Science.gov

Sample records for aid management decisions

  1. 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.

  2. 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.

  3. Science and Technology Text Mining: Management Decision Aids

    DTIC Science & Technology

    2007-11-02

    review; data mining; text mining; bibliometrics ; scientometrics; resource allocation; project selection; operations research; management science. REPORT...review; data mining; text mining; bibliometrics ; scientometrics; resource allocation; project selection; operations research; management science. 16...support techniques include roadmaps, metrics, peer review, data and text mining, information retrieval, bibliometrics , and retrospective studies. The

  4. 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...

  5. Pilot decision making in a computer-aided flight management situation

    NASA Technical Reports Server (NTRS)

    Chu, Y. Y.; Rouse, W. B.

    1978-01-01

    An experimental representation of a computer-aided multi-task flight management situation has been developed. A computer aiding program was implemented to serve as a back-up decision maker. An experiment was conducted with a balanced design of several subject runs for different workload levels. This was achieved using three levels of subsystem event arrival rates, three levels of control task involvement, and three levels of availability of computer aiding. Experimental results compared quite favorably with those from a computer simulation which employed a queueing model. It was shown that the aiding had enhanced system performance as well as subjective ratings, and that the adaptive aiding policy further reduced subsystem delay.

  6. Development of a decision aid for energy resource management for the Navajo Nation incorporating environmental cultural values

    NASA Astrophysics Data System (ADS)

    Necefer, Len Edward

    Decision-making surrounding pathways of future energy resource management are complexity and requires balancing tradeoffs of multiple environmental, social, economic, and technical outcomes. Technical decision aid can provide a framework for informed decision making, allowing individuals to better understand the tradeoff between resources, technology, energy services, and prices. While technical decision aid have made significant advances in evaluating these quantitative aspects of energy planning and performance, they have not been designed to incorporate human factors, such as preferences and behavior that are informed by cultural values. Incorporating cultural values into decision tools can provide not only an improved decision framework for the Navajo Nation, but also generate new insights on how these perspective can improve decision making on energy resources. Ensuring these aids are a cultural fit for each context has the potential to increase trust and promote understanding of the tradeoffs involved in energy resource management. In this dissertation I present the development of a technical tool that explicitly addresses cultural and spiritual values and experimentally assesses their influence on the preferences and decision making of Navajo citizens. Chapter 2 describes the results of a public elicitation effort to gather information about stakeholder views and concerns related to energy development in the Navajo Nation in order to develop a larger sample survey and a decision-support tool that links techno-economic energy models with sociocultural attributes. Chapter 3 details the methods of developing the energy decision aid and its underlying assumptions for alternative energy projects and their impacts. This tool also provides an alternative to economic valuation of cultural impacts based upon an ordinal index tied to environmental impacts. Chapter 4 details the the influence of various cultural, environmental, and economic outcome information provided

  7. 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...

  8. 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.

  9. Difficult Decisions: AIDS.

    ERIC Educational Resources Information Center

    Slesnick, Irwin L.

    1988-01-01

    Focuses on public education about the acquired immune deficiency syndrome (AIDS) epidemic. Discusses the problems of a second epidemic of fear and anxiety. Presents several questions for classroom discussion and analysis of the public fear of AIDS. Gives some statistics highlighting misinformation about AIDS. (CW)

  10. Longitudinal feasibility of MINDSET: a clinic decision aid for epilepsy self-management.

    PubMed

    Begley, Charles; Shegog, Ross; Harding, Angelique; Goldsmith, Corey; Hope, Omotola; Newmark, Michael

    2015-03-01

    The purpose of this paper is to report on the development and feasibility of the longitudinal version of MINDSET, a clinical tool to assist patients and health-care providers in epilepsy self-management. A previous study described the feasibility of using MINDSET to identify and prioritize self-management issues during a clinic visit. This paper describes the development of the longitudinal version of MINDSET and feasibility test over multiple visits with a printed action plan for goal setting and the capacity for monitoring changes in self-management. Feasibility was assessed based on 1) postvisit patient and provider interviews addressing ease of use and usefulness, patient/provider communication, and shared decision-making and 2) the capacity of the tool to monitor epilepsy characteristics and self-management over time. Results indicate MINDSET feasibility for 1) identifying and facilitating discussion of self-management issues during clinic visits, 2) providing a printable list of prioritized issues and tailored self-management goals, and 3) tracking changes in epilepsy characteristics and self-management over time.

  11. Technologies and decision support systems to aid solid-waste management: a systematic review.

    PubMed

    Vitorino de Souza Melaré, Angelina; Montenegro González, Sahudy; Faceli, Katti; Casadei, Vitor

    2017-01-01

    Population growth associated with population migration to urban areas and industrial development have led to a consumption relation that results in environmental, social, and economic problems. With respect to the environment, a critical concern is the lack of control and the inadequate management of the solid waste generated in urban centers. Among the challenges are proper waste-collection management, treatment, and disposal, with an emphasis on sustainable management. This paper presents a systematic review on scientific publications concerning decision support systems applied to Solid Waste Management (SWM) using ICTs and OR in the period of 2010-2013. A statistical analysis of the eighty-seven most relevant publications is presented, encompassing the ICTs and OR methods adopted in SWM, the processes of solid-waste management where they were adopted, and which countries are investigating solutions for the management of solid waste. A detailed discussion on how the ICTs and OR methods have been combined in the solutions was also presented. The analysis and discussion provided aims to help researchers and managers to gather insights on technologies/methods suitable the SWM challenges they have at hand, and on gaps that can be explored regarding technologies/methods that could be useful as well as the processes in SWM that currently do not benefit from using ICTs and OR methods.

  12. Naval Tactical Decision Aids

    DTIC Science & Technology

    1989-09-01

    Strike Planning Aid ( ESPA ) . .V-14 5.4. Tactical Environmental Ship Routing (TESR) V-24 5.5. Chaff Prediction and Planning System (CHAPPS).. V-29...chapter four TDAS from TESS: NAVSAR, acAS program for search and rescue (SARjat sea; ESPA , the Environmental Strike Planning Aid; TESR, the Tactical...STATISTICS CURRENT LOCATION AND CHARACTERISTICS SATELLITE DATA CONVERSION CONSTANTS In 5.1, we give a brief history of TESS. The TDAS NAVSAR, ESPA

  13. 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.

  14. Sensitivity analysis to aid shelter management decisions: how does altering expenditure affect operational viability?

    PubMed

    Widmar, Nicole Olynk; Lord, Emily; Litster, Annette

    2015-01-01

    Streamlining purchasing in nonhuman animal shelters can provide multiple financial benefits. Streamlining shelter inputs and thus reducing shelter costs can include trading paid labor and management for fewer, more involved volunteers or purchasing large quantities of medical supplies from fewer vendors to take advantage of bulk-purchasing discounts. Beyond direct savings, time and energy spent on purchasing and inventory control can be reduced through careful management. Although cost-cutting measures may seem attractive, shelter managers are cautioned to consider the potential unintended consequences of short-term cost reduction measures that could limit revenues or increase costs in the future. This analysis illustrates an example of the impact of cost reductions in specific expense categories and the impact on shelter net revenue, as well as the share of expenses across categories. An in-depth discussion of labor and purchasing cost-reducing strategies in the real world of animal shelter management is provided.

  15. Some aspects of computer aided decision making for the crisis management of unstable slopes

    SciTech Connect

    Faure, R.M.; Pairault, T.; Pham, M.; Bernardeau-Moreau, A.; Fayolle, G.; Robinson, J.C.; Foucheyrand, G.

    1995-12-31

    The authors present here the developments in their risk management research; software tools based on object oriented techniques, an image and graphics based man-machine interface, a new algorithm which allows the quick construction of a GIS, strong links with analysis software with the possibility of using fuzzy logic reasoning. The case of the threatening landslide at Sechilienne (Isere, France), studied using these tools, is briefly presented. The authors will show that is management is facilitated through the use of networks as in the WASSS project approach.

  16. Improving the Flexibility of Optimization-Based Decision Aiding Frameworks for Integrated Water Resource Management

    NASA Astrophysics Data System (ADS)

    Guillaume, J. H.; Kasprzyk, J. R.

    2013-12-01

    Deep uncertainty refers to situations in which stakeholders cannot agree on the full suite of risks for their system or their probabilities. Additionally, systems are often managed for multiple, conflicting objectives such as minimizing cost, maximizing environmental quality, and maximizing hydropower revenues. Many objective analysis (MOA) uses a quantitative model combined with evolutionary optimization to provide a tradeoff set of potential solutions to a planning problem. However, MOA is often performed using a single, fixed problem conceptualization. Focus on development of a single formulation can introduce an "inertia" into the problem solution, such that issues outside the initial formulation are less likely to ever be addressed. This study uses the Iterative Closed Question Methodology (ICQM) to continuously reframe the optimization problem, providing iterative definition and reflection for stakeholders. By using a series of directed questions to look beyond a problem's existing modeling representation, ICQM seeks to provide a working environment within which it is easy to modify the motivating question, assumptions, and model identification in optimization problems. The new approach helps identify and reduce bottle-necks introduced by properties of both the simulation model and optimization approach that reduce flexibility in generation and evaluation of alternatives. It can therefore help introduce new perspectives on the resolution of conflicts between objectives. The Lower Rio Grande Valley portfolio planning problem is used as a case study.

  17. 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.

  18. Management of Student Aid.

    ERIC Educational Resources Information Center

    Nevin, Jeanne, Ed.

    The principles, practices, responsibilities, and controls in student financial aid are described in this manual. It traces the flow of funds, management activities, and legal issues as they occur in the process. The emphasis is on sound management principles of a general and permanent nature rather than on specific government requirements that may…

  19. Job Aiding/Training Decision Process Model

    DTIC Science & Technology

    1992-09-01

    I[ -, . 1’, oo Ii AL-CR-i1992-0004 AD-A256 947lEE = IIEI ifl ll 1l I JOB AIDING/TRAINING DECISION PROCESS MODEL A R M John P. Zenyuh DTIC S Phillip C...March 1990 - April 1990 4. TITLE AND SUBTITLE S. FUNDING NUMBERS C - F33615-86-C-0545 Job Aiding/Training Decision Process Model PE - 62205F PR - 1121 6...Components to Process Model Decision and Selection Points ........... 32 13. Summary of Subject Recommendations for Aiding Approaches

  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. Development and application of patient decision aids.

    PubMed

    Bae, Jong-Myon

    2015-01-01

    With the current overdiagnosis of thyroid cancer resulting from routine screening in Korea, it is necessary to educate the public that not all cancers are malignant. The exposure to patient decision aids (PtDAs) compared to usual care reduced the number of people choosing to undergo prostate-specific antigen screening. This article introduces the definition, usefulness, and developmental processes of PtDAs and suggests the urgent need for a Korean PtDA related to thyroid cancer screening.

  2. Decision Aiding in Europe: Assessment Report,

    DTIC Science & Technology

    1983-05-26

    bodies and ship contours BRLT ratings, the decision-maker keeps produced in this way are quite striking, working on a goal point or reference point and...graphic functions but are multicriteria aspirations are often contra- not specifically European. Cinematic dictory and cannot be achieved simulta...above a certain threshold, then more of Hamburg. Starting from a bare minimum information and aiding are of little use, of assumptions (e.g., rigidity

  3. Management of Student Aid: A Guide for Presidents.

    ERIC Educational Resources Information Center

    El-Khawas, Elaine

    A guide offering a quick review of principles, decisions, and responsibilities in financial aid management has been developed to aid presidents, trustees, and senior administrators of colleges and universities. The handbook stresses the possible implications of aid for enrollment, financial stability, and institutional mission. Topics that are…

  4. 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.

  5. Adaptive Computer Aiding in Dynamic Decision Processes: An Experimental Study of Aiding Effectiveness

    DTIC Science & Technology

    1975-05-01

    and a larger subject group. 1-2 Adaptive Decision Aiding 1-2 The primary function of ADDAM is not simply to model the decision maker’s behavior...maximum expected utility (OEVMAXEU) during the course of the test session was the primary measure of decision performance. As a group, the aided...in Chapter 3. The primary function of ADDAM is not simply to model the decision maker’s behavior but to provide a basis for decision aiding. Once

  6. Development of a Nonlinear Internal Wave Tactical Decision Aid

    DTIC Science & Technology

    2016-06-07

    Development of a Nonlinear Internal Wave Tactical Decision Aid Christopher R. Jackson Global Ocean Associates 6220 Jean Louise Way Alexandria...internal waves that can be used as the basis for a future Tactical Decision Aid . OBJECTIVES The principal objective is to establish a procedure and...of a Nonlinear Internal Wave Tactical Decision Aid 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER

  7. 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.

  8. Addressing health literacy in patient decision aids

    PubMed Central

    2013-01-01

    Background Effective use of a patient decision aid (PtDA) can be affected by the user’s health literacy and the PtDA’s characteristics. Systematic reviews of the relevant literature can guide PtDA developers to attend to the health literacy needs of patients. The reviews reported here aimed to assess: 1. a) the effects of health literacy / numeracy on selected decision-making outcomes, and b) the effects of interventions designed to mitigate the influence of lower health literacy on decision-making outcomes, and 2. the extent to which existing PtDAs a) account for health literacy, and b) are tested in lower health literacy populations. Methods We reviewed literature for evidence relevant to these two aims. When high-quality systematic reviews existed, we summarized their evidence. When reviews were unavailable, we conducted our own systematic reviews. Results Aim 1: In an existing systematic review of PtDA trials, lower health literacy was associated with lower patient health knowledge (14 of 16 eligible studies). Fourteen studies reported practical design strategies to improve knowledge for lower health literacy patients. In our own systematic review, no studies reported on values clarity per se, but in 2 lower health literacy was related to higher decisional uncertainty and regret. Lower health literacy was associated with less desire for involvement in 3 studies, less question-asking in 2, and less patient-centered communication in 4 studies; its effects on other measures of patient involvement were mixed. Only one study assessed the effects of a health literacy intervention on outcomes; it showed that using video to improve the salience of health states reduced decisional uncertainty. Aim 2: In our review of 97 trials, only 3 PtDAs overtly addressed the needs of lower health literacy users. In 90% of trials, user health literacy and readability of the PtDA were not reported. However, increases in knowledge and informed choice were reported in those studies

  9. 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

  10. Management Aids and Procedures for Strategic Planning. Staff Report.

    ERIC Educational Resources Information Center

    Cope, Robert G.

    Management aids required in strategic planning are divided into three categories: (1) assessing the environment, (2) providing a process for reaching decisions, and (3) presenting criteria to evaluate strategic decisions. A model for scanning the environment has four dimensions that concern economic, social, knowledge-technology, and public policy…

  11. 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."

  12. An Interactive Computer Aiding System for Group Decision Making

    DTIC Science & Technology

    1979-05-01

    In addition, system evaluation studies will continue. The specific items of work for the next period include: (1) Operational testing of the color...Aid with other DDF decision aids; and (3) continuation of full scale experimental studies of the Group Decision Aid. The following specific tasks were...experimental studies are in progress at Perceptronics’ California office. The previously completed experimental hypotheses and the CACI-developed scenario

  13. 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.

  14. Contending with uncertainty in conservation management decisions

    PubMed Central

    McCarthy, Michael A

    2014-01-01

    Efficient conservation management is particularly important because current spending is estimated to be insufficient to conserve the world's biodiversity. However, efficient management is confounded by uncertainty that pervades conservation management decisions. Uncertainties exist in objectives, dynamics of systems, the set of management options available, the influence of these management options, and the constraints on these options. Probabilistic and nonprobabilistic quantitative methods can help contend with these uncertainties. The vast majority of these account for known epistemic uncertainties, with methods optimizing the expected performance or finding solutions that achieve minimum performance requirements. Ignorance and indeterminacy continue to confound environmental management problems. While quantitative methods to account for uncertainty must aid decisions if the underlying models are sufficient approximations of reality, whether such models are sufficiently accurate has not yet been examined. PMID:25138920

  15. 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.

  16. Development of Automated Aids for Decision Analysis

    DTIC Science & Technology

    1976-05-01

    called state variables (or environ- mental variables) since they define the state of the decision environment. Decision variables must be defined in such...Vaibeison Endlogetious STRUCTURAL MODELO Varabls ~State Variables* (INTERACTION MODEL) Outcome Variables’ (Either State or Prefeence$Decision...decisions and states of the environment. This type of model requires the decision maker to aggregate mentally the effects of the interactions among his

  17. A Review of Shared Decision-Making and Patient Decision Aids in Radiation Oncology.

    PubMed

    Woodhouse, Kristina Demas; Tremont, Katie; Vachani, Anil; Schapira, Marilyn M; Vapiwala, Neha; Simone, Charles B; Berman, Abigail T

    2017-01-30

    Cancer treatment decisions are complex and may be challenging for patients, as multiple treatment options can often be reasonably considered. As a result, decisional support tools have been developed to assist patients in the decision-making process. A commonly used intervention to facilitate shared decision-making is a decision aid, which provides evidence-based outcomes information and guides patients towards choosing the treatment option that best aligns with their preferences and values. To ensure high quality, systematic frameworks and standards have been proposed for the development of an optimal aid for decision making. Studies have examined the impact of these tools on facilitating treatment decisions and improving decision-related outcomes. In radiation oncology, randomized controlled trials have demonstrated that decision aids have the potential to improve patient outcomes, including increased knowledge about treatment options and decreased decisional conflict with decision-making. This article provides an overview of the shared-decision making process and summarizes the development, validation, and implementation of decision aids as patient educational tools in radiation oncology. Finally, this article reviews the findings from decision aid studies in radiation oncology and offers various strategies to effectively implement shared decision-making into clinical practice.

  18. 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,…

  19. Management decisions for cogeneration

    NASA Astrophysics Data System (ADS)

    Radcliffe, R. R.; Tabors, R. D.

    1982-07-01

    Two interdependent studies which explore the underlying factors in the decision by private, private non-profit, and public sector facility owners to invest in cogeneration technology are summarized. The employ factor analysis techniques to explain the decision to invest and discriminant analysis to group the survey respondents into non-cogenerators and potential cogenerators. Data for both studies come from a survey of commercial, industrial, and institutional electric energy consumers who used more than 750 kW demand in any one month of 1981 for a selected electric utility in the Boston area. There were 129 usable responses to the survey of 32.2% of the population. The studies confirm that a number of factors other than purely economic considerations may prevent use of cogeneration technology at the present time. These factors include: uncertainty caused by regulatory action; desire for energy self sufficiency by the organization; financial flexibility; experience with electricity cogeneration or self generation; and capital budget planning methods.

  20. 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.

  1. 7 CFR 3052.405 - Management decision.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 15 2011-01-01 2011-01-01 false Management decision. 3052.405 Section 3052.405... and Pass-Through Entities § 3052.405 Management decision. (a) General. The management decision shall... the management decision, the Federal agency or pass-through entity may request additional...

  2. 7 CFR 3052.405 - Management decision.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Management decision. 3052.405 Section 3052.405... and Pass-Through Entities § 3052.405 Management decision. (a) General. The management decision shall... the management decision, the Federal agency or pass-through entity may request additional...

  3. 29 CFR 99.405 - Management decision.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Management decision. 99.405 Section 99.405 Labor Office of... Agencies and Pass-through Entities § 99.405 Management decision. (a) General. The management decision shall... the management decision, the Federal agency or pass-through entity may request additional...

  4. 7 CFR 3052.405 - Management decision.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 15 2012-01-01 2012-01-01 false Management decision. 3052.405 Section 3052.405... and Pass-Through Entities § 3052.405 Management decision. (a) General. The management decision shall... the management decision, the Federal agency or pass-through entity may request additional...

  5. 7 CFR 3052.405 - Management decision.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 15 2014-01-01 2014-01-01 false Management decision. 3052.405 Section 3052.405... and Pass-Through Entities § 3052.405 Management decision. (a) General. The management decision shall... the management decision, the Federal agency or pass-through entity may request additional...

  6. 29 CFR 99.405 - Management decision.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 1 2014-07-01 2013-07-01 true Management decision. 99.405 Section 99.405 Labor Office of... Agencies and Pass-through Entities § 99.405 Management decision. (a) General. The management decision shall... the management decision, the Federal agency or pass-through entity may request additional...

  7. 7 CFR 3052.405 - Management decision.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 15 2013-01-01 2013-01-01 false Management decision. 3052.405 Section 3052.405... and Pass-Through Entities § 3052.405 Management decision. (a) General. The management decision shall... the management decision, the Federal agency or pass-through entity may request additional...

  8. Evaluation of a Computerized Contraceptive Decision Aid for Adolescent Patients.

    ERIC Educational Resources Information Center

    Chewning, Betty; Mosena, Pat; Wilson, Dale; Erdman, Harold; Potthoff, Sandra; Murphy, Anita; Kuhnen, Kathleen Kennedy

    1999-01-01

    Discusses a computer-based contraceptive decision aid used with adolescent female family planning clinic patients (N=949). Results show improved short-term knowledge of and confidence in oral contraceptive (OC) efficacy. Higher OC knowledge after one year and fewer pregnancies were seen in one group. Findings suggest the usefulness of informatics…

  9. Submarine Periscope Depth Course Selection Tactical Decision Aid

    DTIC Science & Technology

    1997-12-01

    Tactical Decision Aid, Simulations using PAGES Visual Basic Programming 64 16. PRICE CODE 17. SECURITY CLASSIFICATION 18. SECURITY CLASSIFICATION OF 19...27 APPENDIX A. COMPOSITE OUTPUT DISPLAYS ..................................................................... 29 APPENDIX B. VISUAL BASIC SOURCE...41 APPENDIX D. VISUAL BASIC SOURCE CODE FOR SIMULATION ......................................... 43 APPENDIX E

  10. 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

  11. 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

  12. 25 CFR 217.5 - Management decisions.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false Management decisions. 217.5 Section 217.5 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS MANAGEMENT OF TRIBAL ASSETS OF UTE... Management decisions. In arriving at management decisions concerning the assets, the business committee...

  13. 25 CFR 217.5 - Management decisions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Management decisions. 217.5 Section 217.5 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS MANAGEMENT OF TRIBAL ASSETS OF UTE... Management decisions. In arriving at management decisions concerning the assets, the business committee...

  14. 25 CFR 217.5 - Management decisions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true Management decisions. 217.5 Section 217.5 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS MANAGEMENT OF TRIBAL ASSETS OF UTE... Management decisions. In arriving at management decisions concerning the assets, the business committee...

  15. 25 CFR 217.5 - Management decisions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false Management decisions. 217.5 Section 217.5 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS MANAGEMENT OF TRIBAL ASSETS OF UTE... Management decisions. In arriving at management decisions concerning the assets, the business committee...

  16. 25 CFR 217.5 - Management decisions.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false Management decisions. 217.5 Section 217.5 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS MANAGEMENT OF TRIBAL ASSETS OF UTE... Management decisions. In arriving at management decisions concerning the assets, the business committee...

  17. Refinement of Probability of Survival Decision Aid (PSDA)

    DTIC Science & Technology

    2014-03-01

    Approved for public release; distribution unlimited PSDA predicts the impact of hypothermia and dehydration on survival time during exposure for a wide...thus will have a minimal impact on the heat loss from the body to the environment. survival, model, hypothermia , dehydration, immersion...Decision Aid (PSDA v1.0). PSDA predicts the impact of hypothermia and dehydration on survival time during exposure for a wide range of conditions in

  18. The Ship Response Tactical Decision Aid. Phase 1

    DTIC Science & Technology

    1989-11-01

    was conducted in April 1988 to validate the Phase I Ship Response Tactical Decision Aid. The ship, USS CONYNGHAM ( DDG -17), was equipped with the SPS...the relative direction of the seas and ship. Comparisons between measured and predicted ship motions made aboard USS CONYN- GHAM are presented in Figs...environment. 1 I I I I 18! I I ACKNOWLEDGEMENTS The kind cooperation of the USS CONYNGHAM, under the capable leadership of Commander David Rose, allowed

  19. General Framework of Hearing Aid Fitting Management

    PubMed Central

    Oh, Soo Hee

    2016-01-01

    Hearing aids are one of the most widely used treatment options for the hearing impaired and optimal outcomes of hearing aids are supported by comprehensive hearing aid fitting protocols. Currently, the term 'hearing aid fitting' is prevalently used among service and industry sectors with its comprehensive procedures not systematically explicated. In addition, a variety of non-normalized guidelines for hearing aid fitting has led to non-uniform care, outcome variability, and dissatisfaction of the use of hearing aids. The main purpose of the present study is to suggest a general framework of standardized practice for hearing aid fitting management including its pre- and post-fitting stages. The management framework centers on its fitting process with its prior steps of assessment as well as its posterior steps of follow-up, thereby eliminating diverging interpretations and non-uniform practices. Outcomes of this study are also expected to improve potential benefits such as quality of hearing aid fitting, user satisfaction, and cost effectiveness across relevant stakeholders. PMID:27144226

  20. 38 CFR 41.405 - Management decision.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Management decision. 41... Entities § 41.405 Management decision. (a) General. The management decision shall clearly state whether or... completed corrective action, a timetable for follow-up should be given. Prior to issuing the...

  1. 38 CFR 41.405 - Management decision.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Management decision. 41... Entities § 41.405 Management decision. (a) General. The management decision shall clearly state whether or... completed corrective action, a timetable for follow-up should be given. Prior to issuing the...

  2. 38 CFR 41.405 - Management decision.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Management decision. 41... Entities § 41.405 Management decision. (a) General. The management decision shall clearly state whether or... completed corrective action, a timetable for follow-up should be given. Prior to issuing the...

  3. 38 CFR 41.405 - Management decision.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Management decision. 41... Entities § 41.405 Management decision. (a) General. The management decision shall clearly state whether or... completed corrective action, a timetable for follow-up should be given. Prior to issuing the...

  4. The Effect of a Decision Aid on the Quality of Colorectal Cancer Screening Decisions

    DTIC Science & Technology

    2012-03-29

    Wiley & Sons, Inc. 153. Arterburn, D.E., et al., Randomized trial of a video-based patient decision aid for bariatric surgery . Obesity (Silver Spring... surgery than those who did not, while those who felt strongly about preserving their sexual function were less likely to have surgery 25 [104...knowledge and treatment decision making for breast cancer surgery : a randomized trial. Jama, 2004. 139 292(4): p. 435-41. 118. Street, R.L., Jr., et al

  5. 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

  6. Professional centred shared decision making: Patient decision aids in practice in primary care

    PubMed Central

    Burges Watson, Duika; Thomson, Richard G; Murtagh, Madeleine J

    2008-01-01

    Background Patient decision aids are increasingly regarded as important components of clinical practice that enable shared decision making (SDM) and evidence based patient choice. Despite broad acceptance of their value, there remains little evidence of their successful implementation in primary care settings. Methods Health care practitioners from five general practice surgeries in northern England participated in focus group sessions around the themes of patient decision aids, patient and practitioner preferences and SDM. Participants included general practitioners (n = 19), practice nurses (n = 5) and auxiliary staff (n = 3). Transcripts were analysed using a framework approach. Results We report a) practitioners' discussion of the current impetus towards sharing decisions and their perspectives on barriers to SDM, and b) the implementation of patient decision aids in practice and impediments such as lack of an evidence base and time available in consultations. Conclusion We demonstrate two orientations to sharing decisions: practitioner-centred and patient-centred with the former predominating. We argue that it is necessary to rethink the changes required in practice for the implementation of SDM. PMID:18190683

  7. Decision Making in Prostate Cancer Screening Using Decision Aids vs Usual Care

    PubMed Central

    Taylor, Kathryn L.; Williams, Randi M.; Davis, Kimberly; Luta, George; Penek, Sofiya; Barry, Samantha; Kelly, Scott; Tomko, Catherine; Schwartz, Marc; Krist, Alexander H.; Woolf, Steven H.; Fishman, Mary B.; Cole, Carmella; Miller, Edward

    2014-01-01

    IMPORTANCE The conflicting recommendations for prostate cancer (PCa) screening and the mixed messages communicated to the public about screening effectiveness make it critical to assist men in making informed decisions. OBJECTIVE To assess the effectiveness of 2 decision aids in helping men make informed PCa screening decisions. DESIGN, SETTING, AND PARTICIPANTS A racially diverse group of male outpatients aged 45 to 70 years from 3 sites were interviewed by telephone at baseline, 1 month, and 13 months, from 2007 through 2011. We conducted intention-to-treat univariate analyses and multivariable linear and logistic regression analyses, adjusting for baseline outcome measures. INTERVENTION Random assignment to print-based decision aid (n = 628), web-based interactive decision aid (n = 625), or usual care (UC) (n = 626). MAIN OUTCOMES AND MEASURES Prostate cancer knowledge, decisional conflict, decisional satisfaction, and whether participants underwent PCa screening. RESULTS Of 4794 eligible men approached, 1893 were randomized. At each follow-up assessment, univariate and multivariable analyses indicated that both decision aids resulted in significantly improved PCa knowledge and reduced decisional conflict compared with UC (all P <.001). At 1 month, the standardized mean difference (Cohen’s d) in knowledge for the web group vs UC was 0.74, and in the print group vs UC, 0.73. Decisional conflict was significantly lower for web vs UC (d = 0.33) and print vs UC (d = 0.36). At 13 months, these differences were smaller but remained significant. At 1 month, high satisfaction was reported by significantly more print (60.4%) than web participants (52.2%; P = .009) and significantly more web (P = .001) and print (P = .03) than UC participants (45.5%). At 13 months, differences in the proportion reporting high satisfaction among print (55.7%) compared with UC (49.8%; P = .06) and web participants (50.4%; P = .10) were not significant. Screening rates at 13 months did not

  8. Sediment source fingerprinting as an aid to catchment management: A review of the current state of knowledge and a methodological decision-tree for end-users.

    PubMed

    Collins, A L; Pulley, S; Foster, I D L; Gellis, A; Porto, P; Horowitz, A J

    2016-10-12

    The growing awareness of the environmental significance of fine-grained sediment fluxes through catchment systems continues to underscore the need for reliable information on the principal sources of this material. Source estimates are difficult to obtain using traditional monitoring techniques, but sediment source fingerprinting or tracing procedures, have emerged as a potentially valuable alternative. Despite the rapidly increasing numbers of studies reporting the use of sediment source fingerprinting, several key challenges and uncertainties continue to hamper consensus among the international scientific community on key components of the existing methodological procedures. Accordingly, this contribution reviews and presents recent developments for several key aspects of fingerprinting, namely: sediment source classification, catchment source and target sediment sampling, tracer selection, grain size issues, tracer conservatism, source apportionment modelling, and assessment of source predictions using artificial mixtures. Finally, a decision-tree representing the current state of knowledge is presented, to guide end-users in applying the fingerprinting approach.

  9. Energy Technology Investments: Maximizing Efficiency Through a Maritime Energy Portfolio Interface and Decision Aid

    DTIC Science & Technology

    2012-02-09

    APPROACH The Maritime Energy Portfolio Management Approach provides a means for determining the best course of action where several initiatives...Decision Aid also provides a means for determining the best course of action where several ECMs compete for scarce funds. Efficient, user friendly...Investment (ROI) and Break Even Point ( BEP ). These metrics are essential for determining whether an initiative would be worth pursuing. Balanced

  10. 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

  11. DASACT: A decision aiding software for axiomatic consensus theory.

    PubMed

    Domenach, Florent; Tayari, Ali

    2016-01-01

    There have been various attempts, solutions, and approaches towards constructing an appropriate consensus tree based on a given set of phylogenetic trees. However, for practitioners, it is not always clear, for a given data set, which of these would create the most relevant consensus tree. In this paper, we introduce an open-source software called DASACT (Decision Aiding Software for Axiomatic Consensus Theory) created to assist practitioners on choosing the most appropriate consensus function. It is based on an exhaustive evaluation of axiomatic properties and consensus functions, which define the knowledge space as a concept lattice. Using a selection of axiomatic properties provided by the user, it is able to aid the user in choosing the most suitable function. DASACT is freely available at http://www.cs.unic.ac.cy/florent/software.htm.

  12. Photoelectric log data aids deep-well completion decisions

    SciTech Connect

    Maher, T.M.; Boykin, W.; Heysse, D.R.

    1997-09-01

    In several deep, overpressured wells in Oklahoma and Louisiana, Apache Corp. has used photoelectric measurements provided by wireline density tools to aid in completion decisions. The information helped identify permeable zones in several tight formations; these zones were subsequently perforated, hydraulically fractured and successfully produced. Because formation conditions and small borehole sizes precluded running traditional micrologs as permeability indicators, the photoelectric information proved to be particularly valuable on these wells. The operating principles of the tool, supplied by Halliburton Energy Services, are presented here. And example applications in Caddo County, Oklahoma, and Jackson Parish, Louisiana, deep wells are presented.

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. Computer-Aided Corrosion Program Management

    NASA Technical Reports Server (NTRS)

    MacDowell, Louis

    2010-01-01

    This viewgraph presentation reviews Computer-Aided Corrosion Program Management at John F. Kennedy Space Center. The contents include: 1) Corrosion at the Kennedy Space Center (KSC); 2) Requirements and Objectives; 3) Program Description, Background and History; 4) Approach and Implementation; 5) Challenges; 6) Lessons Learned; 7) Successes and Benefits; and 8) Summary and Conclusions.

  18. Optimization Techniques for College Financial Aid Managers

    ERIC Educational Resources Information Center

    Bosshardt, Donald I.; Lichtenstein, Larry; Palumbo, George; Zaporowski, Mark P.

    2010-01-01

    In the context of a theoretical model of expected profit maximization, this paper shows how historic institutional data can be used to assist enrollment managers in determining the level of financial aid for students with varying demographic and quality characteristics. Optimal tuition pricing in conjunction with empirical estimation of…

  19. Decision aids for localized prostate cancer treatment choice: Systematic review and meta-analysis.

    PubMed

    Violette, Philippe D; Agoritsas, Thomas; Alexander, Paul; Riikonen, Jarno; Santti, Henrikki; Agarwal, Arnav; Bhatnagar, Neera; Dahm, Philipp; Montori, Victor; Guyatt, Gordon H; Tikkinen, Kari A O

    2015-01-01

    Patients who are diagnosed with localized prostate cancer need to make critical treatment decisions that are sensitive to their values and preferences. The role of decision aids in facilitating these decisions is unknown. The authors conducted a systematic review of randomized trials of decision aids for localized prostate cancer. Teams of 2 reviewers independently identified, selected, and abstracted data from 14 eligible trials (n = 3377 men), of which 10 were conducted in North America. Of these, 11 trials compared decision aids with usual care, and 3 trials compared decision aids with other decision aids. Two trials suggested a modest positive impact on decisional regret. Results across studies varied widely for decisional conflict (4 studies), satisfaction with decision (2 studies), and knowledge (2 studies). No impact on treatment choices was observed (6 studies). In conclusion, scant evidence at high risk of bias suggests the variable impact of existing decision aids on a limited set of decisional processes and outcomes. Because current decision aids provide information but do not directly facilitate shared decision making, subsequent efforts would benefit from user-centered design of decision aids that promote shared decision making.

  20. Verification and validation of the night vision goggle tactical decision aid

    NASA Astrophysics Data System (ADS)

    Elrick, John R.

    1995-05-01

    The Night Vision Goggle (NVG) Tactical Decision Aid (TDA) was developed to support Army operations in situations requiring accurate predictions of light levels. Minimum thresholds of illumination are used by the Army to plan and execute missions during periods of darkness or near darkness. The NVG TDA is part of a suite of decision aids that will become part of the fielded Integrated Meteorological System (IMETS). The IMETS is a system designed to be operated by Air Force Staff Weather Officers supporting Army tactical operations in peacetime and in times of conflict. The verification and validation (V & V) effort discussed in this report is part of the Battlefield Environment Directorate configuration management plan to field physically correct and user-friendly software to Army units over the entire conflict spectrum. The V & V described is thorough and shows that the NVG TDA is physically correct and applicable for accreditation before use.

  1. Periodicals collection management using a decision support system

    SciTech Connect

    Compton, M.L.; Moser, E.C.

    1993-12-31

    Sandia National Laboratories is a multiprogram national laboratory established in 1949. The Library currently uses DOBIS for its automated system, including the Periodicals Control function for periodical check-in. DOBIS performs processing and control functions adequately, but could not meet our reporting needs. Therefore the Library`s Periodicals Decision Team decided that they needed another ``system`` for collection management. A Periodicals Decision Support System was created using information downloaded from DOBIS and uploaded into dBASE IV. The Periodical Decision Support System functions as an information-processing system that has aided us in making collection management decisions for periodicals. It certainly allows us to do interactive ad-hoc analysis; although there are no modeling tools currently incorporated in the system. We hope that these modeling tools will come later. We have been gathering information and developing needed reports to achieve this goal.

  2. Decision exploration lab: a visual analytics solution for decision management.

    PubMed

    Broeksema, Bertjan; Baudel, Thomas; Telea, Arthur G; Crisafulli, Paolo

    2013-12-01

    We present a visual analytics solution designed to address prevalent issues in the area of Operational Decision Management (ODM). In ODM, which has its roots in Artificial Intelligence (Expert Systems) and Management Science, it is increasingly important to align business decisions with business goals. In our work, we consider decision models (executable models of the business domain) as ontologies that describe the business domain, and production rules that describe the business logic of decisions to be made over this ontology. Executing a decision model produces an accumulation of decisions made over time for individual cases. We are interested, first, to get insight in the decision logic and the accumulated facts by themselves. Secondly and more importantly, we want to see how the accumulated facts reveal potential divergences between the reality as captured by the decision model, and the reality as captured by the executed decisions. We illustrate the motivation, added value for visual analytics, and our proposed solution and tooling through a business case from the car insurance industry.

  3. 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

  4. Adapting My Weather Impacts Decision Aid (MyWIDA) to Additional Web Application Server Technologies

    DTIC Science & Technology

    2015-08-01

    ARL-TN-0688 ● AUG 2015 US Army Research Laboratory Adapting My Weather Impacts Decision Aid (MyWIDA) to Additional Web...Laboratory Adapting My Weather Impacts Decision Aid (MyWIDA) to Additional Web Application Server Technologies by Jacob C Randall and Jeffrey O...COVERED (From - To) May–Aug 2015 4. TITLE AND SUBTITLE Adapting My Weather Impacts Decision Aid (MyWIDA) to Additional Web Application Server

  5. 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

  6. Uncertainty management in intelligent design aiding systems

    NASA Technical Reports Server (NTRS)

    Brown, Donald E.; Gabbert, Paula S.

    1988-01-01

    A novel approach to uncertainty management which is particularly effective in intelligent design aiding systems for large-scale systems is presented. The use of this approach in the materials handling system design domain is discussed. It is noted that, during any point in the design process, a point value can be obtained for the evaluation of feasible designs; however, the techniques described provide unique solutions for these point values using only the current information about the design environment.

  7. Evaluation of the ryegrass stem rust model STEMRUST_G and its implementation as a decision aid

    Technology Transfer Automated Retrieval System (TEKTRAN)

    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 an heuristic tool and as a decision aid for disease management with fungicides. Model validation was by comparison of model output with observed disease severit...

  8. 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 ...

  9. Decision aid systems for evaluating sustainability: a critical survey

    SciTech Connect

    Brunner, Norbert; Starkl, Markus

    2004-05-01

    Assessing sustainability in compliance with the EU water framework directive is affected by numerous conflicting interests. As they can no longer be resolved by means of intuitive reasoning, some authors propose the integration of the major fragmented indicators into one common indicator of the overall sustainability by means of a codified multi-criteria decision support methodology (DSM). Practitioners in urban water management, however, usually object to the use of a codified DSM, as in the legal context (negotiations between the stakeholders, tendering procedure) it might jeopardize the feasibility of the decision making process (DMP). Here we show that a feasible implementation of a DSM into the DMP is possible. To this end, we design a cooperative approach, which by means of an axiomatic evaluation helps to select an appropriate DSM. We illustrate it by a hypothetical dialogue between the relevant authority and the developer. It will expose the inherent limitations of the DSM, which are due to their underlying mathematical features.

  10. DeMAID/GA USER'S GUIDE Design Manager's Aid for Intelligent Decomposition with a Genetic Algorithm

    NASA Technical Reports Server (NTRS)

    Rogers, James L.

    1996-01-01

    Many companies are looking for new tools and techniques to aid a design manager in making decisions that can reduce the time and cost of a design cycle. One tool that is available to aid in this decision making process is the Design Manager's Aid for Intelligent Decomposition (DeMAID). Since the initial release of DEMAID in 1989, numerous enhancements have been added to aid the design manager in saving both cost and time in a design cycle. The key enhancement is a genetic algorithm (GA) and the enhanced version is called DeMAID/GA. The GA orders the sequence of design processes to minimize the cost and time to converge to a solution. These enhancements as well as the existing features of the original version of DEMAID are described. Two sample problems are used to show how these enhancements can be applied to improve the design cycle. This report serves as a user's guide for DeMAID/GA.

  11. 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.…

  12. 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...

  13. 29 CFR 99.405 - Management decision.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... auditee has not completed corrective action, a timetable for follow-up should be given. Prior to issuing... documentation, as a way of mitigating disallowed costs. The management decision should describe any...

  14. 29 CFR 99.405 - Management decision.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... auditee has not completed corrective action, a timetable for follow-up should be given. Prior to issuing... documentation, as a way of mitigating disallowed costs. The management decision should describe any...

  15. 29 CFR 99.405 - Management decision.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... auditee has not completed corrective action, a timetable for follow-up should be given. Prior to issuing... documentation, as a way of mitigating disallowed costs. The management decision should describe any...

  16. Shared Decision Aids: Increasing Patient Acceptance of Long-Acting Reversible Contraception

    PubMed Central

    George, Tracy P.; DeCristofaro, Claire; Dumas, Bonnie P.; Murphy, Pamela F.

    2015-01-01

    Unintended pregnancies are an important public health issue. Long-acting reversible contraceptive methods (LARCs) are reliable, safe, highly effective methods for most women; however they are underutilized in the United States. Shared decision aids were added to usual care in five public health family planning clinics in the Southeastern United States, staffed by advance practice nurses and registered nurses. All five sites showed an increase in the use of LARCs during the time period that shared decision aids were used (results statistically significant to p < 0.001). It is important for women to make informed choices about contraception, and shared decision aids can be utilized to support this decision making. This resource has been adopted for statewide use in all public health clinics, and implications for practice suggest that the use of shared decision aids is an effective method to support informed patient decision making and acceptance of LARC methods of contraception. PMID:27417757

  17. 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.

  18. Emergency Management Computer-Aided Trainer (EMCAT)

    NASA Technical Reports Server (NTRS)

    Rodriguez, R. C.; Johnson, R. P.

    1986-01-01

    The Emergency Management Computer-Aided Trainer (EMCAT) developed by Essex Corporation or NASA and the Federal Emergency Management Administration's (FEMA) National Fire Academy (NFA) is described. It is a computer based training system for fire fighting personnel. A prototype EMCAT system was developed by NASA first using video tape images and then video disk images when the technology became available. The EMCAT system is meant to fill the training needs of the fire fighting community with affordable state-of-the-art technologies. An automated real time simulation of the fire situation was needed to replace the outdated manual training methods currently being used. In order to be successful, this simulator had to provide realism, be user friendly, be affordable, and support multiple scenarios. The EMCAT system meets these requirements and therefore represents an innovative training tool, not only for the fire fighting community, but also for the needs of other disciplines.

  19. 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

  20. 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

  1. 43 CFR 1610.6 - Management decision review by Congress.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR GENERAL MANAGEMENT (1000) PLANNING, PROGRAMMING, BUDGETING Resource Management Planning § 1610.6 Management decision review by Congress. The Federal Land Policy...

  2. Decision aids for familial breast cancer: exploring women's views using focus groups

    PubMed Central

    Rapport, Frances; Iredale, Rachel; Jones, Wendy; Sivell, Stephanie; Edwards, Adrian; Gray, Jonathon; Elwyn, Glyn

    2006-01-01

    Abstract Background  There is increasing need for accessible information about familial breast cancer for those facing complex decisions around genetic testing, screening and treatment. Information currently includes leaflets and computerized decision aids, offering interactive interfaces to clarify complex choices. Objective  Exploration of users’ views and reactions to three decision aids for genetic testing for breast cancer using focus groups. Setting  A regional cancer genetics service in the UK. Participants  Women over 18 years of age who had been referred to Cancer Genetics Service for Wales (CGSW) and had received a risk assessment for familial breast cancer. Methods  Qualitative study involving one pilot and six extended focus groups with 39 women at high, moderate and population risk. Two CD‐ROMs and one paper‐based aid evaluated for: clarity of presentation, ease of handling, emotive response, increased knowledge and greater informed choice. Results  Women reported variable preferences for different types of decision aids and mixed emotions, indicating the sensitivity of raising issues in decision support tools, lack of consensus over the most appropriate aid and no systematic differences between risk groups. Women remarked that aids increased their knowledge, particularly about breast cancer genes and risk and wanted a decision aid designed within the context of the NHS, in both paper‐based and CD‐ROM formats from an authoritative source. Mixed views about presentation styles suggest decision aids would be most effective with a user‐selected range of formats. Conclusions  Decision aid development should be informed by users and should meet the needs of those concerned about their risk of breast cancer in the UK. Without such aids, patients will continue to search for information from a variety of sources of varying quality. PMID:16911137

  3. Use of ultrasonography to make management decisions

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Transrectal ultrasonography has been available for making management decisions since the mid 1980’s. This technology allows for the real-time visualization of internal structures (i.e. ovary and fetus) that are otherwise difficult to evaluate. The use of this technology in making reproductive manag...

