observers react negatively to overly ambitious leaders, focusing on whether women are more sensitive than men in their perceptions of the traits of decision makers and whether men and women behave differently as a result of such perceptions. Results from two laboratory experiments show how participants react to ambitious decision makers in simple bargaining scenarios. The results indicate that observers tend to equate ambition for decision-making authority with self-interested, unfair, male behavior. Moreover, observers tend to be less satisfied with a decision made by an ambitious decision maker compared to the same decision made by an unambitious decision maker. That is, people generally dislike ambitious decision makers independent of the actual decision that is made. Further, there are important differences in male and female expectations of what decision makers will do that, when combined with perceptions of decision-maker gender, have more nuanced implications for outcome satisfaction and our understanding of "follower behavior."

  18. Briefly Speaking: An Introduction to Student Financial Aid in California for Policy Makers.

    ERIC Educational Resources Information Center

    Eureka Project, Sacramento, CA.

    Designed to help educational policy makers understand student financial aid in California, this booklet covers the importance of aid, how it has changed, current programs, need analysis, packaging, public and student views, graduate aid, and politics and problems of aid. As student financial aid became a larger and more complex educational…

  19. Residents, Decision Makers, and Scientists Discuss Volcanic Hazard in Colombia

    NASA Astrophysics Data System (ADS)

    Sheridan, Michael F.; Cordoba, Gustavo

    2010-02-01

    Knowledge Sharing and Collaboration in Volcanic Risk Mitigation at Galeras Volcano, Colombia; Pasto, Colombia, 6-11 July 2009; Galeras volcano, located in southwestern Colombia, imposes several hazards on the surrounding population: pyroclastic flows, lahars, ashfall, and shock waves. The current hazard map shows three zones: high, medium, and low (see A. D. Hurtado Artunduaga and G. P. Cortés Jiménez, J. Volcanol. Geotherm. Res., 77, 89-100, 1997). The pyroclastic flow hazard on this map defines the Zone of High Volcanic Hazard (ZAVA) for civil authorities. Current activity of Galeras has provoked two contentious issues related to hazard management: (1) Decision makers announce an evacuation order of ZAVA whenever the volcanic alert reaches a high level, and (2) the Colombian government initiated a relocation program for the inhabitants within ZAVA (Colombian Decrees-Laws 4106 and 3905). However, communities within ZAVA refuse to obey both the evacuation orders and the relocation process. To help resolve this situation, the University of Nariño (Colombia) and the State University of New York at Buffalo organized a workshop, which was sponsored by the U.S. National Science Foundation. A daily average of 92 people attended, including residents of ZAVA, decision makers, Colombian technical and scientific personnel, international scientists and researchers, students, and academics from the University of Nariño.

  20. The medical decision model and decision maker tools for management of radiological and nuclear incidents.

    PubMed

    Koerner, John F; Coleman, C Norman; Murrain-Hill, Paula; FitzGerald, Denis J; Sullivan, Julie M

    2014-06-01

    Effective decision making during a rapidly evolving emergency such as a radiological or nuclear incident requires timely interim decisions and communications from onsite decision makers while further data processing, consultation, and review are ongoing by reachback experts. The authors have recently proposed a medical decision model for use during a radiological or nuclear disaster, which is similar in concept to that used in medical care, especially when delay in action can have disastrous effects. For decision makers to function most effectively during a complex response, they require access to onsite subject matter experts who can provide information, recommendations, and participate in public communication efforts. However, in the time before this expertise is available or during the planning phase, just-in-time tools are essential that provide critical overview of the subject matter written specifically for the decision makers. Recognizing the complexity of the science, risk assessment, and multitude of potential response assets that will be required after a nuclear incident, the Office of the Assistant Secretary for Preparedness and Response, in collaboration with other government and non-government experts, has prepared a practical guide for decision makers. This paper illustrates how the medical decision model process could facilitate onsite decision making that includes using the deliberative reachback process from science and policy experts and describes the tools now available to facilitate timely and effective incident management. PMID:24776895

  1. Getting ocean acidification on decision makers' to-do lists: dissecting the process through case studies

    USGS Publications Warehouse

    Cooley, Sarah R.; Jewett, Elizabeth B.; Reichert, Julie; Robbins, Lisa L.; Shrestha, Gyami; Wieczorek, Dan; Weisberg, Stephen B.

    2015-01-01

    Much of the detailed, incremental knowledge being generated by current scientific research on ocean acidification (OA) does not directly address the needs of decision makers, who are asking broad questions such as: Where will OA harm marine resources next? When will this happen? Who will be affected? And how much will it cost? In this review, we use a series of mainly US-based case studies to explore the needs of local to international-scale groups that are making decisions to address OA concerns. Decisions concerning OA have been made most naturally and easily when information needs were clearly defined and closely aligned with science outputs and initiatives. For decisions requiring more complex information, the process slows dramatically. Decision making about OA is greatly aided (1) when a mixture of specialists participates, including scientists, resource users and managers, and policy and law makers; (2) when goals can be clearly agreed upon at the beginning of the process; (3) when mixed groups of specialists plan and create translational documents explaining the likely outcomes of policy decisions on ecosystems and natural resources; (4) when regional work on OA fits into an existing set of priorities concerning climate or water quality; and (5) when decision making can be reviewed and enhanced.

  2. Using Cognitive Conflict to Promote the Use of Dialectical Learning for Strategic Decision-Makers

    ERIC Educational Resources Information Center

    Woods, Jeffrey G.

    2012-01-01

    Purpose: The purpose of this paper is to develop a conceptual model that uses dialectical inquiry (DI) to create cognitive conflict in strategic decision-makers for the purpose of improving strategic decisions. Activation of the dialectical learning process using DI requires strategic decision-makers to integrate conflicting information causing…

  3. Targeting Continuing Medical Education on Decision Makers: Who Decides to Transfuse Blood?

    ERIC Educational Resources Information Center

    Goodnough, Lawrence T.; And Others

    1992-01-01

    Staff communication patterns were observed during 13 open-heart surgeries to identify the transfusion decision makers. It was determined that targeting decision makers for continuing medical education would improve the quality of transfusion practice and increase the efficiency of continuing education. (SK)

  4. Attitudes of Educational Decision Makers toward AVTI Governance and the Local Tax Levy. An Independent Paper.

    ERIC Educational Resources Information Center

    LiaBraaten, James Clayton

    A study investigated the attitudes of vocational education decision makers toward the governance of Minnesota's Area Vocational Technical Institutes (AVTIs) and the impact removal of a local tax to support the AVTIs might have on governance. Five categories of individuals, all considered vocational education decision makers, were surveyed: AVTI…

  5. ENVIRONMENTAL PLANNING FOR SMALL COMMUNITIES: A GUIDE FOR LOCAL DECISION-MAKERS

    EPA Science Inventory

    Environmental Planning for Small Communities - A Guide for Local Decision-Makers presents a process for creating and implementing a community environmental plan. With a comprehensive environmental plan, local decision-makers can create an integrated approach to protecting the env...

  6. A regret theory approach to decision curve analysis: A novel method for eliciting decision makers' preferences and decision-making

    PubMed Central

    2010-01-01

    Background Decision curve analysis (DCA) has been proposed as an alternative method for evaluation of diagnostic tests, prediction models, and molecular markers. However, DCA is based on expected utility theory, which has been routinely violated by decision makers. Decision-making is governed by intuition (system 1), and analytical, deliberative process (system 2), thus, rational decision-making should reflect both formal principles of rationality and intuition about good decisions. We use the cognitive emotion of regret to serve as a link between systems 1 and 2 and to reformulate DCA. Methods First, we analysed a classic decision tree describing three decision alternatives: treat, do not treat, and treat or no treat based on a predictive model. We then computed the expected regret for each of these alternatives as the difference between the utility of the action taken and the utility of the action that, in retrospect, should have been taken. For any pair of strategies, we measure the difference in net expected regret. Finally, we employ the concept of acceptable regret to identify the circumstances under which a potentially wrong strategy is tolerable to a decision-maker. Results We developed a novel dual visual analog scale to describe the relationship between regret associated with "omissions" (e.g. failure to treat) vs. "commissions" (e.g. treating unnecessary) and decision maker's preferences as expressed in terms of threshold probability. We then proved that the Net Expected Regret Difference, first presented in this paper, is equivalent to net benefits as described in the original DCA. Based on the concept of acceptable regret we identified the circumstances under which a decision maker tolerates a potentially wrong decision and expressed it in terms of probability of disease. Conclusions We present a novel method for eliciting decision maker's preferences and an alternative derivation of DCA based on regret theory. Our approach may be intuitively more

  7. Legal briefing: Shared decision making and patient decision aids.

    PubMed

    Pope, Thaddeus Mason; Hexum, Melinda

    2013-01-01

    This "Legal Briefing" column covers recent legal developments involving patient decision aids.This topic has been the subject of recent articles in JCE. It is included in the 2010 Patient Protection and Affordable Care Act. And it has received significant attention in the biomedical literature, including a new book, a thematic issue of Health Affairs, and a recent article in the New England Journal of Medicine. Moreover, physicians and health systems across the United States are increasingly integrating decision aids into their clinical practice. Both federal and state laws play a significant role in promoting this expanded use. On the other hand, concerns about liability could stymie development and implementation. We categorize legal developments concerning patient decision aids into the following five sections: 1. Development of decision aids. 2. Effectiveness of decision aids. 3. Federal regulation of decision aids. 4. State regulation of decision aids. 5. Legal concerns regarding decision aids.

  8. Emodnet Med Sea Check-Point - Indicators for decision- maker

    NASA Astrophysics Data System (ADS)

    Besnard, Sophie; Claverie, Vincent; Blanc, Frédérique

    2015-04-01

    The Emodnet Checkpoint projects aim is to assess the cost-effectiveness, reliability and utility of the existing monitoring at the sea basin level. This involves the development of monitoring system indicators and a GIS Platform to perform the assessment and make it available. Assessment or production of Check-Point information is made by developing targeted products based on the monitoring data and determining whether the products are meeting the needs of industry and public authorities. Check-point users are the research community, the 'institutional' policy makers for IMP and MSFD implementation, the 'intermediate users', i.e., users capable to understand basic raw data but that benefit from seeing the Checkpoint targeted products and the assessment of the fitness for purpose. We define assessment criteria aimed to characterize/depict the input datasets in terms of 3 territories capable to show performance and gaps of the present monitoring system, appropriateness, availability and fitness for purpose. • Appropriateness: What is made available to users? What motivate/decide them to select this observation rather than this one. • Availability: How this is made available to the user? Place to understand the readiness and service performance of the EU infrastructure • Fitness for use / fitness for purpose: Ability for non-expert user to appreciate the data exploitability (feedback on efficiency & reliability of marine data) For each territory (appropriateness, Availability and Fitness for purpose / for use), we define several indicators. For example, for Availability we define Visibility, Accessibility and Performance. And Visibility is itself defined by "Easily found" and "EU service". So these indicators can be classified according to their territory and sub-territory as seen above, but also according to the complexity to build them. Indicators are built from raw descriptors in 3 stages:  Stage 1: to give a neutral and basic status directly computed from

  9. Decision Maker based on Nanoscale Photo-excitation Transfer

    PubMed Central

    Kim, Song-Ju; Naruse, Makoto; Aono, Masashi; Ohtsu, Motoichi; Hara, Masahiko

    2013-01-01

    Decision-making is one of the most important intellectual abilities of the human brain. Here we propose an efficient decision-making system which uses optical energy transfer between quantum dots (QDs) mediated by optical near-field interactions occurring at scales far below the wavelength of light. The simulation results indicate that our system outperforms the softmax rule, which is known as the best-fitting algorithm for human decision-making behaviour. This suggests that we can produce a nano-system which makes decisions efficiently and adaptively by exploiting the intrinsic spatiotemporal dynamics involving QDs mediated by optical near-field interactions. PMID:23928655

  10. Mapping a Research Agenda for Home Care Safety: Perspectives from Researchers, Providers, and Decision Makers

    ERIC Educational Resources Information Center

    Macdonald, Marilyn; Lang, Ariella; MacDonald, Jo-Anne

    2011-01-01

    The purpose of this qualitative interpretive design was to explore the perspectives of researchers, health care providers, policy makers, and decision makers on key risks, concerns, and emerging issues related to home care safety that would inform a line of research inquiry. Defining safety specifically in this home care context has yet to be…

  11. Issues in Distance Education: A Primer for Higher Education Decision Makers

    ERIC Educational Resources Information Center

    Beaudoin, Michael

    2016-01-01

    This chapter presents an overview of current issues related to distance learning in higher education. It identifies central questions, issues, challenges, and opportunities that must be addressed by decision makers, as well as key attributes of effective leaders.

  12. A model of the human observer and decision maker

    NASA Technical Reports Server (NTRS)

    Wewerinke, P. H.

    1981-01-01

    The decision process is described in terms of classical sequential decision theory by considering the hypothesis that an abnormal condition has occurred by means of a generalized likelihood ratio test. For this, a sufficient statistic is provided by the innovation sequence which is the result of the perception an information processing submodel of the human observer. On the basis of only two model parameters, the model predicts the decision speed/accuracy trade-off and various attentional characteristics. A preliminary test of the model for single variable failure detection tasks resulted in a very good fit of the experimental data. In a formal validation program, a variety of multivariable failure detection tasks was investigated and the predictive capability of the model was demonstrated.

  13. Outsourced Investment Management: An Overview for Institutional Decision-Makers

    ERIC Educational Resources Information Center

    Griswold, John S.; Jarvis, William F.

    2013-01-01

    Outsourcing of investment management is a growing trend among institutional investors. With a broad range of institutions using or exploring the outsourced chief investment officer (OCIO) model, portfolio size is no longer the determining factor driving the outsourcing decision. For all but the largest institutional investors--those with deep…

  14. 49 CFR 1503.659 - Petition to reconsider or modify a final decision and order of the TSA decision maker on appeal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... and order of the TSA decision maker on appeal. 1503.659 Section 1503.659 Transportation Other... Practice in TSA Civil Penalty Actions § 1503.659 Petition to reconsider or modify a final decision and order of the TSA decision maker on appeal. (a) General. Any party may petition the TSA decision maker...

  15. Combining communication technology utilization and organizational innovation: evidence from Canadian healthcare decision makers.

    PubMed

    Jbilou, Jalila; Landry, Réjean; Amara, Nabil; El Adlouni, Salaheddine

    2009-08-01

    Information and Communication Technology (ICT) and Organizational Innovation (OI) are seen as the miracle of post-modernity in organizations. In this way, they are supposed to resolve most organizational problems, efficiently and rapidly. OI is highly dependent on the capacity and the investment in knowledge management (internal and external) to support decision making process and to implement significant changes. We know what explains ICT utilization (ICTU) and what determines OI development (OID) in healthcare services. Moreover, the literature tends to link ICTU to OID and vice versa. However, this dependency has never been explored empirically through the lens of roles combination. To identify the existing combined roles profiles of ICTU and OID among healthcare decision makers and determine factors of the shift from a profile to another. We did the following: (1) a structured review of the literature on healthcare management by focusing on ICTU and OID which allowed us to build two indexes and a comprehensive framework; (2) a copula methodology to identify with high precision the thresholds for ICTU and OID; and (3) a cross-sectional study based on a survey done with a sample of 942 decision makers from Canadian healthcare organizations through a multinomial logit model to identify determinants of the shift. ICTU and OID are correlated at 22% (Kendal's Tau). The joint distribution (combination) of ICTU and OID shows that four major profiles exist among decision makers in Canadian healthcare organizations: the traditional decision maker, the innovative decision maker, the technologic decision maker and the contemporary decision maker. We found out that classic factors act as barriers to the shift from one profile to the desired profile (from 1 to 4, from 2 to 4 and from 3 to 4). We have identified that the attitude toward research and relational capital are transversal barriers of shift. We have also found that some factors have a specific impact such as

  16. Severe Weather Forecast Decision Aid

    NASA Technical Reports Server (NTRS)

    Bauman, William H., III; Wheeler, Mark M.; Short, David A.

    2005-01-01

    This report presents a 15-year climatological study of severe weather events and related severe weather atmospheric parameters. Data sources included local forecast rules, archived sounding data, Cloud-to-Ground Lightning Surveillance System (CGLSS) data, surface and upper air maps, and two severe weather event databases covering east-central Florida. The local forecast rules were used to set threat assessment thresholds for stability parameters that were derived from the sounding data. The severe weather events databases were used to identify days with reported severe weather and the CGLSS data was used to differentiate between lightning and non-lightning days. These data sets provided the foundation for analyzing the stability parameters and synoptic patterns that were used to develop an objective tool to aid in forecasting severe weather events. The period of record for the analysis was May - September, 1989 - 2003. The results indicate that there are certain synoptic patterns more prevalent on days with severe weather and some of the stability parameters are better predictors of severe weather days based on locally tuned threat values. The results also revealed the stability parameters that did not display any skill related to severe weather days. An interactive web-based Severe Weather Decision Aid was developed to assist the duty forecaster by providing a level of objective guidance based on the analysis of the stability parameters, CGLSS data, and synoptic-scale dynamics. The tool will be tested and evaluated during the 2005 warm season.

  17. The Decision Maker's Guide to Applied Planning, Organization, Administration, Research, Evaluation, Information Processing and Analysis Techniques.

    ERIC Educational Resources Information Center

    Dumas, Neil S.

    This guide is an attempt to eliminate the need for decision makers to suffer from many of their future errors. It is an attempt to insure that the "right" decision is made the first time. Briefly, the theory is that one can learn from other peoples' experience and thus avoid making future mistakes. This volume is a guide to other…

  18. Contents of Climate Predictions Desired by Agricultural Decision Makers.

    NASA Astrophysics Data System (ADS)

    Changnon, Stanley A.

    1992-12-01

    In-depth interviews with 27 executives in various agribusiness defined usage and needs for climate predictions. Predictions are acquired from various public and private sources but are seldom used in making major decision. Users exhibited little trust of climate predictions, relying heavily on recent weather conditions as the basis of prediction. Additions to predictions involving climatic information would better serve the needs of most of agribusiness. Improved predictive accuracies alone will not materially increase usage. A need exists to familiarize agribusiness leaders with the information currently available, and to realize benefits from this information; many agribusinesses will need to develop models and procedures that allow integration of future weather conditions (actual and predicted) with their corporate activities and economic conditions.

  19. Advanced decision aiding techniques applicable to space

    NASA Technical Reports Server (NTRS)

    Kruchten, Robert J.

    1987-01-01

    RADC has had an intensive program to show the feasibility of applying advanced technology to Air Force decision aiding situations. Some aspects of the program, such as Satellite Autonomy, are directly applicable to space systems. For example, RADC has shown the feasibility of decision aids that combine the advantages of laser disks and computer generated graphics; decision aids that interface object-oriented programs with expert systems; decision aids that solve path optimization problems; etc. Some of the key techniques that could be used in space applications are reviewed. Current applications are reviewed along with their advantages and disadvantages, and examples are given of possible space applications. The emphasis is to share RADC experience in decision aiding techniques.

  20. Improving invasive species management by integrating priorities and contributions of scientists and decision makers.

    PubMed

    N'Guyen, Anouk; Hirsch, Philipp E; Adrian-Kalchhauser, Irene; Burkhardt-Holm, Patricia

    2016-04-01

    Managing invasive species is a major challenge for society. In the case of newly established invaders, rapid action is key for a successful management. Here, we develop, describe and recommend a three-step transdisciplinary process (the "butterfly model") to rapidly initiate action for invasion management. In the framing of a case study, we present results from the first of these steps: assessing priorities and contributions of both scientists and decision makers. Both scientists and decision makers prioritise research on prevention. The available scientific knowledge contributions, however, are publications on impacts rather than prevention of the invasive species. The contribution of scientific knowledge does thus not reflect scientists' perception of what is essentially needed. We argue that a more objective assessment and transparent communication of not only decision makers' but also scientists' priorities is an essential basis for a successful cooperation. Our three-step model can help achieve objectivity via transdisciplinary communication.

  1. The Decision-Makers' Forum on a new paradigm for nuclear energy -- Final Report

    SciTech Connect

    Motloch, C.G.

    1998-09-14

    The Decision-Makers' Forum on a New Paradigm for Nuclear Energy was created in response to the challenge by Sen. Pete V. Domenici to begin, ``a new dialogue with serious discussion about the full range of nuclear technologies.'' Sponsored by the Senate Nuclear Issues Caucus, the Forum was organized and facilitated by the Idaho National Engineering and Environmental Laboratory. The participants were decision-makers and key staff from industry, government, the national laboratories, academia and professional societies. Overall, the Forum was designed to capture the ideas of a large number of decision-makers about the high priority actions recommended to help set a new national agenda for nuclear energy. The Forum recommended 10 priority actions toward this end.

  2. The Decision-Makers Forum on a new Paradigm for Nuclear Energy, Final Report

    SciTech Connect

    Motloch, Chester George

    1998-09-01

    The Decision-Makers' Forum on a New Paradigm for Nuclear Energy was created in response to the challenge by Sen. Pete V. Domenici to begin, "a new dialogue with serious discussion about the full range of nuclear technologies." Sponsored by the Senate Nuclear Issues Caucus, the Forum was organized and facilitated by the Idaho National Engineering and Environmental Laboratory. The participants were decision-makers and key staff from industry, government, the national laboratories, academia and professional societies. Overall, the Forum was designed to capture the ideas of a large number of decision-makers about the high priority actions recommended to help set a new national agenda for nuclear energy. The Forum recommended 10 priority actions toward this end.

  3. A Reward-Maximizing Spiking Neuron as a Bounded Rational Decision Maker.

    PubMed

    Leibfried, Felix; Braun, Daniel A

    2015-08-01

    Rate distortion theory describes how to communicate relevant information most efficiently over a channel with limited capacity. One of the many applications of rate distortion theory is bounded rational decision making, where decision makers are modeled as information channels that transform sensory input into motor output under the constraint that their channel capacity is limited. Such a bounded rational decision maker can be thought to optimize an objective function that trades off the decision maker's utility or cumulative reward against the information processing cost measured by the mutual information between sensory input and motor output. In this study, we interpret a spiking neuron as a bounded rational decision maker that aims to maximize its expected reward under the computational constraint that the mutual information between the neuron's input and output is upper bounded. This abstract computational constraint translates into a penalization of the deviation between the neuron's instantaneous and average firing behavior. We derive a synaptic weight update rule for such a rate distortion optimizing neuron and show in simulations that the neuron efficiently extracts reward-relevant information from the input by trading off its synaptic strengths against the collected reward.

  4. A Reward-Maximizing Spiking Neuron as a Bounded Rational Decision Maker.

    PubMed

    Leibfried, Felix; Braun, Daniel A

    2015-08-01

    Rate distortion theory describes how to communicate relevant information most efficiently over a channel with limited capacity. One of the many applications of rate distortion theory is bounded rational decision making, where decision makers are modeled as information channels that transform sensory input into motor output under the constraint that their channel capacity is limited. Such a bounded rational decision maker can be thought to optimize an objective function that trades off the decision maker's utility or cumulative reward against the information processing cost measured by the mutual information between sensory input and motor output. In this study, we interpret a spiking neuron as a bounded rational decision maker that aims to maximize its expected reward under the computational constraint that the mutual information between the neuron's input and output is upper bounded. This abstract computational constraint translates into a penalization of the deviation between the neuron's instantaneous and average firing behavior. We derive a synaptic weight update rule for such a rate distortion optimizing neuron and show in simulations that the neuron efficiently extracts reward-relevant information from the input by trading off its synaptic strengths against the collected reward. PMID:26079747

  5. Characteristics of community health organizations and decision-makers considering the adoption of motivational interviewing.

    PubMed

    Williams, Jessica Roberts; Dusablon, Tracy; Williams, Weston O; Blais, Marissa Puckett; Hennessy, Kevin D

    2014-07-01

    Research related to the adoption of comparative effectiveness research (CER) in mental health practice is limited. This study explores the factors that influence decisions to adopt motivational interviewing (MI)-an evidence-based practice (EBP) grounded in CER-among decision-makers (n = 311) in community health organizations (n = 92). Descriptive analyses focus on organization and decision-maker characteristics and processes that may influence the decision to adopt an EBP, including demographics, structure and operations, readiness, attitudes, barriers, and facilitators. Within-group agreement is examined to determine the degree to which participants within each organization gave similar responses. Results show characteristics differed according to type of organization (community health versus community behavioral health) and position (directors versus staff). Within-group agreement was also influenced by position. These findings indicate different strategies may be needed to best disseminate CER to the two groups.

  6. An analytical framework to assist decision makers in the use of forest ecosystem model predictions

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The predictions of most terrestrial ecosystem models originate from deterministic simulations. Relatively few uncertainty evaluation exercises in model outputs are performed by either model developers or users. This issue has important consequences for decision makers who rely on models to develop n...

  7. Healthy School Meals...Healthy Kids! A Leadership Guide for School Decision-Makers.

    ERIC Educational Resources Information Center

    Food and Consumer Service (USDA), Washington, DC.

    The School Meals Initiative for Healthy Children was launched in June 1994 to improve the health and education of children through better nutrition. This leadership guide provides information to school decision-makers on using materials and resources developed by the U.S. Department of Agriculture and describes Team Nutrition, an implementation…

  8. Perception and evaluation of public opinion by decision makers: civilian nuclear power in the US

    SciTech Connect

    Cohen, R.L.

    1982-01-01

    This study treats public opinion as problematic and focuses on the way it is defined, identified, and evaluated by nuclear decision makers in industry, government, and the scientific community. The data are based largely on questionnaire responses and interviews. Though public opinion is a social process amenable to empirical investigation, its identification is not self-evident. It is defined within the context of an already-existing set of often unconscious beliefs and value commitments. Like students of public opinion, decision makers focus on such characteristics of public opinion as its membership, direction, intensity, level of information, prior attitudinal predispositions, and representativeness, and on the factors that influence public opinion. They also select among the indicators of public opinion - those that seem to represent the public as against those that claim to speak for it. They identify public opinion in terms of their beliefs about what public opinion is or should be in a democracy. The antinuclear movement and the mass media are seen as important, but their equation with public opinion is challenged. Decision makers see the antinuclear movement as distinct from, though an important influence on, public opinion. Decision makers believe the public has a legitimate role in negotiating nuclear power issues, but expect the public to be informed through exposure to the relevant information and expertise.

  9. Reciprocal Dialogue between Educational Decision Makers and Students of Color: Opportunities and Obstacles

    ERIC Educational Resources Information Center

    Bertrand, Melanie

    2014-01-01

    Purpose: This article explores the possibilities for reciprocal dialogue between educational decision makers and Students of Color. Such dialogue--defined as interactions in which participants build on each other's words--may provide the means to develop creative ways to address manifestations of systemic racism in education. The article uses…

  10. PUMP-AND-TREAT GROUND-WATER REMEDIATION: A GUIDE FOR DECISION MAKERS AND PRACTITIONERS

    EPA Science Inventory

    This guide presents decision makers with a foundation for evaluating the appropriateness of conventional or innovative approaches. An introduction to pump-and-treat ground-water remediation, the guide addresses the following questions: When is pump-and-treat an appropriate remedi...

  11. Decision Maker Perception of Information Quality: A Case Study of Military Command and Control

    ERIC Educational Resources Information Center

    Morgan, Grayson B.

    2013-01-01

    Decision maker perception of information quality cues from an "information system" (IS) and the process which creates such meta cueing, or data about cues, is a critical yet un-modeled component of "situation awareness" (SA). Examples of common information quality meta cueing for quality criteria include custom ring-tones for…

  12. Constructing Perceptions of Climate Change: a case study of regional political decision makers

    NASA Astrophysics Data System (ADS)

    Bray, D.

    2012-12-01

    This case study of climate change communications assesses the salient means of communication and the message adopted by regional political decision makers on the German Baltic coast. Realizing that cultural factors and local values (and not simply knowledge) are significant influences in explaining attitudes towards climate change, this analysis draws from the records of regional weather, from scientists with a specific focus on the region, from the political decision makers for that region, and the media message reaching the decision makers, ensuring all elements of the analysis are drawn from the same socioeconomic, geophysical, political and cultural context. This is important as the social dynamics surrounding the trust in science is of critical importance and, as such, all elements of the case study are specifically contained within a common context. If the utility of climate change knowledge is to prompt well conceived adaptation/mitigation strategies then the political decision process, or at least the perceptions shaping it, can best be understood by locating it within the world view of the decision makers involved in the production process. Using the results of two survey questionnaires, one of regional climate scientists and one of regional political decision makers, ten years of local weather records, and a summary of the message from mass media circulation, the discord in perceptions of regional climate change are quantitatively explored. The conclusions drawn from the analysis include, compared to the scientific assessment: The decision makers' perceptions of recent past differ from actual observations. The decision makers' perceptions of the future differ from scientific assessments. The decision makers tend to over estimate the magnitude of regional climate change and its impacts. The decision makers tend to over estimate the sense of immediacy for adaptation measures. The conclusions drawn suggest that in the regional political realm, it is often a

  13. Clarity versus complexity: land-use modeling as a practical tool for decision-makers

    USGS Publications Warehouse

    Sohl, Terry L.; Claggett, Peter R.

    2013-01-01

    The last decade has seen a remarkable increase in the number of modeling tools available to examine future land-use and land-cover (LULC) change. Integrated modeling frameworks, agent-based models, cellular automata approaches, and other modeling techniques have substantially improved the representation of complex LULC systems, with each method using a different strategy to address complexity. However, despite the development of new and better modeling tools, the use of these tools is limited for actual planning, decision-making, or policy-making purposes. LULC modelers have become very adept at creating tools for modeling LULC change, but complicated models and lack of transparency limit their utility for decision-makers. The complicated nature of many LULC models also makes it impractical or even impossible to perform a rigorous analysis of modeling uncertainty. This paper provides a review of land-cover modeling approaches and the issues causes by the complicated nature of models, and provides suggestions to facilitate the increased use of LULC models by decision-makers and other stakeholders. The utility of LULC models themselves can be improved by 1) providing model code and documentation, 2) through the use of scenario frameworks to frame overall uncertainties, 3) improving methods for generalizing key LULC processes most important to stakeholders, and 4) adopting more rigorous standards for validating models and quantifying uncertainty. Communication with decision-makers and other stakeholders can be improved by increasing stakeholder participation in all stages of the modeling process, increasing the transparency of model structure and uncertainties, and developing user-friendly decision-support systems to bridge the link between LULC science and policy. By considering these options, LULC science will be better positioned to support decision-makers and increase real-world application of LULC modeling results.

  14. Decision maker views on priority setting in the Vancouver Island Health Authority

    PubMed Central

    Dionne, Francois; Mitton, Craig; Smith, Neale; Donaldson, Cam

    2008-01-01

    Background Decisions regarding the allocation of available resources are a source of growing dissatisfaction for healthcare decision-makers. This dissatisfaction has led to increased interest in research on evidence-based resource allocation processes. An emerging area of interest has been the empirical analysis of the characteristics of existing and desired priority setting processes from the perspective of decision-makers. Methods We conducted in-depth, face-to-face interviews with 18 senior managers and medical directors with the Vancouver Island Health Authority, an integrated health care provider in British Columbia responsible for a population of approximately 730,000. Interviews were transcribed and content-analyzed, and major themes and sub-themes were identified and reported. Results Respondents identified nine key features of a desirable priority setting process: inclusion of baseline assessment, use of best evidence, clarity, consistency, clear and measurable criteria, dissemination of information, fair representation, alignment with the strategic direction and evaluation of results. Existing priority setting processes were found to be lacking on most of these desired features. In addition, respondents identified and explicated several factors that influence resource allocation, including political considerations and organizational culture and capacity. Conclusion This study makes a contribution to a growing body of knowledge which provides the type of contextual evidence that is required if priority setting processes are to be used successfully by health care decision-makers. PMID:18644152

  15. An analytical framework to assist decision makers in the use of forest ecosystem model predictions

    USGS Publications Warehouse

    Larocque, Guy R.; Bhatti, Jagtar S.; Ascough, J.C.; Liu, J.; Luckai, N.; Mailly, D.; Archambault, L.; Gordon, Andrew M.

    2011-01-01

    The predictions from most forest ecosystem models originate from deterministic simulations. However, few evaluation exercises for model outputs are performed by either model developers or users. This issue has important consequences for decision makers using these models to develop natural resource management policies, as they cannot evaluate the extent to which predictions stemming from the simulation of alternative management scenarios may result in significant environmental or economic differences. Various numerical methods, such as sensitivity/uncertainty analyses, or bootstrap methods, may be used to evaluate models and the errors associated with their outputs. However, the application of each of these methods carries unique challenges which decision makers do not necessarily understand; guidance is required when interpreting the output generated from each model. This paper proposes a decision flow chart in the form of an analytical framework to help decision makers apply, in an orderly fashion, different steps involved in examining the model outputs. The analytical framework is discussed with regard to the definition of problems and objectives and includes the following topics: model selection, identification of alternatives, modelling tasks and selecting alternatives for developing policy or implementing management scenarios. Its application is illustrated using an on-going exercise in developing silvicultural guidelines for a forest management enterprise in Ontario, Canada. ?? 2010.

  16. How can research organizations more effectively transfer research knowledge to decision makers?

    PubMed

    Lavis, John N; Robertson, Dave; Woodside, Jennifer M; McLeod, Christopher B; Abelson, Julia

    2003-01-01

    Five questions--What should be transferred to decision makers? To whom should it be transferred? By whom? How? With what effect?--provide an organizing framework for a knowledge transfer strategy. Opportunities for improving how research organizations transfer research knowledge can be found in the differences between the answers suggested by our understanding of the research literature and those provided by research-organization directors asked to describe what they do. In Canada, these opportunities include developing actionable messages for decision makers (only 30 percent of research organizations frequently or always do this), developing knowledge-uptake skills in target audiences and knowledge-transfer skills in research organizations (only 20 to 22 percent frequently or always do this), and evaluating the impact of knowledge-transfer activities (only 8 to 12 percent frequently or always conduct an evaluation). Research funders can help research organizations take advantage of these opportunities.

  17. Navigating Ethical Conflicts Between Advance Directives and Surrogate Decision-Makers' Interpretations of Patient Wishes.

    PubMed

    Bruce, Courtenay R; Bibler, Trevor; Childress, Andrew M; Stephens, Ashley L; Pena, Adam M; Allen, Nathan G

    2016-02-01

    There is little guidance on what clinicians should do when advance directives (or living wills, specifically) are challenged, particularly when surrogate decision-makers' interpretations of patients' wishes conflict with the living will. In our commentary, we make a controversial argument suggesting that overriding living wills can be ethically preferable to the alternative of strictly adhering to them. We propose four ethical considerations for determining whether it is ethically supportable to override living wills.

  18. Gender inequalities in the workplace: the effects of organizational structures, processes, practices, and decision makers' sexism.

    PubMed

    Stamarski, Cailin S; Son Hing, Leanne S

    2015-01-01

    Gender inequality in organizations is a complex phenomenon that can be seen in organizational structures, processes, and practices. For women, some of the most harmful gender inequalities are enacted within human resources (HRs) practices. This is because HR practices (i.e., policies, decision-making, and their enactment) affect the hiring, training, pay, and promotion of women. We propose a model of gender discrimination in HR that emphasizes the reciprocal nature of gender inequalities within organizations. We suggest that gender discrimination in HR-related decision-making and in the enactment of HR practices stems from gender inequalities in broader organizational structures, processes, and practices. This includes leadership, structure, strategy, culture, organizational climate, as well as HR policies. In addition, organizational decision makers' levels of sexism can affect their likelihood of making gender biased HR-related decisions and/or behaving in a sexist manner while enacting HR practices. Importantly, institutional discrimination in organizational structures, processes, and practices play a pre-eminent role because not only do they affect HR practices, they also provide a socializing context for organizational decision makers' levels of hostile and benevolent sexism. Although we portray gender inequality as a self-reinforcing system that can perpetuate discrimination, important levers for reducing discrimination are identified. PMID:26441775

  19. Gender inequalities in the workplace: the effects of organizational structures, processes, practices, and decision makers' sexism.

    PubMed

    Stamarski, Cailin S; Son Hing, Leanne S

    2015-01-01

    Gender inequality in organizations is a complex phenomenon that can be seen in organizational structures, processes, and practices. For women, some of the most harmful gender inequalities are enacted within human resources (HRs) practices. This is because HR practices (i.e., policies, decision-making, and their enactment) affect the hiring, training, pay, and promotion of women. We propose a model of gender discrimination in HR that emphasizes the reciprocal nature of gender inequalities within organizations. We suggest that gender discrimination in HR-related decision-making and in the enactment of HR practices stems from gender inequalities in broader organizational structures, processes, and practices. This includes leadership, structure, strategy, culture, organizational climate, as well as HR policies. In addition, organizational decision makers' levels of sexism can affect their likelihood of making gender biased HR-related decisions and/or behaving in a sexist manner while enacting HR practices. Importantly, institutional discrimination in organizational structures, processes, and practices play a pre-eminent role because not only do they affect HR practices, they also provide a socializing context for organizational decision makers' levels of hostile and benevolent sexism. Although we portray gender inequality as a self-reinforcing system that can perpetuate discrimination, important levers for reducing discrimination are identified.

  20. Bridging the Gap between NASA Earth Observations and Decision Makers through the NASA DEVELOP National Program

    NASA Astrophysics Data System (ADS)

    Favors, J. E.; Childs-Gleason, L. M.; Ross, K. W.; Rogers, L.; Allsbrook, K. N.; Ruiz, M. L.; Miller, T. N.; Crepps, G.

    2015-12-01

    The NASA DEVELOP National Program bridges the gap between NASA Earth Science and society by building capacity in both participants and partner organizations who collaborate to conduct projects. These rapid feasibility projects highlight the capabilities of satellite and aerial Earth observations to enhance decision making on a local level. DEVELOP partners with a wide variety of organizations, including state and local governments, federal agencies, regional entities, tribal governments, international organizations and governments, NGOs and private companies. Immersion of decision and policy makers in these feasibility projects increases awareness of the capabilities of Earth observations, and contributes to the tools and resources available to support enhanced decision making. This presentation will highlight best practices, feedback from project end-users, and case studies of successful adoption of methods in the decision making process.

  1. Informing Health Policy Decision Makers: A Nebraska Scope of Practice Case Study.

    PubMed

    Lazure, Linda L; Cramer, Mary E; Hoebelheinrich, Katherine A

    2016-05-01

    Medicare patients seeking care from nurse practitioners (NPs) increased 15-fold from 1998 to 2010, and a 2.5-fold patient increase was recorded in states that have eased the regulatory environment for NPs. It is increasingly important that state regulatory and licensing boards-charged with protecting the public through the assurance of a qualified health-care workforce-examine whether their state regulatory environment restricts or promotes public access to quality health care. This article presents a case study of a statutory scope of practice credentialing review process for NPs in Nebraska. It examines in depth what individuals involved in policy change processes found most useful for informed decision making. The methodology included observation of the process, review of submitted documents, and a survey to individuals involved in the decision-making process (n = 22/48). The study findings have application for those seeking scope of practice policy changes, with specific suggestions for how to better prepare themselves and present information in formats that are helpful to decision makers. Our results also shed new light on what specific evidence submitted during a scope of practice review process is most valued for promoting the understanding of decision makers to effect change. PMID:27540082

  2. An Approach for Web Service Selection Based on Confidence Level of Decision Maker

    PubMed Central

    Khezrian, Mojtaba; Jahan, Ali; Wan Kadir, Wan Mohd Nasir; Ibrahim, Suhaimi

    2014-01-01

    Web services today are among the most widely used groups for Service Oriented Architecture (SOA). Service selection is one of the most significant current discussions in SOA, which evaluates discovered services and chooses the best candidate from them. Although a majority of service selection techniques apply Quality of Service (QoS), the behaviour of QoS-based service selection leads to service selection problems in Multi-Criteria Decision Making (MCDM). In the existing works, the confidence level of decision makers is neglected and does not consider their expertise in assessing Web services. In this paper, we employ the VIKOR (VIšekriterijumskoKOmpromisnoRangiranje) method, which is absent in the literature for service selection, but is well-known in other research. We propose a QoS-based approach that deals with service selection by applying VIKOR with improvement of features. This research determines the weights of criteria based on user preference and accounts for the confidence level of decision makers. The proposed approach is illustrated by an example in order to demonstrate and validate the model. The results of this research may facilitate service consumers to attain a more efficient decision when selecting the appropriate service. PMID:24897426

  3. What contributes to a technical purchasing decision maker's reliance on brand name for design decisions involving I&T products

    NASA Astrophysics Data System (ADS)

    Coutoumanos, Vincent

    The following research is intended to develop more formal mechanisms for collection, analysis, retention and dissemination of information relating to brand influence on high-technology products. Specifically, these high-technology products are associated with the engineering applications that likely would involve the loss of human life in the advent of catastrophic failure. The results of the study lead to an extension of theory involving marketing and product selection of "highly engineered" parts within the aerospace industry. The findings were separated into three distinct areas: 1) Information load will play a large role in the final design decision. If the designer is under a high level of information load during the time of a design decision, he or she likely will gravitate to the traditional design choice, regardless of the level of brand strength. 2) Even when strong brand names, like 3M, were offered as the non-traditional design choice, engineers gravitated to the traditional design choice that was presented in a mock Society for Manufacturing Engineers article. 3) Designer self-efficacy by itself will not often contribute to a decision maker's design choice. However, these data collected indicates that a combination of high designer self-efficacy moderated by high brand strength is likely to contribute significantly to a decision maker's decision. The post-hoc finding shows that many designers having high levels of self-efficacy could be developing a sense of comfort with strong brand names (like 3M) when making a design choice.

  4. Decision maker priorities for providing antiretroviral therapy in HIV-infected South Africans: a qualitative assessment.

    PubMed

    Kimmel, April D; Daniels, Norman; Betancourt, Theresa S; Wood, Robin; Prosser, Lisa A

    2012-01-01

    In resource-limited settings, successful HIV treatment scale-up has been tempered by reports of funding shortfalls. We aimed to determine the priorities, including ethical considerations, of decision makers for HIV antiretroviral programs. We conducted qualitative interviews with 12 decision makers, identified using purposive sampling. Respondents engaged in one-on-one, semi-structured interviews. We developed an interview guide to direct questions about key priorities and motivations for decision making about HIV antiretroviral programs. We evaluated textual data from the interviews to identify themes. Among 12 respondents, 10 (83%) lived and worked in South Africa. Respondents came from Western Cape, Gauteng, and KwaZulu-Natal provinces and worked primarily in urban settings. The respondents supported prioritizing individual patients based on treatment adherence, pregnancy status to prevent maternal-to-child HIV transmission and/or orphans, and severity of illness. However, priorities based on severity of illness varied, with first-come/first-serve, prioritization of the most severely ill, and prioritization of the least severely ill discussed. Respondents opposed prioritizing based on patient socioeconomic characteristics. Other priorities included the number of persons receiving treatment; how treated patients are distributed in the population (e.g., urban/rural); and treatment policy (e.g., number of antiretroviral regimens). Motivations included humanitarian concerns; personal responsibility for individual patients; and clinical outcomes (e.g., patient-level morbidity/mortality, saving lives) and/or social outcomes (e.g., restoring patients as functional family members). Decision makers have a wide range of priorities for antiretroviral provision in South Africa, and the motivations underlying these priorities suggest at times conflicting ethical considerations for providing HIV treatment when resources are limited. PMID:22304657

  5. Assessing ground-water vulnerability to contamination: Providing scientifically defensible information for decision makers

    USGS Publications Warehouse

    Focazio, Michael J.; Reilly, Thomas E.; Rupert, Michael G.; Helsel, Dennis R.

    2002-01-01

    Throughout the United States increasing demands for safe drinking water and requirements to maintain healthy ecosystems are leading policy makers to ask complex social and scientific questions about how to assess and manage our water resources. This challenge becomes particularly difficult as policy and management objectives require scientific assessments of the potential for ground-water resources to become contaminated from anthropogenic, as well as natural sources of contamination. Assessments of the vulnerability of ground water to contamination range in scope and complexity from simple, qualitative, and relatively inexpensive approaches to rigorous, quantitative, and costly assessments. Tradeoffs must be carefully considered among the competing influences of the cost of an assessment, the scientific defensibility, and the amount of acceptable uncertainty in meeting the objectives of the water-resource decision maker.

  6. Bridging the Gap Between NASA Earth Observations and Decision Makers Through the NASA Develop National Program

    NASA Astrophysics Data System (ADS)

    Remillard, C. M.; Madden, M.; Favors, J.; Childs-Gleason, L.; Ross, K. W.; Rogers, L.; Ruiz, M. L.

    2016-06-01

    The NASA DEVELOP National Program bridges the gap between NASA Earth Science and society by building capacity in both participants and partner organizations that collaborate to conduct projects. These rapid feasibility projects highlight the capabilities of satellite and aerial Earth observations. Immersion of decision and policy makers in these feasibility projects increases awareness of the capabilities of Earth observations and contributes to the tools and resources available to support enhanced decision making. This paper will present the DEVELOP model, best practices, and two case studies, the Colombia Ecological Forecasting project and the Miami-Dade County Ecological Forecasting project, that showcase the successful adoption of tools and methods for decision making. Through over 90 projects each year, DEVELOP is always striving for the innovative, practical, and beneficial use of NASA Earth science data.

  7. Learning environment simulator: a tool for local decision makers and first responders

    SciTech Connect

    Leclaire, Rene J; Hirsch, Gary B

    2009-01-01

    The National Infrastructure Simulation and Analysis Center (NISAC) has developed a prototype learning environment simulator (LES) based on the Critical Infrastructure Protection Decision Support System (CIPDSS) infrastructure and scenario models. The LES is designed to engage decision makers at the grass-roots level (local/city/state) to deepen their understanding of an evolving crisis, enhance their intuition and allow them to test their own strategies for events before they occur. An initial version is being developed, centered on a pandemic influenza outbreak and has been successfully tested with a group of hospital administrators and first responders. LES is not a predictive tool but rather a simulated environment allowing the user to experience the complexities of a crisis before it happens. Users can contrast various approaches to the crisis, competing with alternative strategies of their own or other participants. LES is designed to assist decision makers in making informed choices by functionally representing relevant scenarios before they occur, including impacts to critical infrastructures with their interdependencies, and estimating human health & safety and economic impacts. In this paper a brief overview of the underlying models are given followed by a description of the LES, its interface and usage and an overview of the experience testing LES with a group of hospital administrators and first responders. The paper concludes with a brief discussion of the work remaining to make LES operational.

  8. Voice in political decision-making: the effect of group voice on perceived trustworthiness of decision makers and subsequent acceptance of decisions.

    PubMed

    Terwel, Bart W; Harinck, Fieke; Ellemers, Naomi; Daamen, Dancker D L

    2010-06-01

    The implementation of carbon dioxide capture and storage technology (CCS) is considered an important climate change mitigation strategy, but the viability of this technology will depend on public acceptance of CCS policy decisions. The results of three experiments with students as participants show that whether or not interest groups receive an opportunity to express their opinions in the decision-making process (i.e., group voice) affects acceptance of CCS policy decisions, with inferred trustworthiness of the decision maker mediating this effect. Decision-making procedures providing different interest groups with equal opportunities to voice their opinions instigate more trust in the decision maker and, in turn, lead to greater willingness to accept decisions compared to no-voice procedures (i.e., unilateral decision-making-Study 1) and unequal group-voice procedures (i.e., when one type of interest group receives voice, but another type of interest group does not-Study 2). Study 3 further shows that an individual's own level of knowledge about CCS moderates the desire for an opportunity for members of the general public to voice opinions in the decision-making process, inferred trustworthiness of decision makers, and policy acceptance. These results imply that people care about voice in decision-making even when they are not directly personally involved in the decision-making process. We conclude that people tend to use procedural information when deciding to accept or oppose policy decisions on political complex issues; hence, it is important that policymakers use fair group-voice procedures and that they communicate to the public how they arrive at their decisions.

  9. Reaching Local Decision Makers through the OhioView Remote Sensing Consortium

    NASA Astrophysics Data System (ADS)

    Czajkowski, K. P.

    2002-05-01

    Remote sensing technology has been slow to move out of the research lab and into public use. A primary goal of the OhioView Consortium, a consortium of ten Ohio universities working together to spread remote sensing, is to take application-based research and make the results useful to the public. In particular, the group is working to remove the barriers to the use of satellite imagery including costs of imagery and software and training of policy makers. Through collaboration with the Ohio Library and Information Network (OhioLINK), OhioView is disseminating Landsat 7 imagery over Ohio with 30 percent cloud cover or less over the internet for free. In addition, OhioView has provided remote sensing software for local government agencies. As part of the OhoView Consortium, the Department of Geography and Planning at the University of Toledo has worked with policy makers on local issues that can benefit from the addition of satellite imagery. Northwest Ohio traditionally is a region of heavy industry rather than high technology. Few policy makers or environmental consultants had considered using satellite imagery in their work. We will discuss the results of this collaboration from a project we are currently conducting with local government groups to identify wetlands. Wetlands once covered over 90 percent of Northwest Ohio. Through draining, they have virtually disappeared. The goal of this project was to produce a map of existing wetlands in Northwest Ohio that could be used by government officials to make development decisions.

  10. Advisory Committee: A Powerful Tool for Helping Decision Makers inEnvironmental Issues

    PubMed

    Vasseur; Lafrance; Ansseau; Renaud; Morin; Audet

    1997-05-01

    / It has been suggested that the general public should be moreinvolved in environmental policy and decision making. It is important forthem to realize that they will have to live with the consequences ofenvironmental policies and decisions. Consequently, policy makers shouldconsider the concerns and opinions of the general public before makingdecisions on environmental issues. This raises questions such as: How can weintegrate the perceptions and reactions of the general population inenvironmental decisions? What kind of public participation should weconsider? In the present study, using a new regional ecosystem model, weattempted to integrate these aspects in its decision making model byincluding the formation of an advisory committee to resolve problems relatedto waste management. The advisory committee requested the activeparticipation of representatives from all levels of the community: economic,municipal, and governmental intervenors; environmental groups; and citizens.Their mandates were to examine different management strategies available inthe region, considering all the interdisciplinary aspects of each strategy,elaborate recommendations concerning the management strategies that are mostsuitable for all, and collaborate in communication of the information to thegeneral population. The results showed that at least in small municipalitiessuch an advisory committee can be a powerful tool in environmental decisionmaking. Conditions required for a successful consultation process, such aseveryday lay language and the presence of a facilitator other than ascientific expert, are discussed.KEY WORDS: Public consultation; Environmental policies;Interdisciplinary aspects; Municipal sewage sludge management; Generalpopulation; Decision-making process

  11. Operational hydrological projections to aid decision making

    NASA Astrophysics Data System (ADS)

    Schnetler, Thomas; Davis, Richard; Waddingham, John; James, Karen

    2014-05-01

    The Environment Agency of England has wide ranging responsibility for environmental regulation that includes both water resources management and flood management. In order to best fulfil its role decisions need to be taken using the best available evidence in the time available. The manipulation of large amounts of hydrological data in a way that best meets the needs of decision makers is a complex challenge. Not only should any analysis be technically robust but it should also be presented in a way that communicates key messages clearly and quickly. The Environment Agency and its predecessor organisations has a long history of working with hydrological data but in recent years there has been a need to better incorporate risk and uncertainty into hydrological analysis so that subsequent decisions can take this into account. In the face of recent extreme weather events, there has been an increasing demand for forward look projections from water resource and flood risk practitioners, decision makers and contingency planners. These assessments are required to give appropriate lead in time to allow risk mitigation measures to be implemented to minimise impact upon people, the environment and infrastructure. This presentation will outline the methodologies developed by the Environment Agency to produce and publish monthly routine forward look projections using both a scenario and climate ensemble approach. It will cover how information is disseminated, providing a good example of communicating science to decision makers and to the public. Examples of practical applications of these methodologies include: • Risk based planning and forecasting of water availability for inter basin water transfers into water stressed catchments. • Assessment of water resources prospects during droughts for people and the environment • The likelihood and medium term risk of high groundwater levels impacting upon people and infrastructure. There are also a number of future challenges

  12. A data mining system for providing analytical information on brain tumors to public health decision makers.

    PubMed

    Santos, R S; Malheiros, S M F; Cavalheiro, S; de Oliveira, J M Parente

    2013-03-01

    Cancer is the leading cause of death in economically developed countries and the second leading cause of death in developing countries. Malignant brain neoplasms are among the most devastating and incurable forms of cancer, and their treatment may be excessively complex and costly. Public health decision makers require significant amounts of analytical information to manage public treatment programs for these patients. Data mining, a technology that is used to produce analytically useful information, has been employed successfully with medical data. However, the large-scale adoption of this technique has been limited thus far because it is difficult to use, especially for non-expert users. One way to facilitate data mining by non-expert users is to automate the process. Our aim is to present an automated data mining system that allows public health decision makers to access analytical information regarding brain tumors. The emphasis in this study is the use of ontology in an automated data mining process. The non-experts who tried the system obtained useful information about the treatment of brain tumors. These results suggest that future work should be conducted in this area. PMID:23122302

  13. Collaborative Platforms Aid Emergency Decision Making

    NASA Technical Reports Server (NTRS)

    2013-01-01

    Terra. Aqua. Cloudsat. Landsat. NASA runs and partners in many missions dedicated to monitoring the Earth, and the tools used in these missions continuously return data on everything from shifts in temperature to cloud formation to pollution levels over highways. The data are of great scientific value, but they also provide information that can play a critical role in decision making during times of crisis. Real-time developments in weather, wind, ocean currents, and numerous other conditions can have a significant impact on the way disasters, both natural and human-caused, unfold. "NASA has long recognized the need to make its data from real-time sources compatible and accessible for the purposes of decision making," says Michael Goodman, who was Disasters Program manager at NASA Headquarters from 2009-2012. "There are practical applications of NASA Earth science data, and we d like to accelerate the use of those applications." One of the main obstacles standing in the way of eminently practical data is the fact that the data from different missions are collected, formatted, and stored in different ways. Combining data sets in a way that makes them useful for decision makers has proven to be a difficult task. And while the need for a collaborative platform is widely recognized, very few have successfully made it work. Dave Jones, founder and CEO of StormCenter Communications Inc., which consults with decision makers to prepare for emergencies, says that "when I talk to public authorities, they say, If I had a nickel for every time someone told me they had a common operating platform, I d be rich. But one thing we ve seen over the years is that no one has been able to give end users the ability to ingest NASA data sets and merge them with their own."

  14. Haitian and international responders' and decision-makers' perspectives regarding disability and the response to the 2010 Haiti earthquake

    PubMed Central

    Hunt, Matthew R.; Chung, Ryoa; Durocher, Evelyne; Henrys, Jean Hugues

    2015-01-01

    Background Following disasters, persons with disabilities (PWD) are especially vulnerable to harm, yet they have commonly been excluded from disaster planning, and their needs have been poorly addressed during disaster relief. Following the 2010 Haiti earthquake, thousands of individuals experienced acute injuries. Many more individuals with preexisting disabilities experienced heightened vulnerability related to considerations including safety, access to services, and meeting basic needs. Objective The objective of this research was to better understand the perceptions of responders and decision-makers regarding disability and efforts to address the needs of PWD following the 2010 earthquake. Design We conducted a qualitative study using interpretive description methodology and semistructured interviews with 14 Haitian and 10 international participants who were involved in the earthquake response. Results Participants identified PWD as being among the most vulnerable individuals following the earthquake. Though some forms of disability received considerable attention in aid efforts, the needs of other PWD did not. Several factors were identified as challenges for efforts to address the needs of PWD including lack of coordination and information sharing, the involvement of multiple aid sectors, perceptions that this should be the responsibility of specialized organizations, and the need to prioritize limited resources. Participants also reported shifts in local social views related to disability following the earthquake. Conclusions Addressing the needs of PWD following a disaster is a crucial population health challenge and raises questions related to equity and responsibility for non-governmental organizations, governments, and local communities. PMID:26257047

  15. Development of policies for Natura 2000 sites: a multi-criteria approach to support decision makers.

    PubMed

    Cortina, Carla; Boggia, Antonio

    2014-08-01

    The aim of this study is to present a methodology to support decision makers in the choice of Natura 2000 sites needing an appropriate management plan to ensure a sustainable socio-economic development. In order to promote sustainable development in the Natura 2000 sites compatible with nature preservation, conservation measures or management plans are necessary. The main issue is to decide when only conservation measures can be applied and when the sites need an appropriate management plan. We present a case study for the Italian Region of Umbria. The methodology is based on a multi-criteria approach to identify the biodiversity index (BI), and on the development of a human activities index (HAI). By crossing the two indexes for each site on a Cartesian plane, four groups of sites were identified. Each group corresponds to a specific need for an appropriate management plan. Sites in the first group with a high level both of biodiversity and human activities have the most urgent need of an appropriate management plan to ensure sustainable development. The proposed methodology and analysis is replicable in other regions or countries by using the data available for each site in the Natura 2000 standard data form. A multi-criteria analysis is especially suitable for supporting decision makers when they deal with a multidimensional decision process. We found the multi-criteria approach particularly sound in this case, due to the concept of biodiversity itself, which is complex and multidimensional, and to the high number of alternatives (Natura 2000 sites) to be assessed.

  16. Establishing the connection between crowd-sourced data and decision makers

    NASA Astrophysics Data System (ADS)

    Paxton, L. J.; Swartz, W.; Strong, S. B.; Nix, M. G.; Schaefer, R. K.; Weiss, M.

    2014-12-01

    There are many challenges in using, developing, and ensuring the viability of crowd-sourced data. Establishing and maintaining relevance is one of them but each participant in the challenge has different criteria for relevance. Consider, for example, the collection of data using smart phones. Some participants just like to contribute to something they consider good for the community. How do you engender that commitment? This becomes especially problematic when an additional sensor may need to be added to the smart phone. Certainly the humanitarian-egalitarian may be willing to "buy-in" but what value does it hold for the entrepreneurial-individualist? Another challenge is that of the crowd-sourced data themselves. Most readily available apps collect only one kind of data. The frontier lies in not only aggregating the data from those devices but in fusing the data with other data types (e.g. satellite imagery, installed sensors, radars, etc.). Doing this requires resources and the establishment and negotiation of data rights, how data are valued, how data are used, and the model used for support of the process (e.g. profit-driven, communal, scientific, etc.). In this talk we will discuss a few problems that we have looked at wherein distributed sensor networks provide potential value, data fusion is a "value multiplier" of those crowd-sourced data and how we make that connection to decision makers. We have explored active decision making through our Global Assimilation of Information for Action project (see our old website http://gaia.jhuapl.edu) and the use of "serious games" to establish affinities and illuminate opportunities and issues. We assert that the field of dreams approach ("build it and they will come") is not a sufficiently robust approach; the decision-makers (or paying customers) must be involved in the process of defining the data system products and quantifying the value proposition for their clients.

  17. Knowledge Style Profiling: An Exploration of Cognitive, Temperament, Demographic and Organizational Characteristics among Decision Makers Using Advanced Analytical Technologies

    ERIC Educational Resources Information Center

    Polito, Vincent A., Jr.

    2010-01-01

    The objective of this research was to explore the possibilities of identifying knowledge style factors that could be used as central elements of a professional business analyst's (PBA) performance attributes at work for those decision makers that use advanced analytical technologies on decision making tasks. Indicators of knowledge style were…

  18. Is economic valuation of ecosystem services useful to decision-makers? Lessons learned from Australian coastal and marine management.

    PubMed

    Marre, Jean-Baptiste; Thébaud, Olivier; Pascoe, Sean; Jennings, Sarah; Boncoeur, Jean; Coglan, Louisa

    2016-08-01

    Economic valuation of ecosystem services is widely advocated as being useful to support ecosystem management decision-making. However, the extent to which it is actually used or considered useful in decision-making is poorly documented. This literature blindspot is explored with an application to coastal and marine ecosystems management in Australia. Based on a nation-wide survey of eighty-eight decision-makers representing a diversity of management organizations, the perceived usefulness and level of use of economic valuation of ecosystem services, in support of coastal and marine management, are examined. A large majority of decision-makers are found to be familiar with economic valuation and consider it useful - even necessary - in decision-making, although this varies across groups of decision-makers. However, most decision-makers never or rarely use economic valuation. The perceived level of importance and trust in estimated dollar values differ across ecosystem services, and are especially high for values that relate to commercial activities. A number of factors are also found to influence respondent's use of economic valuation. Such findings concur with conclusions from other studies on the usefulness and use of ESV in environmental management decision-making. They also demonstrate the strength of the survey-based approach developed in this application to examine this issue in a variety of contexts.