  4. Decision support system for nursing management control

    SciTech Connect

    Ernst, C.J.

    1983-01-01

    A knowledge representation approach for expert systems supporting decision processes in business is proposed. A description of a knowledge representation schema using a logic programming metalanguage is described, then the role of such a schema in a management expert system is demonstrated through the problem of nursing management control in hospitals. 18 references.

  5. Can patient decision aids help people make good decisions about participating in clinical trials? A study protocol

    PubMed Central

    Brehaut, Jamie C; Lott, Alison; Fergusson, Dean A; Shojania, Kaveh G; Kimmelman, Jonathan; Saginur, Raphael

    2008-01-01

    Background Evidence shows that the standard process for obtaining informed consent in clinical trials can be inadequate, with study participants frequently not understanding even basic information fundamental to giving informed consent. Patient decision aids are effective decision support tools originally designed to help patients make difficult treatment or screening decisions. We propose that incorporating decision aids into the informed consent process will improve the extent to which participants make decisions that are informed and consistent with their preferences. A mixed methods study will test this proposal. Methods Phase one of this project will involve assessment of a stratified random sample of 50 consent documents from recently completed investigator-initiated clinical trials, according to existing standards for supporting good decision making. Phase two will involve interviews of a purposive sample of 50 trial participants (10 participants from each of five different clinical areas) about their experience of the informed consent process, and how it could be improved. In phase three, we will convert consent forms for two completed clinical trials into decision aids and pilot test these new tools using a user-centered design approach, an iterative development process commonly employed in computer usability literature. In phase four, we will conduct a pilot observational study comparing the new tools to standard consent forms, with potential recruits to two hypothetical clinical trials. Outcomes will include knowledge of key aspects of the decision, knowledge of the probabilities of different outcomes, decisional conflict, the hypothetical participation decision, and qualitative impressions of the experience. Discussion This work will provide initial evidence about whether a patient decision aid can improve the informed consent process. The larger goal of this work is to examine whether study recruitment can be improved from (barely) informed consent

  6. 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.

  7. The Changing Role of Financial Aid and Enrollment Management.

    ERIC Educational Resources Information Center

    Kurz, Kathy A.

    1995-01-01

    Explores common institutional strategies for pricing, awarding aid, and controlling the growth of aid budgets in light of changing recruitment practices. Concludes by discussing the new services that aid offices must provide to meet their new challenges effectively. Discusses net tuition revenue goals to enhance effective management of resources.…

  8. Decision Making in Acoustic Neuroma Management

    PubMed Central

    Naguib, Maged B.; Saleh, Essam; Aristegui, Miguel; Mazzoni, Antonio; Sanna, Mario

    1994-01-01

    Patients with acoustic neuroma in their only hearing ear are not frequently seen in clinical practice. Managing this group of patients is a challenge to both patient and surgeon. In this study we report on five cases of acoustic neuroma in an only hearing ear. Our decision for nonsurgical management of those patients with regular follow-up using auditory brainstem responses and magnetic resonance imaging is discussed. Other management options currently available are considered as well. PMID:17170923

  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. Presenting quantitative information about decision outcomes: a risk communication primer for patient decision aid developers

    PubMed Central

    2013-01-01

    Background Making evidence-based decisions often requires comparison of two or more options. Research-based evidence may exist which quantifies how likely the outcomes are for each option. Understanding these numeric estimates improves patients’ risk perception and leads to better informed decision making. This paper summarises current “best practices” in communication of evidence-based numeric outcomes for developers of patient decision aids (PtDAs) and other health communication tools. Method An expert consensus group of fourteen researchers from North America, Europe, and Australasia identified eleven main issues in risk communication. Two experts for each issue wrote a “state of the art” summary of best evidence, drawing on the PtDA, health, psychological, and broader scientific literature. In addition, commonly used terms were defined and a set of guiding principles and key messages derived from the results. Results The eleven key components of risk communication were: 1) Presenting the chance an event will occur; 2) Presenting changes in numeric outcomes; 3) Outcome estimates for test and screening decisions; 4) Numeric estimates in context and with evaluative labels; 5) Conveying uncertainty; 6) Visual formats; 7) Tailoring estimates; 8) Formats for understanding outcomes over time; 9) Narrative methods for conveying the chance of an event; 10) Important skills for understanding numerical estimates; and 11) Interactive web-based formats. Guiding principles from the evidence summaries advise that risk communication formats should reflect the task required of the user, should always define a relevant reference class (i.e., denominator) over time, should aim to use a consistent format throughout documents, should avoid “1 in x” formats and variable denominators, consider the magnitude of numbers used and the possibility of format bias, and should take into account the numeracy and graph literacy of the audience. Conclusion A substantial and

  11. Evaluation of Weather Service Heat Indices Using the USARIEM Heat Strain Decision Aid (HSDA) Model

    DTIC Science & Technology

    2003-06-01

    and Canadian indices differ. The U.S. uses the Heat Index (HI) based on Steadman’s model. Canada uses Humidex (HD). Our comparison used the USARIEM Heat Strain Decision Aid (HSDA) to evaluate both indices.

  12. 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

  13. 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

  14. 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

  15. Do personal stories make patient decision aids more effective? A critical review of theory and evidence

    PubMed Central

    2013-01-01

    Background Patient decision aids support people to make informed decisions between healthcare options. Personal stories provide illustrative examples of others’ experiences and are seen as a useful way to communicate information about health and illness. Evidence indicates that providing information within personal stories affects the judgments and values people have, and the choices they make, differentially from facts presented in non-narrative prose. It is unclear if including narrative communications within patient decision aids enhances their effectiveness to support people to make informed decisions. Methods A survey of primary empirical research employing a systematic review method investigated the effect of patient decision aids with or without a personal story on people’s healthcare judgements and decisions. Searches were carried out between 2005-2012 of electronic databases (Medline, PsycINFO), and reference lists of identified articles, review articles, and key authors. A narrative analysis described and synthesised findings. Results Of 734 citations identified, 11 were included describing 13 studies. All studies found participants’ judgments and/or decisions differed depending on whether or not their decision aid included a patient story. Knowledge was equally facilitated when the decision aids with and without stories had similar information content. Story-enhanced aids may help people recall information over time and/or their motivation to engage with health information. Personal stories affected both “system 1” (e.g., less counterfactual reasoning, more emotional reactions and perceptions) and “system 2” (e.g., more perceived deliberative decision making, more stable evaluations over time) decision-making strategies. Findings exploring associations with narrative communications, decision quality measures, and different levels of literacy and numeracy were mixed. The pattern of findings was similar for both experimental and real

  16. Impact of a Decision Aid on Surrogate Decision-makers’ Perceptions of Feeding Options for Patients with Dementia

    PubMed Central

    Snyder, E. Amanda; Caprio, Anthony J.; Wessell, Kathryn; Lin, Feng Chang; Hanson, Laura C.

    2012-01-01

    Objective In advanced dementia, feeding problems are nearly universal, and families face difficult decisions about feeding options. Initial interviews for a randomized trial were used to describe surrogates’ perceptions feeding options, and to determine if a decision aid on feeding options in advanced dementia would improve knowledge, reduce expectation of benefit from tube feeding, and reduce conflict over treatment choices for persons with advanced dementia. Design Semi-structured interview with pre-post study design for surrogates in the intervention group. Setting Twenty-four skilled nursing facilities across North Carolina participating in a cluster randomized trial. Participants Two hundred fifty-five surrogate decision-makers for nursing home residents with advanced dementia and feeding problems, in control (n=129) and intervention (n=126) groups. Intervention For intervention surrogates only, an audiovisual-print decision aid provided information on dementia, feeding problems in dementia, advantages and disadvantages of feeding tubes or assisted oral feeding options and the role of surrogates in making these decisions. Measurements The interview included open-ended items asking surrogates to report advantages and disadvantages of tube feeding and assisted oral feeding. Knowledge of feeding options was measured with 19 true-false items, and items measuring expectation of benefit from tube feeding. Surrogates reported which of these two feeding options they preferred for the person with dementia, and how confident they were in this choice; their level of conflict about the choice was measured using the Decisional Conflict Scale. Results Prior to the decision aid, surrogates described advantages and disadvantages of assisted oral feeding and tube feeding in practical, ethical and medical terms. After review of the decision aid, intervention surrogates had improved knowledge scores (15.5 vs. 16.8; p<0.001), decreased expectation of benefits from tube feeding

  17. Collaborative Brain-Computer Interface for Aiding Decision-Making

    PubMed Central

    Poli, Riccardo; Valeriani, Davide; Cinel, Caterina

    2014-01-01

    We look at the possibility of integrating the percepts from multiple non-communicating observers as a means of achieving better joint perception and better group decisions. Our approach involves the combination of a brain-computer interface with human behavioural responses. To test ideas in controlled conditions, we asked observers to perform a simple matching task involving the rapid sequential presentation of pairs of visual patterns and the subsequent decision as whether the two patterns in a pair were the same or different. We recorded the response times of observers as well as a neural feature which predicts incorrect decisions and, thus, indirectly indicates the confidence of the decisions made by the observers. We then built a composite neuro-behavioural feature which optimally combines the two measures. For group decisions, we uses a majority rule and three rules which weigh the decisions of each observer based on response times and our neural and neuro-behavioural features. Results indicate that the integration of behavioural responses and neural features can significantly improve accuracy when compared with the majority rule. An analysis of event-related potentials indicates that substantial differences are present in the proximity of the response for correct and incorrect trials, further corroborating the idea of using hybrids of brain-computer interfaces and traditional strategies for improving decision making. PMID:25072739

  18. Development and Testing of a Decision Aid on Goals of Care for Advanced Dementia

    PubMed Central

    Einterz, Seth F.; Gilliam, Robin; Lin, Feng Chang; McBride, J. Marvin; Hanson, Laura C.

    2014-01-01

    Objectives Decision aids are effective to improve decision-making, yet they are rarely tested in nursing homes (NHs). Study objectives were to 1) examine the feasibility of a Goals of Care (GOC) decision aid for surrogate decision-makers (SDMs)of persons with dementia; and 2) test its effect on quality of communication and decision-making. Design Pre-post intervention to test a GOC decision aid intervention for SDMs for persons with dementia in NHs. Investigators collected data from reviews of resident health records and interviews with SDMs at baseline and 3-month follow up. Setting Two NHs in North Carolina. Participants 18 residents who were over 65 years of age, had moderate to severe dementia on the Global Deterioration Scale (GDS=5,6,7), and an English-speaking surrogate decision-maker. Intervention 1) GOC Decision Aid video viewed by the SDM, and 2) a structured care plan meeting between the SDM and interdisciplinary NH team Measurements Surrogate knowledge, quality of communication with health care providers, surrogate-provider concordance on goals of care, and palliative care domains addressed in the care plan. Results 89% of the SDMs thought the decision aid was relevant to their needs. After viewing the video decision aid, SDMs increased the number of correct responses on knowledge-based questions (12.5 vs 14.2, P<.001). At 3 months they reported improved quality of communication scores (6.1 vs 6.8, P=.01) and improved concordance on primary goal of care with nursing home team (50% vs 78%, P=.003). The number of palliative care domains addressed in the care plan increased (1.8 vs 4.3, P<.001). Conclusion The decision-support intervention piloted in this study was feasible and relevant for surrogate decision-makers of persons with advanced dementia in nursing homes, and it improved quality of communication between SDM and NH providers. A larger randomized clinical trial is underway to provide further evidence of the effects of this decision aid

  19. Decision support system for drinking water management

    NASA Astrophysics Data System (ADS)

    Janža, M.

    2012-04-01

    The problems in drinking water management are complex and often solutions must be reached under strict time constrains. This is especially distinct in case of environmental accidents in the catchment areas of the wells that are used for drinking water supply. The beneficial tools that can help decision makers and make program of activities more efficient are decision support systems (DSS). In general they are defined as computer-based support systems that help decision makers utilize data and models to solve unstructured problems. The presented DSS was developed in the frame of INCOME project which is focused on the long-term stable and safe drinking water supply in Ljubljana. The two main water resources Ljubljana polje and Barje alluvial aquifers are characterized by a strong interconnection of surface and groundwater, high vulnerability, high velocities of groundwater flow and pollutant transport. In case of sudden pollution, reactions should be very fast to avoid serious impact to the water supply. In the area high pressures arising from urbanization, industry, traffic, agriculture and old environmental burdens. The aim of the developed DSS is to optimize the activities in cases of emergency water management and to optimize the administrative work regarding the activities that can improve groundwater quality status. The DSS is an interactive computer system that utilizes data base, hydrological modelling, and experts' and stakeholders' knowledge. It consists of three components, tackling the different abovementioned issues in water management. The first one utilizes the work on identification, cleaning up and restoration of illegal dumpsites that are a serious threat to the qualitative status of groundwater. The other two components utilize the predictive capability of the hydrological model and scenario analysis. The user interacts with the system by a graphical interface that guides the user step-by-step to the recommended remedial measures. Consequently, the

  20. 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

  1. Decision Aids and Shared Decision-Making in Neurocritical Care: An Unmet Need in Our NeuroICUs.

    PubMed

    Muehlschlegel, Susanne; Shutter, Lori; Col, Nananda; Goldberg, Robert

    2015-08-01

    Improved resuscitation methods and advances in critical care have significantly increased the survival of patients presenting with devastating brain injuries compared to prior decades. After the patient's stabilization phase, families and patients are faced with "goals-of-care" decisions about continuation of aggressive intensive care unit care or comfort care only (CMO). Highly varying rates of CMO between centers raise the question of "self-fulfilling prophecies." Disease severity, the physician's communication and the family's understanding of projected outcomes, their uncertainties, complication risks with continued care, physician bias, and the patient's and surrogate's wishes and values all influence a CMO decision. Disease-specific decision support interventions, decision aids (DAs), may remedy these issues in the neurocritical care unit, potentially leading to better-informed and less-biased goals-of-care decisions in neurocritically ill patients, while increasing decision knowledge, confidence, and realistic expectations and decreasing decisional conflict and regret. Shared decision-making (SDM) is a collaborative process that enhances patients' and proxies' understanding about prognosis, encourages them to actively weigh the risks and benefits of a treatment, and considers the patient's preferences and values to make better decisions. DAs are SDM tools, which have been successfully implemented for many other conditions to assist difficult decision-making. In this article, we summarize the purposes of SDM, the derivation of DAs, and their potential application in neurocritical care.

  2. LG based decision aid for naval tactical action officer's (TAO) workstation

    NASA Astrophysics Data System (ADS)

    Stilman, Boris; Yakhnis, Vladimir; Umanskiy, Oleg; Boyd, Ron

    2005-05-01

    In the increasingly NetCentric battlespace of the 21st century, Stilman Advanced Strategies Linguistic Geometry software has the potential to revolutionize the way that the Navy fights in two key areas: as a Tactical Decision Aid and for creating a relevant Common Operating Picture. Incorporating STILMAN's software into a prototype Tactical Action Officers (TAO) workstation as a Tactical Decision Aid (TDA) will allow warfighters to manage their assets more intelligently and effectively. This prototype workstation will be developed using human-centered design principles and will be an open, component-based architecture for combat control systems for future small surface combatants. It will integrate both uninhabited vehicles and onboard sensors and weapon systems across a squadron of small surface combatants. In addition, the hypergame representation of complex operations provides a paradigm for the presentation of a common operating picture to operators and personnel throughout the command hierarchy. In the hypergame technology there are game levels that span the range from the tactical to the global strategy level, with each level informing the others. This same principle will be applied to presenting the relevant common operating picture to operators. Each operator will receive a common operating picture that is appropriate for their level in the command hierarchy. The area covered by this operating picture and the level of detail contained within it will be dependent upon the specific tasks the operator is performing (supervisory vice tactical control) and the level of the operator (or command personnel) within the command hierarchy. Each level will inform the others to keep the picture concurrent and up-to-date.

  3. Stakeholder views of management and decision support tools to integrate climate change into Great Lakes Lake Whitefish management

    USGS Publications Warehouse

    Lynch, Abigail J.; Taylor, William W.; McCright, Aaron M.

    2016-01-01

    Decision support tools can aid decision making by systematically incorporating information, accounting for uncertainties, and facilitating evaluation between alternatives. Without user buy-in, however, decision support tools can fail to influence decision-making processes. We surveyed fishery researchers, managers, and fishers affiliated with the Lake Whitefish Coregonus clupeaformis fishery in the 1836 Treaty Waters of Lakes Huron, Michigan, and Superior to assess opinions of current and future management needs to identify barriers to, and opportunities for, developing a decision support tool based on Lake Whitefish recruitment projections with climate change. Approximately 64% of 39 respondents were satisfied with current management, and nearly 85% agreed that science was well integrated into management programs. Though decision support tools can facilitate science integration into management, respondents suggest that they face significant implementation barriers, including lack of political will to change management and perceived uncertainty in decision support outputs. Recommendations from this survey can inform development of decision support tools for fishery management in the Great Lakes and other regions.

  4. Contribution of systematic reviews to management decisions.

    PubMed

    Cook, Carly N; Possingham, Hugh P; Fuller, Richard A

    2013-10-01

    Systematic reviews comprehensively summarize evidence about the effectiveness of conservation interventions. We investigated the contribution to management decisions made by this growing body of literature. We identified 43 systematic reviews of conservation evidence, 23 of which drew some concrete conclusions relevant to management. Most reviews addressed conservation interventions relevant to policy decisions; only 35% considered practical on-the-ground management interventions. The majority of reviews covered only a small fraction of the geographic and taxonomic breadth they aimed to address (median = 13% of relevant countries and 16% of relevant taxa). The likelihood that reviews contained at least some implications for management tended to increase as geographic coverage increased and to decline as taxonomic breadth increased. These results suggest the breadth of a systematic review requires careful consideration. Reviews identified a mean of 312 relevant primary studies but excluded 88% of these because of deficiencies in design or a failure to meet other inclusion criteria. Reviews summarized on average 284 data sets and 112 years of research activity, yet the likelihood that their results had at least some implications for management did not increase as the amount of primary research summarized increased. In some cases, conclusions were elusive despite the inclusion of hundreds of data sets and years of cumulative research activity. Systematic reviews are an important part of the conservation decision making tool kit, although we believe the benefits of systematic reviews could be significantly enhanced by increasing the number of reviews focused on questions of direct relevance to on-the-ground managers; defining a more focused geographic and taxonomic breadth that better reflects available data; including a broader range of evidence types; and appraising the cost-effectiveness of interventions.

  5. Forecasting for Computer Aided Career Decisions: Prospects and Procedures.

    ERIC Educational Resources Information Center

    Durstine, Richard M.

    This paper is the second step in the preparation of forecasts of occupational and industrial information which will meet the needs of the Information System for Vocational Decisions (ISVD). The author discusses the computation routines which need to be developed, tested and operationalized toward the goal of combining occupational and industrial…

  6. 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.

  7. 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.

  8. 43 CFR 4190.1 - Effect of wildfire management decisions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Effect of wildfire management decisions... ALASKA Effect of Wildfire Management Decisions § 4190.1 Effect of wildfire management decisions. (a... on the public lands are at substantial risk of wildfire due to drought, fuels buildup, or...

  9. 43 CFR 4190.1 - Effect of wildfire management decisions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Effect of wildfire management decisions... ALASKA Effect of Wildfire Management Decisions § 4190.1 Effect of wildfire management decisions. (a... on the public lands are at substantial risk of wildfire due to drought, fuels buildup, or...

  10. 43 CFR 4190.1 - Effect of wildfire management decisions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Effect of wildfire management decisions... ALASKA Effect of Wildfire Management Decisions § 4190.1 Effect of wildfire management decisions. (a... on the public lands are at substantial risk of wildfire due to drought, fuels buildup, or...

  11. 43 CFR 4190.1 - Effect of wildfire management decisions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Effect of wildfire management decisions... ALASKA Effect of Wildfire Management Decisions § 4190.1 Effect of wildfire management decisions. (a... on the public lands are at substantial risk of wildfire due to drought, fuels buildup, or...

  12. 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

  13. Warfighter Associate: Decision Aiding and Metrics for Mission Command

    DTIC Science & Technology

    2012-01-23

    planning and in execution, and in determining the best means for error correction. • Agile Development of Knowledge . The underlying knowledge can...experimentation plan focuses on providing decision-support to three of those individuals: S3 (maneuver), S2 (intel), and FSO (fires) Top 20% Laboratory...I n meline " Refresh FSO 12-03-201111:59:48 - ongoing Active Activity Based P ... • lnstanceld: Demonstration Concept Current Commonality Slider

  14. Balancing emotion and cognition: a case for decision aiding in conservation efforts.

    PubMed

    Wilson, Robyn S

    2008-12-01

    Despite advances in the quality of participatory decision making for conservation, many current efforts still suffer from an inability to bridge the gap between science and policy. Judgment and decision-making research suggests this gap may result from a person's reliance on affect-based shortcuts in complex decision contexts. I examined the results from 3 experiments that demonstrate how affect (i.e., the instantaneous reaction one has to a stimulus) influences individual judgments in these contexts and identified techniques from the decision-aiding literature that help encourage a balance between affect-based emotion and cognition in complex decision processes. In the first study, subjects displayed a lack of focus on their stated conservation objectives and made decisions that reflected their initial affective impressions. Value-focused approaches may help individuals incorporate all the decision-relevant objectives by making the technical and value-based objectives more salient. In the second study, subjects displayed a lack of focus on statistical risk and again made affect-based decisions. Trade-off techniques may help individuals incorporate relevant technical data, even when it conflicts with their initial affective impressions or other value-based objectives. In the third study, subjects displayed a lack of trust in decision-making authorities when the decision involved a negatively affect-rich outcome (i.e., a loss). Identifying shared salient values and increasing procedural fairness may help build social trust in both decision-making authorities and the decision process.

  15. Stakeholder engagement in dredged material management decisions.

    PubMed

    Collier, Zachary A; Bates, Matthew E; Wood, Matthew D; Linkov, Igor

    2014-10-15

    Dredging and disposal issues often become controversial with local stakeholders because of their competing interests. These interests tend to manifest themselves in stakeholders holding onto entrenched positions, and deadlock can result without a methodology to move the stakeholder group past the status quo. However, these situations can be represented as multi-stakeholder, multi-criteria decision problems. In this paper, we describe a case study in which multi-criteria decision analysis was implemented in a multi-stakeholder setting in order to generate recommendations on dredged material placement for Long Island Sound's Dredged Material Management Plan. A working-group of representatives from various stakeholder organizations was formed and consulted to help prioritize sediment placement sites for each dredging center in the region by collaboratively building a multi-criteria decision model. The resulting model framed the problem as several alternatives, criteria, sub-criteria, and metrics relevant to stakeholder interests in the Long Island Sound region. An elicitation of values, represented as criteria weights, was then conducted. Results show that in general, stakeholders tended to agree that all criteria were at least somewhat important, and on average there was strong agreement on the order of preferences among the diverse groups of stakeholders. By developing the decision model iteratively with stakeholders as a group and soliciting their preferences, the process sought to increase stakeholder involvement at the front-end of the prioritization process and lead to increased knowledge and consensus regarding the importance of site-specific criteria.

  16. Supporting Shared Decision-making for Children's Complex Behavioral Problems: Development and User Testing of an Option Grid™ Decision Aid.

    PubMed

    Barnett, Erin R; Boucher, Elizabeth A; Daviss, William B; Elwyn, Glyn

    2017-04-11

    There is a lack of research to guide collaborative treatment decision-making for children who have complex behavioral problems, despite the extensive use of mental health services in this population. We developed and pilot-tested a one-page Option Grid™ patient decision aid to facilitate shared decision-making for these situations. An editorial team of parents, child psychiatrists, researchers, and other stakeholders developed the scope and structure of the decision aid. Researchers included information about a carefully chosen number of psychosocial and pharmacological treatment options, using descriptions based on the best available evidence. Using semi-structured qualitative interviews (n = 18), we conducted user testing with four parents and four clinical prescribers and field testing with four parents, four clinical prescribers, and two clinic administrators. The researchers coded and synthesized the interview responses using mixed inductive and deductive methods. Parents, clinicians, and administrators felt the Option Grid had significant value, although they reported that additional training and other support would be required in order to successfully implement the Option Grid and achieve shared decision-making in clinical practice.

  17. Selecting a risk-based tool to aid in decision making

    SciTech Connect

    Bendure, A.O.

    1995-03-01

    Selecting a risk-based tool to aid in decision making is as much of a challenge as properly using the tool once it has been selected. Failure to consider customer and stakeholder requirements and the technical bases and differences in risk-based decision making tools will produce confounding and/or politically unacceptable results when the tool is used. Selecting a risk-based decisionmaking tool must therefore be undertaken with the same, if not greater, rigor than the use of the tool once it is selected. This paper presents a process for selecting a risk-based tool appropriate to a set of prioritization or resource allocation tasks, discusses the results of applying the process to four risk-based decision-making tools, and identifies the ``musts`` for successful selection and implementation of a risk-based tool to aid in decision making.

  18. Computer Aided Management for Information Processing Projects.

    ERIC Educational Resources Information Center

    Akman, Ibrahim; Kocamustafaogullari, Kemal

    1995-01-01

    Outlines the nature of information processing projects and discusses some project management programming packages. Describes an in-house interface program developed to utilize a selected project management package (TIMELINE) by using Oracle Data Base Management System tools and Pascal programming language for the management of information system…

  19. 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.

  20. 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.

  1. Involving staff pharmacists in management decisions.

    PubMed

    Robinson, L A; Vanderveen, T W

    1977-03-01

    Various administrative techniques used to bring staff pharmacists in a decentralized, satellite pharmacy system into the managerial decision-making process are discussed. These techniques include a staff pharmacist on-call procedure to discourage absenteeism, and the concept of a head pharmacist to serve as a link with departmental administration. The head pharmacist works in the satelite pharmacy, is responsible for its daily operation and is the spokesman for the satellite. Active roles for the head pharmacist in the selection and evaluation of technicians are outlines. Management skills are developed in head pharmacists through a program of special classes and discussion groups. It is concluded that this program has improved the credibility of administrative decisions and has tapped an underused source of ideas and talent.

  2. 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.

  3. Structured decision making for managing pneumonia epizootics in bighorn sheep

    USGS Publications Warehouse

    Sells, Sarah N.; Mitchell, Michael S.; Edwards, Victoria L.; Gude, Justin A.; Anderson, Neil J.

    2016-01-01

    Good decision-making is essential to conserving wildlife populations. Although there may be multiple ways to address a problem, perfect solutions rarely exist. Managers are therefore tasked with identifying decisions that will best achieve desired outcomes. Structured decision making (SDM) is a method of decision analysis used to identify the most effective, efficient, and realistic decisions while accounting for values and priorities of the decision maker. The stepwise process includes identifying the management problem, defining objectives for solving the problem, developing alternative approaches to achieve the objectives, and formally evaluating which alternative is most likely to accomplish the objectives. The SDM process can be more effective than informal decision-making because it provides a transparent way to quantitatively evaluate decisions for addressing multiple management objectives while incorporating science, uncertainty, and risk tolerance. To illustrate the application of this process to a management need, we present an SDM-based decision tool developed to identify optimal decisions for proactively managing risk of pneumonia epizootics in bighorn sheep (Ovis canadensis) in Montana. Pneumonia epizootics are a major challenge for managers due to long-term impacts to herds, epistemic uncertainty in timing and location of future epizootics, and consequent difficulty knowing how or when to manage risk. The decision tool facilitates analysis of alternative decisions for how to manage herds based on predictions from a risk model, herd-specific objectives, and predicted costs and benefits of each alternative. Decision analyses for 2 example herds revealed that meeting management objectives necessitates specific approaches unique to each herd. The analyses showed how and under what circumstances the alternatives are optimal compared to other approaches and current management. Managers can be confident that these decisions are effective, efficient, and

  4. Public involvement in radioactive waste management decisions

    SciTech Connect

    1994-04-01

    Current repository siting efforts focus on Yucca Mountain, Nevada, where DOE`s Office of Civilian Radioactive Waste Management (OCRWM) is conducting exploratory studies to determine if the site is suitable. The state of Nevada has resisted these efforts: it has denied permits, brought suit against DOE, and publicly denounced the federal government`s decision to study Yucca Mountain. The state`s opposition reflects public opinion in Nevada, and has considerably slowed DOE`s progress in studying the site. The Yucca Mountain controversy demonstrates the importance of understanding public attitudes and their potential influence as DOE develops a program to manage radioactive waste. The strength and nature of Nevada`s opposition -- its ability to thwart if not outright derail DOE`s activities -- indicate a need to develop alternative methods for making decisions that affect the public. This report analyzes public participation as a key component of this openness, one that provides a means of garnering acceptance of, or reducing public opposition to, DOE`s radioactive waste management activities, including facility siting and transportation. The first section, Public Perceptions: Attitudes, Trust, and Theory, reviews the risk-perception literature to identify how the public perceives the risks associated with radioactivity. DOE and the Public discusses DOE`s low level of credibility among the general public as the product, in part, of the department`s past actions. This section looks at the three components of the radioactive waste management program -- disposal, storage, and transportation -- and the different ways DOE has approached the problem of public confidence in each case. Midwestern Radioactive Waste Management Histories focuses on selected Midwestern facility-siting and transportation activities involving radioactive materials.

  5. 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…

  6. Computer-aided decision support systems for endoscopy in the gastrointestinal tract: a review.

    PubMed

    Liedlgruber, Michael; Uhl, Andreas

    2011-01-01

    Today, medical endoscopy is a widely used procedure to inspect the inner cavities of the human body. The advent of endoscopic imaging techniques-allowing the acquisition of images or videos-created the possibility for the development of the whole new branch of computer-aided decision support systems. Such systems aim at helping physicians to identify possibly malignant abnormalities more accurately. At the beginning of this paper, we give a brief introduction to the history of endoscopy, followed by introducing the main types of endoscopes which emerged so far (flexible endoscope, wireless capsule endoscope, and confocal laser endomicroscope). We then give a brief introduction to computer-aided decision support systems specifically targeted at endoscopy in the gastrointestinal tract. Then we present general facts and figures concerning computer-aided decision support systems and summarize work specifically targeted at computer-aided decision support in the gastrointestinal tract. This summary is followed by a discussion of some common issues concerning the approaches reviewed and suggestions of possible ways to resolve them.

  7. Biomedical informatics for computer-aided decision support systems: a survey.

    PubMed

    Belle, Ashwin; Kon, Mark A; Najarian, Kayvan

    2013-01-01

    The volumes of current patient data as well as their complexity make clinical decision making more challenging than ever for physicians and other care givers. This situation calls for the use of biomedical informatics methods to process data and form recommendations and/or predictions to assist such decision makers. The design, implementation, and use of biomedical informatics systems in the form of computer-aided decision support have become essential and widely used over the last two decades. This paper provides a brief review of such systems, their application protocols and methodologies, and the future challenges and directions they suggest.

  8. Biomedical Informatics for Computer-Aided Decision Support Systems: A Survey

    PubMed Central

    Belle, Ashwin; Kon, Mark A.; Najarian, Kayvan

    2013-01-01

    The volumes of current patient data as well as their complexity make clinical decision making more challenging than ever for physicians and other care givers. This situation calls for the use of biomedical informatics methods to process data and form recommendations and/or predictions to assist such decision makers. The design, implementation, and use of biomedical informatics systems in the form of computer-aided decision support have become essential and widely used over the last two decades. This paper provides a brief review of such systems, their application protocols and methodologies, and the future challenges and directions they suggest. PMID:23431259

  9. UK: AIDS treatment main factor in decision to grant permission to appeal immigration decision.

    PubMed

    Gold, Jennifer

    2003-12-01

    On 26 June 2003, the England and Wales Court of Appeal (Civil Division) granted an application for leave to appeal a decision of the Immigration Appeal Tribunal, which had overturned an adjudicator's decision to allow an HIV-positive citizen of Uganda to immigrate to the United Kingdom (UK).

  10. 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.

  11. Applications of a simulation model to decisions in mallard management

    USGS Publications Warehouse

    Cowardin, L.M.; Johnson, D.H.; Shaffer, T.L.; Sparling, D.W.

    1988-01-01

    A system comprising simulation models and data bases for habitat availability and nest success rates was used to predict results from a mallard (Anas platyrhynchos) management plan and to compare six management methods with a control. Individual treatments in the applications included land purchase for waterfowl production, wetland easement purchase, lease of uplands for waterfowl management, cropland retirement, use of no-till winter wheat, delayed cutting of alfalfa, installation of nest baskets, nesting island construction, and use of predator-resistant fencing.The simulations predicted that implementation of the management plan would increase recruits by 24%. Nest baskets were the most effective treatment, accounting for 20.4% of the recruits. No-till winter wheat was the second most effective, accounting for 5.9% of the recruits. Wetland loss due to drainage would cause an 11% loss of breeding population in 10 years.The models were modified to account for migrational homing. The modification indicated that migrational homing would enhance the effects of management. Nest success rates were critical contributions to individual management methods. The most effective treatments, such as nest baskets, had high success rates and affected a large portion of the breeding population.Economic analyses indicated that nest baskets would be the most economical of the three techniques tested. The applications indicated that the system is a useful tool to aid management decisions, but data are scarce for several important variables. Basic research will be required to adequately model the effect of migrational homing and density dependence on production. The comprehensive nature of predictions desired by managers will also require that production models like the one described here be extended to encompass the entire annual cycle of waterfowl.

  12. Early Commitment on Financial Aid and College Decision Making of Poor Students: Evidence from a Randomized Evaluation in Rural China

    ERIC Educational Resources Information Center

    Liu, Chengfang; Zhang, Linxiu; Luo, Renfu; Wang, Xiaobing; Rozelle, Scott; Sharbono, Brian; Adams, Jennifer; Shi, Yaojiang; Yue, Ai; Li, Hongbin; Glauben, Thomas

    2011-01-01

    Many educational systems have struggled with the question about how best to give out financial aid. In particular, if students do not know the amount of financial aid that they can receive before they make a decision about where to go to college and what major to study, it may distort their decision. This study utilizes an experiment (implemented…

  13. Diverter AI based decision aid, phases 1 and 2

    NASA Technical Reports Server (NTRS)

    Sexton, George A.; Bayles, Scott J.; Patterson, Robert W.; Schulke, Duane A.; Williams, Deborah C.

    1989-01-01

    It was determined that a system to incorporate artificial intelligence (AI) into airborne flight management computers is feasible. The AI functions that would be most useful to the pilot are to perform situational assessment, evaluate outside influences on the contemplated rerouting, perform flight planning/replanning, and perform maneuver planning. A study of the software architecture and software tools capable of demonstrating Diverter was also made. A skeletal planner known as the Knowledge Acquisition Development Tool (KADET), which is a combination script-based and rule-based system, was used to implement the system. A prototype system was developed which demonstrates advanced in-flight planning/replanning capabilities.

  14. 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

  15. Using decision aids in community-based primary care: A theory-driven evaluation with ethnically diverse patients

    PubMed Central

    Frosch, Dominick L.; Légaré, France; Mangione, Carol M.

    2010-01-01

    Objective To assess the effects of informational brochures and video decision aids about cancer screening on patient intention to engage in shared decision making and its predictors in a racially diverse sample. Methods Participants were recruited from 13 community-based primary care practices serving racially and ethnically diverse patients in predominately economically disadvantaged neighborhoods. Participants completed theory-based measures assessing attitudes, perceived social norms, self-efficacy and intentions for working with their physician to make a cancer screening decision after reviewing a brochure or video decision aid, but before seeing the physician. A post-questionnaire assessed screening decisions and participant knowledge. Results Participants who reviewed a video decision aid had higher knowledge and were more likely to want to be the primary decision-maker. They reported lower perceived social norms, self-efficacy and intentions to work with their physicians than participants who reviewed a brochure. Participants who decided against cancer screening reported lower intentions to work with their physician in making a decision and were less likely to report having spoken with their physician about screening. Conclusion Participants who opted against cancer screening after reviewing a brochure or decision aid were less likely to discuss their decision with their physician. The tendency toward autonomous decision-making was stronger among participants who reviewed a video decision aid. PMID:18771875

  16. The Use of Computer-Aided Decision Support Systems for Complex Source Selection Decisions

    DTIC Science & Technology

    1989-09-01

    making processes under which virtually all decisions can be categorized. Optimizing. To optimize is to make the best possible decision under the... community ; 45 AFIT students may not be a representative sample. A subjective case may be made, however, that these subjects were relatively typical...career paths of the population studied, compared with that which apparently exists in the acquisition community . Discussion of Variables Major Constructs

  17. 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.

  18. Employees' perceptions of the Aid-for-AIDS disease-management programme, South Africa.

    PubMed

    Rothberg, Alan; Van Huyssteen, Karen

    2008-11-01

    It is estimated that 18-20% of South Africa's more than 5 million HIV-positive individuals are formally employed. Disease management programmes for these employees vary in scope and sophistication, with services provided by the employer, or third-party specialist disease managers, or through medical aid schemes. This study surveyed 215 HIV-positive employees in two organisations contracted to the Aid for AIDS (AfA) disease management programme through their in-house medical aid schemes. The two organisations differed in their overall approach to HIV and AIDS: one mainly relies on on-site access to voluntary counselling and testing (VCT) and AfA's management of registered HIV-positive employees, while the other has invested in and actively developed a comprehensive programme that also extends to families and the community as well as links employees to the AfA programme. Responses received from 28 of the 215 employees surveyed indicate that fear of disclosure of one's HIV status and of stigmatisation are reasons for late registration with the AfA programme or non-utilisation of other available support programmes. Respondents mentioned that confidence in the employer's ability to maintain confidentiality was also an issue. Respondents' important suggestions for change included: a) on-site educational and awareness programmes for management personnel and staff in order to reduce HIV discrimination and stigmatisation; b) information directed at HIV-positive employees publicising the benefits and effectiveness of medical treatment; c) support groups for HIV-positive employees; and d) management personnel to engage with HIV-infected employees who are willing to take an active role in staff education and the development of workplace policies and programmes.

  19. Federal Student Aid Handbook, 2006-2007. Volume 4: Processing Aid & Managing FSA Funds

    ERIC Educational Resources Information Center

    US Department of Education, 2006

    2006-01-01

    The purpose of this publication is to provide participating schools with guidance on how to request, disburse, manage, and report on the use of Federal Student Aid funds. A summary of the changes and clarifications is presented in greater detail in the chapters that are contained in this volume: Chapter 1, The MPN (Master Promissory Note) and the…

  20. A novel sustainable decision making model for municipal solid waste management

    SciTech Connect

    Hung, M.-L. . E-mail: d89541004@ntu.edu.tw; Ma Hwongwen . E-mail: hwma@ntu.edu.tw; Yang, W.-F. . E-mail: wfyang@ntu.edu.tw

    2007-07-01

    This paper reviews several models developed to support decision making in municipal solid waste management (MSWM). The concepts underlying sustainable MSWM models can be divided into two categories: one incorporates social factors into decision making methods, and the other includes public participation in the decision-making process. The public is only apprised or takes part in discussion, and has little effect on decision making in most research efforts. Few studies have considered public participation in the decision-making process, and the methods have sought to strike a compromise between concerned criteria, not between stakeholders. However, the source of the conflict arises from the stakeholders' complex web of value. Such conflict affects the feasibility of implementing any decision. The purpose of this study is to develop a sustainable decision making model for MSWM to overcome these shortcomings. The proposed model combines multicriteria decision making (MCDM) and a consensus analysis model (CAM). The CAM is built up to aid in decision-making when MCDM methods are utilized and, subsequently, a novel sustainable decision making model for MSWM is developed. The main feature of CAM is the assessment of the degree of consensus between stakeholders for particular alternatives. A case study for food waste management in Taiwan is presented to demonstrate the practicality of this model.

  1. Development and pilot testing of a decision aid for men considering genetic testing for breast and/or ovarian cancer-related mutations (BRCA1/2).

    PubMed

    Juan, Anne S; Wakefield, Claire E; Kasparian, Nadine A; Kirk, Judy; Tyler, Janet; Tucker, Kathy

    2008-12-01

    Despite the fact that both men and women can carry a breast/ovarian cancer-related mutation, the main emphasis in genetic counseling for breast/ovarian cancer-related risk remains on females. This study aimed to develop and pilot a decision aid specifically designed for men with a strong family history of breast and/or ovarian cancer who are considering genetic testing. The decision aid was developed by a multidisciplinary team of experts and a consumer representative. It was then reviewed by 27 men who had previously undergone genetic testing to identify a mutation in a BRCA1 or BRCA2 gene. All men who reviewed the decision aid indicated that they would recommend the booklet to other men in the same situation, and 96% of the sample (n = 26) reported being "very satisfied" or "satisfied" with the information contained in the decision aid. The decision aid was perceived by all participants as "very relevant" or "quite relevant" for men considering genetic testing. Ninety-three percent of men felt that it was easy to weigh the pros and cons of genetic testing with the help of the decision aid. The perceived impact on participants' emotions and understanding of the genetic testing process was also assessed. Several factors may hinder men from effectively weighing up the potential benefits and risks of genetic testing. A greater understanding of these issues may help health professionals to encourage men with a strong family history of breast and/or ovarian cancer to learn about cancer risk and the appropriate management strategies for themselves and their female relatives.

  2. Software Schedules Missions, Aids Project Management

    NASA Technical Reports Server (NTRS)

    2008-01-01

    NASA missions require advanced planning, scheduling, and management, and the Space Agency has worked extensively to develop the programs and software suites necessary to facilitate these complex missions. These enormously intricate undertakings have hundreds of active components that need constant management and monitoring. It is no surprise, then, that the software developed for these tasks is often applicable in other high-stress, complex environments, like in government or industrial settings. NASA work over the past few years has resulted in a handful of new scheduling, knowledge-management, and research tools developed under contract with one of NASA s partners. These tools have the unique responsibility of supporting NASA missions, but they are also finding uses outside of the Space Program.

  3. Bibliometrics: a potential decision making aid in hiring, reappointment, tenure and promotion decisions.

    PubMed

    Holden, Gary; Rosenberg, Gary; Barker, Kathleen

    2005-01-01

    The assessment of scholarship assumes a central role in the evaluation of individual faculty, educational programs and academic fields. Because the production and assessment of scholarship is so central to the faculty role, it is incumbent upon decision makers to strive to make assessments of scholarship fair and equitable. This paper will focus on an approach to the assessment of the quantity and impact of the most important subset of an individual's scholarship-peer-reviewed journal articles. The primary goal of this paper is to stimulate discussion regarding scholarship assessment in hiring, reappointment, tenure and promotion decisions.

  4. Development and commissioning of decision support tools for sewerage management.

    PubMed

    Manic, G; Printemps, C; Zug, M; Lemoine, C

    2006-01-01

    Managing sewerage systems is a highly complex task due to the dynamic nature of the facilities. Their performance strongly depends on the know-how applied by the operators. In order to define optimal operational settings, two decision support tools based on mathematical models have been developed. Moreover, easy-to-use interfaces have been created as well, aiding operators who presumably do not have the necessary skills to use modelling software. The two developed programs simulate the behaviour of both wastewater treatment plants (WWTP) and sewer network systems, respectively. They have essentially the same structure, including raw data management and statistical analysis, a simulation layer using the application programming interface of the applied software and a layer responsible for the representation of the obtained results. Four user modes are provided in the two software including the simulation of historical data using the applied and novel operational settings, as well as modes concerning prediction of possible operation periods and updates. Concerning the WWTP software, it was successfully installed in Nantes (France) in June 2004. Moreover, the one managing sewer networks has been deployed in Saint-Malo (France) in January 2005. This paper presents the structure of the developed software and the first results obtained during the commissioning phase.

  5. 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

  6. Decision Support System for ASD (Aeronatical Systems Division) Program Managers.

    DTIC Science & Technology

    1985-09-01

    quality of the decision depends on the depth of the program manager’s analysis . Recently, management has attempted to use the support of others to make...knowledge of system analysis and management techniques. 4. Program Managers will have access to the developed deci- sion support system. Definitions...the depth of the Progr a Managers analysis . A decision is more apt to be correct if the depth of analysis is increased (21:a-8). The depth of analysis

  7. WESVA: A decision aid for comparing warhead advanced surety R&D options

    SciTech Connect

    Homsy, R.V.; Sicherman, A.; Stephens, D.R.

    1993-10-01

    Newly designed warheads that incorporate advanced surety concepts can reduce the risks of accidental radiological material dispersal, nuclear detonation, and unauthorized use. But these potential surety benefits entail cost and performance penalties. Present constraints on R&D budgets, time, and allowable nuclear tests also create significant uncertainties as to whether new concepts can be successfully developed and implemented. These factors complicate the decisions involved in selecting surety concepts for more extensive R&D. To help decision makers compare R&D options, we developed a decision aid called Weapon Safety Value Assessment (WESVA). This paper describes WESVA and suggests how a WESVA-like approach can be of interest in other decision-making contexts.