  19. Exploring determinants of surrogate decision-maker confidence: an example from the ICU.

    PubMed

    Bolcic-Jankovic, Dragana; Clarridge, Brian R; LeBlanc, Jessica L; Mahmood, Rumel S; Roman, Anthony M; Freeman, Bradley D

    2014-10-01

    This article is an exploratory data analysis of the determinants of confidence in a surrogate decision maker who has been asked to permit an intensive care unit (ICU) patient's participation in genetic research. We pursue the difference between surrogates' and patients' confidence that the surrogate can accurately represent the patient's wishes. The article also explores whether greater confidence leads to greater agreement between patients and surrogates. Our data come from a survey conducted in three hospital ICUs. We interviewed 445 surrogates and 214 patients. The only thing that influences patients' confidence in their surrogate's decision is whether they had prior discussions with him or her; however, there are more influences operating on the surrogate's self-confidence. More confident surrogates are more likely to match their patients' wishes. Patients are more likely to agree to research participation than their surrogates would allow. The surrogates whose response did not match as closely were less trusting of the hospital staff, were less likely to allow patient participation if there were no direct benefits to the patient, had given less thought about the way genetic research is conducted, and were much less likely to have a person in their life who they would trust to make decisions for them if they were incapacitated. PMID:25747298

  20. It takes a giraffe to see the big picture - citizens' view on decision makers in health care rationing.

    PubMed

    Broqvist, Mari; Garpenby, Peter

    2015-03-01

    Previous studies show that citizens usually prefer physicians as decision makers for rationing in health care, while politicians are downgraded. The findings are far from clear-cut due to methodological differences, and as the results are context sensitive they cannot easily be transferred between countries. Drawing on methodological experiences from previous research, this paper aims to identify and describe different ways Swedish citizens understand and experience decision makers for rationing in health care, exclusively on the programme level. We intend to address several challenges that arise when studying citizens' views on rationing by (a) using a method that allows for reflection, (b) using the respondents' nomination of decision makers, and (c) clearly identifying the rationing level. We used phenomenography, a qualitative method for studying variations and changes in perceiving phenomena. Open-ended interviews were conducted with 14 Swedish citizens selected by standard criteria (e.g. age) and by their attitude towards rationing. The main finding was that respondents viewed politicians as more legitimate decision makers in contrast to the results in most other studies. Interestingly, physicians, politicians, and citizens were all associated with some kind of risk related to self-interest in relation to rationing. A collaborative solution for decision making was preferred where the views of different actors were considered important. The fact that politicians were seen as appropriate decision makers could be explained by several factors: the respondents' new insights about necessary trade-offs at the programme level, awareness of the importance of an overview of different health care needs, awareness about self-interest among different categories of decision-makers, including physicians, and the national context of long-term political accountability for health care in Sweden. This study points to the importance of being aware of contextual and

  1. Neural Correlates of Effective Learning in Experienced Medical Decision-Makers

    PubMed Central

    Montague, P. Read

    2011-01-01

    Accurate associative learning is often hindered by confirmation bias and success-chasing, which together can conspire to produce or solidify false beliefs in the decision-maker. We performed functional magnetic resonance imaging in 35 experienced physicians, while they learned to choose between two treatments in a series of virtual patient encounters. We estimated a learning model for each subject based on their observed behavior and this model divided clearly into high performers and low performers. The high performers showed small, but equal learning rates for both successes (positive outcomes) and failures (no response to the drug). In contrast, low performers showed very large and asymmetric learning rates, learning significantly more from successes than failures; a tendency that led to sub-optimal treatment choices. Consistently with these behavioral findings, high performers showed larger, more sustained BOLD responses to failed vs. successful outcomes in the dorsolateral prefrontal cortex and inferior parietal lobule while low performers displayed the opposite response profile. Furthermore, participants' learning asymmetry correlated with anticipatory activation in the nucleus accumbens at trial onset, well before outcome presentation. Subjects with anticipatory activation in the nucleus accumbens showed more success-chasing during learning. These results suggest that high performers' brains achieve better outcomes by attending to informative failures during training, rather than chasing the reward value of successes. The differential brain activations between high and low performers could potentially be developed into biomarkers to identify efficient learners on novel decision tasks, in medical or other contexts. PMID:22132137

  2. Ensuring Adequate Health and Safety Information for Decision Makers during Large-Scale Chemical Releases

    NASA Astrophysics Data System (ADS)

    Petropoulos, Z.; Clavin, C.; Zuckerman, B.

    2015-12-01

    The 2014 4-Methylcyclohexanemethanol (MCHM) spill in the Elk River of West Virginia highlighted existing gaps in emergency planning for, and response to, large-scale chemical releases in the United States. The Emergency Planning and Community Right-to-Know Act requires that facilities with hazardous substances provide Material Safety Data Sheets (MSDSs), which contain health and safety information on the hazardous substances. The MSDS produced by Eastman Chemical Company, the manufacturer of MCHM, listed "no data available" for various human toxicity subcategories, such as reproductive toxicity and carcinogenicity. As a result of incomplete toxicity data, the public and media received conflicting messages on the safety of the contaminated water from government officials, industry, and the public health community. Two days after the governor lifted the ban on water use, the health department partially retracted the ban by warning pregnant women to continue avoiding the contaminated water, which the Centers for Disease Control and Prevention deemed safe three weeks later. The response in West Virginia represents a failure in risk communication and calls to question if government officials have sufficient information to support evidence-based decisions during future incidents. Research capabilities, like the National Science Foundation RAPID funding, can provide a solution to some of the data gaps, such as information on environmental fate in the case of the MCHM spill. In order to inform policy discussions on this issue, a methodology for assessing the outcomes of RAPID and similar National Institutes of Health grants in the context of emergency response is employed to examine the efficacy of research-based capabilities in enhancing public health decision making capacity. The results of this assessment highlight potential roles rapid scientific research can fill in ensuring adequate health and safety data is readily available for decision makers during large

  3. How to Reach Decision Makers: Build a network of educators and practitioners with common goals

    NASA Astrophysics Data System (ADS)

    Boudrias, M. A.; Estrada, M.; Anders, S.; Silva-Send, N. J.; Gershunov, A.

    2013-12-01

    In San Diego County, the Climate Education Partners (CEP) includes climate scientists, science educators, behavioral scientists, environmental practitioners and community organizations that are dedicated to providing local decision makers (elected officials, business leaders, community leaders) with sound climate science learning opportunities and resources that promote informed decision making. Their work over the past three years has found that effective climate education programs are designed for specific audiences with tailored information that is relevant to them, while simultaneously building community efficacy, identity and values. An integrated approach that blends rigorous scientific facts, local climate change impact, and social science education theory is contributing towards the development of a cadre of engaged leaders and communities. To track project progress and to inform the project strategy, local Key Influentials are being interviewed to gauge their current understanding of climate change and their interest in either becoming messengers to their community or becoming the portal to their constituency. Innovation comes from productive collaboration. For this reason, CEP has been working with leading scientists (climatologists, hydrologists, meteorologists, ecologists), environmental groups, museums and zoos, media experts and government agencies (Water Authority, CalFire) to develop and refine a program of learning activities and resources geared specifically for Key Influentials. For example, a water tour has been designed to bring 25 key influential leaders in San Diego County to a dam, a pumping station and a reservoir and provide climate change facts, impacts and potential solutions to the critical issue of water supply for the San Diego Region. While learning local facts about the causes and impacts of climate change, participants also learn about what they can do (increasing efficacy), that they can be a part of a solution centered community

  4. Procuring Stationary Fuel Cells For CHP: A Guide for Federal Facility Decision Makers

    SciTech Connect

    Stinton, David P; McGervey, Joseph; Curran, Scott

    2011-11-01

    Federal agency leaders are expressing growing interest in using innovative fuel cell combined heat and power (CHP) technology at their sites, motivated by both executive branch sustainability targets and a desire to lead by example in the transition to a clean energy economy. Fuel cell CHP can deliver reliable electricity and heat with 70% to 85% efficiency. Implementing this technology can be a high efficiency, clean energy solution for agencies striving to meet ambitious sustainability requirements with limited budgets. Fuel cell CHP systems can use natural gas or renewable fuels, such as biogas. Procuring Stationary Fuel Cells for CHP: A Guide for Federal Facility Decision Makers presents an overview of the process for planning and implementing a fuel cell CHP project in a concise, step-by-step format. This guide is designed to help agency leaders turn their interest in fuel cell technology into successful installations. This guide concentrates on larger (100 kW and greater) fuel cell CHP systems and does not consider other fuel cell applications such as cars, forklifts, backup power supplies or small generators (<100 kW). Because fuel cell technologies are rapidly evolving and have high up front costs, their deployment poses unique challenges. The electrical and thermal output of the CHP system must be integrated with the building s energy systems. Innovative financing mechanisms allow agencies to make a make versus buy decision to maximize savings. This guide outlines methods that federal agencies may use to procure fuel cell CHP systems with little or no capital investment. Each agency and division, however, has its own set of procurement procedures. This guide was written as a starting point, and it defers to the reader s set of rules if differences exist. The fuel cell industry is maturing, and project developers are gaining experience in working with federal agencies. Technology improvements, cost reductions, and experienced project developers are making

  5. New challenges for seismology and decision makers after L'Aquila trial

    NASA Astrophysics Data System (ADS)

    Marzocchi, Warner

    2013-04-01

    On 22 October seven experts who attended a Major Risk Committee meeting were sentenced to six years in prison on charges of manslaughter for underestimating the risk before the devastating 6.3-magnitude earthquake that struck the hillside city of L'Aquila on 6 April 2009, which caused more than 300 deaths. The earthquake followed a sequence of seismic events that started at the beginning of the year, with the largest shock - a 4.2-magnitude earthquake - occurring on 30 March. A day later, the seven experts met in L'Aquila; the minutes of the meeting, which were released after the quake, contained three main conclusions: that earthquakes are not predictable in a deterministic sense; that the L'Aquila region has the highest seismic hazard in Italy; and that the occurrence of a large earthquake in the short term was unlikely. There is not doubt that this trial will represent an important turning point for seismologists, and more in general for scientists who serve as advisors for public safety purposes. Here, starting from the analysis of the accusations made by the prosecutor and a detailed scientific appraisal of what happened, we try to figure out how seismology can evolve in order to be more effective in protecting people, and (possibly) avoiding accusations like the ones who characterize the L'Aquila trial. In particular, we discuss (i) the principles of the Operational Earthquake Forecasting that were put forward by an international Commission on Earthquake Forecasting (ICEF) nominated after L'Aquila earthquake, (ii) the ICEF recommendations for Civil Protection, and (iii) the recent developments in this field in Italy. Finally, we also explore the interface between scientists and decision makers, in particular in the framework of making decisions in a low probability environment.

  6. Scenarios use to engage scientists and decision-makers in a changing Arctic

    NASA Astrophysics Data System (ADS)

    Lee, O. A.; Eicken, H.; Payne, J. F.

    2015-12-01

    Scenarios provide a framework to develop more adaptive Arctic policies that allow decision makers to consider the best available science to address complex relationships and key uncertainties in drivers of change. These drivers may encompass biophysical factors such as climate change, socioeconomic drivers, and wild-cards that represent low likelihood but influential events such as major environmental disasters. We outline some of the lessons learned from the North Slope Science Initiative (NSSI) scenarios project that could help in the development of adaptive science-based policies. Three spatially explicit development scenarios were identified corresponding to low, medium and high resource extraction activities on the North Slope and adjacent seas. In the case of the high energy development scenario science needs were focused on new technology, oil spill response, and the effects of offshore activities on marine mammals important for subsistence. Science needs related to community culture, erosion, permafrost degradation and hunting and trapping on land were also identified for all three scenarios. The NSSI science needs will guide recommendations for future observing efforts, and data from these observing activities could subsequently improve policy guidance for emergency response, subsistence management and other issues. Scenarios at pan-Arctic scales may help improve the development of international policies for resilient northern communities and encourage the use of science to reduce uncertainties in plans for adapting to change in the Arctic.

  7. Knowledge gaps regarding APN roles: what hospital decision-makers tell us.

    PubMed

    Carter, Nancy; Dobbins, Maureen; Ireland, Sandra; Hoxby, Heather; Peachey, Gladys; DiCenso, Alba

    2013-12-01

    The implementation of advanced practice nursing (APN) roles can yield improvements in patient and health system outcomes, and supportive leadership is integral in facilitating the implementation of such roles. The purpose of this study was to explore the awareness and understanding of APN roles among hospital decision-makers, and to learn about the information they require and the ways in which they prefer to receive that information. Fifteen administrators and leaders from two multi-site acute care organizations were interviewed. Their practical knowledge of APN roles was based on experience developing the roles or working with APNs in hospital programs. The most common sources of APN information were internal contacts (i.e., APNs) and documents from nursing organizations. Participants reported difficulty distinguishing between the roles of nurse practitioners (NPs) and clinical nurse specialists (CNSs), and identified knowledge regarding CNS roles as their greatest need. They required specific information regarding the "value-added" benefits offered by an APN role. Strategies to address the knowledge gaps of healthcare leaders are urgently needed in order to support the implementation of new APN roles and to sustain existing ones.

  8. The Current Mind-Set of Federal Information Security Decision-Makers on the Value of Governance: An Informative Study

    ERIC Educational Resources Information Center

    Stroup, Jay Walter

    2014-01-01

    Understanding the mind-set or perceptions of organizational leaders and decision-makers is important to ascertaining the trends and priorities in policy and governance of the organization. This study finds that a significant shift in the mind-set of government IT and information security leaders has started and will likely result in placing a…

  9. Perspectives of Women Decision-Makers Over the Participation and Recreational Events in Sports: A Turkish Perspective

    ERIC Educational Resources Information Center

    Guzel, Pinar

    2015-01-01

    The purpose of this research is to put forth the role of the leisure and recreation events awareness including women decision-makers effects on their fellow women. Three main themes were recognized: Past; "Process of leisure and recreation events of women in Turkey", Present; "Model of Turkey for women on leisure and…

  10. Women and Secondary School Principal Rotation/Succession: A Study of the Beliefs of Decision Makers in Four Provinces

    ERIC Educational Resources Information Center

    Reynolds, Cecilia; White, Robert; Brayman, Carol; Moore, Shawn

    2008-01-01

    Our study investigated patterns of female participation as secondary principals that have varied across contexts and changed slowly. Researchers interviewed decision makers from a purposive sample of 10 urban and rural school districts in Ontario, Nova Scotia, Saskatchewan, and British Columbia, gathering data from structured telephone interviews,…

  11. Evaluation of an Interactive Workshop Designed to Teach Practical Welfare Techniques to Beef Cattle Caretakers and Decision Makers

    ERIC Educational Resources Information Center

    Dewell, Reneé; Hanthorn, Christy; Danielson, Jared; Burzette, Rebecca; Coetzee, Johann; Griffin, D. Dee; Ramirez, Alejandro; Dewell, Grant

    2015-01-01

    The purpose of the project was to evaluate the use of an interactive workshop designed to teach novel practical welfare techniques to beef cattle caretakers and decision makers. Following training, respondents reported being more likely to use or recommend use of local anesthesia for dehorning and castration and were more inclined to use meloxicam…

  12. Adaptive Peircean decision aid project summary assessments.

    SciTech Connect

    Senglaub, Michael E.

    2007-01-01

    This efforts objective was to identify and hybridize a suite of technologies enabling the development of predictive decision aids for use principally in combat environments but also in any complex information terrain. The technologies required included formal concept analysis for knowledge representation and information operations, Peircean reasoning to support hypothesis generation, Mill's's canons to begin defining information operators that support the first two technologies and co-evolutionary game theory to provide the environment/domain to assess predictions from the reasoning engines. The intended application domain is the IED problem because of its inherent evolutionary nature. While a fully functioning integrated algorithm was not achieved the hybridization and demonstration of the technologies was accomplished and demonstration of utility provided for a number of ancillary queries.

  13. Sexually Transmitted Diseases and Young Adults. and Update on AIDS for Teachers and Policy Makers.

    ERIC Educational Resources Information Center

    Yarber, William L.; Newschwander, Gregg E.

    1987-01-01

    Consists of two articles on the topics of (1) sexually transmitted diseases and (2) acquired immune deficiency syndrome (AIDS). Yarber discusses how these topics should be taught to young people, with emphasis on health education as opposed to morality. Newschwander states the facts related to AIDS, including risks of enrolling infected students.…

  14. Different approaches for centralized and decentralized water system management in multiple decision makers' problems

    NASA Astrophysics Data System (ADS)

    Anghileri, D.; Giuliani, M.; Castelletti, A.

    2012-04-01

    There is a general agreement that one of the most challenging issues related to water system management is the presence of many and often conflicting interests as well as the presence of several and independent decision makers. The traditional approach to multi-objective water systems management is a centralized management, in which an ideal central regulator coordinates the operation of the whole system, exploiting all the available information and balancing all the operating objectives. Although this approach allows to obtain Pareto-optimal solutions representing the maximum achievable benefit, it is based on assumptions which strongly limits its application in real world contexts: 1) top-down management, 2) existence of a central regulation institution, 3) complete information exchange within the system, 4) perfect economic efficiency. A bottom-up decentralized approach seems therefore to be more suitable for real case applications since different reservoir operators may maintain their independence. In this work we tested the consequences of a change in the water management approach moving from a centralized toward a decentralized one. In particular we compared three different cases: the centralized management approach, the independent management approach where each reservoir operator takes the daily release decision maximizing (or minimizing) his operating objective independently from each other, and an intermediate approach, leading to the Nash equilibrium of the associated game, where different reservoir operators try to model the behaviours of the other operators. The three approaches are demonstrated using a test case-study composed of two reservoirs regulated for the minimization of flooding in different locations. The operating policies are computed by solving one single multi-objective optimal control problem, in the centralized management approach; multiple single-objective optimization problems, i.e. one for each operator, in the independent case

  15. Strategies for Teaching Regional Climate Modeling: Online Professional Development for Scientists and Decision Makers

    NASA Astrophysics Data System (ADS)

    Walton, P.; Yarker, M. B.; Mesquita, M. D. S.; Otto, F. E. L.

    2014-12-01

    structures of both courses, evaluating the advantages and disadvantages of each, along with the educational approaches used. We conclude by proposing a framework for the develop of educationally robust online professional development programs that actively supports decision makers in understanding, developing and applying regional climate models.

  16. Transferring Knowledge from Observations and Models to Decision Makers: An Overview and Challenges

    NASA Technical Reports Server (NTRS)

    Habib, Shahid; Nokra, Nada Abu

    2003-01-01

    Over the last 25 years, a tremendous progress has been made in the Earth science space-based remote sensing observations, technologies and algorithms. Such advancements have improved the predictability by providing lead-time and accuracy of forecast in weather, climate, natural hazards, and natural resources. It has further reduced or bounded the overall uncertainties by partially improving our understanding of planet Earth as an integrated system that is governed by non-linear and chaotic behavior. Many countries such US, European Community, Japan, China and others have invested billions of dollars in developing and launching space-based assets in the low earth (LEO) and geostationary (GEO) orbits. However, the wealth of this scientific knowledge that has potential of extracting monumental socio-economic benefits from such large investments have been slow in reaching to public and decision makers. For instance, there are a number of areas such as energy forecasting, aviation safety, agricultural competitiveness, disaster management, security, air quality and public health can directly take advantage. Nevertheless, we all live in a global economy that depends on access to the best available Earth Science information for all inhabitants of this planet. This paper surveys and examines a number such applications in terms of their architecture, maturity and economic applicability as they apply to the societal needs. A detailed analysis is also presented of various challenges and issues that pertain to a number of areas such as: (1) difficulties in making a speedy transition of data and information from observations and models to relevant Decision Support Systems (DSS) or tools, (2) data and models inter-operability issues, (3) limitations of spatial, spectral and temporal resolution, (4) communication limitations as dictated by the availability of image processing and data compression techniques. Additionally, the most critical element amongst all is the organizational

  17. Voices of decision makers on evidence-based policy: A case of evolving TB/HIV co-infection policy in India.

    PubMed

    Reddy, K Srikanth; Sahay, Seema

    2016-01-01

    This study explores decision makers' perspectives on evidence-based policy (EBP) development using the case of TB/HIV co-infection in India. Twelve in-depth interviews were conducted with purposively selected key national and international policy decision makers in India. Verbatim transcripts were processed and analysed thematically using QSR (NUD*IST 6). The decision makers were unequivocal in recognizing the TB/HIV co-infection as an important public health issue in India and stated the problem to be different than Africa. The need of having a "third programme" for co-infection was not felt. According to them, the public health management of this co-infection must be within the realm of these two programmes. The study also emphasized on decision makers' perspectives on evidence and the process of utilization of evidence for decision-making for co-infection. Study findings showed global evidence was not always accepted by the decision makers and study shows several examples of decision makers demanding local evidence for policy decisions. Decision makers did make interim policies based on global evidence but most of the time their mandate was to get local evidence. Thus, operations research/implementation science especially multi-centric studies emerge as important strategy for EBP development. Researcher-policy maker interface was a gap where role of researcher as aggressive communicator of research findings was expected.

  18. Domain specific software design for decision aiding

    NASA Technical Reports Server (NTRS)

    Keller, Kirby; Stanley, Kevin

    1992-01-01

    McDonnell Aircraft Company (MCAIR) is involved in many large multi-discipline design and development efforts of tactical aircraft. These involve a number of design disciplines that must be coordinated to produce an integrated design and a successful product. Our interpretation of a domain specific software design (DSSD) is that of a representation or framework that is specialized to support a limited problem domain. A DSSD is an abstract software design that is shaped by the problem characteristics. This parallels the theme of object-oriented analysis and design of letting the problem model directly drive the design. The DSSD concept extends the notion of software reusability to include representations or frameworks. It supports the entire software life cycle and specifically leads to improved prototyping capability, supports system integration, and promotes reuse of software designs and supporting frameworks. The example presented in this paper is the task network architecture or design which was developed for the MCAIR Pilot's Associate program. The task network concept supported both module development and system integration within the domain of operator decision aiding. It is presented as an instance where a software design exhibited many of the attributes associated with DSSD concept.

  19. Who to Blame: Irrational Decision-Makers or Stupid Modelers? (Arne Richter Award for Outstanding Young Scientists Lecture)

    NASA Astrophysics Data System (ADS)

    Madani, Kaveh

    2016-04-01

    Water management benefits from a suite of modelling tools and techniques that help simplifying and understanding the complexities involved in managing water resource systems. Early water management models were mainly concerned with optimizing a single objective, related to the design, operations or management of water resource systems (e.g. economic cost, hydroelectricity production, reliability of water deliveries). Significant improvements in methodologies, computational capacity, and data availability over the last decades have resulted in developing more complex water management models that can now incorporate multiple objectives, various uncertainties, and big data. These models provide an improved understanding of complex water resource systems and provide opportunities for making positive impacts. Nevertheless, there remains an alarming mismatch between the optimal solutions developed by these models and the decisions made by managers and stakeholders of water resource systems. Modelers continue to consider decision makers as irrational agents who fail to implement the optimal solutions developed by sophisticated and mathematically rigours water management models. On the other hand, decision makers and stakeholders accuse modelers of being idealist, lacking a perfect understanding of reality, and developing 'smart' solutions that are not practical (stable). In this talk I will have a closer look at the mismatch between the optimality and stability of solutions and argue that conventional water resources management models suffer inherently from a full-cooperation assumption. According to this assumption, water resources management decisions are based on group rationality where in practice decisions are often based on individual rationality, making the group's optimal solution unstable for individually rational decision makers. I discuss how game theory can be used as an appropriate framework for addressing the irrational "rationality assumption" of water

  20. Alaska Center for Climate Assessment and Policy: Partnering with Decision-Makers in Climate Change Adaptation

    NASA Astrophysics Data System (ADS)

    White, D.; Trainor, S.; Walsh, J.; Gerlach, C.

    2008-12-01

    The Alaska Center for Climate Assessment and Policy (ACCAP; www.uaf.edu/accap) is one of several, NOAA funded, Regional Integrated Science and Policy (RISA) programs nation-wide (http://www.climate.noaa.gov/cpo_pa/risa/). Our mission is to assess the socio-economic and biophysical impacts of climate variability in Alaska, make this information available to local and regional decision-makers, and improve the ability of Alaskans to adapt to a changing climate. We partner with the University of Alaska?s Scenario Network for Alaska Planning (SNAP; http://www.snap.uaf.edu/), state and local government, state and federal agencies, industry, and non-profit organizations to communicate accurate and up-to-date climate science and assist in formulating adaptation and mitigation plans. ACCAP and SNAP scientists are members of the Governor?s Climate Change Sub-Cabinet Adaptation and Mitigation Advisory and Technical Working Groups (http://www.climatechange.alaska.gov/), and apply their scientific expertise to provide down-scaled, state-wide maps of temperature and precipitation projections for these groups. An ACCAP scientist also serves as co-chair for the Fairbanks North Star Borough Climate Change Task Force, assisting this group as they work through the five-step model for climate change planning put forward by the International Council for Local Environmental Initiatives (http://www.investfairbanks.com/Taskforces/climate.php). ACCAP scientists work closely with federal resource managers in on a range of projects including: partnering with the U.S. Fish and Wildlife Service to analyze hydrologic changes associated with climate change and related ecological impacts and wildlife management and development issues on Alaska?s North Slope; partnering with members of the Alaska Interagency Wildland Fire Coordinating Group in statistical modeling to predict seasonal wildfire activity and coordinate fire suppression resources state-wide; and working with Alaska Native Elders and

  1. Decision aid for cigarette smokers scheduled for elective surgery

    PubMed Central

    Warner, David O.; LeBlanc, Annie; Kadimpati, Sandeep; Vickers, Kristin S.; Shi, Yu; Montori, Victor M.

    2015-01-01

    Background Decision aids can increase patient involvement in decision-making about health care. The study goal was to develop and test a decision aid for use by clinicians in discussion options for changing smoking behavior before and after elective surgery. Methods In formative work, a decision aid was designed to facilitate patient-clinician discussion regarding three options: continue smoking, attempt a period of temporary abstinence, and attempt to quit smoking for good. A randomized, two-group pilot study was then conducted in smokers evaluated in preparation for elective surgery in a preoperative clinic to test the hypothesis that the decision aid would improve measures of decisional quality compared with usual care. Results The final decision aid consisted of three laminated cards. The front of each card included a colorful graphic describing each choice; the reverse including 2–3 pros and cons for each decision, a simple graphic illustrating the effects of smoking on the body, and a motivational phrase. In the randomized trial of 130 patients, the decision aid significantly (p<0.05) improved measures of decisional quality and patient involvement in decision making (Cohen’s d effect sizes of 0.76 and 1.20 for the Decisional Conflict and OPTION scales, respectively). However, the decision aid did not affect any aspect of perioperative smoking behavior, including the distribution of or adherence to choices. Conclusions Although use of a decision aid to facilitate clinician-patient discussions regarding tobacco use around the time of surgery substantially improved measures of decisional quality, it alone did not change perioperative tobacco use behavior. PMID:25978327

  2. The CAULDRON game: Helping decision makers understand extreme weather event attribution

    NASA Astrophysics Data System (ADS)

    Walton, P.; Otto, F. E. L.

    2014-12-01

    There is a recognition from academics and stakeholders that climate science has a fundamental role to play in the decision making process, but too frequently there is still uncertainty about what, when, how and why to use it. Stakeholders suggest that it is because the science is presented in an inaccessible manner, while academics suggest it is because the stakeholders do not have the scientific knowledge to understand and apply the science appropriately. What is apparent is that stakeholders need support, and that there is an onus on academia to provide it. This support is even more important with recent developments in climate science, such as extreme weather event attribution. We are already seeing the impacts of extreme weather events around the world causing lost of life and damage to property and infrastructure with current research suggesting that these events could become more frequent and more intense. If this is to be the case then a better understanding of the science will be vital in developing robust adaptation and business planning. The use of games, role playing and simulations to aid learning has long been understood in education but less so as a tool to support stakeholder understanding of climate science. Providing a 'safe' space where participants can actively engage with concepts, ideas and often emotions, can lead to deep understanding that is not possible through more passive mechanisms such as papers and web sites. This paper reports on a game that was developed through a collaboration led by the Red Cross/Red Crescent, University of Oxford and University of Reading to help stakeholders understand the role of weather event attribution in the decision making process. The game has already been played successfully at a number of high profile events including COP 19 and the African Climate Conference. It has also been used with students as part of a postgraduate environmental management course. As well as describing the design principles of the

  3. E-mail as the Appropriate Method of Communication for the Decision-Maker When Soliciting Advice for an Intellective Decision Task.

    PubMed

    Prahl, Andrew; Dexter, Franklin; Swol, Lyn Van; Braun, Michael T; Epstein, Richard H

    2015-09-01

    For many problems in operating room and anesthesia group management, there are tasks with optimal decisions, and yet experienced personnel tend to make decisions that are worse or no better than random chance. Such decisions include staff scheduling, case scheduling, moving cases among operating rooms, and choosing patient arrival times. In such settings, operating room management leadership decision-making should typically be autocratic rather than participative. Autocratic-style decision-making calls for managers to solicit and consider feedback from stakeholders in the decision outcome but to make the decision themselves using their expert knowledge and the facts received. For this to be effective, often the manager will obtain expert advice from outside the organization (e.g., health system). In this narrative review, we evaluate the advantages and disadvantages of using prompt asynchronous written communication (i.e., e-mail) as a communication channel for such interaction between a decision-maker (manager) and advisor. A detailed Appendix (Supplemental Digital Content, http://links.lww.com/AA/B72) lists each observational and experimental result. We find that the current ubiquitous role of e-mail for such communication is appropriate. Its benefits include improved time management via asynchronicity, low cognitive load (e.g., relative to Web conferencing), the ability to hide undesirable and irrelevant cues (e.g., physical appearance), the appropriateness of adding desirable cues (e.g., titles and degrees), the opportunity to provide written expression of confidence, and the ability for the advisor to demonstrate the answer for the decision-maker. Given that the manager is e-mailing an advisor whose competence the manager trusts, it is unnecessary to use a richer communication channel to develop trust. Finally, many of the limitations of e-mail can be rectified through training. We expect that decades from now, e-mail (i.e., asynchronous writing) between an

  4. Video May Aid End-of-Life Decision-Making

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_159659.html Video May Aid End-of-Life Decision-Making Brief ... THURSDAY, June 30, 2016 (HealthDay News) -- Watching a video about end-of-life care options may help ...

  5. Map-based decision aids for fire support

    NASA Astrophysics Data System (ADS)

    Yarosh, Victor

    1996-06-01

    The Fire Control Division at ARDEC is developing prototype decision aid tools to enable fire support echelons to rapidly respond to requests for fire support. Decision aids on fire support platforms can assist in route planning, site selection, and develop mobility overlays to enable the shooter to rapidly move into position and prepare for the fire mission. The Decision Aid system utilizes an integrated design approach which has each module interacting with the others by sharing data bases and common algorithms to provide recommended courses of action for route planning and generation, position selection, self defense, logistics estimates, situational awareness and fire mission planning aids such as tactical assessment, tactical planning, sustainment, etc. The Decision Aid system will use expert system artificial intelligence which will be developed from knowledge bases utilizing object oriented design. The modules currently reason on Defense Mapping Agency Interim Terrain Data and Digital Terrain Elevation Data and collect mission, intelligence, and sensor data from the digitized battlefield information distribution system to provide the crew or mission planners with intelligent recommendations. The system can provide a trade off analysis of time vs. safety, enable commanders to rapidly respond to fire support request, automatically generate OpOrders, and create overlays which depict mobility corridors, NBC areas, friendly units, overhead concealment, communications, and threat areas. The Decision Aids system can provide a vastly improved mobility, situational awareness, and decision cycle capabilities which can be utilized to increase the tempo of battle.

  6. Disclosing conflicts of interest in patient decision aids

    PubMed Central

    2013-01-01

    Background In 2005, the International Patient Decisions Aid Standards (IPDAS) Collaboration developed quality criteria for patient decisions aids; one of the quality dimensions dealt with disclosure of conflicts of interest (COIs). The purposes of this paper are to review newer evidence on dealing with COI in the development of patient decision aids and to readdress the theoretical justification and definition for this quality dimension. Methods The committee conducted a primary systematic literature review to seek published research addressing the question, "What is the evidence that disclosure of COIs in patient decision aids reduces biased decision making?" A secondary literature review included a systematic search for recent meta-analyses addressing COIs in other spheres of health care, including research and publication, medical education, and clinical care. Results No direct evidence was found addressing this quality dimension in the primary literature review. The secondary review yielded a comprehensive Institute of Medicine report, as well as four relevant meta-analyses addressing disclosure of COIs in health care. They revealed a broad consensus that disclosure of COIs is desirable in such areas as research publication, guideline development, medical education, and clinical care. Conclusions The committee recommends the criteria that are currently used to operationally define the quality dimension “disclosing conflicts of interest” be changed as follows (changes in italics): Does the patient decision aid: • report prominently and in plain language the source of funding to develop or exclusively distribute the patient decision aid? • report prominently and in plain language whether funders, authors, or their affiliations, stand to gain or lose by choices patients make after using the patient decision aid? Furthermore, based on a consensus that simple disclosure is insufficient to protect users from potentially biased information, the committee

  7. Enhancing the Profile of Teachers as Curriculum Decision-Makers: Some International Perspectives.

    ERIC Educational Resources Information Center

    Macpherson, Ian; Brooker, Ross; Aspland, Tania; Elliott, Bob

    This paper presents information from a series of preliminary asynchronous international conversations across four cultural contexts that focus on enhancing the profile of teachers in curriculum decision making. The paper challenges education systems to match the rhetoric about the place of teachers in curriculum decision making with curriculum…

  8. Public engagement in priority-setting: results from a pan-Canadian survey of decision-makers in cancer control.

    PubMed

    Regier, Dean A; Bentley, Colene; Mitton, Craig; Bryan, Stirling; Burgess, Michael M; Chesney, Ellen; Coldman, Andy; Gibson, Jennifer; Hoch, Jeffrey; Rahman, Syed; Sabharwal, Mona; Sawka, Carol; Schuckel, Victoria; Peacock, Stuart J

    2014-12-01

    Decision-makers are challenged to incorporate public input into priority-setting decisions. We conducted a pan-Canadian survey of decision-makers in cancer control to investigate the types of evidence, especially evidence supplied by the public, that are utilized in health care priority-setting. We further examined how normative attitudes and contextual factors influence the use of public engagement as evidence at the committee level. Administered between November and December 2012, 67 respondents from 117 invited individuals participated in the survey. The results indicated that public engagement was infrequently utilized compared to clinical effectiveness evidence or cost evidence. General positive agreement between normative attitudes towards the use of evidence and the frequency of evidence utilization was observed, but absence of correlative agreement was found for the types of evidence that are supplied by the general public and for cost-effectiveness inputs. Regression analyses suggested that public engagement was unevenly utilized between jurisdictions and that educational background and barriers to implementing public input may decrease the odds of using public engagement as evidence. We recommend that institutions establish a link between committee members' normative attitudes for using public engagement and its real-world utilization. PMID:25441325

  9. U.S. DOE’S RESPONSE TO THE FUKUSHIMA DAIICHI REACTOR ACCIDENT: ANSWERS AND DATA PRODUCTS FOR DECISION MAKERS

    SciTech Connect

    Reed, Alexis L.

    2012-01-01

    The Fukushima Daiichi response posed a plethora of scientific questions to the U.S. Department of Energy’s (DOE) radiological emergency response community. As concerns arose for decision makers, the DOE leveraged a community of scientists well-versed in the tenants of emergency situations to provide answers to time-sensitive questions from different parts of the world. A chronology of the scientific Q and A that occurred is presented along with descriptions of the challenges that were faced and how new methods were employed throughout the course of the response.

  10. Practical Aspects of a Visual Aid to Decision Making

    ERIC Educational Resources Information Center

    Fisher, Z.; Bailey, R.; Willner, P.

    2012-01-01

    Background: Previous research has demonstrated that people with mild intellectual disabilities (ID) have difficulty in "weighing up" information, defined as integrating disparate items of information in order to reach a decision. However, this problem could be overcome by the use of a visual aid to decision making. In an earlier study,…

  11. Communication with U.S. federal decision makers : a primer with notes on the use of computer models as a means of communication.

    SciTech Connect

    Webb, Erik Karl; Tidwell, Vincent Carroll

    2009-10-01

    This document outlines ways to more effectively communicate with U.S. Federal decision makers by outlining the structure, authority, and motivations of various Federal groups, how to find the trusted advisors, and how to structure communication. All three branches of Federal governments have decision makers engaged in resolving major policy issues. The Legislative Branch (Congress) negotiates the authority and the resources that can be used by the Executive Branch. The Executive Branch has some latitude in implementation and prioritizing resources. The Judicial Branch resolves disputes. The goal of all decision makers is to choose and implement the option that best fits the needs and wants of the community. However, understanding the risk of technical, political and/or financial infeasibility and possible unintended consequences is extremely difficult. Primarily, decision makers are supported in their deliberations by trusted advisors who engage in the analysis of options as well as the day-to-day tasks associated with multi-party negotiations. In the best case, the trusted advisors use many sources of information to inform the process including the opinion of experts and if possible predictive analysis from which they can evaluate the projected consequences of their decisions. The paper covers the following: (1) Understanding Executive and Legislative decision makers - What can these decision makers do? (2) Finding the target audience - Who are the internal and external trusted advisors? (3) Packaging the message - How do we parse and integrate information, and how do we use computer simulation or models in policy communication?

  12. Women as health care decision-makers: implications for health care coverage in the United States.

    PubMed

    Matoff-Stepp, Sabrina; Applebaum, Bethany; Pooler, Jennifer; Kavanagh, Erin

    2014-11-01

    Women in the United States make approximately 80% of the health care decisions for their families, yet often go without health care coverage themselves. The implementation of the Affordable Care Act provides an historical opportunity for women to gain health care coverage for themselves and their families. The focus of this commentary is on women's leadership roles in the context of health care decision- making and Affordable Care Act education and outreach, and implications for reaching broader health and social goals. PMID:25418222

  13. Judgments of policies designed to elicit local cooperation on LLRW disposal siting: Comparing the public and decision makers

    SciTech Connect

    Bord, R.J.

    1987-01-01

    The study reported here solicited the opinions of the general public of the State of Pennsylvania and of key decision makers in environmental, civic, industry, and health groups, on various policy issues connected with the establishment of low-level radioactive waste disposal sites. Specifically, the focus was on their judgment of options designed to elicit local cooperation and their trust in various officials and agencies. The data indicates that the general public views both compensation and power sharing options as important in promoting local cooperation. However, power sharing options are viewed as more important than incentives. The general public consistently demonstrates a preference for options which put control of the site in the hands of locals. On the other hand, influential decision-makers, with the exception of those representing environmental advocacy organizations, tend to view compensation as more important than local power sharing. Their preferences mirror those programs currently being pursued by federal and state officials. Preferences exhibited by leaders of environmental advocacy organizations parallel those of the general public.

  14. Science communication and vernal pool conservation: a study of local decision maker attitudes in a knowledge-action system.

    PubMed

    McGreavy, Bridie; Webler, Thomas; Calhoun, Aram J K

    2012-03-01

    In this study, we describe local decision maker attitudes towards vernal pools to inform science communication and enhance vernal pool conservation efforts. We conducted interviews with town planning board and conservation commission members (n = 9) from two towns in the State of Maine in the northeastern United States. We then mailed a questionnaire to a stratified random sample of planning board members in August and September 2007 with a response rate of 48.4% (n = 320). The majority of survey respondents favored the protection and conservation of vernal pools in their towns. Decision makers were familiar with the term "vernal pool" and demonstrated positive attitudes to vernal pools in general. General appreciation and willingness to conserve vernal pools predicted support for the 2006 revisions to the Natural Resource Protection Act regulating Significant Vernal Pools. However, 48% of respondents were unaware of this law and neither prior knowledge of the law nor workshop attendance predicted support for the vernal pool law. Further, concerns about private property rights and development restrictions predicted disagreement with the vernal pool law. We conclude that science communication must rely on specific frames of reference, be sensitive to cultural values, and occur in an iterative system to link knowledge and action in support of vernal pool conservation.

  15. A comparison of workplace safety perceptions among financial decision-makers of medium- vs. large-size companies.

    PubMed

    Huang, Yueng-Hsiang; Leamon, Tom B; Courtney, Theodore K; Chen, Peter Y; DeArmond, Sarah

    2011-01-01

    This study, through a random national survey in the U.S., explored how corporate financial decision-makers perceive important workplace safety issues as a function of the size of the company for which they worked (medium- vs. large-size companies). Telephone surveys were conducted with 404 U.S. corporate financial decision-makers: 203 from medium-size companies and 201 from large companies. Results showed that the patterns of responding for participants from medium- and large-size companies were somewhat similar. The top-rated safety priorities in resource allocation reported by participants from both groups were overexertion, repetitive motion, and bodily reaction. They believed that there were direct and indirect costs associated with workplace injuries and for every dollar spent improving workplace safety, more than four dollars would be returned. They perceived the top benefits of an effective safety program to be predominately financial in nature - increased productivity and reduced costs - and the safety modification participants mentioned most often was to have more/better safety-focused training. However, more participants from large- than medium-size companies reported that "falling on the same level" was the major cause of workers' compensation loss, which is in line with industry loss data. Participants from large companies were more likely to see their safety programs as better than those of other companies in their industries, and those of medium-size companies were more likely to mention that there were no improvements needed for their companies.

  16. Confidentiality and treatment decisions of minor clients: a health professional's dilemma & policy makers challenge.

    PubMed

    Jackson, Margot Karen; Burns, Katharina Kovacs; Richter, Magdalena S

    2014-01-01

    Issues relating to confidentiality and consent for physical and mental health treatment with minor clients can pose challenges health care providers. Decisions need to be made regarding these issues despite the absence of clear, direct, or comprehensive policies and legislation. In order to fully understand the scope of this topic, a systemic review of several pieces of legislation and guidelines related to this topic are examined. These include the: Canadian Human Rights Act, Children's Rights: International and National Laws and Practices, Health Information Act, Gillick Competence and Medical Emancipation, Freedom of Information and Protection of Privacy Act, Child, Youth and Family Enhancement Act, Common Law Mature Minor Doctrine, and Alberta Health Services Consent to Treatment/Practice(s) Minor/Mature Minor. In order to assist health professionals with decisions regarding confidentiality and treatment with minor clients a case study and guide for decision-making is also presented.

  17. Decision-maker's guide to wood fuel for small industrial energy users. Final report. [Includes glossary

    SciTech Connect

    Levi, M. P.; O'Grady, M. J.

    1980-02-01

    The technology and economics of various wood energy systems available to the small industrial and commercial energy user are considered. This book is designed to help a plant manager, engineer, or others in a decision-making role to become more familiar with wood fuel systems and make informed decisions about switching to wood as a fuel. The following subjects are discussed: wood combustion, pelletized wood, fuel storage, fuel handling and preparation, combustion equipment, retrofitting fossil-fueled boilers, cogeneration, pollution abatement, and economic considerations of wood fuel use. (MHR)

  18. Factors Influencing the Adoption of Cloud Storage by Information Technology Decision Makers

    ERIC Educational Resources Information Center

    Wheelock, Michael D.

    2013-01-01

    This dissertation uses a survey methodology to determine the factors behind the decision to adopt cloud storage. The dependent variable in the study is the intent to adopt cloud storage. Four independent variables are utilized including need, security, cost-effectiveness and reliability. The survey includes a pilot test, field test and statistical…

  19. Decision Makers Calibrate Behavioral Persistence on the Basis of Time-Interval Experience

    ERIC Educational Resources Information Center

    McGuire, Joseph T.; Kable, Joseph W.

    2012-01-01

    A central question in intertemporal decision making is why people reverse their own past choices. Someone who initially prefers a long-run outcome might fail to maintain that preference for long enough to see the outcome realized. Such behavior is usually understood as reflecting preference instability or self-control failure. However, if a…

  20. Improving Children's Competence as Decision Makers: Contrasting Effects of Collaborative Interaction and Direct Instruction

    ERIC Educational Resources Information Center

    Zhang, Xin; Anderson, Richard C.; Morris, Joshua; Miller, Brian; Nguyen-Jahiel, Kim Thi; Lin, Tzu-Jung; Zhang, Jie; Jadallah, May; Scott, Theresa; Sun, Jingjing; Latawiec, Beata; Ma, Shufeng; Grabow, Kay; Hsu, Judy Yu-Li

    2016-01-01

    This research examined the influence of contrasting instructional approaches on children's decision-making competence. A total of 764 fifth graders, mostly African Americans and Hispanic Americans, from 36 classrooms in eight public schools serving children from low-income families completed a six-week unit on wolf management, using either direct…

  1. Assessing the Benefits of Wetland Restoration: A Rapid Benefit Indicators Approach for Decision Makers

    EPA Science Inventory

    This guide presents the Rapid Benefits Indicators (RBI) Approach, a rapid process for assessing the social benefits of ecosystem restoration. Created for those who conduct, advocate for, or support restoration, the RBI approach consists of five steps: (1) Describe the decision co...

  2. Networking CD-ROMs: The Decision Maker's Guide to Local Area Network Solutions.

    ERIC Educational Resources Information Center

    Elshami, Ahmed M.

    In an era when patrons want access to CD-ROM resources but few libraries can afford to buy multiple copies, CD-ROM local area networks (LANs) are emerging as a cost-effective way to provide shared access. To help librarians make informed decisions, this manual offers information on: (1) the basics of LANs, a "local area network primer"; (2) the…

  3. Decentralized Decision-Making. ERS Information Aid.

    ERIC Educational Resources Information Center

    Powell, Janet F.

    In this paper, the current debate over decentralized decisionmaking is highlighted and facts, figures, and models based on a recent nationwide survey are presented. Decentralization in decisionmaking is defined as the involvement of building-level principals in district-wide decisions. Advantages and disadvantages of decentralization, the nature…

  4. Cost Utility: An Aid to Decision Making.

    ERIC Educational Resources Information Center

    Costa, Crist H.

    A set of procedures were developed which assist in structuring tasks and objectives in a manner to permit rational decision making. The model uses a jury of experts to rank various objectives and program processes in terms of their importance. Values are generated which relate to costs in the form of a utility-cost ratio. The model was tested in a…

  5. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: Methods of a decision-maker-researcher partnership systematic review

    PubMed Central

    2010-01-01

    Background Computerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making. As with any healthcare intervention with claims to improve process of care or patient outcomes, decision support systems should be rigorously evaluated before widespread dissemination into clinical practice. Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake. The objective of this research was to form a partnership of healthcare providers, managers, and researchers to review randomized controlled trials assessing the effects of computerized decision support for six clinical application areas: primary preventive care, therapeutic drug monitoring and dosing, drug prescribing, chronic disease management, diagnostic test ordering and interpretation, and acute care management; and to identify study characteristics that predict benefit. Methods The review was undertaken by the Health Information Research Unit, McMaster University, in partnership with Hamilton Health Sciences, the Hamilton, Niagara, Haldimand, and Brant Local Health Integration Network, and pertinent healthcare service teams. Following agreement on information needs and interests with decision-makers, our earlier systematic review was updated by searching Medline, EMBASE, EBM Review databases, and Inspec, and reviewing reference lists through 6 January 2010. Data extraction items were expanded according to input from decision-makers. Authors of primary studies were contacted to confirm data and to provide additional information. Eligible trials were organized according to clinical area of application. We included randomized controlled trials that evaluated the effect on practitioner performance or patient outcomes of patient care provided with a computerized clinical decision support system compared with patient care without such a system. Results Data will be summarized using descriptive summary

  6. Epithelial decision-makers : in search of the “epimmunome”

    PubMed Central

    Swamy, Mahima; Jamora, Colin; Havran, Wendy; Hayday, Adrian

    2010-01-01

    Frequent microbial and non-microbial challenges to epithelial cells trigger discrete pathways, promoting molecular changes, such as the secretion of specific cytokines and chemokines, and alterations to molecules displayed at the epithelial cell surface. In combination, these molecules impose major decisions on innate and adaptive immune cells. Depending on context, those decisions can be as diverse as those imposed by professional antigen presenting cells, benefitting the host by balancing immune competence with the avoidance of immunopathology. Nonetheless, this potency of epithelial cells is also consistent with the causal contribution of epithelial dysregulation to myriad inflammatory diseases. This pathogenic axis provides an attractive target for tissue-specific clinical manipulation. In this context, a research goal should be to identify all molecules used by epithelial cells to instruct immune cells. We term this the epimmunome. PMID:20644571

  7. European decision-maker perspective with regard to influenza prevention policies.

    PubMed

    Lopalco, P L

    2016-01-01

    Influenza is a public health priority in Europe. The impact of influenza pandemics on public health is very high, but seasonal influenza also constitutes an important burden in terms of hospitalisation and excess deaths. Influenza vaccination is a fundamental pillar of disease prevention. In the absence of a clear decision-making process for vaccination policies, EU institutions have, in recent years, fostered collaboration among Member States. Such collaboration was closer during the 2009 pandemic, which constituted a clear cross-border threat to EU citizens' health. The EU institutions have been supporting national vaccination programmes by providing evidence of the effectiveness and safety of influenza vaccination. Decision 1082/2013 was a major step toward EU collaboration, in that it highlighted the role of pandemic vaccination in the field of preparedness and emergency response, in which concerted action is clearly valuable. PMID:27346941

  8. Comparison of display enhancement with intelligent decision-aiding

    NASA Technical Reports Server (NTRS)

    Kirlik, Alex; Markert, Wendy J.; Kossack, Merrick

    1992-01-01

    Currently, two main approaches exist for improving the human-machine interface component of a system in order to improve overall system performance, display enhancement and intelligent decision aiding. Each of these two approaches has its own set of advantages and disadvantages, as well as introduce its own set of additional performance problems. These characteristics should help identify which types of problem situations and domains are better aided by which type of strategy. The characteristic issues are described of these two decision aiding strategies. Then differences in expert and novice decision making are described in order to help determine whether a particular strategy may be better for a particular type of user. Finally, research is outlined to compare and contrast the two technologies, as well as to examine the interaction effects introduced by the different skill levels and the different methods for training operators.

  9. The female community health volunteer programme in Nepal: decision makers' perceptions of volunteerism, payment and other incentives.

    PubMed

    Glenton, Claire; Scheel, Inger B; Pradhan, Sabina; Lewin, Simon; Hodgins, Stephen; Shrestha, Vijaya

    2010-06-01

    The Female Community Health Volunteer (FCHV) Programme in Nepal has existed since the late 1980s and includes almost 50,000 volunteers. Although volunteer programmes are widely thought to be characterised by high attrition levels, the FCHV Programme loses fewer than 5% of its volunteers annually. The degree to which decision makers understand community health worker motivations and match these with appropriate incentives is likely to influence programme sustainability. The purpose of this study was to explore the views of stakeholders who have participated in the design and implementation of the Female Community Health Volunteer regarding Volunteer motivation and appropriate incentives, and to compare these views with the views and expectations of Volunteers. Semi-structured interviews were carried out in 2009 with 19 purposively selected non-Volunteer stakeholders, including policy makers and programme managers. Results were compared with data from previous studies of Female Community Health Volunteers and from interviews with four Volunteers and two Volunteer activists. Stakeholders saw Volunteers as motivated primarily by social respect, religious and moral duty. The freedom to deliver services at their leisure was seen as central to the volunteer concept. While stakeholders also saw the need for extrinsic incentives such as micro-credit, regular wages were regarded not only as financially unfeasible, but as a potential threat to the Volunteers' social respect, and thereby to their motivation. These views were reflected in interviews with and previous studies of Female Community Health Volunteers, and appear to be influenced by a tradition of volunteering as moral behaviour, a lack of respect for paid government workers, and the Programme's community embeddedness. Our study suggests that it may not be useful to promote a generic range of incentives, such as wages, to improve community health worker programme sustainability. Instead, programmes should ensure that

  10. Computers in Medicine: A survey of decision aids for clinicians

    PubMed Central

    Young, D W

    1982-01-01

    Inconsistency in applying medical knowledge is a major reason for varying standards of medical care. Five types of aid have been introduced into medicine to help decision-making: questionnaires, algorithms, database systems, diagnostic systems, and, finally, computer-based decision-support systems. Of these, the most effective act as reminder or prompt systems to assist doctors without threatening their clinical freedom. PMID:6812701

  11. Transportation Energy Futures: Key Opportunities and Tools for Decision Makers (Brochure)

    SciTech Connect

    Not Available

    2012-12-01

    The Transportation Energy Futures (TEF) project examines underexplored greenhouse gas-abatement and oil-savings opportunities by consolidating transportation energy knowledge, conducting advanced analysis, and exploring additional opportunities for sound strategic action. Led by NREL, in collaboration with Argonne National Laboratory, the project's primary goal is to provide analysis to accompany DOE-EERE's long-term transportation energy planning by addressing high-priority questions, informing domestic decisions about transportation energy strategies, priorities, and investments. Research and analysis were conducted with an eye toward short-term actions that support long-term energy goals The project looks beyond technology to examine each key question in the context of the marketplace, consumer behavior, industry capabilities, and infrastructure. This updated fact sheet includes a new section on initial project findings.

  12. Application of a plume model for decision makers' situation awareness during an outdoor airborne HAZMAT release.

    PubMed

    Meris, Ronald G; Barbera, Joseph A

    2014-01-01

    In a large-scale outdoor, airborne, hazardous materials (HAZMAT) incident, such as ruptured chlorine rail cars during a train derailment, the local Incident Commanders and HAZMAT emergency responders must obtain accurate information quickly to assess the situation and act promptly and appropriately. HAZMAT responders must have a clear understanding of key information and how to integrate it into timely and effective decisions for action planning. This study examined the use of HAZMAT plume modeling as a decision support tool during incident action planning in this type of extreme HAZMAT incident. The concept of situation awareness as presented by Endsley's dynamic situation awareness model contains three levels: perception, comprehension, and projection. It was used to examine the actions of incident managers related to adequate data acquisition, current situational understanding, and accurate situation projection. Scientists and engineers have created software to simulate and predict HAZMAT plume behavior, the projected hazard impact areas, and the associated health effects. Incorporating the use of HAZMAT plume projection modeling into an incident action plan may be a complex process. The present analysis used a mixed qualitative and quantitative methodological approach and examined the use and limitations of a "HAZMAT Plume Modeling Cycle" process that can be integrated into the incident action planning cycle. HAZMAT response experts were interviewed using a computer-based simulation. One of the research conclusions indicated the "HAZMAT Plume Modeling Cycle" is a critical function so that an individual/team can be tasked with continually updating the hazard plume model with evolving data, promoting more accurate situation awareness.

  13. Application of a plume model for decision makers' situation awareness during an outdoor airborne HAZMAT release.

    PubMed

    Meris, Ronald G; Barbera, Joseph A

    2014-01-01

    In a large-scale outdoor, airborne, hazardous materials (HAZMAT) incident, such as ruptured chlorine rail cars during a train derailment, the local Incident Commanders and HAZMAT emergency responders must obtain accurate information quickly to assess the situation and act promptly and appropriately. HAZMAT responders must have a clear understanding of key information and how to integrate it into timely and effective decisions for action planning. This study examined the use of HAZMAT plume modeling as a decision support tool during incident action planning in this type of extreme HAZMAT incident. The concept of situation awareness as presented by Endsley's dynamic situation awareness model contains three levels: perception, comprehension, and projection. It was used to examine the actions of incident managers related to adequate data acquisition, current situational understanding, and accurate situation projection. Scientists and engineers have created software to simulate and predict HAZMAT plume behavior, the projected hazard impact areas, and the associated health effects. Incorporating the use of HAZMAT plume projection modeling into an incident action plan may be a complex process. The present analysis used a mixed qualitative and quantitative methodological approach and examined the use and limitations of a "HAZMAT Plume Modeling Cycle" process that can be integrated into the incident action planning cycle. HAZMAT response experts were interviewed using a computer-based simulation. One of the research conclusions indicated the "HAZMAT Plume Modeling Cycle" is a critical function so that an individual/team can be tasked with continually updating the hazard plume model with evolving data, promoting more accurate situation awareness. PMID:25350360

  14. Optimal global value of information trials: better aligning manufacturer and decision maker interests and enabling feasible risk sharing.

    PubMed

    Eckermann, Simon; Willan, Andrew R

    2013-05-01

    Risk sharing arrangements relate to adjusting payments for new health technologies given evidence of their performance over time. Such arrangements rely on prospective information regarding the incremental net benefit of the new technology, and its use in practice. However, once the new technology has been adopted in a particular jurisdiction, randomized clinical trials within that jurisdiction are likely to be infeasible and unethical in the cases where they would be most helpful, i.e. with current evidence of positive while uncertain incremental health and net monetary benefit. Informed patients in these cases would likely be reluctant to participate in a trial, preferring instead to receive the new technology with certainty. Consequently, informing risk sharing arrangements within a jurisdiction is problematic given the infeasibility of collecting prospective trial data. To overcome such problems, we demonstrate that global trials facilitate trialling post adoption, leading to more complete and robust risk sharing arrangements that mitigate the impact of costs of reversal on expected value of information in jurisdictions who adopt while a global trial is undertaken. More generally, optimally designed global trials offer distinct advantages over locally optimal solutions for decision makers and manufacturers alike: avoiding opportunity costs of delay in jurisdictions that adopt; overcoming barriers to evidence collection; and improving levels of expected implementation. Further, the greater strength and translatability of evidence across jurisdictions inherent in optimal global trial design reduces barriers to translation across jurisdictions characteristic of local trials. Consequently, efficiently designed global trials better align the interests of decision makers and manufacturers, increasing the feasibility of risk sharing and the expected strength of evidence over local trials, up until the point that current evidence is globally sufficient.

  15. Optimal global value of information trials: better aligning manufacturer and decision maker interests and enabling feasible risk sharing.

    PubMed

    Eckermann, Simon; Willan, Andrew R

    2013-05-01

    Risk sharing arrangements relate to adjusting payments for new health technologies given evidence of their performance over time. Such arrangements rely on prospective information regarding the incremental net benefit of the new technology, and its use in practice. However, once the new technology has been adopted in a particular jurisdiction, randomized clinical trials within that jurisdiction are likely to be infeasible and unethical in the cases where they would be most helpful, i.e. with current evidence of positive while uncertain incremental health and net monetary benefit. Informed patients in these cases would likely be reluctant to participate in a trial, preferring instead to receive the new technology with certainty. Consequently, informing risk sharing arrangements within a jurisdiction is problematic given the infeasibility of collecting prospective trial data. To overcome such problems, we demonstrate that global trials facilitate trialling post adoption, leading to more complete and robust risk sharing arrangements that mitigate the impact of costs of reversal on expected value of information in jurisdictions who adopt while a global trial is undertaken. More generally, optimally designed global trials offer distinct advantages over locally optimal solutions for decision makers and manufacturers alike: avoiding opportunity costs of delay in jurisdictions that adopt; overcoming barriers to evidence collection; and improving levels of expected implementation. Further, the greater strength and translatability of evidence across jurisdictions inherent in optimal global trial design reduces barriers to translation across jurisdictions characteristic of local trials. Consequently, efficiently designed global trials better align the interests of decision makers and manufacturers, increasing the feasibility of risk sharing and the expected strength of evidence over local trials, up until the point that current evidence is globally sufficient. PMID:23529209

  16. A quantitative method for evaluating alternatives. [aid to decision making

    NASA Technical Reports Server (NTRS)

    Forthofer, M. J.

    1981-01-01

    When faced with choosing between alternatives, people tend to use a number of criteria (often subjective, rather than objective) to decide which is the best alternative for them given their unique situation. The subjectivity inherent in the decision-making process can be reduced by the definition and use of a quantitative method for evaluating alternatives. This type of method can help decision makers achieve degree of uniformity and completeness in the evaluation process, as well as an increased sensitivity to the factors involved. Additional side-effects are better documentation and visibility of the rationale behind the resulting decisions. General guidelines for defining a quantitative method are presented and a particular method (called 'hierarchical weighted average') is defined and applied to the evaluation of design alternatives for a hypothetical computer system capability.

  17. Development and Evaluation of a Lung Cancer Screening Decision Aid.

    PubMed

    Hart, Katelyn; Tofthagen, Cindy; Wang, Hsiao-Lan

    2016-10-01

    Lung cancer is the second most common cancer; however, it often is not diagnosed until the advanced stages. Early-stage lung cancer is curable, but screening tools are not usually implemented in practice because of a lack of provider awareness. A lung cancer screening decision aid may increase screening use and, ultimately, reduce lung cancer deaths.
. PMID:27668377

  18. Objective evaluation of situation awareness for dynamic decision makers in teleoperations

    NASA Technical Reports Server (NTRS)

    Endsley, Mica R.

    1991-01-01

    Situation awareness, a current mental mode of the environment, is critical to the ability of operators to perform complex and dynamic tasks. This should be particularly true for teleoperators, who are separated from the situation they need to be aware of. The design of the man-machine interface must be guided by the goal of maintaining and enhancing situation awareness. The objective of this work has been to build a foundation upon which research in the area can proceed. A model of dynamic human decision making which is inclusive of situation awareness will be presented, along with a definition of situation awareness. A method for measuring situation awareness will also be presented as a tool for evaluating design concepts. The Situation Awareness Global Assessment Technique (SAGAT) is an objective measure of situation awareness originally developed for the fighter cockpit environment. The results of SAGAT validation efforts will be presented. Implications of this research for teleoperators and other operators of dynamic systems will be discussed.

  19. Sharing NASA Science with Decision Makers: A Perspective from NASA's Applied Remote Sensing Training (ARSET) Program

    NASA Astrophysics Data System (ADS)

    Prados, A. I.; Blevins, B.; Hook, E.

    2015-12-01

    NASA ARSET http://arset.gsfc.nasa.gov has been providing applied remote sensing training since 2008. The goals of the program are to develop the technical and analytical skills necessary to utilize NASA resources for decision-support. The program has reached over 3500 participants, with 1600 stakeholders from 100 countries in 2015 alone. The target audience for the program are professionals engaged in environmental management in the public and private sectors, such as air quality forecasters, public utilities, water managers and non-governmental organizations engaged in conservation. Many program participants have little or no expertise in NASA remote sensing, and it's frequently their very first exposure to NASA's vast resources. One the key challenges for the program has been the evolution and refinement of its approach to communicating NASA data access, research, and ultimately its value to stakeholders. We discuss ARSET's best practices for sharing NASA science, which include 1) training ARSET staff and other NASA scientists on methods for science communication, 2) communicating the proper amount of scientific information at a level that is commensurate with the technical skills of program participants, 3) communicating the benefit of NASA resources to stakeholders, and 4) getting to know the audience and tailoring the message so that science information is conveyed within the context of agencies' unique environmental challenges.

  20. The Use of Graphs as Decision Aids in Relation to Information Overload and Managerial Decision Quality.

    ERIC Educational Resources Information Center

    Chan, Siu Y.