  8. Web based collaborative decision making in flood risk management

    NASA Astrophysics Data System (ADS)

    Evers, Mariele; Almoradie, Adrian; Jonoski, Andreja

    2014-05-01

    Stakeholder participation in the development of flood risk management (FRM) plans is essential since stakeholders often have a better understanding or knowledge of the potentials and limitation of their local area. Moreover, a participatory approach also creates trust amongst stakeholders, leading to a successful implementation of measures. Stakeholder participation however has its challenges and potential pitfalls that could lead to its premature termination. Such challenges and pitfalls are the limitation of financial resources, stakeholders' spatial distribution and their interest to participate. Different type of participation in FRM may encounter diverse challenges. These types of participation in FRM can be classified into (1) Information and knowledge sharing (IKS), (2) Consultative participation (CP) or (3) Collaborative decision making (CDM)- the most challenging type of participation. An innovative approach to address these challenges and potential pitfalls is a web-based mobile or computer-aided environment for stakeholder participation. This enhances the remote interaction between participating entities such as stakeholders. This paper presents a developed framework and an implementation of CDM web based environment for the Alster catchment (Hamburg, Germany) and Cranbrook catchment (London, UK). The CDM framework consists of two main stages: (1) Collaborative modelling and (2) Participatory decision making. This paper also highlights the stakeholder analyses, modelling approach and application of General Public License (GPL) technologies in developing the web-based environments. Actual test and evaluation of the environments was through series of stakeholders workshops. The overall results based from stakeholders' evaluation shows that web-based environments can address the challenges and potential pitfalls in stakeholder participation and it enhances participation in flood risk management. The web-based environment was developed within the DIANE

  9. The impact of decision aids to enhance shared decision making for diabetes (the DAD study): protocol of a cluster randomized trial

    PubMed Central

    2012-01-01

    Background Shared decision making contributes to high quality healthcare by promoting a patient-centered approach. Patient involvement in selecting the components of a diabetes medication program that best match the patient’s values and preferences may also enhance medication adherence and improve outcomes. Decision aids are tools designed to involve patients in shared decision making, but their adoption in practice has been limited. In this study, we propose to obtain a preliminary estimate of the impact of patient decision aids vs. usual care on measures of patient involvement in decision making, diabetes care processes, medication adherence, glycemic and cardiovascular risk factor control, and resource utilization. In addition, we propose to identify, describe, and explain factors that promote or inhibit the routine embedding of decision aids in practice. Methods/Design We will be conducting a mixed-methods study comprised of a cluster-randomized, practical, multicentered trial enrolling clinicians and their patients (n = 240) with type 2 diabetes from rural and suburban primary care practices (n = 8), with an embedded qualitative study to examine factors that influence the incorporation of decision aids into routine practice. The intervention will consist of the use of a decision aid (Statin Choice and Aspirin Choice, or Diabetes Medication Choice) during the clinical encounter. The qualitative study will include analysis of video recordings of clinical encounters and in-depth, semi-structured interviews with participating patients, clinicians, and clinic support staff, in both trial arms. Discussion Upon completion of this trial, we will have new knowledge about the effectiveness of diabetes decision aids in these practices. We will also better understand the factors that promote or inhibit the successful implementation and normalization of medication choice decision aids in the care of chronic patients in primary care practices. Trial registration

  10. 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...

  11. 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

    2014-11-03

    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.

  12. Markov model aided decoding for image transmission using soft-decision-feedback.

    PubMed

    Link, R; Kallel, S

    2000-01-01

    Soft-decision-feedback MAP decoders are developed for joint source/channel decoding (JSCD) which uses the residual redundancy in two-dimensional sources. The source redundancy is described by a second order Markov model which is made available to the receiver for row-by-row decoding, wherein the output for one row is used to aid the decoding of the next row. Performance can be improved by generalizing so as to increase the vertical depth of the decoder. This is called sheet decoding, and entails generalizing trellis decoding of one-dimensional data to trellis decoding of two-dimensional data (2-D). The proposed soft-decision-feedback sheet decoder is based on the Bahl algorithm, and it is compared to a hard-decision-feedback sheet decoder which is based on the Viterbi algorithm. The method is applied to 3-bit DPCM picture transmission over a binary symmetric channel, and it is found that the soft-decision-feedback decoder with vertical depth V performs approximately as well as the hard-decision-feedback decoder with vertical depth V+1. Because the computational requirement of the decoders depends exponentially on the vertical depth, the soft-decision-feedbark decoder offers significant reduction in complexity. For standard monochrome Lena, at a channel bit error rate of 0.05, the V=1 and V=2 soft-decision-feedback decoder JSCD gains in RSNR are 5.0 and 6.3 dB, respectively.

  13. 43 CFR 5003.2 - Notice of forest management decisions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... forest management shall be implemented through the publication of a notice of decision in a newspaper of... effective date of the decision. The notice in the newspaper shall reference 43 CFR subpart 5003—Administrative remedies. (b) When a decision is made to conduct an advertised timber sale, the notice of...

  14. 43 CFR 5003.2 - Notice of forest management decisions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... forest management shall be implemented through the publication of a notice of decision in a newspaper of... effective date of the decision. The notice in the newspaper shall reference 43 CFR subpart 5003—Administrative remedies. (b) When a decision is made to conduct an advertised timber sale, the notice of...

  15. 43 CFR 5003.2 - Notice of forest management decisions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... forest management shall be implemented through the publication of a notice of decision in a newspaper of... effective date of the decision. The notice in the newspaper shall reference 43 CFR subpart 5003—Administrative remedies. (b) When a decision is made to conduct an advertised timber sale, the notice of...

  16. 43 CFR 5003.2 - Notice of forest management decisions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... forest management shall be implemented through the publication of a notice of decision in a newspaper of... effective date of the decision. The notice in the newspaper shall reference 43 CFR subpart 5003—Administrative remedies. (b) When a decision is made to conduct an advertised timber sale, the notice of...

  17. Integrated Traffic Flow Management Decision Making

    NASA Technical Reports Server (NTRS)

    Grabbe, Shon R.; Sridhar, Banavar; Mukherjee, Avijit

    2009-01-01

    A generalized approach is proposed to support integrated traffic flow management decision making studies at both the U.S. national and regional levels. It can consider tradeoffs between alternative optimization and heuristic based models, strategic versus tactical flight controls, and system versus fleet preferences. Preliminary testing was accomplished by implementing thirteen unique traffic flow management models, which included all of the key components of the system and conducting 85, six-hour fast-time simulation experiments. These experiments considered variations in the strategic planning look-ahead times, the replanning intervals, and the types of traffic flow management control strategies. Initial testing indicates that longer strategic planning look-ahead times and re-planning intervals result in steadily decreasing levels of sector congestion for a fixed delay level. This applies when accurate estimates of the air traffic demand, airport capacities and airspace capacities are available. In general, the distribution of the delays amongst the users was found to be most equitable when scheduling flights using a heuristic scheduling algorithm, such as ration-by-distance. On the other hand, equity was the worst when using scheduling algorithms that took into account the number of seats aboard each flight. Though the scheduling algorithms were effective at alleviating sector congestion, the tactical rerouting algorithm was the primary control for avoiding en route weather hazards. Finally, the modeled levels of sector congestion, the number of weather incursions, and the total system delays, were found to be in fair agreement with the values that were operationally observed on both good and bad weather days.

  18. DECISION SUPPORT FRAMEWORK FOR STORMWATER MANAGEMENT IN URBAN WATERSHEDS

    EPA Science Inventory

    To assist stormwater management professionals in planning for best management practices (BMPs) implementation, the U.S. Environmental Protection Agency (USEPA) is developing a decision support system for placement of BMPs at strategic locations in urban watersheds. This tool wil...

  19. Time Management and the Military Decision Making Process

    DTIC Science & Technology

    1992-12-18

    This monograph analyzes the military decision making process in terms of time management in order to determine if a timeline will expedite the...process. The monograph begins by establishing the importance of time and time management in planning. This section provides a general discussion of time, an...Perhaps using some of the techniques that other armies use will facilitate time management .... Time management , Decision making, Timeline, Mission analysis, Wargaming, Courses of action, OPORD, Brigade OPS.

  20. 43 CFR 4.416 - Appeals of wildfire management decisions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Appeals of wildfire management decisions. 4.416 Section 4.416 Public Lands: Interior Office of the Secretary of the Interior DEPARTMENT... Board of Land Appeals § 4.416 Appeals of wildfire management decisions. The Board must decide...

  1. 43 CFR 4.416 - Appeals of wildfire management decisions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Appeals of wildfire management decisions. 4.416 Section 4.416 Public Lands: Interior Office of the Secretary of the Interior DEPARTMENT HEARINGS... Board of Land Appeals § 4.416 Appeals of wildfire management decisions. The Board must decide...

  2. 43 CFR 4.416 - Appeals of wildfire management decisions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Appeals of wildfire management decisions. 4.416 Section 4.416 Public Lands: Interior Office of the Secretary of the Interior DEPARTMENT... Board of Land Appeals § 4.416 Appeals of wildfire management decisions. The Board must decide...

  3. 43 CFR 4.416 - Appeals of wildfire management decisions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Appeals of wildfire management decisions. 4.416 Section 4.416 Public Lands: Interior Office of the Secretary of the Interior DEPARTMENT... Board of Land Appeals § 4.416 Appeals of wildfire management decisions. The Board must decide...

  4. 43 CFR 4.416 - Appeals of wildfire management decisions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Appeals of wildfire management decisions. 4.416 Section 4.416 Public Lands: Interior Office of the Secretary of the Interior DEPARTMENT... Board of Land Appeals § 4.416 Appeals of wildfire management decisions. The Board must decide...

  5. Development of Asset Management Decision Support Tools for Power Equipment

    NASA Astrophysics Data System (ADS)

    Okamoto, Tatsuki; Takahashi, Tsuguhiro

    Development of asset management decision support tools become very intensive in order to reduce maintenance cost of power equipment due to the liberalization of power business. This article reviews some aspects of present status of asset management decision support tools development for power equipment based on the papers published in international conferences, domestic conventions, and several journals.

  6. Structuring decisions for managing threatened and endangered species in a changing climate.

    PubMed

    Gregory, Robin; Arvai, Joseph; Gerber, Leah R

    2013-12-01

    The management of endangered species under climate change is a challenging and often controversial task that incorporates input from a variety of different environmental, economic, social, and political interests. Yet many listing and recovery decisions for endangered species unfold on an ad hoc basis without reference to decision-aiding approaches that can improve the quality of management choices. Unlike many treatments of this issue, which consider endangered species management a science-based problem, we suggest that a clear decision-making process is equally necessary. In the face of new threats due to climate change, managers' choices about endangered species require closely linked analyses and deliberations that identify key objectives and develop measurable attributes, generate and compare management alternatives, estimate expected consequences and key sources of uncertainty, and clarify trade-offs across different dimensions of value. Several recent cases of endangered species conservation decisions illustrate our proposed decision-focused approach, including Gulf of Maine Atlantic salmon (Salmo salar) recovery framework development, Cultus Lake sockeye salmon (Oncorhynchus nerka) management, and Upper Columbia River white sturgeon (Acipenser transmontanus) recovery planning. Estructuración de Decisiones para Manejar Especies Amenazadas y en Peligro en un Clima Cambiante.

  7. 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.

  8. Contribution of Systematic Reviews to Management Decisions

    PubMed Central

    COOK, CARLY N; POSSINGHAM, HUGH P; FULLER, RICHARD A

    2014-01-01

    Systematic reviews comprehensively summarize evidence about the effectiveness of conservation interventions. We investigated the contribution to management decisions made by this growing body of literature. We identified 43 systematic reviews of conservation evidence, 23 of which drew some concrete conclusions relevant to management. Most reviews addressed conservation interventions relevant to policy decisions; only 35% considered practical on-the-ground management interventions. The majority of reviews covered only a small fraction of the geographic and taxonomic breadth they aimed to address (median = 13% of relevant countries and 16% of relevant taxa). The likelihood that reviews contained at least some implications for management tended to increase as geographic coverage increased and to decline as taxonomic breadth increased. These results suggest the breadth of a systematic review requires careful consideration. Reviews identified a mean of 312 relevant primary studies but excluded 88% of these because of deficiencies in design or a failure to meet other inclusion criteria. Reviews summarized on average 284 data sets and 112 years of research activity, yet the likelihood that their results had at least some implications for management did not increase as the amount of primary research summarized increased. In some cases, conclusions were elusive despite the inclusion of hundreds of data sets and years of cumulative research activity. Systematic reviews are an important part of the conservation decision making tool kit, although we believe the benefits of systematic reviews could be significantly enhanced by increasing the number of reviews focused on questions of direct relevance to on-the-ground managers; defining a more focused geographic and taxonomic breadth that better reflects available data; including a broader range of evidence types; and appraising the cost-effectiveness of interventions. Contribuciones de las Revisiones Sistemáticas a las

  9. 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…

  10. Design and development of a decision aid to enhance shared decision making by patients with an asymptomatic abdominal aortic aneurysm

    PubMed Central

    Ubbink, Dirk T; Knops, Anouk M; Molenaar, Sjaak; Goossens, Astrid

    2008-01-01

    Objective To design, develop, and evaluate an evidence-based decision aid (DA) for patients with an asymptomatic abdominal aortic aneurysm (AAA) to inform them about the pros and cons of their treatment options (ie, surgery or watchful observation) and to help them make a shared decision. Methods A multidisciplinary team defined criteria for the desired DA as to design, medical content and functionality, particularly for elderly users. Development was according to the international standard (IPDAS). Fifteen patients with an AAA, who were either treated or not yet treated, evaluated the tool. Results A DA was developed to offer information about the disease, the risks and benefits of surgical treatment and watchful observation, and the individual possibilities and threats based on the patient’s aneurysm diameter and risk profile. The DA was improved and judged favorably by physicians and patients. Conclusion This evidence-based DA for AAA patients, developed according to IPDAS criteria, is likely to be a simple, user-friendly tool to offer patients evidence-based information about the pros and cons of treatment options for AAA, to improve patients’ understanding of the disease and treatment options, and may support decision making based on individual values. PMID:19920978

  11. DeMAID/GA an Enhanced Design Manager's Aid for Intelligent Decomposition

    NASA Technical Reports Server (NTRS)

    Rogers, J. L.

    1996-01-01

    Many companies are looking for new tools and techniques to aid a design manager in making decisions that can reduce the time and cost of a design cycle. One tool is the Design Manager's Aid for Intelligent Decomposition (DeMAID). Since the initial public release of DeMAID in 1989, much research has been done in the areas of decomposition, concurrent engineering, parallel processing, and process management; many new tools and techniques have emerged. Based on these recent research and development efforts, numerous enhancements have been added to DeMAID to further aid the design manager in saving both cost and time in a design cycle. The key enhancement, a genetic algorithm (GA), will be available in the next public release called DeMAID/GA. The GA sequences the design processes to minimize the cost and time in converging a solution. The major enhancements in the upgrade of DeMAID to DeMAID/GA are discussed in this paper. A sample conceptual design project is used to show how these enhancements can be applied to improve the design cycle.

  12. Chlorophyll Meters Aid Plant Nutrient Management

    NASA Technical Reports Server (NTRS)

    2009-01-01

    On December 7, 1972, roughly 5 hours and 6 minutes after launch, the crew of Apollo 17 took one of history s most famous photographs. The brilliant image of the fully illuminated Earth, the African and Antarctic continents peering out from behind swirling clouds, came to be known as the Blue Marble. Today, Earth still sometimes goes by the Blue Marble nickname, but as the satellites comprising NASA s Earth Observing System (EOS) scan the planet daily in ever greater resolutions, it is often the amount of green on the planet that is a focus of researchers attention. Earth s over 400,000 known plant species play essential roles in the planet s health: They absorb carbon dioxide and release the oxygen we breathe, help manage the Earth s temperature by absorbing and reflecting sunlight, provide food and habitats for animals, and offer building materials, medication, and sustenance for humans. As part of NASA s efforts to study our own planet along with the universe around it, the Agency s EOS satellites have been accumulating years of valuable data about Earth s vegetation (not to mention its land features, oceans, and atmosphere) since the first EOS satellite launched in 1997. Among the powerful sensors used is the Moderate Resolution Imaging Spectroradiometer (MODIS) on board the NASA Terra and Aqua satellites. MODIS sweeps the entire Earth every few days, beaming back information gathered across 36 bands of visible and infrared light, yielding images that let scientists track how much of Earth is green over the course of seasons and years. Monitoring the density and distribution of vegetation on Earth provides a means of determining everything from the impact of natural and human-induced climate change to the potential outbreak of disease. (Goddard Space Flight Center and U.S. Department of Defense researchers have determined, for example, that vegetation density can be used to pinpoint regions of heavy rainfall in Africa regions ripe for outbreaks of rainfall

  13. Group decision-making techniques for natural resource management applications

    USGS Publications Warehouse

    Coughlan, Beth A.K.; Armour, Carl L.

    1992-01-01

    This report is an introduction to decision analysis and problem-solving techniques for professionals in natural resource management. Although these managers are often called upon to make complex decisions, their training in the natural sciences seldom provides exposure to the decision-making tools developed in management science. Our purpose is to being to fill this gap. We present a general analysis of the pitfalls of group problem solving, and suggestions for improved interactions followed by the specific techniques. Selected techniques are illustrated. The material is easy to understand and apply without previous training or excessive study and is applicable to natural resource management issues.

  14. 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.

  15. The use of multi-criteria decision analysis to tackle waste management problems: a literature review.

    PubMed

    Achillas, Charisios; Moussiopoulos, Nicolas; Karagiannidis, Avraam; Banias, Georgias; Perkoulidis, George

    2013-02-01

    Problems in waste management have become more and more complex during recent decades. The increasing volumes of waste produced and social environmental consciousness present prominent drivers for environmental managers towards the achievement of a sustainable waste management scheme. However, in practice, there are many factors and influences - often mutually conflicting - criteria for finding solutions in real-life applications. This paper presents a review of the literature on multi-criteria decision aiding in waste management problems for all reported waste streams. Despite limitations, which are clearly stated, most of the work published in this field is reviewed. The present review aims to provide environmental managers and decision-makers with a thorough list of practical applications of the multi-criteria decision analysis techniques that are used to solve real-life waste management problems, as well as the criteria that are mostly employed in such applications according to the nature of the problem under study. Moreover, the paper explores the advantages and disadvantages of using multi-criteria decision analysis techniques in waste management problems in comparison to other available alternatives.

  16. Use of the Diabetes Medication Choice Decision Aid in patients with type 2 diabetes in Greece: a cluster randomised trial

    PubMed Central

    Karagiannis, Thomas; Liakos, Aris; Branda, Megan E; Athanasiadou, Eleni; Mainou, Maria; Boura, Panagiota; Goulis, Dimitrios G; LeBlanc, Annie; Montori, Victor M

    2016-01-01

    Objective To assess the efficacy of the Diabetes Medication Choice Decision Aid among patients with type 2 diabetes in Greece. Design Open-label cluster randomised controlled trial. Setting Primary and secondary care practices across Greece. Participants 5 sites allocated to the decision aid (n=101 patients) and 4 sites to control (n=103 patients). Intervention Clinicians and patients in the intervention arm used a decision aid, based on outcomes that both consider important when choosing among antihyperglycaemic medications. Patients in the control arm received usual care. Outcome measures The primary outcome was patient's level of decisional comfort after the initial clinical encounter. Secondary outcomes included patient's knowledge about type 2 diabetes and medications, and patient's and clinician's satisfaction. Adherence to prescribed antihyperglycaemic medication and change in glycated haemoglobin were assessed at 24 weeks. Results Patients in both arms had similar scores in overall decisional comfort (mean difference between the usual care and decision aid arms −6.9, 95% CI −21.5 to 7.7) and its subscales. Patients' knowledge was high in both arms (mean difference 2.3%, 95% CI −15.7% to 20.4%). Patients and clinicians in both groups were equally satisfied with the decision-making. No significant difference in medication adherence and glycaemic control was found across arms. Clinicians found the decision aid useful and reported that its integration in their daily routine was easy. Conclusions The decision aid was implemented and positively received in the clinical setting in Greece, in line with the patient-centred approach endorsed by current guidelines. However, this trial yielded imprecise results in terms of patient outcomes. Further research is needed to investigate the interaction between the patient and the clinician in order to clarify the association between the use of decision aids and implementation of shared decision-making. Trial

  17. The Relationship between Graphic Aids in a Business Report and Decision-Making and Cognitive Style of a Report Reader.

    ERIC Educational Resources Information Center

    Brown, Paula E.

    1992-01-01

    Findings of three tests given to 267 undergraduates (Wonderlic Personnel Test, Group Embedded Figures Test, and a case problem in 4 formats) were that neither graphic aids alone nor cognitive style alone significantly affected decision making; and when graphic aids and cognitive style are considered in conjunction, cognitive style is responsible…

  18. Recent advances in applying decision science to managing national forests

    USGS Publications Warehouse

    Marcot, Bruce G.; Thompson, Matthew P.; Runge, Michael C.; Thompson, Frank R.; McNulty, Steven; Cleaves, David; Tomosy, Monica; Fisher, Larry A.; Andrew, Bliss

    2012-01-01

    Management of federal public forests to meet sustainability goals and multiple use regulations is an immense challenge. To succeed, we suggest use of formal decision science procedures and tools in the context of structured decision making (SDM). SDM entails four stages: problem structuring (framing the problem and defining objectives and evaluation criteria), problem analysis (defining alternatives, evaluating likely consequences, identifying key uncertainties, and analyzing tradeoffs), decision point (identifying the preferred alternative), and implementation and monitoring the preferred alternative with adaptive management feedbacks. We list a wide array of models, techniques, and tools available for each stage, and provide three case studies of their selected use in National Forest land management and project plans. Successful use of SDM involves participation by decision-makers, analysts, scientists, and stakeholders. We suggest specific areas for training and instituting SDM to foster transparency, rigor, clarity, and inclusiveness in formal decision processes regarding management of national forests.

  19. Management decision making for fisher populations informed by occupancy modeling

    USGS Publications Warehouse

    Fuller, Angela K.; Linden, Daniel W.; Royle, J. Andrew

    2016-01-01

    Harvest data are often used by wildlife managers when setting harvest regulations for species because the data are regularly collected and do not require implementation of logistically and financially challenging studies to obtain the data. However, when harvest data are not available because an area had not previously supported a harvest season, alternative approaches are required to help inform management decision making. When distribution or density data are required across large areas, occupancy modeling is a useful approach, and under certain conditions, can be used as a surrogate for density. We collaborated with the New York State Department of Environmental Conservation (NYSDEC) to conduct a camera trapping study across a 70,096-km2 region of southern New York in areas that were currently open to fisher (Pekania [Martes] pennanti) harvest and those that had been closed to harvest for approximately 65 years. We used detection–nondetection data at 826 sites to model occupancy as a function of site-level landscape characteristics while accounting for sampling variation. Fisher occupancy was influenced positively by the proportion of conifer and mixed-wood forest within a 15-km2 grid cell and negatively associated with road density and the proportion of agriculture. Model-averaged predictions indicated high occupancy probabilities (>0.90) when road densities were low (<1 km/km2) and coniferous and mixed forest proportions were high (>0.50). Predicted occupancy ranged 0.41–0.67 in wildlife management units (WMUs) currently open to trapping, which could be used to guide a minimum occupancy threshold for opening new areas to trapping seasons. There were 5 WMUs that had been closed to trapping but had an average predicted occupancy of 0.52 (0.07 SE), and above the threshold of 0.41. These areas are currently under consideration by NYSDEC for opening a conservative harvest season. We demonstrate the use of occupancy modeling as an aid to management

  20. Markov decision processes in natural resources management: observability and uncertainty

    USGS Publications Warehouse

    Williams, Byron K.

    2015-01-01

    The breadth and complexity of stochastic decision processes in natural resources presents a challenge to analysts who need to understand and use these approaches. The objective of this paper is to describe a class of decision processes that are germane to natural resources conservation and management, namely Markov decision processes, and to discuss applications and computing algorithms under different conditions of observability and uncertainty. A number of important similarities are developed in the framing and evaluation of different decision processes, which can be useful in their applications in natural resources management. The challenges attendant to partial observability are highlighted, and possible approaches for dealing with it are discussed.

  1. Small-group decision making can be effective management tool.

    PubMed

    Kennedy, R

    1978-01-01

    One of the key components of effective management is the ability to make decisions. To more effectively assist hospital supervisors and managers in dealing with and making appropriate judgments, educators need to examine carefully the processes involved in decision making and how they impact on both the individual and the group. The following discussion of structured small-group decision making is adapted from an independent study of the literature undertaken by this author to dissect these processes and how they impact on the decisions made.

  2. Markov decision processes in natural resources management: Observability and uncertainty

    USGS Publications Warehouse

    Williams, B.K.

    2009-01-01

    The breadth and complexity of stochastic decision processes in natural resources presents a challenge to analysts who need to understand and use these approaches. The objective of this paper is to describe a class of decision processes that are germane to natural resources conservation and management, namely Markov decision processes, and to discuss applications and computing algorithms under different conditions of observability and uncertainty. A number of important similarities are developed in the framing and evaluation of different decision processes, which can be useful in their applications in natural resources management. The challenges attendant to partial observability are highlighted, and possible approaches for dealing with it are discussed.

  3. Using old technology to implement modern computer-aided decision support for primary diabetes care.

    PubMed Central

    Hunt, D. L.; Haynes, R. B.; Morgan, D.

    2001-01-01

    BACKGROUND: Implementation rates of interventions known to be beneficial for people with diabetes mellitus are often suboptimal. Computer-aided decision support systems (CDSSs) can improve these rates. The complexity of establishing a fully integrated electronic medical record that provides decision support, however, often prevents their use. OBJECTIVE: To develop a CDSS for diabetes care that can be easily introduced into primary care settings and diabetes clinics. THE SYSTEM: The CDSS uses fax-machine-based optical character recognition software for acquiring patient information. Simple, 1-page paper forms, completed by patients or health practitioners, are faxed to a central location. The information is interpreted and recorded in a database. This initiates a routine that matches the information against a knowledge base so that patient-specific recommendations can be generated. These are formatted and faxed back within 4-5 minutes. IMPLEMENTATION: The system is being introduced into 2 diabetes clinics. We are collecting information on frequency of use of the system, as well as satisfaction with the information provided. CONCLUSION: Computer-aided decision support can be provided in any setting with a fax machine, without the need for integrated electronic medical records or computerized data-collection devices. PMID:11825194

  4. Informed choice about breast cancer prevention: randomized controlled trial of an online decision aid intervention

    PubMed Central

    2013-01-01

    Introduction Tamoxifen and raloxifene are chemopreventive drugs that can reduce women's relative risk of primary breast cancer by 50%; however, most women eligible for these drugs have chosen not to take them. The reasons for low uptake may be related to women's knowledge or attitudes towards the drugs. We aimed to examine the impact of an online breast cancer chemoprevention decision aid (DA) on informed intentions and decisions of women at high risk of breast cancer. Methods We conducted a randomized clinical trial, assessing the effect of a DA about breast cancer chemoprevention on informed choices about chemoprevention. Women (n = 585), 46- to 74-years old old, completed online baseline, post-test, and three-month follow-up questionnaires. Participants were randomly assigned to either an intervention group, a standard control group that answered questions about chemoprevention at baseline, or a three-month control group that did not answer questions about chemoprevention at baseline. The main outcome measures were whether women's intentions and decisions regarding chemoprevention drugs were informed, and whether women who viewed the DA were more likely to make informed decisions than women who did not view the DA, using a dichotomous composite variable 'informed choice' (yes/no) to classify informed decisions as those reflecting sufficient knowledge and concordance between a woman's decision and relevant attitudes. Results Analyses showed that more intervention than standard control participants (52.7% versus 5.9%) made informed decisions at post-test, P <0.001. At the three-month follow-up, differences in rates of informed choice between intervention (16.9%) and both control groups (11.8% and 8.0%) were statistically non-significant, P = 0.067. Conclusions The DA increased informed decision making about breast cancer chemoprevention, although the impact on knowledge diminished over time. This study was not designed to determine how much knowledge decision

  5. A dataset of human decision-making in teamwork management

    PubMed Central

    Yu, Han; Shen, Zhiqi; Miao, Chunyan; Leung, Cyril; Chen, Yiqiang; Fauvel, Simon; Lin, Jun; Cui, Lizhen; Pan, Zhengxiang; Yang, Qiang

    2017-01-01

    Today, most endeavours require teamwork by people with diverse skills and characteristics. In managing teamwork, decisions are often made under uncertainty and resource constraints. The strategies and the effectiveness of the strategies different people adopt to manage teamwork under different situations have not yet been fully explored, partially due to a lack of detailed large-scale data. In this paper, we describe a multi-faceted large-scale dataset to bridge this gap. It is derived from a game simulating complex project management processes. It presents the participants with different conditions in terms of team members’ capabilities and task characteristics for them to exhibit their decision-making strategies. The dataset contains detailed data reflecting the decision situations, decision strategies, decision outcomes, and the emotional responses of 1,144 participants from diverse backgrounds. To our knowledge, this is the first dataset simultaneously covering these four facets of decision-making. With repeated measurements, the dataset may help establish baseline variability of decision-making in teamwork management, leading to more realistic decision theoretic models and more effective decision support approaches. PMID:28094787

  6. A dataset of human decision-making in teamwork management

    NASA Astrophysics Data System (ADS)

    Yu, Han; Shen, Zhiqi; Miao, Chunyan; Leung, Cyril; Chen, Yiqiang; Fauvel, Simon; Lin, Jun; Cui, Lizhen; Pan, Zhengxiang; Yang, Qiang

    2017-01-01

    Today, most endeavours require teamwork by people with diverse skills and characteristics. In managing teamwork, decisions are often made under uncertainty and resource constraints. The strategies and the effectiveness of the strategies different people adopt to manage teamwork under different situations have not yet been fully explored, partially due to a lack of detailed large-scale data. In this paper, we describe a multi-faceted large-scale dataset to bridge this gap. It is derived from a game simulating complex project management processes. It presents the participants with different conditions in terms of team members' capabilities and task characteristics for them to exhibit their decision-making strategies. The dataset contains detailed data reflecting the decision situations, decision strategies, decision outcomes, and the emotional responses of 1,144 participants from diverse backgrounds. To our knowledge, this is the first dataset simultaneously covering these four facets of decision-making. With repeated measurements, the dataset may help establish baseline variability of decision-making in teamwork management, leading to more realistic decision theoretic models and more effective decision support approaches.

  7. A dataset of human decision-making in teamwork management.

    PubMed

    Yu, Han; Shen, Zhiqi; Miao, Chunyan; Leung, Cyril; Chen, Yiqiang; Fauvel, Simon; Lin, Jun; Cui, Lizhen; Pan, Zhengxiang; Yang, Qiang

    2017-01-17

    Today, most endeavours require teamwork by people with diverse skills and characteristics. In managing teamwork, decisions are often made under uncertainty and resource constraints. The strategies and the effectiveness of the strategies different people adopt to manage teamwork under different situations have not yet been fully explored, partially due to a lack of detailed large-scale data. In this paper, we describe a multi-faceted large-scale dataset to bridge this gap. It is derived from a game simulating complex project management processes. It presents the participants with different conditions in terms of team members' capabilities and task characteristics for them to exhibit their decision-making strategies. The dataset contains detailed data reflecting the decision situations, decision strategies, decision outcomes, and the emotional responses of 1,144 participants from diverse backgrounds. To our knowledge, this is the first dataset simultaneously covering these four facets of decision-making. With repeated measurements, the dataset may help establish baseline variability of decision-making in teamwork management, leading to more realistic decision theoretic models and more effective decision support approaches.

  8. 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.

  9. 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

  10. Integrating decision tools for the sustainable management of land contamination.

    PubMed

    Pollard, S J T; Brookes, A; Earl, N; Lowe, J; Kearney, T; Nathanail, C P

    2004-06-05

    The approach to taking decisions on the management of land contamination has changed markedly over 30 years. Change has been rapid with policy makers and regulators, practitioners and researchers having to keep pace with new technologies, assessment criteria and diagnostic methods for their measurement, techniques for risk analysis and the frameworks that support decision-makers in their efforts to regenerate historically contaminated land. Having progressed from simple hazard assessment through to 'sustainability appraisal' we might now consider piecing together the experience of decision-making for managing land contamination. Here, we critically review recent developments with a view to considering how better decisions can be made by integrating the decision tools available. We are concerned with the practicality of approach and the issues that arise for practitioners as decision criteria are broadened.

  11. Childbearing Decision Making: A Qualitative Study of Women Living with HIV/AIDS in Southwest Nigeria

    PubMed Central

    Sofolahan, Y. A.; Airhihenbuwa, C. O.

    2012-01-01

    Using the PEN-3 model, the purpose of this qualitative study was to understand the factors responsible for the childbearing decisions of women living with HIV/AIDS (WLHA) in Lagos, Nigeria. Sixty WLHA who sought care at a teaching hospital in Lagos were recruited to participate in in-depth interviews. The average age of the participants was 30 years, and 48 participants were receiving antiretroviral therapy. Healthcare and spiritual practices, healthcare provider-patient communication about childbearing, and husband/partner support emerged as factors that contribute to the childbearing decisions of WLHA. The findings reveal the importance of discussing sexual reproductive health and childbearing issues with WLHA in the healthcare context prior to pregnancy. PMID:23320152

  12. A multi-criteria decision aid methodology to design electric vehicles public charging networks

    NASA Astrophysics Data System (ADS)

    Raposo, João; Rodrigues, Ana; Silva, Carlos; Dentinho, Tomaz

    2015-05-01

    This article presents a new multi-criteria decision aid methodology, dynamic-PROMETHEE, here used to design electric vehicle charging networks. In applying this methodology to a Portuguese city, results suggest that it is effective in designing electric vehicle charging networks, generating time and policy based scenarios, considering offer and demand and the city's urban structure. Dynamic-PROMETHE adds to the already known PROMETHEE's characteristics other useful features, such as decision memory over time, versatility and adaptability. The case study, used here to present the dynamic-PROMETHEE, served as inspiration and base to create this new methodology. It can be used to model different problems and scenarios that may present similar requirement characteristics.

  13. Aeronautical Decision Making - Cockpit Resource Management

    DTIC Science & Technology

    1989-01-01

    of this effort to establish a universal CRM evaluation methodology useful throughout the 7 Codes icd/or AA industry. The author’s participation in the...on communication) to the decision training and evaluation being offered to the single-person cockpit elsewhere described as ADM. From a historical...risk assessment skills. 5) Learning to consider all resources available. 6) Learning to how evaluate your flight and decision making skills. Recent

  14. 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…

  15. Effects of Practice and Memory Aiding on Decision Performance and Information Search in Command and Control

    DTIC Science & Technology

    2001-01-01

    this area are still relatively scant in general (Brehmer, 1987; Flin et al 1997; Kerstholt, 1996; Mynatt et al 1977; Roelofsma, 1995; Zsambok & Klein...in a dynamic decision environment. Management Science, 31, 680-702. Mynatt , C.R., Doherty, M.E. and Tweney, R.T. (1977). Confirmation Bias in a

  16. Data-driven decision-making tools to improve public resource allocation for care and prevention of HIV/AIDS.

    PubMed

    Ryan, Gery W; Bloom, Evan W; Lowsky, David J; Linthicum, Mark T; Juday, Timothy; Rosenblatt, Lisa; Kulkarni, Sonali; Goldman, Dana P; Sayles, Jennifer N

    2014-03-01

    Public health agencies face difficult decisions when allocating scarce resources to control the spread of HIV/AIDS. Decisions are often made with few local empirical data. We demonstrated the use of the robust decision making approach in Los Angeles County, an approach that is data driven and allows decision makers to compare the performance of various intervention strategies across thousands of simulated future scenarios. We found that the prevailing strategy of emphasizing behavioral risk reduction interventions was unlikely to achieve the policy goals of the national HIV/AIDS strategy. Of the alternative strategies we examined, those that invested most heavily in interventions to initiate antiretroviral treatment and support treatment adherence were the most likely to achieve policy objectives. By employing similar methods, other public health agencies can identify robust strategies and invest in interventions more likely to achieve HIV/AIDS policy goals.

  17. DEMAID - A DESIGN MANAGER'S AID FOR INTELLIGENT DECOMPOSITION (SUN VERSION)

    NASA Technical Reports Server (NTRS)

    Rogers, J. L.

    1994-01-01

    Many engineering systems are large and multi-disciplinary. Before the design of new complex systems such as large space platforms can begin, the possible interactions among subsystems and their parts must be determined. Once this is completed the proposed system can be decomposed to identify its hierarchical structure. DeMAID (A Design Manager's Aid for Intelligent Decomposition) is a knowledge-based system for ordering the sequence of modules and identifying a possible multilevel structure for the design problem. DeMAID displays the modules in an N x N matrix format (called a design structure matrix) where a module is any process that requires input and generates an output. (Modules which generate an output but do not require an input, such as an initialization process, are also acceptable.) Although DeMAID requires an investment of time to generate and refine the list of modules for input, it could save a considerable amount of money and time in the total design process, particularly in new design problems where the ordering of the modules has not been defined. The decomposition of a complex design system into subsystems requires the judgement of the design manager. DeMAID reorders and groups the modules based on the links (interactions) among the modules, helping the design manager make decomposition decisions early in the design cycle. The modules are grouped into circuits (the subsystems) and displayed in an N x N matrix format. Feedback links, which indicate an iterative process, are minimized and only occur within a subsystem. Since there are no feedback links among the circuits, the circuits can be displayed in a multilevel format. Thus, a large amount of information is reduced to one or two displays which are stored for later retrieval and modification. The design manager and leaders of the design teams then have a visual display of the design problem and the intricate interactions among the different modules. The design manager could save a substantial

  18. DEMAID - A DESIGN MANAGER'S AID FOR INTELLIGENT DECOMPOSITION (MACINTOSH VERSION)

    NASA Technical Reports Server (NTRS)

    Rogers, J. L.

    1994-01-01

    Many engineering systems are large and multi-disciplinary. Before the design of new complex systems such as large space platforms can begin, the possible interactions among subsystems and their parts must be determined. Once this is completed the proposed system can be decomposed to identify its hierarchical structure. DeMAID (A Design Manager's Aid for Intelligent Decomposition) is a knowledge-based system for ordering the sequence of modules and identifying a possible multilevel structure for the design problem. DeMAID displays the modules in an N x N matrix format (called a design structure matrix) where a module is any process that requires input and generates an output. (Modules which generate an output but do not require an input, such as an initialization process, are also acceptable.) Although DeMAID requires an investment of time to generate and refine the list of modules for input, it could save a considerable amount of money and time in the total design process, particularly in new design problems where the ordering of the modules has not been defined. The decomposition of a complex design system into subsystems requires the judgement of the design manager. DeMAID reorders and groups the modules based on the links (interactions) among the modules, helping the design manager make decomposition decisions early in the design cycle. The modules are grouped into circuits (the subsystems) and displayed in an N x N matrix format. Feedback links, which indicate an iterative process, are minimized and only occur within a subsystem. Since there are no feedback links among the circuits, the circuits can be displayed in a multilevel format. Thus, a large amount of information is reduced to one or two displays which are stored for later retrieval and modification. The design manager and leaders of the design teams then have a visual display of the design problem and the intricate interactions among the different modules. The design manager could save a substantial

  19. DEMAID - A DESIGN MANAGER'S AID FOR INTELLIGENT DECOMPOSITION (SUN VERSION)

    NASA Technical Reports Server (NTRS)

    Rogers, J. L.

    1994-01-01

    Many engineering systems are large and multi-disciplinary. Before the design of new complex systems such as large space platforms can begin, the possible interactions among subsystems and their parts must be determined. Once this is completed the proposed system can be decomposed to identify its hierarchical structure. DeMAID (A Design Manager's Aid for Intelligent Decomposition) is a knowledge-based system for ordering the sequence of modules and identifying a possible multilevel structure for the design problem. DeMAID displays the modules in an N x N matrix format (called a design structure matrix) where a module is any process that requires input and generates an output. (Modules which generate an output but do not require an input, such as an initialization process, are also acceptable.) Although DeMAID requires an investment of time to generate and refine the list of modules for input, it could save a considerable amount of money and time in the total design process, particularly in new design problems where the ordering of the modules has not been defined. The decomposition of a complex design system into subsystems requires the judgement of the design manager. DeMAID reorders and groups the modules based on the links (interactions) among the modules, helping the design manager make decomposition decisions early in the design cycle. The modules are grouped into circuits (the subsystems) and displayed in an N x N matrix format. Feedback links, which indicate an iterative process, are minimized and only occur within a subsystem. Since there are no feedback links among the circuits, the circuits can be displayed in a multilevel format. Thus, a large amount of information is reduced to one or two displays which are stored for later retrieval and modification. The design manager and leaders of the design teams then have a visual display of the design problem and the intricate interactions among the different modules. The design manager could save a substantial

  20. DEMAID - A DESIGN MANAGER'S AID FOR INTELLIGENT DECOMPOSITION (MACINTOSH VERSION)

    NASA Technical Reports Server (NTRS)

    Rogers, J. L.

    1994-01-01

    Many engineering systems are large and multi-disciplinary. Before the design of new complex systems such as large space platforms can begin, the possible interactions among subsystems and their parts must be determined. Once this is completed the proposed system can be decomposed to identify its hierarchical structure. DeMAID (A Design Manager's Aid for Intelligent Decomposition) is a knowledge-based system for ordering the sequence of modules and identifying a possible multilevel structure for the design problem. DeMAID displays the modules in an N x N matrix format (called a design structure matrix) where a module is any process that requires input and generates an output. (Modules which generate an output but do not require an input, such as an initialization process, are also acceptable.) Although DeMAID requires an investment of time to generate and refine the list of modules for input, it could save a considerable amount of money and time in the total design process, particularly in new design problems where the ordering of the modules has not been defined. The decomposition of a complex design system into subsystems requires the judgement of the design manager. DeMAID reorders and groups the modules based on the links (interactions) among the modules, helping the design manager make decomposition decisions early in the design cycle. The modules are grouped into circuits (the subsystems) and displayed in an N x N matrix format. Feedback links, which indicate an iterative process, are minimized and only occur within a subsystem. Since there are no feedback links among the circuits, the circuits can be displayed in a multilevel format. Thus, a large amount of information is reduced to one or two displays which are stored for later retrieval and modification. The design manager and leaders of the design teams then have a visual display of the design problem and the intricate interactions among the different modules. The design manager could save a substantial

  1. A qualitative study on a decision aid for breast cancer screening: Views from women and health professionals.

    PubMed

    Toledo-Chávarri, A; Rué, M; Codern-Bové, N; Carles-Lavila, M; Perestelo-Pérez, L; Pérez-Lacasta, M J; Feijoo-Cid, M

    2017-02-01

    This qualitative study evaluates a decision aid that includes the benefits and harms of breast cancer screening and analyses women's perception of the information received and healthcare professionals' perceptions of the convenience of providing it. Seven focus groups of women aged 40-69 years (n = 39) and two groups of healthcare professionals (n = 23) were conducted in Catalonia and the Canary Islands. The focus groups consisted of guided discussions regarding decision-making about breast cancer screening, and acceptability and feasibility of the decision aid. A content analysis was performed. Women positively value receiving information regarding the benefits and harms of breast cancer screening. Several women had difficulties understanding some concepts, especially those regarding overdiagnosis. Women preferred to share the decisions on screening with healthcare professionals. The professionals noted the lack of inclusion of some harms and benefits in the decision aid, and proposed improving the clarity of the statistical information. The information on overdiagnosis generates confusion among women and controversy among professionals. Faced with the new information presented by the decision aid, the majority of women prefer shared decision-making; however, its feasibility might be limited by a lack of knowledge and attitudes of rejection from healthcare professionals.

  2. Application of decision science to resilience management in Jamaica Bay

    USGS Publications Warehouse

    Eaton, Mitchell; Fuller, Angela K.; Johnson, Fred A.; Hare, M. P.; Stedman, Richard C.; Sanderson, E.W.; Solecki, W. D.; Waldman, J.R.; Paris, A. S.

    2016-01-01

    This book highlights the growing interest in management interventions designed to enhance the resilience of the Jamaica Bay socio-ecological system. Effective management, whether the focus is on managing biological processes or human behavior or (most likely) both, requires decision makers to anticipate how the managed system will respond to interventions (i.e., via predictions or projections). In systems characterized by many interacting components and high uncertainty, making probabilistic predictions is often difficult and requires careful thinking not only about system dynamics, but also about how management objectives are specified and the analytic method used to select the preferred action(s). Developing a clear statement of the problem(s) and articulation of management objectives is often best achieved by including input from managers, scientists and other stakeholders affected by the decision through a process of joint problem framing (Marcot and others 2012; Keeney and others 1990). Using a deliberate, coherent and transparent framework for deciding among management alternatives to best meet these objectives then ensures a greater likelihood for successful intervention. Decision science provides the theoretical and practical basis for developing this framework and applying decision analysis methods for making complex decisions under uncertainty and risk.

  3. 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

  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. 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

  6. 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.