    2001-01-01

    Discussion of information overload focuses on a study of masters degree students at a Hong Kong university that investigated the effectiveness of graphs as decision aids to reduce adverse effects of information overload on decision quality. Results of a simulation of a business prediction task with a sample of business managers are presented.…

  1. GAIA - a generalizable, extensible structure for integrating games, models and social networking to support decision makers

    NASA Astrophysics Data System (ADS)

    Paxton, L. J.; Schaefer, R. K.; Nix, M.; Fountain, G. H.; Weiss, M.; Swartz, W. H.; Parker, C. L.; MacDonald, L.; Ihde, A. G.; Simpkins, S.; GAIA Team

    2011-12-01

    In this paper we describe the application of a proven methodology for modeling the complex social and economic interactions embodied in real-world decision making to water scarcity and water resources. We have developed a generalizable, extensible facility we call "GAIA" - Global Assimilation of Information for Action - and applied it to different problem sets. We describe the use of the "Green Country Model" and other gaming/simulation tools to address the impacts of climate and climate disruption issues at the intersection of science, economics, policy, and society. There is a long history in the Defense community of using what are known as strategic simulations or "wargames" to model the complex interactions between the environment, people, resources, infrastructure and the economy in a competitive environment. We describe in this paper, work that we have done on understanding how this heritage can be repurposed to help us explore how the complex interplay between climate disruption and our socio/political and economic structures will affect our future. Our focus here is on a fundamental and growing issue - water and water availability. We consider water and the role of "virtual water" in the system. Various "actors" are included in the simulations. While these simulations cannot definitively predict what will happen, they do illuminate non-linear feedbacks between, for example, treaty agreement, the environment, the economy, and the government. These simulations can be focused on the global, regional, or local environment. We note that these simulations are not "zero sum" games - there need not be a winner and a loser. They are, however, competitive influence games: they represent the tools that a nation, state, faction or group has at its disposal to influence policy (diplomacy), finances, industry (economy), infrastructure, information, etc to achieve their particular goals. As in the real world the problem is competitive - not everyone shares the same

  2. Aiding Lay Decision Making Using a Cognitive Competencies Approach

    PubMed Central

    Maule, A. J.; Maule, Simon

    2016-01-01

    Two prescriptive approaches have evolved to aid human decision making: just in time interventions that provide support as a decision is being made; and just in case interventions that educate people about future events that they may encounter so that they are better prepared to make an informed decision when these events occur. We review research on these two approaches developed in the context of supporting everyday decisions such as choosing an apartment, a financial product or a medical procedure. We argue that the lack of an underlying prescriptive theory has limited the development and evaluation of these interventions. We draw on recent descriptive research on the cognitive competencies that underpin human decision making to suggest new ways of interpreting how and why existing decision aids may be effective and suggest a different way of evaluating their effectiveness. We also briefly outline how our approach has the potential to develop new interventions to support everyday decision making and highlight the benefits of drawing on descriptive research when developing and evaluating interventions. PMID:26779052

  3. The ecological model web concept: A consultative infrastructure for researchers and decision makers using a Service Oriented Architecture

    NASA Astrophysics Data System (ADS)

    Geller, Gary

    2010-05-01

    Rapid climate and socioeconomic changes may be outrunning society's ability to understand, predict, and respond to change effectively. Decision makers such as natural resource managers want better information about what these changes will be and how the resources they are managing will be affected. Researchers want better understanding of the components and processes of ecological systems, how they interact, and how they respond to change. Nearly all these activities require computer models to make ecological forecasts that can address "what if" questions. However, despite many excellent models in ecology and related disciplines, there is no coordinated model system—that is, a model infrastructure--that researchers or decision makers can consult to gain insight on important ecological questions or help them make decisions. While this is partly due to the complexity of the science, to lack of critical observations, and other issues, limited access to and sharing of models and model outputs is a factor as well. An infrastructure that increased access to and sharing of models and model outputs would benefit researchers, decision makers of all kinds, and modelers. One path to such a "consultative infrastructure" for ecological forecasting is called the Model Web, a concept for an open-ended system of interoperable computer models and databases communicating using a Service Oriented Architectures (SOA). Initially, it could consist of a core of several models, perhaps made interoperable retroactively, and then it could grow gradually as new models or databases were added. Because some models provide basic information of use to many other models, such as simple physical parameters, these "keystone" models are of particular importance in a model web. In the long run, a model web would not be rigidly planned and built--instead, like the World Wide Web, it would grow largely organically, with limited central control, within a framework of broad goals and data exchange

  4. How is the New Public Management applied in the occupational health care system? - decision-makers' and OH personnel's views in Finland

    PubMed Central

    2011-01-01

    Background In many countries occupational health care system is in change. Occupational health studies are mainly focused on occupational health substance and content. This study offers new perspectives on municipal OHS and its operations from management perspective. Aim The aim of this study is to analyse how New Public Management (NPM) doctrines are applied in the Finnish occupational health care system (OHS). The main focus is to describe and compare the views of decision-makers' and OH workers within the framework of NPM. Methods The data were collected by semi-structured interviews from 17 municipal decision-makers' and 26 municipal OH workers. Data was analyzed by examining coded data in a theory-driven way according to Hood's doctrine of NPM. Results The doctrines were not as compatible with the OH personnel view as with the decision-makers' view. Decision-makers and OH personnel highlighted the strict criteria required for operation evaluation. Moreover, decision-makers strongly accentuated professional management in the public sector and the reorganization of public sector units. These were not equally relevant in OH personnel views. In OH personnel views, other doctrines (more attention to performance and accomplishments, emphasizing and augmentation of the competition and better control of public expense and means test) were not similarly in evidence, only weak evidence was observed when their importance viewed as medium by decision-makers. Neither of the respondents group kept the doctrine of management models of the private sector relevant. Conclusions The NPM and Hoods doctrine fitted well with OH research. The doctrine brought out view differences and similarities between decision-makers and OH personnel. For example, policymakers highlighted more strongly the structural change by emphasizing professional management compared to OH personnel. The need for reorganization of municipal OH, regardless of different operational preconditions, was obvious

  5. Understanding and Addressing Vulnerability Following the 2010 Haiti Earthquake: Applying a Feminist Lens to Examine Perspectives of Haitian and Expatriate Health Care Providers and Decision-Makers

    PubMed Central

    Chung, Ryoa; Rochon, Christiane; Hunt, Matthew

    2016-01-01

    Vulnerability is a central concept in humanitarian aid. Discussions of vulnerability in disaster response literature and guidelines for humanitarian aid range from considerations of a universal human vulnerability, to more nuanced examinations of how particular characteristics render individuals more or less at risk. Despite its frequent use, there is a lack of clarity about how vulnerability is conceptualized and how it informs operational priorities in humanitarian assistance. Guided by interpretive description methodology, we draw on the feminist taxonomy of vulnerability presented by Mackenzie, Rogers and Dodds (2014) to examine perspectives of 24 expatriate and Haitian decision-makers and health professionals interviewed between May 2012 and March 2013. The analysis explores concepts of vulnerability and equity in relation to the humanitarian response following the 2010 earthquake in Haiti. Participants’ conceptualizations of vulnerability included consideration for inherent vulnerabilities related to individual characteristics (e.g. being a woman or disabled) and situational vulnerabilities related to particular circumstances such as having less access to health care resources or basic necessities. Participants recognized that vulnerabilities could be exacerbated by socio-political structures but felt ill-equipped to address these. The use of the taxonomy and a set of questions inspired by Hurst’s (2008) approach to identifying and reducing vulnerability can guide the analysis of varied sources of vulnerability and open discussions about how and by whom vulnerabilities should be addressed in humanitarian responses. More research is required to inform how humanitarian responders could balance addressing acute vulnerability with consideration of systemic and pre-existing circumstances that underlie much of the vulnerability experienced following an acute disaster. PMID:27617037

  6. Understanding and Addressing Vulnerability Following the 2010 Haiti Earthquake: Applying a Feminist Lens to Examine Perspectives of Haitian and Expatriate Health Care Providers and Decision-Makers

    PubMed Central

    Chung, Ryoa; Rochon, Christiane; Hunt, Matthew

    2016-01-01

    Vulnerability is a central concept in humanitarian aid. Discussions of vulnerability in disaster response literature and guidelines for humanitarian aid range from considerations of a universal human vulnerability, to more nuanced examinations of how particular characteristics render individuals more or less at risk. Despite its frequent use, there is a lack of clarity about how vulnerability is conceptualized and how it informs operational priorities in humanitarian assistance. Guided by interpretive description methodology, we draw on the feminist taxonomy of vulnerability presented by Mackenzie, Rogers and Dodds (2014) to examine perspectives of 24 expatriate and Haitian decision-makers and health professionals interviewed between May 2012 and March 2013. The analysis explores concepts of vulnerability and equity in relation to the humanitarian response following the 2010 earthquake in Haiti. Participants’ conceptualizations of vulnerability included consideration for inherent vulnerabilities related to individual characteristics (e.g. being a woman or disabled) and situational vulnerabilities related to particular circumstances such as having less access to health care resources or basic necessities. Participants recognized that vulnerabilities could be exacerbated by socio-political structures but felt ill-equipped to address these. The use of the taxonomy and a set of questions inspired by Hurst’s (2008) approach to identifying and reducing vulnerability can guide the analysis of varied sources of vulnerability and open discussions about how and by whom vulnerabilities should be addressed in humanitarian responses. More research is required to inform how humanitarian responders could balance addressing acute vulnerability with consideration of systemic and pre-existing circumstances that underlie much of the vulnerability experienced following an acute disaster.

  7. A decision support system for AIDS intervention and prevention.

    PubMed

    Xu, L D

    1994-08-01

    In recent years, the importance of information systems has been identified as a vital issue to continuing success in AIDS intervention and prevention (AIP). The advances in information technology have resulted in integrative information systems including decision support systems (DSS). The concept of DSS for AIP was created at the intersection of two trends. The first trend was a growing belief that AIP information systems are successful in automating operations in AIP programs. The second was a continuing improvement in modeling and software development in the AIP area. This paper presents an integrated DSS for AIP. The system is integrated with a database and achieves its efficiency by incorporating various algorithms and models to support AIP decision processes. The application examples include screening AIDS-risky behaviors, evaluating educational interventions, and scheduling AIP sessions. The implementation results present evidence of the usefulness of the system in AIP.

  8. A decision aid for diagnosis of liver lesions on MRI.

    PubMed Central

    Tombropoulos, R.; Shiffman, S.; Davidson, C.

    1993-01-01

    Abdominal magnetic resonance imaging (MRI) plays an important role in the evaluation of liver abnormalities. The interpretation of MR images requires expert training in a rapidly changing field. DAFODILL (Decision Aid for Diagnosing Liver Lesions) is a decision-support tool designed to aid radiologists in the diagnosis of hepatic lesions seen on MRI. DAFODILL uses a knowledge base of MRI findings and a belief-network inference engine to generate probabilistic differential diagnoses of the most commonly encountered hepatic lesions. DAFODILL performs limited image processing to identify clinically relevant features, which are presented to the user for confirmation before they are used by the network. Preliminary evaluation of an initial version of the system suggests that DAFODILL may be a useful tool for radiology residents and nonexpert radiologists in interpreting MR images of the liver. PMID:8130512

  9. Promoting Shared Decision Making in Disorders of Sex Development (DSD): Decision Aids and Support Tools.

    PubMed

    Siminoff, L A; Sandberg, D E

    2015-05-01

    Specific complaints and grievances from adult patients with disorders of sex development (DSD), and their advocates center around the lack of information or misinformation they were given about their condition and feeling stigmatized and shamed by the secrecy surrounding their condition and its management. Many also attribute poor sexual function to damaging genital surgery and/or repeated, insensitive genital examinations. These reports suggest the need to reconsider the decision-making process for the treatment of children born with DSD. This paper proposes that shared decision making, an important concept in adult health care, be operationalized for the major decisions commonly encountered in DSD care and facilitated through the utilization of decision aids and support tools. This approach may help patients and their families make informed decisions that are better aligned with their personal values and goals. It may also lead to greater confidence in decision making with greater satisfaction and less regret. A brief review of the past and current approach to DSD decision making is provided, along with a review of shared decision making and decision aids and support tools. A case study explores the need and potential utility of this suggested new approach.

  10. Exploring the Ocean Through Climate Indicators: What Do Research, Predictions, and Decision-makers Need to Know?

    NASA Astrophysics Data System (ADS)

    Arrigo, J. S.

    2015-12-01

    There are several new and ongoing efforts around communicating climate and global change and variability by developing Climate Indicators (e.g. the US Global Change Research Project's Pilot Indicators Program, the US EPA's Climate Change Indicators, and the Ocean Observations Panel for Climate State of the Ocean indicators). Indicators provide information tailored to identified stakeholders and facilitate monitoring status, trends, extremes and variability of important climate features or processes. NOAA's Climate Monitoring program is in the middle of a three-year initiative toward supporting research toward the development of Ocean Climate Indicators for research, prediction, and decision makers. These indices combine ocean observations, climate data and products from platforms like (but not limited to) the drifting buoy, Argo, satellite, and buoy arrays that provide fundamental observations that contribute towards climate understanding, predictions, and projections. The program is supporting eight distinct projects that focus on primarily regional indices that target varied stakeholders and outreach strategies - from public awareness and education to targeted model performance improvement. This presentation will discuss the diverse set of projects, initial results, and discuss possibilities for and examples of using the indicators and processes for developing them for broader science outreach and education, with an eye toward the aim of organizing the ocean climate and observing community around developing a comprehensive ocean monitoring and indicators system.

  11. Job-Related Language Training for Limited English Proficient Employees: A Handbook for Program Developers and A Guide for Decision Makers in Business and Industry.

    ERIC Educational Resources Information Center

    Thomas, Robert J.; And Others

    This two-part manual is designed to assist employers who desire to retain, promote, or retrain their limited-English-proficient (LEP) workforce to meet the challenge of training and adaptation to job restructuring. This document contains manuals for both English-as-a-Second-Language (ESL) program developers and business/industry decision makers.…

  12. State Decision-Makers Guide for Hazardous Waste Management: Defining Hazardous Wastes, Problem Recognition, Land Use, Facility Operations, Conceptual Framework, Policy Issues, Transportation.

    ERIC Educational Resources Information Center

    Corson, Alan; And Others

    Presented are key issues to be addressed by state, regional, and local governments and agencies in creating effective hazardous waste management programs. Eight chapters broadly frame the topics which state-level decision makers should consider. These chapters include: (1) definition of hazardous waste; (2) problem definition and recognition; (3)…

  13. Are patient decision aids the best way to improve clinical decision making? Report of the IPDAS Symposium.

    PubMed

    Holmes-Rovner, Margaret; Nelson, Wendy L; Pignone, Michael; Elwyn, Glyn; Rovner, David R; O'Connor, Annette M; Coulter, Angela; Correa-de-Araujo, Rosaly

    2007-01-01

    This article reports on the International Patient Decision Aid Standards Symposium held in 2006 at the annual meeting of the Society for Medical Decision Making in Cambridge, Massachusetts. The symposium featured a debate regarding the proposition that "decision aids are the best way to improve clinical decision making.'' The formal debate addressed the theoretical problem of the appropriate gold standard for an improved decision, efficacy of decision aids, and prospects for implementation. Audience comments and questions focused on both theory and practice: the often unacknowledged roots of decision aids in expected utility theory and the practical problems of limited patient decision aid implementation in health care. The participants' vote on the proposition was approximately half for and half against. PMID:17873257

  14. How can the results of Health Technology Assessment (HTA) evaluations applied to vaccinations be communicated to decision-makers and stakeholders? The ISPOR Rome Chapter Project.

    PubMed

    Gasparini, R; Mennini, F S; Panatto, D; Bonanni, P; Bechini, A; Ricciardi, W; DE Waure, C; Marcellusi, A; Cicchetti, A; Ruggeri, M; Boccalini, S

    2015-01-01

    HTA is considered the most comprehensive and transparent method of supporting decision-makers in their choices in Public Health. HTA on vaccines is being performed by many experts. However, they often present their studies to colleagues, but not to decisionmakers, who should be the main target and current users. It is therefore crucial to improve the transfer of scientific data to decision- makers and all stakeholders. The aims of the present project are: 1) to set up a team of experts to collect economic evaluations and HTA studies on vaccines and assess their actual use in decision-making processes; 2) to constitute regional working groups in order to identify the critical aspects of the communication process and identify the most appropriate method of data transfer. Systematic reviews of economic evaluations and HTA on vaccines and their actual use in decision-making will be used to draw up the basic documents for discussion by the 3 regional working boards. The working groups will discuss the current scientific evidence and communication methods and will try to implement a model of technology assessment with well-defined and objective criteria, in order to better fit pharmaco-economic and HTA methods to the field of vaccinations. Improving the transfer of HTA results to stakeholders, particularly decision-makers, will enable decisions to be taken on the basis of scientific evidence, and appropriate, sustainable actions to be undertaken. PMID:26900329

  15. Assessment of Unconscious Decision Aids Applied to Complex Patient-Centered Medical Decisions

    PubMed Central

    Manigault, Andrew Wilhelm; Whillock, Summer Rain

    2015-01-01

    Background To improve patient health, recent research urges for medical decision aids that are designed to enhance the effectiveness of specific medically related decisions. Many such decisions involve complex information, and decision aids that independently use deliberative (analytical and slower) or intuitive (more affective and automatic) cognitive processes for such decisions result in suboptimal decisions. Unconscious thought can arguably use both intuitive and deliberative (slow and analytic) processes, and this combination may further benefit complex patient (or practitioner) decisions as medical decision aids. Indeed, mounting research demonstrates that individuals render better decisions generally if they are distracted from thinking consciously about complex information after it is presented (but can think unconsciously), relative to thinking about that information consciously or not at all. Objective The current research tested whether the benefits of unconscious thought processes can be replicated using an Internet platform for a patient medical decision involving complex information. This research also explored the possibility that judgments reported after a period of unconscious thought are actually the result of a short period of conscious deliberation occurring during the decision report phase. Methods A total of 173 participants in a Web-based experiment received information about four medical treatments, the best (worst) associated with mostly positive (negative) side-effects/attributes and the others with equal positive-negative ratios. Next, participants were either distracted for 3 minutes (unconscious thought), instructed to think about the information for 3 minutes (conscious thought), or moved directly to the decision task (immediate decision). Finally, participants reported their choice of, and attitudes toward, the treatments while experiencing high, low, or no cognitive load, which varied their ability to think consciously while

  16. Regional Climate Change and Development of Public Health Decision Aids

    NASA Astrophysics Data System (ADS)

    Hegedus, A. M.; Darmenova, K.; Grant, F.; Kiley, H.; Higgins, G. J.; Apling, D.

    2011-12-01

    According to the World Heath Organization (WHO) climate change is a significant and emerging threat to public health, and changes the way we must look at protecting vulnerable populations. Worldwide, the occurrence of some diseases and other threats to human health depend predominantly on local climate patterns. Rising average temperatures, in combination with changing rainfall patterns and humidity levels, alter the lifecycle and regional distribution of certain disease-carrying vectors, such as mosquitoes, ticks and rodents. In addition, higher surface temperatures will bring heat waves and heat stress to urban regions worldwide and will likely increase heat-related health risks. A growing body of scientific evidence also suggests an increase in extreme weather events such as floods, droughts and hurricanes that can be destructive to human health and well-being. Therefore, climate adaptation and health decision aids are urgently needed by city planners and health officials to determine high risk areas, evaluate vulnerable populations and develop public health infrastructure and surveillance systems. To address current deficiencies in local planning and decision making with respect to regional climate change and its effect on human health, our research is focused on performing a dynamical downscaling with the Weather Research and Forecasting (WRF) model to develop decision aids that translate the regional climate data into actionable information for users. WRF model is initialized with the Max Planck Institute European Center/Hamburg Model version 5 (ECHAM5) General Circulation Model simulations forced with the Special Report on Emissions (SRES) A1B emissions scenario. Our methodology involves development of climatological indices of extreme weather, quantifying the risk of occurrence of water/rodent/vector-borne diseases as well as developing various heat stress related decision aids. Our results indicate that the downscale simulations provide the necessary

  17. From drought indicators to impacts: developing improved tools for monitoring and early warning with decision-makers in mind

    NASA Astrophysics Data System (ADS)

    Hannaford, Jamie; Barker, Lucy; Svensson, Cecilia; Tanguy, Maliko; Laize, Cedric; Bachmair, Sophie; Tijdeman, Erik; Stahl, Kerstin; Collins, Kevin

    2016-04-01

    of M&EW and future aspirations. Different stakeholders clearly have different goals for M&EW, but there are a number of common themes, including a desire to better understand the links between the outputs of large-scale M&EW systems (rainfall, river flow, etc), localised triggers used by decision-makers during drought episodes, and actual impacts of drought. Secondly, we present analyses designed to test the utility of a wide range of drought indicators for their use in UK applications. We demonstrate the suitability of standardised indicators (like the SPI) for use in the UK, addressing the suitability of statistical distributions and using these indicators for drought severity quantification and for understanding propagation from meteorological to hydrological drought; all of which are currently poorly understood aspects that are vital for future monitoring. We then address the extent to which these indicators can be used to predict drought impacts, focusing on several sectors (water supply, agriculture and ecosystems). These analyses test which indicators perform best at predicting drought impacts, and seek to identify indicator thresholds that trigger impact occurrence. Unsurprisingly, we found that no single indicator best predicts impacts, and results are domain, sector and season specific. However, we reveal important linkages between indicators and impacts that could enhance the design and delivery of monitoring and forecasting information and its uptake by decision-makers concerned with drought.

  18. Application of expert systems in project management decision aiding

    NASA Technical Reports Server (NTRS)

    Harris, Regina; Shaffer, Steven; Stokes, James; Goldstein, David

    1987-01-01

    The feasibility of developing an expert systems-based project management decision aid to enhance the performance of NASA project managers was assessed. The research effort included extensive literature reviews in the areas of project management, project management decision aiding, expert systems technology, and human-computer interface engineering. Literature reviews were augmented by focused interviews with NASA managers. Time estimation for project scheduling was identified as the target activity for decision augmentation, and a design was developed for an Integrated NASA System for Intelligent Time Estimation (INSITE). The proposed INSITE design was judged feasible with a low level of risk. A partial proof-of-concept experiment was performed and was successful. Specific conclusions drawn from the research and analyses are included. The INSITE concept is potentially applicable in any management sphere, commercial or government, where time estimation is required for project scheduling. As project scheduling is a nearly universal management activity, the range of possibilities is considerable. The INSITE concept also holds potential for enhancing other management tasks, especially in areas such as cost estimation, where estimation-by-analogy is already a proven method.

  19. Bridging the gap between the economic evaluation literature and daily practice in occupational health: a qualitative study among decision-makers in the healthcare sector

    PubMed Central

    2013-01-01

    Background Continued improvements in occupational health can only be ensured if decisions regarding the implementation and continuation of occupational health and safety interventions (OHS interventions) are based on the best available evidence. To ensure that this is the case, scientific evidence should meet the needs of decision-makers. As a first step in bridging the gap between the economic evaluation literature and daily practice in occupational health, this study aimed to provide insight into the occupational health decision-making process and information needs of decision-makers. Methods An exploratory qualitative study was conducted with a purposeful sample of occupational health decision-makers in the Ontario healthcare sector. Eighteen in-depth interviews were conducted to explore the process by which occupational health decisions are made and the importance given to the financial implications of OHS interventions. Twenty-five structured telephone interviews were conducted to explore the sources of information used during the decision-making process, and decision-makers’ knowledge on economic evaluation methods. In-depth interview data were analyzed according to the constant comparative method. For the structured telephone interviews, summary statistics were prepared. Results The occupational health decision-making process generally consists of three stages: initiation stage, establishing the need for an intervention; pre-implementation stage, developing an intervention and its business case in order to receive senior management approval; and implementation and evaluation stage, implementing and evaluating an intervention. During this process, information on the financial implications of OHS interventions was found to be of great importance, especially the employer’s costs and benefits. However, scientific evidence was rarely consulted, sound ex-post program evaluations were hardly ever performed, and there seemed to be a need to advance the economic

  20. Ten Years, Forty Decision Aids, And Thousands Of Patient Uses: Shared Decision Making At Massachusetts General Hospital.

    PubMed

    Sepucha, Karen R; Simmons, Leigh H; Barry, Michael J; Edgman-Levitan, Susan; Licurse, Adam M; Chaguturu, Sreekanth K

    2016-04-01

    Shared decision making is a core component of population health strategies aimed at improving patient engagement. Massachusetts General Hospital's integration of shared decision making into practice has focused on the following three elements: developing a culture receptive to, and health care providers skilled in, shared decision making conversations; using patient decision aids to help inform and engage patients; and providing infrastructure and resources to support the implementation of shared decision making in practice. In the period 2005-15, more than 900 clinicians and other staff members were trained in shared decision making, and more than 28,000 orders for one of about forty patient decision aids were placed to support informed patient-centered decisions. We profile two different implementation initiatives that increased the use of patient decision aids at the hospital's eighteen adult primary care practices, and we summarize key elements of the shared decision making program.

  1. Decision Aids for Airborne Intercept Operations in Advanced Aircrafts

    NASA Technical Reports Server (NTRS)

    Madni, A.; Freedy, A.

    1981-01-01

    A tactical decision aid (TDA) for the F-14 aircrew, i.e., the naval flight officer and pilot, in conducting a multitarget attack during the performance of a Combat Air Patrol (CAP) role is presented. The TDA employs hierarchical multiattribute utility models for characterizing mission objectives in operationally measurable terms, rule based AI-models for tactical posture selection, and fast time simulation for maneuver consequence prediction. The TDA makes aspect maneuver recommendations, selects and displays the optimum mission posture, evaluates attackable and potentially attackable subsets, and recommends the 'best' attackable subset along with the required course perturbation.

  2. FIESTA: An operational decision aid for space network fault isolation

    NASA Technical Reports Server (NTRS)

    Lowe, Dawn; Quillin, Bob; Matteson, Nadine; Wilkinson, Bill; Miksell, Steve

    1987-01-01

    The Fault Tolerance Expert System for Tracking and Data Relay Satellite System (TDRSS) Applications (FIESTA) is a fault detection and fault diagnosis expert system being developed as a decision aid to support operations in the Network Control Center (NCC) for NASA's Space Network. The operational objectives which influenced FIESTA development are presented and an overview of the architecture used to achieve these goals are provided. The approach to the knowledge engineering effort and the methodology employed are also presented and illustrated with examples drawn from the FIESTA domain.

  3. Shared Decision Making and Patient Decision Aids: Knowledge, Attitudes, and Practices Among Hawai‘i Physicians

    PubMed Central

    Friend, John; Chun, Maria BJ

    2013-01-01

    Background: As the health care field moves toward patient-centered care (PCC), increasing emphasis has been placed on the benefits of patient decision aids for promoting shared decision making (SDM). This study provides a baseline measure of knowledge, attitudes, and practices (KAP) among Hawai‘i's physicians with respect to patient decision aids (DAs). Physicians throughout the State of Hawai‘i were invited to complete a survey assessing their knowledge, attitudes, and practices with respect to the clinical use of DAs. One hundred and seventy four valid surveys were analyzed. Reported awareness and use of DAs were low, but recognition of the benefits of SDM and openness to the use of DAs were very high. The leading perceived barriers to the implementation of DAs were lack of awareness, lack of resources, and limited physician time to learn about DA technology. However, a significant majority of the respondents reported that DAs could empower patients by improving knowledge (88%), increasing satisfaction with the consultation process (81%), and increasing compliance (74%). Among physicians currently employing DAs, use of brochures or options matrix sheets was the most common aid tool. However, leading recommended DA formats were paper-based brochures for clinic use (75%) and interactive online website programs for outside clinic use (73.5%). Given growing emphasis on the PCC model and the recognized desire of many patients to participate in the medical decision making process, positive responses toward SDM and the use of DAs by Hawai‘i physicians are promising. PMID:24251086

  4. A systematic review of decision aids for patients making a decision about treatment for early breast cancer.

    PubMed

    Nicholas Zdenkowski; Butow, Phyllis; Tesson, Stephanie; Boyle, Frances

    2016-04-01

    Several complex treatment decisions may be offered to women with early stage breast cancer, about a range of treatments from different modalities including surgery, radiotherapy, and endocrine and chemotherapy. Decision aids can facilitate shared decision-making and improve decision-related outcomes. We aimed to systematically identify, describe and appraise the literature on treatment decision aids for women with early breast cancer, synthesise the data and identify breast cancer decisions that lack a decision aid. A prospectively developed search strategy was applied to MEDLINE, the Cochrane databases, EMBASE, PsycINFO, Web of Science and abstract databases from major conferences. Data were extracted into a pre-piloted form. Quality and risk of bias were measured using Qualsyst criteria. Results were synthesised into narrative format. Thirty-three eligible articles were identified, evaluating 23 individual treatment decision aids, comprising 13 randomised controlled trial reports, seven non-randomised comparative studies, eight single-arm pre-post studies and five cross-sectional studies. The decisions addressed by these decision aids were: breast conserving surgery versus mastectomy (+/- reconstruction); use of chemotherapy and/or endocrine therapy; radiotherapy; and fertility preservation. Outcome measures were heterogeneous, precluding meta-analysis. Decisional conflict decreased, and knowledge and satisfaction increased, without any change in anxiety or depression, in most studies. No studies were identified that evaluated decision aids for neoadjuvant systemic therapy, or contralateral prophylactic mastectomy. Decision aids are available and improved decision-related outcomes for many breast cancer treatment decisions including surgery, radiotherapy, and endocrine and chemotherapy. Decision aids for neoadjuvant systemic therapy and contralateral prophylactic mastectomy could not be found, and may be warranted.

  5. Patient Decision Aids: A Case for Certification at the National Level in the United States.

    PubMed

    Poddar, Urbashi; Brownlee, Shannon; Stacey, Dawn; Volk, Robert J; Williams, John W; Elwyn, Glyn

    2015-01-01

    Patient decision aids enable patients to be better informed about the potential benefits and harms of their healthcare options. Certification of patient decision aids at the national level in the United States is a critical step towards responsible governance-primarily as a quality measure that increases patients' safety, as mandated in the U.S. Patient Protection and Affordable Care Act (PPACA). Certification would provide a verification process to identify conflicts of interest that may otherwise bias the scientific evidence presented in decision aids. Certification also benefits clinicians who may otherwise face malpractice claims based on harm to patients caused by possible reliance on patient decision aids that are inaccurate, incomplete, or presented in a manner that biases the patient's decision. Existing work by the International Patient Decision Aid Standards Collaboration could guide the establishment of a certification process within the U.S. This article argues for national certification of patient decision aids and discusses how that may be achieved.

  6. A Conceptual Design of a Departure Planner Decision Aid

    NASA Technical Reports Server (NTRS)

    Anagnostakis, Ioannis; Idris, Husni R.; Clark, John-Paul; Feron, Eric; Hansman, R. John; Odoni, Amedeo R.; Hall, William D.

    2000-01-01

    Terminal area Air Traffic Management handles both arriving and departing traffic. To date, research work on terminal area operations has focused primarily on the arrival flow and typically departures are taken into account only in an approximate manner. However, arrivals and departures are highly coupled processes especially in the terminal airspace, with complex interactions and sharing of the same airport resources between arrivals and departures taking place in practically every important terminal area. Therefore, the addition of automation aids for departures, possibly in co-operation with existing arrival flow automation systems, could have a profound contribution in enhancing the overall efficiency of airport operations. This paper presents the conceptual system architecture for such an automation aid, the Departure Planner (DP). This architecture can be used as a core in the development of decision-aiding systems to assist air traffic controllers in improving the performance of departure operations and optimize runway time allocation among different operations at major congested airports. The design of such systems is expected to increase the overall efficiency of terminal area operations and yield benefits for all stakeholders involved in Air Traffic Management (ATM) operations, users as well as service providers.

  7. Voice in Political Decision-Making: The Effect of Group Voice on Perceived Trustworthiness of Decision Makers and Subsequent Acceptance of Decisions

    ERIC Educational Resources Information Center

    Terwel, Bart W.; Harinck, Fieke; Ellemers, Naomi; Daamen, Dancker D. L.

    2010-01-01

    The implementation of carbon dioxide capture and storage technology (CCS) is considered an important climate change mitigation strategy, but the viability of this technology will depend on public acceptance of CCS policy decisions. The results of three experiments with students as participants show that whether or not interest groups receive an…

  8. Market assessment for active solar heating and cooling products. Category B: a survey of decision-makers in the HVAC marketplace. Final report

    SciTech Connect

    1980-09-01

    A comprehensive evaluation of the market for solar heating and cooling products for new and retrofit markets is reported. The emphasis is on the analysis of solar knowledge among HVAC decision makers and a comprehensive evaluation of their solar attitudes and behavior. The data from each of the following sectors are described and analyzed: residential consumers, organizational and manufacturing buildings, HVAC engineers and architects, builders/developers, and commercial/institutional segments. (MHR)

  9. The neglected topic: presentation of cost information in patient decision AIDS.

    PubMed

    Blumenthal-Barby, J S; Robinson, Emily; Cantor, Scott B; Naik, Aanand D; Russell, Heidi Voelker; Volk, Robert J

    2015-05-01

    Costs are an important component of patients' decision making, but a comparatively underemphasized aspect of formal shared decision making. We hypothesized that decision aids also avoid discussion of costs, despite their being tools designed to facilitate shared decision making about patient-centered outcomes. We sought to define the frequency of cost-related information and identify the common modes of presenting cost and cost-related information in the 290 decision aids catalogued in the Ottawa Hospital Research Institute's Decision Aid Library Inventory (DALI) system. We found that 56% (n = 161) of the decision aids mentioned cost in some way, but only 13% (n = 37) gave a specific price or range of prices. We identified 9 different ways in which cost was mentioned. The most common approach was as a "pro" of one of the treatment options (e.g., "you avoid the cost of medication"). Of the 37 decision aids that gave specific prices or ranges of prices for treatment options, only 2 were about surgery decisions despite the fact that surgery decision aids were the most common. Our findings suggest that presentation of cost information in decision aids is highly variable. Evidence-based guidelines should be developed by the International Patient Decision Aid Standards (IPDAS) Collaboration. PMID:25583552

  10. The neglected topic: presentation of cost information in patient decision AIDS.

    PubMed

    Blumenthal-Barby, J S; Robinson, Emily; Cantor, Scott B; Naik, Aanand D; Russell, Heidi Voelker; Volk, Robert J

    2015-05-01

    Costs are an important component of patients' decision making, but a comparatively underemphasized aspect of formal shared decision making. We hypothesized that decision aids also avoid discussion of costs, despite their being tools designed to facilitate shared decision making about patient-centered outcomes. We sought to define the frequency of cost-related information and identify the common modes of presenting cost and cost-related information in the 290 decision aids catalogued in the Ottawa Hospital Research Institute's Decision Aid Library Inventory (DALI) system. We found that 56% (n = 161) of the decision aids mentioned cost in some way, but only 13% (n = 37) gave a specific price or range of prices. We identified 9 different ways in which cost was mentioned. The most common approach was as a "pro" of one of the treatment options (e.g., "you avoid the cost of medication"). Of the 37 decision aids that gave specific prices or ranges of prices for treatment options, only 2 were about surgery decisions despite the fact that surgery decision aids were the most common. Our findings suggest that presentation of cost information in decision aids is highly variable. Evidence-based guidelines should be developed by the International Patient Decision Aid Standards (IPDAS) Collaboration.

  11. Integration of environmental and human health risk assessment for industries using hazardous materials: a quantitative multi criteria approach for environmental decision makers.

    PubMed

    Topuz, E; Talinli, I; Aydin, E

    2011-02-01

    Environmental management, for which environmental and human health risk assessment is the first stage, is a requirement for industries both before construction and during operation in order to sustain improved quality of life in the ecosystem. Therefore, the aim of this study is to propose an approach that integrates environmental and human health risk assessment for industries using hazardous materials in order to support environmental decision makers with quantitative and directive results. Analytic hierarchy process and fuzzy logic are used as tools to handle problems caused by complexity of environment and uncertain data. When the proposed approach is implemented to a scenario, it was concluded that it is possible to define risk sources with their risk classes and related membership degrees in that classes which enable the decision maker to decide which risk source has priority. In addition, they can easily point out and rank the factors contributing those risk sources owing to priority weights of them. As a result, environmental decision makers can use this approach while they are developing management alternatives for unfounded and on-going industrial plants using hazardous materials. PMID:21111481

  12. Decision aids for multiple-decision disease management as affected by weather input errors.

    PubMed

    Pfender, W F; Gent, D H; Mahaffee, W F; Coop, L B; Fox, A D

    2011-06-01

    Many disease management decision support systems (DSSs) rely, exclusively or in part, on weather inputs to calculate an indicator for disease hazard. Error in the weather inputs, typically due to forecasting, interpolation, or estimation from off-site sources, may affect model calculations and management decision recommendations. The extent to which errors in weather inputs affect the quality of the final management outcome depends on a number of aspects of the disease management context, including whether management consists of a single dichotomous decision, or of a multi-decision process extending over the cropping season(s). Decision aids for multi-decision disease management typically are based on simple or complex algorithms of weather data which may be accumulated over several days or weeks. It is difficult to quantify accuracy of multi-decision DSSs due to temporally overlapping disease events, existence of more than one solution to optimizing the outcome, opportunities to take later recourse to modify earlier decisions, and the ongoing, complex decision process in which the DSS is only one component. One approach to assessing importance of weather input errors is to conduct an error analysis in which the DSS outcome from high-quality weather data is compared with that from weather data with various levels of bias and/or variance from the original data. We illustrate this analytical approach for two types of DSS, an infection risk index for hop powdery mildew and a simulation model for grass stem rust. Further exploration of analysis methods is needed to address problems associated with assessing uncertainty in multi-decision DSSs.

  13. A systematic development process for patient decision aids

    PubMed Central

    2013-01-01

    Background The original version of the International Patient Decision Aid Standards (IPDAS) recommended that patient decision aids (PtDAs) should be carefully developed, user-tested and open to scrutiny, with a well-documented and systematically applied development process. We carried out a review to check the relevance and scope of this quality dimension and, if necessary, to update it. Methods Our review drew on three sources: a) published papers describing PtDAs evaluated in randomised controlled trials and included in the most recent Cochrane Collaboration review; b) linked papers cited in the trial reports that described how the PtDAs had been developed; and c) papers and web reports outlining the development process used by organisations experienced in developing multiple PtDAs. We then developed an extended model of the development process indicating the various steps on which documentation is required, as well as a checklist to assess the frequency with which each of the elements was publicly reported. Results Key features common to all patient decision aid (PtDA) development processes include: scoping and design; development of a prototype; ‘alpha’ testing with patients and clinicians in an iterative process; ‘beta’ testing in ‘real life’ conditions (field tests); and production of a final version for use and/or further evaluation. Only about half of the published reports on the development of PtDAs that we reviewed appear to have been field tested with patients, and even fewer had been reviewed or tested by clinicians not involved in the development process. Very few described a distribution strategy, and surprisingly few (17%) described a method for reviewing and synthesizing the clinical evidence. We describe a model development process that includes all the original elements of the original IPDAS criterion, expanded to include consideration of format and distribution plans as well as prototype development. Conclusions The case for including

  14. Examining the Educative Aims and Practices of Decision-Makers in Sport for Development and Peace Organizations

    ERIC Educational Resources Information Center

    Svensson, Per G.; Hancock, Meg G.; Hums, Mary A.

    2016-01-01

    Sport for Development and Peace (SDP) policy-makers and practitioners continue to offer ambitious claims regarding the potential role of sport-based programs for promoting social change. Yet, it is important to put sport under a critical lens in order to develop a more balanced and realistic understanding of the role of sport in society. Whether…

  15. The cost-effectiveness of patient decision aids: A systematic review.

    PubMed

    Trenaman, Logan; Bryan, Stirling; Bansback, Nick

    2014-12-01

    The Affordable Care Act includes provisions to encourage patient-centered care through the use of shared decision making (SDM) and patient decision aids (PtDA). PtDAs are tools that can help encourage SDM by providing information about competing treatment options and elucidating patients׳ values and preferences. Implementing PtDAs into routine practice may incur additional costs through training or increases in physician time. Prominent commentaries have proposed that these costs might be offset if patients choose less expensive options than their providers. However, the cost-effectiveness of PtDAs to date is unclear. The aim of this study was to review the economic evidence from PtDA trials. Our search identified 5347 articles, with 29 included following full-text review. Only one economic evaluation of a PtDA has been completed, which found a PtDA to be cost-saving in women with menorrhagia. Other studies included in the review indicated that PtDAs will likely increase up-front costs, but in some contexts may reduce short-term costs by reducing the uptake of invasive treatments, such as elective surgery. Few studies comprehensively captured long-term costs or measured benefits in a manner conducive to economic evaluation (QALYs or general health utilities). Our review suggests that policy makers currently have insufficient economic evidence to appropriately consider their investments in PtDAs.

  16. Computerized Aid Improves Safety Decision Process for Survivors of Intimate Partner Violence

    PubMed Central

    Glass, Nancy; Eden, Karen B.; Bloom, Tina; Perrin, Nancy

    2011-01-01

    A computerized safety decision aid was developed and tested with Spanish or English-speaking abused women in shelters or domestic violence (DV) support groups (n = 90). The decision aid provides feedback about risk for lethal violence, options for safety, assistance with setting priorities for safety, and a safety plan personalized to the user. Women reported that the decision aid was useful and provided much-needed privacy for making safety decisions. The majority (69%) reported severe to extreme danger in their relationship as scored by Danger Assessment (DA); only 60% reported having made a safety plan. After using the safety decision aid, the women felt more supported in their decision (p = .012) and had less total decisional conflict (p = .014). The study demonstrated that a computerized safety decision aid improved the safety planning process, as demonstrated by reduced decisional conflict after only one use in a sample of abused women. PMID:20040709

  17. Computerized aid improves safety decision process for survivors of intimate partner violence.

    PubMed

    Glass, Nancy; Eden, Karen B; Bloom, Tina; Perrin, Nancy

    2010-11-01

    A computerized safety decision aid was developed and tested with Spanish or English-speaking abused women in shelters or domestic violence (DV) support groups (n = 90). The decision aid provides feedback about risk for lethal violence, options for safety, assistance with setting priorities for safety, and a safety plan personalized to the user. Women reported that the decision aid was useful and provided much-needed privacy for making safety decisions. The majority (69%) reported severe to extreme danger in their relationship as scored by Danger Assessment (DA); only 60% reported having made a safety plan. After using the safety decision aid, the women felt more supported in their decision (p = .012) and had less total decisional conflict (p = .014). The study demonstrated that a computerized safety decision aid improved the safety planning process, as demonstrated by reduced decisional conflict after only one use in a sample of abused women.

  18. Computerized clinical decision support systems for primary preventive care: A decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes

    PubMed Central

    2011-01-01

    Background Computerized clinical decision support systems (CCDSSs) are claimed to improve processes and outcomes of primary preventive care (PPC), but their effects, safety, and acceptance must be confirmed. We updated our previous systematic reviews of CCDSSs and integrated a knowledge translation approach in the process. The objective was to review randomized controlled trials (RCTs) assessing the effects of CCDSSs for PPC on process of care, patient outcomes, harms, and costs. Methods We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews Database, Inspec, and other databases, as well as reference lists through January 2010. We contacted authors to confirm data or provide additional information. We included RCTs that assessed the effect of a CCDSS for PPC on process of care and patient outcomes compared to care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement) if at least 50% of the relevant study outcomes were statistically significantly positive. Results We added 17 new RCTs to our 2005 review for a total of 41 studies. RCT quality improved over time. CCDSSs improved process of care in 25 of 40 (63%) RCTs. Cumulative scientifically strong evidence supports the effectiveness of CCDSSs for screening and management of dyslipidaemia in primary care. There is mixed evidence for effectiveness in screening for cancer and mental health conditions, multiple preventive care activities, vaccination, and other preventive care interventions. Fourteen (34%) trials assessed patient outcomes, and four (29%) reported improvements with the CCDSS. Most trials were not powered to evaluate patient-important outcomes. CCDSS costs and adverse events were reported in only six (15%) and two (5%) trials, respectively. Information on study duration was often missing, limiting our ability to assess sustainability of CCDSS effects. Conclusions Evidence supports the

  19. Health Needs of People Living with HIV/AIDS: From the Perspective of Policy Makers, Physicians and Consultants, and People Living with HIV/AIDS

    PubMed Central

    MORADI, Ghobad; MOHRAZ, Minoo; GOUYA, Mohammad Mehdi; DEJMAN, Masoumeh; SEYEDALINAGHI, SeyedAhmad; KHOSHRAVESH, Sahar; MALEKAFZALI ARDAKANI, Hossein

    2014-01-01

    Abstract Background HIV/AIDS has been concentrated among injecting drug users in the country. This study aimed to investigate and identify health and treatment needs of people living with HIV/AIDS in Iran. Methods This qualitative study was conducted in 2012 in Iran. The study groups consisted of experts, practitioners, and consultants working with People Living with HIV/AIDS and their families. Data was collected through Focus Group Discussions and deep interviews. Data were analyzed using content analysis method. Results The findings of this study included the needs of people living with HIV/AIDS, which were classified in three main categories. The first category was prevention and counseling services with several sub-groups such as education and public and available consultation, distribution of condoms to vulnerable groups, increasing counseling centers in urban areas, providing appropriate psychological and supportive counseling, and family planning services. The second category included diagnostic and treatment services and had several sub-groups such as full retroviral treatment, Tuberculosis treatment and continuing care, providing care and treatment for patients with hepatitis, and providing dental services. The third category included rehabilitation services and had some sub-categories such as home care, social and psychological support, nutritional support, and empowering positive clubs. Conclusions This study puts emphasis on making plans based on the priorities to meet the needs of people living with HIV/AIDS in Iran. PMID:26060705

  20. Review of Multi-Criteria Decision Aid for Integrated Sustainability Assessment of Urban Water Systems - MCEARD

    EPA Science Inventory

    Integrated sustainability assessment is part of a new paradigm for urban water decision making. Multi-criteria decision aid (MCDA) is an integrative framework used in urban water sustainability assessment, which has a particular focus on utilising stakeholder participation. Here ...

  1. Supporting Parental Decisions About Genomic Sequencing for Newborn Screening: The NC NEXUS Decision Aid.

    PubMed

    Lewis, Megan A; Paquin, Ryan S; Roche, Myra I; Furberg, Robert D; Rini, Christine; Berg, Jonathan S; Powell, Cynthia M; Bailey, Donald B

    2016-01-01

    Advances in genomic sequencing technology have raised fundamental challenges to the traditional ways genomic information is communicated. These challenges will become increasingly complex and will affect a much larger population in the future if genomics is incorporated into standard newborn screening practice. Clinicians, public health officials, and other stakeholders will need to agree on the types of information that they should seek and communicate to parents. Currently, few evidence-based and validated tools are available to support parental informed decision-making. These tools will be necessary as genomics is integrated into clinical practice and public health systems. In this article we describe how the North Carolina Newborn Exome Sequencing for Universal Screening study is addressing the need to support parents in making informed decisions about the use of genomic testing in newborn screening. We outline the context for newborn screening and justify the need for parental decision support. We also describe the process of decision aid development and the data sources, processes, and best practices being used in development. By the end of the study, we will have an evidenced-based process and validated tools to support parental informed decision-making about the use of genomic sequencing in newborn screening. Data from the study will help answer important questions about which genomic information ought to be sought and communicated when testing newborns. PMID:26729698

  2. Supporting Parental Decisions About Genomic Sequencing for Newborn Screening: The NC NEXUS Decision Aid

    PubMed Central

    Lewis, Megan A.; Paquin, Ryan S.; Roche, Myra I.; Furberg, Robert D.; Rini, Christine; Berg, Jonathan S.; Powell, Cynthia M.; Bailey, Donald B.

    2016-01-01

    Advances in genomic sequencing technology have raised fundamental challenges to the traditional ways genomic information is communicated. These challenges will become increasingly complex and will affect a much larger population in the future if genomics is incorporated into standard newborn screening practice. Clinicians, public health officials, and other stakeholders will need to agree on the types of information that they should seek and communicate to parents. Currently, few evidence-based and validated tools are available to support parental informed decision-making. These tools will be necessary as genomics is integrated into clinical practice and public health systems. In this article we describe how the North Carolina Newborn Exome Sequencing for Universal Screening study is addressing the need to support parents in making informed decisions about the use of genomic testing in newborn screening. We outline the context for newborn screening and justify the need for parental decision support. We also describe the process of decision aid development and the data sources, processes, and best practices being used in development. By the end of the study, we will have an evidenced-based process and validated tools to support parental informed decision-making about the use of genomic sequencing in newborn screening. Data from the study will help answer important questions about which genomic information ought to be sought and communicated when testing newborns. PMID:26729698

  3. MED SUV TASK 6.3 Capacity building and interaction with decision makers: Improving volcanic risk communication through volcanic hazard tools evaluation, Campi Flegrei Caldera case study (Italy)

    NASA Astrophysics Data System (ADS)

    Nave, Rosella; Isaia, Roberto; Sandri, Laura; Cristiani, Chiara

    2016-04-01

    In the communication chain between scientists and decision makers (end users), scientific outputs, as maps, are a fundamental source of information on hazards zoning and the related at risk areas definition. Anyway the relationship between volcanic phenomena, their probability and potential impact can be complex and the geospatial information not easily decoded or understood by not experts even if decision makers. Focusing on volcanic hazard the goal of MED SUV WP6 Task 3 is to improve the communication efficacy of scientific outputs, to contribute in filling the gap between scientists and decision-makers. Campi Flegrei caldera, in Neapolitan area has been chosen as the pilot research area where to apply an evaluation/validation procedure to provide a robust evaluation of the volcanic maps and its validation resulting from end users response. The selected sample involved are decision makers and officials from Campanian Region Civil Protection and municipalities included in Campi Flegrei RED ZONE, the area exposed to risk from to pyroclastic currents hazard. Semi-structured interviews, with a sample of decision makers and civil protection officials have been conducted to acquire both quantitative and qualitative data. The tested maps have been: the official Campi Flegrei Caldera RED ZONE map, three maps produced by overlapping the Red Zone limit on Orthophoto, DTM and Contour map, as well as other maps included a probabilistic one, showing volcanological data used to border the Red Zone. The outcomes' analysis have assessed level of respondents' understanding of content as displayed, and their needs in representing the complex information embedded in volcanic hazard. The final output has been the development of a leaflet as "guidelines" that can support decision makers and officials in understanding volcanic hazard and risk maps, and also in using them as a communication tool in information program for the population at risk. The same evaluation /validation process

  4. Factors affecting stress experienced by surrogate decision-makers for critically ill patients: implications for nursing practice

    PubMed Central

    Iverson, Ellen; Celious, Aaron; Kennedy, Carie R.; Shehane, Erica; Eastman, Alexander; Warren, Victoria; Freeman, Bradley D.

    2013-01-01

    Objectives This study explores surrogate decision-makers’ (SDMs) challenges making decisions related to the care of patients in critical care, to 1) characterize the SDM stress 2) identify personal, social, care-related factors influencing stress and 3) consider implications of findings to improving critical care practice. Methodology Semi-structured interviews were conducted with SDMs of critically ill patients receiving care in two tertiary care institutions. Transcripts were analyzed using a grounded theory approach. Domains explored were: stress characteristics, stress mitigators, coping strategies, social networks, SDM decision-making role, decision-making concordance, knowledge of patient's preferences, experience with provider team, SDM-provider communication, patient outcome certainty. Main Outcomes We interviewed 34 SDMs. Most were female and described long-term relationships with patients. SDMs described the strain of uncertain outcomes and decision-making without clear, consistent information from providers. Decision-making anxiety was buffered by SDMs’ active engagement of social networks, faith and access to clear communication from providers. Conclusion Stress is a very real factor influencing SDMs confidence and comfort making decisions. These findings suggest that stress can be minimized by improving communication between SDMs and medical providers. Nurses central role in ICU make them uniquely poised to spearhead interventions to improve provider-SDM communication and reduce SDM decision-making anxiety. PMID:24211047

  5. Computerized Aid Improves Safety Decision Process for Survivors of Intimate Partner Violence

    ERIC Educational Resources Information Center

    Glass, Nancy; Eden, Karen B.; Bloom, Tina; Perrin, Nancy

    2010-01-01

    A computerized safety decision aid was developed and tested with Spanish or English-speaking abused women in shelters or domestic violence (DV) support groups (n = 90). The decision aid provides feedback about risk for lethal violence, options for safety, assistance with setting priorities for safety, and a safety plan personalized to the user.…

  6. Diverter Decision Aiding for In-Flight Diversions

    NASA Technical Reports Server (NTRS)

    Rudolph, Frederick M.; Homoki, David A.; Sexton, George A.

    1990-01-01

    It was determined that artificial intelligence technology can provide pilots with the help they need in making the complex decisions concerning en route changes in a flight plan. A diverter system should have the capability to take all of the available information and produce a recommendation to the pilot. Phase three illustrated that using Joshua to develop rules for an expert system and a Statice database provided additional flexibility by permitting the development of dynamic weighting of diversion relevant parameters. This increases the fidelity of the AI functions cited as useful in aiding the pilot to perform situational assessment, navigation rerouting, flight planning/replanning, and maneuver execution. Additionally, a prototype pilot-vehicle interface (PVI) was designed providing for the integration of both text and graphical based information. Advanced technologies were applied to PVI design, resulting in a hierarchical menu based architecture to increase the efficiency of information transfer while reducing expected workload. Additional efficiency was gained by integrating spatial and text displays into an integrated user interface.

  7. An Information-Centric Framework for Designing Patient-Centered Medical Decision Aids and Risk Communication

    PubMed Central

    Franklin, Lyndsey; Plaisant, Catherine; Shneiderman, Ben

    2013-01-01

    Risk communication is a major challenge in productive patient-physician communication. Patient decision making responsibilities come with an implicit assumption that patients are sufficiently educated and confident in their abilities to make decisions about their care based on evidence based treatment recommendations. Attempts to improve health literacy in patients by way of graphical decision aids have met with success. Such decision aids typically have been designed for a general population and evaluated based on whether or not users of the decision aid can accurately report the data points in isolation. To classify decision aids, we present an information-centric framework for assessing the content delivered to patients. We provide examples of our framework from a literature survey and suggest ways improvements can be made by considering all dimensions of our framework. PMID:24551350

  8. Value of Information and Prospect theory as tools to involve decision-makers in water-related design, operation and planning of water systems

    NASA Astrophysics Data System (ADS)

    Alfonso, Leonardo

    2013-04-01

    The role of decision-makers is to take the outputs from hydrological and hydraulic analyses and, in some extent, use them as inputs to make decisions that are related to planning, design and operation of water systems. However, the use of these technical analyses is frequently limited, since there are other non-hydrological issues that must be considered, that may end up in very different solutions than those envisaged by the purely technical ones. A possibility to account for the nature of the human decisions under uncertainty is by exploring the use of concepts from decision theory and behavioural economics, such as Value of Information and Prospect Theory and embed them into the methodologies we use in the hydrology practice. Three examples are presented to illustrate these multidisciplinary interactions. The first one, for monitoring network design, uses Value of Information within a methodology to locate water level stations in a complex canal of networks in the Netherlands. The second example, for operation, shows how the Value of Information concept can be used to formulate alternative methods to evaluate flood risk according to the set of options available for decision-making during a flood event. The third example, for planning, uses Prospect Theory concepts to understand how the "losses hurt more than gains feel good" effect can determine the final decision of urbanise or not a flood-prone area. It is demonstrated that decision theory and behavioural economic principles are promising to evaluate the complex decision-making process in water-related issues.

  9. Beyond the Academic Journal: Unfreezing Misconceptions About Mental Illness and Gun Violence Through Knowledge Translation to Decision-Makers.

    PubMed

    Horwitz, Joshua; Grilley, Anna; Kennedy, Orla

    2015-06-01

    In a policy arena characterized by polarized debate, such as the consideration of legal interventions to prevent gun violence, research evidence is an important tool to inform decision-making processes. However, unless the evidence is communicated to stakeholders who can influence policy decisions, the research will often remain an academic exercise with little practical impact. The Educational Fund to Stop Violence's process of "unfreezing" individual perceptions and conventional interpretations of the relationship between mental illness and gun violence, forming a consensus, and translating this knowledge to stakeholders through state discussion forums is one way to inform policy change. The recent passage of gun violence prevention legislation in California provides an example of successfully closing the knowledge translation gap between research and decision-making processes.

  10. Beyond the Academic Journal: Unfreezing Misconceptions About Mental Illness and Gun Violence Through Knowledge Translation to Decision-Makers.

    PubMed

    Horwitz, Joshua; Grilley, Anna; Kennedy, Orla

    2015-06-01

    In a policy arena characterized by polarized debate, such as the consideration of legal interventions to prevent gun violence, research evidence is an important tool to inform decision-making processes. However, unless the evidence is communicated to stakeholders who can influence policy decisions, the research will often remain an academic exercise with little practical impact. The Educational Fund to Stop Violence's process of "unfreezing" individual perceptions and conventional interpretations of the relationship between mental illness and gun violence, forming a consensus, and translating this knowledge to stakeholders through state discussion forums is one way to inform policy change. The recent passage of gun violence prevention legislation in California provides an example of successfully closing the knowledge translation gap between research and decision-making processes. PMID:25827824

  11. The perspectives of iranian physicians and patients towards patient decision aids: a qualitative study

    PubMed Central

    2013-01-01

    Background Patient preference is one of the main components of clinical decision making, therefore leading to the development of patient decision aids. The goal of this study was to describe physicians’ and patients’ viewpoints on the barriers and limitations of using patient decision aids in Iran, their proposed solutions, and, the benefits of using these tools. Methods This qualitative study was conducted in 2011 in Iran by holding in-depth interviews with 14 physicians and 8 arthritis patient. Interviewees were selected through purposeful and maximum variation sampling. As an example, a patient decision aid on the treatment of knee arthritis was developed upon literature reviews and gathering expert opinion, and was presented at the time of interview. Thematic analysis was conducted to analyze the data by using the OpenCode software. Results The results were summarized into three categories and ten codes. The extracted categories were the perceived benefits of using the tools, as well as the patient-related and physician-related barriers in using decision aids. The following barriers in using patient decision aids were identified in this study: lack of patients and physicians’ trainings in shared decision making, lack of specialist per capita, low treatment tariffs and lack of an exact evaluation system for patient participation in decision making. Conclusions No doubt these barriers demand the health authorities’ special attention. Hence, despite patients and physicians’ inclination toward using patient decision aids, these problems have hindered the practical usage of these tools in Iran - as a developing country. PMID:24066792

  12. Development and pilot testing of a decision aid for drivers with dementia

    PubMed Central

    2014-01-01

    Background An increasing number of older adults drive automobiles. Given that the prevalence of dementia is rising, it is necessary to address the issue of driving retirement. The purpose of this study is to evaluate how a self-administered decision aid contributed to decision making about driving retirement by individuals living with dementia. The primary outcome measure in this study was decisional conflict. Knowledge, decision, satisfaction with decision, booklet use and booklet acceptability were the secondary outcome measures. Methods A mixed methods approach was adopted. Drivers with dementia were recruited from an Aged Care clinic and a Primary Care center in NSW, Australia. Telephone surveys were conducted before and after participants read the decision aid. Results Twelve participants were recruited (mean age 75, SD 6.7). The primary outcome measure, decisional conflict, improved following use of the decision aid. Most participants felt that the decision aid: (i) was balanced; (ii) presented information well; and (iii) helped them decide about driving. In addition, mean knowledge scores improved after booklet use. Conclusions This decision aid shows promise as an acceptable, useful and low-cost tool for drivers with dementia. A self-administered decision aid can be used to assist individuals with dementia decide about driving retirement. A randomized controlled trial is underway to evaluate the effectiveness of the tool. PMID:24642051

  13. The Myth of the Rational Decision Maker: A Framework for Applying and Enhancing Heuristic and Intuitive Decision Making by School Leaders

    ERIC Educational Resources Information Center

    Davis, Stephen H.

    2004-01-01

    This article takes a critical look at administrative decision making in schools and the extent to which complex decisions conform to normative models and common expectations of rationality. An alternative framework for administrative decision making is presented that is informed, but not driven, by theories of rationality. The framework assumes…

  14. From whom the bell tolls: the emerging decision-makers for life-support systems in choices of who shall live and who shall die.

    PubMed

    Porzio, R

    1987-12-01

    In summary, how do we assess these decision-makers, with their wide variations in composition, emerging today from medical technology and advances unknown and unforeseen by earlier practitioners? At the threshold, we should not dismiss lightly the traditional role of the doctor as the autocrat. There is much to be said in his or her favor: 1. The basic decision, after all, is a medical one--diagnosis and prognosis--with the concurrence perhaps of a consultant or a specialist. That decision was and is a major premise. Miss it and one misses the mark. 2. What is so novel, what is so startling about a fateful life-death issue in the medical profession? It is quotidian. In the Armageddon between human life and human demise, doctors have been making those solemn decisions in other areas of medicine from time immemorial. Often--not always--the patient is silently saying to the doctor, "My life is in your hands." 3. And within what context does he act? Usually--not always--he knows the patient. He knows the family. He knows the surrounding circumstances. But there still lurks that gnawing, underlying flaw. The decision-making is not diffused. The doctor stands alone. Small "groups" or "committees," retaining medical guidance, share responsibilities, make more palatable to themselves those agonizing decisions, and contribute to their acceptability by society. Here, then, is the harvest to be reaped by diffusion. What is so striking is that the decision-making process anent life-support systems still calls for a superior breed of men and women.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Computer aided decision support system for cervical cancer classification

    NASA Astrophysics Data System (ADS)

    Rahmadwati, Rahmadwati; Naghdy, Golshah; Ros, Montserrat; Todd, Catherine

    2012-10-01

    Conventional analysis of a cervical histology image, such a pap smear or a biopsy sample, is performed by an expert pathologist manually. This involves inspecting the sample for cellular level abnormalities and determining the spread of the abnormalities. Cancer is graded based on the spread of the abnormal cells. This is a tedious, subjective and time-consuming process with considerable variations in diagnosis between the experts. This paper presents a computer aided decision support system (CADSS) tool to help the pathologists in their examination of the cervical cancer biopsies. The main aim of the proposed CADSS system is to identify abnormalities and quantify cancer grading in a systematic and repeatable manner. The paper proposes three different methods which presents and compares the results using 475 images of cervical biopsies which include normal, three stages of pre cancer, and malignant cases. This paper will explore various components of an effective CADSS; image acquisition, pre-processing, segmentation, feature extraction, classification, grading and disease identification. Cervical histological images are captured using a digital microscope. The images are captured in sufficient resolution to retain enough information for effective classification. Histology images of cervical biopsies consist of three major sections; background, stroma and squamous epithelium. Most diagnostic information are contained within the epithelium region. This paper will present two levels of segmentations; global (macro) and local (micro). At the global level the squamous epithelium is separated from the background and stroma. At the local or cellular level, the nuclei and cytoplasm are segmented for further analysis. Image features that influence the pathologists' decision during the analysis and classification of a cervical biopsy are the nuclei's shape and spread; the ratio of the areas of nuclei and cytoplasm as well as the texture and spread of the abnormalities

  16. Getting Decision Makers to the Table: Digestible Facts, a Few Good Friends and Sharing Recipes for Solutions to Climate Change Impacts.

    NASA Astrophysics Data System (ADS)

    Boudrias, M. A.; Estrada, M.; Gershunov, A.; Silva-Send, N. J.; Young, E.

    2014-12-01

    Decision makers and community leaders are key audiences to engage in our efforts to improve climate literacy. Climate Education Partners has been working with business leaders, elected officials, tribal leaders, and other Key Influentials in the San Diego Region to enhance the channels of communication outside traditional settings. Over the past year we have interviewed over 90 Key Influential San Diego leaders asking them about their knowledge of climate change and their personal and professional efforts to adapt to and/or mitigate the impacts of climate change. We also engaged them directly in the creation of an innovative educational resource called "San Diego, 2050 is Calling. How will we answer?" Results of the interviews indicate that 90% of these leaders are concerned about climate change, more than 50% are already doing something about the impacts, and the majority of them want more information, greater dialogue and examples of actions taken by other community leaders. We found that repeated engagement of leaders at the San Diego County Water Authority went from basic collaboration in our water tours, to greater participation of their top leaders in a water tour for top decision makers from the City of San Diego, finally culminating with full support of and participation in the 2050 report. The 2050 report represents an integrated approach blending local climate change science, social science education theory and presentation of a suite of solution-driven opportunities for local leaders. The report includes science infographics that illustrate rigorous scientific facts, statements from expert scientists and direct quotes from decision makers, and examples of successful climate change adaptation actions from companies, government groups and others. The video and photography sessions for the 2050 report led to many unexpected discussion among leaders with differing opinions on climate change, greater enthusiasm to participate in outreach activities with other

  17. Distributed training, testing, and decision aids within one solution

    NASA Astrophysics Data System (ADS)

    Strini, Robert A.; Strini, Keith

    2002-07-01

    Military air operations in the European theater require U.S. and NATO participants to send various mission experts to 10 Combined Air Operations Centers (CAOCs). Little or no training occurs prior to their arrival for tours of duty ranging between 90 days to 3 years. When training does occur, there is little assessment of its effectiveness in raising CAOC mission readiness. A comprehensive training management system has been developed that utilizes traditional and web based distance-learning methods for providing instruction and task practice as well as distributed simulation to provide mission rehearsal training opportunities on demand for the C2 warrior. This system incorporates new technologies, such as voice interaction and virtual tutors, and a Learning Management System (LMS) that tracks trainee progress from academic learning through procedural practice and mission training exercises. Supervisors can monitor their subordinate's progress through synchronous or asynchronous methods. Embedded within this system are virtual tutors, which provide automated performance measurement as well as tutoring. The training system offers a true time management savings for current instructors and training providers that today must perform On the Job Training (OJT) duties before, during and after each event. Many units do not have the resources to support OJT and are forced to maintain an overlap of several days to minimally maintain unit readiness. One CAOC Commander affected by this paradigm has advocated supporting a beta version of this system to test its ability to offer training on-demand and track the progress of its personnel and unit readiness. If successful, aircrew simulation devices can be connected through either Distributed Interactive Simulation or High Level Architecture methods to provide a DMT-C2 air operations training environment in Europe. This paper presents an approach to establishing a training, testing and decision aid capability and means to assess

  18. The Search for Relevant Climate Change Information to Support Adaptation Decision Makers: Lessons from Reductionism, Emergence and the Past (Invited)

    NASA Astrophysics Data System (ADS)

    Stainforth, D.; Harrison, S.; Smith, L. A.

    2009-12-01

    The reality of anthropogenic climate change is founded on well understood scientific principles and is now widely accepted. The need for international efforts to limit the extent of future changes in climate - climate change mitigation - is therefore clear. Since anthropogenic climate change is well underway, however, and the planet is committed to further changes based on past emissions alone, there will certainly be a need for global society to adapt to the consequences. The physical sciences are increasingly being looked to as sources of information and guidance on adaptation policy and decision making. Unlike mitigation efforts such decisions generally require information on local or regional scales. What is the source of such information? How can we tell when it is robust and fit for the purpose of supporting a specific decision? The availability of rapidly increasing computational resources has led to a steady increase in the resolution of global climate models and of embedded regional climate models. They are approaching a point where they can provide data at a resolution which may be usable in adaptation decision support. Yet models are not equivalent to reality and model errors are significant even at the global scale. By contrast scientific understanding of climatic processes now and in the past can provide information about plausible responses which are more qualitative but may be equally useful. This talk will focus on the relative roles of fundamentally reductionist, model approaches with alternatives based on observations and process understanding. The latter, although more qualitative, are able to inform us about emergent properties; properties which may be difficult or impossible to reproduce within a reductionist paradigm. The contrast between emergent and reductionist approaches has a long history in the physical sciences; a history which provides valuable lessons for the relationship between climate science and societal / policy decisions. Here

  19. Ten years of the International Patient Decision Aid Standards Collaboration: evolution of the core dimensions for assessing the quality of patient decision aids.

    PubMed

    Volk, Robert J; Llewellyn-Thomas, Hilary; Stacey, Dawn; Elwyn, Glyn

    2013-01-01

    In 2003, the International Patient Decision Aid Standards (IPDAS) Collaboration was established to enhance the quality and effectiveness of patient decision aids by establishing an evidence-informed framework for improving their content, development, implementation, and evaluation. Over this 10 year period, the Collaboration has established: a) the background document on 12 core dimensions to inform the original modified Delphi process to establish the IPDAS checklist (74 items); b) the valid and reliable IPDAS instrument (47 items); and c) the IPDAS qualifying (6 items), certifying (6 items + 4 items for screening), and quality criteria (28 items). The objective of this paper is to describe the evolution of the IPDAS Collaboration and discuss the standardized process used to update the background documents on the theoretical rationales, evidence and emerging issues underlying the 12 core dimensions for assessing the quality of patient decision aids.

  20. The DEVELOP National Program: Building Dual Capacity in Decision Makers and Young Professionals Through NASA Earth Observations

    NASA Astrophysics Data System (ADS)

    Childs, L. M.; Rogers, L.; Favors, J.; Ruiz, M.

    2012-12-01

    Through the years, NASA has played a distinct/important/vital role in advancing Earth System Science to meet the challenges of environmental management and policy decision making. Within NASA's Earth Science Division's Applied Sciences' Program, the DEVELOP National Program seeks to extend NASA Earth Science for societal benefit. DEVELOP is a capacity building program providing young professionals and students the opportunity to utilize NASA Earth observations and model output to demonstrate practical applications of those resources to society. Under the guidance of science advisors, DEVELOP teams work in alignment with local, regional, national and international partner organizations to identify the widest array of practical uses for NASA data to enhance related management decisions. The program's structure facilitates a two-fold approach to capacity building by fostering an environment of scientific and professional development opportunities for young professionals and students, while also providing end-user organizations enhanced management and decision making tools for issues impacting their communities. With the competitive nature and growing societal role of science and technology in today's global workplace, DEVELOP is building capacity in the next generation of scientists and leaders by fostering a learning and growing environment where young professionals possess an increased understanding of teamwork, personal development, and scientific/professional development and NASA's Earth Observation System. DEVELOP young professionals are partnered with end user organizations to conduct 10 week feasibility studies that demonstrate the use of NASA Earth science data for enhanced decision making. As a result of the partnership, end user organizations are introduced to NASA Earth Science technologies and capabilities, new methods to augment current practices, hands-on training with practical applications of remote sensing and NASA Earth science, improved remote

  1. Risk communication and trust in decision-maker action: a case study of the Giant Mine Remediation Plan

    PubMed Central

    Jardine, Cynthia G.; Banfield, Laura; Driedger, S. Michelle; Furgal, Christopher M.

    2013-01-01

    Background The development and implementation of a remediation plan for the residual arsenic trioxide stored at the former Giant Mine site in the Canadian Northwest Territories has raised important issues related to trust. Social and individual trust of those responsible for making decisions on risks is critically important in community judgements on risk and the acceptability of risk management decisions. Trust is known to be affected by value similarity and confidence in past performance, which serve as interacting sources of cooperation in acting toward a common goal. Objective To explore the elements of trust associated with the development and implementation of the Giant Mine Remediation Plan. Design Semi-structured interviews were conducted with eight purposively selected key informants representing both various interested and affected parties and the two government proponents. Results Five primary issues related to trust were identified by the participants: (1) a historical legacy of mistrust between the community (particularly Aboriginal peoples) and government; (2) barriers to building trust with the federal government; (3) limited community input and control over the decision-making process; (4) the conflicted and confounded role of the government agencies being both proponent and regulator, and the resulting need for independent oversight; and (5) distrust of the government to commit to the perpetual care required for the remediation option selected. Conclusions The dual-mode model of trust and confidence was shown to be a useful framework for understanding the pivotal role of trust in the development of the Giant Mine Remediation Plan. Failure to recognize issues of trust based on value dissimilarity and lack of confidence based on past performance have resulted in a lack of cooperation characterized by delayed remediation and a prolonged and expensive consultation process. Government recognition of the importance of trust to these issues will hopefully

  2. Decision support aids with anthropomorphic characteristics influence trust and performance in younger and older adults.

    PubMed

    Pak, Richard; Fink, Nicole; Price, Margaux; Bass, Brock; Sturre, Lindsay

    2012-01-01

    This study examined the use of deliberately anthropomorphic automation on younger and older adults' trust, dependence and performance on a diabetes decision-making task. Research with anthropomorphic interface agents has shown mixed effects in judgments of preferences but has rarely examined effects on performance. Meanwhile, research in automation has shown some forms of anthropomorphism (e.g. etiquette) have effects on trust and dependence on automation. Participants answered diabetes questions with no-aid, a non-anthropomorphic aid or an anthropomorphised aid. Trust and dependence in the aid was measured. A minimally anthropomorphic aide primarily affected younger adults' trust in the aid. Dependence, however, for both age groups was influenced by the anthropomorphic aid. Automation that deliberately embodies person-like characteristics can influence trust and dependence on reasonably reliable automation. However, further research is necessary to better understand the specific aspects of the aid that affect different age groups. Automation that embodies human-like characteristics may be useful in situations where there is under-utilisation of reasonably reliable aids by enhancing trust and dependence in that aid. Practitioner Summary: The design of decision-support aids on consumer devices (e.g. smartphones) may influence the level of trust that users place in that system and their amount of use. This study is the first step in articulating how the design of aids may influence user's trust and use of such systems. PMID:22799560

  3. Patient Decision Aids: A Case for Certification at the National Level in the United States.

    PubMed

    Poddar, Urbashi; Brownlee, Shannon; Stacey, Dawn; Volk, Robert J; Williams, John W; Elwyn, Glyn

    2015-01-01

    Patient decision aids enable patients to be better informed about the potential benefits and harms of their healthcare options. Certification of patient decision aids at the national level in the United States is a critical step towards responsible governance-primarily as a quality measure that increases patients' safety, as mandated in the U.S. Patient Protection and Affordable Care Act (PPACA). Certification would provide a verification process to identify conflicts of interest that may otherwise bias the scientific evidence presented in decision aids. Certification also benefits clinicians who may otherwise face malpractice claims based on harm to patients caused by possible reliance on patient decision aids that are inaccurate, incomplete, or presented in a manner that biases the patient's decision. Existing work by the International Patient Decision Aid Standards Collaboration could guide the establishment of a certification process within the U.S. This article argues for national certification of patient decision aids and discusses how that may be achieved. PMID:26752384

  4. Translating PrEP effectiveness into public health impact: key considerations for decision-makers on cost-effectiveness, price, regulatory issues, distributive justice and advocacy for access

    PubMed Central

    Hankins, Catherine; Macklin, Ruth; Warren, Mitchell

    2015-01-01

    Introduction The extraordinary feat of proving the effectiveness of oral pre-exposure prophylaxis (PrEP) in clinical trials in different populations in a variety of settings may prove to have been easier than ensuring it is used well. Decision-makers must make difficult choices to realize the promise of antiretroviral prophylaxis for their countries. This paper outlines key economic, regulatory and distributive justice issues that must be addressed for effective and acceptable PrEP implementation. Discussion In considering the role that PrEP can play in combination prevention programmes, decision-makers must determine who can benefit most from PrEP, how PrEP can be provided safely and efficiently, and what kind of health system support will ensure successful implementation. To do this, they need contextualized information on disease burden by population, analyses of how PrEP services might best be delivered, and projections of the human resource and infrastructure requirements for each potential delivery model. There are cost considerations, varying cost-effectiveness results and regulatory challenges. The principles of ethics can inform thorny discussions about who should be prioritized for oral PrEP and how best to introduce it fairly. We describe the cost-effectiveness of PrEP in different populations at higher risk of HIV exposure, its price in low- and middle-income countries, and the current regulatory situation. We explore the principles of ethics that can inform resource allocation decision-making about PrEP anchored in distributive justice, at a time when universal access to antiretroviral treatment remains to be assured. We then highlight the role of advocacy in moving the PrEP agenda forward. Conclusions The time is ripe now for decisions about whether, how and for whom PrEP should be introduced into a country's HIV response. It has the potential to contribute significantly to high impact HIV prevention if it is tailored to those who can most benefit

  5. Promoting perioperative advance care planning: a systematic review of advance care planning decision aids.

    PubMed

    Aslakson, Rebecca A; Schuster, Anne L R; Reardon, Jessica; Lynch, Thomas; Suarez-Cuervo, Catalina; Miller, Judith A; Moldovan, Rita; Johnston, Fabian; Anton, Blair; Weiss, Matthew; Bridges, John F P

    2015-11-01

    This systematic review identifies possible decision aids that promote perioperative advance care planning (ACP) and synthesizes the available evidence regarding their use. Using PubMed, EMBASE, Cochrane, SCOPUS, Web of Science, CINAHL, PsycINFO and Sociological Abstracts, researchers identified and screened articles for eligibility. Data were abstracted and risk of bias assessed for included articles. Thirty-nine of 5327 articles satisfied the eligibility criteria. Primarily completed in outpatient ambulatory populations, studies evaluated a variety of ACP decision aids. None were evaluated in a perioperative population. Fifty unique outcomes were reported with no head-to-head comparisons conducted. Findings are likely generalizable to a perioperative population and can inform development of a perioperative ACP decision aid. Future studies should compare the effectiveness of ACP decision aids.

  6. Aides' Involvement in Decision-Making and the Quality of Care in Institutional Settings

    ERIC Educational Resources Information Center

    Raynes, Norma V.; And Others

    1977-01-01

    The degree of participation in decision making by direct care staff aides, and its effect on the quality of care for mentally handicapped persons, was assessed among 125 staff of 3 state institutions averaging 1080 patients. (BB)

  7. Features of Computer-Based Decision Aids: Systematic Review, Thematic Synthesis, and Meta-Analyses

    PubMed Central

    Krömker, Dörthe; Meguerditchian, Ari N; Tamblyn, Robyn

    2016-01-01

    Background Patient information and education, such as decision aids, are gradually moving toward online, computer-based environments. Considerable research has been conducted to guide content and presentation of decision aids. However, given the relatively new shift to computer-based support, little attention has been given to how multimedia and interactivity can improve upon paper-based decision aids. Objective The first objective of this review was to summarize published literature into a proposed classification of features that have been integrated into computer-based decision aids. Building on this classification, the second objective was to assess whether integration of specific features was associated with higher-quality decision making. Methods Relevant studies were located by searching MEDLINE, Embase, CINAHL, and CENTRAL databases. The review identified studies that evaluated computer-based decision aids for adults faced with preference-sensitive medical decisions and reported quality of decision-making outcomes. A thematic synthesis was conducted to develop the classification of features. Subsequently, meta-analyses were conducted based on standardized mean differences (SMD) from randomized controlled trials (RCTs) that reported knowledge or decisional conflict. Further subgroup analyses compared pooled SMDs for decision aids that incorporated a specific feature to other computer-based decision aids that did not incorporate the feature, to assess whether specific features improved quality of decision making. Results Of 3541 unique publications, 58 studies met the target criteria and were included in the thematic synthesis. The synthesis identified six features: content control, tailoring, patient narratives, explicit values clarification, feedback, and social support. A subset of 26 RCTs from the thematic synthesis was used to conduct the meta-analyses. As expected, computer-based decision aids performed better than usual care or alternative aids; however

  8. A Perspective on Consumers 3.0: They Are Not Better Decision-Makers than Previous Generations.

    PubMed

    Houdek, Petr

    2016-01-01

    This perspective article builds upon the theory of local thinking in interpretation and prediction of consumer behavior in a contemporary world of information overload. It is shown that even informed and socially and environmentally responsible consumers (consumers 3.0) exhibit selective recall, limited attention, and bounded search in the perception and interpretation of price and quality of purchases. Their decisions fall into local cognitive frames, which specifically focus attention only on a narrow structure and content of the choice. The cognitive frames can be established by recent or regular purchases, but also extreme or primary purchase experiences. The article includes a short conceptual review of car, food, clothing, insurance, drugs, paintings, and other product purchases showing that the local cognitive frames often lead to bad bargains across various sectors. The article presents several suggestions for future research.

  9. Point of care information services: a platform for self-directed continuing medical education for front line decision makers

    PubMed Central

    Moja, Lorenzo; Kwag, Koren Hyogene

    2015-01-01

    The structure and aim of continuing medical education (CME) is shifting from the passive transmission of knowledge to a competency-based model focused on professional development. Self-directed learning is emerging as the foremost educational method for advancing competency-based CME. In a field marked by the constant expansion of knowledge, self-directed learning allows physicians to tailor their learning strategy to meet the information needs of practice. Point of care information services are innovative tools that provide health professionals with digested evidence at the front line to guide decision making. By mobilising self-directing learning to meet the information needs of clinicians at the bedside, point of care information services represent a promising platform for competency-based CME. Several points, however, must be considered to enhance the accessibility and development of these tools to improve competency-based CME and the quality of care. PMID:25655251

  10. A Perspective on Consumers 3.0: They Are Not Better Decision-Makers than Previous Generations.

    PubMed

    Houdek, Petr

    2016-01-01

    This perspective article builds upon the theory of local thinking in interpretation and prediction of consumer behavior in a contemporary world of information overload. It is shown that even informed and socially and environmentally responsible consumers (consumers 3.0) exhibit selective recall, limited attention, and bounded search in the perception and interpretation of price and quality of purchases. Their decisions fall into local cognitive frames, which specifically focus attention only on a narrow structure and content of the choice. The cognitive frames can be established by recent or regular purchases, but also extreme or primary purchase experiences. The article includes a short conceptual review of car, food, clothing, insurance, drugs, paintings, and other product purchases showing that the local cognitive frames often lead to bad bargains across various sectors. The article presents several suggestions for future research. PMID:27375527

  11. A Perspective on Consumers 3.0: They Are Not Better Decision-Makers than Previous Generations

    PubMed Central

    Houdek, Petr

    2016-01-01

    This perspective article builds upon the theory of local thinking in interpretation and prediction of consumer behavior in a contemporary world of information overload. It is shown that even informed and socially and environmentally responsible consumers (consumers 3.0) exhibit selective recall, limited attention, and bounded search in the perception and interpretation of price and quality of purchases. Their decisions fall into local cognitive frames, which specifically focus attention only on a narrow structure and content of the choice. The cognitive frames can be established by recent or regular purchases, but also extreme or primary purchase experiences. The article includes a short conceptual review of car, food, clothing, insurance, drugs, paintings, and other product purchases showing that the local cognitive frames often lead to bad bargains across various sectors. The article presents several suggestions for future research. PMID:27375527

  12. Point of care information services: a platform for self-directed continuing medical education for front line decision makers.

    PubMed

    Moja, Lorenzo; Kwag, Koren Hyogene

    2015-02-01

    The structure and aim of continuing medical education (CME) is shifting from the passive transmission of knowledge to a competency-based model focused on professional development. Self-directed learning is emerging as the foremost educational method for advancing competency-based CME. In a field marked by the constant expansion of knowledge, self-directed learning allows physicians to tailor their learning strategy to meet the information needs of practice. Point of care information services are innovative tools that provide health professionals with digested evidence at the front line to guide decision making. By mobilising self-directing learning to meet the information needs of clinicians at the bedside, point of care information services represent a promising platform for competency-based CME. Several points, however, must be considered to enhance the accessibility and development of these tools to improve competency-based CME and the quality of care.

  13. How seasonal forecast could help a decision maker: an example of climate service for water resource management

    NASA Astrophysics Data System (ADS)

    Viel, Christian; Beaulant, Anne-Lise; Soubeyroux, Jean-Michel; Céron, Jean-Pierre

    2016-04-01

    The FP7 project EUPORIAS was a great opportunity for the climate community to co-design with stakeholders some original and innovative climate services at seasonal time scales. In this framework, Météo-France proposed a prototype that aimed to provide to water resource managers some tailored information to better anticipate the coming season. It is based on a forecasting system, built on a refined hydrological suite, forced by a coupled seasonal forecast model. It particularly delivers probabilistic river flow prediction on river basins all over the French territory. This paper presents the work we have done with "EPTB Seine Grands Lacs" (EPTB SGL), an institutional stakeholder in charge of the management of 4 great reservoirs on the upper Seine Basin. First, we present the co-design phase, which means the translation of classical climate outputs into several indices, relevant to influence the stakeholder's decision making process (DMP). And second, we detail the evaluation of the impact of the forecast on the DMP. This evaluation is based on an experiment realised in collaboration with the stakeholder. Concretely EPTB SGL has replayed some past decisions, in three different contexts: without any forecast, with a forecast A and with a forecast B. One of forecast A and B really contained seasonal forecast, the other only contained random forecasts taken from past climate. This placebo experiment, realised in a blind test, allowed us to calculate promising skill scores of the DMP based on seasonal forecast in comparison to a classical approach based on climatology, and to EPTG SGL current practice.

  14. Enhancing ethical decision making in sexuality and AIDS education.

    PubMed

    Bailey, C E; Piercy, F P

    1997-01-01

    Traditionally, sexuality education has consisted of teaching adolescents about human anatomy, reproduction, and sexually transmitted diseases. Most sexuality and AIDS education curricula have emphasized neither the relational aspects nor the ethical meaning of sexual behavior. However, current guidelines for comprehensive sexuality education from the National Guidelines Task Force acknowledge the ethical dimensions of sexuality. This paper advocates providing sexuality and AIDS education in a way that helps adolescents explore the ethical meaning of their sexual behavior. Principles from Rest's model of moral development are presented as one example of an ethical framework that could inform sexuality and AIDS education curricula. Rest describes four internal processes that produce moral behavior: moral sensitivity, moral judgment, moral motivation, and moral character. For each of these processes, illustrative questions and activities are suggested here which can be used by sexuality and AIDS educators to facilitate discussions with adolescents about the ethical meaning and implications of their sexual behavior.

  15. The Heat Is On: Decision-Maker Perspectives on When and How to Issue a Heat Warning

    NASA Astrophysics Data System (ADS)

    O'Neill, M.; Sampson, N.; McCormick, S.; Rood, R. B.; Buxton, M.; Ebi, K. L.; Gronlund, C. J.; Zhang, K.; Catalano, L.; White-Newsome, J. L.; Conlon, K. C.; Parker, E. A.

    2011-12-01

    To better understand how to prevent illness and deaths during hot weather, particularly among at-risk populations, we conducted a study in Detroit, Michigan; Phoenix, Arizona; New York, New York, and Philadelphia, Pennsylvania. Our aims were to characterize and better understand how heatwave and health early warning systems (HHWS) and related prevention and sustainability programs can be more widely and effectively implemented. Specifically, we here report on the scientific evidence, expert judgments and the process used in deciding to trigger a HHWS and activate public health and social services interventions. We conducted interviews with public officials who decide if and when heat advisories/warnings are issued. After transcribing the interviews, we used a qualitative analysis software, QSR NVivo 9.0, to assign codes to portions of text from each transcript and allow analysis of information with common themes across the data. For example, several sentences in a transcript discussing a heat index might be coded as 'definition of heat wave'. A common theme across cities was that deciding what type of weather is dangerous to health is not straightforward. The time in season that heat occurs; the duration of the heat; the level of humidity and other meteorological factors; the extent to which temperatures drop at night, allowing people to cool off; and prevailing weather conditions all play a role. A single 'safe' threshold is unrealistic because people's individual sensitivity, housing, surrounding environments, behaviors, and access to air conditioning can differ greatly. However, choices must be made as to the trigger for the HHWS. Although quantitative analysis with health data (mortality, hospital admissions) can inform the design of the triggers, historical analysis has limitations, and decisions to issue heat warnings are sometimes related to planned activities, such as parades or fairs, that may expose large numbers of people to heat. The HHWS approach

  16. The Impact of Scientific Information on Ecosystem Management: Making Sense of the Contextual Gap Between Information Providers and Decision Makers

    NASA Astrophysics Data System (ADS)

    van Wyk, Ernita; Roux, Dirk J.; Drackner, Mikael; McCool, Stephen F.

    2008-05-01

    Scientific information is not always effectively incorporated into decision-making processes. This phenomenon seems to hold even when the information is aligned with an articulated need, is generated according to sound scientific procedures, and is packaged with end-user preferences in mind. We propose that contextual or cultural differences contribute significantly to the misalignment in communication between those who generate information and those who seek information for improved management of natural resources. The solution is to cultivate shared understanding, which in turn relies on acknowledgment and sharing of diverse values and attitudes. This constitutes a difficult challenge in a culturally diverse environment. Whereas cultural diversity represents wealth in experiences, knowledge and perspectives it can constrain the potential to develop the shared understandings necessary for effective integration of new information. This article illustrates how a lack of shared understanding among participants engaged in a resource-management process can produce and perpetuate divergent views of the world, to the extent that information and knowledge flows are ineffective and scientific information, even when requested, cannot be used effectively. Four themes were distilled from interviews with management and scientific staff of a natural resource-management agency in South Africa. The themes are used to illustrate how divergent views embedded in different cultures can discourage alignment of effort toward a common purpose. The article then presents a sense-making framework to illustrate the potential for developing shared understandings in a culturally diverse world.

  17. Decision-makers, donors and data: factors influencing the development of mental health and psychosocial policy in the Solomon Islands.

    PubMed

    Zwi, Anthony B; Blignault, Ilse; Bunde-Birouste, Anne W; Ritchie, Jan E; Silove, Derrick M

    2011-07-01

    Mental disorders and psychosocial problems are common, and present a significant public health burden globally. Increasingly, attention has been devoted to these issues in the aftermath of violent conflict. The Solomon Islands, a small Pacific island nation, has in recent years experienced periods of internal conflict. This article examines how policy decisions regarding mental health and wellbeing were incorporated into the national agenda in the years which followed. The study reveals the policy shifts, contextual influences and players responsible. The Solomon Islands' experience reflects incremental change, built upon longstanding but modest concern with mental health and social welfare issues, reinforced by advocacy from the small mental health team. Armed conflict and ethnic tensions from 1998 to 2003 promoted wider recognition of unmet mental health needs and psychosocial problems. Additional impetus was garnered through the positioning of key health leaders, some of whom were trained in public health. Working together, with an understanding of culture and politics, and drawing on external support, they drove the agenda. Contextual factors, notably further violence and the ongoing risk of instability, a growing youth population, and emerging international and local evidence, also played a part. PMID:21115459

  18. The impact of scientific information on ecosystem management: making sense of the contextual gap between information providers and decision makers.

    PubMed

    van Wyk, Ernita; Roux, Dirk J; Drackner, Mikael; McCool, Stephen F

    2008-05-01

    Scientific information is not always effectively incorporated into decision-making processes. This phenomenon seems to hold even when the information is aligned with an articulated need, is generated according to sound scientific procedures, and is packaged with end-user preferences in mind. We propose that contextual or cultural differences contribute significantly to the misalignment in communication between those who generate information and those who seek information for improved management of natural resources. The solution is to cultivate shared understanding, which in turn relies on acknowledgment and sharing of diverse values and attitudes. This constitutes a difficult challenge in a culturally diverse environment. Whereas cultural diversity represents wealth in experiences, knowledge and perspectives it can constrain the potential to develop the shared understandings necessary for effective integration of new information. This article illustrates how a lack of shared understanding among participants engaged in a resource-management process can produce and perpetuate divergent views of the world, to the extent that information and knowledge flows are ineffective and scientific information, even when requested, cannot be used effectively. Four themes were distilled from interviews with management and scientific staff of a natural resource-management agency in South Africa. The themes are used to illustrate how divergent views embedded in different cultures can discourage alignment of effort toward a common purpose. The article then presents a sense-making framework to illustrate the potential for developing shared understandings in a culturally diverse world.

  19. Do choosing wisely tools meet criteria for patient decision aids? A descriptive analysis of patient materials

    PubMed Central

    Légaré, France; Hébert, Jessica; Goh, Larissa; Lewis, Krystina B; Leiva Portocarrero, Maria Ester; Robitaille, Hubert; Stacey, Dawn

    2016-01-01

    Objectives Choosing Wisely is a remarkable physician-led campaign to reduce unnecessary or harmful health services. Some of the literature identifies Choosing Wisely as a shared decision-making approach. We evaluated the patient materials developed by Choosing Wisely Canada to determine whether they meet the criteria for shared decision-making tools known as patient decision aids. Design Descriptive analysis of all Choosing Wisely Canada patient materials. Data source In May 2015, we selected all Choosing Wisely Canada patient materials from its official website. Main outcomes and measures Four team members independently extracted characteristics of the English materials using the International Patient Decision Aid Standards (IPDAS) modified 16-item minimum criteria for qualifying and certifying patient decision aids. The research team discussed discrepancies between data extractors and reached a consensus. Descriptive analysis was conducted. Results Of the 24 patient materials assessed, 12 were about treatments, 11 were about screening and 1 was about prevention. The median score for patient materials using IPDAS criteria was 10/16 (range: 8–11) for screening topics and 6/12 (range: 6–9) for prevention and treatment topics. Commonly missed criteria were stating the decision (21/24 did not), providing balanced information on option benefits/harms (24/24 did not), citing evidence (24/24 did not) and updating policy (24/24 did not). Out of 24 patient materials, only 2 met the 6 IPDAS criteria to qualify as patient decision aids, and neither of these 2 met the 6 certifying criteria. Conclusions Patient materials developed by Choosing Wisely Canada do not meet the IPDAS minimal qualifying or certifying criteria for patient decision aids. Modifications to the Choosing Wisely Canada patient materials would help to ensure that they qualify as patient decision aids and thus as more effective shared decision-making tools. PMID:27566638

  20. Developmental changes in decision making under risk: The role of executive functions and reasoning abilities in 8- to 19-year-old decision makers.

    PubMed

    Schiebener, Johannes; García-Arias, María; García-Villamisar, Domingo; Cabanyes-Truffino, Javier; Brand, Matthias

    2015-01-01

    Previous studies have shown that children and adolescents often tend toward risky decisions despite explicit knowledge about the potential negative consequences. This phenomenon has been suggested to be associated with the immaturity of brain areas involved in cognitive control functions. Particularly, "frontal lobe functions," such as executive functions and reasoning, mature until young adulthood and are thought to be involved in age-related changes in decision making under explicit risk conditions. We investigated 112 participants, aged 8-19 years, with a frequently used task assessing decisions under risk, the Game of Dice Task (GDT). Additionally, we administered the Modified Card Sorting Test assessing executive functioning (categorization, cognitive flexibility, and strategy maintenance) as well as the Ravens Progressive Matrices assessing reasoning. The results showed that risk taking in the GDT decreased with increasing age and this effect was not moderated by reasoning but by executive functions: Particularly, young persons with weak executive functioning showed very risky decision making. Thus, the individual maturation of executive functions, associated with areas in the prefrontal cortex, seems to be an important factor in young peoples' behavior in risky decision-making situations.

  1. Are Normal Decision-Makers Sensitive to Changes in Value Contrast under Uncertainty? Evidence from the Iowa Gambling Task

    PubMed Central

    Lee, We-Kang; Su, Yi-An; Song, Tzu-Jiun; Chiu, Yao-Chu; Lin, Ching-Hung

    2014-01-01

    The Iowa Gambling Task (IGT) developed by Bechara et al. in 1994 is used to diagnose patients with Ventromedial Medial Prefrontal Cortex (VMPFC) lesions, and it has become a landmark in research on decision making. According to Bechara et al., the manipulation of progressive increments of monetary value can normalize the performance of patients with VMPFC lesions; thus, they developed a computerized version of the IGT. However, the empirical results showed that patients' performances did not improve as a result of this manipulation, which suggested that patients with VMPFC lesions performed myopically for future consequences. Using the original version of the IGT, some IGT studies have demonstrated that increments of monetary value significantly influence the performance of normal subjects in the IGT. However, other research has resulted in inconsistent findings. In this study, we used the computerized IGT (1X-IGT) and manipulated the value contrast of progressive increments (i.e., by designing the 10X-IGT, which contained 10 times of progressive increment) to investigate the influence of value contrast on the performance of normal subjects. The resulting empirical observations indicated that the value contrast (1X- vs. 10X-IGT) of the progressive increment had no effect on the performance of normal subjects. This study also provides a discussion of the issue of value in IGT-related studies. Moreover, we found the “prominent deck B phenomenon” in both versions of the IGT, which indicated that the normal subjects were guided mostly by the gain-loss frequency, rather than by the monetary value contrast. In sum, the behavioral performance of normal subjects demonstrated a low correlation with changes in monetary value, even in the 10X-IGT. PMID:25036094

  2. Marine Conservation: Effective Communication is Critical to Engaging the Public and Decision Makers in Sustaining our Seas

    NASA Astrophysics Data System (ADS)

    Crowder, L. B.

    2006-12-01

    Scientists are most comfortable talking to other scientists. But if we hope our science will be used to drive good policy decisions at the state or federal level, we have to be willing to leave the comfortable cloisters of science and venture out into a world where people speak different languages and have different perspectives. Early in my career, I had the good fortune to be involved in two research programs that were focused on basic science, but also proved to be relevant to management and policy. The first project involved modeling the bioenergetics of growth in salmonid fishes. The second modeled the population dynamics of a threatened marine species, loggerhead sea turtle. Somewhat to my surprise, both papers led to major policy changes and the models were actively employed by managers within a year of two of publication. The question for me then became whether this could be done deliberately. Since then I have had the opportunity to communicate with a wide variety of people from congressmen, to school children, to the public, and among professionals across disciplinary boundaries. Communication skills are critical for scientists to become influential in the policy arena. We have to listen to all people involved in the policymaking process AND we have to be able to communicate effectively with them. This requires a deep understanding of the science and a willingness to work hard on communicating the science clearly, concisely, and compellingly. Scientists can work to develop their own skills, but professional training helps. This can come via shortcourses, mentorships, or full university courses. At Duke Marine Lab, we initiated graduate course in Professional Writing that focuses upon writing for different audiences, including commercial fishermen, retirees, teenagers, scientists in different fields, politicians, and managers. This course has been widely endorsed by our graduates as one of the most important courses they attended; interviews and job offers

  3. Husbands as decision-makers in relation to family size: East-West regional differentials in Turkey.

    PubMed

    Kulu, I

    1990-01-01

    Fertility studies usually gather information from women only. This sex-bias present in the research fails to take into account the contribution that men make in forming fertility patterns. This study examines the role of Turkish husbands in the decision-making regarding family size and the use of family planning methods. The historic and cultural background in Turkey is based upon a male-dominant structure. This dominant role of men is present on individual, family, community, and national levels. The differences between the Eastern and Western regions, in regard to socio-economic factors is fully explored. The data used in this study comes from a 1988 national health survey. Three questionnaires were applied in 6,552 households in 5 regions. One questionnaire was for the household, one for ever-married women, and one for ever-married men. This paper focuses on the data generated by the husband's questionnaires (a sub-sample of 2,264 respondents). Several factors are identified that maintain an authoritarian, male-dominated system. These factors include type of marriage, arranged marriages, the payment of bride-price, and participation in the labor force. Both men in the East and West expect their wives to fulfill a traditional sex-role. Women are expected to be wives and mothers, and to obey their husbands. Most men do not approve of married women working outside of the home. Traditional values continue to shape the style of relating between men and women in both regions, despite the modernization that has taken place in the West. "Higher socioeconomic development does not necessarily imply the automatic acquisition of modern values." The author does establish that practices that subjugate women are more prevalent and are deeply rooted in the East. In keeping with the cultural practices of the society, male attitudes and values strongly influence family planning practices. One-fourth of the women in a national survey stated that the reason they did not use a

  4. Assessment of a decision aid to assist genetic testing research participants in the informed consent process.

    PubMed

    Sorenson, J R; Lakon, C; Spinney, T; Jennings-Grant, T

    2004-01-01

    Limited attention has been given to applying decision-making theories from psychology to the content and process of informed consent in genetic testing research. Data are presented from a study that developed and assessed a psychological theory-based decision aid as part of the informed consent process. This innovative approach assisted at-risk women in assessing the consequences of participating in a research project that offered them free hemophilia A genetic carrier testing. Results suggest: (1) the decision aid can be incorporated into the consent process with few problems; (2) women of varying educational backgrounds can complete the decision aid; (3) while women consider many consequences of genetic testing, their primary focus is on the implications for their family; and (4) this is in marked contrast to the typical benefit-harm statements prepared by researchers for genetic testing.

  5. Overdetection in breast cancer screening: development and preliminary evaluation of a decision aid

    PubMed Central

    Hersch, Jolyn; Jansen, Jesse; Barratt, Alexandra; Irwig, Les; Houssami, Nehmat; Jacklyn, Gemma; Thornton, Hazel; Dhillon, Haryana; McCaffery, Kirsten

    2014-01-01

    Objective To develop, pilot and refine a decision aid (ahead of a randomised trial evaluation) for women around age 50 facing their initial decision about whether to undergo mammography screening. Design Two-stage mixed-method pilot study including qualitative interviews (n=15) and a randomised comparison using a quantitative survey (n=34). Setting New South Wales, Australia. Participants Women aged 43–59 years with no personal history of breast cancer. Interventions The decision aid provides evidence-based information about important outcomes of mammography screening over 20 years (breast cancer mortality reduction, overdetection and false positives) compared with no screening. The information is presented in a short booklet for women, combining text and visual formats. A control version produced for the purposes of comparison omits the overdetection-related content. Outcomes Comprehension of key decision aid content and acceptability of the materials. Results Most women considered the decision aid clear and helpful and would recommend it to others. Nonetheless, the piloting process raised important issues that we tried to address in iterative revisions. Some participants found it hard to understand overdetection and why it is of concern, while there was often confusion about the distinction between overdetection and false positives. In a screening context, encountering balanced information rather than persuasion appears to be contrary to people's expectations, but women appreciated the opportunity to become better informed. Conclusions The concept of overdetection is complex and new to the public. This study highlights some key challenges for communicating about this issue. It is important to clarify that overdetection differs from false positives in terms of its more serious consequences (overtreatment and associated harms). Screening decision aids also must clearly explain their purpose of facilitating informed choice. A staged approach to development and

  6. What do hospital decision-makers in Ontario, Canada, have to say about the fairness of priority setting in their institutions?

    PubMed Central

    Reeleder, David; Martin, Douglas K; Keresztes, Christian; Singer, Peter A

    2005-01-01

    Background Priority setting, also known as rationing or resource allocation, occurs at all levels of every health care system. Daniels and Sabin have proposed a framework for priority setting in health care institutions called 'accountability for reasonableness', which links priority setting to theories of democratic deliberation. Fairness is a key goal of priority setting. According to 'accountability for reasonableness', health care institutions engaged in priority setting have a claim to fairness if they satisfy four conditions of relevance, publicity, appeals/revision, and enforcement. This is the first study which has surveyed the views of hospital decision makers throughout an entire health system about the fairness of priority setting in their institutions. The purpose of this study is to elicit hospital decision-makers' self-report of the fairness of priority setting in their hospitals using an explicit conceptual framework, 'accountability for reasonableness'. Methods 160 Ontario hospital Chief Executive Officers, or their designates, were asked to complete a survey questionnaire concerning priority setting in their publicly funded institutions. Eight-six Ontario hospitals completed this survey, for a response rate of 54%. Six close-ended rating scale questions (e.g. Overall, how fair is priority setting at your hospital?), and 3 open-ended questions (e.g. What do you see as the goal(s) of priority setting in your hospital?) were used. Results Overall, 60.7% of respondents indicated their hospitals' priority setting was fair. With respect to the 'accountability for reasonableness' conditions, respondents indicated their hospitals performed best for the relevance (75.0%) condition, followed by appeals/revision (56.6%), publicity (56.0%), and enforcement (39.5%). Conclusions For the first time hospital Chief Executive Officers within an entire health system were surveyed about the fairness of priority setting practices in their institutions using the

  7. Ethical challenges with hemodialysis patients who lack decision-making capacity: behavioral issues, surrogate decision-makers, and end-of-life situations.

    PubMed

    Feely, Molly A; Albright, Robert C; Thorsteinsdottir, Björg; Moss, Alvin H; Swetz, Keith M

    2014-09-01

    Hemodialysis (HD) is routinely offered to patients with end-stage renal disease in the United States who are ineligible for other renal replacement modalities. The frequency of HD among the US population is greater than all other countries, except Taiwan and Japan. In US, patients are often dialyzed irrespective of age, comorbidities, prognosis, or decision-making capacity. Determination of when patients can no longer dialyze is variable and can be dialysis-center specific. Determinants may be related to progressive comorbidities and frailty, mobility or access issues, patient self-determination, or an inability to tolerate the treatment safely for any number of reasons (e.g., hypotension, behavioral issues). Behavioral issues may impact the safety of not only patients themselves, but also those around them. In this article the authors present the case of an elderly patient on HD with progressive cognitive impairment and combative behavior placing him and others at risk of physical harm. The authors discuss the medical, ethical, legal, and psychosocial challenges to care of such patients who lack decision-making capacity with a focus on variable approaches by regions and culture. This manuscript provides recommendations and highlights resources to assist nephrologists, dialysis personnel, ethics consultants, and palliative medicine teams in managing such patients to resolve conflict. PMID:24988063

  8. Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas

    PubMed Central

    2013-01-01

    Background In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension—the delivery of patient decision aids on the Internet—is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. Methods An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. Results The updated definition distinguishes Internet-delivery of patient decision aids from online health information and clinical practice guidelines. Theories in cognitive psychology, decision psychology, communication, and education support the value of Internet features for providing interactive information and deliberative support. Dissemination and implementation theories support Internet-delivery for providing the right information (rapidly updated), to the right person (tailored), at the right time (the appropriate point in the decision making process). Additional efforts are needed to integrate the theoretical rationale and empirical evidence from health technology perspectives, such as consumer health informatics, user experience design, and human-computer interaction. Despite Internet usage ranging from 74% to 85% in developed countries and 80% of users searching for health information, it is unknown how many individuals specifically seek patient decision aids on the Internet. Among the 86 randomized controlled trials in the 2011 Cochrane Collaboration’s review of patient decision aids, only four studies focused on Internet-delivery. Given the limited number of published studies, this paper particularly focused on identifying gaps in the empirical evidence base and

  9. Evidence-Based Medicine in Otolaryngology, Part 5: Patient Decision Aids.

    PubMed

    Pynnonen, Melissa A; Randolph, Gregory W; Shin, Jennifer J

    2015-09-01

    Modern medical decision making is a complex task requiring collaboration between patients and physicians. Related clinical evidence may delineate a clearly favorable path, but in other instances, uncertainty remains. Even in these circumstances, however, there are techniques that optimize decision making by blending existing evidence with individual patient values in the context of physician counseling. This installment of "Evidence-Based Medicine in Otolaryngology" focuses on the crucial issue of how practitioners may approach clinical situations where the data do not delineate a single irrefutable path. We describe decision aids-tools that can educate patients about data related to complex clinical decisions. We review their definition, quality standards, patient interface, benefits, and limitations. We also discuss the related concept of option grids and the role of decision aids in evidence-based practice.

  10. Radiological Decision Aid to determine suitability for medial unicompartmental knee arthroplasty

    PubMed Central

    Hamilton, T. W.; Pandit, H. G.; Lombardi, A. V.; Adams, J. B.; Oosthuizen, C. R.; Clavé, A.; Dodd, C. A. F.; Berend, K. R.; Murray, D. W.

    2016-01-01

    Aims An evidence-based radiographic Decision Aid for meniscal-bearing unicompartmental knee arthroplasty (UKA) has been developed and this study investigates its performance at an independent centre. Patients and Methods Pre-operative radiographs, including stress views, from a consecutive cohort of 550 knees undergoing arthroplasty (UKA or total knee arthroplasty; TKA) by a single-surgeon were assessed. Suitability for UKA was determined using the Decision Aid, with the assessor blinded to treatment received, and compared with actual treatment received, which was determined by an experienced UKA surgeon based on history, examination, radiographic assessment including stress radiographs, and intra-operative assessment in line with the recommended indications as described in the literature. Results The sensitivity and specificity of the Decision Aid was 92% and 88%, respectively. Excluding knees where a clear pre-operative plan was made to perform TKA, i.e. patient request, the sensitivity was 93% and specificity 96%. The false-positive rate was low (2.4%) with all affected patients readily identifiable during joint inspection at surgery. In patients meeting Decision Aid criteria and receiving UKA, the five-year survival was 99% (95% confidence intervals (CI) 97 to 100). The false negatives (3.5%), who received UKA but did not meet the criteria, had significantly worse functional outcomes (flexion p < 0.001, American Knee Society Score - Functional p < 0.001, University of California Los Angeles score p = 0.04), and lower implant survival of 93.1% (95% CI 77.6 to 100). Conclusion The radiographic Decision Aid safely and reliably identifies appropriate patients for meniscal-bearing UKA and achieves good results in this population. The widespread use of the Decision Aid should improve the results of UKA. Cite this article: Bone Joint J 2016;98-B(10 Suppl B):3–10. PMID:27694509

  11. Development of an Analytic Approach to Determine How Environmental Protection Agency’s Integrated Risk Information System (IRIS) Is Used By Non-EPA Decision Makers (Final Contractor Report)

    EPA Science Inventory

    The purpose of this project, Development of an Analytic Approach to Determine How Environmental Protection Agency’s Integrated Risk Information System (IRIS) Is Used By Non EPA Decision Makers, is to describe how IRIS is used by a small number of representative groups of u...

  12. Decision trees and integrated features for computer aided mammographic screening

    SciTech Connect

    Kegelmeyer, W.P. Jr.; Groshong, B.; Allmen, M.; Woods, K.

    1997-02-01

    Breast cancer is a serious problem, which in the United States causes 43,000 deaths a year, eventually striking 1 in 9 women. Early detection is the only effective countermeasure, and mass mammography screening is the only reliable means for early detection. Mass screening has many shortcomings which could be addressed by a computer-aided mammographic screening system. Accordingly, we have applied the pattern recognition methods developed in earlier investigations of speculated lesions in mammograms to the detection of microcalcifications and circumscribed masses, generating new, more rigorous and uniform methods for the detection of both those signs. We have also improved the pattern recognition methods themselves, through the development of a new approach to combinations of multiple classifiers.

  13. Prioritizing groundwater remediation policies: a fuzzy compatibility analysis decision aid.

    PubMed

    Nasiri, Fuzhan; Huang, Gordon; Fuller, Norma

    2007-01-01

    The implementation of groundwater remediation strategies in contaminated areas includes not only a cost-benefit analysis and an environmental risk assessment but also another type of study called compatibility analysis. A compatibility analysis targets the interactions between remediation technologies and site characteristics, such as the types of active contaminants and their concentrations, soil composition and geological features, etc. The purpose of this analysis is to identify the most compatible remediation plan for the contaminated site. In this paper, we introduce a decision support system for the prioritization of remediation plans based on their estimated compatibility index. As this model receives data in terms of linguistic judgments and experts' opinions, we use fuzzy sets theory to deal with these uncertainties. First, we break down the concept of compatibility into the measurable factors. Then by using a multiple-attribute decision-making (MADM) outline, we compute a factorial, regional and overall compatibility indicator for each plan. Finally, by comparing these generated indicators, we rank the remediation policies.

  14. Decision aids for advance care planning: an overview of the state of the science.

    PubMed

    Butler, Mary; Ratner, Edward; McCreedy, Ellen; Shippee, Nathan; Kane, Robert L

    2014-09-16

    Advance care planning honors patients' goals and preferences for future care by creating a plan for when illness or injury impedes the ability to think or communicate about health decisions. Fewer than 50% of severely or terminally ill patients have an advance directive in their medical record, and physicians are accurate only about 65% of the time when predicting patient preferences for intensive care. Decision aids can support the advance care planning process by providing a structured approach to informing patients about care options and prompting them to document and communicate their preferences. This review, commissioned as a technical brief by the Agency for Healthcare Research and Quality Effective Health Care Program, provides a broad overview of current use of and research related to decision aids for adult advance care planning. Using interviews of key informants and a search of the gray and published literature from January 1990 to May 2014, the authors found that many decision aids are widely available but are not assessed in the empirical literature. The 16 published studies testing decision aids as interventions for adult advance care planning found that most are proprietary or not publicly available. Some are constructed for the general population, whereas others address disease-specific conditions that have more predictable end-of-life scenarios and, therefore, more discrete choices. New decision aids should be designed that are responsive to diverse philosophical perspectives and flexible enough to change as patients gain experience with their personal illness courses. Future efforts should include further research, training of advance care planning facilitators, dissemination and access, and tapping potential opportunities in social media or other technologies. PMID:25069709

  15. Advancing Policy Makers' Expertise in Evidence-Use: A New Approach to Enhancing the Role Research Can Have in Aiding Educational Policy Development

    ERIC Educational Resources Information Center

    Brown, Chris

    2014-01-01

    This paper explores the notion of evidence-informed policy making and the factors that have hindered its development in the UK to date. It then explores Flyvbjerg's notion of "phronetic" expertise and hypothesises that the learning that accrues from engaging with multiple cases could also lead to policy-makers developing competency…

  16. How Deep is the Critical Zone: A Scientific Question with Potential Impact For Decision-makers in Areas of Shale-Gas Development and Hydraulic Fracturing

    NASA Astrophysics Data System (ADS)

    Brantley, S. L.

    2014-12-01

    Citizens living in areas of shale-gas development such as the Marcellus gas play in Pennsylvania and surrounding states are cognizant of the possibility that drilling and production of natural gas -- including hydraulic fracturing -- may have environmental impacts on their water. The Critical Zone is defined as the zone from vegetation canopy to the lower limits of groundwater. This definition is nebulous in terms of the lower limit, and yet, defining the bottom of the Critical Zone is important if citizens are to embrace shale-gas development. This is because, although no peer-reviewed study has been presented that documents a case where hydraulic fracturing or formation fluids have migrated upwards from fracturing depths to drinking water resources, a few cases of such leakage have been alleged. On the other hand, many cases of methane migration into aquifers have been documented to occur and some have been attributed to shale-gas development. The Critical Zone science community has a role to play in understanding such contamination problems, how they unfold, and how they should be ameliorated. For example, one big effort of the Critical Zone science community is to promote sharing of data describing the environment. This data effort has been extended to provide data for citizens to understand water quality by a team known as the Shale Network. As scientists learn to publish data online, these efforts must also be made accessible to non-scientists. As citizens access the data, the demand for data will grow and all branches of government will eventually respond by providing more accessible data that will help the public and policy-makers make decisions.

  17. Healthcare Cost Savings Estimator Tool for Chronic Disease Self-Management Program: A New Tool for Program Administrators and Decision Makers

    PubMed Central

    Ahn, SangNam; Smith, Matthew Lee; Altpeter, Mary; Post, Lindsey; Ory, Marcia G.

    2015-01-01

    Chronic disease self-management education (CDSME) programs have been delivered to more than 100,000 older Americans with chronic conditions. As one of the Stanford suite of evidence-based CDSME programs, the chronic disease self-management program (CDSMP) has been disseminated in diverse populations and settings. The objective of this paper is to introduce a practical, universally applicable tool to assist program administrators and decision makers plan implementation efforts and make the case for continued program delivery. This tool was developed utilizing data from a recent National Study of CDSMP to estimate national savings associated with program participation. Potential annual healthcare savings per CDSMP participant were calculated based on averted emergency room visits and hospitalizations. While national data can be utilized to estimate cost savings, the tool has built-in features allowing users to tailor calculations based on their site-specific data. Building upon the National Study of CDSMP’s documented potential savings of $3.3 billion in healthcare costs by reaching 5% of adults with one or more chronic conditions, two heuristic case examples were also explored based on different population projections. The case examples show how a small county and large metropolitan city were not only able to estimate healthcare savings ($38,803 for the small county; $732,290 for the large metropolitan city) for their existing participant populations but also to project significant healthcare savings if they plan to reach higher proportions of middle-aged and older adults. Having a tool to demonstrate the monetary value of CDSMP can contribute to the ongoing dissemination and sustainability of such community-based interventions. Next steps will be creating a user-friendly, internet-based version of Healthcare Cost Savings Estimator Tool: CDSMP, followed by broadening the tool to consider cost savings for other evidence-based programs. PMID:25964946

  18. Exploring the experiences of substitute decision-makers with an exception to consent in a paediatric resuscitation randomised controlled trial: study protocol for a qualitative research study

    PubMed Central

    de Laat, Sonya; Schwartz, Lisa

    2016-01-01

    Introduction Prospective informed consent is required for most research involving human participants; however, this is impracticable under some circumstances. The Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (TCPS) outlines the requirements for research involving human participants in Canada. The need for an exception to consent (deferred consent) is recognised and endorsed in the TCPS for research in individual medical emergencies; however, little is known about substitute decision-maker (SDM) experiences. A paediatric resuscitation trial (SQUEEZE) (NCT01973907) using an exception to consent process began enrolling at McMaster Children's Hospital in January 2014. This qualitative research study aims to generate new knowledge on SDM experiences with the exception to consent process as implemented in a randomised controlled trial. Methods and analysis The SDMs of children enrolled into the SQUEEZE pilot trial will be the sampling frame from which ethics study participants will be derived. Design: Qualitative research study involving individual interviews and grounded theory methodology. Participants: SDMs for children enrolled into the SQUEEZE pilot trial. Sample size: Up to 25 SDMs. Qualitative methodology: SDMs will be invited to participate in the qualitative ethics study. Interviews with consenting SDMs will be conducted in person or by telephone, taped and professionally transcribed. Participants will be encouraged to elaborate on their experience of being asked to consent after the fact and how this process occurred. Analysis: Data gathering and analysis will be undertaken simultaneously. The investigators will collaborate in developing the coding scheme, and data will be coded using NVivo. Emerging themes will be identified. Ethics and dissemination This research represents a rare opportunity to interview parents/guardians of critically ill children enrolled into a resuscitation trial without their knowledge or prior consent

  19. Healthcare cost savings estimator tool for chronic disease self-management program: a new tool for program administrators and decision makers.

    PubMed

    Ahn, SangNam; Smith, Matthew Lee; Altpeter, Mary; Post, Lindsey; Ory, Marcia G

    2015-01-01

    Chronic disease self-management education (CDSME) programs have been delivered to more than 100,000 older Americans with chronic conditions. As one of the Stanford suite of evidence-based CDSME programs, the chronic disease self-management program (CDSMP) has been disseminated in diverse populations and settings. The objective of this paper is to introduce a practical, universally applicable tool to assist program administrators and decision makers plan implementation efforts and make the case for continued program delivery. This tool was developed utilizing data from a recent National Study of CDSMP to estimate national savings associated with program participation. Potential annual healthcare savings per CDSMP participant were calculated based on averted emergency room visits and hospitalizations. While national data can be utilized to estimate cost savings, the tool has built-in features allowing users to tailor calculations based on their site-specific data. Building upon the National Study of CDSMP's documented potential savings of $3.3 billion in healthcare costs by reaching 5% of adults with one or more chronic conditions, two heuristic case examples were also explored based on different population projections. The case examples show how a small county and large metropolitan city were not only able to estimate healthcare savings ($38,803 for the small county; $732,290 for the large metropolitan city) for their existing participant populations but also to project significant healthcare savings if they plan to reach higher proportions of middle-aged and older adults. Having a tool to demonstrate the monetary value of CDSMP can contribute to the ongoing dissemination and sustainability of such community-based interventions. Next steps will be creating a user-friendly, internet-based version of Healthcare Cost Savings Estimator Tool: CDSMP, followed by broadening the tool to consider cost savings for other evidence-based programs.

  20. Healthcare cost savings estimator tool for chronic disease self-management program: a new tool for program administrators and decision makers.

    PubMed

    Ahn, SangNam; Smith, Matthew Lee; Altpeter, Mary; Post, Lindsey; Ory, Marcia G

    2015-01-01

    Chronic disease self-management education (CDSME) programs have been delivered to more than 100,000 older Americans with chronic conditions. As one of the Stanford suite of evidence-based CDSME programs, the chronic disease self-management program (CDSMP) has been disseminated in diverse populations and settings. The objective of this paper is to introduce a practical, universally applicable tool to assist program administrators and decision makers plan implementation efforts and make the case for continued program delivery. This tool was developed utilizing data from a recent National Study of CDSMP to estimate national savings associated with program participation. Potential annual healthcare savings per CDSMP participant were calculated based on averted emergency room visits and hospitalizations. While national data can be utilized to estimate cost savings, the tool has built-in features allowing users to tailor calculations based on their site-specific data. Building upon the National Study of CDSMP's documented potential savings of $3.3 billion in healthcare costs by reaching 5% of adults with one or more chronic conditions, two heuristic case examples were also explored based on different population projections. The case examples show how a small county and large metropolitan city were not only able to estimate healthcare savings ($38,803 for the small county; $732,290 for the large metropolitan city) for their existing participant populations but also to project significant healthcare savings if they plan to reach higher proportions of middle-aged and older adults. Having a tool to demonstrate the monetary value of CDSMP can contribute to the ongoing dissemination and sustainability of such community-based interventions. Next steps will be creating a user-friendly, internet-based version of Healthcare Cost Savings Estimator Tool: CDSMP, followed by broadening the tool to consider cost savings for other evidence-based programs. PMID:25964946

  1. Trustworthy patient decision aids: a qualitative analysis addressing the risk of competing interests

    PubMed Central

    Elwyn, Glyn; Dannenberg, Michelle; Blaine, Arianna; Poddar, Urbashi; Durand, Marie-Anne

    2016-01-01

    Objective Our aim in this study was to examine the competing interest policies and procedures of organisations who develop and maintain patient decision aids. Design Descriptive and thematic analysis of data collected from a cross-sectional survey of patient decision aid developer's competing interest policies and disclosure forms. Results We contacted 25 organisations likely to meet the inclusion criteria. 12 eligible organisations provided data. 11 organisations did not reply and 2 declined to participate. Most patient decision aid developers recognise the need to consider the issue of competing interests. Assessment processes vary widely and, for the most part, are insufficiently robust to minimise the risk of competing interests. Only half of the 12 organisations had competing interest policies. Some considered disclosure to be sufficient, while others imposed differing levels of exclusion. Conclusions Patient decision aid developers do not have a consistent approach to managing competing interests. Some have developed policies and procedures, while others pay no attention to the issue. As is the case for clinical practice guidelines, increasing attention will need to be given to how the competing interests of contributors of evidence-based publications may influence materials, especially if they are designed for patient use. PMID:27612542

  2. Decision Aid Tool and Ontology-Based Reasoning for Critical Infrastructure Vulnerabilities and Threats Analysis

    NASA Astrophysics Data System (ADS)

    Choraś, Michał; Flizikowski, Adam; Kozik, Rafał; Hołubowicz, Witold

    In this paper, a decision aid tool (DAT) for Critical Infrastructure threats analysis and ranking is presented. We propose the ontology-based approach that provides classification, relationships and reasoning about vulnerabilities and threats of the critical infrastructures. Our approach is a part of research within INSPIRE project for increasing security and protection through infrastructure resilience.

  3. In search of tools to aid logical thinking and communicating about medical decision making.

    PubMed

    Hunink, M G

    2001-01-01

    To have real-time impact on medical decision making, decision analysts need a wide variety of tools to aid logical thinking and communication. Decision models provide a formal framework to integrate evidence and values, but they are commonly perceived as complex and difficult to understand by those unfamiliar with the methods, especially in the context of clinical decision making. The theory of constraints, introduced by Eliyahu Goldratt in the business world, provides a set of tools for logical thinking and communication that could potentially be useful in medical decision making. The author used the concept of a conflict resolution diagram to analyze the decision to perform carotid endarterectomy prior to coronary artery bypass grafting in a patient with both symptomatic coronary and asymptomatic carotid artery disease. The method enabled clinicians to visualize and analyze the issues, identify and discuss the underlying assumptions, search for the best available evidence, and use the evidence to make a well-founded decision. The method also facilitated communication among those involved in the care of the patient. Techniques from fields other than decision analysis can potentially expand the repertoire of tools available to support medical decision making and to facilitate communication in decision consults.