  7. 38 CFR 41.405 - Management decision.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Federal Agencies and Pass-Through... not the audit finding is sustained, the reasons for the decision, and the expected auditee action to... from the auditee, including a request for auditor assurance related to the documentation, as a way...

  8. Coaching and guidance with patient decision aids: A review of theoretical and empirical evidence

    PubMed Central

    2013-01-01

    Background Coaching and guidance are structured approaches that can be used within or alongside patient decision aids (PtDAs) to facilitate the process of decision making. Coaching is provided by an individual, and guidance is embedded within the decision support materials. The purpose of this paper is to: a) present updated definitions of the concepts “coaching” and “guidance”; b) present an updated summary of current theoretical and empirical insights into the roles played by coaching/guidance in the context of PtDAs; and c) highlight emerging issues and research opportunities in this aspect of PtDA design. Methods We identified literature published since 2003 on shared decision making theoretical frameworks inclusive of coaching or guidance. We also conducted a sub-analysis of randomized controlled trials included in the 2011 Cochrane Collaboration Review of PtDAs with search results updated to December 2010. The sub-analysis was conducted on the characteristics of coaching and/or guidance included in any trial of PtDAs and trials that allowed the impact of coaching and/or guidance with PtDA to be compared to another intervention or usual care. Results Theoretical evidence continues to justify the use of coaching and/or guidance to better support patients in the process of thinking about a decision and in communicating their values/preferences with others. In 98 randomized controlled trials of PtDAs, 11 trials (11.2%) included coaching and 63 trials (64.3%) provided guidance. Compared to usual care, coaching provided alongside a PtDA improved knowledge and decreased mean costs. The impact on some other outcomes (e.g., participation in decision making, satisfaction, option chosen) was more variable, with some trials showing positive effects and other trials reporting no differences. For values-choice agreement, decisional conflict, adherence, and anxiety there were no differences between groups. None of these outcomes were worse when patients were exposed

  9. AIDS

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/000594.htm HIV/AIDS To use the sharing features on this page, ... immunodeficiency virus (HIV) is the virus that causes AIDS. When a person becomes infected with HIV, the ...

  10. Dissociated Neural Processing for Decisions in Managers and Non-Managers

    PubMed Central

    Caspers, Svenja; Heim, Stefan; Lucas, Marc G.; Stephan, Egon; Fischer, Lorenz; Amunts, Katrin; Zilles, Karl

    2012-01-01

    Functional neuroimaging studies of decision-making so far mainly focused on decisions under uncertainty or negotiation with other persons. Dual process theory assumes that, in such situations, decision making relies on either a rapid intuitive, automated or a slower rational processing system. However, it still remains elusive how personality factors or professional requirements might modulate the decision process and the underlying neural mechanisms. Since decision making is a key task of managers, we hypothesized that managers, facing higher pressure for frequent and rapid decisions than non-managers, prefer the heuristic, automated decision strategy in contrast to non-managers. Such different strategies may, in turn, rely on different neural systems. We tested managers and non-managers in a functional magnetic resonance imaging study using a forced-choice paradigm on word-pairs. Managers showed subcortical activation in the head of the caudate nucleus, and reduced hemodynamic response within the cortex. In contrast, non-managers revealed the opposite pattern. With the head of the caudate nucleus being an initiating component for process automation, these results supported the initial hypothesis, hinting at automation during decisions in managers. More generally, the findings reveal how different professional requirements might modulate cognitive decision processing. PMID:22927984

  11. What can decision analysis do for invasive species management?

    PubMed

    Maguire, Lynn A

    2004-08-01

    Decisions about management of invasive species are difficult for all the reasons typically addressed by multiattribute decision analysis: uncertain outcomes, multiple and conflicting objectives, and many interested parties with differing views on both facts and values. This article illustrates how the tools of multiattribute analysis can improve management of invasive species, with an emphasis on making explicit the social values and preferences that must inform invasive species management. Risk assessment protocols developed previously for invasive species management typically suffer from two interacting flaws: (1) separating risk assessment from risk management, thus disrupting essential connections between the social values at stake in invasive species decisions and the scientific knowledge necessary to predict the likely impacts of management actions, and (2) relying on expert judgment about risk framed in qualitative and value-laden terms, inadvertently mixing the expert's judgment about what is likely to happen with personal preferences. Using the values structuring and probability-modeling elements of formal decision analysis can remedy these difficulties and make invasive species management responsive to both good science and public values. The management of feral pigs in Hawaiian ecosystems illustrates the need for such an integrated approach.

  12. Use of ultrasonography to make reproductive management decisions

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Transrectal ultrasonography has been available for making management decisions since the mid 1980’s. This technology allows for the real-time visualization of internal structures (i.e. ovary and fetus) that are otherwise difficult to evaluate. The use of this technology in making reproductive manag...

  13. Archives and Records Management for Decision Makers: A RAMP Study.

    ERIC Educational Resources Information Center

    Mazikana, Peter C.

    Intended to highlight those aspects of the archival field that government officials should be aware of, this report on the Records and Archives Management Programme (RAMP) outlines the major principles of records management and archives administration, identifies the information needs of the decision makers, and assesses the ways in which records…

  14. Insect pest management decisions in food processing facilities

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Pest management decision making in food processing facilities such as flour mills, rice mills, human and pet food manufacturing facilities, distribution centers and warehouses, and retail stores is a challenging undertaking. Insect pest management programs require an understanding of the food facili...

  15. Bayesian inference and decision theory - A framework for decision making in natural resource management

    USGS Publications Warehouse

    Dorazio, R.M.; Johnson, F.A.

    2003-01-01

    Bayesian inference and decision theory may be used in the solution of relatively complex problems of natural resource management, owing to recent advances in statistical theory and computing. In particular, Markov chain Monte Carlo algorithms provide a computational framework for fitting models of adequate complexity and for evaluating the expected consequences of alternative management actions. We illustrate these features using an example based on management of waterfowl habitat.

  16. Guidance Tools for Use in Nuclear Material Management Decisions Making

    SciTech Connect

    Johnson, G. V.; Baker, D. J.; Sorenson, K. B.; Boeke, S. G.

    2002-02-26

    This paper describes the results of Recommendation 14 of the Integrated Nuclear Materials Management Plan (INMMP) which was the product of a management initiative at the highest levels of the Department of Energy responding to a congressional directive to accelerate the work of achieving integration and cutting long-term costs associated with the management of nuclear materials, with the principal focus on excess materials. The INMMP provided direction to ''Develop policy-level decision support tools to support long-term planning and decision making.'' To accomplish this goal a team from the Savannah River Site, Sandia National Laboratories, Idaho National Engineering and Environmental Laboratory (INEEL), and the U.S. Department of Energy experienced in the decision-making process developed a Guidebook to Decision-Making Methods. The goal of the team organized to implement Recommendation 14 was to instill transparency, consistency, rigor, and discipline in the DOE decision process. The guidebook introduces a process and a selection of proven methods for disciplined decision-making so that the results are clearer, more transparent, and easier for reviewers to understand and accept. It was written to set a standard for a consistent decision process.

  17. Energy Technology Investments: Maximizing Efficiency through a Maritime Energy Portfolio Interface and Decision Aid

    DTIC Science & Technology

    2012-02-01

    APPROACH The Maritime Energy Portfolio Management Approach provides a means for determining the best course of action where several initiatives...course of action where several ECMs compete for scarce funds. Efficient, user friendly use of the Maritime Energy Portfolio Interface and Decision...ship application. Outputs from the Business Case Analysis (BCA) include: Return on Investment (ROI) and Break Even Point ( BEP ). These metrics are

  18. Project Manager Performance and the Decision to Backsource the Project Management Office

    ERIC Educational Resources Information Center

    Lively, William R.

    2014-01-01

    This paper reviews a management decision of an Information Technology Outsource (ITO) provider to backshore the management oversight of its Project Management Office (PMO) after only one year of offshore operations. Governance is a term used in project management to refer to management oversight. The review is a quantitative analysis of existing…

  19. Informed choice in bowel cancer screening: a qualitative study to explore how adults with lower education use decision aids

    PubMed Central

    Smith, Sian K; Kearney, Paul; Trevena, Lyndal; Barratt, Alexandra; Nutbeam, Don; McCaffery, Kirsten J

    2012-01-01

    Abstract Background  Offering informed choice in screening is increasingly advocated, but little is known about how evidence‐based information about the benefits and harms of screening influences understanding and participation in screening. Objective  We aimed to explore how a bowel cancer screening decision aid influenced decision making and screening behaviour among adults with lower education and literacy. Methods  Twenty‐one men and women aged 55–64 years with lower education levels were interviewed about using a decision aid to make their screening decision. Participants were purposively selected to include those who had and had not made an informed choice. Results  Understanding the purpose of the decision aid was an important factor in whether participants made an informed choice about screening. Participants varied in how they understood and integrated quantitative risk information about the benefits and harms of screening into their decision making; some read it carefully and used it to justify their screening decision, whereas others dismissed it because they were sceptical of it or lacked confidence in their own numeracy ability. Participants’ prior knowledge and beliefs about screening influenced how they made sense of the information. Discussion and conclusions  Participants valued information that offered them a choice in a non‐directive way, but were concerned that it would deter people from screening. Healthcare providers need to be aware that people respond to screening information in diverse ways involving a range of literacy skills and cognitive processes. PMID:22512746

  20. Aiding the environment: the Australian Development Agency's experience of implementing an environmental management system

    SciTech Connect

    Keen, Meg . E-mail: meg.keen@anu.edu.au; Sullivan, Marjorie

    2005-08-15

    Aid agencies, like commercial businesses, are increasingly concerned with incorporating sound environmental management into their operations. Different approaches are being used to integrate sustainability into development assistance to ensure that environmental impacts are assessed and managed. One approach being used by AusAID, the Australian aid agency, is to implement an environmental management system (EMS) across program and project areas. This paper examines how AusAID has adapted the EMS approach to suit aid agency operations, and some of the lessons from the Australian experience.

  1. 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

  2. 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.

  3. Managing Decisions on Changes in the Virtual Enterprise Evolution

    NASA Astrophysics Data System (ADS)

    Drissen-Silva, Marcus Vinicius; Rabelo, Ricardo José

    VE evolution deals with problems that happen during the VE operation and that put on risk planned results. This requires the application of problem-solving mechanisms to guarantee the construction of a new but feasible VE plan. Grounded on Project Management and Decision Support Systems foundations, this paper proposes a distributed collaborative decision support system to manage the VE evolution. Its main rationale is that VE’s members are autonomous and hence that all the affected partners should discuss about the necessary changes on the current VE’s plan. In the proposed approach, this discussion is guided by a decision protocol, and the impact of decisions can be evaluated. Results of a first prototype implementation are presented and discussed, with a special focus on the part which regulates the argumentation, voting and comparison of possible solutions.

  4. Factors that influence producer decisions to implement management strategies.

    PubMed

    Field, Thomas G

    2014-12-01

    Cow-calf enterprises in the USA are widely divergent in size, locale, resource availability, management skill, and market focus. Furthermore, variation exists in dependence on the cow-calf enterprise as a primary source of income, perception about the utility of a particular management practice or technology, and assessment of cost: benefit resulting from implementation impact decisions. Enterprises with larger cow inventories, greater dependence on income from the cattle enterprise, and that retain ownership further into the supply chain beyond the cow-calf operation are more likely to institute management protocols such as vaccination programs, defined calving seasons, and reproductive technologies. Successful cow-calf managers place the highest priority on herd nutrition, pasture and range management, herd health, financial management marketing, production management, and genetics. Management practices are more likely to be adopted when they align with a manager's perception of the utility, labor availability, favorable cost: benefit outcomes and profit motivation.

  5. Medical communication and technology: a video-based process study of the use of decision aids in primary care consultations

    PubMed Central

    Kaner, Eileen; Heaven, Ben; Rapley, Tim; Murtagh, Madeleine; Graham, Ruth; Thomson, Richard; May, Carl

    2007-01-01

    Background Much of the research on decision-making in health care has focused on consultation outcomes. Less is known about the process by which clinicians and patients come to a treatment decision. This study aimed to quantitatively describe the behaviour shown by doctors and patients during primary care consultations when three types of decision aids were used to promote treatment decision-making in a randomised controlled trial. Methods A video-based study set in an efficacy trial which compared the use of paper-based guidelines (control) with two forms of computer-based decision aids (implicit and explicit versions of DARTS II). Treatment decision concerned warfarin anti-coagulation to reduce the risk of stroke in older patients with atrial fibrillation. Twenty nine consultations were video-recorded. A ten-minute 'slice' of the consultation was sampled for detailed content analysis using existing interaction analysis protocols for verbal behaviour and ethological techniques for non-verbal behaviour. Results Median consultation times (quartiles) differed significantly depending on the technology used. Paper-based guidelines took 21 (19–26) minutes to work through compared to 31 (16–41) minutes for the implicit tool; and 44 (39–55) minutes for the explicit tool. In the ten minutes immediately preceding the decision point, GPs dominated the conversation, accounting for 64% (58–66%) of all utterances and this trend was similar across all three arms of the trial. Information-giving was the most frequent activity for both GPs and patients, although GPs did this at twice the rate compared to patients and at higher rates in consultations involving computerised decision aids. GPs' language was highly technically focused and just 7% of their conversation was socio-emotional in content; this was half the socio-emotional content shown by patients (15%). However, frequent head nodding and a close mirroring in the direction of eye-gaze suggested that both parties

  6. The impact of management science on political decision making

    NASA Technical Reports Server (NTRS)

    White, M. J.

    1971-01-01

    The possible impact on public policy and organizational decision making of operations research/management science (OR/MS) is discussed. Criticisms based on the assumption that OR/MS will have influence on decision making and criticisms based on the assumption that it will have no influence are described. New directions in the analysis of analysis and in thinking about policy making are also considered.

  7. Making Financial Decisions. Financial Management Module. Operational Management Programme. Increasing Opportunities for Supervisors and Managers.

    ERIC Educational Resources Information Center

    Adamson, Jan; And Others

    One of a series of three self-instructional units, these materials are aimed at helping British hotel and catering managers improve profits and/or reduce costs in their areas of responsibility. Following a paragraph on how to use the unit and an introduction, section 1 covers control levels as the framework for making decisions. The section…

  8. Management of Children Using Cochlear Implants and Hearing Aids.

    ERIC Educational Resources Information Center

    Ching, Teresa Y. C.; Psarros, Colleen; Incerti, Paula; Hill, Mandy

    2001-01-01

    Four case studies identify six factors affecting successful use of a hearing aid with a cochlear implant: duration of hearing aid use prior to implantation, amount of residual hearing in the non-implanted ear, educational and listening demands, cosmetic issues, hearing aid rejection, and extended period of non-use of hearing aid. (Contains…

  9. Small groups' ecological reasoning while making an environmental management decision

    NASA Astrophysics Data System (ADS)

    Hogan, Kathleen

    2002-04-01

    The objective of this study was to explore the ideas and reasoning students use to make a collaborative environmental management decision. Eight groups of 8th-grade students (n = 24) considered ecological and economic information about an invasive aquatic species to make a management recommendation. In addition to discussing the exact information they were given, the groups made a variety of interpretations, elaborations, and inferences concerning ecological structure and dynamics and practical aspects of the management scenario. Value judgments and concerns with uncertainty also appeared in students' discussions, to differing degrees. The students' discussions were compared with scientists' guidelines for making environmental management decisions, and with one expert's analysis of the particular management scenario the students considered. A major finding was that whereas across groups students touched on all of the themes that scientists consider to be important for making environmental management decisions, within most groups students focused more narrowly on particular themes, giving cursory treatment to other dimensions of the problem. The results point to a need to foster students' ecological background knowledge and integrative, systems thinking skills for making principled decisions about complex environmental issues.

  10. Engaging stakeholders for adaptive management using structured decision analysis

    USGS Publications Warehouse

    Irwin, Elise R.; Kathryn, D.; Kennedy, Mickett

    2009-01-01

    Adaptive management is different from other types of management in that it includes all stakeholders (versus only policy makers) in the process, uses resource optimization techniques to evaluate competing objectives, and recognizes and attempts to reduce uncertainty inherent in natural resource systems. Management actions are negotiated by stakeholders, monitored results are compared to predictions of how the system should respond, and management strategies are adjusted in a “monitor-compare-adjust” iterative routine. Many adaptive management projects fail because of the lack of stakeholder identification, engagement, and continued involvement. Primary reasons for this vary but are usually related to either stakeholders not having ownership (or representation) in decision processes or disenfranchisement of stakeholders after adaptive management begins. We present an example in which stakeholders participated fully in adaptive management of a southeastern regulated river. Structured decision analysis was used to define management objectives and stakeholder values and to determine initial flow prescriptions. The process was transparent, and the visual nature of the modeling software allowed stakeholders to see how their interests and values were represented in the decision process. The development of a stakeholder governance structure and communication mechanism has been critical to the success of the project.

  11. All stories are not alike: a purpose-, content-, and valence-based taxonomy of patient narratives in decision aids.

    PubMed

    Shaffer, Victoria A; Zikmund-Fisher, Brian J

    2013-01-01

    The use of patient stories in decision aids is a highly controversial practice. However, the resulting debates and research have yielded little consensus about the impact of patient stories due to vague operational definitions of narratives. In this article, we argue that narratives are not homogeneous in either content or effect and hence should not be considered a single construct in research. The purpose of this article is to provide a taxonomy that guides both the development of decision aids and future research on this topic. We define three dimensions of narratives that are likely to moderate their impact on decision making: 1) the purpose of the narrative, 2) the content of the message, and 3) the evaluative valence, or overall tone, of the message. In addition, we describe predicted effects of different types of narratives on decision making and discuss their potential interactions. Our taxonomy provides a framework that will allow for the precise documentation of different narrative types, the use of appropriate outcome measures, and a systematic evaluation of narratives in all types of decision aids. Failures to recognize the complex structure of narratives will result both in research that does little to inform our understanding of the impact of patient stories and in the use of narratives in patient education materials that have unintended consequences on both decision processes and behavior.

  12. Prioritization of rehabilitation interventions for urban water assets using multiple criteria decision-aid methods.

    PubMed

    Carriço, N; Covas, D I C; Almeida, M Céu; Leitão, J P; Alegre, H

    2012-01-01

    The aim of this paper is to compare sorting and ranking methods for prioritization of rehabilitation interventions of sewers, taking into account risk, performance and cost. For that purpose multiple criteria decision-aid (MCDA) methods such as ELECTRE TRI for sorting and ELECTRE III for ranking are applied in a real case-study and the results obtained are compared. The case study is a small sanitary sewer system from a Portuguese utility located in the metropolitan area of Lisbon. The problem to investigate is the prioritization of the sewer candidates for rehabilitation. The decision maker (a panel group of specialists) has chosen five assessment measures: water level and maximum flow velocity (hydraulic performance indices), sewer importance and failure repair cost (collapse-related consequences of failure) and the risk of collapse. The results show that the outcomes from ELECTRE III are easier to understand than those from ELECTRE TRI method. Two different sets of weights were used, and the sorting and ranking results from both methods were found to be sensitive to them. ELECTRE TRI method is not straightforward as it involves technical parameters that are difficult to define, such as reference profiles and cut levels.

  13. 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

  14. The Design Manager's Aid for Intelligent Decomposition (DeMAID)

    NASA Technical Reports Server (NTRS)

    Rogers, James L.

    1994-01-01

    Before the design of new complex systems such as large space platforms can begin, the possible interactions among subsystems and their parts must be determined. Once this is completed, the proposed system can be decomposed to identify its hierarchical structure. The design manager's aid for intelligent decomposition (DeMAID) is a knowledge based system for ordering the sequence of modules and identifying a possible multilevel structure for design. Although DeMAID requires an investment of time to generate and refine the list of modules for input, it could save considerable money and time in the total design process, particularly in new design problems where the ordering of the modules has not been defined.

  15. Robust Decision Making Approach to Managing Water Resource Risks (Invited)

    NASA Astrophysics Data System (ADS)

    Lempert, R.

    2010-12-01

    The IPCC and US National Academies of Science have recommended iterative risk management as the best approach for water management and many other types of climate-related decisions. Such an approach does not rely on a single set of judgments at any one time but rather actively updates and refines strategies as new information emerges. In addition, the approach emphasizes that a portfolio of different types of responses, rather than any single action, often provides the best means to manage uncertainty. Implementing an iterative risk management approach can however prove difficult in actual decision support applications. This talk will suggest that robust decision making (RDM) provides a particularly useful set of quantitative methods for implementing iterative risk management. This RDM approach is currently being used in a wide variety of water management applications. RDM employs three key concepts that differentiate it from most types of probabilistic risk analysis: 1) characterizing uncertainty with multiple views of the future (which can include sets of probability distributions) rather than a single probabilistic best-estimate, 2) employing a robustness rather than an optimality criterion to assess alternative policies, and 3) organizing the analysis with a vulnerability and response option framework, rather than a predict-then-act framework. This talk will summarize the RDM approach, describe its use in several different types of water management applications, and compare the results to those obtained with other methods.

  16. Identifying environmental features for land management decisions

    NASA Technical Reports Server (NTRS)

    1981-01-01

    The benefits of changes in management organization and facilities for the Center for Remote Sensing and Cartography in Utah are reported as well as interactions with and outreach to state and local agencies. Completed projects are described which studied (1) Unita Basin wetland/land use; (2) Davis County foothill development; (3) Farmington Bay shoreline fluctuation; (4) irrigation detection; and (5) satellite investigation of snow cover/mule deer relationships. Techniques developed for composite computer mapping, contrast enhancement, U-2 CIR/LANDSAT digital interface; factor analysis, and multivariate statistical analysis are described.

  17. 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

  18. Use of graphics in decision aids for telerobotic control: (Parts 5-8 of an 8-part MIT progress report)

    NASA Technical Reports Server (NTRS)

    Sheridan, Thomas B.; Roseborough, James B.; Das, Hari; Chin, Kan-Ping; Inoue, Seiichi

    1989-01-01

    Four separate projects recently completed or in progress at the MIT Man-Machine Systems Laboratory are summarized. They are: a decision aid for retrieving a tumbling satellite in space; kinematic control and graphic display of redundant teleoperators; real time terrain/object generation: a quad-tree approach; and two dimensional control for three dimensional obstacle avoidance.

  19. 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…

  20. 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.

  1. 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…

  2. 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.

  3. 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

  4. Fuzzy Multicriteria Decision Analysis for Adaptive Watershed Management

    NASA Astrophysics Data System (ADS)

    Chang, N.

    2006-12-01

    The dramatic changes of societal complexity due to intensive interactions among agricultural, industrial, and municipal sectors have resulted in acute issues of water resources redistribution and water quality management in many river basins. Given the fact that integrated watershed management is more a political and societal than a technical challenge, there is a need for developing a compelling method leading to justify a water-based land use program in some critical regions. Adaptive watershed management is viewed as an indispensable tool nowadays for providing step-wise constructive decision support that is concerned with all related aspects of the water consumption cycle and those facilities affecting water quality and quantity temporally and spatially. Yet the greatest challenge that decision makers face today is to consider how to leverage ambiguity, paradox, and uncertainty to their competitive advantage of management policy quantitatively. This paper explores a fuzzy multicriteria evaluation method for water resources redistribution and subsequent water quality management with respect to a multipurpose channel-reservoir system--the Tseng- Wen River Basin, South Taiwan. Four fuzzy operators tailored for this fuzzy multicriteria decision analysis depict greater flexibility in representing the complexity of various possible trade-offs among management alternatives constrained by physical, economic, and technical factors essential for adaptive watershed management. The management strategies derived may enable decision makers to integrate a vast number of internal weirs, water intakes, reservoirs, drainage ditches, transfer pipelines, and wastewater treatment facilities within the basin and bring up the permitting issue for transboundary diversion from a neighboring river basin. Experience gained indicates that the use of different types of fuzzy operators is highly instructive, which also provide unique guidance collectively for achieving the overarching goals

  5. Insurance Contract Analysis for Company Decision Support in Acquisition Management

    NASA Astrophysics Data System (ADS)

    Chernovita, H. P.; Manongga, D.; Iriani, A.

    2017-01-01

    One of company activities to retain their business is marketing the products which include in acquisition management to get new customers. Insurance contract analysis using ID3 to produce decision tree and rules to be decision support for the insurance company. The decision tree shows 13 rules that lead to contract termination claim. This could be a guide for the insurance company in acquisition management to prevent contract binding with these contract condition because it has a big chance for the customer to terminate their insurance contract before its expired date. As the result, there are several strong points that could be the determinant of contract termination such as: 1) customer age whether too young or too old, 2) long insurance period (above 10 years), 3) big insurance amount, 4) big amount of premium charges, and 5) payment method.

  6. Joint Data Management for MOVINT Data-to-Decision Making

    DTIC Science & Technology

    2011-07-01

    Joint Data Management for MOVINT Data-to-Decision Making Erik P. Blasch Defence R&D Canada-Valcartier 2459 Pie -XI Blvd...Geographical Hard-Soft Information Fusion Systems,” Fusion10, 2010. [73] E. Blasch and S. Plano , “DFIG Level 5 (User Refinement) issues supporting

  7. INTEGRATED WATERSHED MANAGEMENT: LINKING SCIENCE TO DECISION MAKING

    EPA Science Inventory

    This paper describes some of the challenges and benefits of taking an integrated watershed approach to achieving Clean Water Act (CWA) and Safe Drinking Water Act (SDWA) goals, and some of the activities in EPA to facilitate watershed management decision making.

  8. Evaluating Academic Journals without Impact Factors for Collection Management Decisions.

    ERIC Educational Resources Information Center

    Dilevko, Juris; Atkinson, Esther

    2002-01-01

    Discussion of evaluating academic journals for collection management decisions focuses on a methodological framework for evaluating journals not ranked by impact factors in Journal Citation Reports. Compares nonranked journals with ranked journals and then applies this framework to a case study in the field of medical science. (LRW)

  9. Data Management & Decision Making. Technical Report No. 14.

    ERIC Educational Resources Information Center

    Speedie, Stuart M.; Sanders, Susan

    "Data Management and Decision Making" is a set of instructional materials designed to teach practicing and potential educational administrators about the uses of operations research in educational administration. It consists of five units--"Operations Research in Education,""PERT/CPM: A Planning and Analysis…

  10. 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…

  11. The effect of scientific evidence on conservation practitioners' management decisions.

    PubMed

    Walsh, Jessica C; Dicks, Lynn V; Sutherland, William J

    2015-02-01

    A major justification of environmental management research is that it helps practitioners, yet previous studies show it is rarely used to inform their decisions. We tested whether conservation practitioners focusing on bird management were willing to use a synopsis of relevant scientific literature to inform their management decisions. This allowed us to examine whether the limited use of scientific information in management is due to a lack of access to the scientific literature or whether it is because practitioners are either not interested or unable to incorporate the research into their decisions. In on-line surveys, we asked 92 conservation managers, predominantly from Australia, New Zealand, and the United Kingdom, to provide opinions on 28 management techniques that could be applied to reduce predation on birds. We asked their opinions before and after giving them a summary of the literature about the interventions' effectiveness. We scored the overall effectiveness and certainty of evidence for each intervention through an expert elicitation process-the Delphi method. We used the effectiveness scores to assess the practitioners' level of understanding and awareness of the literature. On average, each survey participant changed their likelihood of using 45.7% of the interventions after reading the synopsis of the evidence. They were more likely to implement effective interventions and avoid ineffective actions, suggesting that their intended future management strategies may be more successful than current practice. More experienced practitioners were less likely to change their management practices than those with less experience, even though they were not more aware of the existing scientific information than less experienced practitioners. The practitioners' willingness to change their management choices when provided with summarized scientific evidence suggests that improved accessibility to scientific information would benefit conservation management

  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... ``USCG Long Range Aids to Navigation (Loran-C) Program'' Web site at http://loranpeis.uscg.e2m-inc.com....1D., and ``Aids to Navigation Authorized,'' which appears at 14 U.S.C. 81. Dated: January 4,...

  13. Machine Learning Techniques for Decision Support in Intelligent Data Management

    NASA Astrophysics Data System (ADS)

    Lynnes, C.; Miller, J.; Ramapriyan, H.; Isaac, D.; Harberts, R.

    2002-12-01

    NASA's growth in remote sensing data volumes has kept pace with Moore's Law, i.e., doubling every 18 months, with future growth likely from new instruments. Also, advances in instrumental design (e.g., hyperspectral scanners) and science algorithms are enabling more near-real-time applications of the data. The confluence of low-latency requirements with high data volumes and numbers of files poses major challenges for archive data management. In order to make the right data available at the right time, an archive will need to apply knowledge of the data content in its data management decisions. This decision support domain includes aspects such as automatic quality assessment, feature detection to support caching decisions, and content-based metadata to support efficient data selection. In this study, we evaluate a variety of machine learning algorithms for use in several decision support roles in intelligent data management. Machine learning algorithms such as neural networks and clustering have been used for decision support in business and policy domains. These techniques have found some use in remote sensing, e.g., for cloud and land cover classification. Yet most research on remote sensing data rests on science-based algorithms, such as those based on radiative transfer equations. Machine learning for scientific applications faces challenges such as discretization constraints, non-physical basis, and the difficulty of assembling training sets. However, these difficulties may be less significant in the decision support role. For instance, it is often enough to know whether a data attribute exceeds a certain threshold when selecting it for an application, without knowing the exact value. The training data problem can be surmounted by using products output by the science-based algorithms. On the other hand, an advantage of machine learning algorithms for decision support is their speed once they have been trained. Data management decisions must be made while the

  14. 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.

  15. 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.

  16. Collaborative environmental planning in river management: An application of multicriteria decision analysis in the White River Watershed in Vermont

    USGS Publications Warehouse

    Hermans, C.; Erickson, J.; Noordewier, T.; Sheldon, A.; Kline, M.

    2007-01-01

    Multicriteria decision analysis (MCDA) provides a well-established family of decision tools to aid stakeholder groups in arriving at collective decisions. MCDA can also function as a framework for the social learning process, serving as an educational aid in decision problems characterized by a high level of public participation. In this paper, the framework and results of a structured decision process using the outranking MCDA methodology preference ranking organization method of enrichment evaluation (PROMETHEE) are presented. PROMETHEE is used to frame multi-stakeholder discussions of river management alternatives for the Upper White River of Central Vermont, in the northeastern United States. Stakeholders met over 10 months to create a shared vision of an ideal river and its services to communities, develop a list of criteria by which to evaluate river management alternatives, and elicit preferences to rank and compare individual and group preferences. The MCDA procedure helped to frame a group process that made stakeholder preferences explicit and substantive discussions about long-term river management possible. ?? 2006 Elsevier Ltd. All rights reserved.

  17. 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

  18. Trade-off decisions in distribution utility management

    NASA Astrophysics Data System (ADS)

    Slavickas, Rimas Anthony

    As a result of the "unbundling" of traditional monopolistic electricity generation and transmission enterprises into a free-market economy, power distribution utilities are faced with very difficult decisions pertaining to electricity supply options and quality of service to the customers. The management of distribution utilities has become increasingly complex, versatile, and dynamic to the extent that conventional, non-automated management tools are almost useless and obsolete. This thesis presents a novel and unified approach to managing electricity supply options and quality of service to customers. The technique formulates the problem in terms of variables, parameters, and constraints. An advanced Mixed Integer Programming (MIP) optimization formulation is developed together with novel, logical, decision-making algorithms. These tools enable the utility management to optimize various cost components and assess their time-trend impacts, taking into account the intangible issues such as customer perception, customer expectation, social pressures, and public response to service deterioration. The above concepts are further generalized and a Logical Proportion Analysis (LPA) methodology and associated software have been developed. Solutions using numbers are replaced with solutions using words (character strings) which more closely emulate the human decision-making process and advance the art of decision-making in the power utility environment. Using practical distribution utility operation data and customer surveys, the developments outlined in this thesis are successfully applied to several important utility management problems. These involve the evaluation of alternative electricity supply options, the impact of rate structures on utility business, and the decision of whether to continue to purchase from a main grid or generate locally (partially or totally) by building Non-Utility Generation (NUG).

  19. HIV/AIDS Case Managers and Client HIV Status Disclosure: Perceived Client Needs, Practices, and Services

    ERIC Educational Resources Information Center

    Kalichman, Seth C.; Klein, Susan J.; Kalichman, Moira O.; O'Connell, Daniel A.; Freedman, Jay A.; Eaton, Lisa; Cain, Demetria

    2007-01-01

    People living with HIV/AIDS often need assistance in deciding whether or how to disclose their HIV status to others, and case managers are in a unique position to offer this assistance. The current study surveyed 223 case managers providing services to people living with HIV/AIDS in New York State. The survey was conducted anonymously, and case…

  20. Visual aid tool to improve decision making in acute stroke care.

    PubMed

    Saposnik, Gustavo; Goyal, Mayank; Majoie, Charles; Dippel, Diederik; Roos, Yvo; Demchuk, Andrew; Menon, Bijoy; Mitchell, Peter; Campbell, Bruce; Dávalos, Antoni; Jovin, Tudor; Hill, Michael D

    2016-10-01

    Background Acute stroke care represents a challenge for decision makers. Recent randomized trials showed the benefits of endovascular therapy. Our goal was to provide a visual aid tool to guide clinicians in the decision process of endovascular intervention in patients with acute ischemic stroke. Methods We created visual plots (Cates' plots; www.nntonline.net ) representing benefits of standard of care vs. endovascular thrombectomy from the pooled analysis of five RCTs using stent retrievers. These plots represent the following clinically relevant outcomes (1) functionally independent state (modified Rankin scale (mRS) 0 to 2 at 90 days) (2) excellent recovery (mRS 0-1) at 90 days, (3) NIHSS 0-2 (4) early neurological recovery, and (5) revascularization at 24 h. Subgroups visually represented include time to treatment and baseline stroke severity strata. Results Overall, 1287 patients (634 assigned to endovascular thrombectomy, 653 assigned to control were included to create the visual plots. Cates' visual plots revealed that for every 100 patients with acute ischemic stroke and large vessel occlusion, 27 would achieve independence at 90 days (mRS 0-2) in the control group compared to 49 (95% CI 43-56) in the intervention group. Similarly, 21 patients would achieve early neurological recovery at 24 h compared to 54 (95% CI 45-63) out of 100 for the intervention group. Conclusion Cates' plots may assist clinicians and patients to visualize and compare potential outcomes after an acute ischemic stroke. Our results suggest that for every 100 treated individuals with an acute ischemic stroke and a large vessel occlusion, endovascular thrombectomy would provide 22 additional patients reaching independency at three months and 33 more patients achieving ENR compared to controls.

  1. Epinephrine for First-aid Management of Anaphylaxis.

    PubMed

    Sicherer, Scott H; Simons, F Estelle R

    2017-03-01

    Anaphylaxis is a severe, generalized allergic or hypersensitivity reaction that is rapid in onset and may cause death. Epinephrine (adrenaline) can be life-saving when administered as rapidly as possible once anaphylaxis is recognized. This clinical report from the American Academy of Pediatrics is an update of the 2007 clinical report on this topic. It provides information to help clinicians identify patients at risk of anaphylaxis and new information about epinephrine and epinephrine autoinjectors (EAs). The report also highlights the importance of patient and family education about the recognition and management of anaphylaxis in the community. Key points emphasized include the following: (1) validated clinical criteria are available to facilitate prompt diagnosis of anaphylaxis; (2) prompt intramuscular epinephrine injection in the mid-outer thigh reduces hospitalizations, morbidity, and mortality; (3) prescribing EAs facilitates timely epinephrine injection in community settings for patients with a history of anaphylaxis and, if specific circumstances warrant, for some high-risk patients who have not previously experienced anaphylaxis; (4) prescribing epinephrine for infants and young children weighing <15 kg, especially those who weigh 7.5 kg and under, currently presents a dilemma, because the lowest dose available in EAs, 0.15 mg, is a high dose for many infants and some young children; (5) effective management of anaphylaxis in the community requires a comprehensive approach involving children, families, preschools, schools, camps, and sports organizations; and (6) prevention of anaphylaxis recurrences involves confirmation of the trigger, discussion of specific allergen avoidance, allergen immunotherapy (eg, with stinging insect venom, if relevant), and a written, personalized anaphylaxis emergency action plan; and (7) the management of anaphylaxis also involves education of children and supervising adults about anaphylaxis recognition and first-aid

  2. Development of a Decision Aid for Patients with Advanced Heart Failure Considering a Destination Therapy Left Ventricular Assist Device

    PubMed Central

    Thompson, Jocelyn S.; Matlock, Daniel D.; McIlvennan, Colleen K.; Jenkins, Amy R.; Allen, Larry A.

    2015-01-01

    STRUCTURED ABSTRACT Objective We aimed to create decision aids (DAs) for patients considering destination therapy left ventricular assist device (DT LVAD). Background DT LVAD is a major decision for patients with end-stage heart failure. Patients facing decisions with complex tradeoffs may benefit from high-quality decision support resources. Methods Following the International Patient Decision Aid Standards (IPDAS) guidelines and based on a needs assessment with stakeholders, we developed drafts of paper and video DAs. With input from patients, caregivers, and clinicians through alpha testing, we iteratively modified the DAs to ensure acceptability. Results We conducted semi-structured interviews with 24 patients, 20 caregivers, and 24 clinicians to assess readability, bias, and usability of the DAs. Stakeholder feedback allowed us to integrate aspects critical to decision-making around highly invasive therapies for life-threatening diseases, including addressing emotion and fear of death, using gain frames for all options that focus on living, highlighting palliative and hospice care, integrating the caregiver role, and utilizing a range of balanced testimonials. After 19 iterative versions of the paper DA and four versions of the video DA, final materials were made available for wider use. Conclusion We developed the first IPDAS-level DAs for DT LVAD. Given the extreme nature of this medical decision, we augmented traditional DA characteristics with non-traditional DA features to address a spectrum of cognitive, automatic, and emotional aspects of end-of-life decision-making. Not only are the DAs important tools for those confronting end-stage heart failure, but the lessons learned will likely inform decision support for other invasive therapies. UNSTRUCTURED ABSTRACT Destination therapy left ventricular assist device (DT LVAD) is a major decision for patients with end-stage heart failure. We aimed to create decision aids (DAs) to support patients and their

  3. Use of decision support systems as a drought management tool

    USGS Publications Warehouse

    Frevert, D.; Lins, H.; ,

    2005-01-01

    Droughts present a unique challenge to water managers throughout the world and the current drought in the western United States is taxing facilities to the limit. Coping with this severe drought requires state of the art decision support systems including efficient and accurate hydrologic process models, detailed hydrologic data bases and effective river systems management modeling frameworks. This paper will outline a system of models developed by the Bureau of Reclamation, the US Geological Survey, the University of Colorado and a number of other governmental and university partners. The application of the technology to drought management in several key western river basins will be discussed.

  4. InformedTogether: Usability Evaluation of a Web-Based Decision Aid to Facilitate Shared Advance Care Planning for Severe Chronic Obstructive Pulmonary Disease

    PubMed Central

    Uhler, Lauren M; Pérez Figueroa, Rafael E; Dickson, Mark; McCullagh, Lauren; Kushniruk, Andre; Monkman, Helen; Witteman, Holly O

    2015-01-01

    Background Advance care planning may help patients receive treatments that better align with their goals for care. We developed a Web-based decision aid called InformedTogether to facilitate shared advance care planning between chronic obstructive pulmonary disease (COPD) patients and their doctors. Objective Our objective was to assess the usability of the InformedTogether decision aid, including whether users could interact with the decision aid to engage in tasks required for shared decision making, whether users found the decision aid acceptable, and implications for redesign. Methods We conducted an observational study with 15 patients and 8 doctors at two ethnically and socioeconomically diverse outpatient clinics. Data included quantitative and qualitative observations of patients and doctors using the decision aid on tablet or laptop computers and data from semistructured interviews. Patients were shown the decision aid by a researcher acting as the doctor. Pulmonary doctors were observed using the decision aid independently and asked to think aloud (ie, verbalize their thoughts). A thematic analysis was implemented to explore key issues related to decision aid usability. Results Although patients and doctors found InformedTogether acceptable and would recommend that doctors use the decision aid with COPD patients, many patients had difficulty understanding the icon arrays that were used to communicate estimated prognoses and could not articulate the definitions of the two treatment choices—Full Code and Do Not Resuscitate (DNR). Minor usability problems regarding content, links, layout, and consistency were also identified and corresponding recommendations were outlined. In particular, participants suggested including more information about potential changes in quality of life resulting from the alternative advance directives. Some doctor participants thought the decision aid was too long and some thought it may cause nervousness among patients due to

  5. Evaluation of a decision aid for prenatal testing of fetal abnormalities: a cluster randomised trial [ISRCTN22532458

    PubMed Central

    Nagle, Cate; Lewis, Sharon; Meiser, Bettina; Metcalfe, Sylvia; Carlin, John B; Bell, Robin; Gunn, Jane; Halliday, Jane

    2006-01-01

    Background By providing information on the relative merits and potential harms of the options available and a framework to clarify preferences, decision aids can improve knowledge and realistic expectations and decrease decisional conflict in individuals facing decisions between alternative forms of action. Decision-making about prenatal testing for fetal abnormalities is often confusing and difficult for women and the effectiveness of decision aids in this field has not been established. This study aims to test whether a decision aid for prenatal testing of fetal abnormalities, when compared to a pamphlet, improves women's informed decision-making and decreases decisional conflict. Methods/design A cluster designed randomised controlled trial is being conducted in Victoria, Australia. Fifty General Practitioners (GPs) have been randomised to one of two arms: providing women with either a decision aid or a pamphlet. The two primary outcomes will be measured by comparing the difference in percentages of women identified as making an informed choice and the difference in mean decisional conflict scores between the two groups. Data will be collected from women using questionnaires at 14 weeks and 24 weeks gestation. The sample size of 159 women in both arms of the trial has been calculated to detect a difference of 18% (50 to 68%) in informed choice between the two groups. The required numbers have been adjusted to accommodate the cluster design, miscarriage and participant lost – to – follow up. Baseline characteristics of women will be summarised for both arms of the trial. Similarly, characteristics of GPs will be compared between arms. Differences in the primary outcomes will be analysed using 'intention-to-treat' principles. Appropriate regression techniques will adjust for the effects of clustering and include covariates to adjust for the stratifying variable and major potential confounding factors. Discussion The findings from this trial will make a

  6. An environmentally sustainable decision model for urban solid waste management

    SciTech Connect

    Costi, P.; Minciardi, R.; Robba, M.; Rovatti, M.; Sacile, R

    2004-07-01

    The aim of this work is to present the structure and the application of a decision support system (DSS) designed to help decision makers of a municipality in the development of incineration, disposal, treatment and recycling integrated programs. Specifically, within a MSW management system, several treatment plants and facilities can generally be found: separators, plants for production of refuse derived fuel (RDF), incinerators with energy recovery, plants for treatment of organic material, and sanitary landfills. The main goal of the DSS is to plan the MSW management, defining the refuse flows that have to be sent to recycling or to different treatment or disposal plants, and suggesting the optimal number, the kinds, and the localization of the plants that have to be active. The DSS is based on a decision model that requires the solution of a constrained non-linear optimization problem, where some decision variables are binary and other ones are continuous. The objective function takes into account all possible economic costs, whereas constraints arise from technical, normative, and environmental issues. Specifically, pollution and impacts, induced by the overall solid waste management system, are considered through the formalization of constraints on incineration emissions and on negative effects produced by disposal or other particular treatments.

  7. 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

  8. 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.

  9. Pilot test of a patient decision aid about liver transplant organ quality.

    PubMed

    Volk, Michael L; Roney, Meghan; Fagerlin, Angela

    2014-07-01

    Prior studies have shown that patients are reluctant to accept donor-specific risks, and transplant professionals lack an effective and time-efficient means of obtaining informed consent. We designed and pilot-tested a Web-based patient decision aid (DA) on organ quality. The DA was administered to 53 liver transplant candidates (median Model for End-Stage Liver Disease score = 14, range = 7-26), and they took a mean of 15 minutes to complete it. Questions about knowledge and attitudes were asked before and after the DA. Subjects' knowledge improved, with 53% and 60% correctly answering questions about hepatitis B virus and human immunodeficiency virus transmission before the DA and 94% and 100%, respectively, correctly answering them afterward (P < 0.001). The accuracy of mortality prediction also improved from a mean 3-month mortality estimate of 22% before the DA to 12% afterward (P < 0.001). After the DA, subjects felt that it was more likely that they might be offered a less-than-perfect liver (P = 0.001), and they were more likely to consider accepting such a liver (P < 0.001). In conclusion, implementing a Web-based patient DA is feasible and improves knowledge among liver transplant candidates. The use of this tool may decrease candidates' reluctance to accept extended criteria organs.

  10. 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

  11. A decision analysis framework for stakeholder involvement and learning in groundwater management

    NASA Astrophysics Data System (ADS)

    Karjalainen, T. P.; Rossi, P. M.; Ala-aho, P.; Eskelinen, R.; Reinikainen, K.; Kløve, B.; Pulido-Velazquez, M.; Yang, H.