  4. Personalised Multi-Criterial Online Decision Support for Siblings Considering Stem Cell Donation: An Interactive Aid.

    PubMed

    Kaltoft, Mette Kjer; Salkeld, Glenn; Dowie, Jack

    2016-01-01

    Person-centred decision support combines the best available information on the considerations that matter to the individual, with the importance the person attaches to those considerations. Nurses and other health professionals can benefit from being able to draw on this support within a clinical conversation. A case study and storyline on four siblings facing a transplant coordinator's call to donate stem cells to their brother [1] is 'translated' and used to demonstrate how an interactive multi-criteria aid can be developed for each within a conversational mode. The personalized dialogue and decision aid are accessible online for interaction. Each sibling's decision exemplifies the communication including physical and psychosocial complexities within any decision cascade from call-to-test and to donate, if compatible. A shared template can embrace the informational and ethical aspects of a decision. By interactive decision support within a clinical conversation, each stakeholder can gain a personalised opinion, as well as increased generic health decision literacy [2]. PMID:27332459

  5. Cultural targeting and tailoring of shared decision making technology: a theoretical framework for improving the effectiveness of patient decision aids in culturally diverse groups.

    PubMed

    Alden, Dana L; Friend, John; Schapira, Marilyn; Stiggelbout, Anne

    2014-03-01

    Patient decision aids are known to positively impact outcomes critical to shared decision making (SDM), such as gist knowledge and decision preparedness. However, research on the potential improvement of these and other important outcomes through cultural targeting and tailoring of decision aids is very limited. This is the case despite extensive evidence supporting use of cultural targeting and tailoring to improve the effectiveness of health communications. Building on prominent psychological theory, we propose a two-stage framework incorporating cultural concepts into the design process for screening and treatment decision aids. The first phase recommends use of cultural constructs, such as collectivism and individualism, to differentially target patients whose cultures are known to vary on these dimensions. Decision aid targeting is operationalized through use of symbols and values that appeal to members of the given culture. Content dimensions within decision aids that appear particularly appropriate for targeting include surface level visual characteristics, language, beliefs, attitudes and values. The second phase of the framework is based on evidence that individuals vary in terms of how strongly cultural norms influence their approach to problem solving and decision making. In particular, the framework hypothesizes that differences in terms of access to cultural mindsets (e.g., access to interdependent versus independent self) can be measured up front and used to tailor decision aids. Thus, the second phase in the framework emphasizes the importance of not only targeting decision aid content, but also tailoring the information to the individual based on measurement of how strongly he/she is connected to dominant cultural mindsets. Overall, the framework provides a theory-based guide for researchers and practitioners who are interested in using cultural targeting and tailoring to develop and test decision aids that move beyond a "one-size fits all" approach

  6. Cultural targeting and tailoring of shared decision making technology: a theoretical framework for improving the effectiveness of patient decision aids in culturally diverse groups.

    PubMed

    Alden, Dana L; Friend, John; Schapira, Marilyn; Stiggelbout, Anne

    2014-03-01

    Patient decision aids are known to positively impact outcomes critical to shared decision making (SDM), such as gist knowledge and decision preparedness. However, research on the potential improvement of these and other important outcomes through cultural targeting and tailoring of decision aids is very limited. This is the case despite extensive evidence supporting use of cultural targeting and tailoring to improve the effectiveness of health communications. Building on prominent psychological theory, we propose a two-stage framework incorporating cultural concepts into the design process for screening and treatment decision aids. The first phase recommends use of cultural constructs, such as collectivism and individualism, to differentially target patients whose cultures are known to vary on these dimensions. Decision aid targeting is operationalized through use of symbols and values that appeal to members of the given culture. Content dimensions within decision aids that appear particularly appropriate for targeting include surface level visual characteristics, language, beliefs, attitudes and values. The second phase of the framework is based on evidence that individuals vary in terms of how strongly cultural norms influence their approach to problem solving and decision making. In particular, the framework hypothesizes that differences in terms of access to cultural mindsets (e.g., access to interdependent versus independent self) can be measured up front and used to tailor decision aids. Thus, the second phase in the framework emphasizes the importance of not only targeting decision aid content, but also tailoring the information to the individual based on measurement of how strongly he/she is connected to dominant cultural mindsets. Overall, the framework provides a theory-based guide for researchers and practitioners who are interested in using cultural targeting and tailoring to develop and test decision aids that move beyond a "one-size fits all" approach

  7. The Impact of Financial Aid on Learning, Career Decisions, and Employment: Evidence from Recent Chinese College Students

    ERIC Educational Resources Information Center

    Yang, Po

    2011-01-01

    China established a large-scale financial aid system in the late 1980s. This multilayered aid system aimed at enhancing educational and employment opportunities. However, very few studies have examined the impact of student aid on learning effort and outcome, career decisions, and early labor market performance. Using two recent Chinese college…

  8. An Integrated Decision-Making Model for Categorizing Weather Products and Decision Aids

    NASA Technical Reports Server (NTRS)

    Elgin, Peter D.; Thomas, Rickey P.

    2004-01-01

    The National Airspace System s capacity will experience considerable growth in the next few decades. Weather adversely affects safe air travel. The FAA and NASA are working to develop new technologies that display weather information to support situation awareness and optimize pilot decision-making in avoiding hazardous weather. Understanding situation awareness and naturalistic decision-making is an important step in achieving this goal. Information representation and situation time stress greatly influence attentional resource allocation and working memory capacity, potentially obstructing accurate situation awareness assessments. Three naturalistic decision-making theories were integrated to provide an understanding of the levels of decision making incorporated in three operational situations and two conditions. The task characteristics associated with each phase of flight govern the level of situation awareness attained and the decision making processes utilized. Weather product s attributes and situation task characteristics combine to classify weather products according to the decision-making processes best supported. In addition, a graphical interface is described that affords intuitive selection of the appropriate weather product relative to the pilot s current flight situation.

  9. Establishing the effectiveness of patient decision aids: key constructs and measurement instruments

    PubMed Central

    2013-01-01

    Background Establishing the effectiveness of patient decision aids (PtDA) requires evidence that PtDAs improve the quality of the decision-making process and the quality of the choice made, or decision quality. The aim of this paper is to review the theoretical and empirical evidence for PtDA effectiveness and discuss emerging practical and research issues in the measurement of effectiveness. Methods This updated overview incorporates: a) an examination of the instruments used to measure five key decision-making process constructs (i.e., recognize decision, feel informed about options and outcomes, feel clear about goals and preferences, discuss goals and preferences with health care provider, and be involved in decisions) and decision quality constructs (i.e., knowledge, realistic expectations, values-choice agreement) within the 86 trials in the Cochrane review; and b) a summary of the 2011 Cochrane Collaboration’s review of PtDAs for these key constructs. Data on the constructs and instruments used were extracted independently by two authors from the 86 trials and any disagreements were resolved by discussion, with adjudication by a third party where required. Results The 86 studies provide considerable evidence that PtDAs improve the decision-making process and decision quality. A majority of the studies (76/86; 88%) measured at least one of the key decision-making process or decision quality constructs. Seventeen different measurement instruments were used to measure decision-making process constructs, but no single instrument covered all five constructs. The Decisional Conflict Scale was most commonly used (n = 47), followed by the Control Preference Scale (n = 9). Many studies reported one or more constructs of decision quality, including knowledge (n = 59), realistic expectation of risks and benefits (n = 21), and values-choice agreement (n = 13). There was considerable variability in how values-choice agreement was defined and determined. No study

  10. Evidence-based patient choice: a prostate cancer decision aid in plain language

    PubMed Central

    Holmes-Rovner, Margaret; Stableford, Sue; Fagerlin, Angela; Wei, John T; Dunn, Rodney L; Ohene-Frempong, Janet; Kelly-Blake, Karen; Rovner, David R

    2005-01-01

    Background Decision aids (DA) to assist patients in evaluating treatment options and sharing in decision making have proliferated in recent years. Most require high literacy and do not use plain language principles. We describe one of the first attempts to design a decision aid using principles from reading research and document design. The plain language DA prototype addressed treatment decisions for localized prostate cancer. Evaluation assessed impact on knowledge, decisions, and discussions with doctors in men newly diagnosed with prostate cancer. Methods Document development steps included preparing an evidence-based DA in standard medical parlance, iteratively translating it to emphasize shared decision making and plain language in three formats (booklet, Internet, and audio-tape). Scientific review of medical content was integrated with expert health literacy review of document structure and design. Formative evaluation methods included focus groups (n = 4) and survey of a new sample of men newly diagnosed with prostate cancer (n = 60), compared with historical controls (n = 184). Results A transparent description of the development process and design elements is reported. Formative evaluation among newly diagnosed prostate cancer patients found the DA to be clear and useful in reaching a decision. Newly diagnosed patients reported more discussions with doctors about treatment options, and showed increases in knowledge of side effects of radiation therapy. Conclusion The plain language DA presenting medical evidence in text and numerical formats appears acceptable and useful in decision-making about localized prostate cancer treatment. Further testing should evaluate the impact of all three media on decisions made and quality of life in the survivorship period, especially among very low literacy men. PMID:15963238

  11. Incorporating Medium-Range Weather Forecasts in Seasonal Crop Scenarios over the Greater Horn of Africa to Support National/Regional/Local Decision Makers

    NASA Astrophysics Data System (ADS)

    Shukla, S.; Husak, G. J.; Funk, C. C.; Verdin, J. P.

    2015-12-01

    The USAID's Famine Early Warning Systems Network (FEWS NET) provides seasonal assessments of crop conditions over the Greater Horn of Africa (GHA) and other food insecure regions. These assessments and current livelihood, nutrition, market conditions and conflicts are used to generate food security scenarios that help national, regional and local decision makers target their resources and mitigate socio-economic losses. Among the various tools that FEWS NET uses is the FAO's Water Requirement Satisfaction Index (WRSI). The WRSI is a simple yet powerful crop assessment model that incorporates current moisture conditions (at the time of the issuance of forecast), precipitation scenarios, potential evapotranspiration and crop parameters to categorize crop conditions into different classes ranging from "failure" to "very good". The WRSI tool has been shown to have a good agreement with local crop yields in the GHA region. At present, the precipitation scenarios used to drive the WRSI are based on either a climatological forecast (that assigns equal chances of occurrence to all possible scenarios and has no skill over the forecast period) or a sea-surface temperature anomaly based scenario (which at best have skill at the seasonal scale). In both cases, the scenarios fail to capture the skill that can be attained by initial atmospheric conditions (i.e., medium-range weather forecasts). During the middle of a cropping season, when a week or two of poor rains can have a devastating effect, two weeks worth of skillful precipitation forecasts could improve the skill of the crop scenarios. With this working hypothesis, we examine the value of incorporating medium-range weather forecasts in improving the skill of crop scenarios in the GHA region. We use the NCEP's Global Ensemble Forecast system (GEFS) weather forecasts and examine the skill of crop scenarios generated using the GEFS weather forecasts with respect to the scenarios based solely on the climatological forecast

  12. Weather Avoidance Using Route Optimization as a Decision Aid: An AWIN Topical Study. Phase 1

    NASA Technical Reports Server (NTRS)

    1998-01-01

    The aviation community is faced with reducing the fatal aircraft accident rate by 80 percent within 10 years. This must be achieved even with ever increasing, traffic and a changing National Airspace System. This is not just an altruistic goal, but a real necessity, if our growing level of commerce is to continue. Honeywell Technology Center's topical study, "Weather Avoidance Using Route Optimization as a Decision Aid", addresses these pressing needs. The goal of this program is to use route optimization and user interface technologies to develop a prototype decision aid for dispatchers and pilots. This decision aid will suggest possible diversions through single or multiple weather hazards and present weather information with a human-centered design. At the conclusion of the program, we will have a laptop prototype decision aid that will be used to demonstrate concepts to industry for integration into commercialized products for dispatchers and/or pilots. With weather a factor in 30% of aircraft accidents, our program will prevent accidents by strategically avoiding weather hazards in flight. By supplying more relevant weather information in a human-centered format along with the tools to generate flight plans around weather, aircraft exposure to weather hazards can be reduced. Our program directly addresses the NASA's five year investment areas of Strategic Weather Information and Weather Operations (simulation/hazard characterization and crew/dispatch/ATChazard monitoring, display, and decision support) (NASA Aeronautics Safety Investment Strategy: Weather Investment Recommendations, April 15, 1997). This program is comprised of two phases, Phase I concluded December 31, 1998. This first phase defined weather data requirements, lateral routing algorithms, an conceptual displays for a user-centered design. Phase II runs from January 1999 through September 1999. The second phase integrates vertical routing into the lateral optimizer and combines the user

  13. Decision Aids for Multiple-Decision Disease Management as Affected by Weather Input Errors

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Many disease management decision support systems (DSS) rely, exclusively or in part, on weather inputs to calculate an indicator for disease hazard. Error in the weather inputs, typically due to forecasting, interpolation or estimation from off-site sources, may affect model calculations and manage...

  14. Ensemble-based analysis of Front Range severe convection on 6-7 June 2012: Forecast uncertainty and communication of weather information to Front Range decision-makers

    NASA Astrophysics Data System (ADS)

    Vincente, Vanessa

    -allowing ensemble also showed greater skill in forecasting heavy precipitation amounts in the vicinity of where they were observed during the most active convective period, particularly near urbanized areas. A total of 9 Front Range EMs were interviewed to research how they understood hazardous weather information, and how their perception of forecast uncertainty would influence their decision making following a heavy rain event. Many of the EMs use situational awareness and past experiences with major weather events to guide their emergency planning. They also highly valued their relationship with the National Weather Service to improve their understanding of weather forecasts and ask questions about the uncertainties. Most of the EMs perceived forecast uncertainty in terms of probability and with the understanding that forecasting the weather is an imprecise science. The greater the likelihood of occurrence (implied by a higher probability of precipitation) showed greater confidence in the forecast that an event was likely to happen. Five probabilistic forecast products were generated from the convection-allowing ensemble output to generate a hypothetical warm season heavy rain event scenario. Responses varied between the EMs in which products they found most practical or least useful. Most EMs believed that there was a high probability for flooding, as illustrated by the degree of forecasted precipitation intensity. Most confirmed perceiving uncertainty in the different forecast representations, sharing the idea that there is an inherent uncertainty that follows modeled forecasts. The long-term goal of this research is to develop and add reliable probabilistic forecast products to the "toolbox" of decision-makers to help them better assess hazardous weather information and improve warning notifications and response.

  15. Medical versus surgical methods of early abortion: protocol for a systematic review and environmental scan of patient decision aids

    PubMed Central

    Donnelly, Kyla Z; Thompson, Rachel

    2015-01-01

    Introduction Currently, we lack understanding of the content, quality and impact of patient decision aids to support decision-making between medical and surgical methods of early abortion. We plan to undertake a systematic review of peer-reviewed literature to identify, appraise and describe the impact of early abortion method decision aids evaluated quantitatively (Part I), and an environmental scan to identify and appraise other early abortion method decision aids developed in the US (Part II). Methods and analysis For the systematic review, we will search PubMed, Cochrane Library, CINAHL, EMBASE and PsycINFO databases for articles describing experimental and observational studies evaluating the impact of an early abortion method decision aid on women's decision-making processes and outcomes. For the environmental scan, we will identify decision aids by supplementing the systematic review search with Internet-based searches and key informant consultation. The primary reviewer will assess all studies and decision aids for eligibility, and a second reviewer will also assess a subset of these. Both reviewers will independently assess risk of bias in the studies and abstract data using a piloted form. Finally, both reviewers will assess decision aid quality using the International Patient Decision Aid Standards criteria, ease of readability using Flesch/Flesch-Kincaid tests, and informational content using directed content analysis. Ethics and dissemination As this study does not involve human subjects, ethical approval will not be sought. We aim to disseminate the findings in a scientific journal, via academic and/or professional conferences and among the broader community to contribute knowledge about current early abortion method decision-making support. Trial registration number This protocol is registered in the International Prospective Register of Systematic Reviews (CRD42015016717). PMID:26173718

  16. Breast cancer anxiety's associations with responses to a chemoprevention decision aid.

    PubMed

    Dillard, Amanda J; Scherer, Laura; Ubel, Peter A; Smith, Dylan M; Zikmund-Fisher, Brian J; McClure, Jennifer B; Greene, Sarah; Stark, Azadeh; Fagerlin, Angela

    2013-01-01

    Few studies have examined how specific emotions may affect decision-making processes. Anxiety may be especially relevant in health decisions such as those related to cancer in which thoughts of illness or death may be abundant. We examined associations between women's anxiety about developing breast cancer and variables related to their decision to take a medication that could reduce their chances of the disease. Six-hundred and thirty-two American women, who had an increased risk of breast cancer, reviewed a web-based decision aid about tamoxifen. We examined associations between their baseline, self-reported anxiety about developing the disease and post decision aid measures including knowledge about tamoxifen, attitude toward the medication, and behavioral intentions to look for more information and take the medication. Results showed that anxiety was not associated with knowledge about tamoxifen, but it was associated with attitude toward the medication such that women who were more anxious about developing breast cancer were more likely to think the benefits were worth the risks. Greater anxiety was also associated with greater behavioral intentions to look for additional information and take the medication in the next few months. Secondary analyses showed that behavioral intentions were related to knowledge of tamoxifen and attitude toward the medication only for women who were reporting low levels of anxiety. Overall, the findings suggest that anxiety about breast cancer may motivate interest in tamoxifen and not necessarily through affecting knowledge or attitudes. PMID:23200299

  17. The Role of Personalised Choice in Decision Support: A Randomized Controlled Trial of an Online Decision Aid for Prostate Cancer Screening

    PubMed Central

    Salkeld, Glenn; Cunich, Michelle; Dowie, Jack; Howard, Kirsten; Patel, Manish I.; Mann, Graham; Lipworth, Wendy

    2016-01-01

    Importance Decision support tools can assist people to apply population-based evidence on benefits and harms to individual health decisions. A key question is whether “personalising” choice within decisions aids leads to better decision quality. Objective To assess the effect of personalising the content of a decision aid for prostate cancer screening using the Prostate Specific Antigen (PSA) test. Design Randomized controlled trial. Setting Australia. Participants 1,970 men aged 40–69 years were approached to participate in the trial. Intervention 1,447 men were randomly allocated to either a standard decision aid with a fixed set of five attributes or a personalised decision aid with choice over the inclusion of up to 10 attributes. Outcome Measures To determine whether there was a difference between the two groups in terms of: 1) the emergent opinion (generated by the decision aid) to have a PSA test or not; 2) self-rated decision quality after completing the online decision aid; 3) their intention to undergo screening in the next 12 months. We also wanted to determine whether men in the personalised choice group made use of the extra decision attributes. Results 5% of men in the fixed attribute group scored ‘Have a PSA test’ as the opinion generated by the aid, as compared to 62% of men in the personalised choice group (χ2 = 569.38, 2df, p< 0001). Those men who used the personalised decision aid had slightly higher decision quality (t = 2.157, df = 1444, p = 0.031). The men in the personalised choice group made extensive use of the additional decision attributes. There was no difference between the two groups in terms of their stated intention to undergo screening in the next 12 months. Conclusions Together, these findings suggest that personalised decision support systems could be an important development in shared decision-making and patient-centered care. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN

  18. Decision-aided sampling frequency offset compensation for reduced-guard-interval coherent optical OFDM systems.

    PubMed

    Wang, Wei; Zhuge, Qunbi; Morsy-Osman, Mohamed; Gao, Yuliang; Xu, Xian; Chagnon, Mathieu; Qiu, Meng; Hoang, Minh Thang; Zhang, Fangyuan; Li, Rui; Plant, David V

    2014-11-01

    We propose a decision-aided algorithm to compensate the sampling frequency offset (SFO) between the transmitter and receiver for reduced-guard-interval (RGI) coherent optical (CO) OFDM systems. In this paper, we first derive the cyclic prefix (CP) requirement for preventing OFDM symbols from SFO induced inter-symbol interference (ISI). Then we propose a new decision-aided SFO compensation (DA-SFOC) algorithm, which shows a high SFO tolerance and reduces the CP requirement. The performance of DA-SFOC is numerically investigated for various situations. Finally, the proposed algorithm is verified in a single channel 28 Gbaud polarization division multiplexing (PDM) RGI CO-OFDM experiment with QPSK, 8 QAM and 16 QAM modulation formats, respectively. Both numerical and experimental results show that the proposed DA-SFOC method is highly robust against the standard SFO in optical fiber transmission. PMID:25401902

  19. Clinical decision aids for chest pain in the emergency department: identifying low-risk patients

    PubMed Central

    Alley, William; Mahler, Simon A

    2015-01-01

    Chest pain is one of the most common presenting complaints in the emergency department, though only a small minority of patients are subsequently diagnosed with acute coronary syndrome (ACS). However, missing the diagnosis has potential for significant morbidity and mortality. ACS presentations can be atypical, and their workups are often prolonged and costly. In order to risk-stratify patients and better direct the workup and care given, many decision aids have been developed. While each may have merit in certain clinical settings, the most useful aid in the emergency department is one that finds all cases of ACS while also identifying a substantial subset of patients at low risk who can be discharged without stress testing or coronary angiography. This review describes several of the chest pain decision aids developed and studied through the recent past, starting with the thrombolysis in myocardial infarction (TIMI) risk score and Global Registry of Acute Coronary Events (GRACE) scores, which were developed as prognostic aids for patients already diagnosed with ACS, then subsequently validated in the undifferentiated chest pain population. Asia-Pacific Evaluation of Chest Pain Trial (ASPECT); Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins (ADAPT); North American Chest Pain Rule (NACPR); and History, Electrocardiogram, Age, Risk factors, Troponin (HEART) score have been developed exclusively for use in the undifferentiated chest pain population as well, with improved performance compared to their predecessors. This review describes the relative merits and limitations of these decision aids so that providers can determine which tool fits the needs of their clinical practice setting. PMID:27147894

  20. Challenging Operations: An Ethical Framework to Assist Humanitarian Aid Workers in their Decision-making Processes

    PubMed Central

    Clarinval, Caroline; Biller-Andorno, Nikola

    2014-01-01

    Introduction: This paper aims to raise awareness regarding ethical issues in the context of humanitarian action, and to offer a framework for systematically and effectively addressing such issues. Methods: Several cases highlight ethical issues that humanitarian aid workers are confronted with at different levels over the course of their deployments. The first case discusses a situation at a macro-level concerning decisions being made at the headquarters of a humanitarian organization. The second case looks at meso-level issues that need to be solved at a country or regional level. The third case proposes an ethical dilemma at the micro-level of the individual patient-provider relationship. Discussion: These real-life cases have been selected to illustrate the ethical dimension of conflicts within the context of humanitarian action that might remain unrecognized in everyday practice. In addition, we propose an ethical framework to assist humanitarian aid workers in their decision-making process. The framework draws on the principles and values that guide humanitarian action and public health ethics more generally. Beyond identifying substantive core values, the framework also includes a ten-step process modelled on tools used in the clinical setting that promotes a transparent and clear decision-making process and improves the monitoring and evaluation of aid interventions. Finally, we recommend organizational measures to implement the framework effectively. Conclusion: This paper uses a combination of public health/clinical ethics concepts and practices and applies them to the decision-making challenges encountered in relief operations in the humanitarian aid context. PMID:24987575

  1. An overview and discussion of the Patient-Centered Outcomes Research Institute's decision aid portfolio.

    PubMed

    Gayer, Christopher C; Crowley, Matthew J; Lawrence, William F; Gierisch, Jennifer M; Gaglio, Bridget; Williams, John W; Myers, Evan R; Kendrick, Amy; Slutsky, Jean; Sanders, Gillian D

    2016-07-01

    Decision aids (DAs) help patients make informed healthcare decisions in a manner consistent with their values and preferences. Despite their promise, DAs developed with public research dollars are not being implemented and adopted in real-world patient care settings at a rate consistent with which they are being developed. To appraise the sum of the parts of the portfolio and create a strategic imperative surrounding future funding, the Patient-Centered Outcomes Research Institute (PCORI) tasked the Duke Evidence Synthesis Group with evaluating its DA portfolio. This paper describes PCORI's portfolio of DAs according to the Duke Evidence Synthesis Group's analysis in the context of PCORI's mission and the field of decision science. The results revealed a diversity within PCORI's portfolio of funded DA projects. Findings support the movement toward more rigorous DA development, assessment and maintenance. PCORI's funding priorities related to DAs are clarified and comparative questions of interest are posed. PMID:27298206

  2. Evaluating a Web-Based MMR Decision Aid to Support Informed Decision-Making by UK Parents: A Before-and-After Feasibility Study

    ERIC Educational Resources Information Center

    Jackson, Cath; Cheater, Francine M.; Peacock, Rose; Leask, Julie; Trevena, Lyndal

    2010-01-01

    Objective: The objective of this feasibility study was to evaluate the acceptability and potential effectiveness of a web-based MMR decision aid in supporting informed decision-making for the MMR vaccine. Design: This was a prospective before-and-after evaluation. Setting: Thirty parents of children eligible for MMR vaccination were recruited from…

  3. Developing and implementing global gender policy to reduce HIV and AIDS in low- and middle-income countries: policy makers' perspectives.

    PubMed

    Olinyk, Shannon; Gibbs, Andrew; Campbell, Catherine

    2014-09-01

    Gender inequalities have been recognised as central to the HIV epidemic for many years. In response, a range of gender policies have been developed in attempts to mitigate the impact and transform gender relations. However, the effects of these policies have been less than successful. In March 2010 the Joint United Nations Programme on HIV/AIDS (UNAIDS) launched the Agenda for accelerated country level action on women, girls, gender equality and HIV (the Agenda), an operational plan on how to integrate women, girls and gender equality into the HIV response. This paper explores the perspectives of those involved in developing and implementing the Agenda to understand its strengths and limitations. In-depth one-on-one interviews were conducted with 16 individuals involved in the development and implementation of the Agenda. The data were analysed using thematic network analysis. Facilitators of the Agenda centred on the Agenda's ability to create political space for women and girls within the global HIV/AIDS response and the collaborative process of developing the Agenda. Barriers to the implementation and development of the Agenda include the limited financial and non-financial resources, the top-down nature of the Agenda's development and implementation and a lack of political will from within UNAIDS to implement it. We suggest that the Agenda achieved many goals, but its effect was constrained by a wide range of factors.

  4. Developing and implementing global gender policy to reduce HIV and AIDS in low- and middle-income countries: policy makers' perspectives.

    PubMed

    Olinyk, Shannon; Gibbs, Andrew; Campbell, Catherine

    2014-09-01

    Gender inequalities have been recognised as central to the HIV epidemic for many years. In response, a range of gender policies have been developed in attempts to mitigate the impact and transform gender relations. However, the effects of these policies have been less than successful. In March 2010 the Joint United Nations Programme on HIV/AIDS (UNAIDS) launched the Agenda for accelerated country level action on women, girls, gender equality and HIV (the Agenda), an operational plan on how to integrate women, girls and gender equality into the HIV response. This paper explores the perspectives of those involved in developing and implementing the Agenda to understand its strengths and limitations. In-depth one-on-one interviews were conducted with 16 individuals involved in the development and implementation of the Agenda. The data were analysed using thematic network analysis. Facilitators of the Agenda centred on the Agenda's ability to create political space for women and girls within the global HIV/AIDS response and the collaborative process of developing the Agenda. Barriers to the implementation and development of the Agenda include the limited financial and non-financial resources, the top-down nature of the Agenda's development and implementation and a lack of political will from within UNAIDS to implement it. We suggest that the Agenda achieved many goals, but its effect was constrained by a wide range of factors. PMID:25388974

  5. A study on spatial decision support systems for HIV/AIDS prevention based on COM GIS technology

    NASA Astrophysics Data System (ADS)

    Yang, Kun; Luo, Huasong; Peng, Shungyun; Xu, Quanli

    2007-06-01

    Based on the deeply analysis of the current status and the existing problems of GIS technology applications in Epidemiology, this paper has proposed the method and process for establishing the spatial decision support systems of AIDS epidemic prevention by integrating the COM GIS, Spatial Database, GPS, Remote Sensing, and Communication technologies, as well as ASP and ActiveX software development technologies. One of the most important issues for constructing the spatial decision support systems of AIDS epidemic prevention is how to integrate the AIDS spreading models with GIS. The capabilities of GIS applications in the AIDS epidemic prevention have been described here in this paper firstly. Then some mature epidemic spreading models have also been discussed for extracting the computation parameters. Furthermore, a technical schema has been proposed for integrating the AIDS spreading models with GIS and relevant geospatial technologies, in which the GIS and model running platforms share a common spatial database and the computing results can be spatially visualized on Desktop or Web GIS clients. Finally, a complete solution for establishing the decision support systems of AIDS epidemic prevention has been offered in this paper based on the model integrating methods and ESRI COM GIS software packages. The general decision support systems are composed of data acquisition sub-systems, network communication sub-systems, model integrating sub-systems, AIDS epidemic information spatial database sub-systems, AIDS epidemic information querying and statistical analysis sub-systems, AIDS epidemic dynamic surveillance sub-systems, AIDS epidemic information spatial analysis and decision support sub-systems, as well as AIDS epidemic information publishing sub-systems based on Web GIS.

  6. Evaluation of a Dispatcher's Route Optimization Decision Aid to Avoid Aviation Weather Hazards

    NASA Technical Reports Server (NTRS)

    Dorneich, Michael C.; Olofinboba, Olu; Pratt, Steve; Osborne, Dannielle; Feyereisen, Thea; Latorella, Kara

    2003-01-01

    This document describes the results and analysis of the formal evaluation plan for the Honeywell software tool developed under the NASA AWIN (Aviation Weather Information) 'Weather Avoidance using Route Optimization as a Decision Aid' project. The software tool aims to provide airline dispatchers with a decision aid for selecting optimal routes that avoid weather and other hazards. This evaluation compares and contrasts route selection performance with the AWIN tool to that of subjects using a more traditional dispatcher environment. The evaluation assesses gains in safety, in fuel efficiency of planned routes, and in time efficiency in the pre-flight dispatch process through the use of the AWIN decision aid. In addition, we are interested in how this AWIN tool affects constructs that can be related to performance. The construct of Situation Awareness (SA), workload, trust in an information system, and operator acceptance are assessed using established scales, where these exist, as well as through the evaluation of questionnaire responses and subject comments. The intention of the experiment is to set up a simulated operations area for the dispatchers to work in. They will be given scenarios in which they are presented with stored company routes for a particular city-pair and aircraft type. A diverse set of external weather information sources is represented by a stand-alone display (MOCK), containing the actual historical weather data typically used by dispatchers. There is also the possibility of presenting selected weather data on the route visualization tool. The company routes have not been modified to avoid the weather except in the case of one additional route generated by the Honeywell prototype flight planning system. The dispatcher will be required to choose the most appropriate and efficient flight plan route in the displayed weather conditions. The route may be modified manually or may be chosen from those automatically displayed.

  7. The effect of positive emotion and perceived risk on usage intention to online decision aids.

    PubMed

    Ma, Qing-guo; Wang, Kai

    2009-10-01

    Although perceived risk has a negative effect on usage intention toward new information technology, both perceived risk and usage intention are the results of cognitive processes, so they are inevitably influenced by emotion. Based on positive mood theory and the appraisal-tendency framework (ATF), a laboratory experiment using online decision aids with 126 participants was conducted. The results indicate that positive emotion (happy emotion in the current study) can increase usage intention and decrease perceived risk, while perceived risk decreases usage intention. Further investigation finds that perceived risk is a mediator between emotion and usage intention.

  8. The NIAID Division of AIDS enterprise information system: integrated decision support for global clinical research programs

    PubMed Central

    Gupta, Nitin; Varghese, Suresh; Virkar, Hemant

    2011-01-01

    The National Institute of Allergy and Infectious Diseases (NIAID) Division of AIDS (DAIDS) Enterprise Information System (DAIDS-ES) is a web-based system that supports NIAID in the scientific, strategic, and tactical management of its global clinical research programs for HIV/AIDS vaccines, prevention, and therapeutics. Different from most commercial clinical trials information systems, which are typically protocol-driven, the DAIDS-ES was built to exchange information with those types of systems and integrate it in ways that help scientific program directors lead the research effort and keep pace with the complex and ever-changing global HIV/AIDS pandemic. Whereas commercially available clinical trials support systems are not usually disease-focused, DAIDS-ES was specifically designed to capture and incorporate unique scientific, demographic, and logistical aspects of HIV/AIDS treatment, prevention, and vaccine research in order to provide a rich source of information to guide informed decision-making. Sharing data across its internal components and with external systems, using defined vocabularies, open standards and flexible interfaces, the DAIDS-ES enables NIAID, its global collaborators and stakeholders, access to timely, quality information about NIAID-supported clinical trials which is utilized to: (1) analyze the research portfolio, assess capacity, identify opportunities, and avoid redundancies; (2) help support study safety, quality, ethics, and regulatory compliance; (3) conduct evidence-based policy analysis and business process re-engineering for improved efficiency. This report summarizes how the DAIDS-ES was conceptualized, how it differs from typical clinical trial support systems, the rationale for key design choices, and examples of how it is being used to advance the efficiency and effectiveness of NIAID's HIV/AIDS clinical research programs. PMID:21816958

  9. The NIAID Division of AIDS enterprise information system: integrated decision support for global clinical research programs.

    PubMed

    Kagan, Jonathan M; Gupta, Nitin; Varghese, Suresh; Virkar, Hemant

    2011-12-01

    The National Institute of Allergy and Infectious Diseases (NIAID) Division of AIDS (DAIDS) Enterprise Information System (DAIDS-ES) is a web-based system that supports NIAID in the scientific, strategic, and tactical management of its global clinical research programs for HIV/AIDS vaccines, prevention, and therapeutics. Different from most commercial clinical trials information systems, which are typically protocol-driven, the DAIDS-ES was built to exchange information with those types of systems and integrate it in ways that help scientific program directors lead the research effort and keep pace with the complex and ever-changing global HIV/AIDS pandemic. Whereas commercially available clinical trials support systems are not usually disease-focused, DAIDS-ES was specifically designed to capture and incorporate unique scientific, demographic, and logistical aspects of HIV/AIDS treatment, prevention, and vaccine research in order to provide a rich source of information to guide informed decision-making. Sharing data across its internal components and with external systems, using defined vocabularies, open standards and flexible interfaces, the DAIDS-ES enables NIAID, its global collaborators and stakeholders, access to timely, quality information about NIAID-supported clinical trials which is utilized to: (1) analyze the research portfolio, assess capacity, identify opportunities, and avoid redundancies; (2) help support study safety, quality, ethics, and regulatory compliance; (3) conduct evidence-based policy analysis and business process re-engineering for improved efficiency. This report summarizes how the DAIDS-ES was conceptualized, how it differs from typical clinical trial support systems, the rationale for key design choices, and examples of how it is being used to advance the efficiency and effectiveness of NIAID's HIV/AIDS clinical research programs.

  10. Factors that influence the medication decision making of persons with HIV/AIDS: a taxonomic exploration.

    PubMed

    Russell, Cynthia K; Bunting, Sheila M; Graney, Marshall; Hartig, Margaret T; Kisner, Patricia; Brown, Brian

    2003-01-01

    It is well known that patients often alter their medication regimens and that these changes may have profound consequences for their health outcomes. Not so well known are the factors that influence the medication decision making of persons managing their own treatment in their day-to-day home situations. In this study, persons living with HIV/AIDS (PLWH) were asked about factors that affected the taking of their medications. Using semistructured interviews in this study of 57 PLWH, the authors used intensive analysis of the narratives to create taxonomies of the barriers and facilitators to taking HIV medications and the decisions that were involved. Categories of identified facilitators included motivation, factors of faith, routines, and others' influences. Categories of identified barriers included perceptions, psycho-emotional issues, provider/clinic issues, interpersonal factors, and disease and treatment factors. This study showed medication decision making to be a complex process, influenced by often-competing life and treatment issues and affected by participants' beliefs and values. These findings call for research into the everyday selfcare of PLWH to understand the reasoned decision-making that PLWH use in managing not only their medications but also their lives.

  11. Cultural and Linguistic Adaptation of a Multimedia Colorectal Cancer Screening Decision Aid for Spanish Speaking Latinos

    PubMed Central

    Ko, Linda K.; Reuland, Daniel; Jolles, Monica; Clay, Rebecca; Pignone, Michael

    2014-01-01

    As the United States becomes more linguistically and culturally diverse, there is a need for effective health communication interventions that target diverse and most vulnerable populations. Latinos also have the lowest colorectal (CRC) screening rates of any ethnic group in the U.S. To address such disparities, health communication interventionists are often faced with the challenge to adapt existing interventions from English into Spanish in a way that retains essential elements of the original intervention while also addressing the linguistic needs and cultural perspectives of the target population. We describe the conceptual framework, context, rationale, methods, and findings of a formative research process used in creating a Spanish language version of an evidenced-based (English language) multimedia CRC screening decision aid. Our multi-step process included identification of essential elements of the existing intervention, literature review, assessment of the regional context and engagement of key stakeholders, and solicitation of direct input from target population. We integrated these findings in the creation of the new adapted intervention. We describe how we used this process to identify and integrate socio-cultural themes such as personalism (personalismo), familism (familismo), fear (miedo), embarrassment (verguenza), power distance (respeto), machismo, and trust (confianza) into the Spanish language decision aid. PMID:24328496

  12. Moral Hypocrisy on the Basis of Construal Level: To Be a Utilitarian Personal Decision Maker or to Be a Moral Advisor?

    PubMed Central

    Xiao, Wei; Wu, Qing; Yang, Qun; Zhou, Liang; Jiang, Yuan; Zhang, Jiaxi; Miao, Danmin; Peng, Jiaxi

    2015-01-01

    Background People encounter various moral issues that involve making decisions for others by giving advice. Objective This study investigated the characteristics of providing suggestions for oneself versus providing suggestions for others in ethical decision-making and the differences between them based on Construal Level Theory (CLT). Methods A total of 768 undergraduate students from three universities in China were randomly assigned to eight groups on the basis of a grid of two Construal Levels (self or others) by two different numbers of people saved (5 people or 15 people) by two problem situations (trolley problem vs. footbridge problem). The investigation examined participants’ decisions to opt to take action or refrain from action that would have the consequence of saving more people. Results The main effects of Construal Level (F1, 752 = 6.46, p = .011), saving number (F1, 752 = 35.81, p < .001), and problem situation type (F1, 752 = 330.55, p < .001) were all significant. The interaction of the problem situation and saving number (F1, 752 = 1.01, p = .31), and social distance and saving number (F1, 752 = 0.85, p = .36), and interaction of the three independent factors (F1, 752 = 0.47, p = .49) were not significant. However, the interaction of social distance and problem situation (F1, 752 = 9.46, p = .002) was significant. Results indicated the participants utilized a component of utilitarian reasoning in the decision-making, and their behaviors appeared more utilitarian at low Construal Levels (CLs) compared to high. Conclusion CLs, saving numbers, and problem situation significantly affected moral decision-making and exhibited significant interaction. Making decisions for oneself (low-construal) rather than giving advice to others (high-construal) was one important factor that determined whether the people were utilitarian or not. Utilitarian considerations are more relevant in impersonal dilemmas. PMID:25689521

  13. An effort to spread decision aids in five California primary care practices yielded low distribution, highlighting hurdles.

    PubMed

    Lin, Grace A; Halley, Meghan; Rendle, Katharine A S; Tietbohl, Caroline; May, Suepattra G; Trujillo, Laurel; Frosch, Dominick L

    2013-02-01

    Despite the proven efficacy of decision aids as interventions for increasing patient engagement and facilitating shared decision making, they are not used routinely in clinical care. Findings from a project designed to achieve such integration, conducted at five primary care practices in 2010-12, document low rates of distribution of decision aids to eligible patients due for colorectal cancer screening (9.3 percent) and experiencing back pain (10.7 percent). There were also no lasting increases in distribution rates in response to training sessions and other promotional activities for physicians and clinic staff. The results of focus groups, ethnographic field notes, and surveys suggest that major structural and cultural changes in health care practice and policy are necessary to achieve the levels of use of decision aids and shared decision making in routine practice envisioned in current policy. Among these changes are ongoing incentives for use, physician training, and a team-based practice model in which all care team members bear formal responsibility for the use of decision aids in routine primary care.

  14. A spatial decision support tool for estimating population catchments to aid rural and remote health service allocation planning.

    PubMed

    Schuurman, Nadine; Randall, Ellen; Berube, Myriam

    2011-12-01

    There is mounting pressure on healthcare planners to manage and contain costs. In rural regions, there is a particular need to rationalize health service allocation to ensure the best possible coverage for a dispersed population. Rural health administrators need to be able to quantify the population affected by their allocation decisions and, therefore, need the capacity to incorporate spatial analyses into their decision-making process. Spatial decision support systems (SDSS) can provide this capability. In this article, we combine geographical information systems (GIS) with a web-based graphical user interface (webGUI) in a SDSS tool that enables rural decision-makers charged with service allocation, to estimate population catchments around specific health services in rural and remote areas. Using this tool, health-care planners can model multiple scenarios to determine the optimal location for health services, as well as the number of people served in each instance.

  15. Which factors may determine the necessary and feasible type of effectiveness evidence? A mixed methods approach to develop an instrument to help coverage decision-makers

    PubMed Central

    de Groot, Saskia; Rijnsburger, Adriana J; Versteegh, Matthijs M; Heymans, Juanita M; Kleijnen, Sarah; Redekop, W Ken; Verstijnen, Ilse M

    2015-01-01

    Objectives Reimbursement decisions require evidence of effectiveness and, in general, a blinded randomised controlled trial (RCT) is the preferred study design to provide it. However, there are situations where a cohort study, or even patient series, can be deemed acceptable. The aim of this study was to develop an instrument that first examines which study characteristics of a blinded RCT are necessary, and then, if particular characteristics are considered necessary, examines whether these characteristics are feasible. Design We retrospectively studied 22 interventions from 20 reimbursement reports concerning medical specialist care made by the Dutch National Health Care Institute (ZIN) to identify any factors that influenced the necessity and feasibility of blinded RCTs, and their constituent study characteristics, that is, blinding, randomisation and a control group. A literature review was performed to identify additional factors. Additional expertise was included by interviewing eight experts in epidemiology, medicine and ethics. The resulting instrument was called the FIT instrument (Feasible Information Trajectory), and was prospectively validated using three consecutive reimbursement reports. Results (Blinded) RCT evidence was lacking in 5 of 11 positive reimbursement decisions and 3 of 11 negative decisions. In the reimbursement reports, we found no empirical evidence supporting situations where a blinded RCT is unnecessary. The literature also revealed few arguments against the necessity of a blinded RCT. In contrast, many factors influencing the feasibility of randomisation, a control group and blinding, were found in the reimbursement reports and the literature; for example, when a patient population is too small or when an intervention is common practice, randomisation will be hindered. Conclusions Policy regarding the necessity and feasibility of different types of evidence of effectiveness would benefit from systematic guidance. The FIT instrument

  16. Design model of computerized personal decision aid for youth: An expert review

    NASA Astrophysics Data System (ADS)

    Sarif, Siti Mahfuzah; Ibrahim, Norfiza; Shiratuddin, Norshuhada

    2016-08-01

    This paper provides a structured review of a design model of a computerized personal decision aid that is intended for youth, named as YouthPDA Design Model. The proposed design model was examined by experts in related areas to ensure the appropriateness of the proposed components and elements, relevancy of the terminologies used, logic of the flow, usability, and practicality of the design model towards development of YouthPDA application. Seven experts from related areas were involved in the evaluation. Discussions on the findings obtained from the expert review are included in this paper. Finally, a revised design model of YouthPDA is proposed as main guidance to develop YouthPDA application.

  17. Decision-Aiding and Optimization for Vertical Navigation of Long-Haul Aircraft

    NASA Technical Reports Server (NTRS)

    Patrick, Nicholas J. M.; Sheridan, Thomas B.

    1996-01-01

    different airspace design and air traffic management policies. A decision aid is proposed which would combine the pilot's notion of optimility with the GA-based optimization, provide the pilot with a number of alternative pareto-optimal trajectories, and allow him to consider un-modelled attributes and constraints in choosing among them. A solution to the problem of displaying alternatives in a multi-attribute decision space is also presented.

  18. Decision-Aiding and Optimization for Vertical Navigation of Long-Haul Aircraft

    NASA Technical Reports Server (NTRS)

    Patrick, Nicholas J. M.; Sheridan, Thomas B.

    1996-01-01

    different airspace design and air traffic management policies. A decision aid is proposed which would combine the pilot's notion of optimality with the GA-based optimization, provide the pilot with a number of alternative pareto-optimal trajectories, and allow him to consider unmodelled attributes and constraints in choosing among them. A solution to the problem of displaying alternatives in a multi-attribute decision space is also presented.

  19. Development and application of culturally appropriate decision aids for smoking cessation in Korea: a pragmatic clustered randomization crossover trial

    PubMed Central

    Lee, Ji Eun; Shin, Dong Wook; Suh, Beomseok; Chun, Sohyun; Nam, You-Seon; Cho, Belong

    2016-01-01

    Introduction In Asian countries, reluctance to seek pharmacological intervention is a major barrier for smoking cessation. Culturally appropriate decision aids are expected to help people in the decision making for the use of smoking cessation medication. Objective The aim of this study was to develop a culturally tailored decision aid for smoking cessation and evaluate its effect on the use of smoking cessation medication. Patients and methods A 7-minute video on smoking cessation information and options was developed. Physicians were randomized into intervention and control groups. The decision aid was provided to patients in the intervention group, and they watched it, while those in the control group were provided usual medical care for smoking cessation. The primary outcome was the proportion of smokers who were prescribed smoking cessation medication within 1 month after consultation. The secondary outcomes were abstinence rate and use of smoking cessation medication within 6 months. A logistic regression analysis was used to assess the effect of the decision aid on the outcomes. Results In total, 414 current smokers (intervention group: 195; control group: 219) were enrolled. The mean age of the participants was 48.2 years, and 381 subjects (92%) were males. In total, 11.8% of the participants in the intervention group and 10.5% in the control group were prescribed smoking cessation medications within 1 month. The odds ratio was 1.02 (95% CI: 0.40–2.63) after adjustment for baseline characteristics. Within 6 months, 17.4% of the participants in the intervention group and 15% in the control group were prescribed medication (adjusted odds ratio 1.12, 95% CI: 0.59–2.13). Conclusion The culturally tailored smoking cessation decision aid developed in this study did not show a significant impact on the decision to use smoking cessation medication. Further research to develop more effective and more interactive interventions is expected. PMID:27703338

  20. Toward systematic reviews to understand the determinants of wait time management success to help decision-makers and managers better manage wait times

    PubMed Central

    2013-01-01

    Background Long waits for core specialized services have consistently been identified as a key barrier to access. Governments and organizations at all levels have responded with strategies for better wait list management. While these initiatives are promising, insufficient attention has been paid to factors influencing the implementation and sustainability of wait time management strategies (WTMS) implemented at the organizational level. Methods A systematic review was conducted using the main electronic databases, such as CINAHL, MEDLINE, and Cochrane Database of Systematic Reviews, to identify articles published between 1990 and 2011 on WTMS for scheduled care implemented at the organizational level or higher and on frameworks for analyzing factors influencing their success. Data was extracted on governance, culture, resources, and tools. We organized a workshop with Canadian healthcare policy-makers and managers to compare our initial findings with their experience. Results Our systematic review included 47 articles: 36 related to implementation and 11 to sustainability. From these, we identified a variety of WTMS initiated at the organizational level or higher, and within these, certain factors that were specific to either implementation or sustainability and others common to both. The main common factors influencing success at the contextual level were stakeholder engagement and strong funding, and at the organizational level, physician involvement, human resources capacity, and information management systems. Specific factors for successful implementation at the contextual level were consultation with front-line actors and common standards and guidelines, and at the organizational level, financial incentives and dedicated staffing. For sustainability, we found no new factors. The workshop participants identified the same major factors as found in the articles and added others, such as information sharing between physicians and managers. Conclusions Factors

  1. Usability testing of ANSWER: a web-based methotrexate decision aid for patients with rheumatoid arthritis

    PubMed Central

    2013-01-01

    Background Decision aids are evidence-based tools designed to inform people of the potential benefit and harm of treatment options, clarify their preferences and provide a shared decision-making structure for discussion at a clinic visit. For patients with rheumatoid arthritis (RA) who are considering methotrexate, we have developed a web-based patient decision aid called the ANSWER (Animated, Self-serve, Web-based Research Tool). This study aimed to: 1) assess the usability of the ANSWER prototype; 2) identify strengths and limitations of the ANSWER from the patient’s perspective. Methods The ANSWER prototype consisted of: 1) six animated patient stories and narrated information on the evidence of methotrexate for RA; 2) interactive questionnaires to clarify patients’ treatment preferences. Eligible participants for the usability test were patients with RA who had been prescribed methotrexate. They were asked to verbalize their thoughts (i.e., think aloud) while using the ANSWER, and to complete the System Usability Scale (SUS) to assess overall usability (range = 0-100; higher = more user friendly). Participants were audiotaped and observed, and field notes were taken. The testing continued until no new modifiable issues were found. We used descriptive statistics to summarize participant characteristics and the SUS scores. Content analysis was used to identified usability issues and navigation problems. Results 15 patients participated in the usability testing. The majority were aged 50 or over and were university/college graduates (n = 8, 53.4%). On average they took 56 minutes (SD = 34.8) to complete the tool. The mean SUS score was 81.2 (SD = 13.5). Content analysis of audiotapes and field notes revealed four categories of modifiable usability issues: 1) information delivery (i.e., clarity of the information and presentation style); 2) navigation control (i.e., difficulties in recognizing and using the navigation control buttons); 3

  2. Perceptions of Prostate Cancer Screening Controversy and Informed Decision Making: Implications for Development of a Targeted Decision Aid for Unaffected Male First-Degree Relatives

    PubMed Central

    Gwede, Clement K.; Davis, Stacy N.; Wilson, Shaenelle; Patel, Mitul; Vadaparampil, Susan T.; Meade, Cathy D.; Rivers, Brian M.; Yu, Daohai; Torres-Roca, Javier; Heysek, Randy; Spiess, Philippe E.; Pow-Sang, Julio; Jacobsen, Paul

    2014-01-01

    Purpose First-degree relatives (FDRs) of prostate cancer (PC) patients should consider multiple concurrent personal risk factors when engaging in informed decision making (IDM) about PC screening. This study assessed perceptions of IDM recommendations and risk-appropriate strategies for IDM among FDRs of varied race/ethnicity. Design A cross-sectional, qualitative Setting Study setting was a cancer center in southwest Florida. Participants The study comprised 44 participants (24 PC patients and 20 unaffected FDRs). Method Focus groups and individual interviews were conducted and analyzed using content analysis and constant comparison methods. Results Patients and FDRs found the PC screening debate and IDM recommendations to be complex and counterintuitive. They overwhelmingly believed screening saves lives and does not have associated harms. There was a strongly expressed need to improve communication between patients and FDRs. A single decision aid that addresses the needs of all FDRs, rather than separating by race/ethnicity, was recommended as sufficient by study participants. These perspectives guided the development of an innovative decision aid that deconstructs the screening controversy and IDM processes into simpler concepts and provides step-by-step strategies for FDRs to engage in IDM. Conclusion Implementing IDM among FDRs is challenging because the IDM paradigm departs from historical messages promoting routine screening. These contradictions should be recognized and addressed for men to participate effectively in IDM. A randomized pilot study evaluating outcomes of the resulting decision aid is underway. PMID:24968183

  3. Utilizing computerized entertainment education in the development of decision aids for lower literate and naïve computer users.

    PubMed

    Jibaja-Weiss, Maria L; Volk, Robert J

    2007-01-01

    Decision aids have been developed by using various delivery methods, including interactive computer programs. Such programs, however, still rely heavily on written information, health and digital literacy, and reading ease. We describe an approach to overcome these potential barriers for low-literate, underserved populations by making design considerations for poor readers and naïve computer users and by using concepts from entertainment education to engage the user and to contextualize the content for the user. The system design goals are to make the program both didactic and entertaining and the navigation and graphical user interface as simple as possible. One entertainment education strategy, the soap opera, is linked seamlessly to interactive learning modules to enhance the content of the soap opera episodes. The edutainment decision aid model (EDAM) guides developers through the design process. Although designing patient decision aids that are educational, entertaining, and targeted toward poor readers and those with limited computer skills is a complex task, it is a promising strategy for aiding this population. Entertainment education may be a highly effective approach to promoting informed decision making for patients with low health literacy.

  4. Effects of a Web-Based Decision Aid Regarding Diagnostic Self-Testing. A Single-Blind Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Ickenroth, Martine H. P.; Grispen, J. E. J.; de Vries, N. K.; Dinant, G. J.; Ronda, G.; van der Weijden, T.

    2016-01-01

    Currently, there are many diagnostic self-tests on body materials available to consumers. The aim of this study was to assess the effect of an online decision aid on diagnostic self-testing for cholesterol and diabetes on knowledge among consumers with an intention to take these tests. A randomized controlled trial was designed. A total of 1259…

  5. arriba-lib: Analyses of user interactions with an electronic library of decision aids on the basis of log data.

    PubMed

    Hirsch, Oliver; Szabo, Elisabeth; Keller, Heidemarie; Kramer, Lena; Krones, Tanja; Donner-Banzhoff, Norbert

    2012-12-01

    Computerised log files are important for analysing user behaviour in health informatics to gain insight into processes that lead to suboptimal user patterns. This is important for software training programmes or for changes to improve usability. Technical user behaviour regarding decision aids has not so far been thoroughly investigated with log files. The aim of our study was to examine more detailed user interactions of primary-care physicians and their patients with arriba-lib, our multimodular electronic library of decision aids used during consultations, on the basis of log data. We analysed 184 consultation log files from 28 primary-care physicians. The average consultation time of our modules was about 8 min. Two-thirds of the consultation time were spent in the history information part of the programme. In this part, mainly bar charts were used to display risk information. Our electronic library of decision aids does not generate specific user behaviour based on physician characteristics such as age, gender, years in practice, or prior experience with decision aids. This supports the widespread use of our e-library in the primary-care sector and probably beyond.

  6. Utilizing computerized entertainment education in the development of decision aids for lower literate and naïve computer users.

    PubMed

    Jibaja-Weiss, Maria L; Volk, Robert J

    2007-01-01

    Decision aids have been developed by using various delivery methods, including interactive computer programs. Such programs, however, still rely heavily on written information, health and digital literacy, and reading ease. We describe an approach to overcome these potential barriers for low-literate, underserved populations by making design considerations for poor readers and naïve computer users and by using concepts from entertainment education to engage the user and to contextualize the content for the user. The system design goals are to make the program both didactic and entertaining and the navigation and graphical user interface as simple as possible. One entertainment education strategy, the soap opera, is linked seamlessly to interactive learning modules to enhance the content of the soap opera episodes. The edutainment decision aid model (EDAM) guides developers through the design process. Although designing patient decision aids that are educational, entertaining, and targeted toward poor readers and those with limited computer skills is a complex task, it is a promising strategy for aiding this population. Entertainment education may be a highly effective approach to promoting informed decision making for patients with low health literacy. PMID:17934944

  7. The Factors that Influence Data Utilization in Decision-Making: The Case of HIV/AIDS Programs in Mexico

    ERIC Educational Resources Information Center

    Rodriguez, Daniela Cristina

    2011-01-01

    In Mexico, as in many other countries, HIV/AIDS strategies are developed at the federal level and implemented at the state level. Local programs are expected to use data, in particular surveillance data, to drive their decisions on programmatic activities and prioritize populations with which the program will engage. Since the early 1980s Mexico…

  8. Decision-making orientation and AIDS-related knowledge, attitudes, and behaviors of Hispanic, African-American, and white adolescents.

    PubMed

    Langer, L M; Zimmerman, R S; Warheit, G J; Duncan, R C

    1993-05-01

    How adolescents' personal sense of directedness (i.e., peer, parent, or self-directed orientation) affects the decision-making processes of adolescent students regarding AIDS-related knowledge, attitudes, beliefs, behaviors, and skills (KABBS) is examined. The sample consisted of 10th-grade students in 8 public high schools (N = 2,515) in Dade County (greater Miami), Florida. The findings showed that decision-making orientation and directedness was a significant predictor of AIDS-related KABBS of adolescents. Overall, the level of AIDS-related KABBS that were associated with low risk was found significantly more often among self-directed students and least often among peer-directed students. The findings of this study suggest that future preadult health-risk research should incorporate the concept of differences of information processing across adolescents. PMID:8500453

  9. Use of online safety decision aid by abused women: effect on decisional conflict in randomized controlled trial

    PubMed Central

    Eden, Karen B.; Perrin, Nancy A.; Hanson, Ginger C.; Messing, Jill T.; Bloom, Tina L.; Campbell, Jacquelyn C.; Gielen, Andrea C.; Clough, Amber S.; Barnes-Hoyt, Jamie S.; Glass, Nancy E.

    2014-01-01

    Background An Internet safety decision aid was developed to help abused women understand their risk for repeat and near-lethal intimate partner violence, clarify priorities related to safety, and develop an action plan customized to these priorities. Purpose The overall purpose of this study was to test the effectiveness of a safety decision aid compared with usual safety planning (control) delivered through a secure website, using a multi-state randomized controlled trial design. The paper evaluated the effectiveness of the safety decision aid in reducing decisional conflict after a single use by abused women. Design Randomized controlled trial referred to as IRIS, Internet Resource for Intervention and Safety Participants Abused women who spoke English (N = 708) were enrolled in a four-state, randomized controlled trial. Intervention and Control The intervention was an interactive safety decision aid with personalized safety plan; the control condition was usual safety planning resources. Both were delivered to participants through the secure study website. Main Outcome Measures This paper compared women’s decisional conflict about safety: total decisional conflict and the four subscales of this measure (feeling: uninformed, uncertain, unclear about safety priorities; and sensing lack of support) between intervention/control conditions. Data were collected 3/2011–5/2013 and analyzed 1/2014–3/2014. Results Immediately following the first use of the interactive safety decision aid, intervention women had significantly lower total decisional conflict than control women, controlling for baseline value of decisional conflict (p=0.002, effect size=.12). After controlling for baseline values, the safety decision aid group had significantly greater reduction in feeling uncertain (p=0.006, effect size=.07), and in feeling unsupported (p=0.008, effect size=.07) about safety than the usual safety planning group. Conclusions Abused women randomized to the safety

  10. Computer-aided detection as a decision assistant in chest radiography

    NASA Astrophysics Data System (ADS)

    Samulski, Maurice R. M.; Snoeren, Peter R.; Platel, Bram; van Ginneken, Bram; Hogeweg, Laurens; Schaefer-Prokop, Cornelia; Karssemeijer, Nico

    2011-03-01

    Background. Contrary to what may be expected, finding abnormalities in complex images like pulmonary nodules in chest radiographs is not dominated by time-consuming search strategies but by an almost immediate global interpretation. This was already known in the nineteen-seventies from experiments with briefly flashed chest radiographs. Later on, experiments with eye-trackers showed that abnormalities attracted the attention quite fast but often without further reader actions. Prolonging one's search seldom leads to newly found abnormalities and may even increase the chance of errors. The problem of reading chest radiographs is therefore not dominated by finding the abnormalities, but by interpreting them. Hypothesis. This suggests that readers could benefit from computer-aided detection (CAD) systems not so much by their ability to prompt potential abnormalities, but more from their ability to 'interpret' the potential abnormalities. In this paper, this hypothesis was investigated by an observer experiment. Experiment. In one condition, the traditional CAD condition, the most suspicious CAD locations were shown to the subjects, without telling them the levels of suspiciousness according to CAD. In the other condition, interactive CAD condition, levels of suspiciousness were given, but only when readers requested them at specified locations. These two conditions focus on decreasing search errors and decision errors, respectively. Results of reading without CAD were also recorded. Six subjects, all non-radiologists, read 223 chest radiographs in both conditions. CAD results were obtained from the OnGuard 5.0 system developed by Riverain Medical (Miamisburg, Ohio). Results. The observer data were analyzed by Location Response Operating Characteristic analysis (LROC). It was found that: 1) With the aid of CAD, the performance is significantly better than without CAD; 2) The performance with interactive CAD is significantly better than with traditional CAD at low false

  11. Sensitivity of disease management decision aids to temperature input errors associated with out-of-canopy and reduced time-resolution measurements

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Plant disease management decision aids typically require inputs of weather elements such as air temperature. Whereas many disease models are created based on weather elements at the crop canopy, and with relatively fine time resolution, the decision aids commonly are implemented with hourly weather...

  12. Application of the Consumer Decision-Making Model to Hearing Aid Adoption in First-Time Users.

    PubMed

    Amlani, Amyn M

    2016-05-01

    Since 1980, hearing aid adoption rates have remained essentially the same, increasing at a rate equal to the organic growth of the population. Researchers have used theoretical models from psychology and sociology to determine those factors or constructs that lead to the adoption of hearing aids by first-time impaired listeners entering the market. In this article, a theoretical model, the Consumer Decision-Making Model (CDM), premised on the neobehavioral approach that considers an individual's psychological and cognitive emphasis toward a product or service, is described. Three theoretical models (i.e., transtheoretical, social model of disability, Health Belief Model), and their relevant findings to the hearing aid market, are initially described. The CDM is then presented, along with supporting evidence of the model's various factors from the hearing aid literature. Future applications of the CDM to hearing health care also are discussed.

  13. MakerBot

    NASA Video Gallery

    Langley’s new Personal Fabrication Laboratory now has a MakerBot. In this video, the 3D printer is making a space shuttle out of glow-in-the-dark plastic material. In real-time, the process took...

  14. Integration of Visibility Sensors in NOAA PORTS® to aid in Decision Making for Safe Navigation

    NASA Astrophysics Data System (ADS)

    Roggenstein, E. B.

    2012-12-01

    The National Oceanic and Atmospheric Administration (NOAA) National Ocean Service (NOS) Physical Oceanographic Real-Time System (PORTS®) provides real-time water level, currents and meteorological data for aid to navigation in twenty-three major ports and harbors. In response to PORTS® users' requests for visibility data, NOS began testing several varieties of visibility sensors for operations in a marine environment. Extensive testing resulted in the selection of the Vaisala FS11 visibility sensor. The FS11 sensor uses forward scattering technology to measure the amount of scattering in a small volume of air between the transmitter and receiver, resulting in an extrapolated visibility at a set height out to 75 km. Two sensors have been successfully operating in the Mobile Bay PORTS® at Middle Bay Port and Pinto Island since installation in 2010. The sensors are positioned at a height of 3 m above the ground, 24 km apart along the western shore of the bay in areas susceptible to fog formation. Real-time data from these sensors are disseminated on NOAA's Center for Operational Oceanographic Products and Services (COOPS) PORTS® website every 6 minutes (min) and for distances up to 10 km (5.4 nm) from the instrument. This has proven to aid port pilots' decision making for safe movement of vessels in the harbor. Additionally, the Pinto Island sensor is located directly adjacent to the shipping channel - an area with high levels of atmospheric particulates of high carbon content. These particulates do not appear to have negatively affected sensor performance. This success has prompted interest in visibility sensors from other harbors with PORTS®. The ports of San Francisco, Narragansett Bay, Chesapeake Bay, Jacksonville FL, and Gulfport MS are planning or exploring the addition of visibility sensors to their PORTS® to aid in navigation. Additionally, the NOAA/COOPS Ocean System Test Evaluation Program (OSTEP) has continued with additional field testing of the FS11

  15. The incorporation of high resolution climatological data into environmental tactical decision aids.

    SciTech Connect

    Hummel, J. R.; Campbell, A. P.; Kehrer, M. L.; Lurie, G. R.; Simunich, K. L.

    1999-09-23

    The environment can significantly impact the performance of weapons systems and how they are used in a theater of operations. A tool has been developed by the US Army Research Laboratory (ARL) to enable operators to assess the impact of environmental factors on the performance of military systems, subsystems, and components. The ARL system, the Integrated Weather Effects Decision Aid (IWEDA) takes weather and environmental data and compares them to a set of rules that relate environmental parameters to weapons system performance. The results from the IWEDA system can enable operators to identify regions and time periods when weapons system performance may be marginal or unfavorable. The Department of Defense (DOD) Air and Space Natural Environment (ASNE) Executive Agents have developed a program, the Advanced Climate Modeling and Environmental Simulations (ACMES), to produce high resolution gridded data for use in generating high resolution climate statistics from simulated weather observations at any desired location around the world. It is intended that data from the ACMES effort could be used by commanders to assess the environmental effects on operations. This paper describes an effort to use data generated from ACMES to drive the IWEDA rules on system performance. The results from this effort are high resolution, gridded values of weapons performance statistics that can be used to support the mission planning cycle.

  16. New observations of scintillation climatology from the Scintillation Network Decision Aid (SCINDA)

    NASA Astrophysics Data System (ADS)

    Su, Y.; Caton, R. G.; Wiens, K.; Groves, K. M.

    2012-12-01

    The Scintillation Network Decision Aid (SCINDA) was established with three ground sites in the mid-1990's by the Air Force Research Laboratory and has continued to grow into a global scintillation observation network. This system consists of an array of VHF and GPS receivers which continually measure scintillation in the equatorial region. In the past few years, the extended network of ground stations has expanded into the African sector. Initial results from yearly scintillation data obtained from two VHF receivers in Narobi, Kenya and Bahir Dar, Ethiopia in 2011 indicate the presence of scintillation activity throughout the June-July -August (northern summer) season which is inconsistent with current state-of-the-art ionospheric climatology models. It is well known that seasonal equatorial scintillation patterns vary with longitude based on geographical location. For example, the scintillation activity at VHF frequencies are absent in the Pacific sector during the months of November to February while observations from South America show nearly continuous scintillation during this same time period. With little to no ground-based observations, the scintillation climatology over the African region has not been well understood. In the paper, we will present S4 measurements various longitudinal sectors, including the first look at solar maximum type conditions over the African sector, and provide comparisons with output from a global climatology model.

  17. An architecture for integrating distributed and cooperating knowledge-based Air Force decision aids

    NASA Technical Reports Server (NTRS)

    Nugent, Richard O.; Tucker, Richard W.

    1988-01-01

    MITRE has been developing a Knowledge-Based Battle Management Testbed for evaluating the viability of integrating independently-developed knowledge-based decision aids in the Air Force tactical domain. The primary goal for the testbed architecture is to permit a new system to be added to a testbed with little change to the system's software. Each system that connects to the testbed network declares that it can provide a number of services to other systems. When a system wants to use another system's service, it does not address the server system by name, but instead transmits a request to the testbed network asking for a particular service to be performed. A key component of the testbed architecture is a common database which uses a relational database management system (RDBMS). The RDBMS provides a database update notification service to requesting systems. Normally, each system is expected to monitor data relations of interest to it. Alternatively, a system may broadcast an announcement message to inform other systems that an event of potential interest has occurred. Current research is aimed at dealing with issues resulting from integration efforts, such as dealing with potential mismatches of each system's assumptions about the common database, decentralizing network control, and coordinating multiple agents.

  18. Survey on computer aided decision support for diagnosis of celiac disease

    PubMed Central

    Hegenbart, Sebastian; Uhl, Andreas; Vécsei, Andreas

    2015-01-01

    Celiac disease (CD) is a complex autoimmune disorder in genetically predisposed individuals of all age groups triggered by the ingestion of food containing gluten. A reliable diagnosis is of high interest in view of embarking on a strict gluten-free diet, which is the CD treatment modality of first choice. The gold standard for diagnosis of CD is currently based on a histological confirmation of serology, using biopsies performed during upper endoscopy. Computer aided decision support is an emerging option in medicine and endoscopy in particular. Such systems could potentially save costs and manpower while simultaneously increasing the safety of the procedure. Research focused on computer-assisted systems in the context of automated diagnosis of CD has started in 2008. Since then, over 40 publications on the topic have appeared. In this context, data from classical flexible endoscopy as well as wireless capsule endoscopy (WCE) and confocal laser endomicrosopy (CLE) has been used. In this survey paper, we try to give a comprehensive overview of the research focused on computer-assisted diagnosis of CD. PMID:25770906

  19. A prototype decision aid for evaluating and selecting R&D proposals

    SciTech Connect

    Al-Ayat, R.A.; Lamont, A.; Sicherman, A.

    1992-05-01

    This report describes a prototype decision aid which has been developed to assist the Institutional Research and Development (IR&D) Committee in selecting proposals for funding. This tool was requested to help address the following concerns about the IR&D proposal selection process: Some good proposals might be overlooked simply because no one on the Committee advocates them forcefully. The process takes a lot of time. The final portfolio of proposals selected may not maximize the long-run benefits to the Laboratory. These concerns stem from the observation that there is no formal framework for making distinctions between proposals, or weighing and comparing those distinctions. It was felt that the process could be improved by a framework that: Provides explicit descriptors that Committee members can use to evaluate and compare different features of proposals. Encourages the Committee to use a uniform, systematic scheme for evaluating the proposals. Helps the Committee focus more quickly on the issues that are truly relevant for distinguishing between proposals.

  20. Values clarification in a decision aid about fertility preservation: does it add to information provision?

    PubMed Central

    2014-01-01

    Background We aimed to evaluate the effect of a decision aid (DA) with information only compared to a DA with values clarification exercise (VCE), and to study the role of personality and information seeking style in DA-use, decisional conflict (DC) and knowledge. Methods Two scenario-based experiments were conducted with two different groups of healthy female participants. Dependent measures were: DC, knowledge, and DA-use (time spent, pages viewed, VCE used). Respondents were randomized between a DA with information only (VCE-) and a DA with information plus a VCE(VCE+) (experiment 1), or between information only (VCE-), information plus VCE without referral to VCE(VCE+), and information plus a VCE with specific referral to the VCE, requesting participants to use the VCE(VCE++) (experiment 2). In experiment 2 we additionally measured personality (neuroticism/conscientiousness) and information seeking style (monitoring/blunting). Results Experiment 1. There were no differences in DC, knowledge or DA-use between VCE- (n=70) and VCE+ (n=70). Both DAs lead to a mean gain in knowledge from 39% at baseline to 73% after viewing the DA. Within VCE+, VCE-users (n=32, 46%) reported less DC compared to non-users. Since there was no difference in DC between VCE- and VCE+, this is likely an effect of VCE-use in a self-selected group, and not of the VCE per se. Experiment 2. There were no differences in DC or knowledge between VCE- (n=65), VCE+ (n=66), VCE++ (n=66). In all groups, knowledge increased on average from 42% at baseline to 72% after viewing the DA. Blunters viewed fewer DA-pages (R=0.38, p<.001). More neurotic women were less certain (R=0.18, p<.01) and felt less supported in decision making (R=0.15, p<.05); conscientious women felt more certain (R=-0.15, p<.05) and had more knowledge after viewing the DA (R=0.15, p<.05). Conclusions Both DAs lead to increased knowledge in healthy populations making hypothetical decisions, and use of the VCE did not improve

  1. A Decision Aid for Women Considering Neoadjuvant Systemic Therapy for Operable Invasive Breast Cancer: Development and Protocol of a Phase II Evaluation Study (ANZ1301 DOMINO)

    PubMed Central

    Butow, Phyllis; Hutchings, Elizabeth; Douglas, Charles; Coll, Joseph R; Boyle, Frances M

    2016-01-01

    Background Neoadjuvant systemic therapy is offered to selected women with large and/or highly proliferative operable breast cancers. This option adds further complexity to an already complex breast cancer treatment decision tree. Patient decision aids are an established method of increasing patient involvement and knowledge while decreasing decisional conflict. There is currently no decision aid available for women considering neoadjuvant systemic therapy. Objective We aimed to develop a decision aid for women diagnosed with operable breast cancer and considered suitable for neoadjuvant systemic therapy, and the protocol for a multicenter pre-post study evaluating the acceptability and feasibility of the decision aid. Methods The decision aid was developed through literature review, expert advisory panel, adherence to the International Patient Decision Aid Standards, and iterative review. The protocol for evaluation of the decision aid consists of the following: eligible women will undertake a series of questionnaires prior to and after using the decision aid. The primary endpoint is decision aid acceptability to patients and investigators and the feasibility of use. Secondary endpoints include change in decisional conflict, participant knowledge, and information involvement preference. Feasibility is defined as the proportion of eligible participants who use the decision aid to help inform their treatment decision. Results This study has recruited 29 out of a planned 50 participants at four Australian sites. A 12-month recruitment period is expected with a further 12-months follow-up. Conclusions The decision aid has the potential to allow patients with operable breast cancer, who have been offered neoadjuvant systemic therapy, decreased decisional conflict, and greater involvement in the decision. If this study finds that an online decision aid is feasible and acceptable, it will be made widely available for routine clinical practice. Trial Registration

  2. Integration of health services in the care of people living with aids: an approach using a decision tree.

    PubMed

    de Medeiros, Leidyanny Barbosa; Trigueiro, Débora Raquel Soares Guedes; da Silva, Daiane Medeiros; do Nascimento, João Agnaldo; Monroe, Aline Aparecida; Nogueira, Jordana de Almeida; Leadebal, Oriana Deyze Correia Paiva

    2016-02-01

    The care offer to people living with HIV/AIDS must transcend specialized outpatient services and include the participation of the Family Health Strategy. By understanding the importance of integration between these two points in the care network, the study aimed to build a decision support model to assist professionals of specialized health services in identifying behavior patterns in the use of Family Health Strategy services by people living with HIV/AIDS attended in the outpatient clinic. Thus, was proposed a model called decision tree, created from a database of 141 people with AIDS, users of a specialized outpatient clinic. The decision-making variable was the use of Family Health Strategy services by evaluating the integration of care. The model enabled the establishment of 23 rules with 80.1% hit percentage, what may support the decision-making of professionals in identifying situations in which it is necessary to stimulate the use of the Family Health Strategy by users. PMID:26910161

  3. Bridging the gap between evidence and policy for infectious diseases: How models can aid public health decision-making.

    PubMed

    Knight, Gwenan M; Dharan, Nila J; Fox, Gregory J; Stennis, Natalie; Zwerling, Alice; Khurana, Renuka; Dowdy, David W

    2016-01-01

    The dominant approach to decision-making in public health policy for infectious diseases relies heavily on expert opinion, which often applies empirical evidence to policy questions in a manner that is neither systematic nor transparent. Although systematic reviews are frequently commissioned to inform specific components of policy (such as efficacy), the same process is rarely applied to the full decision-making process. Mathematical models provide a mechanism through which empirical evidence can be methodically and transparently integrated to address such questions. However, such models are often considered difficult to interpret. In addition, models provide estimates that need to be iteratively re-evaluated as new data or considerations arise. Using the case study of a novel diagnostic for tuberculosis, a framework for improved collaboration between public health decision-makers and mathematical modellers that could lead to more transparent and evidence-driven policy decisions for infectious diseases in the future is proposed. The framework proposes that policymakers should establish long-term collaborations with modellers to address key questions, and that modellers should strive to provide clear explanations of the uncertainty of model structure and outputs. Doing so will improve the applicability of models and clarify their limitations when used to inform real-world public health policy decisions.

  4. Effects of Instructional Aids on the Acquisition of Dynamic Decision-Making Skills

    ERIC Educational Resources Information Center

    Frederiksen, Christian; Kehoe, E. James; Wood, Robert

    2011-01-01

    This study tested the effects of two instructional aids in a complex, dynamic environment, specifically, a business simulation. Participants studied (1) a "causal map," which depicted key variables in an interconnected network, (2) a textual outline of the same relationships, or (3) no-aid. With the relevant aid still available, the participants…

  5. ‘They leave at least believing they had a part in the discussion’: Understanding decision aid use and patient–clinician decision-making through qualitative research

    PubMed Central

    Tiedje, Kristina; Shippee, Nathan D.; Johnson, Anna M.; Flynn, Priscilla M.; Finnie, Dawn M.; Liesinger, Juliette T.; May, Carl R.; Olson, Marianne E.; Ridgeway, Jennifer L.; Shah, Nilay D.; Yawn, Barbara P.; Montori, Victor M.

    2013-01-01

    Objective This study explores how patient decision aids (DAs) for antihyperglycemic agents and statins, designed for use during clinical consultations, are embedded into practice, examining how patients and clinicians understand and experience DAs in primary care visits. Methods We conducted semistructured in-depth interviews with patients (n = 22) and primary care clinicians (n = 19), and videorecorded consultations (n = 44). Two researchers coded all transcripts. Inductive analyses guided by grounded theory led to the identification of themes. Video and interview data were compared and organized by themes. Results DAs used during consultations became flexible artifacts, incorporated into existing decision making roles for clinicians (experts, authority figures, persuaders, advisors) and patients (drivers of healthcare, learners, partners). DAs were applied to different decision making steps (deliberation, bargaining, convincing, case assessment), and introduced into an existing knowledge context (participants’ literacy regarding shared decision-making (SDM) and DAs). Conclusion DAs’ flexible use during consultations effectively provided space for discussion, even when SDM was not achieved. DAs can be used within any decision-making model. Practice implications Clinician training in DA use and SDM practice may be needed to facilitate DA implementation and promote more ideal-type forms of sharing in decision making. PMID:23598292

  6. New approaches with surrogate decision makers.

    PubMed

    Howe, Edmund G

    2014-01-01

    A first principle in ethics consultation is that reasoning is essential. A second principle is that the religious and cultural views of patients and their surrogates are usually respected. What can be done when these principles collide-when patients or surrogates have religious or cultural views and beliefs that clinicians find unreasonable or even offensive? Mediation may provide some approaches to assist us in providing the most ethically appropriate assistance.

  7. Evaluation Bibliography: Parent, Child Decision Makers.

    ERIC Educational Resources Information Center

    North Carolina Univ., Chapel Hill. Technical Assistance Development System.

    This annotated bibliography of tests for children and parents covers tests for children age 0-6 months, 6-12 months, 12-24 months, 24-36 months, 36-48 months, and 48 months and up. The tests measure one or more of the following dimensions: language, cognition, self-help, social-affective, visual-motor, or physical health. The nine tests for…

  8. A Business Casebook for Young Decision Makers.

    ERIC Educational Resources Information Center

    Tedesco, Paul H., Ed.; And Others

    Ten case studies taken from the business world are presented to help secondary school students develop a realistic understanding of economic problems. Discussion of the cases can be integrated into economics or social studies programs. By studying concrete examples of business reacting to changing economic conditions, students should learn to…

  9. High-energy laser tactical decision aid (HELTDA) for mission planning and predictive avoidance

    NASA Astrophysics Data System (ADS)

    Burley, Jarred L.; Fiorino, Steven T.; Randall, Robb M.; Bartell, Richard J.; Cusumano, Salvatore J.

    2012-06-01

    This study demonstrates the development of a high energy laser tactical decision aid (HELTDA) by the AFIT/CDE for mission planning High Energy Laser (HEL) weapon system engagements as well as centralized, decentralized, or hybrid predictive avoidance (CPA/DPA/HPA) assessments. Analyses of example HEL mission engagements are described as well as how mission planners are expected to employ the software. Example HEL engagement simulations are based on geographic location and recent/current atmospheric weather conditions. The atmospheric effects are defined through the AFIT/CDE Laser Environmental Effects Definition and Reference (LEEDR) model or the High Energy Laser End-to-End Operational Simulation (HELEEOS) model upon which the HELTDA is based. These models enable the creation of vertical profiles of temperature, pressure, water vapor content, optical turbulence, and atmospheric particulates and hydrometeors as they relate to line-by-line layer extinction coefficient magnitude at wavelengths from the UV to the RF. Seasonal and boundary layer variations (summer/winter) and time of day variations for a range of relative humidity percentile conditions are considered to determine optimum efficiency in a specific environment. Each atmospheric particulate/hydrometeor is evaluated based on its wavelength-dependent forward and off-axis scattering characteristics and absorption effects on the propagating environment to and beyond the target. In addition to realistic vertical profiles of molecular and aerosol absorption and scattering, correlated optical turbulence profiles in probabilistic (percentile) format are included. Numerical weather model forecasts are incorporated in the model to develop comprehensive understanding of HEL weapon system performance.

  10. Evaluation of the Ryegrass Stem Rust Model STEMRUST_G and Its Implementation as a Decision Aid.

    PubMed

    Pfender, W F; Coop, L B; Seguin, S G; Mellbye, M E; Gingrich, G A; Silberstein, T B

    2015-01-01

    STEMRUST_G, a simulation model for epidemics of stem rust in perennial ryegrass grown to maturity as a seed crop, was validated for use as a heuristic tool and as a decision aid for disease management with fungicides. Multistage validation had been used in model creation by incorporating previously validated submodels for infection, latent period duration, sporulation, fungicide effects, and plant growth. Validation of the complete model was by comparison of model output with observed disease severities in 35 epidemics at nine location-years in the Pacific Northwest of the United States. We judge the model acceptable for its purposes, based on several tests. Graphs of modeled disease progress were generally congruent with plotted disease severity observations. There was negligible average bias in the 570 modeled-versus-observed comparisons across all data, although there was large variance in size of the deviances. Modeled severities were accurate in >80% of the comparisons, where accuracy is defined as the modeled value being within twice the 95% confidence interval of the observed value, within ±1 day of the observation date. An interactive website was created to produce disease estimates by running STEMRUST_G with user-supplied disease scouting information and automated daily weather data inputs from field sites. The model and decision aid supplement disease managers' information by estimating the level of latent (invisible) and expressed disease since the last scouting observation, given season-long weather conditions up to the present, and it estimates effects of fungicides on epidemic development. In additional large-plot experiments conducted in grower fields, the decision aid produced disease management outcomes (management cost and seed yield) as good as or better than the growers' standard practice. In future, STEMRUST_G could be modified to create similar models and decision aids for stem rust of wheat and barley, after additional experiments to

  11. Effects of Viewing an Evidence-Based Video Decision Aid on Patients’ Treatment Preferences for Spine Surgery

    PubMed Central

    Lurie, Jon D.; Spratt, Kevin F.; Blood, Emily A.; Tosteson, Tor D.; Tosteson, Anna N. A.; Weinstein, James N.

    2011-01-01

    Study Design Secondary analysis within a large clinical trial Objective To evaluate the changes in treatment preference before and after watching a video decision aid as part of an informed consent process. Summary of Background Data A randomized trial with a similar decision aid in herniated disc patients had shown decreased rate of surgery in the video group, but the effect of the video on expressed preferences is not known. Methods Subjects enrolling in the Spine Patient Outcomes Research Trial (SPORT) with intervertebral disc herniation (IDH), spinal stenosis (SPS), or degenerative spondylolisthesis (DS) at thirteen multidisciplinary spine centers across the US were given an evidence-based videotape decision aid viewed prior to enrollment as part of informed consent. Results Of the 2505 patients, 86% (n=2151) watched the video and 14% (n=354) did not. Watchers shifted their preference more often than non-watchers(37.9% vs. 20.8%, p < 0.0001) and more often demonstrated a strengthened preference (26.2% vs. 11.1%, p < 0.0001). Among the 806 patients whose preference shifted after watching the video, 55% shifted toward surgery (p=0.003). Among the 617 who started with no preference, after the video 27% preferred non-operative care, 22% preferred surgery, and 51% remained uncertain. Conclusion After watching the evidence-based patient decision aid (video) used in SPORT, patients with specific lumbar spine disorders formed and/or strengthened their treatment preferences in a balanced way that did not appear biased toward or away from surgery. PMID:21358485

  12. Evaluation of the Ryegrass Stem Rust Model STEMRUST_G and Its Implementation as a Decision Aid.

    PubMed

    Pfender, W F; Coop, L B; Seguin, S G; Mellbye, M E; Gingrich, G A; Silberstein, T B

    2015-01-01

    STEMRUST_G, a simulation model for epidemics of stem rust in perennial ryegrass grown to maturity as a seed crop, was validated for use as a heuristic tool and as a decision aid for disease management with fungicides. Multistage validation had been used in model creation by incorporating previously validated submodels for infection, latent period duration, sporulation, fungicide effects, and plant growth. Validation of the complete model was by comparison of model output with observed disease severities in 35 epidemics at nine location-years in the Pacific Northwest of the United States. We judge the model acceptable for its purposes, based on several tests. Graphs of modeled disease progress were generally congruent with plotted disease severity observations. There was negligible average bias in the 570 modeled-versus-observed comparisons across all data, although there was large variance in size of the deviances. Modeled severities were accurate in >80% of the comparisons, where accuracy is defined as the modeled value being within twice the 95% confidence interval of the observed value, within ±1 day of the observation date. An interactive website was created to produce disease estimates by running STEMRUST_G with user-supplied disease scouting information and automated daily weather data inputs from field sites. The model and decision aid supplement disease managers' information by estimating the level of latent (invisible) and expressed disease since the last scouting observation, given season-long weather conditions up to the present, and it estimates effects of fungicides on epidemic development. In additional large-plot experiments conducted in grower fields, the decision aid produced disease management outcomes (management cost and seed yield) as good as or better than the growers' standard practice. In future, STEMRUST_G could be modified to create similar models and decision aids for stem rust of wheat and barley, after additional experiments to

  13. Study of the Impact of Federal Student Financial Aid Policies on State Decisions. Final Report. Revised.

    ERIC Educational Resources Information Center

    Nolfi, George J.; And Others

    The impact of federal student financial aid policy on states and state responses to federal programs are assessed. After reviewing federal and state student aid during the past decade, the State Student Incentive Grant program (SSIG), is discussed, along with the effect of federal policy on SSIG. Perspectives of the state legislatures, governors,…

  14. The Design of an IEP Decision Aid: A Tool for Diverse Parents of Children with Autism

    ERIC Educational Resources Information Center

    Schuttler, Jessica Oeth

    2012-01-01

    Decision-making is a universal process that occurs constantly in life. Parent participation in educational decision-making is recognized as important by special education law, by special education and school psychology literature (Christenson & Sheridan, 2001; IDEIA, 2004;). Partnership in decision-making is especially important for parents of…

  15. EPA Growing DASEES (Decision Analysis For A Sustainable Environment, Economy & Society) - To Aid In Making Decisions On Complex Environmental Issues

    EPA Science Inventory

    Having a framework and tools to help sort through complicated environmental issues in an objective way would be useful to communities and risk managers, and all the stakeholders affected by these issues. This is one need that DASEES (Decision Analysis for a Sustainable En...

  16. The Diamond Makers

    NASA Astrophysics Data System (ADS)

    Hazen, Robert M.

    1999-08-01

    Since time immemorial, we have treasured diamonds for their exquisite beauty and unrivaled hardness. Yet, most of the earth's diamonds lie deep underground and totally unaccessible to us--if only we knew how to fabricate them! In The Diamond Makers Robert Hazen vividly recounts the very human desire to exceed nature and create a synthetic diamond. Spanning centuries of ground-breaking science, instances of bitter rivalry, cases of outright fraud and self-delusion, Hazen blends drama and science to reveal the extraordinary technological advances and devastating failures of the diamond industry. Along the way, readers will be introduced to the brilliant, often eccentric and controversial, pioneers of high-pressure research who have harnessed crushing pressures and scorching temperatures to transform almost any carbon-rich material, from road tar to peanut butter, into the most prized of all gems. Robert M. Hazen is the author of fifteen books, including the bestseller, Science Matters: Achieving Scientific Literacy, which he wrote with James Trefil. Dr. Hazen has won numerous awards for his research and scientific writing.

  17. A Socioecological Model of Rape Survivors' Decisions to Aid in Case Prosecution

    ERIC Educational Resources Information Center

    Anders, Mary C.; Christopher, F. Scott

    2011-01-01

    The purpose of our study was to identify factors underlying rape survivors' post-assault prosecution decisions by testing a decision model that included the complex relations between the multiple social ecological systems within which rape survivors are embedded. We coded 440 police rape cases for characteristics of the assault and characteristics…

  18. A Visual Aid to Decision-Making for People with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Bailey, Rebecca; Willner, Paul; Dymond, Simon

    2011-01-01

    Previous studies have shown that people with mild intellectual disabilities have difficulty in "weighing-up" information, defined as integrating information from two different sources for the purpose of reaching a decision. This was demonstrated in two very different procedures, temporal discounting and a scenario-based financial decision-making…

  19. A Randomized Controlled Trial of a Mobile Clinical Decision Aid to Improve Access to Kidney Transplantation: iChoose Kidney

    PubMed Central

    Patzer, Rachel E.; Basu, Mohua; Mohan, Sumit; Smith, Kayla D.; Wolf, Michael; Ladner, Daniela; Friedewald, John J.; Chiles, Mariana; Russell, Allison; McPherson, Laura; Gander, Jennifer; Pastan, Stephen

    2016-01-01

    Kidney transplantation is the preferred treatment for patients with end-stage renal disease, as it substantially increases a patient's survival and is cost saving compared to a lifetime of dialysis. However, transplantation is not universally chosen by patients with renal failure, and limited knowledge about the survival benefit of transplantation vs. dialysis may play a role. We created a mobile application clinical decision aid called iChoose Kidney to improve access to individualized prognosis information comparing dialysis and transplantation outcomes. We describe the iChoose Kidney study, a randomized controlled trial designed to test the clinical efficacy of a mobile health decision aid among end-stage renal disease patients referred for kidney transplantation at three large, diverse transplant centers across the U.S. Approximately 450 patients will be randomized to receive either: (1) standard of care or “usual” transplantation education, or (2) standard of care plus iChoose Kidney. The primary outcome is change in knowledge about the survival benefit of kidney transplantation vs. dialysis from baseline to immediate follow-up; secondary outcomes include change in treatment preferences, improved decisional conflict, and increased access to kidney transplantation. Analyses are also planned to examine effectiveness across subgroups of race, socioeconomic status, health literacy and health numeracy. Engaging patients in health care choices can increase patient empowerment and improve knowledge and understanding of treatment choices. If the effectiveness of iChoose Kidney has a greater impact on patients with low health literacy, lower socioeconomic status, and minority race, this decision aid could help reduce disparities in access to kidney transplantation. PMID:27610423

  20. The Development and Piloting of a Decision Aid for Parents Considering Sequential Bilateral Cochlear Implantation for Their Child with Hearing Loss

    ERIC Educational Resources Information Center

    Johnston, J. Cyne; Smith, Andree Durieux; O'Connor, Annette; Benzies, Karen; Fitzpatrick, Elizabeth M.; Angus, Douglas

    2009-01-01

    A decision aid for parents considering sequential bilateral cochlear implantation for their children with severe-to-profound hearing loss was developed using local and published evidence. Eight parents of children currently using one cochlear implant, who faced a decision regarding a second cochlear implant, and five clinicians involved in the…

  1. Randomized, Controlled Trial of an Interactive Videodisc Decision Aid for Patients with Ischemic Heart Disease

    PubMed Central

    Morgan, Matthew W; Deber, Raisa B; Llewellyn-Thomas, Hilary A; Gladstone, Peter; Cusimano, RJ; O'rourke, Keith; Tomlinson, George; Detsky, Allan S

    2000-01-01

    OBJECTIVE To determine the effect of the Ischemic Heart Disease Shared Decision-Making Program (IHD SDP) an interactive videodisc designed to assist patients in the decision-making process involving treatment choices for ischemic heart disease, on patient decision-making. DESIGN Randomized, controlled trial. SETTING The Toronto Hospital, University of Toronto, Toronto, Ontario, Canada. PARTICIPANTS Two hundred forty ambulatory patients with ischemic heart disease amenable to elective revascularization and ongoing medical therapy. MEASUREMENTS AND MAIN RESULTS The primary outcome was patient satisfaction with the decision-making process. This was measured using the 12-item Decision-Making Process Questionnaire that was developed and validated in a randomized trial of the benign prostatic hyperplasia SDP. Secondary outcomes included patient knowledge (measured using 20 questions about knowledge deemed necessary for an informed treatment decision), treatment decision, patient-angiographer agreement on decision, and general health scores. Outcomes were measured at the time of treatment decision and/or at 6 months follow-up. Shared decision-making program scores were similar for the intervention and control group (71% and 70%, respectively; 95% confidence interval [CI] for 1% difference, −3% to 7%). The intervention group had higher knowledge scores (75% vs 62%; 95% CI for 13% difference, 8% to 18%). The intervention group chose to pursue revascularization less often (58% vs 75% for the controls; 95% CI for 17% difference, 4% to 31%). At 6 months, 52% of the intervention group and 66% of the controls had undergone revascularization (95% CI for 14% difference, 0% to 28%). General health and angina scores were not different between the groups at 6 months. Exposure to the IHD SDP resulted in more patient-angiographer disagreement about treatment decisions. CONCLUSIONS There was no significant difference in satisfaction with decision-making process scores between the IHD

  2. Back to the Bedside: Developing a Bedside Aid for Concussion and Brain Injury Decisions in the Emergency Department

    PubMed Central

    Melnick, Edward R.; Lopez, Kevin; Hess, Erik P.; Abujarad, Fuad; Brandt, Cynthia A.; Shiffman, Richard N.; Post, Lori A.

    2015-01-01

    Context: Current information-rich electronic health record (EHR) interfaces require large, high-resolution screens running on desktop computers. This interface compromises the provider’s already limited time at the bedside by physically separating the patient from the doctor. The case study presented here describes a patient-centered clinical decision support (CDS) design process that aims to bring the physician back to the bedside by integrating a patient decision aid with CDS for shared use by the patient and provider on a touchscreen tablet computer for deciding whether or not to obtain a CT scan for minor head injury in the emergency department, a clinical scenario that could benefit from CDS but has failed previous implementation attempts. Case Description: This case study follows the user-centered design (UCD) approach to build a bedside aid that is useful and usable, and that promotes shared decision-making between patients and their providers using a tablet computer at the bedside. The patient-centered decision support design process focuses on the prototype build using agile software development, but also describes the following: (1) the requirement gathering phase including triangulated qualitative research (focus groups and cognitive task analysis) to understand current challenges, (2) features for patient education, the physician, and shared decision-making, (3) system architecture and technical requirements, and (4) future plans for formative usability testing and field testing. Lessons Learned: We share specific lessons learned and general recommendations from critical insights gained in the patient-centered decision support design process about early stakeholder engagement, EHR integration, external expert feedback, challenges to two users on a single device, project management, and accessibility. Conclusions: Successful implementation of this tool will require seamless integration into the provider’s workflow. This protocol can create an

  3. Decision aid on breast cancer screening reduces attendance rate: results of a large-scale, randomized, controlled study by the DECIDEO group.

    PubMed

    Bourmaud, Aurelie; Soler-Michel, Patricia; Oriol, Mathieu; Regnier, Véronique; Tinquaut, Fabien; Nourissat, Alice; Bremond, Alain; Moumjid, Nora; Chauvin, Franck

    2016-03-15

    Controversies regarding the benefits of breast cancer screening programs have led to the promotion of new strategies taking into account individual preferences, such as decision aid. The aim of this study was to assess the impact of a decision aid leaflet on the participation of women invited to participate in a national breast cancer screening program. This Randomized, multicentre, controlled trial. Women aged 50 to 74 years, were randomly assigned to receive either a decision aid or the usual invitation letter. Primary outcome was the participation rate 12 months after the invitation. 16 000 women were randomized and 15 844 included in the modified intention-to-treat analysis. The participation rate in the intervention group was 40.25% (3174/7885 women) compared with 42.13% (3353/7959) in the control group (p = 0.02). Previous attendance for screening (RR = 6.24; [95%IC: 5.75-6.77]; p < 0.0001) and medium household income (RR = 1.05; [95%IC: 1.01-1.09]; p = 0.0074) were independently associated with attendance for screening. This large-scale study demonstrates that the decision aid reduced the participation rate. The decision aid activate the decision making process of women toward non-attendance to screening. These results show the importance of promoting informed patient choices, especially when those choices cannot be anticipated.

  4. Re-imagining decision making: addressing a discrete social driver of HIV/AIDS through the lens of complexity science.

    PubMed

    Burman, Christopher J; Moerschell, Linda; Mamabolo, Robert; Aphane, Marota; Delobelle, Peter

    2015-01-01

    This article argues that decision making is a discrete social driver that can be associated with the HIV/AIDS epidemic in the Limpopo province in South Africa. The authors argue that complexity science can inform future research and interventions by presenting two decision making frameworks arising out of complexity science that have the potential to enable young people to better negotiate decision-making contexts whilst simultaneously opening spaces of dialogue that can mitigate the impact of HIV-risk in specific, punctuated contexts. The methodological design was prompted by findings from youth-oriented community engagement projects that include Communication Conversations and Sex & Relationships Education. The proposed methods have the potential to exploit the phenomenon of leadership emergence as a product of decision making at critical moments. This has the potential to promote the growth of home-grown leadership skill sets that make sense to young people and to enable them better manage their own health, thus reducing risk and vulnerability to HIV infection and sexual violence. PMID:25920986

  5. Re-imagining decision making: addressing a discrete social driver of HIV/AIDS through the lens of complexity science.

    PubMed

    Burman, Christopher J; Moerschell, Linda; Mamabolo, Robert; Aphane, Marota; Delobelle, Peter

    2015-01-01

    This article argues that decision making is a discrete social driver that can be associated with the HIV/AIDS epidemic in the Limpopo province in South Africa. The authors argue that complexity science can inform future research and interventions by presenting two decision making frameworks arising out of complexity science that have the potential to enable young people to better negotiate decision-making contexts whilst simultaneously opening spaces of dialogue that can mitigate the impact of HIV-risk in specific, punctuated contexts. The methodological design was prompted by findings from youth-oriented community engagement projects that include Communication Conversations and Sex & Relationships Education. The proposed methods have the potential to exploit the phenomenon of leadership emergence as a product of decision making at critical moments. This has the potential to promote the growth of home-grown leadership skill sets that make sense to young people and to enable them better manage their own health, thus reducing risk and vulnerability to HIV infection and sexual violence.

  6. A decision aid for considering indomethacin prophylaxis vs. symptomatic treatment of PDA for extreme low birth weight infants

    PubMed Central

    2011-01-01

    Background Decision Aids (DA) are well established in various fields of medicine. It can improve the quality of decision-making and reduce decisional conflict. In neonatal care, and due to scientific equipoise, neonatologists caring for extreme low birth weight (ELBW) infants are in need to elicit parents' preferences with regard to the use of indomethacin therapy in ELBW infants. We aimed to develop a DA that elicits parents' preferences with regard to indomethacin therapy in ELBW infants. Methods We developed a DA for the use of the indomethacin therapy in ELBW infants according to the Ottawa Decision Support Framework. The development process involved parents, neonatologists, DA developers and decision making experts. A pilot testing with healthy volunteers was conducted through an evaluation questionnaire, a knowledge scale, and a validated decisional conflict scale. Results The DA is a computer-based interactive tool. In the first part, the DA provides information about patent ductus arteriosus (PDA) as a disease, the different treatment options, and the benefits and downsides of using indomethacin therapy in preterm infants. In the second part, it coaches the parent in the decision making process through clarifying values and preferences. Volunteers rated 10 out of 13 items of the DA positively and showed significant improvement on both the knowledge scale (p = 0.008) and the decisional conflict scale (p = 0.008). Conclusion We have developed a computer based DA to assess parental preferences with regard to indomethacin therapy in preterm infants. Future research will involve measurement of parental preferences to guide and augment the clinical decisions in current neonatal practice. PMID:21888665

  7. Cultural and linguistic adaptation of a multimedia colorectal cancer screening decision aid for Spanish-speaking Latinos.

    PubMed

    Ko, Linda K; Reuland, Daniel; Jolles, Monica; Clay, Rebecca; Pignone, Michael

    2014-01-01

    As the United States becomes more linguistically and culturally diverse, there is a need for effective health communication interventions that target diverse, vulnerable populations, including Latinos. To address such disparities, health communication interventionists often face the challenge to adapt existing interventions from English into Spanish in a way that retains essential elements of the original intervention while also addressing the linguistic needs and cultural perspectives of the target population. The authors describe the conceptual framework, context, rationale, methods, and findings of a formative research process used in creating a Spanish-language version of an evidence-based (English language) multimedia colorectal cancer screening decision aid. The multistep process included identification of essential elements of the existing intervention, literature review, assessment of the regional context and engagement of key stakeholders, and solicitation of direct input from target population. The authors integrated these findings in the creation of the new adapted intervention. They describe how they used this process to identify and integrate sociocultural themes such as personalism (personalismo), familism (familismo), fear (miedo), embarrassment (verguenza), power distance (respeto), machismo, and trust (confianza) into the Spanish-language decision aid.

  8. Psychologist as Policy-Maker.

    ERIC Educational Resources Information Center

    Saks, Michael J.

    Perhaps the most effective way to increase the utilization of behavioral science knowledge by policy-makers is for the behavioral scientist to become one. The psychologist who serves as a policy-maker becomes aware of the policy issues in addition to relevant empirical evidence. The author, a psychologist, relates his experience as a member of a…

  9. Expanding the Reach of Participatory Risk Management: Testing an Online Decision-Aiding Framework for Informing Internally Consistent Choices.

    PubMed

    Bessette, Douglas L; Campbell-Arvai, Victoria; Arvai, Joseph

    2016-05-01

    This article presents research aimed at developing and testing an online, multistakeholder decision-aiding framework for informing multiattribute risk management choices associated with energy development and climate change. The framework was designed to provide necessary background information and facilitate internally consistent choices, or choices that are in line with users' prioritized objectives. In order to test different components of the decision-aiding framework, a six-part, 2 × 2 × 2 factorial experiment was conducted, yielding eight treatment scenarios. The three factors included: (1) whether or not users could construct their own alternatives; (2) the level of detail regarding the composition of alternatives users would evaluate; and (3) the way in which a final choice between users' own constructed (or highest-ranked) portfolio and an internally consistent portfolio was presented. Participants' self-reports revealed the framework was easy to use and providing an opportunity to develop one's own risk-management alternatives (Factor 1) led to the highest knowledge gains. Empirical measures showed the internal consistency of users' decisions across all treatments to be lower than expected and confirmed that providing information about alternatives' composition (Factor 2) resulted in the least internally consistent choices. At the same time, those users who did not develop their own alternatives and were not shown detailed information about the composition of alternatives believed their choices to be the most internally consistent. These results raise concerns about how the amount of information provided and the ability to construct alternatives may inversely affect users' real and perceived internal consistency. PMID:26381043

  10. Manual and computer-aided materials selection for industrial production: An exercise in decision making

    NASA Technical Reports Server (NTRS)

    Bates, Seth P.

    1990-01-01

    Students are introduced to methods and concepts for systematic selection and evaluation of materials which are to be used to manufacture specific products in industry. For this laboratory exercise, students are asked to work in groups to identify and describe a product, then to proceed through the process to select a list of three candidates to make the item from. The exercise draws on knowledge of mechanical, physical, and chemical properties, common materials test techniques, and resource management skills in finding and assessing property data. A very important part of the exercise is the students' introduction to decision making algorithms, and learning how to apply them to a complex decision making process.

  11. Basing information on comprehensive, critically appraised, and up-to-date syntheses of the scientific evidence: a quality dimension of the International Patient Decision Aid Standards

    PubMed Central

    2013-01-01

    Background Patients and clinicians expect patient decision aids to be based on the best available research evidence. Since 2005, this expectation has translated into a quality dimension of the International Patient Decision Aid Standards. Methods We reviewed the 2005 standards and the available literature on the evidence base of decision aids as well as searched for parallel activities in which evidence is brought to bear to inform clinical decisions. In conducting this work, we noted emerging and research issues that require attention and may inform this quality dimension in the future. Results This dimension requires patient decision aids to be based on research evidence about the relevant options and the nature and likelihood of their effect on outcomes that matter to patients. The synthesis of evidence should be comprehensive and up-to-date, and the evidence itself subject to critical appraisal. Ethical (informed patient choice), quality-of-care (patient-centered care), and scientific (evidence-based medicine) arguments justify this requirement. Empirical evidence suggests that over two thirds of available decision aids are based on high-quality evidence syntheses. Emerging issues identified include the duties of developers regarding the conduct of systematic reviews, the impact of comparative effectiveness research, their link with guidelines based on the same evidence, and how to present the developers’ confidence in the estimates to the end-users. Systematic application of the GRADE system, common in contemporary practice guideline development, could enhance satisfaction of this dimension. Conclusions While theoretical and practical issues remained to be addressed, high-quality patient decision aids should adhere to this dimension requiring they be based on comprehensive and up-to-date summaries of critically appraised evidence. PMID:24625191

  12. FORBEEF: A Forage-Livestock System Computer Model Used as a Teaching Aid for Decision Making.

    ERIC Educational Resources Information Center

    Stringer, W. C.; And Others

    1987-01-01

    Describes the development of a computer simulation model of forage-beef production systems, which is intended to incorporate soil, forage, and animal decisions into an enterprise scenario. Produces a summary of forage production and livestock needs. Cites positive assessment of the program's value by participants in inservice training workshops.…

  13. Modeling Comparative Daily Enrollment Indicators To Aid Intelligent College Decisions. AIR 2001 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Lajubutu, Oyebanjo A.

    This paper shows how three critical enrollment indicators drawn from a relationship database were used to guide planning and management decisions. The paper discusses the guidelines for the development of the model, attributes needed, variables to be calculated, and other issues that may improve the effectiveness and efficiency of daily enrollment…

  14. Adaptive Decision Aiding in Computer-Assisted Instruction: Adaptive Computerized Training System (ACTS).

    ERIC Educational Resources Information Center

    Hopf-Weichel, Rosemarie; And Others

    This report describes results of the first year of a three-year program to develop and evaluate a new Adaptive Computerized Training System (ACTS) for electronics maintenance training. (ACTS incorporates an adaptive computer program that learns the student's diagnostic and decision value structure, compares it to that of an expert, and adapts the…

  15. Primary Care Provider Views About Usefulness and Dissemination of a Web-Based Depression Treatment Information Decision Aid

    PubMed Central

    Westmacott, Robin; Walker, John R; Vardanyan, Gohar

    2016-01-01

    Background Decisions related to mental health are often complex, problems often remain undetected and untreated, information unavailable or not used, and treatment decisions frequently not informed by best practice or patient preferences. Objective The objective of this paper was to obtain the opinions of health professionals working in primary health care settings about a Web-based information decision aid (IDA) for patients concerning treatment options for depression and the dissemination of the resources in primary care settings. Methods Participants were recruited from primary care clinics in Winnipeg and Ottawa, Canada, and included 48 family physicians, nurses, and primary care staff. The study design was a qualitative framework analytic approach of 5 focus groups. Focus groups were conducted during regular staff meetings, were digitally recorded, and transcripts created. Analysis involved a content and theme analysis. Results Seven key themes emerged including the key role of the primary care provider, common questions about treatments, treatment barriers, sources of patient information, concern about quality and quantity of available information, positive opinions about the IDA, and disseminating the IDA. The most common questions mentioned were about medication and side effects and alternatives to medication. Patients have limited access to alternative treatment options owing to cost and availability. Conclusions Practitioners evaluated the IDA positively. The resources were described as useful, supportive of providers’ messages, and accessible for patients. There was unanimous consensus that information needs to be available electronically through the Internet. PMID:27277709

  16. Multi-Stakeholder Decision Aid for Improved Prioritization of the Public Health Impact of Climate Sensitive Infectious Diseases.

    PubMed

    Hongoh, Valerie; Michel, Pascal; Gosselin, Pierre; Samoura, Karim; Ravel, André; Campagna, Céline; Cissé, Hassane Djibrilla; Waaub, Jean-Philippe

    2016-04-01

    The effects of climate change on infectious diseases are an important global health concern and necessitate decisions for allocation of resources. Economic tools have been used previously; however, how prioritization results might differ when done using broader considerations identified by local stakeholders has yet to be assessed. A multicriteria decision analysis (MCDA) approach was used to assess multi-stakeholder expressed concerns around disease prioritization via focus groups held in Quebec and Burkina Faso. Stakeholders weighted criteria and comparisons were made across study sites. A pilot disease prioritization was done to examine effects on disease rankings. A majority of identified criteria were common to both sites. The effect of context specific criteria and weights resulted in similar yet distinct prioritizations of diseases. The presence of consistent criteria between sites suggests that common concerns exist for prioritization; however, context-specific adjustments reveal much regarding resource availability, capacity and concerns that should be considered as this impacts disease ranking. Participatory decision aid approaches facilitate rich knowledge exchange and problem structuring. Furthermore, given multiple actors in low- and middle-income countries settings, multi-actor collaborations across non-governmental organizations, local government and community are important. Formal mechanisms such as MCDA provide means to foster consensus, shared awareness and collaboration. PMID:27077875

  17. Multi-Stakeholder Decision Aid for Improved Prioritization of the Public Health Impact of Climate Sensitive Infectious Diseases

    PubMed Central

    Hongoh, Valerie; Michel, Pascal; Gosselin, Pierre; Samoura, Karim; Ravel, André; Campagna, Céline; Cissé, Hassane Djibrilla; Waaub, Jean-Philippe

    2016-01-01

    The effects of climate change on infectious diseases are an important global health concern and necessitate decisions for allocation of resources. Economic tools have been used previously; however, how prioritization results might differ when done using broader considerations identified by local stakeholders has yet to be assessed. A multicriteria decision analysis (MCDA) approach was used to assess multi-stakeholder expressed concerns around disease prioritization via focus groups held in Quebec and Burkina Faso. Stakeholders weighted criteria and comparisons were made across study sites. A pilot disease prioritization was done to examine effects on disease rankings. A majority of identified criteria were common to both sites. The effect of context specific criteria and weights resulted in similar yet distinct prioritizations of diseases. The presence of consistent criteria between sites suggests that common concerns exist for prioritization; however, context-specific adjustments reveal much regarding resource availability, capacity and concerns that should be considered as this impacts disease ranking. Participatory decision aid approaches facilitate rich knowledge exchange and problem structuring. Furthermore, given multiple actors in low- and middle-income countries settings, multi-actor collaborations across non-governmental organizations, local government and community are important. Formal mechanisms such as MCDA provide means to foster consensus, shared awareness and collaboration. PMID:27077875

  18. Communicating the Needs of Climate Change Policy Makers to Scientists

    NASA Technical Reports Server (NTRS)

    Brown, Molly E.; Escobar, Vanessa M.; Lovell, Heather

    2012-01-01

    This chapter will describe the challenges that earth scientists face in developing science data products relevant to decision maker and policy needs, and will describe strategies that can improve the two-way communication between the scientist and the policy maker. Climate change policy and decision making happens at a variety of scales - from local government implementing solar homes policies to international negotiations through the United Nations Framework Convention on Climate Change. Scientists can work to provide data at these different scales, but if they are not aware of the needs of decision makers or understand what challenges the policy maker is facing, they are likely to be less successful in influencing policy makers as they wished. This is because the science questions they are addressing may be compelling, but not relevant to the challenges that are at the forefront of policy concerns. In this chapter we examine case studies of science-policy partnerships, and the strategies each partnership uses to engage the scientist at a variety of scales. We examine three case studies: the global Carbon Monitoring System pilot project developed by NASA, a forest biomass mapping effort for Silvacarbon project, and a forest canopy cover project being conducted for forest management in Maryland. In each of these case studies, relationships between scientists and policy makers were critical for ensuring the focus of the science as well as the success of the decision-making.

  19. Informed Choice for Participation in Down Syndrome Screening: Development and Content of a Web-Based Decision Aid

    PubMed Central

    Hansen, Helle Ploug; Draborg, Eva; Pedersen, Claus Duedal; Lamont, Ronald F; Jørgensen, Jan Stener

    2015-01-01

    Background In Denmark, all pregnant women are offered screening in early pregnancy to estimate the risk of having a fetus with Down syndrome. Pregnant women participating in the screening program should be provided with information and support to allow them to make an informed choice. There is increasing interest in the use of Web-based technology to provide information and digital solutions for the delivery of health care. Objective The aim of this study was to develop an eHealth tool that contained accurate and relevant information to allow pregnant women to make an informed choice about whether to accept or reject participation in screening for Down syndrome. Methods The development of the eHealth tool involved the cooperation of researchers, technology experts, clinicians, and users. The underlying theoretical framework was based on participatory design, the International Patient Decision Aid Standards (IPDAS) Collaboration guide to develop a patient decision aid, and the roadmap for developing eHealth technologies from the Center for eHealth Research and Disease Management (CeHRes). The methods employed were a systematic literature search, focus group interviews with 3 care providers and 14 pregnant women, and 2 weeks of field observations. A qualitative descriptive approach was used in this study. Results Relevant themes from pregnant women and care providers with respect to information about Down syndrome screening were identified. Based on formalized processes for developing patient decision aids and eHealth technologies, an interactive website containing information about Down syndrome, methods of screening, and consequences of the test was developed. The intervention was based on user requests and needs, and reflected the current hospital practice and national guidelines. Conclusions This paper describes the development and content of an interactive website to support pregnant women in making informed choices about Down syndrome screening. To develop the

  20. Three decision-making aids: brainstorming, nominal group, and Delphi technique.

    PubMed

    McMurray, A R

    1994-01-01

    The methods of brainstorming, Nominal Group Technique, and the Delphi technique can be important resources for nursing staff development educators who wish to expand their decision-making skills. Staff development educators may find opportunities to use these methods for such tasks as developing courses, setting departmental goals, and forecasting trends for planning purposes. Brainstorming, Nominal Group Technique, and the Delphi technique provide a structured format that helps increase the quantity and quality of participant responses.

  1. Development of a patient decision aid for people with refractory angina: protocol for a three-phase pilot study

    PubMed Central

    2014-01-01

    to facilitate identification and inclusion of patients’ values and preferences in the decision making process. This is particularly important as refractory angina is an intractable condition, necessitating that the selected course of treatment be lifelong. This study will yield a much needed patient decision aid for people living with refractory angina and pilot data to support a subsequent effectiveness study. PMID:24920518

  2. A single-blind randomised controlled trial of the effects of a web-based decision aid on self-testing for cholesterol and diabetes. study protocol

    PubMed Central

    2012-01-01

    Background Self-tests, tests on body materials to detect medical conditions, are widely available to the general public. Self-testing does have advantages as well as disadvantages, and the debate on whether self-testing should be encouraged or rather discouraged is still ongoing. One of the concerns is whether consumers have sufficient knowledge to perform the test and interpret the results. An online decision aid (DA) with information on self-testing in general, and test specific information on cholesterol and diabetes self-testing was developed. The DA aims to provide objective information on these self-tests as well as a decision support tool to weigh the pros and cons of self-testing. The aim of this study is to evaluate the effect of the online decision aid on knowledge on self-testing, informed choice, ambivalence and psychosocial determinants. Methods/Design A single blind randomised controlled trial in which the online decision aid 'zelftestwijzer' is compared to short, non-interactive information on self-testing in general. The entire trial will be conducted online. Participants will be selected from an existing Internet panel. Consumers who are considering doing a cholesterol or diabetes self-test in the future will be included. Outcome measures will be assessed directly after participants have viewed either the DA or the control condition. Weblog files will be used to record participants' use of the decision aid. Discussion Self-testing does have important pros and cons, and it is important that consumers base their decision whether they want to do a self-test or not on knowledge and personal values. This study is the first to evaluate the effect of an online decision aid for self-testing. Trial registration Dutch Trial Register: NTR3149 PMID:22216905

  3. Development of Patients' Decision Aid for Older Women With Stage I Breast Cancer Considering Radiotherapy After Lumpectomy

    SciTech Connect

    Wong, Jennifer; D'Alimonte, Laura; Angus, Jan; Paszat, Larry; Metcalfe, Kelly; Whelan, Tim; Llewellyn-Thomas, Hilary; Warner, Eiran; Franssen, Edmee; Szumacher, Ewa

    2012-09-01

    Purpose: To develop a patient decision aid (PtDA) for older women with Stage I, pathologically node negative, estrogen receptor-positive progesterone receptor-positive breast cancer who are considering adjuvant radiotherapy after lumpectomy and to examine its impact on patients' decision making. Methods and Materials: A PtDA was developed and evaluated in three steps according to the Ottawa Decision Support Framework: (1) needs assessment (n = 16); (2) Pilot I to examine PtDA acceptability (n = 12); and (3) Pilot II, a pretest posttest (n = 38) with older women with estrogen receptor-positive progesterone receptor-positive breast cancer after lumpectomy who were receiving adjuvant radiation therapy. Measures included patients' satisfaction with the PtDA, self-reported decisional conflict, level of distress, treatment-related knowledge, and choice predisposition. Results: The PtDA is a booklet that details each adjuvant treatment option's benefits, risks, and side effects tailored to the patient's clinical profile; includes a values clarification exercise; and includes steps to guide patients towards their decision. On the basis of qualitative comments and satisfaction ratings, all women thought that the PtDA was helpful and informative. In comparison with their baseline scores, patients had a statistically significant (p < 0.05) reduction in decisional conflict (adjusted mean difference [AMD], -7.18; 95% confidence interval [CI], -13.50 to 12.59); increased clarity of the benefits and risks (AMD, -10.86; CI, -20.33 to 21.49); and improved general treatment knowledge (AMD, 8.99; CI, 2.88-10.28) after using the PtDA. General trends were also reported in the patients' choice predisposition scores that suggested potential differences in treatment decision after PtDA use. Conclusions: This study provides evidence that this PtDA may be a helpful educational tool for this group of women. The quality of care for older breast cancer patients may be enhanced by the use of a

  4. Analysis and quantification of uncertainty for climate change decision aids for energy consumption in the southwestern US

    NASA Astrophysics Data System (ADS)

    Apling, D.; Higgins, G.; Kiley, H.; Darmenova, K.

    2010-12-01

    Outputs from current generation General Circulation Models (GCMs) are being downscaled to produce primary adaptation products used to investigate the utility of such products for aiding end-user decisions on enduring energy infrastructure as well as short and long-term production and conservation policy alternatives. Effective decision support products carry representations of both objective and subjective uncertainty through to the end-user, allowing them to appropriately weigh climate change factors in with myriad other relevant elements of their decisions. To that end, our methodology compares GCMs and their corresponding downscales with relevant objective historical measurements, systematically evaluates these products with respect to common baseline datasets, and then applies statistical bias correction and uncertainty analysis to establish objective confidence intervals. These primary products are then used to drive empirical energy consumption models fitted to end-user supplied energy consumption records, and undergo additional data quality control and model parameter uncertainty analysis. Our results show a high degree of fit for natural gas consumption involved in facility heating, a lesser degree for electrical power consumption for both heating and cooling, and illustrate a climate-change signal from the European Center/Hamburg Model (ECHAM5) GCM constrained Weather Research and Forecasting (WRF) runs for a parallel current period of 1999-2009, and a future period for 2029-2039; along with confidence bounds on monthly and cumulative annual changes base on these statistical analyses expressed as changes in millions of cubic feet of natural gas and megawatt-hours of electrical energy. Results indicate that our bias corrected energy products provide the necessary detailed output and uncertainty bounds required by public and private facility planners to support and develop their long term energy strategies.

  5. Modelling patient flows as an aid to decision making for critical care capacities and organisation.

    PubMed

    Shahani, A K; Ridley, S A; Nielsen, M S

    2008-10-01

    Using real data from a number of hospitals, we predicted the patient flows following a capacity or organisational change. Clinically recognisable patient groups obtained through classification and regression tree analysis were used to tune a simulation model for the flow of patients in critical care units. A tuned model which accurately reflected the base case of the flow of patients was used to predict alterations in service provision in a number of scenarios which included increases in bed numbers, alterations in patients' lengths of stay, fewer delayed discharges, caring for long stay patients outside the formal intensive care unit and amalgamating small units. Where available the predictions' accuracy was checked by comparison with real hospital data collected after an actual capacity change. The model takes variability and uncertainty properly into account and it provides the necessary information for making better decisions about critical care capacity and organisation.

  6. [An expert system of aiding decision making in breast pathology connected to a clinical data base].

    PubMed

    Brunet, M; Durrleman, S; Ferber, J; Ganascia, J G; Hacene, K; Hirt, F; Jouniaux, F; Meeus, L

    1987-01-01

    The René Huguenin Cancer Center holds a medical file for each patient which is intended to store and process medical data. Since 1970, we introduced computerization: a development plan was elaborated and simultaneously a statistical software (Clotilde--GSI/CFRO) was selected. Thus, we now have access to a large database, structured according to medical rationale, and utilizable with methods of artificial intelligence towards three objectives: improved data acquisition, decision making and exploitation. The first application was to breast pathology, which represents one of the Center's primary activities. The structure of the data concerning patients is by all criteria part of the medical knowledge. This information needs to be presented as well as processed with a suitable language. To this end, we chose a language-oriented object, Mering II, usable with Apple and IBM 4 micro-computers. This project has already allowed to work out an operational model. PMID:3620732

  7. Multicriteria decision-aid method to evaluate the performance of stormwater infiltration systems over the time.

    PubMed

    Moura, P; Barraud, S; Baptista, M B; Malard, F

    2011-01-01

    Nowadays, stormwater infiltration systems are frequently used because of their ability to reduce flows and volumes in downstream sewers, decrease overflows in surface waters and make it possible to recharge groundwater. Moreover, they come in various forms with different uses. Despite these advantages the long term sustainability of these systems is questionable and their real performances have to be assessed taking into account various and sometimes conflicting aspects. To address this problem a decision support system is proposed. It is based on a multicriteria method built to help managers to evaluate the performance of an existing infiltration system at different stages of its lifespan and identify whether it performs correctly or not, according to environmental, socio-economic, technical and sanitary aspects. The paper presents successively: the performance indicators and the way they were built, the multicriteria method to identify if the system works properly and a case study. PMID:22105120

  8. Managing urinary incontinence through hand-held real-time decision support aid.

    PubMed

    Koutsojannis, Constantinos; Lithari, Chrysa; Hatzilygeroudis, Ioannis

    2012-07-01

    In this paper, we present an intelligent system for the diagnosis and treatment of urinary incontinence (UI) for males as well as females, called e-URIN. e-URIN is an intelligent system for diagnosis and treatment of urinary incontinence according to symptoms that are realized in one patient and usually recorded through his clinical examination as well as specific test results. The user-friendly proposed intelligent system is accommodated on a hospital server supporting e-health tools, for use through pocket PCs under wireless connection as a decision support system for resident doctors, as well as an educational tool for medical students. It is based on expert system knowledge representation provided from urology experts in combination with rich bibliographic search and study ratified with statistical results from clinical practice. Preliminary experimental results on a real patient hospital database provide acceptable performance that can be improved using more than one computational intelligence approaches in the future.

  9. Intelligent information extraction to aid science decision making in autonomous space exploration

    NASA Astrophysics Data System (ADS)

    Merényi, Erzsébet; Tasdemir, Kadim; Farrand, William H.

    2008-04-01

    Effective scientific exploration of remote targets such as solar system objects increasingly calls for autonomous data analysis and decision making on-board. Today, robots in space missions are programmed to traverse from one location to another without regard to what they might be passing by. By not processing data as they travel, they can miss important discoveries, or will need to travel back if scientists on Earth find the data warrant backtracking. This is a suboptimal use of resources even on relatively close targets such as the Moon or Mars. The farther mankind ventures into space, the longer the delay in communication, due to which interesting findings from data sent back to Earth are made too late to command a (roving, floating, or orbiting) robot to further examine a given location. However, autonomous commanding of robots in scientific exploration can only be as reliable as the scientific information extracted from the data that is collected and provided for decision making. In this paper, we focus on the discovery scenario, where information extraction is accomplished with unsupervised clustering. For high-dimensional data with complicated structure, detailed segmentation that identifies all significant groups and discovers the small, surprising anomalies in the data, is a challenging task at which conventional algorithms often fail. We approach the problem with precision manifold learning using self-organizing neural maps with non-standard features developed in the course of our research. We demonstrate the effectiveness and robustness of this approach on multi-spectral imagery from the Mars Exploration Rovers Pancam, and on synthetic hyperspectral imagery.

  10. [Experience assisting an AIDS-infected homosexual patient and his same-sex partner make a do-not-resuscitate decision].