    2013-12-01

    Multi-criteria decision analysis (MCDA) methods are increasingly used to facilitate both rigorous analysis and stakeholder involvement in natural and water resource planning. Decision-making in that context is often complex and multi-faceted with numerous trade-offs between social, environmental and economic impacts. However, practical applications of decision-support methods are often too technically oriented and hard to use, understand or interpret for all participants. The learning of participants in these processes is seldom examined, even though successful deliberation depends on learning. This paper analyzes the potential of an interactive MCDA framework, the decision analysis interview (DAI) approach, for facilitating stakeholder involvement and learning in groundwater management. It evaluates the results of the MCDA process in assessing land-use management alternatives in a Finnish esker aquifer area where conflicting land uses affect the groundwater body and dependent ecosystems. In the assessment process, emphasis was placed on the interactive role of the MCDA tool in facilitating stakeholder participation and learning. The results confirmed that the structured decision analysis framework can foster learning and collaboration in a process where disputes and diverse interests are represented. Computer-aided interviews helped the participants to see how their preferences affected the desirability and ranking of alternatives. During the process, the participants' knowledge and preferences evolved as they assessed their initial knowledge with the help of fresh scientific information. The decision analysis process led to the opening of a dialogue, showing the overall picture of the problem context and the critical issues for the further process.

  12. A decision analysis framework for stakeholder involvement and learning in groundwater management

    NASA Astrophysics Data System (ADS)

    Karjalainen, T. P.; Rossi, P. M.; Ala-aho, P.; Eskelinen, R.; Reinikainen, K.; Kløve, B.; Pulido-Velazquez, M.; Yang, H.

    2013-07-01

    Multi-criteria decision analysis (MCDA) methods are increasingly used to facilitate both rigorous analysis and stakeholder involvement in natural and water resource planning. Decision making in that context is often complex and multi-faceted with numerous trade-offs between social, environmental and economic impacts. However, practical applications of decision-support methods are often too technically oriented and hard to use, understand or interpret for all participants. The learning of participants in these processes is seldom examined, even though successful deliberation depends on learning. This paper analyzes the potential of an interactive MCDA framework, the decision analysis interview (DAI) approach, for facilitating stakeholder involvement and learning in groundwater management. It evaluates the results of an MCDA process in assessing land-use management alternatives in a Finnish esker aquifer area where conflicting land uses affect the groundwater body and dependent ecosystems. In the assessment process, emphasis was placed on the interactive role of the MCDA tool in facilitating stakeholder participation and learning. The results confirmed that the structured decision analysis framework can foster learning and collaboration in a process where disputes and diverse interests are represented. Computer-aided interviews helped the participants to see how their preferences affected the desirability and ranking of alternatives. During the process, the participants' knowledge and preferences evolved as they assess their initial knowledge with the help of fresh scientific information. The decision analysis process led to the opening of a dialogue, showing the overall picture of the problem context, and the critical issues for the further process.

  13. Resolving future fire management conflicts using multicriteria decision making.

    PubMed

    Driscoll, Don A; Bode, Michael; Bradstock, Ross A; Keith, David A; Penman, Trent D; Price, Owen F

    2016-02-01

    Management strategies to reduce the risks to human life and property from wildfire commonly involve burning native vegetation. However, planned burning can conflict with other societal objectives such as human health and biodiversity conservation. These conflicts are likely to intensify as fire regimes change under future climates and as growing human populations encroach farther into fire-prone ecosystems. Decisions about managing fire risks are therefore complex and warrant more sophisticated approaches than are typically used. We applied a multicriteria decision making approach (MCDA) with the potential to improve fire management outcomes to the case of a highly populated, biodiverse, and flammable wildland-urban interface. We considered the effects of 22 planned burning options on 8 objectives: house protection, maximizing water quality, minimizing carbon emissions and impacts on human health, and minimizing declines of 5 distinct species types. The MCDA identified a small number of management options (burning forest adjacent to houses) that performed well for most objectives, but not for one species type (arboreal mammal) or for water quality. Although MCDA made the conflict between objectives explicit, resolution of the problem depended on the weighting assigned to each objective. Additive weighting of criteria traded off the arboreal mammal and water quality objectives for other objectives. Multiplicative weighting identified scenarios that avoided poor outcomes for any objective, which is important for avoiding potentially irreversible biodiversity losses. To distinguish reliably among management options, future work should focus on reducing uncertainty in outcomes across a range of objectives. Considering management actions that have more predictable outcomes than landscape fuel management will be important. We found that, where data were adequate, an MCDA can support decision making in the complex and often conflicted area of fire management.

  14. The use of a spatial information system in the management of HIV/AIDS in South Africa.

    PubMed

    Busgeeth, Karishma; Rivett, Ulrike

    2004-07-07

    BACKGROUND: South Africa is experiencing an HIV/AIDS pandemic of shattering dimensions. The availability and provision of antiretroviral (ARV) drugs could bring relief to the situation, but the treatment is unfortunately complex with each patient being assigned a different antiretroviral therapy varying in diet-medication regiment. The context of South Africa, its variety of urban and rural settings adds to the challenge of administering and monitoring the HIV+ person throughout the treatment, which will last for the rest of their lives. The lack of physical infrastructure, reliable statistics and adequate resources hinder the efficient management of HIV/AIDS. RESULTS: The collection of reliable data will be a first step to assess the status of HIV/AIDS in communities. A number of hospitals have started this process using the conventional approach to collect information about their patients using a paper-based system. Since time is of essence in the fight against the pandemic, data exchange between various hospitals, municipalities and decision-making bodies is becoming more and more important. The logical response to such a need is a computerised system, which will collect and administer HIV/AIDS related information within the local context and allow a monitored access to the data from a number of stakeholders. CONCLUSIONS: The purpose of this study was to design and develop an HIV/AIDS database, which is embedded in a Spatial Information Management System. The pilot study area is the Gugulethu township in Cape Town where more than 27% of the 325 000 residents are HIV+. It is shown that the implementation of the HIV/AIDS database and the Spatial Information Management System can play a critical role in determining where and when to intervene, improving the quality of care for HIV+ patients, increasing accessibility of service and delivering a cost-effective mode of information.

  15. The use of a spatial information system in the management of HIV/AIDS in South Africa

    PubMed Central

    Busgeeth, Karishma; Rivett, Ulrike

    2004-01-01

    Background South Africa is experiencing an HIV/AIDS pandemic of shattering dimensions. The availability and provision of antiretroviral (ARV) drugs could bring relief to the situation, but the treatment is unfortunately complex with each patient being assigned a different antiretroviral therapy varying in diet-medication regiment. The context of South Africa, its variety of urban and rural settings adds to the challenge of administering and monitoring the HIV+ person throughout the treatment, which will last for the rest of their lives. The lack of physical infrastructure, reliable statistics and adequate resources hinder the efficient management of HIV/AIDS. Results The collection of reliable data will be a first step to assess the status of HIV/AIDS in communities. A number of hospitals have started this process using the conventional approach to collect information about their patients using a paper-based system. Since time is of essence in the fight against the pandemic, data exchange between various hospitals, municipalities and decision-making bodies is becoming more and more important. The logical response to such a need is a computerised system, which will collect and administer HIV/AIDS related information within the local context and allow a monitored access to the data from a number of stakeholders. Conclusions The purpose of this study was to design and develop an HIV/AIDS database, which is embedded in a Spatial Information Management System. The pilot study area is the Gugulethu township in Cape Town where more than 27% of the 325 000 residents are HIV+. It is shown that the implementation of the HIV/AIDS database and the Spatial Information Management System can play a critical role in determining where and when to intervene, improving the quality of care for HIV+ patients, increasing accessibility of service and delivering a cost-effective mode of information. PMID:15239839

  16. Choosing a sustainable demolition waste management strategy using multicriteria decision analysis.

    PubMed

    Roussat, Nicolas; Dujet, Christiane; Méhu, Jacques

    2009-01-01

    This paper presents an application of the ELECTRE III decision-aid method in the context of choosing a sustainable demolition waste management strategy for a case study in the city of Lyon, France. This choice of waste management strategy takes into consideration the sustainable development objectives, i.e. economic aspects, environmental consequences, and social issues. Nine alternatives for demolition waste management were compared with the aid of eight criteria, taking into account energy consumption, depletion of abiotic resources, global warming, dispersion of dangerous substances in the environment, economic activity, employment, and quality of life of the local population. The case study concerned the demolition of 25 buildings of an old military camp. Each alternative was illustrated with different waste treatments, such as material recovery, recycling, landfilling, and energy recovery. The recommended solution for sustainable demolition waste management for the case study is a selective deconstruction of each building with local material recovery in road engineering of inert wastes, local energy recovery of wood wastes, and specific treatments for hazardous wastes.

  17. Choosing a sustainable demolition waste management strategy using multicriteria decision analysis

    SciTech Connect

    Roussat, Nicolas Dujet, Christiane; Mehu, Jacques

    2009-01-15

    This paper presents an application of the ELECTRE III decision-aid method in the context of choosing a sustainable demolition waste management strategy for a case study in the city of Lyon, France. This choice of waste management strategy takes into consideration the sustainable development objectives, i.e. economic aspects, environmental consequences, and social issues. Nine alternatives for demolition waste management were compared with the aid of eight criteria, taking into account energy consumption, depletion of abiotic resources, global warming, dispersion of dangerous substances in the environment, economic activity, employment, and quality of life of the local population. The case study concerned the demolition of 25 buildings of an old military camp. Each alternative was illustrated with different waste treatments, such as material recovery, recycling, landfilling, and energy recovery. The recommended solution for sustainable demolition waste management for the case study is a selective deconstruction of each building with local material recovery in road engineering of inert wastes, local energy recovery of wood wastes, and specific treatments for hazardous wastes.

  18. Keeping a tight grip on the reins: donor control over aid coordination and management in Bangladesh.

    PubMed

    Buse, K

    1999-09-01

    A long-standing consensus that aid coordination should be owned by recipient authorities has been eclipsed by accord on the desirability of recipient management of aid along-side domestic resources. Nonetheless, in many low and lower-middle income countries, donors remain remarkably uncoordinated; where attempts at coordination are made, they are often donor-driven, and only a small proportion of aid is directly managed by recipients. This paper draws on evidence from an in-depth review of aid to the health sector in Bangladesh to analyze the systems by which external resources are managed. Based on interviews with key stakeholders, a questionnaire survey and analysis of documentary sources, the factors constraining the government from assuming a more active role in aid management are explored. The results suggest that donor perceptions of weak government capacity, inadequate accountability and compromised integrity only partially account for the propensity for donor leadership. Equally important is the consideration that aid coordination has a markedly political dimension. Stakeholders are well aware of the power, influence and leverage which aid coordination confers, an awareness which colours the desire of some stakeholders to lead aid coordination processes, and conditions the extent and manner by which others wish to be involved. It is argued that recipient management of external aid is dependent on major changes in the attitudes and behaviours of recipients and donors alike.

  19. Portfolio Decision Analysis Framework for Value-Focused Ecosystem Management.

    PubMed

    Convertino, Matteo; Valverde, L James

    2013-01-01

    Management of natural resources in coastal ecosystems is a complex process that is made more challenging by the need for stakeholders to confront the prospect of sea level rise and a host of other environmental stressors. This situation is especially true for coastal military installations, where resource managers need to balance conflicting objectives of environmental conservation against military mission. The development of restoration plans will necessitate incorporating stakeholder preferences, and will, moreover, require compliance with applicable federal/state laws and regulations. To promote the efficient allocation of scarce resources in space and time, we develop a portfolio decision analytic (PDA) framework that integrates models yielding policy-dependent predictions for changes in land cover and species metapopulations in response to restoration plans, under different climate change scenarios. In a manner that is somewhat analogous to financial portfolios, infrastructure and natural resources are classified as human and natural assets requiring management. The predictions serve as inputs to a Multi Criteria Decision Analysis model (MCDA) that is used to measure the benefits of restoration plans, as well as to construct Pareto frontiers that represent optimal portfolio allocations of restoration actions and resources. Optimal plans allow managers to maintain or increase asset values by contrasting the overall degradation of the habitat and possible increased risk of species decline against the benefits of mission success. The optimal combination of restoration actions that emerge from the PDA framework allows decision-makers to achieve higher environmental benefits, with equal or lower costs, than those achievable by adopting the myopic prescriptions of the MCDA model. The analytic framework presented here is generalizable for the selection of optimal management plans in any ecosystem where human use of the environment conflicts with the needs of

  20. Portfolio Decision Analysis Framework for Value-Focused Ecosystem Management

    PubMed Central

    Convertino, Matteo; Valverde, L. James

    2013-01-01

    Management of natural resources in coastal ecosystems is a complex process that is made more challenging by the need for stakeholders to confront the prospect of sea level rise and a host of other environmental stressors. This situation is especially true for coastal military installations, where resource managers need to balance conflicting objectives of environmental conservation against military mission. The development of restoration plans will necessitate incorporating stakeholder preferences, and will, moreover, require compliance with applicable federal/state laws and regulations. To promote the efficient allocation of scarce resources in space and time, we develop a portfolio decision analytic (PDA) framework that integrates models yielding policy-dependent predictions for changes in land cover and species metapopulations in response to restoration plans, under different climate change scenarios. In a manner that is somewhat analogous to financial portfolios, infrastructure and natural resources are classified as human and natural assets requiring management. The predictions serve as inputs to a Multi Criteria Decision Analysis model (MCDA) that is used to measure the benefits of restoration plans, as well as to construct Pareto frontiers that represent optimal portfolio allocations of restoration actions and resources. Optimal plans allow managers to maintain or increase asset values by contrasting the overall degradation of the habitat and possible increased risk of species decline against the benefits of mission success. The optimal combination of restoration actions that emerge from the PDA framework allows decision-makers to achieve higher environmental benefits, with equal or lower costs, than those achievable by adopting the myopic prescriptions of the MCDA model. The analytic framework presented here is generalizable for the selection of optimal management plans in any ecosystem where human use of the environment conflicts with the needs of

  1. 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…

  2. The Ebb and Flow of Airborne Pathogens: Monitoring and Use in Disease Management Decisions.

    PubMed

    Mahaffee, Walter F; Stoll, Rob

    2016-05-01

    Perhaps the earliest form of monitoring the regional spread of plant disease was a group of growers gathering together at the market and discussing what they see in their crops. This type of reporting continues to this day through regional extension blogs, by crop consultants and more formal scouting of sentential plots in the IPM PIPE network (http://www.ipmpipe.org/). As our knowledge of plant disease epidemiology has increased, we have also increased our ability to detect and monitor the presence of pathogens and use this information to make management decisions in commercial production systems. The advent of phylogenetics, next-generation sequencing, and nucleic acid amplification technologies has allowed for development of sensitive and accurate assays for pathogen inoculum detection and quantification. The application of these tools is beginning to change how we manage diseases with airborne inoculum by allowing for the detection of pathogen movement instead of assuming it and by targeting management strategies to the early phases of the epidemic development when there is the greatest opportunity to reduce the rate of disease development. While there are numerous advantages to using data on inoculum presence to aid management decisions, there are limitations in what the data represent that are often unrecognized. In addition, our understanding of where and how to effectively monitor airborne inoculum is limited. There is a strong need to improve our knowledge of the mechanisms that influence inoculum dispersion across scales as particles move from leaf to leaf, and everything in between.

  3. 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.

  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. A Pilot Randomized Trial of a Video Patient Decision Aid to Facilitate Early Intervention Referrals From Primary Care.

    PubMed

    Jimenez, Manuel E; DuRivage, Nathalie E; Bezpalko, Orysia; Suh, Andrew; Wade, Roy; Blum, Nathan J; Fiks, Alexander G

    2017-03-01

    Many young children identified with developmental concerns in pediatric settings do not receive early intervention (EI). We assessed the impact of a video decision aid and text message reminder on knowledge and attitudes regarding developmental delay and EI as well as referral completion. We conducted a pilot randomized controlled trial in an urban setting and enrolled 64 parent-child dyads referred to EI. Compared with controls, participants who received the intervention demonstrated increased knowledge regarding developmental delay and EI as well as more favorable attitudes in certain topics. Although we did not find a significant difference between arms in EI intake and evaluation, we found a pattern suggestive of increased intake and evaluation among participants with low health literacy in the intervention arm. Additional study is needed to identify strategies that improve the EI referral process for families and to understand the potential targeted role for decision aids and text messages.

  6. Restoring and Managing Gulf of Mexico Fisheries: A Path Toward Creative Decision-Making

    EPA Science Inventory

    This chapter introduces decision analysis concepts with examples for managing fisheries. Decision analytic methods provide useful tools for structuring environmental management problems and separating technical judgments from preference judgments to better weigh the prospects fro...

  7. Risk Management for Weapon Systems Acquisition: A Decision Support System

    DTIC Science & Technology

    1985-02-28

    identification purposes. As another example, consider the well-known multiattribute utility theory approach. Such a method may be an appropriate risk...provide comprcbensive and balanced asseisnient unlcsted. B-25 B.5.1 Decision Analysis/Multiactribute Utility Theory (DA/ MAUT ) (Keeney and Raiffa...Perspective, Addison-Wesley, Boston, 1978. Keeney, R.L., "An Illustrated Procedure for Assessing Multiattributed Utility Functions," Sloan Management

  8. The role of behavioral decision theory for cockpit information management

    NASA Technical Reports Server (NTRS)

    Jonsson, Jon E.

    1991-01-01

    The focus of this report is the consideration of one form of cognition, judgment and decision making, while examining some information management issues associated with the implementation of new forms of automation. As technology matures and more tasks become suitable to automation, human factors researchers will have to consider the effect that increasing automation will have on operator performance. Current technology allows flight deck designers the opportunity to automate activities involving substantially more cognitive processing.

  9. 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

  10. The effect of offering different numbers of colorectal cancer screening test options in a decision aid: a pilot randomized trial

    PubMed Central

    Griffith, Jennifer M; Lewis, Carmen L; Brenner, Alison RT; Pignone, Michael P

    2008-01-01

    Background Decision aids can improve decision making processes, but the amount and type of information that they should attempt to communicate is controversial. We sought to compare, in a pilot randomized trial, two colorectal cancer (CRC) screening decision aids that differed in the number of screening options presented. Methods Adults ages 48–75 not currently up to date with screening were recruited from the community and randomized to view one of two versions of our previously tested CRC screening decision aid. The first version included five screening options: fecal occult blood test (FOBT), sigmoidoscopy, a combination of FOBT and sigmoidoscopy, colonoscopy, and barium enema. The second discussed only the two most frequently selected screening options, FOBT and colonoscopy. Main outcomes were differences in screening interest and test preferences between groups after decision aid viewing. Patient test preference was elicited first without any associated out-of-pocket costs (OPC), and then with the following costs: FOBT-$10, sigmoidoscopy-$50, barium enema-$50, and colonoscopy-$200. Results 62 adults participated: 25 viewed the 5-option decision aid, and 37 viewed the 2-option version. Mean age was 54 (range 48–72), 58% were women, 71% were White, 24% African-American; 58% had completed at least a 4-year college degree. Comparing participants that viewed the 5-option version with participants who viewed the 2-option version, there were no differences in screening interest after viewing (1.8 vs. 1.9, t-test p = 0.76). Those viewing the 2-option version were somewhat more likely to choose colonoscopy than those viewing the 5-option version when no out of pocket costs were assumed (68% vs. 46%, p = 0.11), but not when such costs were imposed (41% vs. 42%, p = 1.00). Conclusion The number of screening options available does not appear to have a large effect on interest in colorectal cancer screening. The effect of offering differing numbers of options may

  11. Contingency Management and Deliberative Decision-Making Processes

    PubMed Central

    Regier, Paul S.; Redish, A. David

    2015-01-01

    Contingency management is an effective treatment for drug addiction. The current explanation for its success is rooted in alternative reinforcement theory. We suggest that alternative reinforcement theory is inadequate to explain the success of contingency management and produce a model based on demand curves that show how little the monetary rewards offered in this treatment would affect drug use. Instead, we offer an explanation of its success based on the concept that it accesses deliberative decision-making processes. We suggest that contingency management is effective because it offers a concrete and immediate alternative to using drugs, which engages deliberative processes, improves the ability of those deliberative processes to attend to non-drug options, and offsets more automatic action-selection systems. This theory makes explicit predictions that can be tested, suggests which users will be most helped by contingency management, and suggests improvements in its implementation. PMID:26082725

  12. Contingency Management and Deliberative Decision-Making Processes.

    PubMed

    Regier, Paul S; Redish, A David

    2015-01-01

    Contingency management is an effective treatment for drug addiction. The current explanation for its success is rooted in alternative reinforcement theory. We suggest that alternative reinforcement theory is inadequate to explain the success of contingency management and produce a model based on demand curves that show how little the monetary rewards offered in this treatment would affect drug use. Instead, we offer an explanation of its success based on the concept that it accesses deliberative decision-making processes. We suggest that contingency management is effective because it offers a concrete and immediate alternative to using drugs, which engages deliberative processes, improves the ability of those deliberative processes to attend to non-drug options, and offsets more automatic action-selection systems. This theory makes explicit predictions that can be tested, suggests which users will be most helped by contingency management, and suggests improvements in its implementation.

  13. 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.

  14. Artificial intelligence based decision support for trumpeter swan management

    USGS Publications Warehouse

    Sojda, Richard S.

    2002-01-01

    The number of trumpeter swans (Cygnus buccinator) breeding in the Tri-State area where Montana, Idaho, and Wyoming come together has declined to just a few hundred pairs. However, these birds are part of the Rocky Mountain Population which additionally has over 3,500 birds breeding in Alberta, British Columbia, Northwest Territories, and Yukon Territory. To a large degree, these birds seem to have abandoned traditional migratory pathways in the flyway. Waterfowl managers have been interested in decision support tools that would help them explore simulated management scenarios in their quest towards reaching population recovery and the reestablishment of traditional migratory pathways. I have developed a decision support system to assist biologists with such management, especially related to wetland ecology. Decision support systems use a combination of models, analytical techniques, and information retrieval to help develop and evaluate appropriate alternatives. Swan management is a domain that is ecologically complex, and this complexity is compounded by spatial and temporal issues. As such, swan management is an inherently distributed problem. Therefore, the ecological context for modeling swan movements in response to management actions was built as a multiagent system of interacting intelligent agents that implements a queuing model representing swan migration. These agents accessed ecological knowledge about swans, their habitats, and flyway management principles from three independent expert systems. The agents were autonomous, had some sensory capability, and could respond to changing conditions. A key problem when developing ecological decision support systems is empirically determining that the recommendations provided are valid. Because Rocky Mountain trumpeter swans have been surveyed for a long period of time, I was able to compare simulated distributions provided by the system with actual field observations across 20 areas for the period 1988

  15. Disaster Management with a Next Generation Disaster Decision Support System

    NASA Astrophysics Data System (ADS)

    Chen, Y.

    2015-12-01

    As populations become increasingly concentrated in large cities, the world is experiencing an inevitably growing trend towards the urbanisation of disasters. Scientists have contributed significant advances in understanding the geophysical causes of natural hazards and have developed sophisticated tools to predict their effects; while, much less attention has been devoted to tools that increase situational awareness, facilitate leadership, provide effective communication channels and data flow and enhance the cognitive abilities of decision makers and first responders. In this paper, we envisioned the capabilities of a next generation disaster decision support system and hence proposed a state-of-the-art system architecture design to facilitate the decision making process in natural catastrophes such as flood and bushfire by utilising a combination of technologies for multi-channel data aggregation, disaster modelling, visualisation and optimisation. Moreover, we put our thoughts into action by implementing an Intelligent Disaster Decision Support System (IDDSS). The developed system can easily plug in to external disaster models and aggregate large amount of heterogeneous data from government agencies, sensor networks, and crowd sourcing platforms in real-time to enhance the situational awareness of decision makers and offer them a comprehensive understanding of disaster impacts from diverse perspectives such as environment, infrastructure and economy, etc. Sponsored by the Australian Government and the Victorian Department of Justice (Australia), the system was built upon a series of open-source frameworks (see attached figure) with four key components: data management layer, model application layer, processing service layer and presentation layer. It has the potential to be adopted by a range of agencies across Australian jurisdictions to assist stakeholders in accessing, sharing and utilising available information in their management of disaster events.

  16. Enrollment Management and Financial Aid Part Two: A Public Policy Perspective

    ERIC Educational Resources Information Center

    Hossler, Don; Kalsbeek, David

    2008-01-01

    In our previous essay, we considered the role of institutional financial aid and the practice of enrollment management. In that essay we explored the use of financial aid as a tool to enhance equity increase prestige, as a revenue enhancement tool and as a means to shape institutional image in the various markets that comprise our diverse system…

  17. A patient decision aid to support shared decision‐making on anti‐thrombotic treatment of patients with atrial fibrillation: randomised controlled trial

    PubMed Central

    Thomson, Richard G; Eccles, Martin P; Steen, I Nick; Greenaway, Jane; Stobbart, Lynne; Murtagh, Madeleine J; May, Carl R

    2007-01-01

    Objective To determine the efficacy of a computerised decision aid in patients with atrial fibrillation making decisions on whether to take warfarin or aspirin therapy. Design Two‐armed open exploratory randomised controlled trial. Setting Two research clinics deriving participants from general practices in Northeast England. Participants 109 patients with atrial fibrillation aged over 60. Interventions Computerised decision aid applied in shared decision‐making clinic compared to evidence‐based paper guidelines applied as direct advice. Main outcome measures Primary outcome measure was the decision conflict scale. Secondary outcome measures included anxiety, knowledge, decision‐making preference, treatment decision, use of primary and secondary care services and health outcomes. Results Decision conflict was lower in the computerised decision aid group immediately after the clinic; mean difference −0.18 (95% CI −0.34 to −0.01). Participants in this group not already on warfarin were much less likely to start warfarin than those in the guidelines arm (4/16, 25% compared to the guidelines group 15/16, 93.8%, RR 0.27, 95% CI 0.11 to 0.63). Conclusions Decision conflict was lower immediately following the use of a computerised decision aid in a shared decision‐making consultation than immediately following direct doctor‐led advice based on paper guidelines. Furthermore, participants in the computerised decision aid group were significantly much less likely to start warfarin than those in the guidelines arm. The results show that such an approach has a positive impact on decision conflict comparable to other studies of decision aids, but also reduces the uptake of a clinically effective treatment that may have important implications for health outcomes. PMID:17545350

  18. Managing health care decisions and improvement through simulation modeling.

    PubMed

    Forsberg, Helena Hvitfeldt; Aronsson, Håkan; Keller, Christina; Lindblad, Staffan

    2011-01-01

    Simulation modeling is a way to test changes in a computerized environment to give ideas for improvements before implementation. This article reviews research literature on simulation modeling as support for health care decision making. The aim is to investigate the experience and potential value of such decision support and quality of articles retrieved. A literature search was conducted, and the selection criteria yielded 59 articles derived from diverse applications and methods. Most met the stated research-quality criteria. This review identified how simulation can facilitate decision making and that it may induce learning. Furthermore, simulation offers immediate feedback about proposed changes, allows analysis of scenarios, and promotes communication on building a shared system view and understanding of how a complex system works. However, only 14 of the 59 articles reported on implementation experiences, including how decision making was supported. On the basis of these articles, we proposed steps essential for the success of simulation projects, not just in the computer, but also in clinical reality. We also presented a novel concept combining simulation modeling with the established plan-do-study-act cycle for improvement. Future scientific inquiries concerning implementation, impact, and the value for health care management are needed to realize the full potential of simulation modeling.

  19. 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…

  20. Patient management scenario: a framework for clinical decision and prognosis.

    PubMed

    Gospodarowicz, Mary; O'Sullivan, Brian

    2003-01-01

    The depiction of prognosis is one of the main activities and a mainstay in medical practice. In cancer, as in other diseases, the prognosis differs for a variety of situations and evolves with time and with medical interventions. Although most commonly described at diagnosis, prognosis may be defined at any time during the course of the disease and for any endpoint including response to therapy, failure of treatment, survival, or preservation of function, and so forth. To facilitate the accurate portrayal of the future, the prognosis should be defined within a specific setting, referred to as a 'management scenario'. In the concept of a management scenario, the prognosis is defined using systematically considered prognostic factors, interventions and the outcome of interest. A deliberate and careful determination of prognosis is essential to clinical decision making and patient care. We illustrate the use of the concept of management scenario in several clinical examples.

  1. Conceptualization of a Collaborative Decision Making for Flood Disaster Management

    NASA Astrophysics Data System (ADS)

    Nur Aishah Zubir, Siti; Thiruchelvam, Sivadass; Nasharuddin Mustapha, Kamal; Che Muda, Zakaria; Ghazali, Azrul; Hakimie, Hazlinda; Razak, Normy Norfiza Abdul; Aziz Mat Isa, Abdul; Hasini, Hasril; Sahari, Khairul Salleh Mohamed; Mat Husin, Norhayati; Ezanee Rusli, Mohd; Sabri Muda, Rahsidi; Mohd Sidek, Lariyah; Basri, Hidayah; Tukiman, Izawati

    2016-03-01

    Flooding is the utmost major natural hazard in Malaysia in terms of populations affected, frequency, area extent, flood duration and social economic damage. The recent flood devastation towards the end of 2014 witnessed almost 250,000 people being displaced from eight states in Peninsular Malaysia. The affected victims required evacuation within a short period of time to the designated evacuation centres. An effective and efficient flood disaster management would assure non-futile efforts for life-saving. Effective flood disaster management requires collective and cooperative emergency teamwork from various government agencies. Intergovernmental collaborations among government agencies at different levels have become part of flood disaster management due to the need for sharing resources and coordinating efforts. Collaborative decision making during disaster is an integral element in providing prompt and effective response for evacuating the victims.

  2. [Knowledge management system for laboratory work and clinical decision support].

    PubMed

    Inada, Masanori; Sato, Mayumi; Yoneyama, Akiko

    2011-05-01

    This paper discusses a knowledge management system for clinical laboratories. In the clinical laboratory of Toranomon Hospital, we receive about 20 questions relevant to laboratory tests per day from medical doctors or co-medical staff. These questions mostly involve the essence to appropriately accomplish laboratory tests. We have to answer them carefully and suitably because an incorrect answer may cause a medical accident. Up to now, no method has been in place to achieve a rapid response and standardized answers. For this reason, the laboratory staff have responded to various questions based on their individual knowledge. We began to develop a knowledge management system to promote the knowledge of staff working for the laboratory. This system is a type of knowledge base for assisting the work, such as inquiry management, laboratory consultation, process management, and clinical support. It consists of several functions: guiding laboratory test information, managing inquiries from medical staff, reporting results of patient consultation, distributing laboratory staffs notes, and recording guidelines for laboratory medicine. The laboratory test information guide has 2,000 records of medical test information registered in the database with flexible retrieval. The inquiry management tool provides a methos to record all questions, answer easily, and retrieve cases. It helps staff to respond appropriately in a short period of time. The consulting report system treats patients' claims regarding medical tests. The laboratory staffs notes enter a file management system so they can be accessed to aid in clinical support. Knowledge sharing using this function can achieve the transition from individual to organizational learning. Storing guidelines for laboratory medicine will support EBM. Finally, it is expected that this system will support intellectual activity concerning laboratory work and contribute to the practice of knowledge management for clinical work support.

  3. Decision making for health care managers and supervisors: theory into practice.

    PubMed

    Layman, Elizabeth J

    2011-01-01

    Health care managers and supervisors make decisions throughout the day. Often, they use the common steps of decision making. This article describes common decision theories that underpin the steps. The article includes specific examples of applications of the theories and a glossary of terms. Experienced and novice health care managers and supervisors can improve their decision making by matching concepts from the decision theories to their problems.

  4. Self-Managed Work Teams in Nursing Homes: Implementing and Empowering Nurse Aide Teams

    ERIC Educational Resources Information Center

    Yeatts, Dale E.; Cready, Cynthia; Ray, Beth; DeWitt, Amy; Queen, Courtney

    2004-01-01

    Purpose: This article describes the progress of our study to examine the advantages and costs of using self-managed nurse aide teams in nursing homes, steps that are being taken to implement such teams, and management strategies being used to manage the teams. Design and Methods: A quasi-experimental design is underway where certified nurse aide…

  5. Clinical decision support systems: data quality management and governance.

    PubMed

    Liaw, Siaw-Teng

    2013-01-01

    This chapter examines data quality management (DQM) and information governance (IG) of electronic decision support (EDS) systems so that they are safe and fit for use by clinicians and patients and their carers. This is consistent with the ISO definition of data quality as being fit for purpose. The scope of DQM & IG should range from data creation and collection in clinical settings, through cleaning and, where obtained from multiple sources, linkage, storage, use by the EDS logic engine and algorithms, knowledge base and guidance provided, to curation and presentation. It must also include protocols and mechanisms to monitor the safety of EDS, which will feedback into DQM & IG activities. Ultimately, DQM & IG must be integrated across the data cycle to ensure that the EDS systems provide guidance that leads to safe and effective clinical decisions and care.

  6. The Effect of Patient Narratives on Information Search in a Web-Based Breast Cancer Decision Aid: An Eye-Tracking Study

    PubMed Central

    Owens, Justin; Zikmund-Fisher, Brian J

    2013-01-01

    Background Previous research has examined the impact of patient narratives on treatment choices, but to our knowledge, no study has examined the effect of narratives on information search. Further, no research has considered the relative impact of their format (text vs video) on health care decisions in a single study. Objective Our goal was to examine the impact of video and text-based narratives on information search in a Web-based patient decision aid for early stage breast cancer. Methods Fifty-six women were asked to imagine that they had been diagnosed with early stage breast cancer and needed to choose between two surgical treatments (lumpectomy with radiation or mastectomy). Participants were randomly assigned to view one of four versions of a Web decision aid. Two versions of the decision aid included videos of interviews with patients and physicians or videos of interviews with physicians only. To distinguish between the effect of narratives and the effect of videos, we created two text versions of the Web decision aid by replacing the patient and physician interviews with text transcripts of the videos. Participants could freely browse the Web decision aid until they developed a treatment preference. We recorded participants’ eye movements using the Tobii 1750 eye-tracking system equipped with Tobii Studio software. A priori, we defined 24 areas of interest (AOIs) in the Web decision aid. These AOIs were either separate pages of the Web decision aid or sections within a single page covering different content. Results We used multilevel modeling to examine the effect of narrative presence, narrative format, and their interaction on information search. There was a significant main effect of condition, P=.02; participants viewing decision aids with patient narratives spent more time searching for information than participants viewing the decision aids without narratives. The main effect of format was not significant, P=.10. However, there was a

  7. Negotiating case decisions in substance abuse managed care.

    PubMed

    Sosin, Michael R

    2002-09-01

    In substance abuse managed care, the number of treatment sessions that a provider can deliver is constrained by the policies and procedures of the specialized managed care organizations (MCOs) that typically administer the substance abuse portions of healthcare plans. Managed care organizations commonly are alleged to control treatment providers through rules, but they also might rely on a particular patterned authorization of discretion, whereby they determine when and how frequently to respond to providers' appeals of rule-based decisions. The current paper uses data from a national random sample of managed care contracts between MCOs and substance abuse providers to test the hypotheses that (1) managed care organizations' "logics" about the types of provider discretion to allow affect the rate to which they concede to appeals, and (2) the rate of conceding to appeals, in turn, affects the providers' duration of substance abuse treatment. Results from generalized linear estimation models support the hypotheses and suggest that many MCOs pattern discretion to balance strict rules with concern about the quality or cost of care. The results more generally suggest that MCOs use discretion in planned ways, and thus that the patterns of control are more complex and sophisticated than commonly described in the literatures on managed care, transaction cost economics, or other perspectives.

  8. [Decision support system for watershed management: a review].

    PubMed

    Cao, Yu; Yan, Jing

    2012-07-01

    Watershed management decision support system (DSS) is an intellectual system developed for the optimal allocation of water resources by watershed managers, and the simulation results of the system can directly affect the scientificity and practicability of watershed management. This paper summarized the related researches from the aspects of water quantity simulation and deployment systems, water quality monitoring and evaluation systems, and integrated watershed management systems. The main features and problems in existing DSS were analyzed, and the model structure and development status of the representative systems such as AQUA-Tool, Elbe-DSS, and HD were introduced. It was suggested that the accuracy and stability of simulated results, the succinctness of working process, and the high degree of user visualization would be the focuses in developing the DSS in the future, and the optimization of program-selecting models and 3D visualization tools, the research and development of inter-basin integrated management DSS, and the improvement of stakeholder participation would be the development trend for the future watershed management DSS.

  9. Caries detection methods: can they aid decision making for invasive sealant treatment?

    PubMed

    Pereira, A C; Verdonschot, E H; Huysmans, M C

    2001-01-01

    The decision to place sealants is a difficult one, and it has been suggested that in a low risk population it may be efficient to wait until caries is detected in the fissure. An invasive sealant technique with fissure preparation may then be indicated. The diagnostic method used in the indication of such a procedure should accurately detect both dentine caries and sound fissures: high sensitivity for dentine caries (at D3 threshold) with high specificity for enamel caries (at D1 threshold). The aims of this study were to assess the diagnostic performance of selected diagnostic methods at normal cut-offs for traditional dentine caries detection and at reduced cut-offs in relation to the desired performance mentioned above, and to assess whether fissure opening allows for accurate visual detection of dentinal caries. Data were obtained from 230 occlusal sites of 101 extracted human molar teeth. Diagnostic methods used on the entire sample were: visual inspection, electrical conductance measurements and laser fluorescence measurements. The sample was then divided into two groups. Group 1 was subjected to visual inspection after application of a dye. Group 2 was subjected to visual inspection after fissure opening only, and after subsequent dye application. Validation was performed by histological investigation. The results with cut-offs normally used in dentine caries detection were roughly in accordance with the literature, except for laser fluorescence. The sensitivity of visual inspection for dentinal caries (D3) was 17% before and 70% after fissure opening. Using reduced cut-offs, a 100% sensitivity (D3) was achieved with 2 methods, but this also resulted in 63 or 87% false positive diagnoses of sound surfaces. Visual inspection and electrical methods both showed a moderate to high sensitivity (D3) with a higher than 50% specificity (D1). It was concluded that visual inspection and electrical methods at reduced cut-offs may aid the indication of invasive sealant

  10. Proposal for Development of EBM-CDSS (Evidence-based Clinical Decision Support System) to Aid Prognostication in Terminally Ill Patients

    DTIC Science & Technology

    2014-10-01

    TITLE: Proposal for Development of EBM-CDSS (Evidence-based Clinical Decision Support System) to Aid Prognostication in Terminally Ill Patients...SUBTITLE Proposal for development of EBM-CDSS (Evidence-based Clinical Decision Support System) to aid prognostication in terminally ill patients 5a...to improve prognostication of the life expectancy of terminally ill patients to improve referral of patients to hospice. In addition, the EBM-CDSS

  11. Translating comparative effectiveness of depression medications into practice by comparing the depression medication choice decision aid to usual care: study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Comparative effectiveness research (CER) documents important differences in antidepressants in terms of efficacy, safety, cost, and burden to the patient. Decision aids can adapt this evidence to help patients participate in making informed choices. In turn, antidepressant therapy will more likely reflect patients’ values and context, leading to improved adherence and mood outcomes. Methods/Design The objective of this study is to develop the Depression Medication Choice decision aid for use during primary care encounters, and to test its efficacy by conducting a clustered practical randomized trial comparing the decision aid to usual depression care in primary care practices. We will use a novel practice-based, patient-centered approach based on participatory action research that involves a multidisciplinary team of designers, investigators, clinicians, patient representatives, and other stakeholders for the development of the decision aid. We will then conduct a clustered practical randomized trial enrolling clinicians and their patients (n = 300) with moderate to severe depression from rural, suburban and inner city primary care practices (n = 10). The intervention will consist of the use of the depression medication choice decision aid during the clinical encounter. This trial will generate preliminary evidence of the relative impact of the decision aid on patient involvement in decision making, decision making quality, patient knowledge, and 6-month measures of medication adherence and mental health compared to usual depression care. Discussion Upon completion of the proposed research, we will have developed and evaluated the efficacy of the decision aid depression medication choice as a novel translational tool for CER in depression treatment, engaged patients with depression in their care, and refined the process by which we conduct practice-based trials with limited research footprint. Trial registration Clinical Trials.gov: NCT01502891 PMID

  12. AIDS: The Impact on the Criminal Justice System Management of Aids in Corrections.

    DTIC Science & Technology

    1991-01-01

    Issues in Corrections ...... 18 What is AIDS? ................................. 18 Scientific Response to HIV .................. 20 HIV Test Results... disclosure of HIV test results without the written authorization of the infected party. Correctional officers base their case for disclosure on the rationale...patient. No civil or criminal liability will be imposed for disclosure of HIV blood tests to a public health officer when the disclosure is necessary

  13. Similarity, Self-Esteem and Reactions to Aid in a Simulated Decision Making Task.

    DTIC Science & Technology

    The study explored the effects of the overall similarity between donor and recipient of resistance and the recipient’s level of self - esteem on his... esteem -low self esteem recipients were the three experimental factors. The effect of these experimental variables on the recipients self -perceptions...reactions to being helped. A 2 x 2 x 2 factorial between subjects design was employed in which aid-no aid, similar donor-dissimilar donor and high self

  14. Health Care Decision Support System for the Pediatric Emeregency Department Management.

    PubMed

    Ben Othman, Sarah; Hammadi, Slim; Quilliot, Alain; Martinot, Alain; Renard, Jean-Marie

    2015-01-01

    Health organization management is facing a high amount of complexity due to the inherent dynamics of the processes and the distributed organization of hospitals. It is therefore necessary for health care institutions to focus on this issue in order to deal with patients' requirements and satisfy their needs. The main objective of this study is to develop and implement a Decision Support System which can help physicians to better manage their organization, to anticipate the overcrowding feature, and to establish avoidance proposals for it. This work is a part of HOST project (Hospital: Optimization, Simulation, and Crowding Avoidance) of the French National Research Agency (ANR). It aims to optimize the functioning of the Pediatric Emergency Department characterized by stochastic arrivals of patients which leads to its overcrowding and services overload. Our study is a set of tools to smooth out patient flows, enhance care quality and minimize long waiting times and costs due to resources allocation. So we defined a decision aided tool based on Multi-agent Systems where actors negotiate and cooperate under some constraints in a dynamic environment. These entities which can be either physical agents representing real actors in the health care institution or software agents allowing the implementation of optimizing tools, cooperate to satisfy the demands of patients while respecting emergency degrees. This paper is concerned with agents' negotiation. It proposes a new approach for multi-skill tasks scheduling based on interactions between agents.

  15. Decision Support Model for Municipal Solid Waste Management at Department of Defense Installations.

    DTIC Science & Technology

    1995-12-01

    This research focuses on the development of a decision support model to identify the preferred strategy for managing municipal solid waste using the...principles of decision analysis theory. The model provides an effective decision making tool to evaluate and compare different municipal solid waste management

  16. How Managers' everyday decisions create or destroy your company's strategy.

    PubMed

    Bower, Joseph L; Gilbert, Clark G

    2007-02-01

    Senior executives have long been frustrated by the disconnection between the plans and strategies they devise and the actual behavior of the managers throughout the company. This article approaches the problem from the ground up, recognizing that every time a manager allocates resources, that decision moves the company either into or out of alignment with its announced strategy. A well-known story--Intel's exit from the memory business--illustrates this point. When discussing what businesses Intel should be in, Andy Grove asked Gordon Moore what they would do if Intel were a company that they had just acquired. When Moore answered, "Get out of memory," they decided to do just that. It turned out, though, that Intel's revenues from memory were by this time only 4% of total sales. Intel's lower-level managers had already exited the business. What Intel hadn't done was to shut down the flow of research funding into memory (which was still eating up one-third of all research expenditures); nor had the company announced its exit to the outside world. Because divisional and operating managers-as well as customers and capital markets-have such a powerful impact on the realized strategy of the firm, senior management might consider focusing less on the company's formal strategy and more on the processes by which the company allocates resources. Top managers must know the track record of the people who are making resource allocation proposals; recognize the strategic issues at stake; reach down to operational managers to work across division lines; frame resource questions to reflect the corporate perspective, especially when large sums of money are involved and conditions are highly uncertain; and create a new context that allows top executives to circumvent the regular resource allocation process when necessary.

  17. 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

  18. 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…

  19. 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.

  20. Remote sensing as an aid for marsh management

    NASA Technical Reports Server (NTRS)

    Ragan, J. G.; Green, J. H.

    1973-01-01

    NASA aerial photography, primarily color infrared and color positive transparencies, is used in a study of marsh management practices and in comparing managed and unmanaged marsh areas. Weir locations for tidal control are recommended.

  1. Integrated Services Management System (ISMS): A management and decision making tool

    SciTech Connect

    Barber, D.S.; Brockman, D.L.; Buxton, L.D.

    1995-10-01

    This document provides information concerning the Integrated Services Management System (ISMS) that was developed for the Laboratories Services Division during the period February 1994 through May 1995. ISMS was developed as a formal method for centralized management of programs within the Division. With minor modifications, this system can be adapted for management of all overhead functions at SNL or for sector level program management. Included in this document are the reasons for the creation of this system as well as the resulting benefits. The ISMS consists of six interlinked processes; Issues Management, Task/Activity Planning, Work Decision, Commitment Management, Process/Project Management, and Performance Assessment. Those processes are described in detail within this document. Additionally, lessons learned and suggestions for future improvements are indicated.