    PubMed

    Wang, Shu-Jang; Lai, Pei-Yu; Liou, Siao-Ying; Ko, Wen-Chien; Ko, Nai-Ying

    2012-10-01

    Family members play an important role in the process of writing advance directives. Homosexual men infected with HIV often wish to authorize their intimate same-sex partner or friends rather than immediate family members to make medical decisions on their behalf. Although same-sex marriage is currently illegal in Taiwan, HIV infected homosexual patients are able to write advance directives appointing their same-sex partner to be their surrogate decision maker for end-of-life medical decisions. This case report describes an experience assisting a homosexual patient with HIV to write his advance directives. The nurse assisted the patient and his partner to make a self-determined decision not to resuscitate. Family conferences held to discuss the patient's decisions regarding resuscitation helped legitimize his partner's primary role in making end-of-life healthcare decisions on his behalf. As an advocate for patient rights, nurses should understand the law as it relates to homosexuality and end-of-life decision making, inform patients on the durable power of autonomy, and help execute their advance directives.

  11. Developing a Climate Service: Using Hydroclimate Monitoring and Forecasting to Aid Decision Making in Africa and Latin America

    NASA Astrophysics Data System (ADS)

    Wood, E. F.; Sheffield, J.; Fisher, C. K.; Chaney, N.; Wanders, N.

    2015-12-01

    forecast skill and the effective delivery of the information to decision makers.

  12. 75 FR 997 - Record of Decision (ROD) on the U.S. Coast Guard Long Range Aids to Navigation (Loran-C) Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-07

    ... SECURITY Coast Guard Record of Decision (ROD) on the U.S. Coast Guard Long Range Aids to Navigation (Loran-C) Program AGENCY: Coast Guard, DHS. ACTION: Notice of availability. SUMMARY: The Department of Homeland Security (DHS), United States Coast Guard (USCG), announces the availability of the Record...

  13. Agricultural Management Decision Aids Driven by Real-Time Satellite Data.

    NASA Astrophysics Data System (ADS)

    Diak, George R.; Anderson, Martha C.; Bland, William L.; Norman, John M.; Mecikalski, John M.; Aune, Robert M.

    1998-07-01

    In a NASA-sponsored program entitled Use of Earth and Space Science Data Over the Internet, scientists at the University of Wisconsin-Madison have developed a suite of products for agriculture that are based in satellite and conventional observations, as well as state-of-the-art forecast models of the atmosphere and soil_canopy environments. These products include an irrigation scheduling product based in satellite estimates of daily solar energy, a frost protection product that relies on prediction models and satellite estimates of clouds, and a product for the prediction of foliar disease that is based in satellite net radiation, rainfall measured by NEXRAD, and a detailed model of the soil_canopy environment. During the growing season, the first two products are available in near-real time on the Internet. The last product involving foliar disease depends on a decision support system named WISDOM developed by the University of Wisconsin-Extension, which resides locally on growers' home computers. Growers interface WISDOM with a server to obtain the rainfall, meteorological data, surface radiation inputs, and canopy model output required by WISDOM for the blight models.

  14. Barriers and Facilitators to Patient-Provider Communication When Discussing Breast Cancer Risk to Aid in the Development of Decision Support Tools.

    PubMed

    Yi, Haeseung; Xiao, Tong; Thomas, Parijatham S; Aguirre, Alejandra N; Smalletz, Cindy; Dimond, Jill; Finkelstein, Joseph; Infante, Katherine; Trivedi, Meghna; David, Raven; Vargas, Jennifer; Crew, Katherine D; Kukafka, Rita

    2015-01-01

    The purpose of this study was to identify barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools. Four patient focus groups (N=34) and eight provider focus groups (N=10) took place in Northern Manhattan. A qualitative analysis was conducted using Atlas.ti software. The coding yielded 62.3%-94.5% agreement. The results showed that 1) barriers are time constraints, lack of knowledge, low health literacy, and language barriers, and 2) facilitators are information needs, desire for personalization, and autonomy when communicating risk in patient-provider encounters. These results will inform the development of a patient-centered decision aid (RealRisks) and a provider-facing breast cancer risk navigation (BNAV) tool, which are designed to facilitate patient-provider risk communication and shared decision-making about breast cancer prevention strategies, such as chemoprevention.

  15. Barriers and Facilitators to Patient-Provider Communication When Discussing Breast Cancer Risk to Aid in the Development of Decision Support Tools

    PubMed Central

    Yi, Haeseung; Xiao, Tong; Thomas, Parijatham S.; Aguirre, Alejandra N.; Smalletz, Cindy; Dimond, Jill; Finkelstein, Joseph; Infante, Katherine; Trivedi, Meghna; David, Raven; Vargas, Jennifer; Crew, Katherine D.; Kukafka, Rita

    2015-01-01

    The purpose of this study was to identify barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools. Four patient focus groups (N=34) and eight provider focus groups (N=10) took place in Northern Manhattan. A qualitative analysis was conducted using Atlas.ti software. The coding yielded 62.3%–94.5% agreement. The results showed that 1) barriers are time constraints, lack of knowledge, low health literacy, and language barriers, and 2) facilitators are information needs, desire for personalization, and autonomy when communicating risk in patient-provider encounters. These results will inform the development of a patient-centered decision aid (RealRisks) and a provider-facing breast cancer risk navigation (BNAV) tool, which are designed to facilitate patient-provider risk communication and shared decision-making about breast cancer prevention strategies, such as chemoprevention. PMID:26958276

  16. The Attitude of Physicians toward the Use of Patient Decision Aids in Iran as a Developing Country

    PubMed Central

    Rashidian, Hamideh; Nedjat, Saharnaz; Mounesan, Leila; Haghjou, Leila; Majdzadeh, Reza

    2015-01-01

    Background: The patient decision aids (PDAs), which can facilitate the decision-making process when choosing the optimal method of treatment, are a challenge to patients. This study tried to determine the attitude of physicians on the barriers of using PDAs in the way of prioritizing and proposing solutions to them. Methods: This study was a cross-sectional research carried out on 150 clinical faculty members of research centers and scientific associations affiliated with Tehran University of Medical Sciences. The participants were chosen using the convenience sampling method. The attitude of physicians toward the application of PDAs was interviewed using a self-made questionnaire composed of 23 questions. The association between physicians’ attitude to the use of PDAs and their characteristics was examined using the t-test, analysis of variance, and correlation test. Results: The mean score of physicians’ attitude was 76.2 (standard deviation =11.9) and the range was 33–107. There was a significant and direct association between the attitude toward the use of PDA and the respondents’ age (r = 0.237, P = 0.007), years of experience (r = 0.205, P = 0.02), being male (P = 0.04), and working in the private sector (P = 0.009). The attitude score of instructors was significantly lower than that of professors (P = 0.02). Conclusions: The general attitude of physicians toward the use of PDAs was positive. However, apparently as a result of problems mentioned in this study for the developing countries such as Iran, it is much easier to employ these tools in centers run by the private sector. Usage of such tools in public centers necessitates systemic infrastructure as well as credits and budgets required for the training of patients and physicians. PMID:25789150

  17. Film Makers On Film Making.

    ERIC Educational Resources Information Center

    Geduld, Harry M., Ed.

    This collection includes essays by and interviews with more than 30 film-makers, both classic and contemporary, on the subjects of their major interests and procedures in making films. The directors are: Louis Lumiere, Cecil Hepworth, Edwin S. Porter, Mack Sennett, David W. Griffith, Robert Flaherty, Charles Chaplin, Eric von Stroheim, Dziga…

  18. Condensed summary of the systems prioritization method as a decision-aiding approach for the Waste Isolation Pilot Plant

    SciTech Connect

    Boak, D.M.; Prindle, N.H.; Lincoln, R.

    1997-03-01

    In March 1994, the US Department of Energy Carlsbad Area Office (DOE/CAO) implemented a performance based decision-aiding method to assist in programmatic prioritization within the Waste Isolation Pilot Plant (WIPP) project. The prioritization was with respect to 40 CFR Part 191.13(a) and 40 CFR part 268.6. U.S. Environmental Protection Agency (EPA) requirements for long-term isolation of radioactive and hazardous wastes. The Systems Prioritization Method (SPM), was designed by Sandia National Laboratories to: (1) identify programmatic options (activities), their costs and durations; (2) analyze combinations of activities in terms of their predicted contribution to long-term performance of the WIPP disposal system; and (3) analyze cost, duration, and performance tradeoffs. SPM results were the basis for activities recommended to DOE/CAO in May 1995. SPM identified eight activities (less than 15% of the 58 proposed for consideration) predicted to be essential in addressing key regulatory issues. The SPM method proved useful for risk or performance-based prioritization in which options are interdependent and system behavior is nonlinear. 10 refs., 2 figs., 1 tab.

  19. A flexible decision-aided maximum likelihood phase estimation in hybrid QPSK/OOK coherent optical WDM systems

    NASA Astrophysics Data System (ADS)

    Zhang, Yong; Wang, Yulong

    2016-04-01

    Although decision-aided (DA) maximum likelihood (ML) phase estimation (PE) algorithm has been investigated intensively, block length effect impacts system performance and leads to the increasing of hardware complexity. In this paper, a flexible DA-ML algorithm is proposed in hybrid QPSK/OOK coherent optical wavelength division multiplexed (WDM) systems. We present a general cross phase modulation (XPM) model based on Volterra series transfer function (VSTF) method to describe XPM effects induced by OOK channels at the end of dispersion management (DM) fiber links. Based on our model, the weighted factors obtained from maximum likelihood method are introduced to eliminate the block length effect. We derive the analytical expression of phase error variance for the performance prediction of coherent receiver with the flexible DA-ML algorithm. Bit error ratio (BER) performance is evaluated and compared through both theoretical derivation and Monte Carlo (MC) simulation. The results show that our flexible DA-ML algorithm has significant improvement in performance compared with the conventional DA-ML algorithm as block length is a fixed value. Compared with the conventional DA-ML with optimum block length, our flexible DA-ML can obtain better system performance. It means our flexible DA-ML algorithm is more effective for mitigating phase noise than conventional DA-ML algorithm.

  20. Summary of the systems prioritization method as a decision-aiding method for the waste isolation pilot plant

    SciTech Connect

    Boak, D.M.; Prindle, N.H.; Lincoln, R.

    1996-12-01

    In March 1994, the U.S. Department of Energy Carlsbad Area Office (DOE/CAO) implemented a performance-based decision-aiding method to assist in programmatic prioritization within the Waste Isolation Pilot Plant (WIPP) Project with respect to applicable U.S. Environmental Protection Agency (EPA) long-term performance requirements in 40 CFR 191.13(a) (radionuclide containment requirements) and 40 CFR 268.6 (hazardous constituent concentration requirements). This method, the Systems Prioritization Method (SPM), was designed by Sandia National Laboratories (SNL) to: (1) identify programmatic options (activities) and their costs and durations; (2) analyze combinations of activities (activity sets) in terms of their predicted contribution to long-term performance of the WIPP disposal system; and (3) analyze cost, duration, and performance tradeoffs. The results of the second iteration of SPM (SPM-2) were the basis for recommendations to DOE/CAO in May 1995 for programmatic prioritization within the WIPP project. This paper presents a summary of the SPM implementation, key results, and lessons learned.

  1. Decision-aided maximum likelihood phase estimation with optimum block length in hybrid QPSK/16QAM coherent optical WDM systems

    NASA Astrophysics Data System (ADS)

    Zhang, Yong; Wang, Yulong

    2016-01-01

    We propose a general model to entirely describe XPM effects induced by 16QAM channels in hybrid QPSK/16QAM wavelength division multiplexed (WDM) systems. A power spectral density (PSD) formula is presented to predict the statistical properties of XPM effects at the end of dispersion management (DM) fiber links. We derive the analytical expression of phase error variance for optimizing block length of QPSK channel coherent receiver with decision-aided (DA) maximum-likelihood (ML) phase estimation (PE). With our theoretical analysis, the optimum block length can be employed to improve the performance of coherent receiver. Bit error rate (BER) performance in QPSK channel is evaluated and compared through both theoretical derivation and Monte Carlo simulation. The results show that by using the DA-ML with optimum block length, bit signal-to-noise ratio (SNR) improvement over DA-ML with fixed block length of 10, 20 and 40 at BER of 10-3 is 0.18 dB, 0.46 dB and 0.65 dB, respectively, when in-line residual dispersion is 0 ps/nm.

  2. Developing a computer touch-screen interactive colorectal screening decision aid for a low-literacy African American population: lessons learned.

    PubMed

    Bass, Sarah Bauerle; Gordon, Thomas F; Ruzek, Sheryl Burt; Wolak, Caitlin; Ruggieri, Dominique; Mora, Gabriella; Rovito, Michael J; Britto, Johnson; Parameswaran, Lalitha; Abedin, Zainab; Ward, Stephanie; Paranjape, Anuradha; Lin, Karen; Meyer, Brian; Pitts, Khaliah

    2013-07-01

    African Americans have higher colorectal cancer (CRC) mortality than White Americans and yet have lower rates of CRC screening. Increased screening aids in early detection and higher survival rates. Coupled with low literacy rates, the burden of CRC morbidity and mortality is exacerbated in this population, making it important to develop culturally and literacy appropriate aids to help low-literacy African Americans make informed decisions about CRC screening. This article outlines the development of a low-literacy computer touch-screen colonoscopy decision aid using an innovative marketing method called perceptual mapping and message vector modeling. This method was used to mathematically model key messages for the decision aid, which were then used to modify an existing CRC screening tutorial with different messages. The final tutorial was delivered through computer touch-screen technology to increase access and ease of use for participants. Testing showed users were not only more comfortable with the touch-screen technology but were also significantly more willing to have a colonoscopy compared with a "usual care group." Results confirm the importance of including participants in planning and that the use of these innovative mapping and message design methods can lead to significant CRC screening attitude change.

  3. Results from a randomized trial of a web-based, tailored decision aid for women at high risk for breast cancer

    PubMed Central

    Banegas, Matthew P.; McClure, Jennifer B.; Barlow, William E.; Ubel, Peter A.; Smith, Dylan M.; Zikmund-Fisher, Brian J.; Greene, Sarah M.; Fagerlin, Angela

    2013-01-01

    Objective To assess the impact of Guide to Decide (GtD), a web-based, personally-tailored decision aid designed to inform women’s decisions about prophylactic tamoxifen and raloxifene use. Methods Postmenopausal women, age 46–74, with BCRAT 5-year risk ≥1.66% and no prior history of breast cancer were randomized to one of three study arms: intervention (n = 690), Time 1 control (n = 160), or 3-month control (n = 162). Intervention participants viewed GtD prior to completing a post-test and 3 month follow-up assessment. Controls did not. We assessed the impact of GtD on women’s decisional conflict levels and treatment decision behavior at post-test and at 3 months, respectively. Results Intervention participants had significantly lower decisional conflict levels at post-test (p < 0.001) and significantly higher odds of making a decision about whether or not to take prophylactic tamoxifen or raloxifene at 3-month follow-up (p < 0.001) compared to control participants. Conclusion GtD lowered decisional conflict and helped women at high risk of breast cancer decide whether to take prophylactic tamoxifen or raloxifene to reduce their cancer risk. Practice implications Web-based, tailored decision aids should be used more routinely to facilitate informed medical decisions, reduce patients’ decisional conflict, and empower patients to choose the treatment strategy that best reflects their own values. PMID:23395006

  4. The AFFORD Clinical Decision Aid To Identify Emergency Department Patients With Atrial Fibrillation At Low Risk For 30-Day Adverse Events

    PubMed Central

    Barrett, Tyler W.; Storrow, Alan B.; Jenkins, Cathy A.; Abraham, Robert L.; Liu, Dandan; Miller, Karen F.; Moser, Kelly M.; Russ, Stephan; Roden, Dan M.; Harrell, Frank E.; Darbar, Dawood

    2015-01-01

    There is wide variation in the management of emergency department (ED) patients with atrial fibrillation (AF). We aimed to derive and internally validate the first prospective, ED-based clinical decision aid to identify patients with AF at low risk for 30-day adverse events. We performed a prospective cohort study at a university-affiliated, tertiary-care, ED. Patients were enrolled from June 9, 2010 to February 28, 2013 and followed for 30 days. We enrolled a convenience sample of ED patients presenting with symptomatic AF. Candidate predictors were based on ED data available in the first two hours. The decision aid was derived using model approximation (preconditioning) followed by strong bootstrap internal validation. We utilized an ordinal outcome hierarchy defined as the incidence of the most severe adverse event within 30 days of the ED evaluation. Of 497 patients enrolled, stroke and AF-related death occurred in 13 (3%) and 4 (<1%) patients, respectively. The decision aid included the following: age, triage vitals (systolic blood pressure, temperature, respiratory rate, oxygen saturation, supplemental oxygen requirement); medical history (heart failure, home sotalol use, prior percutaneous coronary intervention, electrical cardioversion, cardiac ablation, frequency of AF symptoms); ED data (2 hour heart rate, chest radiograph results, hemoglobin, creatinine, and brain natriuretic peptide). The decision aid’s c-statistic in predicting any 30-day adverse event was 0.7 (95% CI, 0.65, 0.76). In conclusion, among ED patients with AF, AFFORD provides the first evidence based decision aid for identifying patients who are at low risk for 30-day adverse events and candidates for safe discharge. PMID:25633190

  5. Controversial Issues: Concerns for Policy Makers. ERIC Digest No. 14.

    ERIC Educational Resources Information Center

    Cook, Kay K.

    Intended for educational policy makers, this publication considers the teaching of controversial topics. Specifically discussed are what issues are considered controversial, why controversial topics should be taught, court decisions, ways educators can prepare for community response or complaints, and questions to address when making curriculum…

  6. Development and Validation of a Personalized, Web-Based Decision Aid for Lung Cancer Screening Using Mixed Methods: A Study Protocol

    PubMed Central

    Lau, Yan Kwan; Caverly, Tanner J; Cherng, Sarah T; Cao, Pianpian; West, Mindy; Arenberg, Douglas

    2014-01-01

    Background The National Lung Screening Trial demonstrated that low-dose computed tomography (LDCT) screening could be an effective way to reduce lung cancer mortality. Informed decision-making in the context of lung cancer screening requires that potential screening subjects accurately recognize their own lung cancer risk, as well as the harms and benefits associated with screening, while taking into account their personal values and preferences. Objective Our objective is to develop a Web-based decision aid in accordance with the qualifying and certification criteria in the International Patient Decision Aid Standards instrument version 4.0 that will assist patients in making informed decisions with regard to lung cancer screening. Methods In “alpha” testing, a prototype of the decision aid was tested for usability with 10 potential screening participants in focus groups. Feedback was also sought from public health and health risk communication experts external to the study. Following that, improvements to the prototype were made accordingly, and “beta” testing was done in the form of a quasi-experimental design—a before-after study—with a group of 60 participants. Outcomes tested were knowledge, risk perception of lung cancer and lung cancer screening, decisional conflict, and acceptability of the decision aid as determined by means of a self-administered electronic survey. Focus groups of a subsample of survey participants will be conducted to gain further insight into usability issues. Results Alpha testing is completed. Beta testing is currently being carried out. As of 2014 December 7, 60 participants had completed the before-after study. We expect to have results by 2015 January 31. Qualitative data collection and analysis are expected to be completed by 2015 May 31. Conclusions We hypothesize that this Web-based, interactive decision aid containing personalized, graphical, and contextual information on the benefits and harms of LDCT screening

  7. Sound credit scores and financial decisions despite cognitive aging

    PubMed Central

    Li, Ye; Gao, Jie; Enkavi, A. Zeynep; Zaval, Lisa; Weber, Elke U.; Johnson, Eric J.

    2015-01-01

    Age-related deterioration in cognitive ability may compromise the ability of older adults to make major financial decisions. We explore whether knowledge and expertise accumulated from past decisions can offset cognitive decline to maintain decision quality over the life span. Using a unique dataset that combines measures of cognitive ability (fluid intelligence) and of general and domain-specific knowledge (crystallized intelligence), credit report data, and other measures of decision quality, we show that domain-specific knowledge and expertise provide an alternative route for sound financial decisions. That is, cognitive aging does not spell doom for financial decision-making in domains where the decision maker has developed expertise. These results have important implications for public policy and for the design of effective interventions and decision aids. PMID:25535381

  8. The use of laser Doppler imaging as an aid in clinical management decision making in the treatment of vesicant burns.

    PubMed

    Brown, R F; Rice, P; Bennett, N J

    1998-12-01

    Vesicants are a group of chemicals recognised, under the terms of the Chemical Weapons Convention, as potential chemical warfare agents whose prime effect on the skin is to cause burns and blistering. Experience of the clinical management of these injuries is not readily available and therefore an accurate assessment of the severity of the lesion and extent of tissue involvement is an important factor when determining the subsequent clinical management strategy for such lesions. This study was performed to assess the use of laser Doppler imaging (LDI) as a noninvasive means of assessing wound microvascular perfusion following challenge with the vesicant agents (sulphur mustard or lewisite) by comparing the images obtained with histopathological analysis of the lesion. Large white pigs were challenged with sulphur mustard (1.91 mg cm(-2)) or lewisite (0.3 mg.cm(-2)) vapour for periods of up to 6 h At intervals of between 1 h and 7 days following vesicant challenge, LDI images were acquired and samples for routine histopathology were taken. The results from this study suggest that LDI was: (i) a simple, reproducible and noninvasive means of assessing changes in tissue perfusion, and hence tissue viability, in developing and healing vesicant burns; (ii) the LDI images correlates well with histopathological assessment of the resulting lesions and the technique was sufficiently sensitive enough to discriminate between skin lesions of different aetiology. These attributes suggest that LDI would be a useful investigative tool that could aid clinical management decision making in the early treatment of vesicant agent-induced skin burns.

  9. An approach to decision aid of boreal forest fire control using both of ground observation and remote sensing

    NASA Astrophysics Data System (ADS)

    Nakau, K.; Fukuda, M.; Hayasaka, H.; Kimura, K.; Kushida, K.; Matsuura, N.

    2004-12-01

    Burned area of boreal forest fires is increasing in these decades. Two thirds of forest fires are judged as man-made in Siberia. On the other hand, for boreal forest fire emits global warming gas due to combustion and to change of land coverage, forest fire may accelerate global warming. In 2003 summer, 17million hectares are burned in Siberia and CO2 emission is estimated as 3 hundred million tons. Thus, it is important to control forest fire. Toward this aim, we collected data of boreal forest fire in Alaska and east Siberia in summer fire seasons for two years. Data were acquired from each of ground observation, observation from aircraft and remotely sensed fire detection in June and July. Remotely detected fire using some algorisms were compared with observed data to evaluate the accuracy and earliness of automatic detection. Study areas are Alaska and East Siberia in this year and squares of 1000km centered on Yakutsk, Irkutsk and Krasnoyarsk for each in 2003. Daily NOAA and MODIS satellite images are corrected and used for fire detection. 750 ground observation reports are corrected from Russian agency including location, weather and fire front size and severity. 178 reports are corrected from JAL aircraft flying across Siberia including location and time. Comparison between ground truth data and satellite images was done for validation of automatic forest fire detection. Almost all location of ground and aircraft observation data of forest fires as large as 1 hectare were automatically detected at almost same time using satellite images where whether permitting. We are developing connection of fire detection algorithm and fire expansion simulation model to forecast the possible burned area. On the basis of fire expansion forecast, risk analysis of possible fire expansion for decision aid of fire-fighting activities will be analyzed.@@On the basis of these analyses, we will discuss some possible utilizations of remotely sensed forest fire to control them.

  10. Effectiveness of the head CT choice decision aid in parents of children with minor head trauma: study protocol for a multicenter randomized trial

    PubMed Central

    2014-01-01

    Background Blunt head trauma is a common cause of death and disability in children worldwide. Cranial computed tomography (CT), the reference standard for the diagnosis of traumatic brain injury (TBI), exposes children to ionizing radiation which has been linked to the development of brain tumors, leukemia, and other cancers. We describe the methods used to develop and test the effectiveness of a decision aid to facilitate shared decision-making with parents regarding whether to obtain a head CT scan or to further observe their child at home. Methods/Design This is a protocol for a multicenter clinician-level parallel randomized trial to compare an intervention group receiving a decision aid, ‘Head CT Choice’, to a control group receiving usual care. The trial will be conducted at five diverse emergency departments (EDs) in Minnesota and California. Clinicians will be randomized to decision aid or usual care. Parents visiting the ED with children who are less than 18-years-old, have experienced blunt head trauma within 24 hours, and have one or two risk factors for clinically-important TBI (ciTBI) from the Pediatric Emergency Care Applied Research Network head injury clinical prediction rules will be eligible for enrollment. We will measure the effect of Head CT Choice on: (1) parent knowledge regarding their child’s risk of ciTBI, the available diagnostic options, and the risks of radiation exposure associated with a cranial CT scan (primary outcome); (2) parent engagement in the decision-making process; (3) the degree of conflict parents experience related to feeling uninformed; (4) patient and clinician satisfaction with the decision made; (5) the rate of ciTBI at seven days; (6) the proportion of patients in whom a cranial CT scan is obtained; and (7) seven-day healthcare utilization. To capture these outcomes, we will administer parent and clinician surveys immediately after each clinical encounter, obtain video recordings of parent

  11. Low Literacy Decision Aid Enhances Knowledge and Reduces Decisional Conflict among Diverse Population of Adults with Rheumatoid Arthritis: Results of a Pilot Study

    PubMed Central

    Barton, Jennifer L.; Trupin, Laura; Schillinger, Dean; Evans-Young, Gina; Imboden, John; Montori, Victor M.; Yelin, Edward

    2016-01-01

    Objective Despite innovations in treatment of rheumatoid arthritis (RA), adherence is poor and disparities persist. Shared decision making (SDM) promotes patient engagement and enhances adherence, however few tools support SDM in RA. Our objective was to pilot a low literacy medication guide and decision aid to facilitate patient-clinician conversations about RA medications. Methods RA patients were consecutively enrolled into one of three arms: (1) control, patients received existing medication guide prior to clinic visit; (2) adapted guide prior to visit; (3) adapted guide prior plus decision aid during visit. Outcomes were collected immediately post-visit, at 1-week, 3- and 6-month interviews. Eligible adults had to have failed at least one DMARD and fulfill one of the following: age >65, immigrant, non-English speaker, < high school education, limited health literacy, racial/ethnic minority. Primary outcomes were knowledge of RA medications, decisional conflict, and acceptability of interventions. Results Majority of 166 patients were immigrants (66%), non-English speakers (54%), and had limited health literacy (71%). Adequate RA knowledge post visit in arm 3 was higher (78%) than arm 1 (53%, adjusted OR 2.7, 95% CI 1.2–6.1). Among patients with a medication change, there was lower (better) mean decisional conflict in arms 2 and 3 (p=0.03). No significant differences in acceptability. Conclusion A low literacy medication guide and decision aid was acceptable, improved knowledge, and reduced decisional conflict among vulnerable RA patients. Enhancing knowledge and patient engagement with decision support tools may lead to medication choices better aligned with patient values and preferences in RA. PMID:26605752

  12. Decision Making In A High-Tech World: Automation Bias and Countermeasures

    NASA Technical Reports Server (NTRS)

    Mosier, Kathleen L.; Skitka, Linda J.; Burdick, Mark R.; Heers, Susan T.; Rosekind, Mark R. (Technical Monitor)

    1996-01-01

    Automated decision aids and decision support systems have become essential tools in many high-tech environments. In aviation, for example, flight management systems computers not only fly the aircraft, but also calculate fuel efficient paths, detect and diagnose system malfunctions and abnormalities, and recommend or carry out decisions. Air Traffic Controllers will soon be utilizing decision support tools to help them predict and detect potential conflicts and to generate clearances. Other fields as disparate as nuclear power plants and medical diagnostics are similarly becoming more and more automated. Ideally, the combination of human decision maker and automated decision aid should result in a high-performing team, maximizing the advantages of additional cognitive and observational power in the decision-making process. In reality, however, the presence of these aids often short-circuits the way that even very experienced decision makers have traditionally handled tasks and made decisions, and introduces opportunities for new decision heuristics and biases. Results of recent research investigating the use of automated aids have indicated the presence of automation bias, that is, errors made when decision makers rely on automated cues as a heuristic replacement for vigilant information seeking and processing. Automation commission errors, i.e., errors made when decision makers inappropriately follow an automated directive, or automation omission errors, i.e., errors made when humans fail to take action or notice a problem because an automated aid fails to inform them, can result from this tendency. Evidence of the tendency to make automation-related omission and commission errors has been found in pilot self reports, in studies using pilots in flight simulations, and in non-flight decision making contexts with student samples. Considerable research has found that increasing social accountability can successfully ameliorate a broad array of cognitive biases and

  13. Fiber optic diffraction grating maker

    DOEpatents

    Deason, Vance A.; Ward, Michael B.

    1991-01-01

    A compact and portable diffraction grating maker comprised of a laser beam, optical and fiber optics devices coupling the beam to one or more evanescent beam splitters, and collimating lenses or mirrors directing the split beam at an appropriate photosensitive material. The collimating optics, the output ends of the fiber optic coupler and the photosensitive plate holder are all mounted on an articulated framework so that the angle of intersection of the beams can be altered at will without disturbing the spatial filter, collimation or beam quality, and assuring that the beams will always intersect at the position of the plate.

  14. Fiber optic diffraction grating maker

    DOEpatents

    Deason, V.A.; Ward, M.B.

    1991-05-21

    A compact and portable diffraction grating maker is comprised of a laser beam, optical and fiber optics devices coupling the beam to one or more evanescent beam splitters, and collimating lenses or mirrors directing the split beam at an appropriate photosensitive material. The collimating optics, the output ends of the fiber optic coupler and the photosensitive plate holder are all mounted on an articulated framework so that the angle of intersection of the beams can be altered at will without disturbing the spatial filter, collimation or beam quality, and assuring that the beams will always intersect at the position of the plate. 4 figures.

  15. Randomized Trial of a Computerized Touch Screen Decision Aid to Increase Acceptance of Colonoscopy Screening in an African American Population with Limited Literacy.

    PubMed

    Ruzek, Sheryl B; Bass, Sarah Bauerle; Greener, Judith; Wolak, Caitlin; Gordon, Thomas F

    2016-10-01

    The goal of this study was to assess the effectiveness of a touch screen decision aid to increase acceptance of colonoscopy screening among African American patients with low literacy, developed and tailored using perceptual mapping methods grounded in Illness Self-Regulation and Information-Communication Theories. The pilot randomized controlled trial investigated the effects of a theory-based intervention on patients' acceptance of screening, including their perceptions of educational value, feelings about colonoscopy, likelihood to undergo screening, and decisional conflict about colonoscopy screening. Sixty-one African American patients with low literacy, aged 50-70 years, with no history of colonoscopy, were randomly assigned to receive a computerized touch screen decision aid (CDA; n = 33) or a literacy appropriate print tool (PT; n = 28) immediately before a primary care appointment in an urban, university-affiliated general internal medicine clinic. Patients rated the CDA significantly higher than the PT on all indicators of acceptance, including the helpfulness of the information for making a screening decision, and reported positive feelings about colonoscopy, greater likelihood to be screened, and lower decisional conflict. Results showed that a touch screen decision tool is acceptable to African American patients with low iteracy and, by increasing intent to screen, may increase rates of colonoscopy screening.

  16. Randomized Trial of a Computerized Touch Screen Decision Aid to Increase Acceptance of Colonoscopy Screening in an African American Population with Limited Literacy.

    PubMed

    Ruzek, Sheryl B; Bass, Sarah Bauerle; Greener, Judith; Wolak, Caitlin; Gordon, Thomas F

    2016-10-01

    The goal of this study was to assess the effectiveness of a touch screen decision aid to increase acceptance of colonoscopy screening among African American patients with low literacy, developed and tailored using perceptual mapping methods grounded in Illness Self-Regulation and Information-Communication Theories. The pilot randomized controlled trial investigated the effects of a theory-based intervention on patients' acceptance of screening, including their perceptions of educational value, feelings about colonoscopy, likelihood to undergo screening, and decisional conflict about colonoscopy screening. Sixty-one African American patients with low literacy, aged 50-70 years, with no history of colonoscopy, were randomly assigned to receive a computerized touch screen decision aid (CDA; n = 33) or a literacy appropriate print tool (PT; n = 28) immediately before a primary care appointment in an urban, university-affiliated general internal medicine clinic. Patients rated the CDA significantly higher than the PT on all indicators of acceptance, including the helpfulness of the information for making a screening decision, and reported positive feelings about colonoscopy, greater likelihood to be screened, and lower decisional conflict. Results showed that a touch screen decision tool is acceptable to African American patients with low iteracy and, by increasing intent to screen, may increase rates of colonoscopy screening. PMID:26940369

  17. Simulation modeling to derive the value-of-information for risky animal disease-import decisions.

    PubMed

    Disney, W Terry; Peters, Mark A

    2003-11-12

    Simulation modeling can be used in aiding decision-makers in deciding when to invest in additional research and when the risky animal disease-import decision should go forward. Simulation modeling to evaluate value-of-information (VOI) techniques provides a robust, objective and transparent framework for assisting decision-makers in making risky animal and animal product decisions. In this analysis, the hypothetical risk from poultry disease in chicken-meat imports was modeled. Economic criteria were used to quantify alternative confidence-increasing decisions regarding potential import testing and additional research requirements. In our hypothetical example, additional information about poultry disease in the exporting country (either by requiring additional export-flock surveillance that results in no sign of disease, or by conducting additional research into lack of disease transmittal through chicken-meat ingestion) captured >75% of the value-of-information attainable regarding the chicken-meat-import decision.

  18. Design-to-fabricate: maker hardware requires maker software.

    PubMed

    Schmidt, Ryan; Ratto, Matt

    2013-01-01

    As a result of consumer-level 3D printers' increasing availability and affordability, the audience for 3D-design tools has grown considerably. However, current tools are ill-suited for these users. They have steep learning curves and don't take into account that the end goal is a physical object, not a digital model. A new class of "maker"-level design tools is needed to accompany this new commodity hardware. However, recent examples of such tools achieve accessibility primarily by constraining functionality. In contrast, the meshmixer project is building tools that provide accessibility and expressive power by leveraging recent computer graphics research in geometry processing. The project members have had positive experiences with several 3D-design-to-print workshops and are exploring several design-to-fabricate problems. This article is part of a special issue on 3D printing.

  19. Decision Analysis System for Selection of Appropriate Decontamination Technologies

    SciTech Connect

    Ebadian, M.A.; Boudreaux, J.F.; Chinta, S.; Zanakis, S.H.

    1998-01-01

    The principal objective for designing Decision Analysis System for Decontamination (DASD) is to support DOE-EM's endeavor to employ the most efficient and effective technologies for treating radiologically contaminated surfaces while minimizing personnel and environmental risks. DASD will provide a tool for environmental decision makers to improve the quality, consistency, and efficacy of their technology selection decisions. The system will facilitate methodical comparisons between innovative and baseline decontamination technologies and aid in identifying the most suitable technologies for performing surface decontamination at DOE environmental restoration sites.

  20. The Havemann-Taylor Fast Radiative Transfer Code (HT-FRTC) and its application within Tactical Decision Aids (TDAs)

    NASA Astrophysics Data System (ADS)

    Thelen, Jean-Claude; Havemann, Stephan; Wong, Gerald

    2015-10-01

    The Havemann-Taylor Fast Radiative Transfer Code (HT-FRTC) is a core component of the Met Office NEON Tactical Decision Aid (TDA). Within NEON, the HT-FRTC has for a number of years been used to predict the infrared apparent thermal contrasts between different surface types as observed by an airborne sensor. To achieve this, the HT-FRTC is supplied with the inherent temperatures and spectral properties of these surfaces (i.e. ground target(s) and backgrounds). A key strength of the HT-FRTC is its ability to take into account the detailed properties of the atmosphere, which in the context of NEON tend to be provided by a Numerical Weather Prediction (NWP) forecast model. While water vapour and ozone are generally the most important gases, additional trace gases are now being incorporated into the HT-FRTC. The HT-FRTC also includes an exact treatment of atmospheric scattering based on spherical harmonics. This allows for the treatment of several different aerosol species and of liquid and ice clouds. Recent developments can even account for rain and falling snow. The HT-FRTC works in Principal Component (PC) space and is trained on a wide variety of atmospheric and surface conditions, which significantly reduces the computational requirements regarding memory and processing time. One clear-sky simulation takes approximately one millisecond at the time of writing. Recent developments allow the training of HT-FRTC to be both completely generalised and sensor independent. This is significant as the user of the code can add new sensors and new surfaces/targets by supplying extra files which contain their (possibly classified) spectral properties. The HT-FRTC has been extended to cover the spectral range of Photopic and NVG sensors. One aim here is to give guidance on the expected, directionally resolved sky brightness, especially at night, again taking the actual or forecast atmospheric conditions into account. Recent developments include light level predictions during

  1. Mobile chemical detector (AP2C+SP4E) as an aid for medical decision making in the battlefield.

    PubMed

    Eisenkraft, Arik; Markel, Gal; Simovich, Shirley; Layish, Ido; Hoffman, Azik; Finkelstein, Arseny; Rotman, Eran; Dushnitsky, Tsvika; Krivoy, Amir

    2007-09-01

    The combination of the AP2C unit with the SP4E kit composes a lightweight mobile detector of chemical warfare agents (CWA), such as nerve and mustard agents, with both vapor- and liquid-sampling capabilities. This apparatus was recently introduced into our military medical units as an aid for detection of CWA on casualties. Importantly, critical information regarding the applicability in the battlefield was absent. In view of the serious consequences that might follow a proclamation of CWA recognition in battlefield, a high false-positive rate positions the utilization of this apparatus as a medical decision tool in question. We have therefore conducted a field experiment to test the false-positive rate as well as analyze possible factors leading to false-positive readings with this device. The experiment was carried out before and after a 4-day army field exercise, using a standard AP2C device, a SP4E surface sampling kit, and a specially designed medical sampling kit for casualties, intended for medical teams. Soldiers were examined at rest, after mild exercise, and after 4 days in the field. The readings with AP2C alone were compared to the combination of AP2C and SP4E and to the medical sampling kit. Various body fluids served as negative controls. Remarkably, we found a false-positive rate of 57% at rest and after mild exercise, and an even higher rate of 64% after the 4-day field exercise with the AP2C detector alone, as compared to almost no false-positive readings with the combination of AP2C and SP4E. Strikingly, the medical sampling kit has yielded numerous false-positive readings, even in normal body fluids such as blood, urine, and saliva. We therefore see no place for using the medical sampling kit due to an unaccepted high rate of false-positive readings. Finally, we have designed an algorithm that uses the entire apparatus of AP2C and SP4E as a reliable validation tool for medical triage in the setting of exposure to nerve agents in the battlefield.

  2. Providing Climate Policy Makers With a Strong Scientific Base (Invited)

    NASA Astrophysics Data System (ADS)

    Struzik, E.

    2009-12-01

    Scientists can and should inform public policy decisions in the Arctic. But the pace of climate change in the polar world has been occurring far more quickly than most scientists have been able to predict. This creates problems for decision-makers who recognize that difficult management decisions have to be made in matters pertaining to wildlife management, cultural integrity and economic development. With sea ice melting, glaciers receding, permafrost thawing, forest fires intensifying, and disease and invasive species rapidly moving north, the challenge for scientists to provide climate policy makers with a strong scientific base has been daunting. Clashing as this data sometimes does with the “traditional knowledge” of indigenous peoples in the north, it can also become very political. As a result the need to effectively communicate complex data is more imperative now than ever before. Here, the author describes how the work of scientists can often be misinterpreted or exploited in ways that were not intended. Examples include the inappropriate use of scientific data in decision-making on polar bears, caribou and other wildlife populations; the use of scientific data to debunk the fact that greenhouse gases are driving climate change, and the use of scientific data to position one scientist against another when there is no inherent conflict. This work will highlight the need for climate policy makers to increase support for scientists working in the Arctic, as well as illustrate why it is important to find new and more effective ways of communicating scientific data. Strategies that might be considered by granting agencies, scientists and climate policy decision-makers will also be discussed.

  3. Application of Adaptive Decision Aiding Systems to Computer-Assisted Instruction. Final Report, January-December 1974.

    ERIC Educational Resources Information Center

    May, Donald M.; And Others

    The minicomputer-based Computerized Diagnostic and Decision Training (CDDT) system described combines the principles of artificial intelligence, decision theory, and adaptive computer assisted instruction for training in electronic troubleshooting. The system incorporates an adaptive computer program which learns the student's diagnostic and…

  4. A multiattribute utility analysis of sites nominated for characterization for the first radioactive-waste repository: A decision-aiding methodology

    SciTech Connect

    none,

    1986-05-01

    In December 1984, the Department of Energy (DOE) published draft environmental assessments (EAs) to support the proposed nomination of five sites and the recommendation of three sites for characterization for the first radioactive-waste repository. A chapter common to all the draft EAs (Chapter 7) presented rankings of the five sites against the postclosure and the preclosure technical siting guidelines. To determine which three sites appeared most favorable for recommendation for characterization, three simple quantitative methods were used to aggregate the rankings assigned to each site for the various technical guidelines. In response to numerous comments on the methods, the DOE has undertaken a formal application of one of them (hereafter referred to as the decision-aiding methodology) for the purpose of obtaining a more rigorous evaluation of the nominated sites. The application of the revised methodology is described in this report. The method of analysis is known as multiattribute utility analysis; it is a tool for providing insights as to which sites are preferable and why. The decision-aiding methodology accounts for all the fundamental considerations specified by the siting guidelines and uses as source information the data and evaluations reported or referenced in the EAs. It explicitly addresses the uncertainties and value judgments that are part of all siting problems. Furthermore, all scientific and value judgments are made explicit for the reviewer. An independent review of the application of the decision-aiding methodology has been conducted by the Board on Radioactive Waste Management of the National Academy of Sciences; the comments of the Board are included as an appendix to this report.

  5. GT-MSOCC - A domain for research on human-computer interaction and decision aiding in supervisory control systems. [Georgia Tech - Multisatellite Operations Control Center

    NASA Technical Reports Server (NTRS)

    Mitchell, Christine M.

    1987-01-01

    The Georgia Tech-Multisatellite Operations Control Center (GT-MSOCC), a real-time interactive simulation of the operator interface to a NASA ground control system for unmanned earth-orbiting satellites, is described. The GT-MSOCC program for investigating a range of modeling, decision aiding, and workstation design issues related to the human-computer interaction is discussed. A GT-MSOCC operator function model is described in which operator actions, both cognitive and manual, are represented as the lowest level discrete control network nodes, and operator action nodes are linked to information needs or system reconfiguration commands.

  6. Group decision making with the analytic hierarchy process in benefit-risk assessment: a tutorial.

    PubMed

    Hummel, J Marjan; Bridges, John F P; IJzerman, Maarten J

    2014-01-01

    The analytic hierarchy process (AHP) has been increasingly applied as a technique for multi-criteria decision analysis in healthcare. The AHP can aid decision makers in selecting the most valuable technology for patients, while taking into account multiple, and even conflicting, decision criteria. This tutorial illustrates the procedural steps of the AHP in supporting group decision making about new healthcare technology, including (1) identifying the decision goal, decision criteria, and alternative healthcare technologies to compare, (2) structuring the decision criteria, (3) judging the value of the alternative technologies on each decision criterion, (4) judging the importance of the decision criteria, (5) calculating group judgments, (6) analyzing the inconsistency in judgments, (7) calculating the overall value of the technologies, and (8) conducting sensitivity analyses. The AHP is illustrated via a hypothetical example, adapted from an empirical AHP analysis on the benefits and risks of tissue regeneration to repair small cartilage lesions in the knee.

  7. Programmable Calculators and Minicomputers in Agriculture. A Symposium Exploring Computerized Decision-Making Aids and Their Extension to the Farm Level. Proceedings of a Symposium (Hot Springs, Arkansas, February 6-7, 1980)

    ERIC Educational Resources Information Center

    Bentley, Ernest, Ed.

    Ten papers presented at a symposium discuss the array of computerized decision-making aids currently available to farmers and ways to speed up the rate of adoption of computers by agriculturalists. Topics presented include the development of software for agricultural decision-making; the role of programmable calculators and minicomputers in…

  8. Why Breast Cancer Risk by the Numbers Is Not Enough: Evaluation of a Decision Aid in Multi-Ethnic, Low-Numerate Women

    PubMed Central

    Yi, Haeseung; Xiao, Tong; Thomas, Parijatham; Aguirre, Alejandra; Smalletz, Cindy; David, Raven; Crew, Katherine

    2015-01-01

    Background Breast cancer risk assessment including genetic testing can be used to classify people into different risk groups with screening and preventive interventions tailored to the needs of each group, yet the implementation of risk-stratified breast cancer prevention in primary care settings is complex. Objective To address barriers to breast cancer risk assessment, risk communication, and prevention strategies in primary care settings, we developed a Web-based decision aid, RealRisks, that aims to improve preference-based decision-making for breast cancer prevention, particularly in low-numerate women. Methods RealRisks incorporates experience-based dynamic interfaces to communicate risk aimed at reducing inaccurate risk perceptions, with modules on breast cancer risk, genetic testing, and chemoprevention that are tailored. To begin, participants learn about risk by interacting with two games of experience-based risk interfaces, demonstrating average 5-year and lifetime breast cancer risk. We conducted four focus groups in English-speaking women (age ≥18 years), a questionnaire completed before and after interacting with the decision aid, and a semistructured group discussion. We employed a mixed-methods approach to assess accuracy of perceived breast cancer risk and acceptability of RealRisks. The qualitative analysis of the semistructured discussions assessed understanding of risk, risk models, and risk appropriate prevention strategies. Results Among 34 participants, mean age was 53.4 years, 62% (21/34) were Hispanic, and 41% (14/34) demonstrated low numeracy. According to the Gail breast cancer risk assessment tool (BCRAT), the mean 5-year and lifetime breast cancer risk were 1.11% (SD 0.77) and 7.46% (SD 2.87), respectively. After interacting with RealRisks, the difference in perceived and estimated breast cancer risk according to BCRAT improved for 5-year risk (P=.008). In the qualitative analysis, we identified potential barriers to adopting risk

  9. Decision Making and Drug Abuse Among HIV+ Men Who Have Sex with Men: A Preliminary Report from the Chicago Multicenter AIDS Cohort Study

    PubMed Central

    Martin, Eileen M.; DeHaan, Samantha; Vassileva, Jasmin; Gonzalez, Raul; Weller, Joshua; Bechara, Antoine

    2013-01-01

    HIV+ substance dependent individuals (SDIs) make significantly poorer decisions compared with HIV− SDIs, but the neurocognitive mechanisms underlying this impairment have not been identified. We administered the Iowa Gambling Task, a measure of decision making under uncertain risk, and the Cups Task, a measure of decision making under specified risk, to a group of 56 HIV+ and 23 HIV− men who have sex with men (MSMs) with a history of substance dependence enrolled in the Multicenter AIDS Cohort Study. The IGT provides no explicit information regarding the contingencies for each possible choice, and the probability of each outcome remains ambiguous at least for the early trials; in contrast, the Cups Task provides explicit information about the probability of each outcome. The HIV+ group made significantly poorer decisions on the IGT compared with the HIV− group. Cups Task performance did not differ significantly between HIV− and HIV+ groups. Exploratory analyses of the IGT data suggested that HIV+ subjects tended to perform more poorly during the early learning phase when uncertainty about specific outcomes was greatest. Additionally, performance on the final two trial blocks was significantly correlated with Stroop Interference scores, suggesting IGT performance is driven increasingly by executive control during the later portion of the task. Potential cognitive mechanisms to be explored in later studies are discussed, including impairment in implicit learning processing PMID:23701366

  10. Making predictive ecology more relevant to policy makers and practitioners

    PubMed Central

    Sutherland, William J.; Freckleton, Robert P.

    2012-01-01

    One of the aims of ecology is to aid policy makers and practitioners through the development of testable predictions of relevance to society. Here, we argue that this capacity can be improved in three ways. Firstly, by thinking more clearly about the priority issues using a range of methods including horizon scanning, identifying policy gaps, identifying priority questions and using evidence-based conservation to identify knowledge gaps. Secondly, by linking ecological models with models of other systems, such as economic and social models. Thirdly, by considering alternative approaches to generate and model data that use, for example, discrete or categorical states to model ecological systems. We particularly highlight that models are essential for making predictions. However, a key to the limitation in their use is the degree to which ecologists are able to communicate results to policy makers in a clear, useful and timely fashion. PMID:22144394

  11. Understanding The Decision Context: DPSIR, Decision Landscape, And Social Network Analysis

    EPA Science Inventory

    Establishing the decision context for a management problem is the critical first step for effective decision analysis. Understanding the decision context allow stakeholders and decision-makers to integrate the societal, environmental, and economic considerations that must be con...

  12. Recent developments associated with decision support systems in water resources

    NASA Astrophysics Data System (ADS)

    Watkins, David W.; McKinney, Daene C.

    1995-07-01

    In order to limit the scope of this review, a working definition of a decision support system is needed. L. Adelman has defined decision support systems (DSSs) as "interactive computer programs that utilize analytical methods, such as decision analysis, optimization algorithms, program scheduling routines, and so on, for developing models to help decision makers formulate alternatives, analyze their impacts, and interpret and select appropriate options for implementation" (Adelman [1992], p. 2). Another definition has been offered by S. J. Andriole, who defined decision support as consisting of "any and all data, information, expertise or activities that contribute to option selection" (Andriole [1989], p. 3). A common idea explicit in each of these definitions is that DSSs integrate various technologies and aid in option selection. Implicit in each definition is that these are options for solving relatively large, unstructured problems. Thus, the following working definition of a DSS will be used in this review: A DSS is an integrated, interactive computer system, consisting of analytical tools and information management capabilities, designed to aid decision makers in solving relatively large, unstructured problems.

  13. The development of a multi-criteria decision analysis aid to help with contraceptive choices: My Contraception Tool.

    PubMed

    French, Rebecca S; Cowan, Frances M; Wellings, Kaye; Dowie, Jack

    2014-04-01

    My Contraception Tool (MCT) applies the principles of multi-criteria decision analysis to the choice of contraceptive method. Its purpose is to make the decision-making process transparent to the user and to suggest a method to them based on their own preferences. The contraceptive option that emerges as optimal from the analysis takes account of the probability of a range of outcomes and the relative weight ascribed to them by the user. The development of MCT was a collaborative project between London School of Hygiene & Tropical Medicine, Brook, FPA and Maldaba Ltd. MCT is available online via the Brook and FPA websites. In this article we describe MCT's development and how it works. Further work is needed to assess the impact it has on decision quality and contraceptive behaviour.

  14. Is Twitter a forum for disseminating research to health policy makers?

    PubMed

    Kapp, Julie M; Hensel, Brian; Schnoring, Kyle T

    2015-12-01

    Findings from scientific research largely remain inside the scientific community. Research scientists are being encouraged to use social media, and especially Twitter, for dissemination of evidence. The potential for Twitter to narrow the gap on evidence translated into policy presents new opportunities. We explored the innovative question of the feasibility of Twitter as a tool for the scientific community to disseminate to and engage with health policy makers for research impact. We created a list of federal "health policy makers." In December 2014, we identified members using several data sources, then collected and summarized their Twitter usage data. Nearly all health policy makers had Twitter accounts. Their communication volume varied broadly. Policy makers are more likely to push information via Twitter than engage with constituents, although usage varied broadly. Twitter has the potential to aid the scientific community in dissemination of health-related research to health policy makers, after understanding how to effectively (and selectively) use Twitter.

  15. Top Benefits Challenges Facing School Business Decision Makers

    ERIC Educational Resources Information Center

    Bohling, Joseph

    2012-01-01

    What's the main factor coloring employee satisfaction? Many organizations' leaders think the answer is salary, yet in reality, employee benefits packages are one of the biggest incentives an employer can offer. Educational institutions have done well in providing benefits to employees. However, with an unpredictable economic climate and a complex…

  16. Characters at Crossroads: Reflective Decision Makers in Contemporary Newbery Books.

    ERIC Educational Resources Information Center

    Friedman, Audrey A.; Cataldo, Christina A.

    2002-01-01

    Presents a table summarizing the pertinent literary aspects of Newbery Medal books. Discusses how middle school students generally believe every problem has a right or wrong answer and authorities have all the answers. Presents activities to help students connect to the literature. Concludes that Newbery heroes and heroines are models of effective…

  17. Crossing disciplines to increase effective decision maker-scientist interactions

    NASA Astrophysics Data System (ADS)

    Morelli, T. L.

    2015-12-01

    Despite increasing knowledge of how climate will continue to change, there remain substantial challenges in determining what actions to take to curb the anticipated loss of biodiversity. Scientists sometimes struggle to speak across disciplines, and managers are often treated as a repository of information rather than a partner in the scientific process. However, through integrative study and collaboration, resource managers can collaborate with physical and biological scientists to translate the latest science into strategies that conserve species in spite of climate change uncertainty. We highlight case studies of how scientists and managers are working together to manage forest ecosystems, songbirds, and cold-adapted fish species in the face of climate change. This work is a collaboration of postdoctoral researchers and graduate students funded through the Department of Interior Northeast Climate Science Center.

  18. A Pedagogy for Teachers and Other Educational Decision Makers.

    ERIC Educational Resources Information Center

    Patterson, Graham

    1980-01-01

    Using Pirsig's "Zen and the Art of Motorcycle Maintenance" as a basis, the author offers an alternative to deficit model programing (catch-up classes for "deficient" students) and posits an approach to problem solving that depends on dialog and interaction. (WD)

  19. Developing Tomorrow's Decision-Makers: Opportunities for Biotechnology Education Research

    ERIC Educational Resources Information Center

    Hilton, Annette; Nichols, Kim; Kanasa, Harry

    2011-01-01

    Globally, science curricula have been described as outdated, and students perceive school science as lacking in relevance. Declines in senior secondary and tertiary student participation in science indicate an urgent need for change if we are to sustain future scientific research and development, and perhaps more importantly, to equip students…

  20. Early Childhood Program Evaluations: A Decision-Maker's Guide

    ERIC Educational Resources Information Center

    National Forum on Early Childhood Program Evaluation, 2007

    2007-01-01

    Increasing demands for evidence-based early childhood services and the need by policymakers to know whether a program is effective or whether it warrants a significant investment of public and/or private funds--coupled with the often-politicized debate around these topics--make it imperative for policymakers and civic leaders to have independent…

  1. Digital Solutions for Informed Decision Making: An Academic-Community Partnership for the Development of a Prostate Cancer Decision Aid for African-American Men

    PubMed Central

    Owens, Otis L.; Friedman, Daniela B.; Brandt, Heather M.; Bernhardt, Jay M.; Hébert, James R.

    2014-01-01

    African-American (AA) men are significantly more likely to die of prostate cancer (PrCA) than other racial groups, and there is a critical need to identify strategies for providing information about PrCA screening and the importance of informed decision making (IDM). To assess whether a computer-based IDM intervention for PrCA screening would be appropriate for AA men, this formative evaluation study examined their (1) PrCA risk and screening knowledge, (2) decision-making processes for PrCA screening, (3) usage of, attitudes toward, and access to interactive communication technologies (ICTs), and (4) perceptions regarding a future novel computer-based PrCA education intervention. A purposive convenience sample of 39 AA men aged 37–66 years in the Southeastern United States were recruited through faith-based organizations to participate in one of six 90-minute focus groups and complete a 45-item descriptive survey. Participants were generally knowledgeable about PrCA; however, few engaged in IDM with their doctor and few were informed about the associated risks and uncertainties of PrCA screening. Most participants used ICTs on a daily basis for various purposes including health information seeking. Most participants were open to a novel computer-based intervention if the system was easy to use and its animated avatars were culturally appropriate. Because study participants had low exposure to IDM for PrCA, but frequently used ICTs, IDM interventions using ICTs (e.g, computers) hold promise for AA men and should be explored for feasibility and effectiveness. These interventions should aim to increase PrCA screening knowledge and stress the importance of participating in IDM with their doctor. PMID:25563381

  2. Shared Problem Models and Crew Decision Making

    NASA Technical Reports Server (NTRS)

    Orasanu, Judith; Statler, Irving C. (Technical Monitor)

    1994-01-01

    The importance of crew decision making to aviation safety has been well established through NTSB accident analyses: Crew judgment and decision making have been cited as causes or contributing factors in over half of all accidents in commercial air transport, general aviation, and military aviation. Yet the bulk of research on decision making has not proven helpful in improving the quality of decisions in the cockpit. One reason is that traditional analytic decision models are inappropriate to the dynamic complex nature of cockpit decision making and do not accurately describe what expert human decision makers do when they make decisions. A new model of dynamic naturalistic decision making is offered that may prove more useful for training or aiding cockpit decision making. Based on analyses of crew performance in full-mission simulation and National Transportation Safety Board accident reports, features that define effective decision strategies in abnormal or emergency situations have been identified. These include accurate situation assessment (including time and risk assessment), appreciation of the complexity of the problem, sensitivity to constraints on the decision, timeliness of the response, and use of adequate information. More effective crews also manage their workload to provide themselves with time and resources to make good decisions. In brief, good decisions are appropriate to the demands of the situation and reflect the crew's metacognitive skill. Effective crew decision making and overall performance are mediated by crew communication. Communication contributes to performance because it assures that all crew members have essential information, but it also regulates and coordinates crew actions and is the medium of collective thinking in response to a problem. This presentation will examine the relation between communication that serves to build performance. Implications of these findings for crew training will be discussed.

  3. Perceived Barriers and Facilitators of Using a Web-Based Interactive Decision Aid for Colorectal Cancer Screening in Community Practice Settings: Findings From Focus Groups With Primary Care Clinicians and Medical Office Staff

    PubMed Central

    2013-01-01

    Background Information is lacking about the capacity of those working in community practice settings to utilize health information technology for colorectal cancer screening. Objective To address this gap we asked those working in community practice settings to share their perspectives about how the implementation of a Web-based patient-led decision aid might affect patient-clinician conversations about colorectal cancer screening and the day-to-day clinical workflow. Methods Five focus groups in five community practice settings were conducted with 8 physicians, 1 physician assistant, and 18 clinic staff. Focus groups were organized using a semistructured discussion guide designed to identify factors that mediate and impede the use of a Web-based decision aid intended to clarify patient preferences for colorectal cancer screening and to trigger shared decision making during the clinical encounter. Results All physicians, the physician assistant, and 8 of the 18 clinic staff were active participants in the focus groups. Clinician and staff participants from each setting reported a belief that the Web-based patient-led decision aid could be an informative and educational tool; in all but one setting participants reported a readiness to recommend the tool to patients. The exception related to clinicians from one clinic who described a preference for patients having fewer screening choices, noting that a colonoscopy was the preferred screening modality for patients in their clinic. Perceived barriers to utilizing the Web-based decision aid included patients’ lack of Internet access or low computer literacy, and potential impediments to the clinics’ daily workflow. Expanding patients’ use of an online decision aid that is both easy to access and understand and that is utilized by patients outside of the office visit was described as a potentially efficient means for soliciting patients’ screening preferences. Participants described that a system to link the

  4. Emerging medical informatics with case-based reasoning for aiding clinical decision in multi-agent system.

    PubMed

    Shen, Ying; Colloc, Joël; Jacquet-Andrieu, Armelle; Lei, Kai

    2015-08-01

    This research aims to depict the methodological steps and tools about the combined operation of case-based reasoning (CBR) and multi-agent system (MAS) to expose the ontological application in the field of clinical decision support. The multi-agent architecture works for the consideration of the whole cycle of clinical decision-making adaptable to many medical aspects such as the diagnosis, prognosis, treatment, therapeutic monitoring of gastric cancer. In the multi-agent architecture, the ontological agent type employs the domain knowledge to ease the extraction of similar clinical cases and provide treatment suggestions to patients and physicians. Ontological agent is used for the extension of domain hierarchy and the interpretation of input requests. Case-based reasoning memorizes and restores experience data for solving similar problems, with the help of matching approach and defined interfaces of ontologies. A typical case is developed to illustrate the implementation of the knowledge acquisition and restitution of medical experts.

  5. The Performance Analysis of the Map-Aided Fuzzy Decision Tree Based on the Pedestrian Dead Reckoning Algorithm in an Indoor Environment.

    PubMed

    Chiang, Kai-Wei; Liao, Jhen-Kai; Tsai, Guang-Je; Chang, Hsiu-Wen

    2015-12-28

    Hardware sensors embedded in a smartphone allow the device to become an excellent mobile navigator. A smartphone is ideal for this task because its great international popularity has led to increased phone power and since most of the necessary infrastructure is already in place. However, using a smartphone for indoor pedestrian navigation can be problematic due to the low accuracy of sensors, imprecise predictability of pedestrian motion, and inaccessibility of the Global Navigation Satellite System (GNSS) in some indoor environments. Pedestrian Dead Reckoning (PDR) is one of the most common technologies used for pedestrian navigation, but in its present form, various errors tend to accumulate. This study introduces a fuzzy decision tree (FDT) aided by map information to improve the accuracy and stability of PDR with less dependency on infrastructure. First, the map is quickly surveyed by the Indoor Mobile Mapping System (IMMS). Next, Bluetooth beacons are implemented to enable the initializing of any position. Finally, map-aided FDT can estimate navigation solutions in real time. The experiments were conducted in different fields using a variety of smartphones and users in order to verify stability. The contrast PDR system demonstrates low stability for each case without pre-calibration and post-processing, but the proposed low-complexity FDT algorithm shows good stability and accuracy under the same conditions.

  6. The Performance Analysis of the Map-Aided Fuzzy Decision Tree Based on the Pedestrian Dead Reckoning Algorithm in an Indoor Environment.