  2. The Watershed and River Systems Management Program: Decision Support for Water- and Environmental-Resource Management

    NASA Astrophysics Data System (ADS)

    Leavesley, G.; Markstrom, S.; Frevert, D.; Fulp, T.; Zagona, E.; Viger, R.

    2004-12-01

    Increasing demands for limited fresh-water supplies, and increasing complexity of water-management issues, present the water-resource manager with the difficult task of achieving an equitable balance of water allocation among a diverse group of water users. The Watershed and River System Management Program (WARSMP) is a cooperative effort between the U.S. Geological Survey (USGS) and the Bureau of Reclamation (BOR) to develop and deploy a database-centered, decision-support system (DSS) to address these multi-objective, resource-management problems. The decision-support system couples the USGS Modular Modeling System (MMS) with the BOR RiverWare tools using a shared relational database. MMS is an integrated system of computer software that provides a research and operational framework to support the development and integration of a wide variety of hydrologic and ecosystem models, and their application to water- and ecosystem-resource management. RiverWare is an object-oriented reservoir and river-system modeling framework developed to provide tools for evaluating and applying water-allocation and management strategies. The modeling capabilities of MMS and Riverware include simulating watershed runoff, reservoir inflows, and the impacts of resource-management decisions on municipal, agricultural, and industrial water users, environmental concerns, power generation, and recreational interests. Forecasts of future climatic conditions are a key component in the application of MMS models to resource-management decisions. Forecast methods applied in MMS include a modified version of the National Weather Service's Extended Streamflow Prediction Program (ESP) and statistical downscaling from atmospheric models. The WARSMP DSS is currently operational in the Gunnison River Basin, Colorado; Yakima River Basin, Washington; Rio Grande Basin in Colorado and New Mexico; and Truckee River Basin in California and Nevada.

  3. Assessing environmental conditions of Antarctic footpaths to support management decisions.

    PubMed

    Tejedo, Pablo; Benayas, Javier; Cajiao, Daniela; Albertos, Belén; Lara, Francisco; Pertierra, Luis R; Andrés-Abellán, Manuela; Wic, Consuelo; Luciáñez, Maria José; Enríquez, Natalia; Justel, Ana; Reck, Günther K

    2016-07-15

    Thousands of tourists visit certain Antarctic sites each year, generating a wide variety of environmental impacts. Scientific knowledge of human activities and their impacts can help in the effective design of management measures and impact mitigation. We present a case study from Barrientos Island in which a management measure was originally put in place with the goal of minimizing environmental impacts but resulted in new undesired impacts. Two alternative footpaths used by tourist groups were compared. Both affected extensive moss carpets that cover the middle part of the island and that are very vulnerable to trampling. The first path has been used by tourists and scientists since over a decade and is a marked route that is clearly visible. The second one was created more recently. Several physical and biological indicators were measured in order to assess the environmental conditions for both paths. Some physical variables related to human impact were lower for the first path (e.g. soil penetration resistance and secondary treads), while other biochemical and microbiological variables were higher for the second path (e.g. β-glucosidase and phosphatase activities, soil respiration). Moss communities located along the new path were also more diverse and sensitive to trampling. Soil biota (Collembola) was also more abundant and richer. These data indicate that the decision to adopt the second path did not lead to the reduction of environmental impacts as this path runs over a more vulnerable area with more outstanding biological features (e.g. microbiota activity, flora and soil fauna diversity). In addition, the adoption of a new route effectively doubles the human footprint on the island. We propose using only the original path that is less vulnerable to the impacts of trampling. Finally from this process, we identify several key issues that may be taken into account when carrying out impact assessment and environmental management decision-making in the

  4. Measuring HIV Self-Management in Women Living with HIV/AIDS: A Psychometric Evaluation Study of the HIV Self-Management Scale

    PubMed Central

    Webel, Allison R.; Asher, Alice; Cuca, Yvette; Okonsky, Jennifer G.; Kaihura, Alphoncina; Rose, Carol Dawson; Hanson, Jan E.; Salata, Robert A.

    2012-01-01

    Objective To develop and validate the HIV Self-Management Scale for women, a new measure of HIV self-management, defined as the day-to-day decisions that individuals make to manage their illness. Methods The development and validation of the scale was undertaken in three phases: focus groups, expert review and psychometric evaluation. Focus groups identified items describing the process and context of self-management in women living with HIV/AIDS (WLHA). Items were refined using expert review and were then administered to WLHA in two sites in the U.S. (n=260). Validity of the scale was assessed through factor analyses, model fit statistics, reliability testing, and convergent and discriminate validity. Results The final scale consists of 3-domains with 20 items describing the construct of HIV self-management. Daily self-management health practices, Social support and HIV self-management, and Chronicity of HIV self-management comprise the three domains. These domains explained 48.6% of the total variance in the scale. The item mean scores ranged from 1.7-2.77, and each domain demonstrated acceptable reliability (0.72-0.86) and stability (0.61-0.85). Conclusions Self-management is critical for WLHA, who constitute over 50% of PLWHA and have poorer health outcomes than their male counterparts. Methods to assess the self-management behavior of WLHA are needed to enhance their health and well-being. Presently no scales exist to measure HIV self-management. Our new 20-item HIV Self-Management Scale is a valid and reliable measure of HIV self-management in this population. Differences in aspects of self-management may be related to social roles and community resources and interventions targeting these factors may decrease morbidity in WLHA. PMID:22569267

  5. Optimal management of cytomegalovirus retinitis in patients with AIDS

    PubMed Central

    Stewart, Michael W

    2010-01-01

    Cytomegalovirus (CMV) retinitis is the most common cause of vision loss in patients with acquired immunodeficiency syndrome (AIDS). CMV retinitis afflicted 25% to 42% of AIDS patients in the pre-highly active antiretroviral therapy (HAART) era, with most vision loss due to macula-involving retinitis or retinal detachment. The introduction of HAART significantly decreased the incidence and severity of CMV retinitis. Optimal treatment of CMV retinitis requires a thorough evaluation of the patient’s immune status and an accurate classification of the retinal lesions. When retinitis is diagnosed, HAART therapy should be started or improved, and anti-CMV therapy with oral valganciclovir, intravenous ganciclovir, foscarnet, or cidofovir should be administered. Selected patients, especially those with zone 1 retinitis, may receive intravitreal drug injections or surgical implantation of a sustained-release ganciclovir reservoir. Effective anti-CMV therapy coupled with HAART significantly decreases the incidence of vision loss and improves patient survival. Immune recovery uveitis and retinal detachments are important causes of moderate to severe loss of vision. Compared with the early years of the AIDS epidemic, the treatment emphasis in the post- HAART era has changed from short-term control of retinitis to long-term preservation of vision. Developing countries face shortages of health care professionals and inadequate supplies of anti-CMV and anti-HIV medications. Intravitreal ganciclovir injections may be the most cost effective strategy to treat CMV retinitis in these areas. PMID:20463796

  6. HOME MANAGEMENT AIDES, A HOME SKILLS TEACHING SERVICE FOR LOW INCOME MOTHERS.

    ERIC Educational Resources Information Center

    MURTON, BONNIE J.; AND OTHERS

    ABOUT 25 PERCENT OF ALL AID FOR DEPENDENT CHILDREN CASES IN THE CITY OF MINNEAPOLIS WERE IN TWO YOUTH DEVELOPMENT PROJECT TARGET AREAS WHERE MOTHERS OFTEN LACKED HOME MANAGEMENT SKILLS NECESSARY TO REAR THEIR CHILDREN. AS ONE OF SEVERAL DEMONSTRATION PROGRAMS TO PREVENT AND ALLEVIATE PROBLEMS OF DELINQUENCY, IN 1964 FOUR HOME MANAGEMENT AIDES…

  7. Database architecture for data mining to aid real-time range safety decision in a test range

    NASA Astrophysics Data System (ADS)

    Checker, A. K.; Raj, R. Appavu

    2006-04-01

    Flight vehicles carrying sensitive payloads and large amount of propellants pose danger to life and property around launch pad area. There are inherent limitations in conventional decision support system and at times the man in the loop is under severe strain while analyzing the real time data of flight vehicle for range safety decision support system. It is essential to use newer technological input for designing flight termination system for handling high speed, high maneuvering and multi-platform based flight vehicles. This calls for extensive trajectory simulation under various flight conditions and failure modes, collection of actual test data of sub systems and post flight data along with geographical, metrological and tracking instrument data to be collected and organized in a data warehouse for data mining. The information obtained in real time using large data base will aid range safety decision making in a complex scenario of flight testing in a test range. This paper highlights briefly the existing system and its constraints and attempt to evolve an innovative system combining knowledge base and real time data from multiple sensors and fusing the data from similar and dissimilar sensors using state-vector fusion technique for more reliable and quick range safety decision making.

  8. Surrogate decision makers and proxy ownership: challenges of privacy management in health care decision making.

    PubMed

    Bute, Jennifer J; Petronio, Sandra; Torke, Alexia M

    2015-01-01

    This study explored the communicative experiences of surrogates who served as decision makers for patients who were unable to convey health information and choices about treatment options. Drawing on assumptions from communication privacy management theory (Petronio, 2002), 35 surrogates were interviewed to explore how they navigated the role of guardian of patients' private health information while the patient was hospitalized. This research determined that not only are surrogates guardians and thereby co-owners of the patients' private health information, they actually served in a "proxy ownership" role. Surrogates described obstacles to both obtaining and sharing private health information about the patient, suggesting that their rights as legitimate co-owners of the patients' information were not fully acknowledged by the medical teams. Surrogates also described challenges in performing the proxy ownership role when they were not fully aware of the patient's wishes. Theoretical and practical implications of these challenges are discussed.

  9. Surrogate Decision Makers and Proxy Ownership: Challenges of Privacy Management in Health Care Decision Making

    PubMed Central

    Bute, Jennifer J.; Petronio, Sandra; Torke, Alexia M.

    2016-01-01

    This study explored the communicative experiences of surrogates who served as decision makers for patients who were unable to convey health information and choices about treatment options. Drawing on assumptions from communication privacy management theory (Petronio, 2002), 35 surrogates were interviewed to explore how they navigated the role of guardian of patients’ private health information while the patient was hospitalized. This research determined that surrogates are not only guardians and thereby co-owners of the patients’ private health information, they actually served in a “proxy ownership” role. Surrogates described obstacles to both obtaining and sharing private health information about the patient, suggesting that their rights as legitimate co-owners of the patients’ information were not fully acknowledged by the medical teams. Surrogates also described challenges in performing the proxy ownership role when they were not fully aware of the patient's wishes. Theoretical and practical implications of these challenges are discussed. PMID:25175060

  10. Design of an Aircrew Scheduling Decision Aid for the 6916th Electronic Security Squadron.

    DTIC Science & Technology

    1987-06-01

    air squadron. Roege formulated the problem as an assignment problem. The objective was to assign pilots to duties at a specified cost subject to crew...rest conitraints. Roege solved the problem using integer programming. Roege used the requirements in TACM 51-50 to form an objective function. The costs ...Measures: Measure of the impact the DSS has on decisions. Examples of productivity measures include the time required to reach a decision, the cost of making

  11. A decision support system for managing forest fire casualties.

    PubMed

    Bonazountas, Marc; Kallidromitou, Despina; Kassomenos, Pavlos; Passas, Nikos

    2007-09-01

    Southern Europe is exposed to anthropogenic and natural forest fires. These result in loss of lives, goods and infrastructure, but also deteriorate the natural environment and degrade ecosystems. The early detection and combating of such catastrophes requires the use of a decision support system (DSS) for emergency management. The current literature reports on a series of efforts aimed to deliver DSSs for the management of the forest fires by utilising technologies like remote sensing and geographical information systems (GIS), yet no integrated system exists. This manuscript presents the results of scientific research aiming to the development of a DSS for managing forest fires. The system provides a series of software tools for the assessment of the propagation and combating of forest fires based on Arc/Info, ArcView, Arc Spatial Analyst, Arc Avenue, and Visual C++ technologies. The system integrates GIS technologies under the same data environment and utilises a common user interface to produce an integrated computer system based on semi-automatic satellite image processing (fuel maps), socio-economic risk modelling and probabilistic models that would serve as a useful tool for forest fire prevention, planning and management. Its performance has been demonstrated via real time up-to-date accurate information on the position and evolution of the fire. The system can assist emergency assessment, management and combating of the incident. A site demonstration and validation has been accomplished for the island of Evoia, Greece, an area particularly vulnerable to forest fires due to its ecological characteristics and prevailing wind patterns.

  12. Use of a computerised decision aid (DA) to inform the decision process on adjuvant chemotherapy in patients with stage II colorectal cancer: development and preliminary evaluation

    PubMed Central

    Miles, A; Chronakis, I; Fox, J; Mayer, A

    2017-01-01

    Objectives To develop a computerised decision aid (DA) to inform the decision process on adjuvant chemotherapy in patients with stage II colorectal cancer, and examine perceived usefulness, acceptability and areas for improvement of the DA. Design Mixed methods. Setting Single outpatient oncology department in central London. Participants Consecutive recruitment of 13 patients with stage II colorectal cancer, 12 of whom completed the study. Inclusion criteria were: age >18 years; complete resection for stage II adenocarcinoma of the colon or rectum; patients within 14–56 days after surgery; no contraindication to adjuvant chemotherapy; able to give written informed consent. Exclusion criterion: previous chemotherapy. Primary outcomes Patient perceived usefulness (assessed by the PrepDM questionnaire) and acceptability of the DA. Results PrepDM scores, measuring the perceived usefulness of the DA in preparing the patient to communicate with their doctor and make a health decision, were above those reported in other patient groups. Patient acceptability scores were also high; however, interviews showed that there was evidence of a lack of understanding of key information among some patients, in particular their baseline risk of recurrence, the net benefit of combination chemotherapy and the rationale for having chemotherapy when cancer had apparently gone. Conclusions Patients found the DA acceptable and useful in supporting their decision about whether or not to have adjuvant chemotherapy. Suggested improvements for the DA include: sequential presentation of treatment options (eg, no treatment vs 1 drug, 1 drug vs 2 drugs) to enhance patient understanding of the difference between combination and single therapy, diagrams to help patients understand the rationale for chemotherapy to prevent a recurrence and inbuilt checks on patient understanding of baseline risk of recurrence and net benefit of chemotherapy. PMID:28341685

  13. Effectiveness and Cost Benefits of Computer-Based Decision Aids for Equipment Maintenance

    DTIC Science & Technology

    2003-02-01

    Computer-based assessment of problem solving. Computers in Human Behavior , 15, 269–282. Booher, H.R. (1978). Job performance aids: Research and...Perspectives on computer-based performance assessment of problem solving. Computers in Human Behavior , 15, 255–268. Orasanu, J., and Connolly, T. (1993). The

  14. 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.

  15. Phenology for Science, Resource Management, Decision Making, and Education

    NASA Astrophysics Data System (ADS)

    Nolan, Vivian P.; Weltzin, Jake F.

    2011-01-01

    Fourth USA National Phenology Network (USA-NPN) Research Coordination Network (RCN) Annual Meeting and Stakeholders Workshop; Milwaukee, Wisconsin, 21-22 September 2010; Phenology, the study of recurring plant and animal life cycle events, is rapidly emerging as a fundamental approach for understanding how ecological systems respond to environmental variation and climate change. The USA National Phenology Network (USA-NPN; http://www.usanpn.org) is a large-scale network of governmental and nongovernmental organizations, academic institutions, resource management agencies, and tribes. The network is dedicated to conducting and promoting repeated and integrated plant and animal phenological observations, identifying linkages with other relevant biological and physical data sources, and developing and distributing the tools to analyze these data at local to national scales. The primary goal of the USA-NPN is to improve the ability of decision makers to design strategies for climate adaptation.

  16. Phenology for science, resource management, decision making, and education

    USGS Publications Warehouse

    Nolan, V.P.; Weltzin, J.F.

    2011-01-01

    Fourth USA National Phenology Network (USA-NPN) Research Coordination Network (RCN) Annual Meeting and Stakeholders Workshop; Milwaukee, Wisconsin, 21-22 September 2010; Phenology, the study of recurring plant and animal life cycle events, is rapidly emerging as a fundamental approach for understanding how ecological systems respond to environmental variation and climate change. The USA National Phenology Network (USA-NPN; http://www.usanpn.org) is a large-scale network of governmental and nongovernmental organizations, academic institutions, resource management agencies, and tribes. The network is dedicated to conducting and promoting repeated and integrated plant and animal phenological observations, identifying linkages with other relevant biological and physical data sources, and developing and distributing the tools to analyze these data at local to national scales. The primary goal of the USA-NPN is to improve the ability of decision makers to design strategies for climate adaptation.

  17. KwaZulu-Natal commercial farmers' perceptions of and management responses to HIV/AIDS.

    PubMed

    Gray, Lyndon; Ferrer, Stuart; Ortmann, Gerald

    2009-06-01

    This study examines commercial farmers' perceptions of and management responses to the HIV epidemic, among a sample in KwaZulu-Natal Province in South Africa. The analysis is based on responses to a postal survey of commercial farmers belonging to KwaZulu-Natal Agricultural Union (Kwanalu), in April-May 2007. The findings show that, on average, the Kwanalu members were highly concerned about the impacts of HIV and AIDS on their businesses. The majority of respondents perceived HIV and AIDS as negatively affecting the current and future profitability of their farming enterprise, increasing the rates of workers' absenteeism and staff turnover, and reducing workers' productivity. An analysis of variance (ANOVA) of the data shows that the farm managers' HIV/ AIDS-management responses varied by farm size and enterprise type, but included paying higher-than-average wages to attract and retain healthy and productive workers, multi-skilling staff to provide back-up, and investing in mechanisation to defer the costs of HIV and AIDS. The respondents tended to believe that effective HIV/AIDS prevention and treatment programmes require an integrated approach that is shared by employees, employers and government. Many commercial farm employers already play an important but economical role in HIV and AIDS prevention and treatment through encouraging voluntary HIV testing and providing workers with information and transportation to clinics. Policymakers should take this into consideration when formulating policies in response to the HIV epidemic.

  18. Decision-making for ecosystem-based management: evaluating options for a krill fishery with an ecosystem dynamics model.

    PubMed

    Watters, G M; Hill, S L; Hinke, J T; Matthews, J; Reid, K

    2013-06-01

    Decision-makers charged with implementing ecosystem-based management (EBM) rely on scientists to predict the consequences of decisions relating to multiple, potentially conflicting, objectives. Such predictions are inherently uncertain, and this can be a barrier to decision-making. The Convention on the Conservation of Antarctic Marine Living Resources requires managers of Southern Ocean fisheries to sustain the productivity of target stocks, the health and resilience of the ecosystem, and the performance of the fisheries themselves. The managers of the Antarctic krill fishery in the Scotia Sea and southern Drake Passage have requested advice on candidate management measures consisting of a regional catch limit and options for subdividing this among smaller areas. We developed a spatially resolved model that simulates krill-predator-fishery interactions and reproduces a plausible representation of past dynamics. We worked with experts and stakeholders to identify (1) key uncertainties affecting our ability to predict ecosystem state; (2) illustrative reference points that represent the management objectives; and (3) a clear and simple way of conveying our results to decision-makers. We developed four scenarios that bracket the key uncertainties and evaluated candidate management measures in each of these scenarios using multiple stochastic simulations. The model emphasizes uncertainty and simulates multiple ecosystem components relating to diverse objectives. We summarize the potentially complex results as estimates of the risk that each illustrative objective will not be achieved (i.e., of the state being outside the range specified by the reference point). This approach allows direct comparisons between objectives. It also demonstrates that a candid appraisal of uncertainty, in the form of risk estimates, can be an aid, rather than a barrier, to understanding and using ecosystem model predictions. Management measures that reduce coastal fishing, relative to

  19. Analysis of ETMS Data Quality for Traffic Flow Management Decisions

    NASA Technical Reports Server (NTRS)

    Chatterji, Gano B.; Sridhar, Banavar; Kim, Douglas

    2003-01-01

    The data needed for air traffic flow management decision support tools is provided by the Enhanced Traffic Management System (ETMS). This includes both the tools that are in current use and the ones being developed for future deployment. Since the quality of decision support provided by all these tools will be influenced by the quality of the input ETMS data, an assessment of ETMS data quality is needed. Motivated by this desire, ETMS data quality is examined in this paper in terms of the unavailability of flight plans, deviation from the filed flight plans, departure delays, altitude errors and track data drops. Although many of these data quality issues are not new, little is known about their extent. A goal of this paper is to document the magnitude of data quality issues supported by numerical analysis of ETMS data. Guided by this goal, ETMS data for a 24-hour period were processed to determine the number of aircraft with missing flight plan messages at any given instant of time. Results are presented for aircraft above 18,000 feet altitude and also at all altitudes. Since deviation from filed flight plan is also a major cause of trajectory-modeling errors, statistics of deviations are presented. Errors in proposed departure times and ETMS-generated vertical profiles are also shown. A method for conditioning the vertical profiles for improving demand prediction accuracy is described. Graphs of actual sector counts obtained using these vertical profiles are compared with those obtained using the Host data for sectors in the Fort Worth Center to demonstrate the benefit of preprocessing. Finally, results are presented to quantify the extent of data drops. A method for propagating track positions during ETMS data drops is also described.

  20. Enhancing Drought Risk Management: Tools and Services for Decision Support

    NASA Astrophysics Data System (ADS)

    Svoboda, M. D.; Hayes, M. J.

    2011-12-01

    The National Drought Mitigation Center (NDMC) (http://drought.unl.edu) has been working with the National Integrated Drought Information System (NIDIS) (http://drought.gov) and other partners with a goal of developing tools, products, services and outreach with a goal of contributing to a U.S. drought early warning system (DEWS) as well as contributing to efforts underway toward building a virtual and collaborative global drought early warning system (GDEWS). The NDMC's mission is to work to reduce societal vulnerability to drought by helping decision makers at all levels to: develop and implement DEWS, understand and prevent drought impacts and increase long-term resilience to drought through proactive risk management planning. The NDMC is a national center founded in 1995 and located at the University of Nebraska-Lincoln. The NDMC conducts basic and applied research, services and decision support applications, along with the maintaining of a number of operational drought-related tools, products and outreach activities, including the U.S. Drought Monitor (USDM), Drought Impact Reporter (DIR), Vegetation Drought Response Index (VegDRI) along with the newly developed and enhanced National Drought Atlas, Drought Ready Communities Guide to Community Drought Preparedness and our Managing Drought Risk on the Ranch planning section on our newly revamped web site at http://drought.unl.edu. This presentation will describe in more detail the various drought resources, tools, research efforts, services and collaborations already being provided by the NDMC and its partners toward developing a collaborative DEWS in the U.S. and around the world.

  1. A National Modeling Framework for Water Management Decisions

    NASA Astrophysics Data System (ADS)

    Bales, J. D.; Cline, D. W.; Pietrowsky, R.

    2013-12-01

    The National Weather Service (NWS), the U.S. Army Corps of Engineers (USACE), and the U.S. Geological Survey (USGS), all Federal agencies with complementary water-resources activities, entered into an Interagency Memorandum of Understanding (MOU) "Collaborative Science Services and Tools to Support Integrated and Adaptive Water Resources Management" to collaborate in activities that are supportive to their respective missions. One of the interagency activities is the development of a highly integrated national water modeling framework and information services framework. Together these frameworks establish a common operating picture, improve modeling and synthesis, support the sharing of data and products among agencies, and provide a platform for incorporation of new scientific understanding. Each of the agencies has existing operational systems to assist in carrying out their respective missions. The systems generally are designed, developed, tested, fielded, and supported by specialized teams. A broader, shared approach is envisioned and would include community modeling, wherein multiple independent investigators or teams develop and contribute new modeling capabilities based on science advances; modern technology in coupling model components and visualizing results; and a coupled atmospheric - hydrologic model construct such that the framework could be used in real-time water-resources decision making or for long-term management decisions. The framework also is being developed to account for organizational structures of the three partners such that, for example, national data sets can move down to the regional scale, and vice versa. We envision the national water modeling framework to be an important element of North American Water Program, to contribute to goals of the Program, and to be informed by the science and approaches developed as a part of the Program.

  2. Conceptualizing the cross-cultural gaps in managing international aid: HIV/AIDS and TB project delivery in Southern Africa.

    PubMed

    Jackson, Terence

    2011-01-01

    There appears to be a gap between the billions of dollars inputted into fighting HIV/AIDS and TB and outcomes. This in part can be attributed to the lack of attention in International Development to managing programmes and projects within complex levels of cross-cultural interactions. International Development often ignores management issues, yet Management Studies is left wanting through a lack of engagement with development issues including the fight against disease and poverty. This paper attempts to link these two disciplines towards mutual benefit, through a critical cross-cultural approach. It provides contextualization of international development policies/strategies; conceptualization of dominant paradigms; structural analysis of how a programme/project fits into the global governance structure; analysis of complexities and levels of cross-cultural interaction and their consequences and the process and implications of knowledge transfer across cultural distances. It concludes with implications for policy and practice, as well as what is needed from cross-disciplinary research. This includes how feedback loops can be strengthened from local to global, how indigenous knowledge may be better understood and integrated, how power relations within the global governance structure could be managed, how cross-cultural interaction could be better understood, and how knowledge transfer/sharing should be critically managed.

  3. A GIS-Based Multicriteria Evaluation for Aiding Risk Management Pinus pinaster Ait. Forests: A Case Study in Corsican Island, Western Mediterranean Region

    NASA Astrophysics Data System (ADS)

    Pasqualini, Vanina; Oberti, Pascal; Vigetta, Stéphanie; Riffard, Olivier; Panaïotis, Christophe; Cannac, Magali; Ferrat, Lila

    2011-07-01

    Forest management can benefit from decision support tools, including GIS-based multicriteria decision-aiding approach. In the Mediterranean region, Pinus pinaster forests play a very important role in biodiversity conservation and offer many socioeconomic benefits. However, the conservation of this species is affected by the increase in forest fires and the expansion of Matsucoccus feytaudi. This paper proposes a methodology based on commonly available data for assessing the values and risks of P. pinaster forests and to generating maps to aid in decisions pertaining to fire and phytosanitary risk management. The criteria for assessing the values (land cover type, legislative tools for biodiversity conservation, environmental tourist sites and access routes, and timber yield) and the risks (fire and phytosanitation) of P. pinaster forests were obtained directly or by considering specific indicators, and they were subsequently aggregated by means of GIS-based multicriteria analysis. This approach was tested on the island of Corsica (France), and maps to aid in decisions pertaining to fire risk and phytosanitary risk ( M. feytaudi) were obtained for P. pinaster forest management. Study results are used by the technical offices of the local administration— Corsican Agricultural and Rural Development Agency (ODARC)—for planning the conservation of P. pinaster forests with regard to fire prevention and safety and phytosanitary risks. The decision maker took part in the evaluation criteria study (weight, normalization, and classification of the values). Most suitable locations are given to target the public intervention. The methodology presented in this paper could be applied to other species and in other Mediterranean regions.

  4. A GIS-based multicriteria evaluation for aiding risk management Pinus pinaster Ait. forests: a case study in Corsican Island, western Mediterranean Region.

    PubMed

    Pasqualini, Vanina; Oberti, Pascal; Vigetta, Stéphanie; Riffard, Olivier; Panaïotis, Christophe; Cannac, Magali; Ferrat, Lila

    2011-07-01

    Forest management can benefit from decision support tools, including GIS-based multicriteria decision-aiding approach. In the Mediterranean region, Pinus pinaster forests play a very important role in biodiversity conservation and offer many socioeconomic benefits. However, the conservation of this species is affected by the increase in forest fires and the expansion of Matsucoccus feytaudi. This paper proposes a methodology based on commonly available data for assessing the values and risks of P. pinaster forests and to generating maps to aid in decisions pertaining to fire and phytosanitary risk management. The criteria for assessing the values (land cover type, legislative tools for biodiversity conservation, environmental tourist sites and access routes, and timber yield) and the risks (fire and phytosanitation) of P. pinaster forests were obtained directly or by considering specific indicators, and they were subsequently aggregated by means of GIS-based multicriteria analysis. This approach was tested on the island of Corsica (France), and maps to aid in decisions pertaining to fire risk and phytosanitary risk (M. feytaudi) were obtained for P. pinaster forest management. Study results are used by the technical offices of the local administration-Corsican Agricultural and Rural Development Agency (ODARC)-for planning the conservation of P. pinaster forests with regard to fire prevention and safety and phytosanitary risks. The decision maker took part in the evaluation criteria study (weight, normalization, and classification of the values). Most suitable locations are given to target the public intervention. The methodology presented in this paper could be applied to other species and in other Mediterranean regions.

  5. Facilitating adaptive management in the Chesapeake Bay Watershed through the use of online decision support tools

    USGS Publications Warehouse

    Mullinx, Cassandra; Phillips, Scott; Shenk, Kelly; Hearn, Paul; Devereux, Olivia

    2009-01-01

    The Chesapeake Bay Program (CBP) is attempting to more strategically implement management actions to improve the health of the Nation’s largest estuary. In 2007 the U.S. Geological Survey (USGS) and U.S. Environmental Protection Agency (USEPA) CBP office began a joint effort to develop a suite of Internetaccessible decision-support tools and to help meet the needs of CBP partners to improve water quality and habitat conditions in the Chesapeake Bay and its watersheds. An adaptive management framework is being used to provide a structured decision process for information and individual tools needed to implement and assess practices to improve the condition of the Chesapeake Bay ecosystem. The Chesapeake Online Adaptive Support Toolkit (COAST) is a collection of web-based analytical tools and information, organized in an adaptive management framework, intended to aid decisionmakers in protecting and restoring the integrity of the Bay ecosystem. The initial version of COAST is focused on water quality issues. During early and mid- 2008, initial ideas for COAST were shared and discussed with various CBP partners and other potential user groups. At these meetings, test cases were selected to help improve understanding of the types of information and analytical functionality that would be most useful for specific partners’ needs. These discussions added considerable knowledge about the nature of decisionmaking for Federal, State, local and nongovernmental partners. Version 1.0 of COAST, released in early winter of 2008, will be further reviewed to determine improvements needed to address implementation and assessment of water quality practices. Future versions of COAST may address other aspects of ecosystem restoration, including restoration of habitat and living resources and maintaining watershed health.

  6. Early decision framework for integrating sustainable risk management for complex remediation sites: Drivers, barriers, and performance metrics.

    PubMed

    Harclerode, Melissa A; Macbeth, Tamzen W; Miller, Michael E; Gurr, Christopher J; Myers, Teri S

    2016-12-15

    As the environmental remediation industry matures, remaining sites often have significant underlying technical challenges and financial constraints. More often than not, significant remediation efforts at these "complex" sites have not achieved stringent, promulgated cleanup goals. Decisions then have to be made about whether and how to commit additional resources towards achieving those goals, which are often not achievable nor required to protect receptors. Guidance on cleanup approaches focused on evaluating and managing site-specific conditions and risks, rather than uniformly meeting contaminant cleanup criteria in all media, is available to aid in this decision. Although these risk-based cleanup approaches, such as alternative endpoints and adaptive management strategies, have been developed, they are under-utilized due to environmental, socio-economic, and risk perception barriers. Also, these approaches are usually implemented late in the project life cycle after unsuccessful remedial attempts to achieve stringent cleanup criteria. In this article, we address these barriers by developing an early decision framework to identify if site characteristics support sustainable risk management, and develop performance metrics and tools to evaluate and implement successful risk-based cleanup approaches. In addition, we address uncertainty and risk perception challenges by aligning risk-based cleanup approaches with the concepts of risk management and sustainable remediation. This approach was developed in the context of lessons learned from implementing remediation at complex sites, but as a framework can, and should, be applied to all sites undergoing remediation.

  7. Design Principles for Personalized Decision Aiding: An Application to Tactical Air Force Route Planning.

    DTIC Science & Technology

    1985-07-01

    contingency plans have not been in- corporated in an option, but significant information is likely to become available during its execution. 2.6.1.4...Technology Corporation , 16 September 1983. Riemenschneider, R.A., Rockmore, A.J., and Wikman, T.A.A. Route planning aid: System specification (PAR Report...83-135). New Hartford, NY: PAR Technology Corporation , 31 October 1983. Savage, L.J. The foundations of statistics. NY: Wiley, 1954. Schum, D

  8. Decision-making processes for the self-management of persistent pain: a grounded theory study.

    PubMed

    Fenwick, Clare; Chaboyer, Wendy; St John, Winsome

    2012-08-01

    Persistent pain negatively impacts upon the individual suffering this condition. Almost all care related to persistent pain is self-managed. Decision-making is a critical skill of the self-manager and without these skills it would be improbable that effective self-management would emerge. However, current theories regarding decision-making and self-management have not adequately accounted for the many difficulties faced by individuals enduring persistent pain and the consequences of these experiences for the decision-maker. This grounded theory study revealed that individuals will transform into three distinct types of decision-makers using three different styles of decision-making in response to the many and varied problems related to the experience of persistent pain. These findings will provide nurses with valuable information to better equip individuals with persistent pain through the decision-making processes necessary for successful self-management.

  9. Towards personalised intra-arterial treatment of patients with acute ischaemic stroke: a study protocol for development and validation of a clinical decision aid

    PubMed Central

    Mulder, Maxim J H L; Venema, Esmee; Roozenbeek, Bob; Broderick, Joseph P; Yeatts, Sharon D; Khatri, Pooja; Berkhemer, Olvert A; Roos, Yvo B W E M; Majoie, Charles B L M; van Oostenbrugge, Robert J; van Zwam, Wim H; van der Lugt, Aad; Steyerberg, Ewout W; Dippel, Diederik W J; Lingsma, Hester F

    2017-01-01

    Introduction Overall, intra-arterial treatment (IAT) proved to be beneficial in patients with acute ischaemic stroke due to a proximal occlusion in the anterior circulation. However, heterogeneity in treatment benefit may be relevant for personalised clinical decision-making. Our aim is to improve selection of patients for IAT by predicting individual treatment benefit or harm. Methods and analysis We will use data collected in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) trial to analyse the effect of baseline characteristics on outcome and treatment effect. A multivariable proportional odds model with interaction terms will be developed to predict the outcome for each individual patient, both with and without IAT. Model performance will be expressed as discrimination and calibration, after bootstrap resampling and shrinkage of regression coefficients, to correct for optimism. External validation will be conducted on data of patients in the Interventional Management of Stroke III trial (IMS III). Primary outcome will be the modified Rankin Scale (mRS) at 90 days after stroke. Ethics and dissemination The proposed study will provide an internationally applicable clinical decision aid for IAT. Findings will be disseminated widely through peer-reviewed publications, conference presentations and in an online web application tool. Formal ethical approval was not required as primary data were already collected. Trial registration numbers ISRCTN10888758; Post-results and NCT00359424; Post-resultsc. PMID:28336740

  10. 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

  11. Management of pulmonary aspergillosis in AIDS: an emerging clinical problem.

    PubMed Central

    Keating, J J; Rogers, T; Petrou, M; Cartledge, J D; Woodrow, D; Nelson, M; Hawkins, D A; Gazzard, B G

    1994-01-01

    AIMS--To review the clinical, radiographic, and therapeutic features of 11 cases of respiratory Aspergillus infection in patients with AIDS. METHODS--All induced sputum and bronchoalveolar lavage samples obtained from HIV seropositive patients between January 1985 and March 1993 were analysed for Aspergillus species. Additionally, where appropriate, bronchial or renal biopsy specimens, or both, were taken before treatment had started. RESULTS--In 11 patients Aspergillus fumigatus was identified in alveolar samples obtained by sputum induction. This was confirmed by bronchoalveolar lavage in eight. Three patients had Aspergillus plaques in the trachea and bronchus, while a fourth patient had an aspergilloma. Risk factors for Aspergillus infection were present in all patients, including corticosteroid treatment in three cases and neutropenia in four, three of whom had received chemotherapy for Kaposi's sarcoma. Four patients had concomitant cytomegalovirus infection. Ten patients had a CD4 count of less than 50 cells/mm3 while one patient had a disseminated T cell lymphoma with a CD4 count of 242 cells/mm3. Of the three patients with samples obtained by sputum induction who did not undergo bronchoscopy, two had a normal chest x ray picture and the third had a right lobar pneumonia complicating an aggressive lymphoma. All three were treated with itraconazole 200 mg twice a day without further investigation. Survival from the time of diagnosis of Aspergillus infection was short: seven patients died within six weeks, although only one death was directly attributed to pulmonary aspergillosis. At six monthly follow up, one patient, who initially had a positive Aspergillus culture from bronchial washings and a normal chest radiograph, developed a renal aspergilloma despite the disappearance of Aspergillus sp from the sputum. CONCLUSION--Pulmonary aspergillosis is an important clinical problem in patients with AIDS with a CD4 count of less than 50 cells/mm. Furthermore

  12. Adaptive Decision Aiding in Computer-Assisted Instruction: Adaptive Computerized Training System (ACTS)

    DTIC Science & Technology

    1980-09-01

    CATALOG NUMBERTechnical Report 475%; , ADAPTIVE DECISION &IDING IN OMPUTER-ASSISTED *JECHNICAL REPOT INSTRUCTION: ADAPTIVE COMPUTERIZED TRAINING )16...alternative. For example, in auto maintenance, the mechanic is trained to adjust the dis- tributor with a "feeler" guage or a dwell tachometer . He

  13. 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.…

  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. Computer-Aided Decisions in Human Services: Expert Systems and Multivariate Models.

    ERIC Educational Resources Information Center

    Sicoly, Fiore

    1989-01-01

    This comparison of two approaches to the development of computerized supports for decision making--expert systems and multivariate models--focuses on computerized systems that assist professionals with tasks related to diagnosis or classification in human services. Validation of both expert systems and statistical models is emphasized. (39…

  16. Commander’s Decision Aid for Predictive Battlespace Awareness (CDA4PBA)

    DTIC Science & Technology

    2006-12-01

    Air Force Research Laboratory Human Effectiveness Directorate Warfighter Interface Division Cognitive Systems Branch...REPORT Warfighter Interface Division NUMBER(S) Cognitive Systems Branch Wright-Patterson AFB OH 45433-7604 AFRL-HE-WP-TR-2007-0042 12...training to support a commanders’ predictive battle-space awareness ability. The program provided an understanding of the decisions and other cognitive

  17. The effect of scientific evidence on conservation practitioners’ management decisions

    PubMed Central

    Walsh, Jessica C; Dicks, Lynn V; Sutherland, William J

    2015-01-01

    A major justification of environmental management research is that it helps practitioners, yet previous studies show it is rarely used to inform their decisions. We tested whether conservation practitioners focusing on bird management were willing to use a synopsis of relevant scientific literature to inform their management decisions. This allowed us to examine whether the limited use of scientific information in management is due to a lack of access to the scientific literature or whether it is because practitioners are either not interested or unable to incorporate the research into their decisions. In on-line surveys, we asked 92 conservation managers, predominantly from Australia, New Zealand, and the United Kingdom, to provide opinions on 28 management techniques that could be applied to reduce predation on birds. We asked their opinions before and after giving them a summary of the literature about the interventions’ effectiveness. We scored the overall effectiveness and certainty of evidence for each intervention through an expert elicitation process—the Delphi method. We used the effectiveness scores to assess the practitioners’ level of understanding and awareness of the literature. On average, each survey participant changed their likelihood of using 45.7% of the interventions after reading the synopsis of the evidence. They were more likely to implement effective interventions and avoid ineffective actions, suggesting that their intended future management strategies may be more successful than current practice. More experienced practitioners were less likely to change their management practices than those with less experience, even though they were not more aware of the existing scientific information than less experienced practitioners. The practitioners’ willingness to change their management choices when provided with summarized scientific evidence suggests that improved accessibility to scientific information would benefit conservation

  18. Knowledge Producers or Knowledge Consumers? Argumentation and Decision Making about Environmental Management.

    ERIC Educational Resources Information Center

    Jimenez-Aleixandre, Maria-Pilar; Pereiro-Munoz, Cristina

    2002-01-01

    Describes a study involving decision making and argumentation in the context of wetland environmental management by 11th grade students. Focuses on knowledge and skills needed to reach a decision in socio-scientific contexts and to identify them in classroom discourse. Explores using relevant knowledge to understand and make decisions about a…

  19. Menstrual Management and Women Who Have Intellectual Disabilities: Service Providers and Decision-Making.

    ERIC Educational Resources Information Center

    Carlson, Glenys; Wilson, Jill

    1996-01-01

    Service providers (n=63) were interviewed regarding menstrual management decision making for women with intellectual disabilities. The interviews focused on decision-making bases, opinions about decision-making processes, enhancing practical support for the young women and their families, and reviewing staff training and service delivery.…

  20. A queueing model of pilot decision making in a multi-task flight management situation

    NASA Technical Reports Server (NTRS)

    Walden, R. S.; Rouse, W. B.

    1977-01-01

    Allocation of decision making responsibility between pilot and computer is considered and a flight management task, designed for the study of pilot-computer interaction, is discussed. A queueing theory model of pilot decision making in this multi-task, control and monitoring situation is presented. An experimental investigation of pilot decision making and the resulting model parameters are discussed.

  1. Voice, perceived fairness, agency trust, and acceptance of management decisions among Minnesota anglers

    USGS Publications Warehouse

    Schroeder, Susan A.; Fulton, David C.

    2017-01-01

    Although researchers agree that public participation in natural resource decision making is critical to institutional acceptance by stakeholders and the general public, the processes to gain public perceptions of fairness, agency trust, and acceptance of management decisions are not clear. Using results from a mail survey of Minnesota resident anglers, we used structural equation modeling to examine how instrumental versus symbolic motives related to anglers’ perceptions of agency fairness, trustworthiness, and ultimately acceptance of fisheries management decisions. We applied laboratory research on relationships among procedural fairness, trust, and management acceptance, and then tested models incorporating anglers’ perceptions of voice for anglers and nonanglers in management decisions. Results suggested that trust fully mediated the relationship between procedural fairness and management acceptance. Angler perceptions of angler and nonangler voice both related to views of procedural fairness, but angler voice was more strongly related and was also significantly related to acceptance of management decisions.

  2. The prevalence and management of pain in patients with AIDS: a review of 134 cases.

    PubMed

    Lebovits, A H; Lefkowitz, M; McCarthy, D; Simon, R; Wilpon, H; Jung, R; Fried, E

    1989-09-01

    In light of the lack of any prior systematic evaluations of the prevalence and types of pain syndromes and treatments found in patients with AIDS, a chart review study was undertaken to evaluate this issue. Fifty-two of 96 charts reviewed (54%) had at least one note on nonprocedural pain or analgesic prescription. Although chest pain was the most prevalent pain location (22%), presumably because of the high incidence of Pneumocystis carinii pneumonia, other possible AIDS-related entities, such as peripheral neuropathy and thrombophlebitis, were also found. No specific AIDS syndromes could be identified that were related to a higher incidence of pain. Nearly one-third of patients with pain received codeine (31%), others received acetaminophen (27%), and 17% of patients received acetaminophen and oxycodone HCl. Specific pain management interventions must be evaluated and applied to control the nontrivial occurrence of pain in patients who have AIDS symptoms that may be overlooked by the physician given the overwhelming disease process.

  3. Portfolio Management Decision Support Tools Analysis Relating to Management Value Metrics

    DTIC Science & Technology

    2007-03-01

    operating environment. The intangible asset , management, which is required to ensure these important activities are executed at the appropriate time and... intangible asset . An important concept that is stressed in this literature is the assumption that there is a direct relationship between knowledge and...an intangible asset such as knowledge and utilizes this asset in decision making to increase the value of an organization. The next step is to lay

  4. Enrollment Management and Financial Aid: Seeking a Strategic Integration

    ERIC Educational Resources Information Center

    Kalsbeek, David H.; Hossler, Donald

    2008-01-01

    Enrollment management has become an important leadership function on many college and university campuses. It is also attracting critical attention here and abroad among observers of the system of postsecondary education. With this essay, the authors continue a series that examines policies and practices that are central to campus-based efforts to…

  5. Problems Encountered when Linking Environmental Management to Development Aid.

    ERIC Educational Resources Information Center

    O'Riordan, Timothy

    1981-01-01

    Environmental management is defined and four barriers to its incorporation into economic growth as related to Third World development assistance are identified. Recommends incorporating environmental and social assessments in project planning, improving administration coordination, and developing new training skills and diplomacy. (DC)

  6. The Financial Aid Office's Role in Enrollment Management: Part 2

    ERIC Educational Resources Information Center

    McGhee, Kenneth

    2016-01-01

    Student retention is an important part of a strategic enrollment management plan. Many scholars have written about the challenges of helping students not only enroll in college but also complete their degree programs. Among students pursuing a doctoral degree in higher education administration, student retention is a popular topic. Many doctoral…

  7. Graphic visualization of program performance aids management review

    NASA Technical Reports Server (NTRS)

    Eisenhart, G. N.

    1967-01-01

    Chart technique /PERTREE/ which displays the essential status elements of a PERT system in a vertical flow array, of high graphic quality, enables visual review by management of program performance. Since the display is versatile, it can accommodate any aspect of the program which the presenter wishes to accent.

  8. A Web-based environmental decision support system (WEDSS) for environmental planning and watershed management

    NASA Astrophysics Data System (ADS)

    Sugumaran, Ramanathan; Meyer, James C.; Davis, Jim

    2004-10-01

    Local governments often struggle to balance competing demands for residential, commercial and industrial development with imperatives to minimize environmental degradation. In order to effectively manage this development process on a sustainable basis, local planners and government agencies are increasingly seeking better tools and techniques. In this paper, we describe the development of a Web-Based Environmental Decision Support System (WEDSS), which helps to prioritize local watersheds in terms of environmental sensitivity using multiple criteria identified by planners and local government staff in the city of Columbia, and Boone County, Missouri. The development of the system involved three steps, the first was to establish the relevant environmental criteria and develop data layers for each criterion, then a spatial model was developed for analysis, and lastly a Web-based interface with analysis tools was developed using client-server technology. The WEDSS is an example of a way to run spatial models over the Web and represents a significant increase in capability over other WWW-based GIS applications that focus on database querying and map display. The WEDSS seeks to aid in the development of agreement regarding specific local areas deserving increased protection and the public policies to be pursued in minimizing the environmental impact of future development. The tool is also intended to assist ongoing public information and education efforts concerning watershed management and water quality issues for the City of Columbia, Missouri and adjacent developing areas within Boone County, Missouri.

  9. Decision Support System (DSS) for MSMA Integrated Stormwater Management Ecohydrology for Sustainable Green Infrastructure

    NASA Astrophysics Data System (ADS)

    Sidek, L. M.; Mohiyaden, H. A.; Haris, H.; Basri, H.; Muda, Z. C.; Roseli, Z. A.; Norlida, M. D.

    2016-03-01

    Rapid urbanization has known to have several adverse impacts towards hydrological cycle due to increasing impervious surface and degradation of water quality in stormwater runoff. In the past, urban waterways have been confined to narrow river corridors with the channels canalised and concrete and other synthetic materials forming the bed and banks of the river. Apart from that, stormwater pollutants such as litter, debris and sediments in drainage system are common problems that can lead to flooding and the degradation of water quality. To solve this problem, implementing stormwater Best Management Practices (BMPs) proves very promising due to its near natural characteristics and multiple effects on the drainage of stormwater runoff in urban areas. This judgment of using BMPs depends on not only relevant theoretical considerations, but also a large amount of practical experience and the availability of relevant data, as well. To fulfil this task, the so-called Decision Support System (DSS) in MSMA Design Aid and Database system are able to assist engineers and developers in management and improvement of water quantity and quality entering urban rivers from urban regions. This system is also helpful when an expert level judgment procure some repetitive and large amount of cases, like in the planning of stormwater BMPs systems for an entire city catchment. One of the advantages of an expert system is that it provides automation of expert-level judgement using availability of checking tools system.

  10. FRAMEWORK FOR DECISION SUPPORT USED IN CONTAMINATED LAND MANAGEMENT IN EUROPE AND NORTH AMERICA.

    SciTech Connect

    SULLIVAN,T.; BARDOS,R.P.; MAROT,C.; MARIOTTI,R.

    2000-06-01

    Effective contaminated land management requires a number of decisions addressing a suite of technical, economic and social concerns. This paper offers a common framework and terminology for describing decision support approaches, along with an overview of recent applications of decision support tools in Europe and the USA. A common problem with work on decision support approaches is a lack of a common framework and terminology to describe the process. These have been proposed in this paper.

  11. Visualization support for risk-informed decision making when planning and managing software developments

    NASA Technical Reports Server (NTRS)

    Feather, Martin S.; Kiper, James D.; Menzies, Tim

    2005-01-01

    Key decisions are made in the early stages of planning and management of software developments. The information basis for these decisions is often a mix of analogy with past developments, and the best judgments of domain experts. Visualization of this information can support to such decision making by clarifying the status of the information and yielding insights into the ramifications of that information vis-a-vis decision alternatives.

  12. Smartphone applications to aid weight loss and management: current perspectives.

    PubMed

    Sutton, Elizabeth F; Redman, Leanne M

    2016-01-01

    The development and dissemination of smart devices has cultivated a global environment of hyperconnectivity and increased our access to information. The paralleled launch and success of the Mobile Health industry has created a market of commercially available applications or "apps" along with tools or sensors, which allow the user to receive and collect personal health information. Apps and accompanying tools now allow an individual to "self-digitize" and, pertaining to weight management, monitor their body weight, caloric intake, physical activity, and more. These products possess the ability to improve the scalability of traditional in-person weight management services considering their near ubiquity, affordability, and capability to deliver information directly and personally to the user. However, similar to the dietary supplement market, the anecdotal value of these products has driven their popularity and acceptance by the general public without requirement of scientific validation or, in the area of weight management or diet/exercise, validation of the safety and efficacy by the Food and Drug Administration prior to market launch. By conducting a literature and clinical trial search, we found remarkably few active, completed, or published studies testing the efficacy of smart device applications using randomized controlled trials. Research efforts must be focused on illuminating the efficacy of behavioral interventions and remote self-monitoring for weight loss/maintenance treatment with true, randomized controlled trials.

  13. Smartphone applications to aid weight loss and management: current perspectives

    PubMed Central

    Sutton, Elizabeth F; Redman, Leanne M

    2016-01-01

    The development and dissemination of smart devices has cultivated a global environment of hyperconnectivity and increased our access to information. The paralleled launch and success of the Mobile Health industry has created a market of commercially available applications or “apps” along with tools or sensors, which allow the user to receive and collect personal health information. Apps and accompanying tools now allow an individual to “self-digitize” and, pertaining to weight management, monitor their body weight, caloric intake, physical activity, and more. These products possess the ability to improve the scalability of traditional in-person weight management services considering their near ubiquity, affordability, and capability to deliver information directly and personally to the user. However, similar to the dietary supplement market, the anecdotal value of these products has driven their popularity and acceptance by the general public without requirement of scientific validation or, in the area of weight management or diet/exercise, validation of the safety and efficacy by the Food and Drug Administration prior to market launch. By conducting a literature and clinical trial search, we found remarkably few active, completed, or published studies testing the efficacy of smart device applications using randomized controlled trials. Research efforts must be focused on illuminating the efficacy of behavioral interventions and remote self-monitoring for weight loss/maintenance treatment with true, randomized controlled trials. PMID:27486338

  14. The Role of Social Entrepreneurship in HIV/AIDS Management across the Education Sector in Kenya

    ERIC Educational Resources Information Center

    Ayiro, Laban P.

    2010-01-01

    Purpose: The overall purpose of this study is to identify key entrepreneurial variables in the realm of social entrepreneurship that may contribute to enhancing impact mitigation of HIV/AIDS. In addition, the study seeks to establish which of the correlations between the entrepreneurial variables and management of response of impact mitigation of…

  15. Data Management Standards in Computer-aided Acquisition and Logistic Support (CALS)

    NASA Technical Reports Server (NTRS)

    Jefferson, David K.

    1990-01-01

    Viewgraphs and discussion on data management standards in computer-aided acquisition and logistic support (CALS) are presented. CALS is intended to reduce cost, increase quality, and improve timeliness of weapon system acquisition and support by greatly improving the flow of technical information. The phase 2 standards, industrial environment, are discussed. The information resource dictionary system (IRDS) is described.

  16. Patient-Centered Robot-Aided Passive Neurorehabilitation Exercise Based on Safety-Motion Decision-Making Mechanism

    PubMed Central

    Duan, Suolin; Yu, Zhuqing

    2017-01-01

    Safety is one of the crucial issues for robot-aided neurorehabilitation exercise. When it comes to the passive rehabilitation training for stroke patients, the existing control strategies are usually just based on position control to carry out the training, and the patient is out of the controller. However, to some extent, the patient should be taken as a “cooperator” of the training activity, and the movement speed and range of the training movement should be dynamically regulated according to the internal or external state of the subject, just as what the therapist does in clinical therapy. This research presents a novel motion control strategy for patient-centered robot-aided passive neurorehabilitation exercise from the point of the safety. The safety-motion decision-making mechanism is developed to online observe and assess the physical state of training impaired-limb and motion performances and regulate the training parameters (motion speed and training rage), ensuring the safety of the supplied rehabilitation exercise. Meanwhile, position-based impedance control is employed to realize the trajectory tracking motion with interactive compliance. Functional experiments and clinical experiments are investigated with a healthy adult and four recruited stroke patients, respectively. The two types of experimental results demonstrate that the suggested control strategy not only serves with safety-motion training but also presents rehabilitation efficacy. PMID:28194413

  17. 75 FR 55341 - Recovery Policy, RP 9523.6, Mutual Aid Agreements for Public Assistance and Fire Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-10

    ... Assistance and Fire Management Assistance AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice of... comments on Recovery Policy, RP 9523.6, Mutual Aid Agreements for Public Assistance and Fire...

  18. Clinical decision support for perioperative information management systems.

    PubMed

    Wanderer, Jonathan P; Ehrenfeld, Jesse M

    2013-12-01

    Clinical decision support (CDS) systems are being used to optimize the increasingly complex care that our health care system delivers. These systems have become increasingly important in the delivery of perioperative care for patients undergoing cardiac, thoracic, and vascular procedures. The adoption of perioperative information management systems (PIMS) has allowed these technologies to enter the operating room and support the clinical work flow of anesthesiologists and operational processes. Constructing effective CDS systems necessitates an understanding of operative work flow and technical considerations as well as achieving integration with existing information systems. In this review, we describe published examples of CDS for PIMS, including support for cardiopulmonary bypass separation physiological alarms, β-blocker guideline adherence, enhanced revenue capture for arterial line placement, and detection of hemodynamic monitoring gaps. Although these and other areas are amenable to CDS systems, the challenges of latency and data reliability represent fundamental limitations on the potential application of these tools to specific types of clinical issues. Ultimately, we expect that CDS will remain an important tool in our efforts to optimize the quality of care delivered.

  19. Real-time decision aiding - Aircraft guidance for wind shear avoidance

    NASA Technical Reports Server (NTRS)

    Stratton, D. A.; Stengel, Robert F.

    1992-01-01

    Modern control theory and artificial intelligence technology are applied to the Wind Shear Safety Advisor, a conceptual airborne advisory system to help flight crews avoid or survive encounter with hazardous low-altitude wind shear. Numerical and symbolic processes of the system fuse diverse, time-varying data from ground-based and airborne measurements. Simulated wind-shear-encounter scenarios illustrate the need to consider a variety of factors for optimal decision reliability. The wind-shear-encounter simulations show the Wind Shear Safety Advisor's potential for effectively integrating the available information, highlighting the benefits of the computational techniques employed.

  20. Aide memoire for the management of gunshot wounds.

    PubMed Central

    MacFarlane, C.

    2002-01-01

    The hospitals in Johannesburg deal with about 4,000 gunshot wounds a year. Although most are from hand guns, a number are from high velocity, military-type weapons. Extensive experience has been built up and many lessons learned. Attention is directed to the actual damage inflicted rather than on theoretical predictions based on presumed velocity of the bullets involved, as this can often be misleading. Some patients are delayed in their presentation to emergency departments, in other cases several gunshot wound patients arrive at the same time, requiring appropriate triage and urgent management. PMID:12215024

  1. Thresholds for conservation and management: structured decision making as a conceptual framework

    USGS Publications Warehouse

    Nichols, James D.; Eaton, Mitchell J.; Martin, Julien; Edited by Guntenspergen, Glenn R.

    2014-01-01

    changes in system dynamics. They are frequently incorporated into ecological models used to project system responses to management actions. Utility thresholds are components of management objectives and are values of state or performance variables at which small changes yield substantial changes in the value of the management outcome. Decision thresholds are values of system state variables at which small changes prompt changes in management actions in order to reach specified management objectives. Decision thresholds are derived from the other components of the decision process.We advocate a structured decision making (SDM) approach within which the following components are identified: objectives (possibly including utility thresholds), potential actions, models (possibly including ecological thresholds), monitoring program, and a solution algorithm (which produces decision thresholds). Adaptive resource management (ARM) is described as a special case of SDM developed for recurrent decision problems that are characterized by uncertainty. We believe that SDM, in general, and ARM, in particular, provide good approaches to conservation and management. Use of SDM and ARM also clarifies the distinct roles of ecological thresholds, utility thresholds, and decision thresholds in informed decision processes.

  2. Decision support models for solid waste management: Review and game-theoretic approaches

    SciTech Connect

    Karmperis, Athanasios C.; Aravossis, Konstantinos; Tatsiopoulos, Ilias P.; Sotirchos, Anastasios

    2013-05-15

    Highlights: ► The mainly used decision support frameworks for solid waste management are reviewed. ► The LCA, CBA and MCDM models are presented and their strengths, weaknesses, similarities and possible combinations are analyzed. ► The game-theoretic approach in a solid waste management context is presented. ► The waste management bargaining game is introduced as a specific decision support framework. ► Cooperative and non-cooperative game-theoretic approaches to decision support for solid waste management are discussed. - Abstract: This paper surveys decision support models that are commonly used in the solid waste management area. Most models are mainly developed within three decision support frameworks, which are the life-cycle assessment, the cost–benefit analysis and the multi-criteria decision-making. These frameworks are reviewed and their strengths and weaknesses as well as their critical issues are analyzed, while their possible combinations and extensions are also discussed. Furthermore, the paper presents how cooperative and non-cooperative game-theoretic approaches can be used for the purpose of modeling and analyzing decision-making in situations with multiple stakeholders. Specifically, since a waste management model is sustainable when considering not only environmental and economic but also social aspects, the waste management bargaining game is introduced as a specific decision support framework in which future models can be developed.

  3. Virginity testing: managing sexuality in a maturing HIV/AIDS epidemic.

    PubMed

    Leclerc-Madlala, S

    2001-12-01

    KwaZulu-Natal province in South Africa is currently the site of the world's fastest growing HIV/AIDS epidemic, where it is estimated that between 30 and 40 percent of the adult population is seropositive for HIV. With support from local politicians and members of various government ministries, several self-styled guardians of tradition have emerged to form organizations that advocate and conduct regular virginity testing of girls. Reference to the current HIV/AIDS epidemic is central to calls for greater support of this practice. Drawing on original research among Zulu-speaking people in the periurban communities of Durban, this article examines the sociocultural construction of HIV/AIDS and locates the growing popularity of virginity testing within a gendered meaning-making process consistent with commonly held beliefs that the epidemic is the result of women being sexually "out of control." With the social impact of AIDS starting to take its toll in the forms of increasing AIDS-related deaths and a growing population of orphans, I argue that virginity testing is an attempt to manage the epidemic by exerting greater control over women and their sexuality. In addition, virginity testing of girls helps to draw attention away from the role of men in the maturing epidemic, consideration of which has been conspicuously absent in the popular discourse on AIDS at all levels of South African society.

  4. Usability Testing of a Web-Based Decision Aid for Breast Cancer Risk Assessment Among Multi-Ethnic Women.

    PubMed

    Coe, Austin M; Ueng, William; Vargas, Jennifer M; David, Raven; Vanegas, Alejandro; Infante, Katherine; Trivedi, Meghna; Yi, Haeseung; Dimond, Jill; Crew, Katherine D; Kukafka, Rita

    2016-01-01

    Chemoprevention with antiestrogens could decrease the incidence of invasive breast cancer but uptake has been low among high-risk women in the United States. We have designed a web-based patient-facing decision aid, called RealRisks, to inform high-risk women about the risks and benefits of chemoprevention and facilitate shared decision-making with their primary care provider. We conducted two rounds of usability testing to determine how subjects engaged with and understood the information in RealRisks. A total of 7 English-speaking and 4 Spanish-speaking subjects completed testing. Using surveys, think-aloud protocols, and subject recordings, we identified several themes relating to the usability of RealRisks, specifically in the content, ease of use, and navigability of the application. By conducting studies in two languages with a diverse multi-ethnic population, we were able to implement interface changes to make RealRisks accessible to users with varying health literacy and acculturation.

  5. Usability Testing of a Web-Based Decision Aid for Breast Cancer Risk Assessment Among Multi-Ethnic Women

    PubMed Central

    Coe, Austin M.; Ueng, William; Vargas, Jennifer M.; David, Raven; Vanegas, Alejandro; Infante, Katherine; Trivedi, Meghna; Yi, Haeseung; Dimond, Jill; Crew, Katherine D.; Kukafka, Rita

    2016-01-01

    Chemoprevention with antiestrogens could decrease the incidence of invasive breast cancer but uptake has been low among high-risk women in the United States. We have designed a web-based patient-facing decision aid, called RealRisks, to inform high-risk women about the risks and benefits of chemoprevention and facilitate shared decision-making with their primary care provider. We conducted two rounds of usability testing to determine how subjects engaged with and understood the information in RealRisks. A total of 7 English-speaking and 4 Spanish-speaking subjects completed testing. Using surveys, think-aloud protocols, and subject recordings, we identified several themes relating to the usability of RealRisks, specifically in the content, ease of use, and navigability of the application. By conducting studies in two languages with a diverse multi-ethnic population, we were able to implement interface changes to make RealRisks accessible to users with varying health literacy and acculturation. PMID:28269836

  6. 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

  7. Health information as an aid to effective hospital management.

    PubMed

    Mogli, G D

    2003-03-01

    No institution can be efficiently organized and managed unless one makes a critical analysis of organizational needs and takes appropriate action to develop the way one wishes it to be. It is, in fact, more true with hospital organization, usually the new hospital starts as a simple and small organization and with-in the space of few years, however, it evolves into a complex body governed by precise laws and regulations, especially as regards finances, facilities and organizations. In order to maintain any organization especially the hospital administration efficiently it is necessary to develop management tools that would reflect the true operation of the hospital and enable resources (personnel, equipment and buildings) to be fully utilized and adapted to the needs of the population serviced. These indicators of true hospital operation would then serve as a basis for determining hospital activity at any given time, in relation to the number and characteristics of the patients, as well as for evaluation hospital activity in terms of progress made towards good utilization of resources. A record of activities, related to the individual patient, would provide a valid basis for establishing a relationship with the morbidity observed in the hospital and would be a first step towards an evaluation of the services "rendered" by the hospital, or its impact on the demand for care in its own particular area. Thus, in its aims of establishing a hospital to adjusting supply to demand in the field of health care. The author had stressed too much emphasis on health information collection and interpretation because of valid reasons. Correct and timely administrative and clinical information which is a barometer of hospital efficiency could indicate whether the quality is balanced with expenditure or whether leading into financial crisis. So, whatever may be the motive behind establishing a hospital whether for profit making, or public-service, it is necessary the investors

  8. The Protected Areas Visitor Impact Management (PAVIM) framework: A simplified process for making management decisions

    USGS Publications Warehouse

    Farrell, T.A.; Marion, J.L.

    2002-01-01

    Ecotourism and protected area visitation in Central and South America have resulted in ecological impacts, which some protected areas managers have addressed by employing visitor impact management frameworks. In this paper, we propose the Protected Area Visitor Impact Management (PAVIM) framework as an alternative to carrying capacity and other frameworks such as Limits of Acceptable Change. We use a set of evaluation criteria to compare the relative positive and negative attributes of carrying capacity, other decision-making frameworks and the new framework, within the context of their actual and potential use in Central and South America. Positive attributes of PAVIM include simplicity, flexibility, cost effectiveness, timeliness, and incorporating input from stakeholders and local residents. Negative attributes include diminished objectivity and cultural sensitivity issues. Further research and application of PAVIM are recommended.

  9. Goal Management in Organizations: A Markov Decision Process (MDP) Approach

    DTIC Science & Technology

    2005-01-01

    model by introducing novel problem domain-specific heuristic evaluation functions ( HEF ) to aid the search process. We employ the optimal AO* search...introducing novel problem domain-specific heuristic evaluation functions ( HEF ) to aid the search process. We employ the optimal AO* search and two...algorithm, and greedy heuristics. Novel problem domain-based heuristic evaluation functions ( HEFs ) are introduced and evidence of their admissibility is

  10. 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.

  11. Study comparing the management decisions by IMNCI algorithm and pediatricians in a teaching hospital for the young infants between 0 to 2 months.

    PubMed

    Bhattacharyya, Agnihotri; Saha, Sanjay Kumar; Ghosh, Pramit; Chatterjee, Chitra; Dasgupta, Samir

    2011-01-01

    Integrated management of neonatal and childhood illness (IMNCI) was already operational in many states of India, but there were very few studies in Indian scenario comparing its validity and reliability with the decisions of pediatricians. The general objective of the study is to compare the IMNCI decisions with the decisions of pediatricians and the specific objectives are to assess the agreement between IMNCI decisions and the decisions of pediatricians, to assess the under diagnosis and over diagnosis in IMNCI algorithm in comparison to the decisions of pediatricians and to assess the significance of multiple presenting symptoms in IMNCI algorithm. The study was conducted among the sick young infants presenting in pediatric department from January to March 2009. The IMNCI decision was compared with pediatrician's decisions by percent agreement, Kappa and weighted Kappa with the aids of SPSS version 10. The overall diagnostic agreement between IMNCI algorithm and pediatrician's decisions was 55.56%, (Kappa 0.32 and weighted Kappa 0.41) with 33.33% over diagnosis, and 11.11% under diagnosis. 71.88% young infants with multiple symptoms and 40% with single symptom were classified as red by IMNCI algorithm, which is statistically significant (P=0.004) whereas 56.25% young infants with multiple and 31.76% with single symptom were considered admissible by pediatricians, which is not statistically significant (P=0.052).

  12. Upscaling of Environmental Information: Support of Land-Use Management Decisions by Spatio-Temporal Regionalization Approaches

    NASA Astrophysics Data System (ADS)

    Zirlewagen, Dietmar; von Wilpert, Klaus

    2010-12-01

    This article presents several case studies in southwest Germany, which aimed to support land use management decisions by a process-oriented statistical upscaling of point-related environmental monitoring data to the landscape scale. When techniques of data subsetting were used in a sensible way and corresponding to the appropriate scale for the evaluation envisaged, multiple linear regression offered a data mining technique which was able to spatially predict relatively complex environmental patterns with parsimonious, interpretable and accurate models, whereby different evaluation scales were best represented by different DTM resolutions. Scenario models based upon the regression formulas were a valuable tool for visualizing management options and evaluating management impacts (tree species selection) on soil functions (carbon storage), which qualifies the presented methodology as a useful aid in decision making. Such upscaling techniques may be used for forecasting long-term effects of ecosystem management, but they provided no information on temporal dynamics. Therefore, time trends of point information on soil solution data were scaled by linking them to soil chemical data which was available in higher spatial resolution, using both statistical and process-oriented methods.

  13. Aeromedical decision-making: an evidence-based risk management paradigm.

    PubMed

    Watson, Dougal B

    2005-01-01

    Aeromedical decisions take many forms and are made by different groups and individuals. Because of the ubiquity of aviation in the world today, it is important that aeromedical decisions are of the highest quality that can be reasonably achieved. A paradigm of evidence-based aeromedical risk management is reported on here. It combines the concept of evidence-based medicine with structured risk management methodologies to produce a methodology capable of delivering the highest quality of aeromedical decisions. While neither of these concepts is new, practitioners do need to ensure that they have the skills and knowledge to maximize the quality of their aeromedical decisions.

  14. Benchmarking Usage Statistics in Collection Management Decisions for Serials

    ERIC Educational Resources Information Center

    Tucker, Cory

    2009-01-01

    Usage statistics are an important metric for making decisions on serials. Although the University of Nevada, Las Vegas (UNLV) Libraries have been collecting usage statistics, the statistics had not frequently been used to make decisions and had not been included in collection development policy. After undergoing a collection assessment, the…

  15. Wind Prediction Accuracy for Air Traffic Management Decision Support Tools

    NASA Technical Reports Server (NTRS)

    Cole, Rod; Green, Steve; Jardin, Matt; Schwartz, Barry; Benjamin, Stan

    2000-01-01

    The performance of Air Traffic Management and flight deck decision support tools depends in large part on the accuracy of the supporting 4D trajectory predictions. This is particularly relevant to conflict prediction and active advisories for the resolution of conflicts and the conformance with of traffic-flow management flow-rate constraints (e.g., arrival metering / required time of arrival). Flight test results have indicated that wind prediction errors may represent the largest source of trajectory prediction error. The tests also discovered relatively large errors (e.g., greater than 20 knots), existing in pockets of space and time critical to ATM DST performance (one or more sectors, greater than 20 minutes), are inadequately represented by the classic RMS aggregate prediction-accuracy studies of the past. To facilitate the identification and reduction of DST-critical wind-prediction errors, NASA has lead a collaborative research and development activity with MIT Lincoln Laboratories and the Forecast Systems Lab of the National Oceanographic and Atmospheric Administration (NOAA). This activity, begun in 1996, has focussed on the development of key metrics for ATM DST performance, assessment of wind-prediction skill for state of the art systems, and development/validation of system enhancements to improve skill. A 13 month study was conducted for the Denver Center airspace in 1997. Two complementary wind-prediction systems were analyzed and compared to the forecast performance of the then standard 60 km Rapid Update Cycle - version 1 (RUC-1). One system, developed by NOAA, was the prototype 40-km RUC-2 that became operational at NCEP in 1999. RUC-2 introduced a faster cycle (1 hr vs. 3 hr) and improved mesoscale physics. The second system, Augmented Winds (AW), is a prototype en route wind application developed by MITLL based on the Integrated Terminal Wind System (ITWS). AW is run at a local facility (Center) level, and updates RUC predictions based on an

  16. Using structured decision making to manage disease risk for Montana wildlife

    USGS Publications Warehouse

    Mitchell, Michael S.; Gude, Justin A.; Anderson, Neil J.; Ramsey, Jennifer M.; Thompson, Michael J.; Sullivan, Mark G.; Edwards, Victoria L.; Gower, Claire N.; Cochrane, Jean Fitts; Irwin, Elise R.; Walshe, Terry

    2013-01-01

    We used structured decision-making to develop a 2-part framework to assist managers in the proactive management of disease outbreaks in Montana, USA. The first part of the framework is a model to estimate the probability of disease outbreak given field observations available to managers. The second part of the framework is decision analysis that evaluates likely outcomes of management alternatives based on the estimated probability of disease outbreak, and applies managers' values for different objectives to indicate a preferred management strategy. We used pneumonia in bighorn sheep (Ovis canadensis) as a case study for our approach, applying it to 2 populations in Montana that differed in their likelihood of a pneumonia outbreak. The framework provided credible predictions of both probability of disease outbreaks, as well as biological and monetary consequences of management actions. The structured decision-making approach to this problem was valuable for defining the challenges of disease management in a decentralized agency where decisions are generally made at the local level in cooperation with stakeholders. Our approach provides local managers with the ability to tailor management planning for disease outbreaks to local conditions. Further work is needed to refine our disease risk models and decision analysis, including robust prediction of disease outbreaks and improved assessment of management alternatives.

  17. 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.

  18. Analysis and Management of Animal Populations: Modeling, Estimation and Decision Making

    USGS Publications Warehouse

    Williams, B.K.; Nichols, J.D.; Conroy, M.J.

    2002-01-01

    This book deals with the processes involved in making informed decisions about the management of animal populations. It covers the modeling of population responses to management actions, the estimation of quantities needed in the modeling effort, and the application of these estimates and models to the development of sound management decisions. The book synthesizes and integrates in a single volume the methods associated with these themes, as they apply to ecological assessment and conservation of animal populations. KEY FEATURES * Integrates population modeling, parameter estimation and * decision-theoretic approaches to management in a single, cohesive framework * Provides authoritative, state-of-the-art descriptions of quantitative * approaches to modeling, estimation and decision-making * Emphasizes the role of mathematical modeling in the conduct of science * and management * Utilizes a unifying biological context, consistent mathematical notation, * and numerous biological examples

  19. 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

  20. 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.

  1. Research on Group Decision-Making Mechanism of Internet Emergency Management

    NASA Astrophysics Data System (ADS)

    Xie, Kefan; Chen, Gang; Qian, Wu; Shi, Zhao

    With the development of information technology, internet has become a popular term and internet emergency has an intensive influence on people's life. This article offers a short history of internet emergency management. It discusses the definition, characteristics, and factor of internet emergency management. A group decision-making mechanism of internet emergency is presented based on the discussion. The authors establish a so-called Rough Set Scenario Flow Graphs (RSSFG) of group decision-making mechanism of internet emergency management and make an empirical analysis based on the RSSFG approach. The experimental results confirm that this approach is effective in internet emergency decision-making.

  2. 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.

  3. 75 FR 53980 - Notice of Availability of the Record of Decision; Elk Management Plan/Environmental Impact...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-02

    ... National Park Service Notice of Availability of the Record of Decision; Elk Management Plan/Environmental... Decision on the Elk Management Plan/Environmental Impact Statement for Theodore Roosevelt National Park... the Record of Decision (ROD) for the Elk Management Plan/Environmental Impact Statement (Plan/EIS)...

  4. Self-management education programs for people living with HIV/AIDS: a systematic review.

    PubMed

    Millard, Tanya; Elliott, Julian; Girdler, Sonya

    2013-02-01

    The effectiveness of self-management programs to improve physical, psychosocial, health knowledge, and behavioral outcomes for adults living with HIV has not been well established. This article reviews the effectiveness of self-management education programs to improve physical, psychosocial, health knowledge, and behavior outcomes for adults living with HIV/AIDS. A systematic review of English articles using CINAHL, MEDLINE, and PsycINFO were used to identify and retrieve relevant studies. Each database was searched from its earliest record to October 2010. Search terms included HIV/AIDS, self-management, self-care, patient education, and education programs. Only studies that (1) reported on a HIV-specific intervention that aimed to increase participants HIV-related knowledge through a self-management component, (2) included a control group, (3) provided skills training or targeted behavior change, and (4) reported clinical outcomes were included. Independent data extraction by one author using the methods described in the Cochrane Handbook for Systematic Reviews. A second reviewer checked the data extraction. Six protocols were reported in eight publications (n=1178), all contained elements of self-management interventions. Effect size calculations were not conducted due to limitations in the available data. The review found randomized controlled trials (RCT) evidence sufficient to infer that self-management programs for people living with HIV/AIDS result in short-term improvements in physical, psychosocial, and health knowledge and behavioral outcomes. Statistically significant improvements were reported for intervention participants compared to control participants across most outcomes. There is insufficient evidence to provide conclusions regarding the long-term outcomes of HIV-specific self-management interventions.

  5. 75 FR 10308 - Fire Management Plan, Final Environmental Impact Statement, Record of Decision, Grand Canyon...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-05

    ... Doc No: 2010-4414] DEPARTMENT OF THE INTERIOR National Park Service Fire Management Plan, Final... Impact Statement for the Fire Management Plan, Grand Canyon National Park. SUMMARY: Pursuant to the... availability of the Record of Decision for the Fire Management Plan, Grand Canyon National Park, Arizona....

  6. Development of a forecasting tool to guide field management decisions related to fertilizer and manure

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Managing the timing of fertilizer and manure application is critical to protecting water quality in the Chesapeake Bay watershed. While modern nutrient management tools are designed to help farmers with their long-term field management planning, they do not support daily decisions on when and where...

  7. Crisis Management: Psychological and Sociological Factors in Decision Making

    DTIC Science & Technology

    1975-03-01

    psychologists and the limiiations of that research in terms of applicabihty to foreign policy decision-making. It it a study of risk-Uking behivior by Lieblich ...attached to different alternatives, so it becomes important to study a decision-maker’s tendency to choose a risky alternative. Lieblich (1968:304...Seymour (1971). "Stress and Behavior " Scientific American. 224 (January), pp. 26-31. Lieblich , Amia (1968). "Effects of Stress on Risk Taking

  8. Modular analytics management architecture for interoperability and decision support

    NASA Astrophysics Data System (ADS)

    Marotta, Stephen; Metzger, Max; Gorman, Joe; Sliva, Amy

    2016-05-01

    The Dual Node Decision Wheels (DNDW) architecture is a new approach to information fusion and decision support systems. By combining cognitive systems engineering organizational analysis tools, such as decision trees, with the Dual Node Network (DNN) technical architecture for information fusion, the DNDW can align relevant data and information products with an organization's decision-making processes. In this paper, we present the Compositional Inference and Machine Learning Environment (CIMLE), a prototype framework based on the principles of the DNDW architecture. CIMLE provides a flexible environment so heterogeneous data sources, messaging frameworks, and analytic processes can interoperate to provide the specific information required for situation understanding and decision making. It was designed to support the creation of modular, distributed solutions over large monolithic systems. With CIMLE, users can repurpose individual analytics to address evolving decision-making requirements or to adapt to new mission contexts; CIMLE's modular design simplifies integration with new host operating environments. CIMLE's configurable system design enables model developers to build analytical systems that closely align with organizational structures and processes and support the organization's information needs.

  9. Structured decision making as a conceptual framework to identify thresholds for conservation and management

    USGS Publications Warehouse

    Martin, J.; Runge, M.C.; Nichols, J.D.; Lubow, B.C.; Kendall, W.L.

    2009-01-01

    Thresholds and their relevance to conservation have become a major topic of discussion in the ecological literature. Unfortunately, in many cases the lack of a clear conceptual framework for thinking about thresholds may have led to confusion in attempts to apply the concept of thresholds to conservation decisions. Here, we advocate a framework for thinking about thresholds in terms of a structured decision making process. The purpose of this framework is to promote a logical and transparent process for making informed decisions for conservation. Specification of such a framework leads naturally to consideration of definitions and roles of different kinds of thresholds in the process. We distinguish among three categories of thresholds. Ecological thresholds are values of system state variables at which small changes bring about substantial changes in system dynamics. Utility thresholds are components of management objectives (determined by human values) and are values of state or performance variables at which small changes yield substantial changes in the value of the management outcome. Decision thresholds are values of system state variables at which small changes prompt changes in management actions in order to reach specified management objectives. The approach that we present focuses directly on the objectives of management, with an aim to providing decisions that are optimal with respect to those objectives. This approach clearly distinguishes the components of the decision process that are inherently subjective (management objectives, potential management actions) from those that are more objective (system models, estimates of system state). Optimization based on these components then leads to decision matrices specifying optimal actions to be taken at various values of system state variables. Values of state variables separating different actions in such matrices are viewed as decision thresholds. Utility thresholds are included in the objectives

  10. Anticoagulation manager: development of a clinical decision support mobile application for management of anticoagulants.

    PubMed

    Chih-Wen Cheng; Hang Wu; Thompson, Pamela J; Taylor, Julie R; Zehnbauer, Barbara A; Wilson, Karlyn K; Wang, May D

    2016-08-01

    Patients with certain clotting disorders or conditions have a greater risk of developing arterial or venous clots and downstream embolisms, strokes, and arterial insufficiency. These patients need prescription anticoagulant drugs to reduce the possibility of clot formation. However, historically, the clinical decision making workflow in determining the correct type and dosage of anticoagulant(s) is part science and part art. To address this problem, we developed Anticoagulation Manager, an intelligent clinical decision workflow management system on iOS-based mobile devices to help clinicians effectively choose the most appropriate and helpful follow-up clotting tests for patients with a common clotting profile. The app can provide physicians guidance to prescribe the most appropriate medication for patients in need of anticoagulant drugs. This intelligent app was jointly designed and developed by medical professionals in CDC and engineers at Georgia Tech, and will be evaluated by physicians for ease-of-use, robustness, flexibility, and scalability. Eventually, it will be deployed and shared in both physician community and developer community.

  11. Use of structured decision making to identify monitoring variables and management priorities for salt marsh ecosystems

    USGS Publications Warehouse

    Neckles, Hilary A.; Lyons, James E.; Guntenspergen, Glenn R.; Shriver, W. Gregory; Adamowicz, Susan C.

    2015-01-01

    Most salt marshes in the USA have been degraded by human activities, and coastal managers are faced with complex choices among possible actions to restore or enhance ecosystem integrity. We applied structured decision making (SDM) to guide selection of monitoring variables and management priorities for salt marshes within the National Wildlife Refuge System in the northeastern USA. In general, SDM is a systematic process for decomposing a decision into its essential elements. We first engaged stakeholders in clarifying regional salt marsh decision problems, defining objectives and attributes to evaluate whether objectives are achieved, and developing a pool of alternative management actions for achieving objectives. Through this process, we identified salt marsh attributes that were applicable to monitoring National Wildlife Refuges on a regional scale and that targeted management needs. We then analyzed management decisions within three salt marsh units at Prime Hook National Wildlife Refuge, coastal Delaware, as a case example of prioritizing management alternatives. Values for salt marsh attributes were estimated from 2 years of baseline monitoring data and expert opinion. We used linear value modeling to aggregate multiple attributes into a single performance score for each alternative, constrained optimization to identify alternatives that maximized total management benefits subject to refuge-wide cost constraints, and used graphical analysis to identify the optimal set of alternatives for the refuge. SDM offers an efficient, transparent approach for integrating monitoring into management practice and improving the quality of management decisions.

  12. Decision-making and evacuation planning for flood risk management in the Netherlands.

    PubMed

    Kolen, Bas; Helsloot, Ira

    2014-07-01

    A traditional view of decision-making for evacuation planning is that, given an uncertain threat, there is a deterministic way of defining the best decision. In other words, there is a linear relation between threat, decision, and execution consequences. Alternatives and the impact of uncertainties are not taken into account. This study considers the 'top strategic decision-making' for mass evacuation owing to flooding in the Netherlands. It reveals that the top strategic decision-making process itself is probabilistic because of the decision-makers involved and their crisis managers (as advisers). The paper concludes that deterministic planning is not sufficient, and it recommends probabilistic planning that considers uncertainties in the decision-making process itself as well as other uncertainties, such as forecasts, citizens responses, and the capacity of infrastructure. This results in less optimistic, but more realistic, strategies and a need to pay attention to alternative strategies.

  13. 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

  14. Introduction to Decision Support Systems for Risk Based Management of Contaminated Sites

    EPA Science Inventory

    A book on Decision Support Systems for Risk-based Management of contaminated sites is appealing for two reasons. First, it addresses the problem of contaminated sites, which has worldwide importance. Second, it presents Decision Support Systems (DSSs), which are powerful comput...

  15. Gender, Sex Role, and Career Decision Making of Certified Management Accountants.

    ERIC Educational Resources Information Center

    Keys, David E.

    1985-01-01

    Reports results of investigations into relationships of gender and sex role with career decision making of Certified Management Accountants (CMA). The Bem Sex Role Inventory responses from 87 women CMA's and 87 men CMA's show both gender and sex role to be significantly related to various aspects of career decision making. (Author/SA)

  16. Decision Support Systems (DSSs) For Contaminated Land Management - Gaps And Challenges

    EPA Science Inventory

    A plethora of information is available when considering decision support systems for risk-based management of contaminated land. Broad issues of what is contaminated land, what is a brownfield, and what is remediation are discussed in EU countries and the U.S. Making decisions ...

  17. School-Based Management: An Approach to Decision-Making Quality in Egyptian General Secondary Schools

    ERIC Educational Resources Information Center

    Elmelegy, Reda Ibrahim

    2015-01-01

    The current research aims at clarifying how school-based management (SBM) can contribute to achieve the decision-making quality in Egyptian general secondary schools and determine the requirements of quality decision-making. It depends on the descriptive method in order to acknowledge the basics of the SBM and its relationship with the quality of…

  18. DASEES: A Tripartite Decision Analysis Framework to Achieve Sustainable Environment, Economy & Society Growth and Management Goals

    EPA Science Inventory

    Many of Societies management and growth decisions are often made without a balanced consideration of pertinent factors from environmental, economic and societal perspectives. All three of these areas are key players in many of the decisions facing societies as they strive to ope...

  19. Decision-aids for enhancing intergovernmental interactions: The Pre-notification Analysis Support System (PASS)

    SciTech Connect

    Lester, M.; Liebow, E.; Holm, J.

    1994-05-01

    The Department of Energy (DOE) plans to honor its commitment to government-to-government interactions by providing advance notice of DOE spent fuel and high-level waste shipments to Indian tribes whose jurisdictions are crossed by or adjacent to transportation routes. The tribes are important contributors to a regional response network, and providing tribes with advance notice of DOE shipping plans marks the start -- not the end -- of direct, government-to-government interactions with DOE. The Tribal Prenotification Analysis Support System (PASS) is being developed for the Office of Special Programs within the Department`s Office of Environmental Restoration and Waste Management. PASS will help DOE-Headquarters to coordinate field office activities and provide technical and institutional support to the DOE field offices. PASS is designed to be used by anyone with minimum computer literacy and having contemporary computer hardware and software. It uses on-screen maps to choose and display a shipment route, and to display the tribal jurisdictions. With forms that are easy to understand, it provides information about each jurisdiction and points of contact. PASS records all contacts, commitments made, and actions taken.

  20. 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.

  1. Developing Evidence-Based Care Standards and a Decision-Making Support System for Pain Management.

    PubMed

    Feng, Rung-Chuang; Chang, Polun

    2016-01-01

    Pain is a crucial sign and symptom in hospitalised patients. This paper describes how a medical centre created a knowledge-based, computerised pain management decision-making process to support nurses in personalising preventive interventions based on patient requirements.

  2. A Decision Support System for Managing a Diverse Portfolio of Technology Resources

    NASA Technical Reports Server (NTRS)

    Smith, J.

    2000-01-01

    This paper describes an automated decision support system designed to facilitate the management of a continuously changing portfolio of technologies as new technologies are deployed and older technologies are decommissioned.

  3. Waste Management Decision-Making Process During a Homeland Security Incident Response

    EPA Pesticide Factsheets

    A step-by-step guide on how to make waste management-related decisions including how waste can be minimized, collected and treated, as well as where waste can be sent for staging, storage and final disposal.

  4. Effect of a Cognitive Aid on Adherence to Perioperative Assessment and Management Guidelines for the Cardiac Evaluation of Non-Cardiac Surgical Patients

    PubMed Central

    Bridges, Kathryn H; Stiegler, Marjorie P; Schell, Randall M; DiLorenzo, Amy N; Ehrenfeld, Jesse M; Nietert, Paul J; McEvoy, Matthew D

    2014-01-01

    BACKGROUND The 2007 American College of Cardiologists/American Heart Association Guidelines on Perioperative Cardiac Evaluation and Care for Noncardiac Surgery is the standard for perioperative cardiac evaluation. Recent work has shown residents and anesthesiologists do not apply these guidelines when tested. This research hypothesized that a decision support tool would improve adherence to this consensus guideline. METHODS Anesthesiology residents at 4 training programs participated in an unblinded prospective randomized cross-over trial in which they completed two tests covering clinical scenarios. One quiz was completed from memory and one with the aid of an electronic decision support tool. Performance was evaluated by overall score (% correct), number of incorrect answers with possibly increased cost or risk of care, and the amount of time required to complete the quizzes both with and without the cognitive aid. The primary outcome was the proportion of correct responses attributable to the use of the decision support tool. RESULTS All anesthesiology residents at four institutions were recruited and 111 residents participated. Use of the decision support tool resulted in a 25% improvement in adherence to guidelines compared to memory alone (p<0.0001), and participants made 77% fewer incorrect responses that would have resulted in increased costs. Use of the tool was associated with a 3.4-minute increase in time to complete the test (p<0.001). CONCLUSIONS Use of an electronic decision support tool significantly improved adherence to the guidelines as compared to memory alone. The decision support tool also prevented inappropriate management steps possibly associated with increased healthcare costs. PMID:24705442

  5. Joining forces for food security - Linking earth observation and crowd-sourcing for improved decision-support to aid organizations

    NASA Astrophysics Data System (ADS)

    Enenkel, M.; Dorigo, W.; See, L. M.; Vinck, P.; Pham, P.

    2013-12-01

    Droughts statistically exceed all other natural disasters in spatio-temporal extent, number of people affected or financial loss. Triggered by crop failure, food insecurity is a major manifestation of agricultural drought and water scarcity. However, other socio-economic precursors, such as chronically low levels of disaster preparedness, hampered access to food security or a lack of social safety nets are equally important factors. Consequently, this study is focused on two complementary developments - a new satellite-derived agricultural drought index and a mobile phone application. The Combined Drought Index (CDI) is enhanced by replacing field measurements of temperature and rainfall modelled/assimilated data. The vegetation component is replaced by a smoothed NDVI dataset. A soil moisture component is introduced to close the gap between rainfall deficiencies and the first visible impacts of atmospheric anomalies on vegetation. The mobile phone application enables the validation of drought index outputs and gives aid organizations an opportunity to increase the speed of socio-economic vulnerability assessments. Supported by Doctors without Borders (MSF) this approach aims at decreasing uncertainties in decision-making via a more holistic risk framework.

  6. A decision support framework for characterizing and managing dermal exposures to chemicals during Emergency Management and Operations

    PubMed Central

    Dotson, G. Scott; Hudson, Naomi L.; Maier, Andrew

    2016-01-01

    Emergency Management and Operations (EMO) personnel are in need of resources and tools to assist in understanding the health risks associated with dermal exposures during chemical incidents. This article reviews available resources and presents a conceptual framework for a decision support system (DSS) that assists in characterizing and managing risk during chemical emergencies involving dermal exposures. The framework merges principles of three decision-making techniques: 1) scenario planning, 2) risk analysis, and 3) multicriteria decision analysis (MCDA). This DSS facilitates dynamic decision making during each of the distinct life cycle phases of an emergency incident (ie, preparedness, response, or recovery) and identifies EMO needs. A checklist tool provides key questions intended to guide users through the complexities of conducting a dermal risk assessment. The questions define the scope of the framework for resource identification and application to support decision-making needs. The framework consists of three primary modules: 1) resource compilation, 2) prioritization, and 3) decision. The modules systematically identify, organize, and rank relevant information resources relating to the hazards of dermal exposures to chemicals and risk management strategies. Each module is subdivided into critical elements designed to further delineate the resources based on relevant incident phase and type of information. The DSS framework provides a much needed structure based on contemporary decision analysis principles for 1) documenting key questions for EMO problem formulation and 2) a method for systematically organizing, screening, and prioritizing information resources on dermal hazards, exposures, risk characterization, and management. PMID:26312660

  7. A decision support framework for characterizing and managing dermal exposures to chemicals during Emergency Management and Operations.