    PubMed

    Chiang, Kai-Wei; Liao, Jhen-Kai; Tsai, Guang-Je; Chang, Hsiu-Wen

    2015-01-01

    Hardware sensors embedded in a smartphone allow the device to become an excellent mobile navigator. A smartphone is ideal for this task because its great international popularity has led to increased phone power and since most of the necessary infrastructure is already in place. However, using a smartphone for indoor pedestrian navigation can be problematic due to the low accuracy of sensors, imprecise predictability of pedestrian motion, and inaccessibility of the Global Navigation Satellite System (GNSS) in some indoor environments. Pedestrian Dead Reckoning (PDR) is one of the most common technologies used for pedestrian navigation, but in its present form, various errors tend to accumulate. This study introduces a fuzzy decision tree (FDT) aided by map information to improve the accuracy and stability of PDR with less dependency on infrastructure. First, the map is quickly surveyed by the Indoor Mobile Mapping System (IMMS). Next, Bluetooth beacons are implemented to enable the initializing of any position. Finally, map-aided FDT can estimate navigation solutions in real time. The experiments were conducted in different fields using a variety of smartphones and users in order to verify stability. The contrast PDR system demonstrates low stability for each case without pre-calibration and post-processing, but the proposed low-complexity FDT algorithm shows good stability and accuracy under the same conditions. PMID:26729114

  7. The Performance Analysis of the Map-Aided Fuzzy Decision Tree Based on the Pedestrian Dead Reckoning Algorithm in an Indoor Environment

    PubMed Central

    Chiang, Kai-Wei; Liao, Jhen-Kai; Tsai, Guang-Je; Chang, Hsiu-Wen

    2015-01-01

    Hardware sensors embedded in a smartphone allow the device to become an excellent mobile navigator. A smartphone is ideal for this task because its great international popularity has led to increased phone power and since most of the necessary infrastructure is already in place. However, using a smartphone for indoor pedestrian navigation can be problematic due to the low accuracy of sensors, imprecise predictability of pedestrian motion, and inaccessibility of the Global Navigation Satellite System (GNSS) in some indoor environments. Pedestrian Dead Reckoning (PDR) is one of the most common technologies used for pedestrian navigation, but in its present form, various errors tend to accumulate. This study introduces a fuzzy decision tree (FDT) aided by map information to improve the accuracy and stability of PDR with less dependency on infrastructure. First, the map is quickly surveyed by the Indoor Mobile Mapping System (IMMS). Next, Bluetooth beacons are implemented to enable the initializing of any position. Finally, map-aided FDT can estimate navigation solutions in real time. The experiments were conducted in different fields using a variety of smartphones and users in order to verify stability. The contrast PDR system demonstrates low stability for each case without pre-calibration and post-processing, but the proposed low-complexity FDT algorithm shows good stability and accuracy under the same conditions. PMID:26729114

  8. 49 CFR 1503.657 - Appeal from initial decision.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... AND ENFORCEMENT PROCEDURES Rules of Practice in TSA Civil Penalty Actions § 1503.657 Appeal from... order of the TSA decision maker have been entered on the record. (b) Issues on appeal. A party may... appeal with the consent of the TSA decision maker. If the TSA decision maker grants an extension of...

  9. Technical Bases to Aid in the Decision of Conducting Full Power Ground Nuclear Tests for Space Fission Reactors

    NASA Astrophysics Data System (ADS)

    Hixson, Laurie L.; Houts, Michael G.; Clement, Steven D.

    2004-02-01

    The extent to which, if any, full power ground nuclear testing of space reactors should be performed has been a point of discussion within the industry for decades. Do the benefits outweigh the risks? Are there equivalent alternatives? Can a test facility be constructed (or modified) in a reasonable amount of time? Is the test article an accurate representation of the flight system? Are the costs too restrictive? The obvious benefits of full power ground nuclear testing; obtaining systems integrated reliability data on a full-scale, complete end-to-end system; come at some programmatic risk. Safety related information is not obtained from a full-power ground nuclear test. This paper will discuss and assess these and other technical considerations essential in the decision to conduct full power ground nuclear-or alternative-tests.

  10. Visual aids improve diagnostic inferences and metacognitive judgment calibration

    PubMed Central

    Garcia-Retamero, Rocio; Cokely, Edward T.; Hoffrage, Ulrich

    2015-01-01

    Visual aids can improve comprehension of risks associated with medical treatments, screenings, and lifestyles. Do visual aids also help decision makers accurately assess their risk comprehension? That is, do visual aids help them become well calibrated? To address these questions, we investigated the benefits of visual aids displaying numerical information and measured accuracy of self-assessment of diagnostic inferences (i.e., metacognitive judgment calibration) controlling for individual differences in numeracy. Participants included 108 patients who made diagnostic inferences about three medical tests on the basis of information about the sensitivity and false-positive rate of the tests and disease prevalence. Half of the patients received the information in numbers without a visual aid, while the other half received numbers along with a grid representing the numerical information. In the numerical condition, many patients–especially those with low numeracy–misinterpreted the predictive value of the tests and profoundly overestimated the accuracy of their inferences. Metacognitive judgment calibration mediated the relationship between numeracy and accuracy of diagnostic inferences. In contrast, in the visual aid condition, patients at all levels of numeracy showed high-levels of inferential accuracy and metacognitive judgment calibration. Results indicate that accurate metacognitive assessment may explain the beneficial effects of visual aids and numeracy–a result that accords with theory suggesting that metacognition is an essential part of risk literacy. We conclude that well-designed risk communications can inform patients about healthrelevant numerical information while helping them assess the quality of their own risk comprehension. PMID:26236247

  11. An Assessment of the Level of Influence of Family Life and HIV/AIDS Education on Knowledge, Attitude and Decision Making among Adolescents with Hearing Impairment in Some States in Nigeria

    ERIC Educational Resources Information Center

    Adeniyi, S. O.; Oyewumi, A. M.; Fakolade, O. A.

    2011-01-01

    This study investigated knowledge, attitude and decision making on HIV/AIDS among adolescents with hearing impairment in Oyo, Lagos and Kwara States. Seventy-six respondents participated in the study with age range between 16 and 20. The research adopted a descriptive survey research design. Seventy-six students with hearing impairment…

  12. Decision Theory and the Governance of Technology.

    ERIC Educational Resources Information Center

    Woodhouse, Edward J.

    1987-01-01

    Provides an overview of the decision making process for science and technology. Finds that government agencies and officials are not the major decision makers. Examines obstacles to achieving intelligent decisions when policy makers are scientists, business executives, and consumers. Concludes with five strategies for improving technological…

  13. URBAN DECISION-MAKING, THE UNIVERSITY'S ROLE.

    ERIC Educational Resources Information Center

    BAILEY, STEPHEN K.

    THE AUTHOR EXAMINES THE VARIOUS WAYS IN WHICH THE UNIVERSITY CAN AND SHOULD INFLUENCE URBAN DECISION MAKING. THE CENTRAL UNIVERSITY ROLE IS SENSITIZING THE DECISION MAKERS AND THE CITIZENS TO HUMAN MISERY, SUCH AS BIGOTRY, SQUALOR, DISEASE, UGLINESS, POVERTY, AND IGNORANCE. LONG-RANGE ROLES ARE PINPOINTING THE PROBLEMS URBAN DECISION MAKERS SHOULD…

  14. Fracture risk assessment: improved evaluation of vertebral integrity among metastatic cancer patients to aid in surgical decision-making

    NASA Astrophysics Data System (ADS)

    Augustine, Kurt E.; Camp, Jon J.; Holmes, David R.; Huddleston, Paul M.; Lu, Lichun; Yaszemski, Michael J.; Robb, Richard A.

    2012-03-01

    Failure of the spine's structural integrity from metastatic disease can lead to both pain and neurologic deficit. Fractures that require treatment occur in over 30% of bony metastases. Our objective is to use computed tomography (CT) in conjunction with analytic techniques that have been previously developed to predict fracture risk in cancer patients with metastatic disease to the spine. Current clinical practice for cancer patients with spine metastasis often requires an empirical decision regarding spinal reconstructive surgery. Early image-based software systems used for CT analysis are time consuming and poorly suited for clinical application. The Biomedical Image Resource (BIR) at Mayo Clinic, Rochester has developed an image analysis computer program that calculates from CT scans, the residual load-bearing capacity in a vertebra with metastatic cancer. The Spine Cancer Assessment (SCA) program is built on a platform designed for clinical practice, with a workflow format that allows for rapid selection of patient CT exams, followed by guided image analysis tasks, resulting in a fracture risk report. The analysis features allow the surgeon to quickly isolate a single vertebra and obtain an immediate pre-surgical multiple parallel section composite beam fracture risk analysis based on algorithms developed at Mayo Clinic. The analysis software is undergoing clinical validation studies. We expect this approach will facilitate patient management and utilization of reliable guidelines for selecting among various treatment option based on fracture risk.

  15. Can scientists and policy makers work together?

    PubMed Central

    Choi, B.; Pang, T.; Lin, V.; Puska, P.; Sherman, G.; Goddard, M.; Ackland, M.; Sainsbury, P.; Stachenko, S.; Morrison, H.; Clottey, C.

    2005-01-01

    This paper addresses a fundamental question in evidence based policy making—can scientists and policy makers work together? It first provides a scenario outlining the different mentalities and imperatives of scientists and policy makers, and then discusses various issues and solutions relating to whether and how scientists and policy makers can work together. Scientists and policy makers have different goals, attitudes toward information, languages, perception of time, and career paths. Important issues affecting their working together include lack of mutual trust and respect, different views on the production and use of evidence, different accountabilities, and whether there should be a link between science and policy. The suggested solutions include providing new incentives to encourage scientists and policy makers to work together, using knowledge brokers (translational scientists), making organisational changes, defining research in a broader sense, re-defining the starting point for knowledge transfer, expanding the accountability horizon, and finally, acknowledging the complexity of policy making. It is hoped that further discussion and debate on the partnership idea, the need for incentives, recognising the incompatibility problems, the role of civil society, and other related themes will lead to new opportunities for further advancing evidence based policy and practice. PMID:16020638

  16. Can scientists and policy makers work together?

    PubMed

    Choi, Bernard C K; Pang, Tikki; Lin, Vivian; Puska, Pekka; Sherman, Gregory; Goddard, Michael; Ackland, Michael J; Sainsbury, Peter; Stachenko, Sylvie; Morrison, Howard; Clottey, Clarence

    2005-08-01

    This paper addresses a fundamental question in evidence based policy making--can scientists and policy makers work together? It first provides a scenario outlining the different mentalities and imperatives of scientists and policy makers, and then discusses various issues and solutions relating to whether and how scientists and policy makers can work together. Scientists and policy makers have different goals, attitudes toward information, languages, perception of time, and career paths. Important issues affecting their working together include lack of mutual trust and respect, different views on the production and use of evidence, different accountabilities, and whether there should be a link between science and policy. The suggested solutions include providing new incentives to encourage scientists and policy makers to work together, using knowledge brokers (translational scientists), making organisational changes, defining research in a broader sense, re-defining the starting point for knowledge transfer, expanding the accountability horizon, and finally, acknowledging the complexity of policy making. It is hoped that further discussion and debate on the partnership idea, the need for incentives, recognising the incompatibility problems, the role of civil society, and other related themes will lead to new opportunities for further advancing evidence based policy and practice. PMID:16020638

  17. Decision-tree analysis of clinical data to aid diagnostic reasoning for equine laminitis: a cross-sectional study.

    PubMed

    Wylie, C E; Shaw, D J; Verheyen, K L P; Newton, J R

    2016-04-23

    The objective of this cross-sectional study was to compare the prevalence of selected clinical signs in laminitis cases and non-laminitic but lame controls to evaluate their capability to discriminate laminitis from other causes of lameness. Participating veterinary practitioners completed a checklist of laminitis-associated clinical signs identified by literature review. Cases were defined as horses/ponies with veterinary-diagnosed, clinically apparent laminitis; controls were horses/ponies with any lameness other than laminitis. Associations were tested by logistic regression with adjusted odds ratios (ORs) and 95% confidence intervals, with veterinary practice as an a priori fixed effect. Multivariable analysis using graphical classification tree-based statistical models linked laminitis prevalence with specific combinations of clinical signs. Data were collected for 588 cases and 201 controls. Five clinical signs had a difference in prevalence of greater than +50 per cent: 'reluctance to walk' (OR 4.4), 'short, stilted gait at walk' (OR 9.4), 'difficulty turning' (OR 16.9), 'shifting weight' (OR 17.7) and 'increased digital pulse' (OR 13.2) (all P<0.001). 'Bilateral forelimb lameness' was the best discriminator; 92 per cent of animals with this clinical sign had laminitis (OR 40.5, P<0.001). If, in addition, horses/ponies had an 'increased digital pulse', 99 per cent were identified as laminitis. 'Presence of a flat/convex sole' also significantly enhanced clinical diagnosis discrimination (OR 15.5, P<0.001). This is the first epidemiological laminitis study to use decision-tree analysis, providing the first evidence base for evaluating clinical signs to differentially diagnose laminitis from other causes of lameness. Improved evaluation of the clinical signs displayed by laminitic animals examined by first-opinion practitioners will lead to equine welfare improvements. PMID:26969668

  18. 17 CFR 240.11a1-5 - Transactions by registered competitive market makers and registered equity market makers.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... competitive market makers and registered equity market makers. 240.11a1-5 Section 240.11a1-5 Commodity and... registered equity market makers. Any transaction by a New York Stock Exchange registered competitive market maker or an American Stock Exchange registered equity market maker effected in compliance with...

  19. 17 CFR 240.11a1-5 - Transactions by registered competitive market makers and registered equity market makers.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... competitive market makers and registered equity market makers. 240.11a1-5 Section 240.11a1-5 Commodity and... registered equity market makers. Any transaction by a New York Stock Exchange registered competitive market maker or an American Stock Exchange registered equity market maker effected in compliance with...

  20. Making better decisions in uncertain times (Invited)

    NASA Astrophysics Data System (ADS)

    St John, C.

    2013-12-01

    Scientific information about climate change and other human impacts on the environment are increasingly available and sought after (often in the form of probabilistic forecasts or technical information related to engineering solutions). However, it is increasingly apparent that there are barriers to the use of this information by decision makers - either from its lack of application altogether, its usability for people without scientific backgrounds, or its ability to inform sound decisions and widespread behavior change. While the argument has been made that an information deficit is to blame, we argue that there is also a motivation deficit contributing to a lack of understanding of information about climate change impacts and solutions. Utilizing insight from over thirty years of research in social and cognitive psychology, in addition to other social sciences, the Center for Research on Environmental Decisions (CRED) seeks to understand how people make environmental decisions under conditions of uncertainty, and how these decisions can be improved. This presentation will focus specifically on recent research that has come forth since the 2009 publication of CRED's popular guide 'The Psychology of Climate Change Communication: A Guide for Scientists, Journalists, Educators, Political Aides, and the Interested Public.' Utilizing case studies from real world examples, this talk will explore how decision making can be improved through a better understanding of how people perceive and process uncertainty and risk. It will explore techniques such as choice architecture and 'nudging' behavior change, how social goals and group participation affect decision making, and how framing of environmental information influences mitigative behavior.

  1. Examining Decision-Making Regarding Environmental Information

    SciTech Connect

    Marble, Julie Lynne; Medema, Heather Dawne; Hill, Susan Gardiner

    2001-10-01

    Eight participants were asked to view a computer-based multimedia presentation on an environmental phenomenon. Participants were asked to play a role as a senior aide to a national legislator. In this role, they were told that the legislator had asked them to review a multimedia presentation regarding the hypoxic zone phenomenon in the Gulf of Mexico. Their task in assuming the role of a senior aide was to decide how important a problem this issue was to the United States as a whole, and the proportion of the legislator’s research budget that should be devoted to study of the problem. The presentation was divided into 7 segments, each containing some new information not contained in the previous segments. After viewing each segment, participants were asked to indicate how close they were to making a decision and how certain they were that their current opinion would be their final decision. After indicating their current state of decision-making, participants were interviewed regarding the factors affecting their decision-making. Of interest was the process by which participants moved toward a decision. This experiment revealed a number of possible directions for future research. There appeared to be two approaches to decision-making: Some decision-makers moved steadily toward a decision, and occasionally reversed decisions after viewing information, while others abruptly reached a decision after a certain time period spent reviewing the information. Although the difference in estimates of distance to decisions did not differ statistically for these two groups, that difference was reflected in the participants’ estimates of confidence that their current opinion would be their final decision. The interviews revealed that the primary difference between these two groups was in their trade-offs between willingness to spend time in information search and the acquisition of new information. Participants who were less confident about their final decision, tended to be

  2. Regulating Emotions during Difficult Multiattribute Decision Making: The Role of Pre-Decisional Coherence Shifting

    PubMed Central

    Carpenter, Stephanie M.; Yates, J. Frank; Preston, Stephanie D.; Chen, Lydia

    2016-01-01

    Almost all real-life decisions entail attribute conflict; every serious choice alternative is better than its competitors on some attribute dimensions but worse on others. In pre-decisional “coherence shifting,” the decision maker gradually softens that conflict psychologically to the point where one alternative is seen as dominant over its competitors, or nearly so. Specifically, weaknesses of the eventually chosen alternative come to be perceived as less severe and less important while its strengths seem more desirable and significant. The research described here demonstrates that difficult multiattribute decision problems are aversive and that pre-decisional coherence shifting aids individuals in regulating that emotional discomfort. Across three studies, attribute conflict was confirmed to be aversive (Study 1), and skin conductance responses and ratings of decision difficulty both decreased in participants who coherence shifted (Study 2). Coherence shifting was also diminished among decision makers who were depleted of regulatory resources, known to be required for common emotion regulation mechanisms. Further, coherence shifting was shown to be relatively common among people who reported strong suppression tendencies in everyday emotion regulation (Study 3). Overall, the data suggest that, at least in part, coherence shifting serves as a tool that helps decision makers manage the pre-decisional discomfort generated by attribute conflict. Theoretical and practical implications are discussed. PMID:26986752

  3. Real-Time Monitoring and Evaluation of a Visual-Based Cervical Cancer Screening Program Using a Decision Support Job Aid

    PubMed Central

    Peterson, Curtis W.; Rose, Donny; Mink, Jonah; Levitz, David

    2016-01-01

    In many developing nations, cervical cancer screening is done by visual inspection with acetic acid (VIA). Monitoring and evaluation (M&E) of such screening programs is challenging. An enhanced visual assessment (EVA) system was developed to augment VIA procedures in low-resource settings. The EVA System consists of a mobile colposcope built around a smartphone, and an online image portal for storing and annotating images. A smartphone app is used to control the mobile colposcope, and upload pictures to the image portal. In this paper, a new app feature that documents clinical decisions using an integrated job aid was deployed in a cervical cancer screening camp in Kenya. Six organizations conducting VIA used the EVA System to screen 824 patients over the course of a week, and providers recorded their diagnoses and treatments in the application. Real-time aggregated statistics were broadcast on a public website. Screening organizations were able to assess the number of patients screened, alongside treatment rates, and the patients who tested positive and required treatment in real time, which allowed them to make adjustments as needed. The real-time M&E enabled by “smart” diagnostic medical devices holds promise for broader use in screening programs in low-resource settings. PMID:27196932

  4. Real-Time Monitoring and Evaluation of a Visual-Based Cervical Cancer Screening Program Using a Decision Support Job Aid.

    PubMed

    Peterson, Curtis W; Rose, Donny; Mink, Jonah; Levitz, David

    2016-01-01

    In many developing nations, cervical cancer screening is done by visual inspection with acetic acid (VIA). Monitoring and evaluation (M&E) of such screening programs is challenging. An enhanced visual assessment (EVA) system was developed to augment VIA procedures in low-resource settings. The EVA System consists of a mobile colposcope built around a smartphone, and an online image portal for storing and annotating images. A smartphone app is used to control the mobile colposcope, and upload pictures to the image portal. In this paper, a new app feature that documents clinical decisions using an integrated job aid was deployed in a cervical cancer screening camp in Kenya. Six organizations conducting VIA used the EVA System to screen 824 patients over the course of a week, and providers recorded their diagnoses and treatments in the application. Real-time aggregated statistics were broadcast on a public website. Screening organizations were able to assess the number of patients screened, alongside treatment rates, and the patients who tested positive and required treatment in real time, which allowed them to make adjustments as needed. The real-time M&E enabled by "smart" diagnostic medical devices holds promise for broader use in screening programs in low-resource settings. PMID:27196932

  5. Quantitative Decision Making.

    ERIC Educational Resources Information Center

    Baldwin, Grover H.

    The use of quantitative decision making tools provides the decision maker with a range of alternatives among which to decide, permits acceptance and use of the optimal solution, and decreases risk. Training line administrators in the use of these tools can help school business officials obtain reliable information upon which to base district…

  6. School Boards as Policy-Makers.

    ERIC Educational Resources Information Center

    Coleman, Peter

    Decision-making in general and policy decisions in particular are the prime responsibility of school boards because policies are control mechanisms by which trustees assert local control. Policy decisions differ from others in their concern with values and purposes and the legitimization of the organization to society at large. Additionally, they…

  7. The second iteration of the Systems Prioritization Method: A systems prioritization and decision-aiding tool for the Waste Isolation Pilot Plant: Volume 3, Analysis for final programmatic recommendations

    SciTech Connect

    Prindle, N.H.; Boak, D.M.; Weiner, R.F.

    1996-05-01

    Systems Prioritization Method (SPM) is a decision-aiding tool developed by Sandia National Laboratories for the US DOE Carlsbad Area Office (DOE/CAO). This tool provides an analytical basis for programmatic decision making for the Waste Isolation Pilot Plant (WIPP). SPM integrates decision-analysis techniques, performance,a nd risk-assessment tools, and advanced information technology. Potential outcomes of proposed activities and combination of activities are used to calculate a probability of demonstrating compliance (PDC) with selected regulations. The results are presented in a decision matrix showing cost, duration, and maximum PDC for all activities in a given cost and duration category. This is the third and final volume in the series which presents the analysis for final programmatic recommendations.

  8. 10 CFR 429.45 - Automatic commercial ice makers.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Automatic commercial ice makers. 429.45 Section 429.45... PRODUCTS AND COMMERCIAL AND INDUSTRIAL EQUIPMENT Certification § 429.45 Automatic commercial ice makers. (a... automatic commercial ice makers; and (2) For each basic model of automatic commercial ice maker selected...

  9. 10 CFR 429.45 - Automatic commercial ice makers.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Automatic commercial ice makers. 429.45 Section 429.45... PRODUCTS AND COMMERCIAL AND INDUSTRIAL EQUIPMENT Certification § 429.45 Automatic commercial ice makers. (a... automatic commercial ice makers; and (2) For each basic model of automatic commercial ice maker selected...

  10. 10 CFR 429.45 - Automatic commercial ice makers.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 false Automatic commercial ice makers. 429.45 Section 429.45... PRODUCTS AND COMMERCIAL AND INDUSTRIAL EQUIPMENT Certification § 429.45 Automatic commercial ice makers. (a... automatic commercial ice makers; and (2) For each basic model of automatic commercial ice maker selected...

  11. Religious influences on the reproductive health decisions of HIV-positive Latinas on the border.

    PubMed

    Instone, Susan; Mueller, Mary-Rose

    2011-12-01

    The number of HIV-positive Latinas of child-bearing age living on the US-Mexico border is a growing concern. Little is known about how religious beliefs influence the reproductive health decisions of these women in light of disease demands and cultural and religious norms that support high fertility rates and childbearing. Such decisions may be further complicated by the stigma of HIV/AIDS and structural issues related to immigration status and trans-border lives. This paper analyzes extant literature and supports the need for further research so that policy makers and heath and social service providers can develop meaningful and comprehensive reproductive-health related interventions.

  12. What about AIDS?

    ERIC Educational Resources Information Center

    Dreyfuss, Katharine R.

    1987-01-01

    Discusses the nature of Acquired Immune Deficiency Syndrome (AIDS). Suggests ways in which camp directors can establish procedures for making appropriate decisions about accepting campers/staff workers with AIDS. Reviews aspects of environmental sanitation, physical health, confidentiality, camper/staff drug use and sexual behavior, medical…

  13. Bridge over troubled waters: A Synthesis Session to connect scientific and decision making sectors

    EPA Science Inventory

    Lack of access to relevant scientific data has limited decision makers from incorporating scientific information into their management and policy schemes. Yet, there is increasing interest among decision makers and scientists to integrate coastal and marine science into the polic...

  14. Mapping with the Masses: Google Map Maker

    NASA Astrophysics Data System (ADS)

    Pfund, J.

    2008-12-01

    After some 15,000 years of map making, which saw the innovations of cardinal directions, map projections for a spherical earth, and GIS analysis, many parts of the world still appear as the "Dark Continent" on modern maps. Google Map Maker intends to shine a light on these areas by tapping into the power of the GeoWeb. Google Map Maker is a website which allows you to collaborate with others on one unified map to add, edit, locate, describe, and moderate map features, such as roads, cities, businesses, parks, schools and more, for certain regions of the world using Google Maps imagery. In this session, we will show some examples of how people are mapping with this powerful tool as well as what they are doing with the data. With Google Map Maker, you can become a citizen cartographer and join the global network of users helping to improve the quality of maps and local information in your region of interest. You are invited to map the world with us!

  15. MWD aids vital drilling decisions

    SciTech Connect

    Fontenot, J.E.; Rao, M.V.

    1988-03-14

    Measurement-While-Drilling (MWD) sensors can supply much of the critical downhole information needed in a systems approach to improving drilling efficiency. The author looks at some areas where MWD information has helped to improve drilling efficiency. To date, most use of MWD has been for directional survey, pressure prediction, and formation evaluation. As MWD systems become more reliable and cost effective, their applications will expand.

  16. Severe Weather Forecast Decision Aid

    NASA Technical Reports Server (NTRS)

    Bauman, William H., III; Wheeler, Mark

    2005-01-01

    The Applied Meteorology Unit developed a forecast tool that provides an assessment of the likelihood of local convective severe weather for the day in order to enhance protection of personnel and material assets of the 45th Space Wing Cape Canaveral Air Force Station (CCAFS), and Kennedy Space Center (KSC).

  17. Can Gait Signatures Provide Quantitative Measures for Aiding Clinical Decision-Making? A Systematic Meta-Analysis of Gait Variability Behavior in Patients with Parkinson's Disease.

    PubMed

    König, Niklas; Singh, Navrag B; Baumann, Christian R; Taylor, William R

    2016-01-01

    A disturbed, inconsistent walking pattern is a common feature of patients with Parkinson's disease (PwPD). Such extreme variability in both temporal and spatial parameters of gait has been associated with unstable walking and an elevated prevalence of falls. However, despite their ability to discretise healthy from pathological function, normative variability values for key gait parameters are still missing. Furthermore, an understanding of each parameter's response to pathology, as well as the inter-parameter relationships, has received little attention. The aim of this systematic literature review and meta-analysis was therefore to define threshold levels for pathological gait variability as well as to investigate whether all gait parameters are equally perturbed in PwPD. Based on a broader systematic literature search that included 13'195 titles, 34 studies addressed Parkinson's disease, presenting 800 PwPD and 854 healthy subjects. Eight gait parameters were compared, of which six showed increased levels of variability during walking in PwPD. The most commonly reported parameter, coefficient of variation of stride time, revealed an upper threshold of 2.4% to discriminate the two groups. Variability of step width, however, was consistently lower in PwPD compared to healthy subjects, and therefore suggests an explicit sensory motor system control mechanism to prioritize balance during walking. The results provide a clear functional threshold for monitoring treatment efficacy in patients with Parkinson's disease. More importantly, however, quantification of specific functional deficits could well provide a basis for locating the source and extent of the neurological damage, and therefore aid clinical decision-making for individualizing therapies. PMID:27445759

  18. Can Gait Signatures Provide Quantitative Measures for Aiding Clinical Decision-Making? A Systematic Meta-Analysis of Gait Variability Behavior in Patients with Parkinson's Disease

    PubMed Central

    König, Niklas; Singh, Navrag B.; Baumann, Christian R.; Taylor, William R.

    2016-01-01

    A disturbed, inconsistent walking pattern is a common feature of patients with Parkinson's disease (PwPD). Such extreme variability in both temporal and spatial parameters of gait has been associated with unstable walking and an elevated prevalence of falls. However, despite their ability to discretise healthy from pathological function, normative variability values for key gait parameters are still missing. Furthermore, an understanding of each parameter's response to pathology, as well as the inter-parameter relationships, has received little attention. The aim of this systematic literature review and meta-analysis was therefore to define threshold levels for pathological gait variability as well as to investigate whether all gait parameters are equally perturbed in PwPD. Based on a broader systematic literature search that included 13′195 titles, 34 studies addressed Parkinson's disease, presenting 800 PwPD and 854 healthy subjects. Eight gait parameters were compared, of which six showed increased levels of variability during walking in PwPD. The most commonly reported parameter, coefficient of variation of stride time, revealed an upper threshold of 2.4% to discriminate the two groups. Variability of step width, however, was consistently lower in PwPD compared to healthy subjects, and therefore suggests an explicit sensory motor system control mechanism to prioritize balance during walking. The results provide a clear functional threshold for monitoring treatment efficacy in patients with Parkinson's disease. More importantly, however, quantification of specific functional deficits could well provide a basis for locating the source and extent of the neurological damage, and therefore aid clinical decision-making for individualizing therapies. PMID:27445759

  19. Changing Times, Complex Decisions: Presidential Values and Decision Making

    ERIC Educational Resources Information Center

    Hornak, Anne M.; Garza Mitchell, Regina L.

    2016-01-01

    Objective: The objective of this article is to delve more deeply into the thought processes of the key decision makers at community colleges and understand how they make decisions. Specifically, this article focuses on the role of the community college president's personal values in decision making. Method: We conducted interviews with 13…

  20. How Setswana Cultural Beliefs and Practices on Sexuality Affect Teachers' and Adolescents' Sexual Decisions, Practices, and Experiences as well as HIV/AIDS and STI Prevention in Select Botswanan Secondary Schools.

    PubMed

    Nleya, Paul T; Segale, Emelda

    2015-01-01

    The article reports on the aspects of a Botswana Ministry of Education and Skills Development (MoE & SD) HIV/AIDS Instructional Television (ITV) project modeled on a similar HIV/AIDS program implemented in Brazil. This Teacher Capacity Building Project (TCBP) in Botswana is in its initial years of implementation. Its overall goal is to contribute to the prevention and mitigation of the impact of HIV and AIDS by strengthening the capacity of the education and communication sectors to deliver interactive, distance HIV/AIDS education primarily to teachers so that they act as agents of behavior change among the in-school youth. One of the components of the TCBP program is a live teacher education television HIV/AIDS program called Talk Back program. Talk Back is a collaborative effort of the MoE & SD and the Botswana national television station. The Talk Back program involves development and implementation of weekly 1 hour live HIV/AIDS education interactive TV broadcasts for teachers. The development of the live programs is guided by a curriculum that provides a wide range of themes related to HIV/AIDS and education. This article reports the results of a survey of a sample of teachers and students at junior secondary schools and senior secondary schools, first, on their views and opinions regarding the Talk Back program as a TCBP. Second, how Setswana cultural beliefs, myths, and practices on sexuality affect teachers' and adolescents' sexual decisions, practices, and experiences as well as HIV/AIDS and sexually transmitted infection prevention. A questionnaire survey and focus group interviews were used as data collection instruments in selected secondary schools. The findings of the study suggest that the Talk Back program has not met much success as a TCBP. The findings further suggest that several myths, beliefs, misconceptions, and attitudes about HIV/AIDS exist among Botswana teachers and students and thus make it difficult for the Talk Back program to impart

  1. MANAGING UNCERTAINTY IN ENVIRONMENTAL DECISIONS

    EPA Science Inventory

    Many environmental decision makers and practitioners worldwide assume that the quality of data pertaining to a contaminated site is primarily determined by the nature of thhe analytical chemistry methods used to collect information. This assumption, which diminishes the importan...

  2. Framing bioremediation decision making as negotiation: Rationale & guidelineFraming bioremediation decision making as negotiation: Rationale & guidelines

    SciTech Connect

    Bjornstad, David J.; Wolfe, Amy K.

    2004-03-17

    Framing remediation decision making as negotiation: (1) social choice, not technology choice; (2) prompts decision makers to identify interested and affected parties, anticipate objections, effectively address and ameliorate objections, and avoid unacceptable decisions.

  3. The second iteration of the Systems Prioritization Method: A systems prioritization and decision-aiding tool for the Waste Isolation Pilot Plant: Volume 2, Summary of technical input and model implementation

    SciTech Connect

    Prindle, N.H.; Mendenhall, F.T.; Trauth, K.; Boak, D.M.; Beyeler, W.; Hora, S.; Rudeen, D.

    1996-05-01

    The Systems Prioritization Method (SPM) is a decision-aiding tool developed by Sandia National Laboratories (SNL). SPM provides an analytical basis for supporting programmatic decisions for the Waste Isolation Pilot Plant (WIPP) to meet selected portions of the applicable US EPA long-term performance regulations. The first iteration of SPM (SPM-1), the prototype for SPM< was completed in 1994. It served as a benchmark and a test bed for developing the tools needed for the second iteration of SPM (SPM-2). SPM-2, completed in 1995, is intended for programmatic decision making. This is Volume II of the three-volume final report of the second iteration of the SPM. It describes the technical input and model implementation for SPM-2, and presents the SPM-2 technical baseline and the activities, activity outcomes, outcome probabilities, and the input parameters for SPM-2 analysis.

  4. HUMAN HEALTH METRICS FOR ENVIRONMENTAL DECISION SUPPORT TOOLS: LESSONS FROM HEALTH ECONOMICS AND DECISION ANALYSIS

    EPA Science Inventory

    Decision makers using environmental decision support tools are often confronted with information that predicts a multitude of different human health effects due to environmental stressors. If these health effects need to be contrasted with costs or compared with alternative scena...

  5. Acquisition and production of skilled behavior in dynamic decision-making tasks: Modeling strategic behavior in human-automation interaction: Why and aid can (and should) go unused

    NASA Technical Reports Server (NTRS)

    Kirlik, Alex

    1991-01-01

    Advances in computer and control technology offer the opportunity for task-offload aiding in human-machine systems. A task-offload aid (e.g., an autopilot, an intelligent assistant) can be selectively engaged by the human operator to dynamically delegate tasks to an automated system. Successful design and performance prediction in such systems requires knowledge of the factors influencing the strategy the operator develops and uses for managing interaction with the task-offload aid. A model is presented that shows how such strategies can be predicted as a function of three task context properties (frequency and duration of secondary tasks and costs of delaying secondary tasks) and three aid design properties (aid engagement and disengagement times, aid performance relative to human performance). Sensitivity analysis indicates how each of these contextual and design factors affect the optimal aid aid usage strategy and attainable system performance. The model is applied to understanding human-automation interaction in laboratory experiments on human supervisory control behavior. The laboratory task allowed subjects freedom to determine strategies for using an autopilot in a dynamic, multi-task environment. Modeling results suggested that many subjects may indeed have been acting appropriately by not using the autopilot in the way its designers intended. Although autopilot function was technically sound, this aid was not designed with due regard to the overall task context in which it was placed. These results demonstrate the need for additional research on how people may strategically manage their own resources, as well as those provided by automation, in an effort to keep workload and performance at acceptable levels.

  6. The second iteration of the Systems Prioritization Method: A systems prioritization and decision-aiding tool for the Waste Isolation Pilot Plant: Volume 1, Synopsis of method and results

    SciTech Connect

    Prindle, N.H.; Mendenhall, F.T.; Boak, D.M.

    1996-05-01

    In March 1994, the US Department of Energy Carlsbad Area Office (DOE/CAO) embarked on an effort to design and implement a performance- based decision-aiding tool to provide an analytical basis for planning, prioritizing, and selecting programmatic options for the Waste Isolation Pilot Plant (WIPP). This tool, called Systems Prioritization Method (SPM) defines the most viable combinations of scientific investigations, engineered alternatives (EAs), and waste acceptance criteria (WAC) for supporting the final WIPP compliance application. The scope of SPM is restricted to selected portions of applicable Environmental Protection Agency (EPA) long-term performance regulations. SPM calculates the probabilities of certain sets of activities demonstrating compliance with various regulations. SPM provides results in the form of a decision matrix to identify cost-effective programmatic paths with a high probability of successfully demonstrating compliance.

  7. AIDS, the Schools, and Policy Issues.

    ERIC Educational Resources Information Center

    Price, James H.

    1986-01-01

    This article reviews the discovery of Acquired Immune Deficiency Syndrome (AIDS) and describes the biology of the disease. The problem of AIDS among children is discussed and implications for school policy decisions are cited. (Author/MT)

  8. Redesigning State Financial Aid: Principles to Guide State Aid Policymaking

    ERIC Educational Resources Information Center

    Pingel, Sarah; Sponsler, Brian A.

    2015-01-01

    Several factors create a challenging environment for individuals seeking financial support to complete a postsecondary degree program. In recognition of the challenges of paying for higher education, decision-makers at the federal and state levels support college-going with public policy. Through direct institutional allocations, need and…

  9. HIV / AIDS

    MedlinePlus

    ... Marketing Share this: Main Content Area Understanding HIV/AIDS AIDS was first reported in the United States in ... and has since become a major worldwide epidemic. AIDS is caused by the human immunodeficiency virus, or ...

  10. Risk perception & strategic decision making :general insights, a framework, and specific application to electricity generation using nuclear energy.

    SciTech Connect

    Brewer, Jeffrey D.

    2005-11-01

    The objective of this report is to promote increased understanding of decision making processes and hopefully to enable improved decision making regarding high-consequence, highly sophisticated technological systems. This report brings together insights regarding risk perception and decision making across domains ranging from nuclear power technology safety, cognitive psychology, economics, science education, public policy, and neural science (to name a few). It forms them into a unique, coherent, concise framework, and list of strategies to aid in decision making. It is suggested that all decision makers, whether ordinary citizens, academics, or political leaders, ought to cultivate their abilities to separate the wheat from the chaff in these types of decision making instances. The wheat includes proper data sources and helpful human decision making heuristics; these should be sought. The chaff includes ''unhelpful biases'' that hinder proper interpretation of available data and lead people unwittingly toward inappropriate decision making ''strategies''; obviously, these should be avoided. It is further proposed that successfully accomplishing the wheat vs. chaff separation is very difficult, yet tenable. This report hopes to expose and facilitate navigation away from decision-making traps which often ensnare the unwary. Furthermore, it is emphasized that one's personal decision making biases can be examined, and tools can be provided allowing better means to generate, evaluate, and select among decision options. Many examples in this report are tailored to the energy domain (esp. nuclear power for electricity generation). The decision making framework and approach presented here are applicable to any high-consequence, highly sophisticated technological system.

  11. Global HIV/AIDS funding and health systems: Searching for the win-win.

    PubMed

    Levine, Ruth; Oomman, Nandini

    2009-11-01

    Donors, developing country governments, and NGOs are searching for ways to use funding for HIV/AIDS programs that strengthen the functioning of weak health systems. This is motivated both by the realization that a large share of donor funding for global health is and will continue to be dedicated to HIV/AIDS, and that the aims of more and better treatment, prevention, and care can be achieved only with attention to systemic capacities. For AIDS resources to strengthen health systems, decision makers should: (a) mitigate the risks that AIDS spending may weaken the ability of health systems to respond to other health problems; (b) find ways for procurement, supply chain, management information, and other systems that are created to support AIDS treatment to be broadened to serve other types of services; and (c) build upon the ways in which AIDS programs have overcome some demand-side barriers to use of services. In pursuing this agenda, donors should recognize that health system development is a function of the national and local political economy and place respect for national sovereignty as a central tenet of their policies and practices. PMID:19858934

  12. PUBLIC AWARENESS OF HIV/AIDS: HOW MEDIA PLAY A ROLE?.

    PubMed

    Sern, Tham Jen; Zanuddin, Hasmah

    2015-07-01

    Abstract. This paper examines the effectiveness of media in public awareness of the HIV/AIDS issue among the public in an area in central Selangor, comprising Kuala Lumpur and its surroundings and suburbs in Malaysia. Cross-sectional survey questionnaires were distributed to 384 respondents about accessing the public awareness of modes of HIV transmission, perceptions and attitudes towards people living with HIV/AIDS, as well as people's understanding about government policies to curb HIV/AIDS. Health care practitioners and newspapers were the preferred sources of information seeking on HIV/AIDS among the public. Most of the respondents were aware of the modes of HIV transmission. However, they were some respondents who still have misconceptions about the modes of transmission. Most of the respondents were not aware about the government's significant policies to address HIV/AIDS in the region. Overall, the respondents had certain knowledge about HIV transmission modes and moderate positive perceptions and attitudes towards people living with HIV/AIDS. Future studies should be conducted to examine about who sets the agenda in the media, and apart from gatekeepers, who are the real decision makers in deciding what is important to inform the public. PMID:26867387

  13. Improving IT Portfolio Management Decision Confidence Using Multi-Criteria Decision Making and Hypervariate Display Techniques

    ERIC Educational Resources Information Center

    Landmesser, John Andrew

    2014-01-01

    Information technology (IT) investment decision makers are required to process large volumes of complex data. An existing body of knowledge relevant to IT portfolio management (PfM), decision analysis, visual comprehension of large volumes of information, and IT investment decision making suggest Multi-Criteria Decision Making (MCDM) and…

  14. Climate Change Boot Camps: Targeting Policy Makers and Outreach Trainers in Arizona to Improve Climate Literacy

    NASA Astrophysics Data System (ADS)

    Ferguson, D. B.; Guido, Z. S.; Buizer, J.; Roy, M.

    2010-12-01

    Bringing climate change issues into focus for decision makers is a growing challenge. Decision makers are often confronted with unique informational needs, a lack of useable information, and needs for customized climate change training, among other issues. Despite significant progress in improving climate literacy among certain stakeholders such as water managers, recent reports have highlighted the growing demand for climate-change information in regions and sectors across the US. In recent years many ventures have sprung up to address these gaps and have predominantly focused on K-12 education and resource management agencies such as the National Park Service and National Weather Service. However, two groups that are critical for integrating climate information into actions have received less attention: (1) policy makers and (2) outreach experts, such as Cooperative Extension agents. Climate Change Boot Camps (CCBC) is a joint effort between the Climate Assessment for the Southwest (CLIMAS)—a NOAA Regionally Integrated Sciences and Assessments (RISA) program—and researchers at Arizona State University to diagnose climate literacy and training gaps in Arizona and develop a process that converts these deficiencies into actionable knowledge among the two aforementioned groups. This presentation will highlight the initial phases of the CCBC process, which has as its outcomes the identification of effective strategies for reaching legislators, climate literacy and training needs for both policy makers and trainers, and effective metrics to evaluate the success of these efforts. Specific attention is given to evaluating the process from initial needs assessment to the effectiveness of the workshops. Web curriculum and training models made available on the internet will also be developed, drawing on extensive existing Web resources for other training efforts and converted to meet the needs of these two groups. CCBC will also leverage CLIMAS’ long history of

  15. Health equity in humanitarian emergencies: a role for evidence aid.

    PubMed

    Pottie, Kevin

    2015-02-01

    Humanitarian emergencies require a range of planned and coordinated actions: security, healthcare, and, as this article highlights, health equity responses. Health equity is an evidence-based science that aims to address unfair and unjust health inequality outcomes. New approaches are using health equity to guide the development of community programs, equity methods are being used to identify disadvantaged groups that may face health inequities in a humanitarian emergency, and equity is being used to prevent unintended harms and consequences in interventions. Limitations to health equity approaches include acquiring sufficient data to make equity interpretations, integrating disadvantage populations in to the equity approach, and ensuring buy-in from decision-makers. This article uses examples from World Health Organization, Refugee Health Guidelines and Health Impact Assessment to demonstrate the emerging role for health equity in humanitarian emergencies. It is based on a presentation at the Evidence Aid Symposium, on 20 September 2014, at Hyderabad, India.

  16. A decision science approach for integrating social science in climate and energy solutions

    NASA Astrophysics Data System (ADS)

    Wong-Parodi, Gabrielle; Krishnamurti, Tamar; Davis, Alex; Schwartz, Daniel; Fischhoff, Baruch

    2016-06-01

    The social and behavioural sciences are critical for informing climate- and energy-related policies. We describe a decision science approach to applying those sciences. It has three stages: formal analysis of decisions, characterizing how well-informed actors should view them; descriptive research, examining how people actually behave in such circumstances; and interventions, informed by formal analysis and descriptive research, designed to create attractive options and help decision-makers choose among them. Each stage requires collaboration with technical experts (for example, climate scientists, geologists, power systems engineers and regulatory analysts), as well as continuing engagement with decision-makers. We illustrate the approach with examples from our own research in three domains related to mitigating climate change or adapting to its effects: preparing for sea-level rise, adopting smart grid technologies in homes, and investing in energy efficiency for office buildings. The decision science approach can facilitate creating climate- and energy-related policies that are behaviourally informed, realistic and respectful of the people whom they seek to aid.

  17. [Involving patients, the insured and the general public in healthcare decision making].

    PubMed

    Mühlbacher, Axel C; Juhnke, Christin

    2016-01-01

    No doubt, the public should be involved in healthcare decision making, especially when decision makers from politics and self-government agencies are faced with the difficult task of setting priorities. There is a general consensus on the need for a stronger patient centeredness, even in HTA processes, and internationally different ways of public participation are discussed and tested in decision making processes. This paper describes how the public can be involved in different decision situations, and it shows how preference measurement methods are currently being used in an international context to support decision making. It distinguishes between different levels of decision making on health technologies: approval, assessment, pricing, and finally utilization. The range of participation efforts extends from qualitative surveys of patients' needs (Citizen Councils of NICE in the UK) to science-based documentation of quantitative patient preferences, such as in the current pilot projects of the FDA in the US and the EMA at the European level. Possible approaches for the elicitation and documentation of preference structures and trade-offs in relation to alternate health technologies are decision aids, such as multi-criteria decision analysis (MCDA), that provide the necessary information for weighting and prioritizing decision criteria. PMID:26875034

  18. [Involving patients, the insured and the general public in healthcare decision making].

    PubMed

    Mühlbacher, Axel C; Juhnke, Christin

    2016-01-01

    No doubt, the public should be involved in healthcare decision making, especially when decision makers from politics and self-government agencies are faced with the difficult task of setting priorities. There is a general consensus on the need for a stronger patient centeredness, even in HTA processes, and internationally different ways of public participation are discussed and tested in decision making processes. This paper describes how the public can be involved in different decision situations, and it shows how preference measurement methods are currently being used in an international context to support decision making. It distinguishes between different levels of decision making on health technologies: approval, assessment, pricing, and finally utilization. The range of participation efforts extends from qualitative surveys of patients' needs (Citizen Councils of NICE in the UK) to science-based documentation of quantitative patient preferences, such as in the current pilot projects of the FDA in the US and the EMA at the European level. Possible approaches for the elicitation and documentation of preference structures and trade-offs in relation to alternate health technologies are decision aids, such as multi-criteria decision analysis (MCDA), that provide the necessary information for weighting and prioritizing decision criteria.

  19. Canadian policy makers' views on pharmaceutical reimbursement contracts involving confidential discounts from drug manufacturers.

    PubMed

    Morgan, Steven G; Thomson, Paige A; Daw, Jamie R; Friesen, Melissa K

    2013-10-01

    Pharmaceutical policy makers are increasingly negotiating reimbursement contracts that include confidential price terms that may be affected by drug utilization volumes, patterns, or outcomes. Though such contracts may offer a variety of benefits, including the ability to tie payment to the actual performance of a product, they may also create potential policy challenges. Through telephone interviews about this type of contract, we studied the views of officials in nine of ten Canadian provinces. Use of reimbursement contracts involving confidential discounts is new in Canada and ideas about power and equity emerged as cross-cutting themes in our interviews. Though confidential rebates can lower prices and thereby increase coverage of new medicines, several policy makers felt they had little power in the decision to negotiate rebates. Study participants explained that the recent rise in the use of rebates had been driven by manufacturers' pricing tactics and precedent set by other jurisdictions. Several policy makers expressed concerns that confidential rebates could result in inter-jurisdictional inequities in drug pricing and coverage. Policy makers also noted un-insured and under-insured patients must pay inflated "list prices" even if rebates are negotiated by drug plans. The establishment of policies for disciplined negotiations, inter-jurisdictional cooperation, and provision of drug coverage for all citizens are potential solutions to the challenges created by this new pharmaceutical pricing paradigm.

  20. Canadian policy makers' views on pharmaceutical reimbursement contracts involving confidential discounts from drug manufacturers.

    PubMed

    Morgan, Steven G; Thomson, Paige A; Daw, Jamie R; Friesen, Melissa K

    2013-10-01

    Pharmaceutical policy makers are increasingly negotiating reimbursement contracts that include confidential price terms that may be affected by drug utilization volumes, patterns, or outcomes. Though such contracts may offer a variety of benefits, including the ability to tie payment to the actual performance of a product, they may also create potential policy challenges. Through telephone interviews about this type of contract, we studied the views of officials in nine of ten Canadian provinces. Use of reimbursement contracts involving confidential discounts is new in Canada and ideas about power and equity emerged as cross-cutting themes in our interviews. Though confidential rebates can lower prices and thereby increase coverage of new medicines, several policy makers felt they had little power in the decision to negotiate rebates. Study participants explained that the recent rise in the use of rebates had been driven by manufacturers' pricing tactics and precedent set by other jurisdictions. Several policy makers expressed concerns that confidential rebates could result in inter-jurisdictional inequities in drug pricing and coverage. Policy makers also noted un-insured and under-insured patients must pay inflated "list prices" even if rebates are negotiated by drug plans. The establishment of policies for disciplined negotiations, inter-jurisdictional cooperation, and provision of drug coverage for all citizens are potential solutions to the challenges created by this new pharmaceutical pricing paradigm. PMID:23809914

  1. A Method for Decision Making using Sustainability Indicators

    EPA Science Inventory

    Calculations aimed at representing the thought process of decision makers are common within multi-objective decision support tools. These calculations that mathematically describe preferences most often combine various utility scores (i.e., abilities to satisfy desires) with weig...

  2. Job Grading Standard for Model Maker, WG-4714.

    ERIC Educational Resources Information Center

    Civil Service Commission, Washington, DC. Bureau of Policies and Standards.

    The pamphlet explains the different job requirements for different grades of model maker (WG-14 and WG-15) and contrasts them to the position of premium journeyman. It includes comment on what a model maker is (a nonsupervisory job involved in planning and fabricating complex research and prototype models which are made from a variety of materials…

  3. Maker Movement Spreads Innovation One Project at a Time

    ERIC Educational Resources Information Center

    Peppler, Kylie; Bender, Sophia

    2013-01-01

    The maker movement consists of a growing culture of hands-on making, creating, designing, and innovating. A hallmark of the maker movement is its do-it-yourself (or do-it-with-others) mindset that brings individuals together around a range of activities, both high- and low-tech, all involving some form of creation or repair. The movement's…

  4. A Model for Evaluation of Decision Passages.

    ERIC Educational Resources Information Center

    Stimac, Michele

    In an age when decision making is becoming more and more significant for us human beings as we face dilemmas about whether or not to clone, to engineer behavior on mass scale, to expand or to decrease nuclear power, we educators must assist students to increase their decision-making skills. Many of our students will soon be decision makers for…

  5. Decision Support Systems for Academic Administration.

    ERIC Educational Resources Information Center

    Moore, Laurence J.; Greenwood, Allen G.

    1984-01-01

    The history and features of Decision Support Systems (DSS) and use of the approach by academic administrators are discussed. The objective of DSS is to involve the manager/decision maker in the decision-analysis process while simultaneously relieving that person of the burden of developing and performing detailed analysis. DSS represents a…

  6. Risk Attitude in Small Timesaving Decisions

    ERIC Educational Resources Information Center

    Munichor, Nira; Erev, Ido; Lotem, Arnon

    2006-01-01

    Four experiments are presented that explore situations in which a decision maker has to rely on personal experience in an attempt to minimize delays. Experiment 1 shows that risk-attitude in these timesaving decisions is similar to risk-attitude in money-related decisions from experience: A risky prospect is more attractive than a safer prospect…

  7. Relevance of a Managerial Decision-Model to Educational Administration.

    ERIC Educational Resources Information Center

    Lundin, Edward.; Welty, Gordon

    The rational model of classical economic theory assumes that the decision maker has complete information on alternatives and consequences, and that he chooses the alternative that maximizes expected utility. This model does not allow for constraints placed on the decision maker resulting from lack of information, organizational pressures,…

  8. System Dynamics Models and Institutional Pricing Decisions.

    ERIC Educational Resources Information Center

    Chen, Fiona

    1986-01-01

    A system dynamics model for the pricing of tuition is presented, illustrating how such models enable decision-makers to anticipate cause-and-effect relationships and test alternative courses of action. (Author)

  9. AIDS (image)

    MedlinePlus

    AIDS (acquired immune deficiency syndrome) is caused by HIV (human immunodeficiency virus), and is a syndrome that ... life-threatening illnesses. There is no cure for AIDS, but treatment with antiviral medicine can suppress symptoms. ...

  10. Hearing Aids

    MedlinePlus

    ... more in both quiet and noisy situations. Hearing aids help people who have hearing loss from damage ... your doctor. There are different kinds of hearing aids. They differ by size, their placement on or ...

  11. Shared decision making in the physician-patient encounter in France: a general overview in 2011.

    PubMed

    Moumjid, Nora; Christine Durif-Bruckert; Denois-Régnier, Véronique; Roux, Pauline; Soum-Pouyalet, Fanny

    2011-01-01

    WHAT ABOUT POLICY REGARDING SDM? There is a social demand in France for more healthcare user information and greater patient participation in the decision making process, as reflected by the law of March 4(th) 2002 pertaining to patients' rights and the quality of the healthcare system known as the Law on Democracy in healthcare. WHAT ABOUT TOOLS - DECISION SUPPORT FOR PATIENTS? At the micro level, some research projects are being developed, some of them using decision aids. Preliminary results show that patients want to be informed but that the concept of shared decision making needs to be analysed and refined from both the patients' and the physicians' points of views. WHAT ABOUT PROFESSIONAL INTEREST AND IMPLEMENTATION? However, the relationship between physicians/healthcare professionals and patients/healthcare users is very complex and progress in this field takes time. Only ten years after enactment of the Law on Democracy in healthcare, it might be premature to try and determine the state of the art of shared medical decision making at the macro and meso levels in France. WHAT DOES THE FUTURE LOOK LIKE? There is room in France for further studies on shared decision making in the medical encounter. Researchers, decision makers, healthcare users and healthcare professionals need a place to meet and exchange. An observatory dedicated to shared decision making will be launched in the coming months, both at the national level and in collaboration with several other French-speaking areas like Switzerland and the province of Quebec.

  12. Hearing Aids

    MedlinePlus

    ... type and degree of loss. Are there different styles of hearing aids? Styles of hearing aids Source: NIH/NIDCD Behind-the- ... the ear canal and are available in two styles. The in-the-canal (ITC) hearing aid is ...

  13. Restoration handbook for sagebrush steppe ecosystems with emphasis on greater sage-grouse habitat—Part 2. Landscape level restoration decisions

    USGS Publications Warehouse

    Pyke, David A.; Knick, Steven T.; Chambers, Jeanne C.; Pellant, Mike; Miller, Richard F.; Beck, Jeffrey L.; Doescher, Paul S.; Schupp, Eugene W.; Roundy, Bruce A.; Brunson, Mark; McIver, James D.

    2015-12-07

    Land managers do not have resources to restore all locations because of the extent of the restoration need and because some land uses are not likely to change, therefore, restoration decisions made at the landscape to regional scale may improve the effectiveness of restoration to achieve landscape and local restoration objectives. We present a landscape restoration decision tool intended to assist decision makers in determining landscape objectives, to identify and prioritize landscape areas where sites for priority restoration projects might be located, and to aid in ultimately selecting restoration sites guided by criteria used to define the landscape objectives. The landscape restoration decision tool is structured in five sections that should be addressed sequentially. Each section has a primary question or statement followed by related questions and statements to assist the user in addressing the primary question or statement. This handbook will guide decision makers through the important process steps of identifying appropriate questions, gathering appropriate data, developing landscape objectives, and prioritizing landscape patches where potential sites for restoration projects may be located. Once potential sites are selected, land managers can move to the site-specific decision tool to guide restoration decisions at the site level.

  14. Evidence-based decision-making 7: Knowledge translation.

    PubMed

    Manns, Braden J

    2015-01-01

    There is a significant gap between what is known and what is implemented by key stakeholders in practice (the evidence to practice gap). The primary purpose of knowledge translation is to address this gap, bridging evidence to clinical practice. The knowledge to action cycle is one framework for knowledge translation that integrates policy-makers throughout the research cycle. The knowledge to action cycle begins with the identification of a problem (usually a gap in care provision). After identification of the problem, knowledge creation is undertaken, depicted at the center of the cycle as a funnel. Knowledge inquiry is at the wide end of the funnel, and moving down the funnel, the primary data is synthesized into knowledge products in the form of educational materials, guidelines, decision aids, or clinical pathways. The remaining components of the knowledge to action cycle refer to the action of applying the knowledge that has been created. This includes adapting knowledge to local context, assessing barriers to knowledge use, selecting, tailoring implementing interventions, monitoring knowledge use, evaluating outcomes, and sustaining knowledge use. Each of these steps is connected by bidirectional arrows and ideally involves healthcare decision-makers and key stakeholders at each transition.

  15. Make Energy at the Bay Area Maker Faire

    ScienceCinema

    None

    2016-07-12

    Think. Make. Innovate. A festival of invention, creativity and resourcefulness that gathers makers of all kinds. Scientists are seeking to find innovative solutions to the energy challenges in the world.

  16. 3. BARREL VIEW, LOOKING DOWN LENGTH OF BRIDGE, SHOWING MAKER'S ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. BARREL VIEW, LOOKING DOWN LENGTH OF BRIDGE, SHOWING MAKER'S PLATE, DECORATIVE SCROLLWORK AND URN FINIALS ON NORTHEAST PORTAL - "Forder" Pratt Through Truss Bridge, Spanning Maumee River at County Route 73, Antwerp, Paulding County, OH

  17. 5. DETAIL VIEW OF UPPER CHORD MEMBER, SHOWING MAKER'S PLATE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. DETAIL VIEW OF UPPER CHORD MEMBER, SHOWING MAKER'S PLATE STATING 'KING IRON BRIDGE & MFG. CO., K & F & Z KING PATENT, CLEVELAND, O.' - Smith Road Bowstring Arch Bridge, Spanning Sycamore Creek at Smith Road (TR 62), Lykens, Crawford County, OH

  18. Decision framework for technology choice. Volume 2: decision analysis user's manual. [TCM computer code

    SciTech Connect

    Sicherman, A.; Keeney, R.L.

    1982-03-01

    A computer program was developed to aid decision makers in choosing among alternatives. It facilitiates the implementation of the decision analysis approach to multiobjective decision-making problems. The program's main functions are to store the information and perform all the necessary computations required by the approach. The program is designed so that only a few basic commands need to be understood in order to use it effectively. The style of input can be both batch and interactively oriented. Detailed specification of preferences and alternatives is usually done in batch mode while sensitivity analysis can be performed interactively. The output consists of ranking, preference and alternative information displays. The program is quite general and should be applicable to a wide variety of problems. The code allows for an interface to user supplied models when that is desirable. It is designed to run on most computer systems without or with very minor system-specific modifications. This report presents a user's manual for the program that includes a simple illustrative example.

  19. The ichnogenus Rhizocorallium: Classification, trace makers, palaeoenvironments and evolution

    NASA Astrophysics Data System (ADS)

    Knaust, Dirk

    2013-11-01

    Rhizocorallium is one of the oldest known trace fossils, with wide distribution through the Phanerozoic and all over the world. Originally introduced from the epicontinental Triassic of central Germany, its high morphological lability gave reason for the subsequent erection of about twenty ichnospecies. The study of newly collected material from the type area and many specimens from various collections permits the conclusion that Rhizocorallium jenense and Rhizocorallium commune are the only valid ichnospecies of Rhizocorallium. The type ichnospecies, R. jenense, is a comparatively small, inclined and heavily scratched firmground burrow with passive fill, while R. commune consists of extensive, more or less horizontal burrows with occasionally scratched marginal tubes and an actively filled spreite between the tubes. The faecal pellets Coprulus oblongus are typically associated with R. commune. Morphological variations of R. commune are captured in ichnosubspecies and varieties of this ichnospecies and can aid a refined reconstruction of palaeoenvironments. A review of more than 180 records from the literature reveals the common confusion of both ichnospecies, which has consequences for the application of Rhizocorallium in facies interpretations. The end members of both ichnospecies may be linked by transitional forms, which suggests the same kind of trace maker. Polychaetes are the most likely producers of marine Rhizocorallium, based on their long-ranging occurrence, morphological features, appearance of faecal pellets, associated soft-body remains, and modern analogues. R. commune occurs from Early Cambrian to Holocene, while R. jenense just appears after the end-Permian mass extinction, probably as a consequence of an adapted firmground burrowing lifestyle of its producer. Fluvial R. jenense are probably produced by mayfly larvae in homology to marine polychaete burrows. A consequent application of the newly established classification scheme allows for a more

  20. Latina women and AIDS.

    PubMed

    Worth, D; Rodriguez, R

    1987-01-01

    The incidence of AIDS in Latina women is over 11 times that of white women. Women account for 13% of all Latino AIDS deaths since 1980. This examination of the impact of AIDS on Latino women concentrates on Manhattan's Lower East Side. The AIDS deaths among Puerto Rican women in this neighborhood are predominantly intravenous drug abuse related. Latina women accounted for more than 1/2 of all female AIDS deaths on the Lower East Side during the 1980-1985 period. The age range is parallel with that in the rest of New York City, with the exception of a higher number of deaths on the Lower East Side in the age ranges of 15-19 and over 40. Serious obstacles exist to providing AIDS risk reduction information to Puerto Rican women and their partners. Latinos account for 11% of all US AIDS cases among gay and bisexual men. The cultural proscription against these sexual practices in the Puerto Rican community makes AIDS education related to such practices extremely difficult. Many of the female sex partners of these men are unaware of their bisexuality, and, therefore not aware that they are at risk of HIV infection. The Latina women most at risk are young, poor, and have low educational levels. Latina women seriously underutilize ongoing primary health care, family planning, prenatal or pediatric care. Attempts to reach Latina women with AIDS risk reduction education must also contend with issues such as cultural gender roles. Females tend to be dependent on males and defer to male decision making related to sexual practices. In formulating policy regarding services and education, it is essential to involve the leadership of the Latino community. PMID:12268416