    PubMed

    Dotson, G Scott; Hudson, Naomi L; Maier, Andrew

    2015-01-01

    Emergency Management and Operations (EMO) personnel are in need of resources and tools to assist in understanding the health risks associated with dermal exposures during chemical incidents. This article reviews available resources and presents a conceptual framework for a decision support system (DSS) that assists in characterizing and managing risk during chemical emergencies involving dermal exposures. The framework merges principles of three decision-making techniques: 1) scenario planning, 2) risk analysis, and 3) multicriteria decision analysis (MCDA). This DSS facilitates dynamic decision making during each of the distinct life cycle phases of an emergency incident (ie, preparedness, response, or recovery) and identifies EMO needs. A checklist tool provides key questions intended to guide users through the complexities of conducting a dermal risk assessment. The questions define the scope of the framework for resource identification and application to support decision-making needs. The framework consists of three primary modules: 1) resource compilation, 2) prioritization, and 3) decision. The modules systematically identify, organize, and rank relevant information resources relating to the hazards of dermal exposures to chemicals and risk management strategies. Each module is subdivided into critical elements designed to further delineate the resources based on relevant incident phase and type of information. The DSS framework provides a much needed structure based on contemporary decision analysis principles for 1) documenting key questions for EMO problem formulation and 2) a method for systematically organizing, screening, and prioritizing information resources on dermal hazards, exposures, risk characterization, and management.

  8. Monitoring in the context of structured decision-making and adaptive management

    USGS Publications Warehouse

    Lyons, J.E.; Runge, M.C.; Laskowski, H.P.; Kendall, W.L.

    2008-01-01

    In a natural resource management setting, monitoring is a crucial component of an informed process for making decisions, and monitoring design should be driven by the decision context and associated uncertainties. Monitoring itself can play >3 roles. First, it is important for state-dependent decision-making, as when managers need to know the system state before deciding on the appropriate course of action during the ensuing management cycle. Second, monitoring is critical for evaluating the effectiveness of management actions relative to objectives. Third, in an adaptive management setting, monitoring provides the feedback loop for learning about the system; learning is sought not for its own sake but primarily to better achieve management objectives. In this case, monitoring should be designed to reduce the critical uncertainties in models of the managed system. The United States Geological Survey and United States Fish and Wildlife Service are conducting a large-scale management experiment on 23 National Wildlife Refuges across the Northeast and Midwest Regions. The primary management objective is to provide habitat for migratory waterbirds, particularly during migration, using water-level manipulations in managed wetlands. Key uncertainties are related to the potential trade-offs created by management for a specific waterbird guild (e.g., migratory shorebirds) and the response of waterbirds, plant communities, and invertebrates to specific experimental hydroperiods. We reviewed the monitoring program associated with this study, and the ways that specific observations fill >1 of the roles identified above. We used observations from our monitoring to improve state-dependent decisions to control undesired plants, to evaluate management performance relative to shallow-water habitat objectives, and to evaluate potential trade-offs between waterfowl and shorebird habitat management. With limited staff and budgets, management agencies need efficient monitoring

  9. Policy, practice and decision making for zoonotic disease management: water and Cryptosporidium.

    PubMed

    Austin, Zoë; Alcock, Ruth E; Christley, Robert M; Haygarth, Philip M; Heathwaite, A Louise; Latham, Sophia M; Mort, Maggie; Oliver, David M; Pickup, Roger; Wastling, Jonathan M; Wynne, Brian

    2012-04-01

    Decision making for zoonotic disease management should be based on many forms of appropriate data and sources of evidence. However, the criteria and timing for policy response and the resulting management decisions are often altered when a disease outbreak occurs and captures full media attention. In the case of waterborne disease, such as the robust protozoa, Cryptosporidium spp, exposure can cause significant human health risks and preventing exposure by maintaining high standards of biological and chemical water quality remains a priority for water companies in the UK. Little has been documented on how knowledge and information is translated between the many stakeholders involved in the management of Cryptosporidium, which is surprising given the different drivers that have shaped management decisions. Such information, coupled with the uncertainties that surround these data is essential for improving future management strategies that minimise disease outbreaks. Here, we examine the interplay between scientific information, the media, and emergent government and company policies to examine these issues using qualitative and quantitative data relating to Cryptosporidium management decisions by a water company in the North West of England. Our results show that political and media influences are powerful drivers of management decisions if fuelled by high profile outbreaks. Furthermore, the strength of the scientific evidence is often constrained by uncertainties in the data, and in the way knowledge is translated between policy levels during established risk management procedures. In particular, under or over-estimating risk during risk assessment procedures together with uncertainty regarding risk factors within the wider environment, was found to restrict the knowledge-base for decision-making in Cryptosporidium management. Our findings highlight some key current and future challenges facing the management of such diseases that are widely applicable to other

  10. A decision support framework for sustainable urban water planning and management in new urban areas.

    PubMed

    Makropoulos, C K; Morley, M; Memon, F A; Butler, D; Savic, D; Ashley, R A

    2006-01-01

    The paper discusses issues of decision support within the context of sustainable development and more specifically sustainable water cycle management to provide a context and a rationale for the decision support approach adopted within an on-going U.K. EPSRC-funded project, WaND. The paper proposes a set-up for a flexible, upgradeable, efficient and modular decision support framework and associated tools. Furthermore, the paper presents early prototypes of three decision support tools developed within the proposed framework including initial results for one of them.

  11. Decision Support Systems for Research and Management in Advanced Life Support

    NASA Technical Reports Server (NTRS)

    Rodriquez, Luis F.

    2004-01-01

    Decision support systems have been implemented in many applications including strategic planning for battlefield scenarios, corporate decision making for business planning, production planning and control systems, and recommendation generators like those on Amazon.com(Registered TradeMark). Such tools are reviewed for developing a similar tool for NASA's ALS Program. DSS are considered concurrently with the development of the OPIS system, a database designed for chronicling of research and development in ALS. By utilizing the OPIS database, it is anticipated that decision support can be provided to increase the quality of decisions by ALS managers and researchers.

  12. Clinical judgment and decision-making in wound assessment and management: is experience enough?

    PubMed

    Logan, Gemma

    2015-03-01

    The assessment and management of wounds forms a large proportion of community nurses' workload, often requiring judgment and decision-making in complex, challenging and uncertain circumstances. The processes through which nurses form judgments and make decisions within this context are reviewed in this article against existing theories on these subjects. There is variability in wound assessment and management practice which may be attributed to uncertainties within the context, a lack of knowledge in appropriate treatment choices and the inability to correctly value the importance of the clinical information presented. Nurses may be required to draw on intuition to guide their judgments and decision-making by association with experience and expertise. In addition, a step-by-step analytical approach underpinned by an evidence base may be required to ensure accuracy in practice. Developing an understanding of the different theories of judgment and decision-making may facilitate nurses' abilities to reflect on their own decision tasks, thereby enhancing the care provided.

  13. “Making Do” Decisions: How Home Healthcare Personnel Manage Their Exposure to Home Hazards

    PubMed Central

    Wills, Celia E.; Polivka, Barbara J.; Darragh, Amy; Lavender, Steven; Sommerich, Carolyn; Stredney, Donald

    2016-01-01

    This study describes the decision-making processes home healthcare personnel (HHP) use to manage their personal health and safety when managing hazards in client homes. A professionally diverse national sample of 68 HHP participated in individual semi-structured interviews and focus group discussions, and described their decision making and strategies for hazard management in their work environments. HHP described 353 hazard management dilemmas within 394 specifically identified hazards, which were clustered within three broader categories: electrical/fire, slip/trip/lift, and environmental exposures. HHP described multiple types of “making do” decisions for hazard management solutions in which perceived and actual resource limitations constrained response options. A majority of hazard management decisions in the broader hazards categories (72.5%, 68.5%, and 63.5%, respectively) were classifiable as less than optimal. These findings stress the need for more support of HHPs, including comprehensive training, to improve HHP decision making and hazard management strategies, especially in context of resource constraints. PMID:26669605

  14. Satisfaction with dental case management among people living with HIV/AIDS.

    PubMed

    Lemay, Celeste A; Kretsedemas, Myrtise; Graves, John R

    2010-02-01

    We evaluated access to and satisfaction with dental services for people living with HIV/AIDS receiving services from a dental case manager (DCM). People living with HIV/AIDS who had received dental services at two Community Dental Centers on Cape Cod, Massachusetts were eligible to participate in a mailed, anonymous return, Dental Satisfaction Survey (N = 160). Overall, respondents were satisfied with the dental care they had received. Most patients (58%) were new to the practice and were more likely to report that they had not been seen by a dental provider for more than 12 months (OR 3.0, P = 0.044). The majority of respondents reported that they heard about the clinic from local agencies. Of respondents recognizing they had a DCM, almost all answered that their DCM had helped them receive the care they needed. Respondents who agreed that they sometimes avoided going to the dentist due to pain were significantly more likely to report that they had a dental case manager than patients who disagreed (OR 3.42, P = 0.027). When patients were asked how their DCM had helped them, themes identified included: assisting with access to dental care, conducting a needs assessment, and providing comfort. People living with HIV/AIDS often have unmet needs regarding dental care. The addition of the DCM to the dental facility appears to facilitate access to dental care for those connected to medical care through community outreach/partnerships and provides some respondents with an identified dental advocate.

  15. Fuzzy rule-based models for decision support in ecosystem management.

    PubMed

    Adriaenssens, Veronique; De Baets, Bernard; Goethals, Peter L M; De Pauw, Niels

    2004-02-05

    To facilitate decision support in the ecosystem management, ecological expertise and site-specific data need to be integrated. Fuzzy logic can deal with highly variable, linguistic, vague and uncertain data or knowledge and, therefore, has the ability to allow for a logical, reliable and transparent information stream from data collection down to data usage in decision-making. Several environmental applications already implicate the use of fuzzy logic. Most of these applications have been set up by trial and error and are mainly limited to the domain of environmental assessment. In this article, applications of fuzzy logic for decision support in ecosystem management are reviewed and assessed, with an emphasis on rule-based models. In particular, the identification, optimisation, validation, the interpretability and uncertainty aspects of fuzzy rule-based models for decision support in ecosystem management are discussed.

  16. 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.

  17. Observational study of the development and evaluation of a fertility preservation patient decision aid for teenage and adult women diagnosed with cancer: the Cancer, Fertility and Me research protocol

    PubMed Central

    Jones, G L; Hughes, J; Mahmoodi, N; Greenfield, D; Brauten-Smith, G; Skull, J; Gath, J; Yeomanson, D; Baskind, E; Snowden, J A; Velikova, G; Collins, K; Stark, D; Phillips, R; Lane, S; Bekker, H L

    2017-01-01

    approval (Ref: 16/EM/0122) and Health Research Authority approval (Ref: 194751) has been granted. Findings will be published in open access peer-reviewed journals, presented at conferences for academic and health professional audiences, with feedback to health professionals and program managers. The Cancer, Fertility and Me patient decision aid (PtDA) will be disseminated via a diverse range of open-access media, study and charity websites, professional organisations and academic sources. External endorsement will be sought from the International Patient Decision Aid Standards (IPDAS) Collaboration inventory of PtDAs and other relevant professional organisations, for example, the British Fertility Society. Trial registration number NCT02753296; pre-results. PMID:28289046

  18. DEMAID - A DESIGN MANAGER'S AID FOR INTELLIGENT DECOMPOSITION (SGI IRIS VERSION)

    NASA Technical Reports Server (NTRS)

    Rogers, J. L.

    1994-01-01

    Many engineering systems are large and multi-disciplinary. Before the design of new complex systems such as large space platforms can begin, the possible interactions among subsystems and their parts must be determined. Once this is completed the proposed system can be decomposed to identify its hierarchical structure. DeMAID (A Design Manager's Aid for Intelligent Decomposition) is a knowledge-based system for ordering the sequence of modules and identifying a possible multilevel structure for the design problem. DeMAID displays the modules in an N x N matrix format (called a design structure matrix) where a module is any process that requires input and generates an output. (Modules which generate an output but do not require an input, such as an initialization process, are also acceptable.) Although DeMAID requires an investment of time to generate and refine the list of modules for input, it could save a considerable amount of money and time in the total design process, particularly in new design problems where the ordering of the modules has not been defined. The decomposition of a complex design system into subsystems requires the judgement of the design manager. DeMAID reorders and groups the modules based on the links (interactions) among the modules, helping the design manager make decomposition decisions early in the design cycle. The modules are grouped into circuits (the subsystems) and displayed in an N x N matrix format. Feedback links, which indicate an iterative process, are minimized and only occur within a subsystem. Since there are no feedback links among the circuits, the circuits can be displayed in a multilevel format. Thus, a large amount of information is reduced to one or two displays which are stored for later retrieval and modification. The design manager and leaders of the design teams then have a visual display of the design problem and the intricate interactions among the different modules. The design manager could save a substantial

  19. DEMAID - A DESIGN MANAGER'S AID FOR INTELLIGENT DECOMPOSITION (SGI IRIS VERSION)

    NASA Technical Reports Server (NTRS)

    Rogers, J. L.

    1994-01-01

    Many engineering systems are large and multi-disciplinary. Before the design of new complex systems such as large space platforms can begin, the possible interactions among subsystems and their parts must be determined. Once this is completed the proposed system can be decomposed to identify its hierarchical structure. DeMAID (A Design Manager's Aid for Intelligent Decomposition) is a knowledge-based system for ordering the sequence of modules and identifying a possible multilevel structure for the design problem. DeMAID displays the modules in an N x N matrix format (called a design structure matrix) where a module is any process that requires input and generates an output. (Modules which generate an output but do not require an input, such as an initialization process, are also acceptable.) Although DeMAID requires an investment of time to generate and refine the list of modules for input, it could save a considerable amount of money and time in the total design process, particularly in new design problems where the ordering of the modules has not been defined. The decomposition of a complex design system into subsystems requires the judgement of the design manager. DeMAID reorders and groups the modules based on the links (interactions) among the modules, helping the design manager make decomposition decisions early in the design cycle. The modules are grouped into circuits (the subsystems) and displayed in an N x N matrix format. Feedback links, which indicate an iterative process, are minimized and only occur within a subsystem. Since there are no feedback links among the circuits, the circuits can be displayed in a multilevel format. Thus, a large amount of information is reduced to one or two displays which are stored for later retrieval and modification. The design manager and leaders of the design teams then have a visual display of the design problem and the intricate interactions among the different modules. The design manager could save a substantial

  20. An Instructional Management Guide to Cost Effective Decision Making,

    DTIC Science & Technology

    1974-01-01

    PD’A116 209 WISCONSIN UNIV-MADISON F/S 111/1 AN INSTRUCTIONAL MAGEMENT GUIDE TO COST EFFECTIVE DECISION MA-ETC(U) 1974 R H PEARSON LW-LASSIFIFn TR73...Educa- tional Technology that in improving learning, cost and cost- benefit relationships were the areas of greatest uncertainty (Carpenter, 1970, p. 5...that the goals/objectives originator may specify a goal/objective that is unattainable by means of current technology . STEP 2: REVIEW THE

  1. A SPATIALLY REALISTIC MODEL FOR INFORMING FOREST MANAGEMENT DECISIONS

    EPA Science Inventory

    Spatially realistic population models (SRPMs) address a fundamental
    problem commonly confronted by wildlife managers - predicting the
    effects of landscape-scale habitat management on an animal population.
    SRPMs typically consist of three submodels: (1) a habitat submodel...

  2. Using Decision Analysis to Select Facility Maintenance Management Information Systems

    DTIC Science & Technology

    2010-03-01

    OF THE AIR FORCE AIR UNIVERSITY AIR FORCE INSTITUTE OF TECHNOLOGY Wright-Patterson Air Force Base, Ohio APPROVED FOR PUBLIC RELEASE...Systems and Engineering Management Graduate School of Engineering and Management Air Force Institute of Technology Air University Air...increased (Garg & Deshmukh, 2006). According to Teicholz and Ikeda (1995), the support for technology -based maintenance systems began during the

  3. Impact of Adding a Decision Aid to Patient Education in Adults with Asthma: A Randomized Clinical Trial

    PubMed Central

    Légaré, France; Moisan, Jocelyne; Boulet, Louis-Philippe

    2017-01-01

    Background Not providing adequate patient education interventions to asthma patients remains a major care gap. To help asthma patients and caregivers discuss inhaled controller medication use, our team has previously developed a decision aid (DA). We sought to assess whether adding this DA to education interventions improved knowledge, decisional conflict, and asthma control among adults with asthma. Methods A parallel clinical trial (NCT02516449). We recruited adults with asthma, aged 18 to 65 years, prescribed inhaled controller medication to optimize asthma control. Educators randomly allocated participants either to the education + DA or to the education group. At baseline and two-month follow-up, we measured asthma knowledge (primary outcome) with a validated self-administered questionnaire (score –37 to +37). Secondary outcomes included decisional conflict and asthma control. Blinded assessors collected data. Between the two time points, the within- and between-group changes were estimated by generalized linear mixed models. Results Fifty-one participants (response rate: 53%; age: 44 ± 13 years; women: n = 32) were randomized either to the education + DA group (n = 26) or to the education group (n = 25), and included in statistical analyses. Between baseline and follow-up, mean [95% CI] knowledge scores increased from 21.5 [19.9–23.2] to 25.1 [23.1–27.0] in the education + DA group (P = 0.0002) and from 24.0 [22.3–25.7] to 26.0 [24.0–28.0] in the education group (P = 0.0298). In both of the groups, decisional conflict and asthma control improved. There were no differences between groups. Conclusions Education improved knowledge, decisional conflict, and asthma control whether the DA was added or not. PMID:28107540

  4. North Slope Decision Support for Water Resource Planning and Management

    SciTech Connect

    Schnabel, William; Brumbelow, Kelly

    2013-03-31

    The objective of this project was to enhance the water resource decision-making process with respect to oil and gas exploration/production activities on Alaska’s North Slope. To this end, a web-based software tool was developed to allow stakeholders to assemble, evaluate, and communicate relevant information between and amongst themselves. The software, termed North Slope Decision Support System (NSDSS), is a visually-referenced database that provides a platform for running complex natural system, planning, and optimization models. The NSDSS design was based upon community input garnered during a series of stakeholder workshops, and the end product software is freely available to all stakeholders via the project website. The tool now resides on servers hosted by the UAF Water and Environmental Research Center, and will remain accessible and free-of-charge for all interested stakeholders. The development of the tool fostered new advances in the area of data evaluation and decision support technologies, and the finished product is envisioned to enhance water resource planning activities on Alaska’s North Slope.

  5. Exploring the Influence of Information Overload on Middle Management Decision-Making in Organizations

    ERIC Educational Resources Information Center

    Carlevale, Edward A.

    2010-01-01

    This phenomenological study was an exploration of information overload and how it influenced middle management decision-making in a single organization. In-depth interviews were used to gather lived experiences of 22 middle managers at XYZ Defense Company in California. Data were analyzed using both HyperRESEARCH TM 2.8 software and a manual…

  6. Balancing Data, Time, and Expectations: The Complex Decision-­Making Environment of Enrollment Management

    ERIC Educational Resources Information Center

    Johnson, Adam W.

    2016-01-01

    As a growing entity within higher education organizational structures, enrollment managers (EMs) are primarily tasked with projecting, recruiting, and retaining the student population of their campuses. Enrollment managers are expected by institutional presidents as well as through industry standards to make data-driven planning decisions to reach…

  7. Beyond the lab: observations on the process by which science successfully informs management and policy decisions

    NASA Astrophysics Data System (ADS)

    Flores, S.

    2012-12-01

    Scientific findings inform management decisions and policy products through various ways, these include: synthesis reports, white papers, in-person and web-based seminars (webinars), communication from specialized staff, and seminal peer-reviewed journal articles. Scientists are often told that if they want their science to inform management decisions and policy products that they must: clearly and simply articulate discreet pieces of scientific information and avoid attaching advocacy messages to the science; however, solely relying on these tenants does not ensure that scientific products will infuse the realms of management and policy. The process by which science successfully informs management decisions and policy products rarely begins at the time the results come out of the lab, but rather, before the research is carried out. Having an understanding of the political climate, management needs, agency research agendas, and funding limitations, as well as developing a working relationship with the intended managers and policy makers are key elements to developing the kind of science results and products that often make an impact in the management and policy world. In my presentation I will provide case-studies from California (USA) to highlight the type of coastal, ocean and climate science that has been successful in informing management decisions and policy documents, as well as provide a state-level agency perspective on the process by which this occurs.

  8. Preparing Students for Front-Line Management: Non-Routine Day-to-Day Decisions

    ERIC Educational Resources Information Center

    Clydesdale, Greg; Tan, John

    2009-01-01

    Purpose: This paper attempts to reduce the gap between management education and practice. It emphasises day-to-day decisions that middle and lower level managers make. The purpose is to provide an education framework embodying a flexible approach to interpretation and solution creation, suitable for situations of ambiguity and uncertainty.…

  9. Balancing Data, Time, and Expectations: The Complex Decision-Making Environment of Enrollment Management

    ERIC Educational Resources Information Center

    Johnson, Adam W.

    2013-01-01

    As a growing entity within higher education organizational structures, enrollment managers (EMs) are primarily tasked with projecting, recruiting, and retaining the student population of their campuses. Enrollment managers are expected by institutional presidents as well as through industry standards to make data-driven planning decisions to reach…

  10. Using Modern Digital Photography Tools to Guide Management Decisions on Forested Land

    ERIC Educational Resources Information Center

    Craft, Brandon; Barlow, Rebecca; Kush, John; Hemard, Charles

    2016-01-01

    Forestland management depends on assessing changes that occur over time. Long-term photo point monitoring is a low-cost method for documenting these changes. Using forestry as an example, this article highlights the idea that long-term photo point monitoring can be used to improve many types of land management decision making. Guidance on…

  11. APPLICATION OF THE US DECISION SUPPORT TOOL FOR MATERIALS AND WASTE MANAGEMENT

    EPA Science Inventory

    EPA¿s National Risk Management Research Laboratory has led the development of a municipal solid waste decision support tool (MSW-DST). The computer software can be used to calculate life-cycle environmental tradeoffs and full costs of different waste management plans or recycling...

  12. Preliminary testing of a just‐in‐time, user‐defined values clarification exercise to aid lower literate women in making informed breast cancer treatment decisions

    PubMed Central

    Jibaja‐Weiss, Maria L.; Volk, Robert J.; Friedman, Lois C.; Granchi, Thomas S.; Neff, Nancy E.; Spann, Stephen J.; Robinson, Emily K.; Aoki, Noriaki; Robert Beck, J.

    2006-01-01

    Abstract Objective  To report on the initial testing of a values clarification exercise utilizing a jewellery box within a computerized patient decision aid (CPtDA) designed to assist women in making a surgical breast cancer treatment decision. Design  Pre‐post design, with patients interviewed after diagnosis, and then after completing the CPtDA sometime later at their preoperative visit. Sample  Fifty‐one female patients, who are low literate and naïve computer users, newly diagnosed with early stage breast cancer from two urban public hospitals. Intervention  A computerized decision aid that combines entertainment‐education (edutainment) with enhanced (factual) content. An interactive jewellery box is featured to assist women in: (1) recording and reflecting over issues of concern with possible treatments, (2) deliberating over surgery decision, and (3) communicating with physician and significant others. Outcomes  Patients’ use of the jewellery box to store issues during completion of the CPtDA, and perceived clarity of values in making a treatment decision, as measured by a low literacy version of the Decisional Conflict Scale (DCS). Results  Over half of the participants utilized the jewellery box to store issues they found concerning about the treatments. On average, users flagged over 13 issues of concern with the treatments. Scores on the DCS Uncertainty and Feeling Unclear about Values subscales were lower after the intervention compared to before the decision was made. Conclusions  A values clarification exercise using an interactive jewellery box may be a promising method for promoting informed treatment decision making by low literacy breast cancer patients. PMID:16911136

  13. 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

  14. Managing risk: clinical decision-making in mental health services.

    PubMed

    Muir-Cochrane, Eimear; Gerace, Adam; Mosel, Krista; O'Kane, Debra; Barkway, Patricia; Curren, David; Oster, Candice

    2011-01-01

    Risk assessment and management is a major component of contemporary mental health practice. Risk assessment in health care exists within contemporary perspectives of management and risk aversive practices in health care. This has led to much discussion about the best approach to assessing possible risks posed by people with mental health problems. In addition, researchers and commentators have expressed concern that clinical practice is being dominated by managerial models of risk management at the expense of meeting the patient's health and social care needs. The purpose of the present study is to investigate the risk assessment practices of a multidisciplinary mental health service. Findings indicate that mental health professionals draw on both managerial and therapeutic approaches to risk management, integrating these approaches into their clinical practice. Rather than being dominated by managerial concerns regarding risk, the participants demonstrate professional autonomy and concern for the needs of their clients.

  15. Applications of fuzzy ranking methods to risk-management decisions

    NASA Astrophysics Data System (ADS)

    Mitchell, Harold A.; Carter, James C., III

    1993-12-01

    The Department of Energy is making significant improvements to its nuclear facilities as a result of more stringent regulation, internal audits, and recommendations from external review groups. A large backlog of upgrades has resulted. Currently, a prioritization method is being utilized which relies on a matrix of potential consequence and probability of occurrence. The attributes of the potential consequences considered include likelihood, exposure, public health and safety, environmental impact, site personnel safety, public relations, legal liability, and business loss. This paper describes an improved method which utilizes fuzzy multiple attribute decision methods to rank proposed improvement projects.

  16. Management by the manager, decisions by the team: Leadership style for the future, or just a hopeless muddle

    SciTech Connect

    Furaus, J.P.; Shirley, C.G.

    1988-01-01

    A characteristic of team implementation of projects is some type of participatory decision-making. Opinions differ on whether this is a valuable tool for project managers or whether it is only a management fad that blurs accountability. This paper recounts experience and offers observations about the effectiveness of participatory decision-making in project management. The basis of the paper is approximately a decade of projects in construction of specialized facilities for research and development (RandD) at Sandia National Laboratories in Albuquerque, New Mexico. Over the time we have developed a participatory style that distributes a balance of authority and accountability. It is a style that has worked well in our environment and is evidence that shared decision-making can be made to work. 4 figs.

  17. Using multi-species occupancy models in structured decision making on managed lands

    USGS Publications Warehouse

    Sauer, John R.; Blank, Peter J.; Zipkin, Elise F.; Fallon, Jane E.; Fallon, Frederick W.

    2013-01-01

    Land managers must balance the needs of a variety of species when manipulating habitats. Structured decision making provides a systematic means of defining choices and choosing among alternative management options; implementation of a structured decision requires quantitative approaches to predicting consequences of management on the relevant species. Multi-species occupancy models provide a convenient framework for making structured decisions when the management objective is focused on a collection of species. These models use replicate survey data that are often collected on managed lands. Occupancy can be modeled for each species as a function of habitat and other environmental features, and Bayesian methods allow for estimation and prediction of collective responses of groups of species to alternative scenarios of habitat management. We provide an example of this approach using data from breeding bird surveys conducted in 2008 at the Patuxent Research Refuge in Laurel, Maryland, evaluating the effects of eliminating meadow and wetland habitats on scrub-successional and woodland-breeding bird species using summed total occupancy of species as an objective function. Removal of meadows and wetlands decreased value of an objective function based on scrub-successional species by 23.3% (95% CI: 20.3–26.5), but caused only a 2% (0.5, 3.5) increase in value of an objective function based on woodland species, documenting differential effects of elimination of meadows and wetlands on these groups of breeding birds. This approach provides a useful quantitative tool for managers interested in structured decision making.

  18. A coastal information system to propel emerging science and inform environmental management decisions

    EPA Science Inventory

    The Estuary Data Mapper (EDM) is a free, interactive virtual gateway to coastal data aimed to promote research and aid in environmental management. The graphical user interface allows users to custom select and subset data based on their spatial and temporal interests giving them...

  19. Estuary Data Mapper: A coastal information system to propel emerging science and inform environmental management decisions

    EPA Science Inventory

    The Estuary Data Mapper (EDM) is a free, interactive virtual gateway to coastal data aimed to promote research and aid in environmental management. The graphical user interface allows users to custom select and subset data based on their spatial and temporal interests giving them...

  20. Effectiveness and Comparison of Various Audio Distraction Aids in Management of Anxious Dental Paediatric Patients

    PubMed Central

    Johri, Nikita; Khan, Suleman Abbas; Singh, Rahul Kumar; Chadha, Dheera; Navit, Pragati; Sharma, Anshul; Bahuguna, Rachana

    2015-01-01

    Background Dental anxiety is a widespread phenomenon and a concern for paediatric dentistry. The inability of children to deal with threatening dental stimuli often manifests as behaviour management problems. Nowadays, the use of non-aversive behaviour management techniques is more advocated, which are more acceptable to parents, patients and practitioners. Therefore, this present study was conducted to find out which audio aid was the most effective in the managing anxious children. Aims and Objectives The aim of the present study was to compare the efficacy of audio-distraction aids in reducing the anxiety of paediatric patients while undergoing various stressful and invasive dental procedures. The objectives were to ascertain whether audio distraction is an effective means of anxiety management and which type of audio aid is the most effective. Materials and Methods A total number of 150 children, aged between 6 to 12 years, randomly selected amongst the patients who came for their first dental check-up, were placed in five groups of 30 each. These groups were the control group, the instrumental music group, the musical nursery rhymes group, the movie songs group and the audio stories group. The control group was treated under normal set-up & audio group listened to various audio presentations during treatment. Each child had four visits. In each visit, after the procedures was completed, the anxiety levels of the children were measured by the Venham’s Picture Test (VPT), Venham’s Clinical Rating Scale (VCRS) and pulse rate measurement with the help of pulse oximeter. Results A significant difference was seen between all the groups for the mean pulse rate, with an increase in subsequent visit. However, no significant difference was seen in the VPT & VCRS scores between all the groups. Audio aids in general reduced anxiety in comparison to the control group, and the most significant reduction in anxiety level was observed in the audio stories group

  1. 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.

  2. An integrated decision support system for diagnosing and managing patients with community-acquired pneumonia.

    PubMed Central

    Aronsky, D.; Haug, P. J.

    1999-01-01

    Decision support systems that integrate guidelines have become popular applications to reduce variation and deliver cost-effective care. However, adverse characteristics of decision support systems, such as additional and time-consuming data entry or manually identifying eligible patients, result in a "behavioral bottleneck" that prevents decision support systems to become part of the clinical routine. This paper describes the design and the implementation of an integrated decision support system that explores a novel approach for bypassing the behavioral bottleneck. The real-time decision support system does not require health care providers to enter additional data and consists of a diagnostic and a management component. Images Fig. 1 Fig. 2 Fig. 3 PMID:10566348

  3. An Integrated Web-based Decision Support System in Disaster Risk Management

    NASA Astrophysics Data System (ADS)

    Aye, Z. C.; Jaboyedoff, M.; Derron, M. H.

    2012-04-01

    Nowadays, web based decision support systems (DSS) play an essential role in disaster risk management because of their supporting abilities which help the decision makers to improve their performances and make better decisions without needing to solve complex problems while reducing human resources and time. Since the decision making process is one of the main factors which highly influence the damages and losses of society, it is extremely important to make right decisions at right time by combining available risk information with advanced web technology of Geographic Information System (GIS) and Decision Support System (DSS). This paper presents an integrated web-based decision support system (DSS) of how to use risk information in risk management efficiently and effectively while highlighting the importance of a decision support system in the field of risk reduction. Beyond the conventional systems, it provides the users to define their own strategies starting from risk identification to the risk reduction, which leads to an integrated approach in risk management. In addition, it also considers the complexity of changing environment from different perspectives and sectors with diverse stakeholders' involvement in the development process. The aim of this platform is to contribute a part towards the natural hazards and geosciences society by developing an open-source web platform where the users can analyze risk profiles and make decisions by performing cost benefit analysis, Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA) with the support of others tools and resources provided. There are different access rights to the system depending on the user profiles and their responsibilities. The system is still under development and the current version provides maps viewing, basic GIS functionality, assessment of important infrastructures (e.g. bridge, hospital, etc.) affected by landslides and visualization of the impact

  4. The application of natural science data to land management decision-making

    NASA Technical Reports Server (NTRS)

    Williams, D. L.; Sharpe, C. P.; Rowe, P. G.

    1974-01-01

    A natural environmental analysis process which allows the decision maker to know the probable consequences of a decision prior to the act is developed. Emphasis is placed on the fit between the natural environment and the social, economic, and functional attributes of man's communities and the transition from nature in its present state to various forms and intensities of development. Applications of the analysis are examined. It is concluded that the analysis is a workable system for land use management.

  5. Decision-support systems for natural-hazards and land-management issues

    USGS Publications Warehouse

    Dinitz, Laura; Forney, William; Byrd, Kristin

    2012-01-01

    Scientists at the USGS Western Geographic Science Center are developing decision-support systems (DSSs) for natural-hazards and land-management issues. DSSs are interactive computer-based tools that use data and models to help identify and solve problems. These systems can provide crucial support to policymakers, planners, and communities for making better decisions about long-term natural hazards mitigation and land-use planning.

  6. Choice of biodiversity index drives optimal fire management decisions.

    PubMed

    Giljohann, K M; McCarthy, M A; Kelly, L T; Regan, T J

    2015-01-01

    Preservation of biodiversity is a central goal of conservation management, yet the conditions that promote persistence may differ for the species in the community. For systems subject to stochastic disturbances such as fire, understanding which management practices promote persistence for all species in a community is complex. Before deciding on the best course of action, an objective must be specified. Yet an overarching goal of species persistence can be specified into a measureable objective many different ways. We investigated four alternative management objectives for maximizing species persistence that use common biodiversity indices: (1) attaining the minimally acceptable mix of successional vegetation states to support species' relative abundances, (2) maximizing the arithmetic mean abundance of species, (3) maximizing the geometric mean abundance of species, and (4) minimizing the average extinction risk of species. We used stochastic dynamic programming to model successional changes in vegetation in the presence of both planned and unplanned fires, and utilize an extensive data set on the occurrence of birds, reptiles, and small mammals in different successional states in semiarid Australia. We investigated the influence the choice of objective function and taxonomic focus has on the optimal fire management recommendations. We also evaluated a recent hazard reduction policy to annually burn a fixed amount of the landscape and compare results to the optimal solution. The optimal management strategy to maximize species persistence over a 100-year period is predominantly to minimize wildfires. This is because the majority of species are more likely to occur in intermediate, and late successional vegetation. However the optimal solution showed sensitivity to the objective and the species included in the analysis. These results highlight the need for careful consideration when specifying an objective to represent overarching conservation goals. Using the

  7. Achieving a Risk-Informed Decision-Making Environment at NASA: The Emphasis of NASA's Risk Management Policy

    NASA Technical Reports Server (NTRS)

    Dezfuli, Homayoon

    2010-01-01

    This slide presentation reviews the evolution of risk management (RM) at NASA. The aim of the RM approach at NASA is to promote an approach that is heuristic, proactive, and coherent across all of NASA. Risk Informed Decision Making (RIDM) is a decision making process that uses a diverse set of performance measures along with other considerations within a deliberative process to inform decision making. RIDM is invoked for key decisions such as architecture and design decisions, make-buy decisions, and budget reallocation. The RIDM process and how it relates to the continuous Risk Management (CRM) process is reviewed.

  8. Lumbo-sacral radiculopathy referral decision-making and primary care management. A case report.

    PubMed

    Haswell, Kate; Gilmour, John Martin; Moore, Barbara Joyce

    2015-04-01

    Low back pain guideline recommendations can inform a decision in primary care to refer for surgical assessment. The purpose of this report is to present a patient with clinical signs and symptoms of lumbo-sacral radiculopathy who experienced pain of high intensity, severe paresis and depression. The guideline informed decision-making process resulted in a decision not to refer. This case report aims to increase awareness of referral guidelines and to demonstrate radicular pain and weakness, disability and depression outcomes subsequent to primary care management.

  9. Risk communication, geoethics and decision science issues in Japan's disaster management system

    NASA Astrophysics Data System (ADS)

    Sugimoto, M.

    2014-12-01

    Issues in Japan's disaster management system were revealed by the 2011 Tohoku earthquake and tsunami, and by the Fukushima Dai-ichi nuclear power station accident. Many important decisions were based on scientific data, but appear not to have sufficiently considered the uncertainties of the data and the societal aspects of the problems. The issues that arose show the need for scientists to appropriately deal with risk communication and geoethics and issues. This paper discusses necessity of education for risk communication, geoethics and decisions science in school before students become sicentific decision makers in future.

  10. The Strategic Association between Enterprise Content Management and Decision Support

    ERIC Educational Resources Information Center

    Alalwan, Jaffar Ahmad

    2012-01-01

    To deal with the increasing information overload and with the structured and unstructured data complexity, many organizations have implemented enterprise content management (ECM) systems. Published research on ECM so far is very limited and reports on ECM implementations have been scarce until recently (Tyrvainen et al. 2006). However, the little…

  11. Management and Decision-Making in Educational Planning.

    ERIC Educational Resources Information Center

    Kravetz, Nathan, Ed.

    This IIEP seminar focused on administrative, management, supervisory, and decisionmaking techniques that are useful in the educational planning process. The techniques studied included: delphi, program evaluation and review technique (PERT), and program planning and budgeting systems (PPBS). Various experts presented papers on these techniques,…

  12. Decision Making and Risk Management in Adventure Sports Coaching

    ERIC Educational Resources Information Center

    Collins, Loel; Collins, Dave

    2013-01-01

    Adventure sport coaches practice in environments that are dynamic and high in risk, both perceived and actual. The inherent risks associated with these activities, individuals' responses and the optimal exploitation of both combine to make the processes of risk management more complex and hazardous than the traditional sports where risk management…

  13. 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.

  14. 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

  15. 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

    Hydrological and water scarcity predictions have the potential to provide vital information for a variety of needs including water resources management, agricultural and urban water supply, and flood mitigation. In particular, seasonal forecasts of drought risk can enable farmers to make adaptive choices on crop varieties, labor usage, and technology investments. Forecast skill is generally derived from teleconnections with ocean variability specifically sea surface temperature (SST) anomalies and, equally important persistence in the state of the land in terms of soil moisture, snowpack, or streamflow conditions. Short term precipitation forecasts are critical in flood prediction by extending flood prediction lead times beyond the basin travel time, and thus allows for extended warnings. The Global Framework for Climate Services (GFCS) is a UN-wide initiative in which WMO Members and inter- and non- governmental, regional, national and local stakeholders work in partnership to develop targeted climate services. Thus, GFCS offers the potential for hydroclimatologists to develop products (hydroclimatic forecasts) and information services (i.e. product dissemination) to users with the expectation that GFCS will increase the resilience of the society to weather and climate events and to reduce operational costs for economic sectors and regions dependent on water. This presentation will discuss the development of a nascent climate service system focused on hydroclimatic monitoring and forecasting, and initially developed by the authors for Africa and Latin America. Central to this system is the use of satellite remote sensing and hydroclimate forecasts (from days to seasons) in the development of weather and climate information useful for water management in sectors such as flood protection (precipitation and streamflow forecasting) and agriculture (drought and crop forecasting). The elements of this system will be discussed, including the challenges of monitoring and

  16. CAMEO-Valdez: A user's perspective. [Computer-Aided Management of Emergency Operations

    SciTech Connect

    Haas, T.J.

    1990-01-11

    On the morning of March 24, 1989, the tanker EXXON VALDEZ ran aground on Bligh Reef in Alaska's Prince William Sound. The vessel was carrying over 53 million gallons of North Slope crude oil of which almost 11 million gallons were spilled in the water. The immediately impacted area included most of the western part of the Sound, but eventually, the area expanded to include parts of Seward, Homer, and Kodiak. This event constituted the worst oil spill in the history of this country, and was identified as a 'spill of national significance.' A major response to clean up the oil by EXXON, which was closely monitored by Federal and State agencies and various interest groups, was necessary. Early in the response it was obvious to the Federal On-Scene Coordinator (FOSC) that a computer-aided management system was necessary to monitor the progress of the spill clean-up operations. This paper will describe CAMEO (Computer-Aided Management of Emergency Operations) - Valdez, developed for the FOSC by the National Oceanographic and Atmospheric Administration acting in its role as the Scientific Support Coordinator (SSC). A discussion of how CAMEO was used and an evaluation of its effectiveness will also be presented.

  17. Substance Abuse Treatment in Persons with HIV/AIDS: Challenges in Managing Triple Diagnosis

    PubMed Central

    Durvasula, Ramani; Miller, Theodore R.

    2014-01-01

    This paper provides a review of the current literature addressing substance abuse treatment in persons living with HIV/AIDS. Clinical management of HIV must account for the “triple diagnosis” of HIV, psychiatric diagnosis, and substance use disorders and requires integrated treatment services that focus beyond just mitigation of substance use and psychiatric and medical symptoms but also address other health behaviors. Because clinical management of HIV/AIDS has shifted significantly with the advent of highly active antiretroviral therapies (HAART) in the mid 1990's, a literature review focusing on literature published since 2000, and using relevant key words was conducted using a wide range of literature search databases. This literature review was complemented by studies to expand on specific treatment modalities for which there was a dearth of literature addressing HIV infected cohorts and to provide discussion of issues around substance abuse treatment as an HIV prevention tool. Existing models of substance abuse treatment including cognitive behavioral therapy and motivational interviewing have proven to be useful for enhancing adherence and reducing substance use in outpatient populations, while methadone maintenance and directly observed treatment have been useful with specific subgroups of users. Contextualization of services heightens the likelihood of successful outcomes and relapse prevention. PMID:24274175

  18. 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.

  19. An urban runoff model designed to inform stormwater management decisions.

    PubMed

    Beck, Nicole G; Conley, Gary; Kanner, Lisa; Mathias, Margaret

    2017-02-19

    We present an urban runoff model designed for stormwater managers to quantify runoff reduction benefits of mitigation actions that has lower input data and user expertise requirements than most commonly used models. The stormwater tool to estimate load reductions (TELR) employs a semi-distributed approach, where landscape characteristics and process representation are spatially-lumped within urban catchments on the order of 100 acres (40 ha). Hydrologic computations use a set of metrics that describe a 30-year rainfall distribution, combined with well-tested algorithms for rainfall-runoff transformation and routing to generate average annual runoff estimates for each catchment. User inputs include the locations and specifications for a range of structural best management practice (BMP) types. The model was tested in a set of urban catchments within the Lake Tahoe Basin of California, USA, where modeled annual flows matched that of the observed flows within 18% relative error for 5 of the 6 catchments and had good regional performance for a suite of performance metrics. Comparisons with continuous simulation models showed an average of 3% difference from TELR predicted runoff for a range of hypothetical urban catchments. The model usually identified the dominant BMP outflow components within 5% relative error of event-based measured flow data and simulated the correct proportionality between outflow components. TELR has been implemented as a web-based platform for use by municipal stormwater managers to inform prioritization, report program benefits and meet regulatory reporting requirements (www.swtelr.com).

  20. The economic value of drought information: Application to water resources management decisions in Spain

    NASA Astrophysics Data System (ADS)

    Garrote, Luis; Sordo, Alvaro; Iglesias, Ana

    2016-04-01

    Information is valuable when it improves decision-making (e.g., actions can be adjusted to better suit the situation at hand) and enables the mitigation of damage. However, quantifying the value of information is often difficult. Here we explore a general approach to understand the economic value of drought information for water managers framing our approach in the precautionary principle that reminds us that uncertainty is not a reason to postpone or avoid action. We explore how decision making can disregard uncertain effects, taking a short-term approach and focusing instead on the certain costs and benefits of taking action. Two main questions arise: How do we know that advanced drought information is actually helping decisions?; and What is the value of information in the decision process? The approach is applied to several regulated water resources systems in Spain. It first views drought information as a factor in the decision process which can be used by water managers to reduce uncertainty. Second, the value of drought information is the expected gain in a decision outcome (utility) from using additional information. Finally, the gains of improved information are compared with the information collection costs. Here we estimate the value by taking into account the accuracy of the drought information, the subjective probabilities about the value, analyzed as Bayesian probabilities, and the ability or skill of the stakeholders to apply the drought information to modify their actions. Since information may be considered a public good (non-rivalry and non-excludability), it may justify public policy in the provision of information, considering social costs and benefits. The application of the framework to the Spanish case studies shows that information benefits exceeds to costs when drought frequency is 20-40% above normal values; below these values uncertainty in the decisions dominate the results; above these values, the management decisions are limited even